When detected early and treated promptly, most skin cancers are curable. Our board-certified dermatologists have extensive experience in diagnosing and treating skin cancer, and many have been fellowship trained in Mohs Surgery under Dr. Roy G. Geronemus. With our expertise and qualifications, you can rest assured that we will provide you with the most effective treatment options available in Manhattan and Southampton, New York.

At the Laser & Skin Surgery Center of New York, we believe screening exams and consults are the cornerstones of effective prevention strategies against skin cancers. However, the first step is educating yourself about the disease. One of our board-certified dermatologists and Mohs surgeons, Dr. Leonard Bernstein, conducted a webinar that focuses on the importance of skin cancer screening, prevention, and the available treatment options. Below, we share the highlights.

In his webinar, Dr. Bernstein pointed out that skin cancer is the most common form of cancer in the United States, with more people diagnosed with it each year than all other cancers combined.

There are over 5 million non-melanoma skin cancer (NMSC) diagnoses in the US each year with approximately 2,000 deaths, and 20% of the population will develop NMSC by age 70. Organ transplant patients and connective tissue disease patients who are immuno-compromised due to medications are also far more likely to develop NMSC.

Melanoma skin cancer, on the other hand, accounts for 200,000 new diagnoses and 7000 deaths annually. Fortunately, half of the diagnoses are superficial as patients and doctors are identifying them sooner which prevents spread and improves the cure rate for these potentially deadly cancers.

To read more about the basics of skin cancer, please visit cdc.gov.

Dr. Bernstein recommends an appointment with a dermatologist for your skin check. Dermatologists are experts in all skin diseases. Mohs surgeons, specifically, are cutaneous oncologists who specialize in skin cancer and therapies.

Skin examinations are typically done in a dermatologist’s office, but telemedicine is also available. However, tele-consults are far inferior compared to a physical exam. Dermatologists need to be able to see and touch lesions in person and use magnifying devices (dermatoscopes) that help them look at subtle minute patterns in the lesions, helping them make a proper diagnosis. Essentially, a skin examination involves a systematic check of your skin from head to toe, covering every inch of the body.

The best thing you can do to prevent skin cancer is to protect your skin from the sun. Wear sunblock with at least SPF30 and preferably one that has both UVA and UVB protection. SPF is just a multiple of how long it takes for your skin to burn. For instance, if you normally become red after 10 mins in the sun without sunscreen, a SPF30 sunscreen will give you protection for approximately 30 times longer or 300 mins (5 hours).

Sunscreen consists of chemicals that need to interact with your skin 30 minutes prior to sun exposure. Active ingredients include avobenzone, PABA, octinoxate, oxybenzone, homosalate, octocrylene, ecamsule, and octisalate. Sunblocks, on the other hand, are mineral-based, typically consisting of zinc oxide and titanium dioxide, which are physical blockers that immediately block out the sun’s UV rays. As soon as you put them on, you have protection.

Recent FDA reports state that chemicals used in some sunscreens have been found to be elevated in the blood for days to weeks after regular use for a short period of time and in some cases, also harmful to aquatic life. The FDA is proposing that two ingredients are “generally recognized as safe and effective” (GRASE). These ingredients are titanium dioxide and zinc oxide.
UPF (ultraviolet protection factor) clothing may also be worn for sun protection. Solumbra, Coolibar, and Solbari are companies that produce clothing that protect you from the sun without having to put on sunblock underneath them.

Non-melanoma skin cancer represents a group of cancers that gradually develop in the upper layers of the skin. The term “non-melanoma” distinguishes these more common types of skin cancer from the less common and more serious skin cancer known as melanoma.

Risk Factors:

• Excessive sun exposure over a lifetime
• Frequent sunburns, especially in youth
• History of radiation exposure
• History of arsenic exposure
• History of old scars
• History of “pre-skin cancer” (actinic keratosis)
• Past history of skin cancers
• Genetic disorders – xeroderma pigmentosum, basal cell nevus syndrome
• History of human papilloma virus (HPV)
• History of smoking

Skin cancer develops when skin cells that make up your skin reproduce abnormally in the epidermis, the skin’s outermost layer. They can mutate and metastasize, forming malignant tumors or spreading through other parts of the body.
Chronic sun damage can cause changes in the skin that can precede the development of skin cancer.

Squamous Cell Carcinoma (SCC)

• Second most common cutaneous malignancy
• 20% of NMSC are squamous cell carcinoma
• Arises from uncontrolled growth of mid-layers of the epidermis
• Clinical appearance includes red, rough patches, red bumps, ulcers, bumps with central craters
• Squamous cell carcinomas have a greater risk of distant spread than BCC
• Most common NMSC to develop in organ transplant patients and immune-compromised people

Learn more about squamous cell carcinoma.

Merkel Cell Carcinoma

• A rare form of NMSC (3000 cases annually)
• Aggressive tumor with a high rate of spread (metastasis) and recurrence
• Clinical appearance includes pink to red bumps (nodules), can be ulcerated often on head or neck but can be seen elsewhere
• Risk factors are UV exposure, history of other NMSC or melanoma, mostly seen in men and people above age 50

Skin Cancer treatment options will vary, depending on the size, type, depth, and location of the lesions. Common treatment options include:

• Topical treatments with agents such as 5-fluorouracil, imiquimod, and ingenol mebutate
• Injectable chemotherapy (cisplatin, methotrexate, 5-fluorouracil)
• Photodynamic therapy – blue or red light with topical 5-aminolevulinic acid
• Cryotherapy – targets the cancerous area with liquid nitrogen, causing it to instantly freeze and eventually sloughs off
• Electrodessication and Curettage – also called electrosurgery, this surgical procedure removes cancerous tissue by cutting it from the skin using a curette (a tool with a circular blade) and using a needle-shaped electrode to treat the area with an electric current to destroy the cancer cells that remain around the wound
• Excision – surgical removal of all the cancerous lesions together with a safe border of surrounding normal skin to prevent the cancer from spreading
• Radiation therapy – uses radiation such as x-rays or electron beams to damage or kill cancer cells
• Immunotherapy – uses medicine to help the body’s immune system find and kill melanoma cells

Being proactive about preventing and detecting skin cancer can be lifesaving. While Dr. Bernstein’s webinar is a good place to begin the education process, nothing beats an in-person consultation with a board-certified dermatologist. Contact the Laser & Skin Surgery Center of New York to schedule your consultation at either our Manhattan or Southampton office.