One of the most important topics in healthcare is prevention. Insurance companies are making moves to cover more of the costs, up to 100% in many cases, of preventative care. Doctors, associations, and hospitals are encouraging patients to seek preventative care. Much of it can be attributed to catching skin cancer before it becomes a serious problem. Even if you are reading this and are not a dermatologist, but instead are a cosmetic surgeon, aesthetic practitioner, or a staff member at a medical spa, it is something to be aware of. That is why we have made this a topic and focus of SCALE 2019 Music City.
How Often To Get Checked – The Insurance Companies Agree
There is complete agreement among medical professionals and health insurance companies that it is important to get a full body skin check annually. This can happen with a dermatologist, or with a person’s primary care physician, who would then refer to a dermatologist if a potential issue was found. When the primary care physician is used, it actually adds an additional step in the diagnosis, potentially slowing down treatment and adding significant expenses. Thus, our profession should work alongside the insurance industry to keep costs low for people’s medical skin care needs.
The following is an excerpt from an insurance company’s memo to employers, part of a benefits guide on controlling costs:
After all, what’s more expensive — paying for an annual skin exam or developing skin cancer? The cost of treating skin cancer in the United States tops $8 billion per year, according to the Skin Cancer Foundation, and 1 in 5 people will develop some sort of skin cancer before age 70. Preventive care and early treatment of melanoma and nonmelanoma skin cancers can drastically lower the cost of treatment and keep your employees working. Don’t let them forget about their skin when they manage their overall wellness. (Source).
With most major healthcare providers now encouraging skin care as part of the package of care to focus on, major companies with national name recognition like Cigna, are putting out guides to consumers, as well, to help educate them.
What they put together makes a lot of sense and can be used by non-dermatologists to help clients think about having their skin examined:
Learn your ABCDEs, the changes in a mole or skin growth that are warning signs of melanoma:
- Asymmetry: One half doesn’t match the other half.
- Border irregularity: The edges are ragged, notched, or blurred.
- Color: The pigmentation is not uniform. Shades of tan, brown, and black are present. Dashes of red, white, and blue add to the mottled appearance. Color may spread from the edge of a mole into the surrounding skin.
- Diameter: The size of the mole is greater than 6 mm (0.25 in.), or about the size of a pencil eraser.
- Evolution: There is a change in the size, shape, symptoms (such as itching or tenderness), surface (especially bleeding), or color.
A melanoma may also look like a bruise that isn’t healing, or it may show up as a brown or black streak under a fingernail or toenail.
Promoting Healthy SkinCare
Beyond encouraging people to have a skin check annually, we have a professional responsibility to our clients to take care of their skin as part of that prevention. This means a number of things, but high up on the list is sun protection. Protection from pollution and other elements is a key part of ensuring there are not significant skin health and/or aesthetic issues down the road. Statistically, one American dies from skin cancer every single hour, so protection from the sun should be of top concern in the quest to promote healthy skin.
The best ways to protect the skin, in addition to annual check ups, include:
- Using SPF full spectrum sunscreen every day year round.
- Avoiding tanning; which directs an intense level of UVA rays and has caused even the FDA to issue warnings against the use of beds and salons. (Source)
- Regular, monthly self-checks, as recommended by the Skin Cancer Foundation.
Eating a good diet rich in antioxidants, staying well-hydrated, getting plenty of exercise, and maintaining proper hygiene can also help to keep skin healthy – but the only way to truly prevent skin cancer is to avoid harmful UVA and UVB rays. Exposure not only increases your risk of cancer, it also allows for sun damage, causing premature signs of aging.
Next Steps When An Issue Arises
If your client has a spot that is suspicious, it can be extremely stress inducing for them. As their doctor, or provider of aesthetic services, you owe them calm, compassionate, and empathetic guidance.
Dermatologists performing a dermoscopy will be the best equipped to determine if spots on the skin are likely cancer, or benign. If that exam makes the doctor suspicious, we will do a skin biopsy. The American Cancer Society describes this in a way that can be shared with your clients to help them understand the next steps:
There are many ways to do a skin biopsy. The doctor will choose one based on the suspected type of skin cancer, where it is on your body, the size of the affected area, and other factors. For more detailed information on skin biopsies, see our documents Melanoma Skin Cancer or Basal and Squamous Cell Skin Cancer.
If a spot is found to be cancer or a pre-cancer, your doctor might want to do more tests or just treat it. If the spot is small and has not spread, a more extensive biopsy (to remove more tissue) or some type of surgery may be all that’s needed. For cancers that might be more widespread (especially melanomas), imaging tests might be done to see if the cancer has spread, and treatment such as immunotherapy, targeted therapy, chemotherapy, or radiation might be needed.