Skin cancer, sunscreen, all the things
May 17, 2022 7:29 AM Subscribe
Last week I got a basal cell carcinoma taken off my face (for the second time). This one was between my nose and one eye and contemplating my scar-to-be is not fun. Am getting the stitches out later this week, and I have questions.
* What, if anything, is helpful when it comes to minimizing the scar after I get the stitches out?
* Is it possible to avoid sunscreen by wearing hats constantly to avoid future skin cancers? I am not fond of sunscreen because of the harmful chemicals, which is bad for people as well as the environment.
* Is there anything else I can do to help care for my face and avoid cancer in the future?
* What, if anything, is helpful when it comes to minimizing the scar after I get the stitches out?
* Is it possible to avoid sunscreen by wearing hats constantly to avoid future skin cancers? I am not fond of sunscreen because of the harmful chemicals, which is bad for people as well as the environment.
* Is there anything else I can do to help care for my face and avoid cancer in the future?
Best answer: You really need to use sunscreen AND protective shade, both while you are healing and in the future now that you know you are at risk.
I generally trust Dr. Dray on product-related topics, and she does a really good job explaining what each product does and the pros and cons.
I have a friend who had a pretty massive Mohs surgery on her forehead about a year pre-pandemic, and now in the mask era doesn't feel terribly awkward wearing an SPF fabric gaiter over most of her face, and wears an SPF balaclava on her motorcycle and while doing yardwork and similar around the house. (Those DO creep people out, way more than a gaiter.) She also wears a lot of lightweight SPF hiking clothing, or arm covers. Her bigger complaint about sunscreen is how much maintenance it takes for it to actually work and keep working, so covering is certainly something that should be a big part of your arsenal, but just wearing a hat doesn't protect the planes of your face from reflected UV from everything around you. You can minimize your use, though, with clothing.
posted by Lyn Never at 7:56 AM on May 17, 2022 [7 favorites]
I generally trust Dr. Dray on product-related topics, and she does a really good job explaining what each product does and the pros and cons.
I have a friend who had a pretty massive Mohs surgery on her forehead about a year pre-pandemic, and now in the mask era doesn't feel terribly awkward wearing an SPF fabric gaiter over most of her face, and wears an SPF balaclava on her motorcycle and while doing yardwork and similar around the house. (Those DO creep people out, way more than a gaiter.) She also wears a lot of lightweight SPF hiking clothing, or arm covers. Her bigger complaint about sunscreen is how much maintenance it takes for it to actually work and keep working, so covering is certainly something that should be a big part of your arsenal, but just wearing a hat doesn't protect the planes of your face from reflected UV from everything around you. You can minimize your use, though, with clothing.
posted by Lyn Never at 7:56 AM on May 17, 2022 [7 favorites]
Best answer: I've had two bits of melanoma removed from my face and neck, and the biggest difference between the two scars is the doctor who removed it. The first one I was referred to a plastic surgeon, and he did such a fantastic job that my dermatologist has a hard time finding the scar. The second one was removed by a dermatologist, and despite my liberal use of Mederma, I have a horrible keloid scar and it looks like someone tried to slit my throat open. If it's an option for you, please do speak to your doctor about your concerns of scarring and if it's possible to be referred to a plastic surgeon. It's not just vanity, my second scar is painful and itchy and I wish I would have advocated for myself better. The good news it that although where yours is located is very visible, it sounds like it's not in a spot that gets a lot of skin movement so it should have an opportunity to heal nicely.
posted by shornco at 8:03 AM on May 17, 2022 [5 favorites]
posted by shornco at 8:03 AM on May 17, 2022 [5 favorites]
Best answer: You really need to wear sunscreen. It will reduce your risk of further carcinomas, as well as help prevent hyperpigmentation of your scar.
The EWG page you linked to discusses mineral sunscreens as a safe alternative to chemical sunscreens. The article about the environmental toll also discussed chemical sunscreens as the issue. There are lots of great options for mineral sunscreens these days.
posted by bluloo at 8:15 AM on May 17, 2022 [5 favorites]
The EWG page you linked to discusses mineral sunscreens as a safe alternative to chemical sunscreens. The article about the environmental toll also discussed chemical sunscreens as the issue. There are lots of great options for mineral sunscreens these days.
posted by bluloo at 8:15 AM on May 17, 2022 [5 favorites]
Best answer: I think if you know you’re at increased risk of skin cancer, you could re-frame the potential for harm from sunscreen chemicals as a form of harm reduction relative to your known harm from the sun.
posted by nouvelle-personne at 8:20 AM on May 17, 2022 [8 favorites]
posted by nouvelle-personne at 8:20 AM on May 17, 2022 [8 favorites]
Best answer: You are an "n" of one, but you have already shown that your skin responds to sun damage by forming carcinoma. I would move forward and wear BOTH sunscreen and hats, and cover my exposed skin as much as possible.
