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.
Thanks for the information on your site! My mom has had a nickel-sized pink patch on her neck for over 18 months and I kept pestering her to get it looked at. Her doctor told her it’s just eczema and to put cream on it. I started looking up pictures of BCC and when it didn’t clear up I pushed her to insist on a biopsy. The doctor did a punch biopsy and told her, “now you’re going to have a scar for nothing.” Well, the lab results came back as BCC and he wants her to come back in two weeks from now to “cut it all out”
I got her in at a local dermatologist and they recommended Moh’s. I think this is a much better option and I feel much more comfortable with someone who knows more about it than her doctor who has taken such a casual and dismissive approach this whole time.
I’m showing my mom your scar photo so she can have an idea of what to expect and hopefully lessen her anxiety! Thanks again!
Thanks for sharing your experience. I’m so glad your mom has you to advocate for her. I think Mohs is a great option also. Especially given the less than attentive reception from her doctor!
I loved reading your story. I had MOHS 2 weeks ago on my forehead and am on the steri strip part of the deal. I also had the procedure done in a super comfy office in Newport Beach where my husband could hang out with me, but don’t think it was the same, unless they stopped passing the yummy snacks between rounds. My original dermatologist was not the one who did the procedure, and in fact she missed my basal cell when I had been in for a regular mole check. Only biopsied when I pointed it out for the second time. So I am looking for a new dermatologist and yours sounds great! Since we are in the same area I would love a referral!
You had Mohs on your forehead?
I have three spots on my forehead that my Dermotologist says are basal cell carcinoma, most likely will require two Mohs surgeries due to location on my forehead.
Did you have grafting ?
Or stitches ?
I’m very nervous but going back in October for biopsies , I was so thrown I had multiple areas of BCC on my forehead i opted out of biopsies thinking at 72 how much longer will I be Around, do I really need to go through this process/ procedure .
I’ve had one Mohs surgery on my nose about 5 years ago .
Took 5 layers off my nose but does not look that bad , grafted skin from the back of my neck .
Would you mind sharing your surgery and extent on your forehead ?
I’m so sorry you had to go through the procedure and would appreciate any help ?
Betsy
I had mohs done on my face February 22, 2016. I have a thick scar that is 1 1/2 inches long and it is also bumpy. How long do you think this will heal. Do you think it will get a lot better?
Hi Christine, Thanks so much for commenting! I’m so sorry you had to have a Mohs procedure. Since I don’t know you or how you heal from wounds regularly, I can’t tell you how much better your scar will get. The procedure was not that long ago so it will take some time to see big improvements. When I compare my scar over the course of a year, it healed really well, a few months out probably isn’t enough time to see a drastic improvement. That being said, my doctor had me massage the scar, twice a day, when it wasn’t tender. He said it would help break up scar tissue or something. Check with your doctor and see what he thinks about that. Each doctor is different. Also be sure to keep it out of the sun! Hang in there! It should get better!
Thank you for sharing…I’ve had 2 MOHS on face and will be having MOHS on top of foot (squamous cell) end of month. How do you deal with “sun anxiety”? The fear of the sun is so bad…
Hi Rose! Sun anxiety is hard! Especially being in Southern CA where I am. I try to do my best, use my sunscreen, try not to be out in it. I try to use hats and sunbrellas. It helps to plan ahead and be prepared. If I don’t, that is when I get all anxious and fearful. I try to keep a few things on hand in the car if I’m headed to an event or party where I am unsure if there will be shade or a place to be out of the elements. Try not to let it get the better of you and always talk to your dermatologist about it for more tips! Good luck with your foot MOHS!
I just had a Moh’s procedure on my nose yesterday, and I can identify with your feelings from your initial post. I’m an RN and should know what to expect, so I surprised myself with a minor freak-out last night. Like you, I had plans for running errands after the procedure and preparing for Christmas. I was fine throughout the procedure and went to lunch and shopping with my husband immediately after. A few hours later when the anesthetic wore off, BAM! I felt like I had been punched in the nose. I had my husband stop at the drugstore to buy Tylenol and take me home. I spent the rest of the evening using an ice pack for 15 minutes every hour and wondering if something had gone wrong. I’m better today, but realizing that I won’t be able to bend, stoop and lift to cook the Christmas Eve dinner I was planning. I obviously didn’t think this one through!
