The Skin Cancer Selfie


In 2015 I posted a selfie on Facebook. It wasn't a very pretty one. I had been using Imiquimod on my face for weeks to treat several AK's and superficial basal cell carcinomas. Scabbed and inflamed, I was miserable from the treatment and felt compelled to share a picture of my face, hoping that I may deter just one person from tanning. That selfie went viral. There were articles written, questions asked, praise given, and a lot of judgement. I accepted interviews and responded to as many messages as I could, but I feel like a comprehensive post about this experience could be helpful for those who are interested in knowing more about the treatment, my experience, and "the skin cancer selfie."




As I have mentioned in my previous posts, I was an avid tanner in high school and had been diagnosed with basal cell carcinoma early into my 20's. Over time, the number of lesions surprised my dermatologists and their location made complete removal challenging. When I went to my annual skin exam in 2015, I had several spots on my face, and three distinct spots on various parts of my body which were worrisome. One of the most frequent questions I am asked is what the lesions looked like before they were examined or treated. The lesions on both my calf and collarbone were flat, red, shiny spots which were growing slowly. The lesion on my collarbone had appeared just a few months prior to this exam. On my shoulder was a raised, red, shiny spot that sometimes bled and crusted. There were two distinct types of "spots" on my face. The first was small, scaly, and persistent patches that did not change much over time. The second type of lesion was red sores that were also persistent, but were slowly evolving or growing.

We opted for a round of a topical cream called Imiquimod to treat the lesions on my face, and used liquid nitrogen to freeze the lesion on my collarbone. Shave biopsies were obtained from my shoulder and calf, the results would be available within 7-10 days.

Imiquimod, the generic form of Aldara, is an immune response modulator. The cream stimulates your immune system to destroy cancerous cells where it is applied. If there is cancerous growth, your skin should react - it means that the cream is working. The reaction includes redness, swelling, burning, itching, and tenderness; and I experienced them all. The cream was to be applied five nights per week for six weeks. I documented my treatment daily using photos and notes. My expectation was to have a mild reaction and was prepared for some irritation, but with each application the reaction became worse. As shocked as I was, I was also grateful to be treating the cancerous lesions on my face.

About a week after my appointment, I got the call verifying that the two biopsies were, in fact, cancerous: basal cell carcinoma on my left shoulder and squamous cell carcinoma on my right calf. I had gotten used to the basal cell diagnosis and almost expected it, but this was my first squamous cell carcinoma diagnosis. Basal cell carcinoma is highly curable, very slow growing and the most common type of skin cancer. Squamous cell carcinoma also has a high cure rate, but it has a higher chance of spreading and can grow faster. I was alarmed by my squamous cell diagnosis and felt as if I was one step closer to Melanoma. At a little over a week into my Imiquimod treatment, I returned to the office to have the basal cell lesion completely excised and the squamous cell lesion treated with electrodessication and curettage.


Left Shoulder Excision



I was vigilant with the Imiquimod treatment for the full six week period. As I continued, my skin reactions grew stronger and I was advised by my dermatologist to take breaks from treatment for 1-2 days at a time as needed if the side-effects became intolerable. Irritation, redness, itching, burning, swelling, headache, fatigue, nausea and flu-like symptoms - I experienced them all during the treatment, but my face completely healed on its own within a week of finishing the therapy. I was shocked and relieved to be left with little to no scarring over the areas where the reaction was most severe; just soft, reddish skin. The redness faded over the next few month and now, three years later, most of it is completely undetectable except for a few pink areas on my nose and cheeks.


2 weeks of treatment

4.5 weeks of treatment

5 weeks of treatment

10 days post treatment



Since my photo went viral three years ago, I have moved back to my home state of Kentucky, started a new job as a nurse, and underwent numerous changes in my personal life. The skin cancer journey, however, continues with every annual exam. Every year my dermatologist and I scrutinize, biopsy, and treat various growths, spots and lesions on my skin. I feel incredibly grateful for the family and friends who supported me during my treatment, and continue to support me to this day. I was humbled by the response to my photo: the shares, likes, messages, well wishes, and positive vibes; and even more humbled to learn that one simple picture could help another current or ex-tanner.



For more information on the types of skin cancer as well as common signs and symptoms click here

To see the original Facebook post, click here.

Comments

  1. Ha e you ever discussed having the Mohs's surgery to remove your BCC's?

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