My dermatologist told me that besides the face, the ankles, feet, and scalp are frequent sites for skin cancers, so a hat will reduce your scalp risk, and sunscreen on your legs and feet will reduce risk there. I got a squamous cell carcinoma on my collar bone and another on the back of a hand, areas I was not faithfully protecting with sunscreen.
My best friend is going through a hellacious ongoing plastic surgery ordeal to remove a basal cell carcinoma from the tip of her nose, which office-based Mohs surgery was unsuccessful (twice) in removing. The cancer had tentacles that reached inside her nostril; she has had to have extensive surgery to remove it (and part of the tip of her nose) including skin expanders and skin and cartilage grafts at an academic medical center, and she is in line for more reconstructive surgery to restore the appearance of her nose.
Agree with nouvelle-personne on the sunscreen issue. At this point nothing would deter me from daily sunscreen.
posted by citygirl at 9:24 AM on May 17, 2022 [2 favorites]
My dermatologist told me that besides the face, the ankles, feet, and scalp are frequent sites for skin cancers, so a hat will reduce your scalp risk, and sunscreen on your legs and feet will reduce risk there. I got a squamous cell carcinoma on my collar bone and another on the back of a hand, areas I was not faithfully protecting with sunscreen.
My best friend is going through a hellacious ongoing plastic surgery ordeal to remove a basal cell carcinoma from the tip of her nose, which office-based Mohs surgery was unsuccessful (twice) in removing. The cancer had tentacles that reached inside her nostril; she has had to have extensive surgery to remove it (and part of the tip of her nose) including skin expanders and skin and cartilage grafts at an academic medical center, and she is in line for more reconstructive surgery to restore the appearance of her nose.
Agree with nouvelle-personne on the sunscreen issue. At this point nothing would deter me from daily sunscreen.
posted by citygirl at 9:24 AM on May 17, 2022 [2 favorites]
Best answer: How do you feel about reef-safe mineral sunscreen? My understanding (as a sunburn-prone layperson) is that it’s better for the environment and our bodies because it is a physical sunscreen not a chemical one.
posted by sugarbomb at 9:26 AM on May 17, 2022 [5 favorites]
posted by sugarbomb at 9:26 AM on May 17, 2022 [5 favorites]
Best answer: Various mineral sunscreen use tests by middle aged woman who can’t tolerate chemical sunscreens well and is interested in cosmetically pleasing options playlist
posted by koahiatamadl at 9:51 AM on May 17, 2022 [1 favorite]
posted by koahiatamadl at 9:51 AM on May 17, 2022 [1 favorite]
Best answer: I agree with nouvelle-personne about reframing sunscreen as a form of harm reduction. My 85-year-old father has a quarterly dermatologist appointment to have precancerous lesions burned off his face and scalp with fluorouracil. Please take this seriously. We want you to stick around!
If you still live in the country in your profile, Suntribe is a locally made, reef-safe and cruelty-free non-nano SPF 30 zinc oxide (ZO) sunscreen.
The following alternatives are discussed in this post on r/NordicSkinCare, Allergic to all chemical sunscreens:
Avene Very High Protection Mineral Lotion SPF 50 (nano titanium dioxide: TiO).
Heliocare 360 Mineral Tolerance Fluid SPF 50 (nano ZO and TiO).
Drmtology Physical Universal Tinted Moisturizer SPF44 (ZO and TiO; nano or non-nano: N/A; available via drmtology.com).
Clinique SPF 50 Mineral Sunscreen Fluid for Face (TiO and nano ZO; available at Kicks).
Australian Gold Tinted SPF 50 (TiO and ZO; non-nano; available at amazon.se). A review by Emily of My Dad the Chemist, one of my favorite skin care bloggers.
posted by virago at 9:54 AM on May 17, 2022 [2 favorites]
If you still live in the country in your profile, Suntribe is a locally made, reef-safe and cruelty-free non-nano SPF 30 zinc oxide (ZO) sunscreen.
The following alternatives are discussed in this post on r/NordicSkinCare, Allergic to all chemical sunscreens:
Avene Very High Protection Mineral Lotion SPF 50 (nano titanium dioxide: TiO).
