the pimple that's not a pimple

It seems like a pimple on the nose.  Only it's been there for 3 months.  And sometimes it bleeds.  And when squeezed, nothing seems to come out of it.  What's up with this wierd pimple?

This "pimple" has a funny name.  It's called basal cell carcinoma.  And it's not a pimple; it's a skin cancer.  The most common type of skin cancer, in fact.  According to the Skin Cancer Foundation, an estimated 2.8 million are diagnosed annually in the US (check out http://www.skincancer.org/Skin-Cancer-Facts/ for some great info).  It tends to show up on sun exposed areas, like the nose, ears, and chest.  Although it almost always is limited to the skin, basal cell carcinoma can be locally destructive if not treated. 

Depending on the type and location of the basal cell carcinoma, different treatment options can be used.  Superficial basal cells may be treated with a cream called imiquimod that is applied 5 times a week for 6 weeks.  Or, a scraping procedure called electrodessication and curettage (ed&c) can be performed in the dermatologist's office.  Larger or infiltrative basal cells can be excised in the office under local anesthesia by the dermatologist.  Very large basal cells, or ones located on the nose, lips, ears, or close to the eyes, where there is not a lot of tissue available, may be removed by the Mohs procedure.  This is a special type of skin cancer surgery where tissue is removed and checked under the microscope while the patient is still in the office.  Once the Mohs surgeon has determined that all the skin cancer has been removed, the area is stitched up.  Mohs surgery has a very high cure rate.  Usually dermatologists who perform this procedure have an additional year of training after residency to become experts in Mohs.      

Once someone has had one basal cell carcinoma, they are 50% more likely to develop a second one.  As this type of skin cancer is directly related to sun exposure, protecting your skin from the sun is a great way to prevent their development.  Proper sunscreen use of a broad spectrum UVA/UVB sunblock is essential.  Clothing, such as hats and shirts, that are specially treated to have a UPF (ultraviolet protection factor) of 50+ can really help protect your skin from the sun.  See my recent interview on NBC6 on sunprotective clothing on our website, www.southbeachdermatology.biz for more information. 

Any "pimple" that doesn't go away, bleeds, itches, crusts, or grows needs to be seen by a dermatologist to make sure it's not a skin cancer ASAP.  Remember, one in five Americans will develop skin cancer in the course of a lifetime.  Stay on top of your skin - it's the only one you have!