Skin Cancer Treatment

Early detection of skin cancer improves outcomes

New Zealand has high rates of skin cancer which are still on the rise – in the early 2000s, about 250 people died each year from melanoma; by 2013 this number had increased to 489. There are several different types of skin cancer. You can have your skin checked at the Upper Hutt Skin Clinic with advanced imaging technology (Dermatoscopy). At your Skin Assessment appointment, we will give you advice on how to examine your own skin and how frequently you should have a skin check with your doctor.

It is also vital to check your skin regularly for any moles that have changed over time. Skin cancers can be in places you can’t see yourself, so you may need to ask someone to help you check, and remember to check in places that are hard to see or might not normally get exposed to the sun, such as your armpits, behind your ears, your scalp, the bottom of your feet and your fingernails and toenails. It’s a good idea to keep track of how spots and moles look so you know if they have changed since you last checked your skin, and if you have any concerns, talk to your doctor and show them what is worrying you.

Upper Hutt Skin Clinic are specialists in mole checks and mole removal with accredited doctors through The Skin Cancer College’s Accreditation Program. Contact us on 0800 SKIN CLINIC to make your appointment.

What is Skin Cancer?

Skin cancer is generally caused by over-exposure to the sun’s ultraviolet (UV) radiation. This is why it is so important to wear sunscreen with a high UV factor at all times when in the sun. There are also certain skin cancers that can occur in areas that don’t see the sun. Skin cancer can manifest itself in different forms for different people, it is not always a black spot. It is therefore important to see your Doctor for regular skin checks.

Dermatoscopy for skin cancer diagnosis

A hands-on consultation with Dermatoscopy is our preferred method of diagnosing skin cancer.

Our doctors are trained in the use of Dermatoscopes. These are hand held instruments which use epiluminscent microscopy to look deep into the skin. This allows our trained doctors to recognise the microscopic signs of skin cancer. It also gives confidence in checking that moles are normal and do not require excision.

How to stay safe in the sun

Most Kiwis know about ‘slip, slap, slop’, but the ‘slop’ part – applying sunscreen – needs a bit more attention if you are going to be out in the sun for long periods of time. You need to use a ‘two coat’ approach, applying your sunscreen 20 minutes before going outside and again when you’ve been outside for 10 to 20 minutes. Applying two coats of sunscreen helps cover up areas you may have missed on your first application, and gives you a thicker, more protective layer of sunscreen.

  • Be sun smart – slip, slap, and wrap
  • Spend less time outside when the sun is strongest – between 10am and 3pm
  • Seek shade when outdoors
  • Wear clothing that covers as much as your body and limbs as possible if in direct sunlight
  • Wear a hat that shades your face and neck
  • Wear sunglasses
  • Apply broad spectrum water resistant SPF 30 sunscreen as often as is directed
  • Do not use sunscreen to extend the time you spend in the sun

The Sun Protection Alert can be found at www.sunsmart.org.nz  and tells you the time each day that you need to protect your skin and eyes. The key message is that you need to protect your skin and eyes from 10.50am to 3.30pm. Protection is required when UV radiation is damaging (when UV levels are 3 or higher).

Your Moles and Spots Explained

Harmless (Benign)

Freckles

  • Freckles are harmless coloured spots that range in size from 1 to 10mm

Seborrhoeic Keratosis

  • By the age of 60, most people have at least one or two
  • They have a very discrete edge and frequently sit up on top of the skin
  • Colour varies from pale skin through to orange to black
  • Size varies from a few millimetres to 2cm
  • Wart like

Moles and spots to keep an eye on

Dysplastic Naevi

  • A dysplastic naevus is not a skin cancer, but can be a warning that you may be prone to melanoma
  • Characterised by irregular borders and uneven colour with multiple shades of brown and sometimes pink
  • If changing, they may require removal to differentiate from early melanoma

Solar Keratoses

  • Also known as sun spots
  • A solar keratosis is not skin cancer, but could be a warning that you may be prone to developing skin cancer
  • Characterised by red, flattish, scaly areas which may sting if scratched
  • If sunspots change and become lumpy or tender, they may have become a skin cancer

Dangerous skin lesions

Basal Cell Carcinoma (BCC)

This is the most common type of skin cancer. It is very rarely life threatening when correctly treated. It is more common in people with fair skin or those who have had a lot of sun exposure. The tendency to develop BCC may be inherited. There are several different types of BCC. Treatment of BCC depends on the type, size and location and the number of lesions. Most BCCs will require excision. PDT can be used for small superficial BCCs.

  • Most common skin cancer
  • Appears as a lump or scaling area
  • Red, pale or pearly in colour
  • As it grows, it may become ulcerated like an  non-healing sore or one that heals and breaks down again
  • Grows slowly usually on the head, neck and upper torso

Squamous Cell Carcinoma (SCC)

Most SCCs occur on sun exposed areas of skin: the face, lips, ears, forearms, hands and lower legs. SCC can also be caused by smoking, burns and some viral infections and is more common in people who take immuno-suppressive drugs. SCCs can become invasive and spread to other parts of the body. Treatment depends on the type, size and location of the SCC. Invasive SCCs are usually treated with excision. Superficial SCCs can sometimes be treated with topical creams or PDT.

  • Not as dangerous as melanoma but may spread to other parts of the body if not treated
  • A thickened red, scaly spot. Later it may bleed easily or ulcerate
  • Appears on sites most often exposed to the sun
  • Grows over some months and rarely grows rapidly

Melanoma

The fourth most common cancer in NZ. It is the most serious type of skin cancer because it can spread rapidly and can be life threatening if left untreated. Most melanomas are caused by exposure to UV radiation in sunlight and sun beds. Early detection of melanoma is important to improve prognosis. If you have an unusual, changing or new mole it should be checked as soon as possible. If your doctor thinks that the mole is suspicious it will be excised to confirm that diagnosis.

The best way to prevent Melanoma is to avoid sunburn by using protective clothing and sun screen.