Dr Julia Sen is a Consultant Ophthalmic Plastic, Reconstructive & Cosmetic Surgeon with more than 20 years of experience in her field. Every month on DLUXE she shares with us her own observations from almost 30 years of medical practice and 50 years of life experience.
In this month’s post, Dr. Julia Sen unveils the importance of skin health vigilance
I never imagined that I would have anything to thank the Kardashians for but I’m prepared to admit that I was wrong…
Khloe Kardashian’s recent shock revelation about her surgery to remove a melanoma from her left cheek exposed a very large audience to the sobering truth that this skin cancer can strike even young, healthy, rich, beautiful people and was a timely reminder that we all need to be more vigilant about protecting our skin.
Skin cancer is the most common human malignancy, with 1 in 5 UK adults predicted to be affected within their lifetime and according the Cancer Research UK, the annual number of UK adults diagnosed with melanoma (the deadliest form) has hit an all time high of 17,500 and is predicted to double over next 20 years.
Why, you ask?
It’s a perfect storm of an ageing, predominantly white population, the Brits’ penchant for holidays in the sun and a relaxed attitude to UV protection. There’s also a link with compromised immunity – patients on medication to prevent transplanted organ rejection are at higher risk and there may also be a nutritional element, since vitamin B3 supplementation appears to be protective against the non-melanoma skin cancers.
Sun-exposed skin on the face, neck, décolletage and for men, tops of ears and scalp are particularly common sights. I expect that the vogue for young men to shave their heads will contribute to a future glut of cancers in this site and perhaps the return of the comb-over, both highly undesirable prospects.
Managing Skin Cancers
Skin cancers are painless but grow over a number of months and in most cases are managed, as was the case for KK, by surgical removal, usually under local anaesthetic. The tissue removed extends beyond the visible tumour to clear microscopic root extensions and prevent regrowth. This is important, as recurrences tend to behave more aggressively and are more challenging to clear on subsequent attempts. In the case of melanoma, additional investigations, such as lymph node biopsy and MRI scanning may be needed if there is concern about possible metastasis (spread beyond the primary lesion).
As you can imagine, facial surgery is a scary prospect and not just because of the diagnosis. The plastic surgery needed to reconstruct an eyelid (my specialist area) must ensure that the eye is protected, whilst also achieving a good cosmetic result. My patients are often just as concerned about how they will look afterwards as they are about being cured. It’s not vanity; visible scarring and facial asymmetry can be life-changing due to high rates of depression and social anxiety.
The nose, ears and scalp also require highly specialised reconstructive techniques. This is where my Consultant Maxillofacial Surgeon colleagues, Mr Eoin Twohig and Mr James Gallagher excel. Fellow members of the Worcestershire Skin Cancer Multidisciplinary Team (MDT) alongside Dermatologists, Pathologists, Oncologists (cancer specialists) and Clinical Nurse Specialists, we manage skin cancer patients in both the NHS and private sectors. Teams like ours are replicated throughout the UK to ensure that patients receive high standards of care.
So if you notice a change in your skin, a new nodule, ulceration or change in an existing mole, it’s worth getting it checked out
Your GP will be able to advise and if there is any suspicion about the nature of your lesion, you will be referred for removal and biopsy. Benign lumps such as skin tags, warts and moles aren’t currently eligible for NHS treatment but if you want rid, there are private clinics who can help. You should look for CQC registered services who also offer histology (analysis and diagnosis of the lump by a pathologist) and you can usually self-refer.
To find out more or to make an appointment, email hello@drjuliasen, phone 07939286850 or visit my website, www.drjuliasen.co.uk
Love, Julia x