Basal cell carcinoma

[thekarens]

I found a spot on my face and went to the derm today. She said it looks like a classic basal cell and did a biopsy. She said I'd have to come back in in about a week for a little outpatient surgery.

I haven't done much riding in the past year, but my New Year's resolution was to get out more. Now I'm wondering about this issue. There's lots of sun here in Texas and I'm concerned about the re-occurrence (sp) rate.

For those of you who have "been there, done that" what precautions do you take?

[yellow]

First, thank you for going to the doc so quickly. I can't tell you how many people I know who neglect to do this. Most skin cancers are very treatable, as long as they are caught early. There are too many sad stories out there about people who just didn't bother.

I have had 3 BCCs removed, 2 from my scalp and one from my arm. I also had a SCC removed from my arm. I tend to be a super overheater and it is uncomfortable, but I make an effort to always have my scalp covered when I am out running or whatever. I have thin hair and am one of the lucky women who has male pattern baldness, so I will also apply sunscreen to the more exposed parts of my scalp. I just use my daily moisturizer, which is SPF 30, most of the time. Am I perfect? No. But I do the best I can.

Re: the rest of me, I apply sunscreen to my face and neck every day and to any other exposed body parts if I am going to be out in the sun. I haven't gone as far as wearing SPF clothing (see "super overheater" comment above), but this is an option. There are many companies that make SPF clothing that is lightweight and might be tolerable for you. Something to look in to. Cover up when you can.

Honestly, the best thing you can do is just keep checking yourself and making and going to regular appointments with your dermatologist. Have your partner or a friend check your back on a regular basis. Ask your hairdresser to let you know if s/he sees anything weird on your scalp. It's likely that anything that pops up now will be a result of sun exposure from many years ago, and missing a few days of sunscreen now aren't going to make a huge difference. Also, things like SCC can and will show up where the sun don't shine. It's not only about sun exposure. Genetics seem to play a big role (according to my derm).

For those of us who love the outdoors and can't imagine life without it, we do the best we can. Be smart and enjoy and be grateful for your time outside. Establish a relationship with a single dermatologist, preferably one who maps your moles and other markings and does a thorough, head-to-toe exam.

[thekarens]

Thanks yellow! I've always been super conscious of my face due to severe rosacea. I always go in for yearly mole check ups. However, until a co-worker told me about a sore she had that wouldn't heal that turned out to be precancerous. I never thought about that. My face is extremely dry and I tend to scratch at it without thinking so that's what I thought my spot was. I wasn't due for my yearly checkup until April, but when she told me about hers I got in right away.

I'm lucky in that I'm naturally cold natured so I always wear more close than most. Like you. I have little hair and it's very fine, so I guess I'll be adding a cycling cap to my wardrobe.

It does seem a hair weird since to my knowledge I've never had a serious sunburn and I rarely go outside. It's not inherited as far as I know, but I was told the rosacea is often inherited also and I'm the only one with that too.

Can I ask if you found all of yours at once or were they one at a time? I admit I don't completely trust my deem to be thorough, but she was the only one I could get into quickly. I plan on seeing a new one for my yearly check up.

[Catrin]

I've no advice, but wishing you all the best outcome!

[yellow]

Can I ask if you found all of yours at once or were they one at a time? I admit I don't completely trust my deem to be thorough, but she was the only one I could get into quickly. I plan on seeing a new one for my yearly check up.
This was over a period of several years, probably starting when I was in my mid-30s. The last 2-3 years have been clean as far as bad moles go, although my official records now repeat "sun damaged skin" (poikiloderma). Yes, days and days on the beach as a young person. I don't really burn too easily, which made it too easy to be out in the sun for so many years (and these were the days of Hawaiian Tropic sunTAN lotion).

[thekarens]

Thanks Catrin!

Thanks for sharing your experiences yellow. I think we grew up in the same era, but I was the nerd that never went outside, but I do burn at the drop of a hat.

[OakLeaf]

All I've had was a dysplastic nevus taken off my back under the bra line - a classic location that hardly ever gets any sun, so back in the day I had a couple of pretty bad burns including that area. It was a roughly 4 cm Mohs procedure, and several years later the scar is fading.

One thing I'd look out for is to be careful of what sunblocking creams you use. Many of the sunblock chemicals (including titanium dioxide nanoparticles) are themselves implicated in skin cancer. I personally use only zinc oxide, I feel reasonably confident that zinc nanoparticles are safe, but it's kind of hard to even find sunblocks without all the other nasties that aren't also non-nano zinc. Physical-only sunblocks are environmentally safer also, for an extra plus. ThinkSport is easily available (and they make a lip sunblock as well if you prefer a stick to dipping your finger and smearing your lips with whatever you use on the rest of yourself), Badger is also fairly easy to find (though it turns me kind of blue ...) I'm still working my way through a couple of tubes of eco logical that I bought up when it was discontinued, and there may still be some of that floating around. Whenever possible I wear clothing rather than creams, since they all break me out and inhibit sweating, which is the last thing I need. So I typically only use cream on my nose, ear tips, lips, back of neck and décolletage, and cover the rest with fabric when needed. Love my Zoot cool sleeves!

