David B. Pharis, M.D., P.C. Skin Cancer and Dermatologic Surgery


What should I know about skin cancer?

Skin cancer is the most common form of cancer in human beings. The two most common types, basal cell carcinoma and squamous cell carcinoma, both start as a single point in the upper layers of skin and slowly enlarge, spreading along the surface and down through the skin. These extensions are not always directly visible to the naked eye. The tumor often extends far beyond what can be seen on the surface of the skin. If not removed completely, both types can invade and destroy structures in their path. Although these skin cancers are locally destructive, they do not tend to metastasize (spread) to other parts of the body. Metastasis of basal cell carcinoma is extremely rare, and usually occurs in the setting of large, long-standing tumors in which the patient's immune system is compromised. Squamous cell carcinoma is somewhat more dangerous with a greater chance of internal spread of tumor. Such spread is still infrequent. Melanoma is a very different and more serious type of skin cancer which has a higher potential for spreading internally.

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What does skin cancer look like?

Basal cell carcinoma and squamous cell carcinoma often appear as a small, flesh-colored or pink bump. They may also appear as a scaly, pink patch or have a very rough surface. A common description offered by patients is that of a "pimple that doesn't totally go away". Melanoma skin cancer is most often pigmented (brown), but may have areas that are pink, white and/or black. It may be asymmetric (one side not a mirror image of the other side) or have irregular borders. Other warning signs for melanoma include: surface changes in a mole, scaliness, oozing, bleeding, and a new bump. A change in pigmentation or a change in sensation (pain, itching, tenderness). The safest thing to do is to consult your physician if you are concerned about any area on your skin.

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What causes skin cancer?

Excessive exposure to sunlight is the single most important factor associated with the development of skin cancer. In addition, the tendency to develop these cancers appears to be hereditary in certain groups of people, especially those with fair complexions and poor tanning ability. Fair-skinned people develop skin cancers more frequently than dark-skinned people, and the more sun exposure they receive, the more likely they are to develop skin cancer. Other factors include exposure to radiation, exposure to arsenic, and chronic scars. In certain instances, skin cancers can be more aggressive. Patients with abnormal immune systems (lymphoma, leukemia, organ transplant patients, etc.) tend to have aggressive tumors. Tumors in certain locations tend to be more aggressive as well, such as those located on the ears, lower nose, lips and those around the eyes.

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How is skin cancer treated?

There are five common methods for treating skin cancer. The two nonsurgical methods are cryotherapy (deep-freezing) and radiation therapy. The three surgical methods include curettage and electrodessication (scrape & burn), simple excision (cut out and repair with stitches) and Mohs micrographic surgery. Newer methods currently under investigation include photodynamic therapy and topical immunochemotherapy.

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How do I protect myself from getting future skin cancers?

Use daily sunscreen with a sun protection factor (SPF) of at least 15 with both UVA/UVB protection. 80% of all skin cancers occur on the head and neck, mostly due to day-to-day exposure to the sun that we do not really think about. Do not forget the backs of your hands, forearms and upper chest if these areas are exposed. Several of the following products are combined with a moisturizer and do not have a greasy feeling to them.

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Recommended Moisturizers With Sunscreen

  • Cetaphil Daily Facial Moisturizer with Parsol 1789
  • Purpose
  • Oil of Olay (with UV protection)
  • Aveeno Products
  • Eucerin Daily Protective Lotion
  • Lubriderm Daily UV
    • Healthy Skin
    • Daily Defense (tinted or untinted)

If you know you are going to be outside for more than 20 minutes of direct sun exposure, apply a sunscreen with an SPF 45 or higher with both UVA/UVB protection . Do not forget to reapply the sunscreen every 2 hours while outside; even products labeled "waterproof” must be reapplied. Waterproof sunscreen will be a better choice if you are likely to be perspiring or swimming. Be sure to apply waterproof sunscreen to dry skin (prior to swimming/perspiring) in order for it to bind to the skin correctly. Remember to apply it to often-missed areas: ears, neck, backs of hands, etc.

Recommended Waterproof Sunscreens

  • Coppertone Sport (spray on version available)
  • Pre-Sun or Pre-Sun Ultra
  • Aveeno "Continuous Protection" Active
  • Banana Boat Sport
  • Neutrogena
    • Sport or Sport Face
    • Ultra Sheer

Special note on Parsol 1789

Parsol 1789 is a sunscreen agent that blocks a broader spectrum of ultraviolet rays. It is particularly helpful if you are very fair skinned, outdoors a lot, or if you want to minimize the aging effects of sunlight. (Look for it on the label.) Physical blockers such as titanium or zinc oxide also provide broader UVA coverage. "Mexoryl" and "Helioplex" are two new agents that stabilize Parsol and help it last longer. Mexoryl containing sunblocks may do a better job of blocking UVA (the "tanning/freckling" and "wrinkling" rays)

  • LaRoche-Posay Anthelios SX - available by the pharmacy register at CVS drugstores


protection tip

Remember to apply sunscreen on cloudy days too since theultraviolet light penetrates easily through the clouds

Avoid sun exposure during mid-day hours (10 am to 4 pm) when the ultraviolet rays are most powerful.

Wear sun protective gear such as a broad-brimmed hat, sunglasses and long sleeve shirts or pants.

Don't forget to protect your lips with a lip balm containing sunscreen.

Seek shade wherever possible





3855 Pleasant Hill Rd. Suite 200
Duluth, GA 30096

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