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There are three main types of skin cancers affecting the face,
head and neck region. The majority of skin cancers are caused by excessive
exposure to the sun. The number of new skin cancers is increasing in the United
Kingdom and the United States, particularly melanoma. This is in contrast with
the decreasing trend in Australia.
The commonest type of skin cancer is basal cell carcinoma (BCC). It is again
closely related to chronic sun damage and fair-skinned individuals. The
majority of BCC occurs on the face and it can appear as an ulcer, slowly
enlarging and gnawing away facial structures including facial skeleton, hence
the traditional name 'rodent ulcer.' It can also appear as a lump or a cyst on
the skin. As a result of sun damage, these lesions grow slowly but do not
spread to other parts of the body. The main treatment is surgical removal of
the cancer with appropriate repair or reconstruction of the defect. Superficial
radiotherapy can also offer good results to some BCC's.
The second commonest skin cancer is squamous cell carcinoma (SCC) which
predominantly affects the older age group among fair-skinned people again due
to prolonged sun exposure or ultraviolet irradiation. It occurs mainly on the
face with a white scaly appearance, lump, ulcer or crusted plaque. SCC not only
spread locally on the face but some can spread to the lymph glands in the neck.
Surgery and/or radiotherapy are the main treatment of choice.
Malignant melanoma is the last type of skin cancer which is related to
excessive sunlight exposure and changes to previously pigmented skin moles. It
may have a genetic link as fair-skinned, blue eyed and failure to tan
individuals are particularly at risk. It can start on normal skin or within a
previous mole. Over a long period of time (years), the mole may become larger
or bleed or show changes in the colour, outline and surface of the lesion. The
colour can vary and it may become like a lump. Some may spread more rapidly to
involve lymph glands in the neck. Early recognition and treatment are crucial
because they can be life-saving. Diagnosis is made after a biopsy and surgery
is the main treatment option.
Prevention of skin cancers is very important in health promotion in order to
prevent deaths from skin cancer, particularly malignant melanoma. As the
majority of the above mentioned skin cancers are caused by excessive exposure
to the sun, avoidance of sunburn and midday sun, wearing protective clothing
and a hat, seeking shade and applying sunscreen with a high sun protection
factor are essential. Although there is no evidence in linking sunbeds and skin
cancers, it is wise to avoid them because sunbed is a source of intense
ultraviolet radiation like sunlight which can pose a potential risk to skin in
cosmetic tanning.
So when you are out and about in the sun, slip on a shirt, slap on a hat and
slop on some sun cream, the so called 'slip, slap, slop' policy.
Any lump or ulcer on sun-damaged or sensitive facial skin should be seen by a
specialist Oral and Maxillofacial Surgeon for biopsy and treatment.
Any patients with suspected facial or oral melanoma must be referred or seen by
specialist Oral and Maxillofacial surgeon urgently for early diagnosis and
prompt treatment.
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