Mohs surgery Archives | Water's Edge Dermatology

What Does Lip Cancer Look Like?

Medical Review By: Thomas Pham, MD

Your lips are important for lots of things, including chewing and kissing. While the occasional cold sore or cause of chapped lips is annoying, lip cancer is another story entirely.

Lip cancer in its early stages is hard to notice, but that’s when it’s most treatable. By the time a lip tumor becomes obvious, cancer requires more invasive treatment, and it may spread to other parts of your body.

If you get a lot of sun exposure, or you smoke, chew tobacco, or drink heavily, it’s time to learn how to spot it.

Types of lip cancer

Lip cancer usually takes the form of squamous cell carcinoma. This type of cancer occurs in the squamous cells, which are thin, flat cells found in the middle and outer layers of the skin. Squamous cell cancer of the lip is much more aggressive than squamous cell cancer found in other places of the skin. It’s more likely to spread to the head and neck and harder to treat.

Much less frequently, lip cancer is melanoma, one of the deadliest types of cancer.

Lip cancer symptoms

The lower lip is more vulnerable to lip cancer because it gets more sun exposure than the upper lip. Symptoms to watch for include:

A sore, ulcer or lesion on your lip that doesn’t heal (a cold sore, unlike lip cancer, does heal)
A lump or thickened area on the lip
Whitish or reddish patches on the lip
Lip pain, bleeding or numbness
A lump in your neck or swollen glands
Jaw swelling or tightness

A precancerous condition that can lead to squamous cell cancer of the lip is actinic cheilitis. Symptoms include:

Scaly whitish patches on the lip
Dryness or peeling that won’t heal
A rough, sandpapery texture
Blurring of the border between the lip and the adjacent skin
Loss of color in the skin of the lip
Swelling or redness of the lip

Who gets lip cancer?

UV radiation from spending a lot of time in the sun or using tanning beds is the leading cause of lip cancer. Certain habits, such as smoking or chewing tobacco and excessive drinking, also increase the risk.

Other risk factors for lip cancer include having a weakened immune system, having fair skin, being over 40 years old, and being infected with certain strains of human papillomavirus (particularly strains 16 and 18). Lip cancer is more common in men, possibly because they are more likely to work outdoors and less likely to use lip balm with SPF. They may also be more likely to have smoked or consumed too much alcohol in the past.

Recent research suggests that taking hydrochlorothiazide, a diuretic, is strongly associated with an increased risk of developing lip cancer. This drug is used alone or in combination with other medications to treat high blood pressure.

Lip cancer treatment

Lip cancer is usually curable; most people survive it and have a good outcome after treatment.

The doctor may recommend Mohs surgery to remove the tumor. In this procedure, the surgeon gradually removes layers of the tumor and a small amount of tissue surrounding it, checking each layer for cancer cells. The surgery ends when cancer cells can no longer be detected under a microscope. Mohs surgery lets surgeons identify and remove tiny roots of cancer, which helps prevent it from spreading to other parts of the body.

Advanced cases are usually treated by an ear, nose, and throat doctor (ENT). Radiation and/or chemotherapy may be used in conjunction with surgery. In rare cases, radiation “seed” therapy is used to treat patients who opt out of surgery. Reconstructive surgery may be necessary to repair the lip.

Protect your lips by following these tips:

Wear lip balm with SPF. Choose a lip balm with an SPF of at least 30 and wear it whenever you go outside. A wide-brimmed hat is also a good idea.

Don’t use tanning beds. Indoor tanning isn’t any safer for your skin than lying in the sun.

Limit or quit smoking and drinking. This is especially important if you drink and also smoke. These habits together put you at much higher risk for lip cancer than either habit alone.

See your dentist regularly. Dentists are often the ones to detect lip cancer, so keep up with routine cleanings and exams.

If you notice any unusual changes in your lip when you look in the mirror, don’t panic. But if something looks or feels different and the problem doesn’t resolve quickly, call your dermatologist ASAP. Treating lip cancer early means less risk of spoiling your smile.

Article Written By: Jessica Brown, a health and science writer/editor based in Brooklyn, New York. She has written for Prevention magazine, jnj.com, BCRF.org, and many other outlets.

by Bishara Gattas

Mohs Surgery for Skin Cancer Treatment

Updated May 19, 2020

The number of people developing skin cancer has been increasing for decades, to the point that skin cancer is now the most common cancer in the United States. Every day, more than 95,000 people are diagnosed with the disease, and one in five people will develop it in their lifetime.

Most cases are slow-growing nonmelanoma skin cancers like basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).

Sun exposure and indoor tanning are the biggest risk factors for developing these skin cancers, and most of them form in areas that get the most sun, such as the head and neck. For people who develop BCC, SCC or some early melanomas, Mohs (pronounced “moes”) surgery is a very effective treatment, with a cure rate of up to 99 percent according to the Skin Cancer Foundation. The technique also provides the best cosmetic results of any skin cancer treatment.

What is Mohs surgery?

Mohs surgery, also known as Mohs micrographic surgery, is a technique invented by Dr. Frederic Mohs in the 1930s. Since being refined in the 1970s, it's become a mainstream treatment for skin cancers on the head and neck.

Mohs surgery differs from more routine skin cancer removal surgery in that it's done in stages. After the surgeon removes a layer of tissue, he or she examines it under a microscope to see whether it contains cancer cells. The process is repeated until no more cancer cells are found. This way, healthy tissue is spared, and the scar is minimized.

In Mohs surgery, all of the edges (called "margins") of the removed tissue are evaluated, which is not the case with conventional surgery according to Dr. Justin Platzer, a board-certified dermatologist at Water's Edge Dermatology. In conventional surgery, "[the sample] is cut differently, and it's only a small fraction of the margin that's evaluated, so you can miss tumors." By contrast, he said, "Mohs surgery allows for recurrence rates of tumors to be as low as 1 percent."

