Saturday, June 25, 2016

Skin Care: Professional Full-Body Skin Examination



The earlier you find a skin cancer, the easier it is to treat successfully. Both skin self-examinations and professional whole-body skin exams are useful in early detection of skin cancers, including melanoma, the deadliest form of skin cancer.  Note that melanoma can surface in some of the most unusual places:[7,13]
  • Under your toenails
  • Behind your ears
  • On the crown of your head
  • In your eyes
  • In your belly button, armpits and groin

In this article, I will cover the following topics:




Basal Cell Carcinoma vs. Melanoma


The most common skin cancer, with over a million cases diagnosed annually, is basal cell carcinoma (BCC).[1] Basal cell carcinomas rarely metastasize (spread) and are unlikely to be fatal. Melanoma is less common than either basal or squamous cell carcinoma (the second most common skin cancer), but (when advanced), much more likely to spread throughout the body and lead to death.

There are several risk factors that can make someone more likely to develop melanoma:[12]
  1. Exposure to ultraviolet (UV) rays; sunlight is the main source of UV rays
  2. Lots of moles
  3. Having fair skin, blue or green eyes, or blonde or red hair
  4. Having a family history of  melanoma
  5. You’ve already had melanoma
  6. You have a weakened immune system
  7. You are an older adult
Therefore, it is essential to detect melanoma early, because the deeper the tumor grows, the worse the prognosis.

Whole-Body Skin Exam


First of all, it's really hard to find a general dermatologist instead of a specialist these days. You know the reason (hint: cosmetic surgery).

Secondly, I have never heard of "whole-body skin exam" until I called a general dermatologist's clinic recently. But, I'm glad that I took it. I wanted to check some brown raised spots on my skin, which were newly formed. They turned out to be "Seborrheic Keratosis".

When you see a dermatologist for a complete skin checkup, do expect at least a 10-15-minute visit, including a review of your medical history and a head-to-toe skin examination.

With my visit, I have 4 moles treated with two different procedures:
  • Freezing (or cryotherapy).
    • Uses liquid nitrogen to freeze and destroy abnormal cells.
  • Punch biopsy
    • Typically, a spot that the doctor suspects is cancerous will be biopsied.
      • During a biopsy, a sliver of tissue is removed for evaluation by a pathologist, who confirms (or refutes) the dermatologist’s suspicions.


Wound Care for Liquid Nitrogen (LN2)


Two of my moles were treated with cryotherapy, which recovered very quickly. Here are the caring steps after the procedure:
  • Keep areas clean daily with gentle soap and water
  • Apply Aquaphor or Vaseline for faster healing
  • The area(s) will crust, scab and peel off after 7-10 days (areas of the legs can take up to 3 weeks
  • Do not pick the area(s)
  • If a blister forms, you may pop with a sterile needle
  • Makeup can be applied cover area(s) if necessary
  • Discomfort may occur after treatment, we recommend Tylenol or Advil for pain
  • Discoloration may occur after treatment for brown spots, but usually fade after 2-3 weeks

Wound Care for Punch Biopsy


Two of my other moles were biopsied, which took more time for the doctor to operate on and more time for me to recover. To care for the wounds, here are the steps:
  • Wash areas daily with gentle soap and water
  • Change the bandage daily; each time you change the bandage apply a thin layer of protective ointment to the wound (Aquaphor, Polysporin, Bacitracin, Vaseline)
    • Neosporin is not recommended
      • Note that both Polysporin and Bacitracin are also topical antibiotics.
    • The use of topical antibiotics on clean surgical wounds has not been shown to reduce the rate of infection compared to the use of non-antibiotic ointment or no ointment. Topical antibiotics can aggravate open wounds, hindering the normal wound-healing process.
      • For example, Aquaphor has demonstrated fast and effective improvements in several wound-healing parameters compared with antibiotic-containing treatments.[16]
  • The area(s) may be sore, tender, sting or burn the first few nights
    • Tylenol or Advil is recommended for pain
  • If you should have stitches they will need to be removed after 7-14 days, depending on the location of the biopsy site
  • We recommend Mederma scar cream and Silicone scar sheets for scar prevention, after area(s) are completely healed
  • You will be called within 7 days with your biopsy results
Please call your dermatologist if you experience pain, redness, yellow discharge or swelling persisting more than 2-3 days.



Try Duoderm


Here are Dr. Mercola's comments on using Dulderm on skin healing:
However, one of the best tricks I ever learned on wound healing is the use of Duoderm which I first learned of in residency about 25 years ago. It is really amazing especially for burns. It seems to consistently virtually eliminate all the pain of a burn once it placed over the wound.

Duoderm is a skin dressing that is available without a prescription and typically comes in 4 inch by 4 inch squares (other sizes are available). All you do is simply clean the wound with hydrogen peroxide and then cut the Duoderm about half an inch larger than the wound. It typically sticks very well to your skin.

After applying Duoderm, I didn't use any other dressings on top of it (see the above picture). After a few days it looks like pus might be coming up under the wound but it is merely the dressing dissolving.

Because it is semi-waterproof, I have taken showers as normal without worrying about the wound being contaminated. At the beginning, I changed my dressing every 3 days. After removing the dressing, I left my wound exposed in the air for a while and, also, applied some antibiotics. Then I re-wrapped my wound with a new dressing. These steps were repeated for weeks.

As you can tell, the removed area after biopsy was relatively large. It took me about one month to fully recover from it (see the top photo). For the last dressing, I have left it on for about a week.

Overall speaking, I'm happy with the experience of using Duoderm. However, there are newer (maybe better) products such as Aquacel Ag® and from other companies (e.g., 3M, Smith&Nephew) too.

References

  1. What should I expect from a full-body exam?
  2. Seborrheic keratosis
  3. What you need to know about hydrocolloid dressings
  4. A Great Trick For Healing Wounds
  5. Skin cancer risk for freckly red-heads equivalent to 21 years in sun
    • Having genes that give you red hair, pale skin and freckles increases your risk of developing skin cancer as much as an extra 21 years' exposure to the sun, researchers said on 07/12/2016
  6. Skin can show first signs of some internal diseases
  7. Strange places to look for skin cancer
  8. Printing Skin Cells on Burn Wounds
  9. Precancerous Skin Lesions and Skin Cancer Slideshow
  10. Common blood pressure drug raises skin cancer risk
    • The research revealed that those who took HCTZ were up to seven times more likely to develop skin cancer.
  11. Experts explain how to detect the warning signs of skin cancer
  12. Best Way to Beat Melanoma is to Know the Symptoms
  13. 5 Strange Places You Can Get Melanoma
  14. Moles to Melanoma: Recognizing the ABCDE Features
  15. A hidden cancer success story: declining deaths from melanoma
  16. Meeting Abstract: A Comparison of Aquaphor Healing Ointment, Polysporin, and Neosporin Topical Wound Care Ointments Using a Laser Wound Model
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