It’s the time of the year when many think about skin issues and a skin check after holidays in the sun and the heat of summer.
Skin cancer is a surgical disease and most skin cancers need to be removed. Many times temporary measures such as freezing with liquid nitrogen, chemotherapy creams and gels just delay the inevitable and make a small problem complicated. Definitive treatment is surgical excision with the piece of skin being sent to an expert pathologist who gives a proper diagnosis that determines if further treatment is required.
Topical agents such as the creams and gels are only suitable for superficial skin lesions and really are only effective for very early and fairly trivial problems. Any skin blemish or sore that hangs about for more than a month and doesn’t disappear or heal needs to be removed and sent for analysis.
This is where a skin check and clinical experience is important. Simple skin checks at chemists using computer-based machines tend to be commercial enterprises and falsely report skin problems. In most situations the customer is told to see a doctor. A proper clinical skin check should be done by a experienced specialist who can provide a full service from diagnosis, biopsy to definitive treatment.
All skin cancers of the head and neck including special anatomical sites such as the scalp, face, nose, ears and eyelids should be treated by a surgeon because of the technical complexity and the high risk of issues in non-expert hands including cosmetic disfigurement.
As well as this cancers of the fingers, toes and also the palms and soles of the feet should also be treated by a specialist surgeon because of the high risk of wound complications. After-care is just as important and beware the practitioner who just cuts out any skin lesion and fails to review the wound in the days after the event or doesn’t give you a written pathology report to keep.
In only a very few situations is a melanoma identified and if excised and done early then that is all that is necessary. Only a tiny proportion of melanomas that go on to be life-threatening through spread to other parts of the body. The most common skin lesions or blemishes tend to be squamous cell carcinomas and basal cell cancers and if they are treated and excised early then are of no long-term concern.
This information is provided by Mr Adrian Aitken MBBS, FRACS, PhD who is a local specialist surgeon in Gippsland who has run a skin cancer service ‘Gippsland Melanoma and Skin Cancer Clinic’ for over a decade and provides complete care from diagnosis to definitive treatment. Just ask your GP for a referral.