How does Mohs surgery work?

After injecting a local anesthetic to numb the skin, the surgeon removes the visible portion of the cancer along with a thin segment of surrounding skin and examines it under a microscope. Water's Edge Dermatology has an onsite pathology lab where samples are read immediately, and patients learn the results throughout the procedure. (Patients who undergo traditional skin cancer surgery can wait up to a week to get pathology results indicating whether or not the cancer is gone.)

If the sample contains cancer cells, the surgeon removes an additional layer of skin and sends it back to the lab. "If it’s positive [for skin cancer] in just one area, you’re able to take a little more of the skin only in that area, so it keeps the wound smaller," explained Dr. Platzer. This process is repeated until the margins are clean, meaning that no cancer cells remain. Most patients need only two rounds to remove all the cancerous tissue. The procedure lasts a few hours.

After the cancer is removed, the surgeon will decide whether and how to repair the wound. Smaller wounds are often left to heal on their own. Larger wounds may require stitches or even skin grafts. At Water's Edge Dermatology, surgical removal, lab evaluation and wound reconstruction are done in one visit in most cases. When patients walk out of the surgery, they have peace of mind knowing that their cancer is fully treated.

Who should have Mohs surgery?

Mohs surgery is typically recommended for nonmelanoma skin cancers in places where you want to preserve as much healthy tissue as possible to maintain maximum function and provide a good cosmetic result, such as around the eyes, ears, nose, mouth, hands, feet and genitals. Mohs is also used to treat cancers that:

Returned after initial treatment
Have a high risk of recurring
Weren’t completely removed by other treatments
Are large or aggressive

Will Mohs surgery leave a scar?

All surgical procedures have the potential to leave a scar. Mohs surgery often results in smaller, less noticeable scars than other skin cancer removal methods. Most scars improve in appearance naturally over time. "It takes a full year for scars to fully heal, but most scars from Mohs surgery start looking cosmetically acceptable after four to six weeks," said Dr. Platzer.

Is Mohs surgery covered by insurance?

Most insurance plans, including Medicare, cover Mohs surgery. Check with your insurance provider to confirm that Mohs is covered under your plan.

What should I do if I am concerned about possible skin cancer?

If you have a suspicious area on your skin, make an appointment to have it evaluated as soon as possible. If the dermatologist suspects skin cancer, he or she may perform a biopsy for further examination.

Don't think you’re too young for skin cancer. Nonmelanoma skin cancers typically appear after age 50, but even people in their 20s and 30s can develop them, according to Dr. Platzer. "It takes a while to develop a BCC or SCC, so people usually have to be pretty fair-skinned and have significant amounts of sun damage to have it when they're very young, but it's definitely possible to get it then."

To book an appointment for a skin evaluation, call (877-544-3880) or request one online. It’s a good idea to have your skin examined at least one a year. The sooner skin cancer is detected and treated, the better the chances of a complete cure, and the lower the chances of disfigurement.

by Bishara Gattas

Skin Cancer Treatment

There are treatments for skin cancer. Everyone can get skin cancer, no matter how light or dark your skin may be. Exposure may come from UV rays, X-rays, genetics, a weak immune system, scarring from bad burns, cancer-causing compounds such as arsenic, sunburns, and the use of tanning beds.

You aren’t alone. Water’s Edge medical dermatologists are here to provide you with compassionate and thorough care.

Treatments

Excision: Dermatologists will numb the skin and surgically remove the cancer along with a small bit of healthy skin around the area. The small bit of skin is called a margin.

Mohs Surgery: Performed by dermatologists who have received special training, this procedure involves taking layers of skin from the cancerous area layer-by-layer until the current layer is cancer-free. The dermatologist will scrutinize the skin layers through a microscope to determine if another layer needs taken.

Curettage and Electrodesiccation: This process involves scraping off a bit of skin from the top layer of the cancer and then gently cauterizing the remaining cancer cells. This treatment typically needs to be repeated three times.

Other Treatments

Immunotherapy: Doctors will use the patient’s own immune system to fight the cancer.

Cryosurgery: Freezing the cancer cells and allowing them to slough off.

Chemotherapy applied to the skin: Physicians will apply medicine to the skin cancer and it will destroy the cancer cells.

Chemotherapy: Medicine used when the skin cancer goes beyond the skin.

Photodynamic Therapy: This process involves a chemical peel and exposure to a special light.

Radiation Therapy: Radiation may be used for large areas of skin cancer on older adults.

With dermatology centers throughout southeast Florida, Water’s Edge Dermatology can help you. Request a skin cancer screening today. Prevent skin cancer now by performing a self-exam on your skin.

by Bishara Gattas

Mohs Surgery for Skin Cancer Treatment

Skin cancer is the most common type of cancer in the United States. And skin cancer rates are increasing in all races across the country.

At Water’s Edge Dermatology, our specially trained providers perform Mohs Surgery to treat skin cancer. Mohs micrographic surgery is a specialized, highly effective technique for the removal of skin cancer that is practiced throughout the world.

Here’s what Water’s Edge Dermatology patients are saying about Mohs Surgery.

Mohs Surgery permits the immediate and complete microscopic examination of the removed cancerous tissue, so all “roots” and extensions of the cancer can be eliminated. Due to the methodical manner in which tissue is removed and examined, Mohs surgery has been recognized as the skin cancer treatment with the highest reported cure rate.

Talk to your Water’s Edge Dermatologist about Mohs Surgery, or schedule your appointment for a skin cancer screening today.

Learn more about the types of skin cancer and skin cancer treatments.

by Bishara Gattas