December 2003
Dear Paula,
I had a little skin cancer last year, and will continue to see a dermatologist on a regular basis, but I was wondering what you would do if you had skin cancer. I have two very small spots on my face that appear light pink and scale a little even though I use SPF 15 sunscreen on my face and moisturize with a good product. Are there products that may remove any new cancer that may be blossoming, or do I have to go as far as skin peels?

The plastic surgeon who removed this cancer has given me a prescription for a cancer cream that I could use on these spots, but I'm not sure if I feel comfortable doing this. If there is an exfoliating cream that can perhaps do the trick, that is what I'm looking for. It seems the people I know who have had skin cancer on their faces continually have it recur somewhere else on their face, and continually have it removed. What should I do?

Deb, via email

Dear Deb,
It's hard to say hypothetically what I would do if I had a skin cancer because there are so many variables to address that it would be hard to generalize. An all-purpose rule to use for any health concern is to become a voracious researcher. You should be looking for all the research you can find about the issue, and be proactive about finding physicians open to answering questions. Nonetheless, for your own specific situation, it would have been far better had you been more specific in the details you provided because it isn't possible for me to understand what is really happening without knowing the exact type of skin cancer you had removed and the prescription medication you are apprehensive about using. There are three main types of skin cancers: basal cell carcinoma, squamous cell carcinoma, and melanoma. Actinic keratosis, also referred to as solar keratosis, is a precancerous condition that is often included in this group. Each condition has its own treatment modalities, health concerns, and recurrence risks. When it comes to skin cancers, there are no over-the-counter options for removing or treating lesions. An AHA or BHA peel (which affects primarily the top layers of skin) will not eliminate or prevent a skin cancer. Treatments for skin cancer and precancerous lesions lie strictly in the purview of dermatologists or oncologists. You would never want to risk your life solely on the knowledge of an aesthetician or cosmetics salesperson. If you are not comfortable with your physician's recommendation, then get a second opinion from another physician whose specialty is skin cancer, and then decide what course of treatment you want to follow.

In addition, I am very concerned to read that you are using only an SPF 15 for your sun protection, and you didn't mention whether or not it contained UVA-protecting ingredients (either avobenzone, titanium dioxide, or zinc oxide). Ideally, you should be using an SPF 30 with one or more of those active ingredients, and there are many dermatologists who would suggest that you use a pure mineral sunscreen; that is, one that contains only titanium dioxide and/or zinc oxide as the active ingredient(s), because many believe that they provide the best protection of all against skin cancer. Those with skin cancer and those who have had it previously should strongly consider using a mineral sunscreen. Be aware that if the skin turns tan or pink—in any amount—it is a sign of sun damage, and the cumulative effect of this is most likely what got you to the place you are right now.