I am very glad I found this site. I had mohs surgery on my arm at the elbow 5 days ago. It was very traumatizing and I just wanted to cry the whole time. The doctor and staff were wonderful, but I fell apart. I couldn’t believe what a baby I was being! I’ve had other skin cancers taken off, but this was a recurrent one and it hurts and the tape and bandages hurt! I will have about a 2 1/2 inch scar. Don’t get the stitches out until the 2 week mark.
Thank you for making me feel better about feeling awful!
Hi Catherine, I’m so glad you commented. There is no wrong way to behave! Remember that! I can’t believe how irritating the tape can be on your skin! I think that bothers me more than the stitches! (probably not. I REALLY hate stitches!) I’m glad they took that yucky old cancer off and I wish you a speedy recovery! (or a long one – whatever you need it to be!) I’m glad my post could help to make you feel a little better. That is exactly why I shared my story. XO, friend!
OH MY GOODNESS! Thank you for posting, sharing your experience! I’m 38 and have seen my dermatologist annually for YEARS and have always had stuff removed, never anything concerning. Just being blonde, brown eyes, never worn sunscreen as a kid, and living in Texas I think automatically makes me high risk for developing skin cancer. I never thought I hear the words, “basal cell” until this week when I asked my derm to remove a irritated mole at the base of my neck that I keep catching on my sports bra and necklaces. When she called yesterday to tell me it came back as a basal cell, I dropped my phone and started crying. In addition to the neck, I also have a “spot” above my eyebrow she’s been treating since December with cryosurgery that she now wants to do a punch biopsy ON MY FACE. I feel like I’m falling apart at the ripe age of 38! I took the day off from work today to sit in my living room watch Bravo and sulk. I’ll put on my big girl panties tomorrow, but today I just want to cry. I’m terrified of developing more skin cancers or worse skin cancers. How do you manage the fear? Thank you for posting your sunscreen recommendations. I just spent $120 at least on every type of sunscreen the grocery store had. ;-)
I feel you, Tracy! I’m dealing with the fear the way you are dealing. Sometimes tears, lots of Bravo and not thinking about it. As long as I am wearing my sunscreen, changing my patterns (this CA girls loves the sun!) and am seeing my derm regularly, that is all I can do! I expect to have more and just have to go with the flow. I am lucky that I have a derm that is careful about the work he does on the face and will send me to a derm with a plastic surgery background for things that are really visible. I was the one who pushed for a punch biopsy on my face in lieu of stitches because I don’t deal well with stitches. The punch might leave a little scar, but it is not bad at all! And if you have concerns, bring them up with your derm! They’ll be able to explain more. Sometimes they forget that we are new to this and would like a little more hand holding or info. Just ask for it. :) I think I’ll go watch some Bravo in your honor. XOXO
I read your post bc I’m about to have MOHs for a basal cell in the exact same spot
I’m only 37 so I was shocked. I’m familiar with the procedure bc I work in the medical field but don’t do well when stuff is wrong with me. Your post really helped me to realize what I need to prepare for. I have two little kids so I’m hoping to take it easy and recruit some help for a few days. I think having it on the neck seems worse bc that part of your body moves around a lot. I’m hoping it goes well. Thanks
Alison, thanks so much for commenting. You will do awesome! Having help made it a little easier to just take it easy and deal with the stitches. You won’t be able to shower for 2 days so plan ahead! :)
Hi Sharon,
Thank you so much for sharing your story! I stumbled across your blog and like you have been told that Mohs is “no big deal”. I am scheduled to have my surgery on Thursday (on the left side of my neck) and to be honest haven’t really allowed myself to be nervous. I’ve tried to distract myself as much as I possibly can (crazy how you can bury yourself in something as silly as work!), but as time draws closer it’s definitely becoming more real. Of course after my initial diagnosis and opting for Mohs I did more than my fair share of googling and the images that appear (mostly large gaping holes) really scared me, so I immediately stopped and went with the “less you know the better” theory. After reading your story and looking at your post-op pictures I’m taking comfort in knowing I’m not “alone”.
Thank you and fingers crossed for no more stitches for you :)
Ashley
So glad my story could help a little bit. You are going to do great! It is super common! Several of the moms at my kid’s school battle basal cell as well and so I’ve seen a lot of the different kinds of scars that come out of it. None of them are awful and most of them are on necks, faces and noses. One friend had, what I would consider, a pretty severe case around her nose and even on her, you can hardly see a scar! Be brave! And buy yourself a treat for when you get home. :) Best of luck!