Heliocare 360 Mineral Tolerance Fluid SPF 50 (nano ZO and TiO).
Drmtology Physical Universal Tinted Moisturizer SPF44 (ZO and TiO; nano or non-nano: N/A; available via drmtology.com).
Clinique SPF 50 Mineral Sunscreen Fluid for Face (TiO and nano ZO; available at Kicks).
Australian Gold Tinted SPF 50 (TiO and ZO; non-nano; available at amazon.se). A review by Emily of My Dad the Chemist, one of my favorite skin care bloggers.
posted by virago at 9:54 AM on May 17, 2022 [2 favorites]
Best answer: Hats can help but you probably will also need a sunscreen.
Do Hats and Umbrellas Protect You Enough From the Sun?
Some sunscreen ingredients are potentially bad for the environment, but not all of them. Nor is it as simple as "chemical sunscreens bad, mineral sunscreens good": both chemical and mineral screens show potential (in high concentrations) to affect coral bleaching.
I've been getting a bit into skincare recently and apparently there have been a lot of improvements to sunscreen formulation in recent years, so if you look around a bit you can probably find one that meets your needs while keeping you safe. Check out the description in the second video link for some sunscreens that don't contain coral bleaching actives.
posted by radiogreentea at 10:24 AM on May 17, 2022 [1 favorite]
Do Hats and Umbrellas Protect You Enough From the Sun?
Some sunscreen ingredients are potentially bad for the environment, but not all of them. Nor is it as simple as "chemical sunscreens bad, mineral sunscreens good": both chemical and mineral screens show potential (in high concentrations) to affect coral bleaching.
I've been getting a bit into skincare recently and apparently there have been a lot of improvements to sunscreen formulation in recent years, so if you look around a bit you can probably find one that meets your needs while keeping you safe. Check out the description in the second video link for some sunscreens that don't contain coral bleaching actives.
posted by radiogreentea at 10:24 AM on May 17, 2022 [1 favorite]
Best answer: I'm glad you've had the good news of removing these carcinomas. Can you please be brave for this internet stranger and choose the safer option of sunscreen over more carcinoma?
There's should be non-oil and moisturising sunblock available, factor 30 and factor 50, and you can certainly wash it off with your normal skincare program.
posted by k3ninho at 11:36 AM on May 17, 2022 [2 favorites]
There's should be non-oil and moisturising sunblock available, factor 30 and factor 50, and you can certainly wash it off with your normal skincare program.
posted by k3ninho at 11:36 AM on May 17, 2022 [2 favorites]
Best answer: I've had skin cancer too (not the same kind, unfortunately) and several face biopsies. I had a great dermatologist, and the scar always healed to almost nothing. My doctor had had some plastic surgery training so maybe this helped? That said, I've also had extensive radiation on my face that charred it and let me tell you, it went back to normal after a few months. Faces heal exceptionally well. (Other parts of my body have not -- this is normal.)
And let me tell you from my sad and sorry experience, you must wear sunscreen. Reef-safe, mineral, all great and safe for you and the world. Even if you went with a traditional sunscreen, don't apologize -- this is just not a time to put fears of chemicals and a small effect on the environment above your life -- and I do mean life.
posted by heavenknows at 12:08 PM on May 17, 2022 [1 favorite]
And let me tell you from my sad and sorry experience, you must wear sunscreen. Reef-safe, mineral, all great and safe for you and the world. Even if you went with a traditional sunscreen, don't apologize -- this is just not a time to put fears of chemicals and a small effect on the environment above your life -- and I do mean life.
posted by heavenknows at 12:08 PM on May 17, 2022 [1 favorite]
Best answer: Joining the chorus about applying sunscreen while on land to avoid additional UV-caused troubles. The Consumer Reports' article about sunscreen's detrimental effects is relevant only if you're going to swim, snorkel or scuba dive among coral reefs. If you swim among the coral reefs, showering to wash off the sunscreen immediately before diving and then immediately re-applying sunscreen afterwards is an option. The Consumer Reports' suggestion [wearing coral reef diving clothing in lieu of sunscreen (third paragraph of the article's sixth section)] provides another option while diving the coral reefs. I don't think there's been any studies identifying coral reef harm coming from sunscreens' manufacture. I don't think there are any coral reefs in Sweden either.
posted by dlwr300 at 12:24 PM on May 17, 2022 [1 favorite]
posted by dlwr300 at 12:24 PM on May 17, 2022 [1 favorite]
Best answer: I haven't tried it myself, but NeoGenesis Recovery has good reviews for scars:
Link
For facial sunscreen, I like Canmake Mermaid.
posted by bangles at 1:22 PM on May 17, 2022 [1 favorite]
Link
For facial sunscreen, I like Canmake Mermaid.
posted by bangles at 1:22 PM on May 17, 2022 [1 favorite]
Response by poster: I love AskMetafilter so much. Thanks to each of you who commented. Your advice makes me feel loved and nurtured in the face of something that is uncomfortable and scary. Each of your comments have been helpful.
