How Not to Get Skin Cancer

Three dermatologists who’ve beaten the disease share their (sometimes unconventional) approaches to staying healthy and preventing recurrence

By Michele Bender
Photograph: Photo courtesy of Iphoto

A sobering statistic: You have a one in two chance of getting skin cancer by the time you’re 65—even
if you haven’t baked at the beach in decades. But America’s most common cancer is usually treatable and, even better, it’s still preventable (even af

Cheryl Karcher, MD, 50 
Cosmetic and general dermatologist
New York City
Growing up in Daytona Beach, Florida, Cheryl Karcher was a sun worshipper who walked around with a tan nearly 365 days a year. “I never wore sunscreen, and as a teen, I magnified the sun’s rays with baby oil and a reflector,” she admits. And although she eventually put down that reflector, she remained careless throughout her twenties. By the time she started protecting her skin in her thirties, she was a newly minted dermatologist—but she had already set herself up for cancer, because she’d been exposed to a great deal of sun both as a child and as a young adult.While conventional wisdom has long held that only childhood sun exposure (which causes changes in skin cells) counts in the development of cancer, experts now believe that continuing exposure after age 18 is most likely to transform your damaged cells into cancerous ones.
For Karcher, the first damage took place during childhood, and the second in her twenties. Whatever her history, at age 46 Karcher discovered a skin-colored, pencil eraser–size bump on her chest. “To the untrained eye, it would look like nothing,” she recalls. “But as a dermatologist, I knew it was a basal cell carcinoma.” Basal cell carcinoma (BCC), the most common form of skin cancer (diagnosed in one million Americans every year), is rarely fatal but can cause disfigurement.

How she treated it

Knowing that surgical removal of the cancerous bump was likely to leave a scar (the skin on the chest is
very thin and typically heals poorly), Karcher opted instead to treat the spot with Aldara Cream, a prescription medication that’s approved by the FDA to treat superficial BCC, common precancerous spots (called actinic keratoses) and genital warts. The drug works by activating the body’s immune cells in a specific area of the skin.For up to five nights a week for about six weeks, Karcher slathered the bump with Aldara, which left the area temporarily red, itchy and swollen. “It wasn’t pretty,” Karcher recalls. “But once I knew the Aldara had produced an ulcer deep enough to get rid of the basal cells, I stopped applying the cream and let the area heal. I do have a tiny scar, but it’s barely noticeable.” Just three weeks later, she used the same cream again—to treat a BCC she discovered on her left arm. “It’s been three years and neither skin cancer spot has returned,” says Karcher, who cautions that people who do not hold medical degrees should only use Aldara under a der­matologist’s supervision.

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