The other thing is that after your procedure, to minimize scarring, you'll want to keep the scar ABSOLUTELY protected from the sun for at least a year. For me with the scar from my face plant, that meant a heavy band-aid any time I went outside, often with a dollop of sunblock on top of that. Plus a hat, obviously. The scar is still noticeable, but it's not too terribly bad, and it was worth the effort and the year of looking dorky.

And as far as your derm, there's "thorough" like the ones that don't let you out of your office without biopsying every single mole on your body, and there's "thorough" like actually doing an exam and using some judgment. I'd go for the second kind every time. I know too many people who pay for dozens of biopsies every year of moles that show no sign of dysplasia. On a tangentially related note, you see the thing where they found that heart patients survive longer when their cardiologists are out of town for conferences? :rolleyes:

[thekarens]

Thanks for the thoughts Oak.

When I was referring to thorough I meant that I'm not sure that she mapped my moles (on the original visit) and I know for a fact that she didn't look under my bra or ask about it. That's what I meant about thorough. I'm definitely not interested in biopsies all the time. They aren't horrid, but they aren't pleasant either. Plus they are stressful.

The derm recommended EltaMD sunscreen. Up until now I've only used zinc oxide, but I'm supposed to wear sunscreen every day now, so that's something to think about.

The spot is on my right temple next to my eye so I think I can cover it with a sweat band or cycling cap when exercising. I don't love sunsleeves, but I'm going to learn to appreciate them to save my arms.

A little irony, I haven't been able to see out of that eye for about 5 weeks due to ocular rosacea. I see the ophthalmologist on Monday. I'm hoping she'll have some suggestions. I'm allergic to many of the traditional treatments for it.

[rocknrollgirl]

We have both had stuff removed. We were out a ton in our teens and twenties. Our derm falls into the second category. We go every year and get checked. I am a cover and slather kind of girl. We only use zinc. The derm told us to stay away from everything else. I use the arm coolers and every other surface is slathered in the summer. And obviously we try and avoid mid-day sun. I have also purchased a number of sunblock clothes. LS shirts in particular. They make some really nice stuff these days.

I wish I had know. I teach high school and we live at the shore, so it is a beach community. I am on my students constantly to protect themselves. Unfortunately many of their parents still believe that a "base" tan is healthy protection.

[ny biker]

I've tried to use zinc oxide sunscreen, but I sweat off a lot of it, and the rest gets on my clothes, purse, backpack, etc. and never washes off. It cakes in the skin creases (elbows) and won't wash off from there, either.

Good luck with your treatments, Karen.

[thekarens]

I appreciate everyone's suggestions and encouragement. TE looks like it has some nice long sleeve spf jerseys that I'm going to try.

[ny biker]

I like the DeSoto Cool Wings with tank tops when it's really hot outside. I've also tried Craft sun sleeves with a lightweight short-sleeve jersey on days when it's kinda hot but not too bad (temps in the 80s). I bought the Craft sleeves because a friend has tried several brands and likes them best.

I've considered buying the summer long-sleeve Canari jerseys but haven't tried them yet. It does seem that several companies are making nice light jerseys these days, much more comfortable in hot weather than most jerseys used to be. I hope you find some that you like.

[thekarens]

Just an update: I had my procedure today. They gave me 6 shots to numb the area and then the doc went to town. She felt fairly confident, but I won't know for sure that she got it all for about a week. They originally told me I'd have 2 stitches, one on the inside and one on the outside, but I count 6 on the outside. I really don't care if it means she got everything. Stitches come out in a week. She says I can start riding whenever I want, but I might skip this she's due to the fact that my helmet will hit that spot at least partially.

[emily_in_nc]

Ouch! That's a lot of stitches. Yeah, riding can wait -- I would not want anything hitting that place for quite some time.

Hope she got it all. When will you find out for sure?

[Pax]

Glad you're on to the healing up part, hope the doc got it all and you're good to go!

[thekarens]

Thanks! She said I should know in about a week. Assuming they got it all I don't have to go back for 6 months.

I appreciate the well wishes :)

[Helene2013]

Wishing you all the best! If she is hopeful, I would not worry too much. But I know we are never relieved until all is over.

[OakLeaf]

Fast healing! FWIW, I don't know if you're a yogini, but my yoga teacher who's also an RN says you shouldn't do yoga until you get your stitches out.

Also FWIW, I had three layers and what it is, the internal stitches poke through so it seems like they're all on the outer layer. They can actually take months to dissolve, I had the nurse yank out at least two of the internal stitches even though it meant more of a scar, just because it was so uncomfortable being poked by the ends of the internal sutures.

[thekarens]

Thanks Oak for the information, makes sense and in a way makes me feel better. I don't do yoga, but lord knows I should. I have zero flexibility.