Wellness FAQ: Skin Cancer

Whether you regularly see a dermatologist or not, checking your skin regularly for any signs of sun damage and taking precautions is a crucial part of living somewhere with ample months of sun exposure. So, as the summer months move in quickly, we’ve asked Dr. Liqiao Ma some of our burning questions about skin cancer and how to navigate your largest organ.  

AFM: What do you see most often in your daily practice with patients? 

Dr. Ma: By far, most patients come to see me for skin cancer screenings, which is great because I end up diagnosing quite a lot of pre-cancers and skin cancers that patients did not know they had. However, I also see a variety of other conditions such as rashes, acne, warts and cosmetic concerns. 

AFM: What are some common signs or things to look out for when self-checking for melanoma?  

Dr. Ma: Most melanomas can be identified using the ABCDEs (asymmetry, border, color, diameter and evolution). No one sign alone means a melanoma has developed necessarily, but rather a combination of several signs, especially in comparison to other moles on the body.

If someone spots something that may fit these identifiers, they should contact their primary care doctor or a board-certified dermatologist as soon as possible for evaluation. Their dermatologist will usually perform an exam with dermoscopy, and possibly a biopsy if needed.

AFM: Who is most at risk for melanoma? Does family history play a large role? 

Dr. Ma: Factors that increase the risk of melanoma include a history of severe or blistering sunburns, lighter skin (red or blonde hair) and having many moles on the body (>50-100 moles especially). Personal and family history of melanoma also increases risk for future melanoma; about 1 in 10 patients diagnosed with melanoma have a family history of melanoma.

AFM: What is the treatment like for melanoma? 

Dr. Ma: If the melanoma is caught early, which the majority is, thankfully, an excision is all that is needed. This is similar to the treatment for other, less dangerous skin cancers, though a larger piece of skin will need to be removed, typically. If the melanoma is caught later or at a more advanced stage, then the treatment becomes more complicated. This usually involves treatment with an oncologist, who may need to perform surgery on the lymph nodes and add other therapies like chemotherapy or immunotherapy.

AFM: How can one protect themselves, regardless of their family history? 

Dr. Ma: Protecting oneself from sunburns and getting regular skin checks by a board-certified dermatologist allows for early detection of evolving melanomas. Patients should wear sunscreen every day that is at least SPF 30 and broad-spectrum, and remember to reapply every one to two hours. In fair-skinned individuals, sunscreen alone is not enough to protect from sunburn and sun damage; these patients should also be wearing protective clothing like wide-brimmed hats and long sleeves. I like to recommend sports clothing that is SPF- or UPF-rated so that it is built-in sunscreen. 

AFM: Besides melanoma, what are some sun-induced skin issues or ailments one should look out for?  

Dr. Ma: Other issues include more common skin cancers like basal cell and squamous cell carcinoma, which are the first and second most common skin cancers in the U.S., respectively. Sun damage can also lead to dark spots, light spots, visible blood vessels and deep-set wrinkles over time that can only be reversed with expensive cosmetic procedures. 

AFM: What are some common misconceptions about melanoma and skincare in general that you hear often in your practice? 

Dr. Ma: A common misconception about melanoma is that it takes a lot of sun exposure to develop one. On the contrary, although UV damage plays a role in many melanomas, some develop with very minimal sun exposure. These include melanomas on typically hidden areas like the buttocks or soles of the feet. Another common misconception about skincare I hear often is that sunscreen alone protects from UV damage. Unfortunately for fair-skinned individuals, protective clothing and staying in the shade is also necessary to prevent sunburns and sun damage.  

AFM: What is one thing you wished everyone knew about their skin and skincare? 

Dr. Ma: I wish patients knew that it is never too late to start wearing sunscreen and protective clothing. Even if a patient is older and sustained most of their sun damage in their youth, it is not too late to start covering up and taking preventative measures. Given that life expectancy is increasing every year in the U.S., even a patient in their 60s and 70s can slow down the rate of sun damage and development of pre-cancers and skin cancers by taking precautions now. 

Dr. Liqiao Ma is a board-certified dermatologist and fellow of the American Academy of Dermatology practicing general, surgical and cosmetic dermatology in Austin and the surrounding communities. She completed her medical training at the University of Texas Southwestern Medical Center in Dallas. Dr. Ma served as a chief resident during her final year of residency and spent this time caring for veterans at the Dallas VA Medical Center, where she took care of countless patients with extensive sun damage and skin cancers.