A special shout out to Lyn Never, nouvelle-personne, citygirl, and virago for helping shift my perspective. I just ordered some Avene Very High Protection Mineral Lotion SPF 50 to try; if that is not a good fit, I will move down the list.
This forum may be extending my lifespan, which I appreciate. I didn't want to take meds to lower my blood pressure, did an Ask about it, and y'all convinced me my concerns were misguided. I've been on the meds for a year or so and my blood pressure is great. Harm reduction is a smart reframing that I would never have thought of myself. Thanks, again!
posted by Bella Donna at 1:55 PM on May 17, 2022 [17 favorites]
A special shout out to Lyn Never, nouvelle-personne, citygirl, and virago for helping shift my perspective. I just ordered some Avene Very High Protection Mineral Lotion SPF 50 to try; if that is not a good fit, I will move down the list.
This forum may be extending my lifespan, which I appreciate. I didn't want to take meds to lower my blood pressure, did an Ask about it, and y'all convinced me my concerns were misguided. I've been on the meds for a year or so and my blood pressure is great. Harm reduction is a smart reframing that I would never have thought of myself. Thanks, again!
posted by Bella Donna at 1:55 PM on May 17, 2022 [17 favorites]
Best answer: Boy, do I feel you. I’ve had Mohs surgery twice on my face now, and I have a new spot on my head that’s about an inch from one scar from a previous surgery that I’m going to have to deal with in a few weeks.
Both of the scars are fairly visible because they’re quite white, and the one on my cheek is in the middle of a lot of damage to the blood vessels or capillaries or something and I just hate looking at them so much.
It took me almost 2 years to pay off the surgeries I had in 2020, so plastic surgery isn’t really an option for me financially, but if it is for you, definitely ask them if they don’t bring it up themselves. There are also things like chemical peels and lasers. At some point I would like to do something like that to minimize these because I’m starting to feel like Frankenstein‘s monster.
I have used Mederma many times before but to be honest it isn’t really effective, and I haven’t been able to find any real convincing proof that it does work. But I think it doesn’t hurt to try something and I always try to massage at least something into my skin as the scars heal.
But you definitely have to wear sunscreen and hats and sunglasses and things, and the other element to consider is how much sun exposure you had when you were younger. A lot of what happens to skin in later age is damage from years and years ago—some of us are just genetically doomed to have this happen, so do whatever extra you can to avoid it.
posted by kitten kaboodle at 2:21 PM on May 17, 2022 [1 favorite]
Both of the scars are fairly visible because they’re quite white, and the one on my cheek is in the middle of a lot of damage to the blood vessels or capillaries or something and I just hate looking at them so much.
It took me almost 2 years to pay off the surgeries I had in 2020, so plastic surgery isn’t really an option for me financially, but if it is for you, definitely ask them if they don’t bring it up themselves. There are also things like chemical peels and lasers. At some point I would like to do something like that to minimize these because I’m starting to feel like Frankenstein‘s monster.
I have used Mederma many times before but to be honest it isn’t really effective, and I haven’t been able to find any real convincing proof that it does work. But I think it doesn’t hurt to try something and I always try to massage at least something into my skin as the scars heal.
But you definitely have to wear sunscreen and hats and sunglasses and things, and the other element to consider is how much sun exposure you had when you were younger. A lot of what happens to skin in later age is damage from years and years ago—some of us are just genetically doomed to have this happen, so do whatever extra you can to avoid it.
posted by kitten kaboodle at 2:21 PM on May 17, 2022 [1 favorite]
Product recommendation : been using Cotz brand sunscreen since 2016 -- it's an all physical reef safe sunscreen with no white cast and I love using it, and I have always strongly disliked chemical sunscreen.
posted by yueliang at 7:42 AM on May 18, 2022 [2 favorites]
posted by yueliang at 7:42 AM on May 18, 2022 [2 favorites]
This thread is closed to new comments.
posted by Blue Jello Elf at 7:39 AM on May 17, 2022 [1 favorite]