I interrupt our regularly scheduled superficiality-fest for an important public-service announcement: Last month, as I was wrapping up my whitening-and-brightening road trip, I decided to push it just a wee bit further and popped in to see my deeply glamorous derm, Debra Jaliman, M.D.
"What can I do for you, missy?" she asked.
"I'd love a peel," I responded. "And there's this annoying patch of flaky skin on my forehead I hope you can do something about."
We never got to that peel.
Dr. J took one look at the pinkish, nickel-size spot and cut right to the chase: "We have two options. I can freeze it, but then you'll never know what it was. Or I can biopsy it, and we can talk about appropriate options when we get the results back."
I blanched, which is ironic, since it was my quest for luminously pale skin that had brought me to her office in the first place. "Maybe it's just eczema," I whimpered.
"It's not eczema," she said. (How much do you love this woman? She doesn't even attempt to sugarcoat.) "It's probably a premalignancy."
And as it turns out, it was. Specifically, it was an actinic keratosis, AK for short. Although they're only precancerous, if left unchecked, AKs can devolve into squamous cell carcinoma, a condition I never want to see attached to my name on a medical chart.
Jointly, Dr. J and I decided that she should slice off the remaining dodgy tissue. Alternatively, I could have had cryotherapy (which freezes the suspect) or used a topical agent, such as Aldara Cream or Efudex. But since it was a fairly small piece of real estate we were dealing with, I greenlighted the scalpel. (Thank God for the Donald-esque comb-over I've been sporting these days.)
She then sent me away with a multistep home regimen that includes her high-test glycolic-acid Alpha Pads and two great creams: Remergent DNA Repair Formula and NIA24 Skin Strengthening Complex Repair Cream. Both are designed to reverse sun damage, and while they're definitely spendy ($125 for 50 milliliters and $85 for 1.8 ounces, respectively), if they can keep even one future AK at bay, I consider them worth every penny. Bonus: My skin has never looked better.
Obsessed with learning more about my condition, I called Gervaise Gerstner, M.D., a derm affiliated with the Skin Cancer Foundation, which has a fabulously in-depth website. "One in 100 AKs will develop into squamous cell cancer," she said. "So by treating them, we're preventing that. They're caused by a lifetime of sun abuse, whereas melanoma is often genetic, or the by-product of a very bad burn during childhood."
So here's where my PSA comes in: It's not just suspicious moles that need to be monitored. Flaky, scaly, or shiny spots can also spell trouble. Be on the lookout for anything you haven't seen before. And if it doesn't beat a hasty retreat, beat a path to your derm's door.
