Understanding Skin Cancer: A Rising Concern Among the Younger Generations

**WARNING** This post contains graphic medical imaging used for educational purposes only.

The Misconceptions about Skin Cancer

Skin cancer is often perceived as an ailment that primarily afflicts the older population, leading to widespread misconceptions about its demographics. Many individuals, particularly among the younger generations, believe that they are immune to this disease due to their age. However, this assumption is significantly misleading. Recent statistics indicate a disturbing trend: the incidence of skin cancer among younger people, particularly those aged 18 to 29, has been steadily rising over the last few decades. According to the American Cancer Society, the rates of melanoma, the most serious form of skin cancer, have increased by 2% annually among young adults over the past 30 years.

The belief that only older individuals are at risk serves to perpetuate dangerous behaviors, such as neglecting skin protection measures like sunscreen application and regular dermatological check-ups. Young adults frequently engage in tanning practices, whether through sun exposure or tanning beds, without understanding the long-term consequences. I was someone who practiced such negligence with my skin care. As a result, a routine check-up to the dermatologist led to a more invasive procedure: MOHs surgery. MOHs microscopic surgery is a practice that carefully removes a skin tumor by excising the margins layer by layer and examining it under a microscope until all the cancer margins are clear (Cleveland clinic, 2022).

Recognizing the Signs: What to Look For

It started out as a small, hard papule on the left lateral side of my nose. I wear glasses regularly so I at first, I thought it was just a benign indentation from that. I kept thinking it would eventually go away and tried to minimize the appearance. Even though it was not very big or noticeable, I felt very self-conscious about it. My co-worker suggested that if it bothered me that much, I should just get it taken off at the dermatologist even if it was for cosmetic reasons. Reluctantly, I made an appointment.

Initially, the provider thought it was a harmless clogged sebaceous gland, also known as sebaceous hyperplasia. I was given the option to do a shave biopsy or let it alone and monitor it. Ideally, I just wanted it off because I did not like the look of it. (I felt silly because again, it felt like it was just cosmetic). About a week later the office called me to go over my results and they said that they were not able to get enough tissue to make a determinate diagnosis. They gave me the option to be referred to a MOHs surgeon for a deeper tissue extraction or just monitor it. I thought, why not, let’s just go to the surgeon.

My consult with the surgeon was about the same as the previous provider. The likelihood of me having a cancerous skin tumor was very low as I was young (in my early 30s) and healthy. Through shared decision making I did decide to go ahead and just get it all taken out. My thought process was, even if there’s nothing wrong, at least this little bump will be gone and not grow back.

The day of my surgery was fairly uneventful. I arrived there promptly at 08:00 am and sat in a waiting room with several older patients who were also there for MOHs. Every time they shaved off a layer of skin, they would send me back to the waiting room while the biopsy was microscopically evaluated. Once all margins were clear, the surgeon would close the wound and the procedure would finally be over. One by one, I watched as everyone in the waiting room got their margins cleared and left the office until I was alone. At this point it was 04:00 pm, so it had been a full day.

Finally, when it was my turn to have the wound closed, they peeled off the bandage and I looked in the mirror with horror. Where the little bump on the left side of my nose had been was now a gaping quarter-sized hole in my face. I literally screamed and wanted to cry. The surgeon was very reassuring and carefully explained how he would put my face back together. Even after all the stitches, I still felt like my face resembled that of some Halloween voodoo doll.

A few weeks later, when my stiches were out and my face was starting to look more human again, the surgeon called me to go over my pathology report. To my utter shock, that little bump on my nose was actually a skin cancer called Microcystic Adenexal Carcinoma or (MAC). This type of tumor is a rare form of skin cancer that arises in the sweat glands and if not treated, can continue to grow aggressively (National Library of Medicine, 2023). Thankfully, according to my surgeon the cancer tends to remain localized.

The ABCDE rule

Recognizing the early signs of skin cancer is crucial for effective treatment and management. One of the most widely recommended methods for identifying potential skin cancers, particularly melanoma, is the ABCDE rule. This system helps individuals evaluate moles and skin lesions by focusing on five specific characteristics: Asymmetry, Border, Color, Diameter, and Evolving. Each component serves as a guideline for determining whether further medical evaluation is necessary.

Asymmetry refers to the shape of the mole. If one half differs significantly from the other, this could indicate a problem. The Border component assesses the edges of the mole; irregular, scalloped, or poorly defined borders may raise concern. The Color aspect emphasizes the significance of uniformity; moles that display multiple shades, particularly dark or unusual colors, warrant closer inspection. Diameter matters as well, with moles larger than six millimeters being more likely to signify malignancy. Lastly, Evolving indicates any changes in the mole’s appearance over time, which could include variations in size, shape, or color.

In addition to the ABCDE rule, other warning signs should not be overlooked. New growths on the skin, particularly those that emerge after the age of 30, can signal potential skin cancer. Changes in existing moles, such as itching, bleeding, or crusting, may also be indicative of a problem. Furthermore, skin lesions that do not heal, or that cause persistent irritation, are additional signals to observe. Being vigilant about these changes and undergoing regular skin screenings can significantly enhance early detection efforts, thereby improving outcomes for individuals at risk of skin cancer.

Prevention and Aftercare

It was recommended to me that I use a silicon-based scar cream to minimize the keloid that was now left in place of the tumor. I used a brand called ScarAway that I purchased on Amazon. By using it as directed and massaging it on the affected area twice a day, my scar is hardly noticeable.

In addition, MAC tumors like other types of skin cancer can be caused primarily by ultraviolet radiation. Therefore, it is imperative to develop and maintain a preventive skin care regimen. My favorite products include TULA Skin Care Radiant Skin Brightening serum SPF 30. This serum provides light makeup coverage while protecting your skin from the harmful UV sunrays. I also like elta MD Lip balm sunscreen as it provides a nice way to moisturize your lips while offering UV protection for sensitive lips. These items have become some of my skin care staples and are small enough to carry them around in a small purse or wallet. Lastly, I will never miss an annual skin care check-up and encourage everyone to do the same.