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Skin

Skin Cancer Awareness Month with Dr. Overman from Dermatology of The Rockies

TELL US A LITTLE ABOUT YOURSELF AND SKIN CANCER AWARENESS MONTH? 

Dr. Overman: I am a board-certified dermatologist and fellowship-trained Mohs micrographic and reconstructive surgeon, which means I have the highest level of training in identifying and removing skin cancers with the most effective method, Mohs surgery. I also have extensive training in reconstructing the face, head, neck and body using plastic surgery techniques after skin cancer has been removed. By using the Mohs method I can remove 100% of the cancer while leaving behind as much normal surrounding skin as possible. This leads to smaller scars and higher cure rates than traditional methods of skin cancer treatment. 

Skin Cancer Awareness Month is an important effort to educate the public about the importance of yearly skin checks and the prevalence of skin cancer. Simply knowing what skin cancers look like and how common they are can lead to earlier treatment, smaller surgeries and higher survival rates. Early detection and treatment can be critical to saving lives.

WHAT’S UNIQUE ABOUT MOHS SURGERY?

Dr. Overman:  First, instead of simply taking a predefined wide margin around the tumor and closing the site immediately without knowing if the tumor is completely gone (which means coming back for another surgery), the Mohs method involves initially taking just 1-2mm around the tumor. I examine it under a microscope to look at 100% of the peripheral and deep margin, making sure no cancer remains. This thorough examination of the margins leads to the highest cure rates of any skin cancer removal method, providing an almost 99% cure rate. (In traditional methods, the tissue is sent out and less than 1% of the margins are examined.) If any of the margins are positive, I take another 1-2mm area of tissue just where it is still positive, preserving the normal surrounding tissue. When I determine the margins are clear, I use the best plastic and reconstructive surgery techniques available for the smallest, least conspicuous scar possible. By acting as surgeon and pathologist, a Mohs surgeon is uniquely qualified to perform this procedure. This is all done onsite under local anesthesia without the increased costs, risks and downtime of general anesthesia. Only Board-Certified Dermatologists can perform Mohs Surgery, and it's best to find a member of ACMS (American College of Mohs Surgery) which means they completed an intensive, accredited fellowship after their three-year residency performing 1,000-2,500 cases under the supervision of a senior Mohs Surgeon. I have performed over 4,000 cases to date and look forward to providing world-class care to my Boulder County patients. 

HOW CAN YOU PREVENT SKIN CANCER? 

Dr. Overman: The easiest answer is stay out of the sun, but for most of us, that’s not a reasonable answer. I love hiking, mountain biking, skiing, going to the beach and being outdoors. As with most things in life, moderation is key. Spending more time in the shade during peak sun hours from 10 a.m.-2 p.m. is a good start. Wearing long sleeves and a wide-brimmed hat are great ideas. The last line of defense is wearing sunscreen. Just like brushing your teeth, putting on a daily moisturizer/sunscreen combo on your face, ears and neck should be a part of everyone’s daily routine. I treat hundreds of skin cancers on the lips and ears every year, so make sure you apply sunscreen there too. My patients who do this every day look 10-15 years younger and have significantly fewer cancers than their counterparts who do not. 

WHAT ARE YOUR TOP 5 THINGS TO DO TO TAKE CARE OF YOUR SKIN? 

Dr. Overman: 

1) Put on facial moisturizer with SPF 30 or greater every day.

2) Use retinol or prescription retinoid cream every night before bed. 

3) Avoid abrasive face washes, usually gentle face washes get the job done.

4) Reapply sunscreen every 2 hours when outside or every time you get out of the water.

5) Consider a laser treatment from a board-certified dermatologist once a year to help rejuvenate your skin and build collagen.

WHAT SUNSCREEN BRANDS AND INGREDIENTS DO YOU RECOMMEND? 

Dr. Overman: Make sure it's a broad-spectrum SPF 30 or greater and apply it liberally. From peer-reviewed research, we know there is benefit to getting a higher 50-70 SPF because most people do not put on enough sunscreen, effectively cutting the true SPF in half. When I’m at the beach or pool, I’m going through a lot of sunscreen. My go-to is Neutrogena SPF 50 or 70 for my body and Elta MD sunscreen for my face. If you get a spray, make sure you rub it in. If you're acne prone or have sensitive skin or melasma, using a physical blocking sunscreen containing zinc oxide or titanium dioxide is best. In the end, the best sunscreen is the one you’re going to use.

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