Summer is here, and for many of us in the Northern Nevada area, it means participating in a variety of great outdoor activities. Whether you will be hiking, biking, or headed to the beach, you will be enjoying the fun in the sun after our long winter. June is Men’s Health Month and considering skin cancer is so prevalent, especially for men here in Northern Nevada, we thought we would share information on how America’s most common skin cancer presents in men. According to The Skin Cancer Foundation, from age 50 on, significantly more men develop melanoma than women. One in 28 white men will develop melanoma in their lifetime.
For insights on skin cancer assessment, we met with Dr. Michael Zumwalt, a Board-Certified Dermatologist and Fellowship-Trained Mohs Surgeon based at the Carson City location of the Skin Cancer & Dermatology Institute.
What skin cancer screening tips do you have to help identify skin cancer early?
I find patients are typically pretty good at picking up on the early signs and symptoms of skin cancer. In over half the skin cancers I have diagnosed and treated, the patient noticed the concerning lesion and made an appointment for it to be evaluated. Skin cancers can present in a variety of ways depending on the type of skin cancer; however, I find that these are the most common warning signs:
1. Scabbing/bleeding: This is probably the most common symptom patients experience with their skin cancer. Especially for men, it is common to hear them say that they keep nicking the same area while shaving. It is rarely normal to have an area consistently bleeding/scabbing anywhere on the face, so it is important to see a dermatologist right away if you are experiencing this.
2. Lesions that come and go: This is a common presentation for basal cell carcinoma (the most common form of skin cancer). Patients will commonly note that they have a focal bleeding/scabbing area that they initially attributed as a pimple since it seemed to fully resolve but kept coming back in the same spot. It is important to recognize that facial skin cancers early on can appear very similar to a resolving pimple. If the area in question does not resolve within two weeks, it needs to be evaluated by a dermatology provider.
3. Pain: Although pain is present in the minority of skin cancers diagnosed, it is another important symptom to recognize. Patients commonly experience pain and tenderness with squamous cell carcinomas (the second most common form of skin cancer). Squamous cell carcinomas can sometimes rapidly grow (doubling in size every two weeks). It is important to book an appointment with a dermatologist as soon as possible if you note a new painful growing skin lesion.
4. The ugly duckling mole: This last sign is specifically for diagnosing melanoma, the third most common form of skin cancer. Melanoma is a cancerous mole that can be deadly if not identified and diagnosed early. The most common presenting sign for this type of skin cancer is a growing/changing mole that stands out from the rest of your moles (the ugly duckling sign). Any new/changing or odd-looking mole that stands out from the rest of your moles needs prompt evaluation.
Which types of skin cancers do you consider the most challenging to diagnose and frequently overlooked by patients? What tips can you give to help individuals identify these subtle forms of skin cancer?
The most commonly difficult-to-diagnose skin cancers that I see regularly are infiltrative basal cell carcinoma and melanoma in-situ, the earliest form of melanoma. Infiltrative Basal Cell carcinomas are an aggressive form of basal cell carcinoma that typically presents as a small, indented white scar on the head and neck. This form of skin cancer typically lacks the four common skin cancer signs/symptoms listed above. That is because infiltrative basal cell carcinoma grows in a root-like pattern deeper in the skin, leaving the top layer of the skin, called the epidermis, unaffected. Diagnosing this form of skin cancer requires a discerning eye. I recommend patients periodically do facial skin checks in the mirror carefully looking for any new lesions including small, indented white scars on their face.
Melanoma in situ, stage 0 melanoma, is by far the most common type of melanoma diagnosed. The good news is that this early form of melanoma is not life-threatening. The problem is that this skin cancer can sometimes be difficult to diagnose as melanoma in situs do not always follow the ugly duckling rule. Many times, melanoma in situ presents as a subtle, ill-defined, slightly irregular, light brown sunspot. I have seen this type of skin cancer commonly go unnoticed on the face for years as the lesion typically does not look overtly concerning unless you know what you are looking for. It is important to be aware of your sun spots and have your dermatologist evaluate any new/changing sun spot to diagnose melanoma in situ early.
If you have any concerns with lesions or moles, you can conveniently book an appointment with Skin Cancer & Dermatology Institute’s Carson City location online at SkinCancerDerm.com.
About the Dermatology Provider
Dr. Michael Zumwalt is a Fellowship-Trained Mohs Surgeon and Board-Certified Dermatologist working at Skin Cancer & Dermatology Institute’s Carson City location. He is passionate about using his expertise to help his patients treat skin cancers. When he is not at work, he spends time with his family hiking, mountain biking, camping, and enjoying other outdoor activities.