Skin. It’s a wonderful substance. It protects us from the elements, keeps our temperature under control, covers our internal organs and in general looks rather nice too!
But as most of us know, as we age our skin starts to show all kinds of signs of wear and tear, from those we’ve heard of (skin tags) to some lesser known symptoms (seborrheic keratoses anyone?!)
Most of these are harmless – or fairly easily treated – but in some cases you’ll need to visit your GP to rule out anything more serious before you have them removed.
Milia and syringomas. These are little fatty growths in the skin and tend to occur more in people with oily skin. Again, they can be easily treated with a laser.
Seborrheic keratoses. These are also called senile warts (which is a terrible name in my opinion!). They are described in dermatology books as having a ‘cow pat or stuck on’ appearance. Lovely! They are usually benign and can be removed by laser but you’ll need to see your GP first to rule out skin cancer.
Skin tags. As the name suggests, these are unsightly little tags of skin, but they’re benign and easily removed by laser.
They tend to occur in areas of friction so men get them round collar lines and ladies grow them under arms and where our underwired bra fits against our skin.
Moles. This is where things become a little trickier (and potentially dangerous). If your doctor is worried that a mole may be malignant then they’ll remove it and send it to a laboratory for a definite diagnosis before deciding on any course of treatment. This is why you must be vigilant before having any type of lesion removed at a beauty salon. Once it’s been removed by laser, there is nothing to diagnose. So you’re left with the following options, if the lesion was:
- Benign, then that’s the end of the story.
- A basal cell carcinoma (BCC) and has been completely removed then this can also be the end of the story, except that your notes are never updated to say that there has been an incident of skin cancer and the normal follow-up checks will never be carried out. If it was incompletely removed then it will regrow and you’ll need further intervention.
- A squamous cell carcinoma (SCC) and was completely removed it will almost certainly regrow – these are more aggressive skin cancers and will destroy skin tissue if left unattended. SCCs need to be removed with a border of clear skin and this is not done with lasers.
- A malignant melanoma (MM) then the problem is different and potentially more sinister. If the only outer evidence of the disease is a mole and this is lasered off then you’ll still have an undiagnosed MM and this situation is very serious. These can become fatal if left unchecked.
You can see a skin expert, either through your GP or privately, who will look at the lesion through a dermatoscope, which will magnify the lesion and help them to make a diagnosis. If in doubt a biopsy, or small sample, will be taken for examination.
When do we need to be worried?
A reputable salon or clinic will never agree to remove the brown pigment from your moles, as changing pigment is one of your first warning signs if something is amiss.
Keep a close eye on your moles following the ABCDE system:
A. Asymmetry. Is the mole larger at one end than the other or is it an odd shape?
B. Border. Is the border uneven?
C. Colour. Is the pigment much the same thoughout the mole or does it vary?
D. Diameter. How big is it? Most moles are no bigger than the width of a pencil. Has it grown rapidly recently?
E. Elevation. Does it stand proud of the skin and has this changed recently?
Other signs and symptoms are itching, bleeding, redness and inflammation.
Even if you have a lesion with all these signs, it isn’t necessarily malignant but it is well worth getting checked out. If you have a lot of moles it may be worth investing in a service known as Mole Mapping, which allows a dermatologist to check and photograph all moles and lesions and recheck them on a regular basis.
If you have a skin lesion that’s bothering you then it’s always worth considering removal, but the NHS won’t pay for this as it is a cosmetic procedure. Your first port of call should be your GP to make sure that it’s safe for you to go through with the process.
Pretty much all small benign lesions can be removed by laser, which reduces the likelihood of scarring. Always check the credentials of the person carrying out the treatment and make sure they have experience in these procedures. Never let anybody take the pigment out of your moles – it’s there for a very good reason.
There are an increasing number of special offers and vouchers around offering discount on this kind of treatment. While it’s tempting to go for the low-cost option, make sure you do your research first.
As I said earlier, your skin is a wonderful substance. It deserves treating with respect.
How to be skin cancer savvy