Mohs surgery is done under local anaesthetic and it’s usually very well tolerated. Most people don’t need anything more than local anaesthetic injections. Occasionally some people need oral sedation or intravenous sedation but that’s not common.
Mohs surgery is done under local anaesthetic and it’s usually very well tolerated. Most people don’t need anything more than local anaesthetic injections. Occasionally some people need oral sedation or intravenous sedation but that’s not common.
So skin cancer can actually manifest in a number of ways. There's two main types of skin cancer, you've got your melanoma skin cancers which normally look like moles, so these are either pre-existing moles that change or new moles that develop. And then you've got your non-melanoma skin cancers, and they often look like open sores that don't heal, red scaly patches, or lumps and bumps on the skin.
So there are a number of risk factors for skin cancer. The first is if you have very pale skin. So if you're very fair-skinned, you've got blonde hair, you've got blue eyes, that's the first risk factor. The second thing is if there is a family history of melanoma. So about 10% of melanomas run in families. If you've got a first-degree relative that has suffered with that, you're at a slightly higher risk. The third thing is if you have a large number of moles. So if you've got over 100 moles on your body and a lot of them look quite different to each other, something called atypical mole syndrome, that can put you at more risk. The fourth thing is having multiple sunburns, particularly before the age of 18. So four or five sunburns below the age of 18 can double your lifetime risk of developing melanoma. It's also a good idea not to use sunbeds, because using sunbeds can also give you high doses of ultraviolet light that, again, can promote development of skin cancers further down the line. If you enjoy a lot of outdoor hobbies and you've had a lot of sunburns, that puts you more at risk as well. So when you see a dermatologist, they will make an assessment of all these risk factors.
It's important to get some sunlight. You rely on the sun to produce vitamin D. However, in the UK, between the months of October to March, our latitude is as such we do not have enough ultraviolet around to produce vitamin D in our skin anyway. So it is much safer to get your vitamin D from food sources, so things like oily fish, salmon, or take a supplement during the winter months rather than put yourself at risk of developing skin cancer.
Here are my five top tips for sun safety. My first tip is to make sure that you are wearing regular sun protection. So you should be wearing an SPF of at least 15. It should be broad-spectrum, providing cover against UVA and UVB. Tip two: Stay out of the sun between the hours of 11:00 A.M. and 4:00 P.M., if possible. These are the peaks sunlight hours when your skin is at most risk of burning. Tip three: Wear protective clothing. It's a good idea if you're out and about in bright sunshine to make sure that you're wearing tightly woven clothing that will cover your arms and legs and other exposed areas. Tip four: It's a good idea to also make sure you're protecting the delicate skin around the eyes, so make sure you wear a good pair of quality sunglasses. Tip five: Reapply your sunscreen frequently. To get the factor on the bottle, you need to be reapplying every 90 minutes. Also, bear in mind that ultraviolet light will reflect off water and off snow, so take particular care when you're on the beach or if you're skiing.
If you see a dermatologist, and the dermatologist is concerned that your mole may be cancerous, they will perform a biopsy. And they will remove the mole in its entirety. The sample is then sent off to the lab and analysed, and if there are any worrying cells or if there is signs of melanoma, usually then a second surgery is performed and a little bit more tissue is taken.
It is important to wear an SPF of at least 15 or above every day. There is still ultraviolet light around even in the winter months. In terms of quantities, people tend to under-apply and not use as much as they need. So you're talking about a teaspoon for your face and your neck and any other exposed sites. It's a good idea to get a sunscreen that is broad spectrum. So by that, I mean it's got both UVA and UVB protection. The other thing is to actually get the value it says on the bottle. So to, say, get an SPF 30, you do actually have to be reapplying every 90 minutes or so. Otherwise, you're not getting that factor.
There are lots of treatments for skin cancer nowadays. They range from cream treatments and more destructive treatments to surgery and radiotherapy.
So, non-melanoma skin cancer is a type of skin cancer which is more common than melanoma, but can be less serious. It typically presents as a scaly patch or a flesh coloured or pink bump on the skin, which doesn't heal, or doesn't go away by itself.
So, skin cancer is one of the most common cancers of the Western world. It affects all skin types, but predominantly fairer skin types and typically on sun exposed areas. It can occur because of a genetic predisposition, but also because of excess sun exposure particularly in early life.
Skin cancers can be triggered by sun exposure, particularly in earlier life, in childhood, and the best way to reduce your risk is to take precautions in the sun. Wear sun hats and glasses, and regular application of sunscreen.
Mohs surgery is for people with skin cancers, particularly on the face or on cosmetically sensitive areas, or areas which are functionally important. For example, the digits or the feet.
Most surgery needs to be done, ideally, by a dermatologist or a dermatological surgeon who has training in dermatology, pathology, and skin cancer surgery. Typically, most surgeons will have completed medical school as well as five years of specialty training and an additional one year of fellowship training specifically in dermatologic surgery.
It's used in non-melanoma skin cancer, particularly to achieve a high cure rate and gives the best cosmetic outcome of any treatment modality.
Mohs surgery is very specialised because the technique is very intricate and requires a lot of skill and training and resources in order to carry it out effectively. The Mohs surgeon needs training in skin cancer diagnosis as well as surgery and pathology in order to be able to read the slides and to be able to take the skin cancer out very accurately.