Basal Cell Carcinoma : An Update

Well, it’s summer. Which for the last few years has been kind of hard for me in terms of my skin. In August of 2012 I started seeing a dermatologist. He immediately started removing moles and marks and such for biopsies. Very quickly, we found basil cell carcinoma. You can see my original post about the Mohs Surgery procedure I had here. But I thought it was time to update that post. I have had several people find that post and email me that they were about to have the Mohs procedure as well. And I think my post sort of freaked them out. Essentially, I talked about the slight depression that I went in to after the removal. But looking back, I see that there were other personal things happening that clouded that post, like friendship let-downs, etc. Oh and I also found out that I EFFING HATE STITCHES. And to most people, stitches are no big deal. And I can see how they are no big deal. But to me they are the worst thing on the face of the planet. So that also played in to that first post although I didn’t realize I was averse to the stitches at the time. But the two more times that I’ve had to have stitches really drove that home.

I joke in my first post that I would tell people I had been in a knife fight if anyone asked me about my scar. I only had one person ever ask me about it and it was my allergist, right after I had the procedure, because if it was a thyroid surgery I had (which scars in a similar spot) I couldn’t get my allergy shots. So I didn’t get to have any fun with it. Looks pretty good right? You can see the scar, when it was a little more fresh in this post which was about 5 months after the procedure.

I had the Mohs surgery Thanksgiving week in 2012. In case you had trouble seeing the scar, here it is a little closer up. You almost can’t see it. There was never anything special I did to make it scar less other than follow the rules the dermatologist gave me for immediate care of the stitches. No extra creams, nothing. I know that I had a GREAT dermatologist do the procedure and that helped. But I do try to put sunscreen on it and keep it out of the sun. Well, really, I stay out of the sun as much as possible. Gone are the days of basking by the pool. I try to sit in the shade and slather on the sunscreen. I’m still struggling with making it habit of putting on sunscreen every day. My skin is very sensitive and I break out very easily. This is still my favorite sunscreen though.

Since my Mohs procedure, I’ve also had to have excisional biopsies. Luckily (?) they were both in the same spot so I only ended up with one scar. Where as for Mohs, they do the biopsy and pathology at the same time to make sure they clear the margins, excision is a biopsy where they send the sample out for pathology. In my case, I had a dot that looked like someone drew on me with purple marker. Both dermatologists (I have a regular derm and then one who does the procedures who has a specialty in plastic surgery) told me it needed to be removed and that the biopsy would take “a stitch or two.” No thank you. So I asked them to do it like they do my other small biopsies where they numb me and cut it out. Remember I hate stitches. So initially, it was cut and sent out for biopsy. But then I got a call. It wasn’t cancer, but they didn’t like the pathology report as it came back with words like “cloning” and they wanted to get all of the cells out to be safe. Considering my history, my family history of skin cancer (my dad) and my coloring they felt it was better safe than sorry. So we scheduled an excision procedure for the week of Thanksgiving 2013. I ended up with about 10 stitches from the procedure. But I was done. Or so I thought. A few weeks later I got a call that said the pathology report came back and they wanted to take a little more of the offensive area to ensure that they got all the bad cells out. So about 8 weeks later, I went back in for the same exact procedure. With a few extra stitches.

I wasn’t sure how the scar would end up looking considering they had to cut in the same spot. But looks pretty good, right?! Again, I didn’t apply any extra creams or anything to the scar. The only thing I was instructed to do was to massage the scar a month after the stitches were out. Apparently that helps to break up the scar tissue under the skin and help to get the scar to lie flat. It could be a touch tender at times, but I tried to massage it as often as I remembered. And because of the location at the jawline, you can’t see this at all. And I never even bother with concealer on it.

I hope if anyone reading this is about to go through a similar procedure, please know that it is really no big deal. Of course there are varying degrees of the cancer, and it matters where it is located and how large an area is being treated. Basal cell carcinoma is super common and something dermatologists deal with often. The one thing I will say is that I think the dermatologists and staff forget to fill the patient in on the after care, before coming in for the procedure. I was really thrown off, after my Mohs, when I couldn’t shower for 2 days due to the stitches. Which means you may want to plan ahead and go to the store before your stitches, not plan a big outing, etc. I also am in really achy pain for the first two days of my stitches so it helps to have someone available to help with the kids. Could I manage the kids on my own. Yes. But it is nice to be able to take it easy for a few days. Those were things I had to learn on my own which would have been helpful to know before heading in for the stitches.

My main dermatologist tells me that I will have more basal cell carcinoma at some point. I see him every few months and we monitor areas that could be a problem. I have enough experience now to know how it all works and I’m not afraid of it. And I’ll deal with it as it comes. For now I stay out of the sun, use my sunscreen and rock super cute hats.

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