Skin Cancer

Actinic keratoses (sunspots) are precancerous lesions caused by exposure to ultraviolet (UV) radiation. A proportion of actinic keratoses if left untreated may progress to skin cancer known as a squamous cell carcinoma. Actinic keratoses may appear as flat or thickened areas of red or pigmented scaly skin. They may sometimes be sensitive or tender. The presence of actinic keratoses is an indication of sun damage to your skin and so other signs of sun damage such as pigmentation, redness, broken capillaries and fine lines may be present.

What Are the Treatment Options?

The type of treatment for your actinic keratoses will depend on the nature, number and location. Cryotherapy or liquid nitrogen therapy may be used to freeze the damaged cells.

If you have a number of sunspots, then “field treatment” may be more appropriate. Field treatment involves treating a whole area such as the entire face to achieve a more uniform and improved result. Field treatment may be in the form of a cream called 5-Fluoruracil which is a chemotherapy medication. This is a chemical way of removing the sun damaged skin cells. Photodynamic Therapy (PDT) may also be used for “field treatment” of the precancerous lesions. Photodynamic therapy is a non-invasive treatment that uses a light-sensitive cream and red light to destroy abnormal skin cells. Lasers may also be used for “field treatment” of the precancerous lesions. The ablative Erbium-Yag laser fully ablates (peels) the skin from the outer layer of the skin called the epidermis to the deeper layer of the skin called the dermis. The Ablative Erbium-Yag laser also has the ability to coagulate (heat) the collagen in the dermis. This process has two effects:

• Expels the sun damaged cells in the epidermis.
• Activates a molecule called Activator Protein 1 (AP-1) transcription factor which leads to upregulation of matrix metalloproteinase (MMPs) which stimulates collagen remodelling.

Abaltive Erbium Yag laser is a more wholistic approach to photorejuvenation which aims to address all the facets of sun damage.

Basal cell carcinoma (BCC) is the most common skin cancer worldwide. Basal cell carcinomas are caused by environmental factors including sunlight and genetic factors. There are different variants of BCCs, which reflects the biological behaviour of the cancer. If left untreated BCCs will grow and cause local structural damage and disfigurement. Sometimes a diagnosis of a BCC may require a biopsy.

What Are the Treatment Options?

Basal cell carcinomas may be treated with topical creams, photodynamic therapy, standard surgical excision or Mohs micrographic surgery. Your dermatologist at Laye Dermatology will discuss with you your treatment options, which will depend on the variant you have, location, size and medical history.

Squamous cell carcinoma (SCC) is the second most common skin cancer in Australia. Ultraviolet radiation from the sun is a common risk factor for developing SCCs. Other risk factors include a supressed immune system, sites of previous injury such as a burn or radiation, or a viral infection such as the human papilloma virus (HPV). Squamous cell carcinomas may arise from a pre-existing actinic keratosis (sunspot). An SCC that is confined to the top layer of the skin (epidermis) is called Bowen’s disease. When the tumour cells break away from the epidermis, then it is known as an invasive SCC. If left untreated, squamous cell carcinomas can potentially spread to the lymph nodes and internal organs. Sometimes a diagnosis of an SCC may require a biopsy.

What Are the Treatment Options?

Squamous cell carcinomas may be treated with topical creams, photodynamic therapy, standard surgical excision or Mohs micrographic surgery. Your dermatologist at Laye Dermatology will discuss with you your treatment options, which will depend on the variant you have, location, size and medical history.

Malignant melanoma is a serious type of skin cancer that if left untreated is life-threatening. Australia and New Zealand have the highest incidence of malignant melanoma.

Within the skin there are normal pigment cells called melanocytes, which gives our natural skin colour and form the moles (naevi) on our body. When the melanocytes undergo cancerous change then it is known as a malignant melanoma. The development of malignant melanoma is influenced by both environmental and genetic factors. Your dermatologist at Laye Dermatology will ask you whether there is a family history as this is often useful in identifying those at risk.

Malignant melanomas can arise as a new spot on your skin or from an existing mole that has recently changed. It is important to tell your dermatologist about any new or changing moles. A biopsy is necessary to make a diagnosis of malignant melanoma.

What Are the Treatment Options?

The treatment of malignant melanoma is dependent on the stage and type of malignant melanoma. Early-stage melanomas are usually successfully treated with surgical excision. Your dermatologist at Laye Dermatology will make the most appropriate plan of management for your malignant melanoma.