What Is Facial & Eyelid Skin Cancer?
Skin cancer commonly involves eyelid skin and adjacent facial areas. The most common location for eyelid skin cancer is the lower eyelid it typically presents as a painless, elevated nodule. Basal cell carcinoma is the most common type of eyelid skin cancer. The second most common type of eyelid skin cancer is squamous cell carcinoma, with melanoma being the third most common. Basal cell and squamous cell carcinoma are typically slow growing, and tend to invade locally. Melanoma and sebaceous cell carcinoma are more aggressive types of eyelid skin cancer, and can potentially metastasize (spread to other parts of the body) and lead to further problems. It is imperative to diagnose eyelid skin cancer and facial skin cancer as soon as possible so that prompt surgical intervention can be utilized.
What Kind of Symptoms would Patients have with Facial & Eyelid Skin Cancer?
Signs and symptoms of eyelid skin cancer include missing eyelashes, ulceration, bleeding and crusting, as well as any increase in size of any eyelid or facial lesions. Patients who have fair skin, blue eyes, and red or blonde hair have an increased risk for facial skin cancer. Patients who have a history of prolonged sun exposure during the first two decades of life are also at an increased risk for facial skin cancer. It should also be noted that patients with a history of prior basal cell carcinoma have a higher probability of developing skin cancers in the future.
What Causes Facial & Eyelid Skin Cancer?
Risk factors such as fair skin, blue eyes, history of prolonged sun exposure, and cigarette smoking, all increase the risk of facial and eyelid skin cancer. It has been estimated that 40-50% of fair skinned people who reach the age of 65% will eventually develop at least 1 skin cancer. Facial skin cancers may arise from preexisting lesions such as actinic keratosis, and can also arise from cutaneous horns, which is a funnel shaped growth that extends from a red base on the skin.
Regarding melanoma, a skin care specialist should examine any mole or freckle that looks different from others, and has any characteristics of the ABCDE classification. A represents any asymmetry, which means one half of the mole does not match the other half. B is for border, if the border edges of the mole are blurred or irregular. C is for color, which is a mole that does not have the same color throughout. D is for diameter; a mole is suspicious if the diameter is larger than a pencil head eraser. E is for evolving; a mole that is growing larger or changing color, or is beginning to itch or bleed should also be checked. If a patient notices any characteristics of the ABCDE classification in any moles on the face, then the patient should seek further evaluation. As discussed, melanoma is not as common as the other types of skin cancer, but it is potentially much more serious.
Squamous cell carcinoma may appear as a firm red nodule, or a scaly growth that bleeds or develops a crust. Basal cell carcinoma is the most common type of skin caner on the eyelids and face and it tends to spread slowly. Basal cell carcinoma can present as a pearly white or waxy bump, often times with visible blood vessels. Sun exposure is the number one cause of skin cancer. Other exposures to environmental hazards, radiation treatment, and even hereditary treatment can also play a role. Approximately 90 to 95% of malignant eyelid tumors fall into the basal cell carcinoma category, with the lower eyelid being the most common site.
What Is The Treatment for Facial & Eyelid Skin Cancers?
The most common treatment for eyelid and facial skin cancer is surgical excision with reconstruction. Typically, any lesions that are suspicious or exhibit any of the factors discussed under the ABCDE classification require a biopsy to rule out skin cancer. At the Mack Center, this is performed in the office under local anesthetic. Oftentimes, patients are referred to the Mack Center from their dermatologist, or other health care provider after they have already had a biopsy proving skin cancer on the eyelid or facial regions.
Following pathological confirmation of the skin cancer, the patient will be scheduled for surgical excision with reconstruction. This can be done under Frozen Section or Mohs Technique. With Frozen Section, the cancer is removed and the pathologist confirms that the margins are free of cancer while the patient is in the operating room, and reconstruction occurs at that time. Excision of skin cancer with Mohs Technique is performed by a dermatologist who confirms that all the margins are free of tumor, and Dr. Mack sees the patient for the reconstruction of the eyelid or facial defect. Both of the techniques confirm that the skin cancer is completely excised. Dr. Mack will choose the reconstructive surgical technique based upon the size and location of the eyelid or skin cancer
What Type of Anesthesia is used for Facial & Eyelid Surgical Correction?
IV sedation (MAC anesthesia), also called “twilight anesthesia” is the anesthesia of choice for the surgical excision/ reconstruction of eyelid and facial skin cancers. These surgeries are performed on an outpatient basis at a local surgery center. MAC anesthesia is a technique where the anesthesia team administers small increments of a sedative to allow the patient to be relaxed so that local anesthetic can be administered for the patient’s comfort. Patients at the Mack Center find this to be a pain-free procedure.
What is the Recovery Time Following Facial & Eyelid Surgical Correction?
The patient is instructed to apply an antibiotic ointment for the first week and as to limit lifting bending and straining. Sutures are typically removed at approximately one week. Dissolving sutures can also be used in certain surgical interventions. Post-operative evaluations are performed at the Mack Center. Typically for the first 1-2 months following surgical excision, it is very important that the patient follows up very closely to monitor for any potential recurrence of the skin cancer.
What Can a Patient Expect Following Surgical Correction of Facial & Eyelid Skin Cancer?
Following the surgical procedure, the patient will notice swelling and bruising which will continue to improve on a day-by-day basis. Following suture removal, the patient is seen for follow-up evaluations to monitor for any recurrence of the facial skin cancer. The patient is also asked to monitor the areas at home, and a follow-up examination with the patient’s dermatologist or other health care provider is also recommended.
For more information on Tampa plastic surgery and skin cancer removal, contact Dr. Mack’s office to schedule a consultation today.
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