Facing Sun Damage and Skin Cancer

Henry D Sandel IV, MD

As people age their skin can sustain damage from years of sun exposure.  It is almost impossible to avoid sun on your face or use sun block every time you step outside.  It is even more difficult for people who love the outdoors and thrive in the summer sun.  Over time this damage can lead to skin lesions, brown spots, loss of elasticity, and enhance the loss of tone around the eyes, cheeks, jawline, and neck.  These findings can be discouraging to active healthy people who sometimes do not look as healthy as they feel.

The more common diagnoses found in my office are benign skin lesions called seborrheic keratosis, actinic keratosis, lentigines (brown spots), and nevi (moles).  They appear mostly on sun-exposed areas of the face and neck and can be a direct result of photodamage sustained earlier in life.  Although some lesions require biopsy to rule out cancer, most lesions can be determined to be benign just based on a patient’s history and skin examination.

Benign or noncancerous lesions are mostly found to have been present for a long period of time.  These lesions rarely undergo rapid growth or change in color or appearance.  Many of these lesions appear as flat brown spots, have a raised “stuck on” appearance, or have an even color with well-defined borders.  Some can even become quite large. 

The accumulation of these lesions on the face can have a negative effect on a person’s appearance.  Because of the location on the face, patients are hesitant to have them removed.  Most patients fear that removal will produce a scar or leave a white spot or depression in its place.  However, if properly removed to avoid damage to the surrounding skin, these lesions can be taken away completely with almost no evidence of scarring. 

Cancerous or precancerous lesions are generally those that have appeared suddenly, changed in appearance, or have undergone rapid growth.  They can be varied in appearance ranging from a small red area to a raised nodule, a discolored and irregular, possibly ulcerated lesion.  They can even present as an area that just doesn’t seem to ever really heal or is chronically flaking or peeling off.   These lesions should always be biopsied and sent for pathologic diagnosis.  If the area is found to be cancerous, it should be completely removed in a timely fashion and in such a way that produces a minimal scar and preserves the natural creases of the face.

To learn more about skin cancer, diagnosis, and treatment options visit the National Cancer Institutes website.  National Cancer Institute