My Skin Cancer Story

Trust your gut and wear sunscreen!

Hello! A content warning: I’m sharing my skin cancer diagnosis and treatment today. If this topic is triggering for you, please skip this newsletter. 

I wrestled a bit with whether and how to talk about this, but kept coming back to three things. First, my sincere hope is to encourage sun safety for you and your family year-round (not just summer!) including wearing sunscreen and a hat whenever possible. I’ve been reasonably vigilant about the former since writing a piece about daily sunscreen use for the Wall Street Journal back in 2012. The TL:DR is that what’s in your make-up is not enough and you always need more than you think! EltaMD UV Clear Face Sunscreen is my personal gold standard; I also wear Neutrogena’s Ultra Sheer Face Serum. My dermatologist recommended I reapply every two hours.

Hats have become a part of my wardrobe since moving to California, particularly here in Los Angeles. Abby Arad of Your Stylist Says makes what is fittingly called The Best Hat as well as The Visor. I also have two straw hats in my regular rotation from H&M’s assortment, which features styles in a range of sizes — meaning I can find one that comfortably fits my big head! Love a baseball cap, too, especially a timeless and logo-less white one like this (also comes in HRH blue), faded navy like this or a simple stripe like this.

I also wanted to detail my journey for you as a gentle nudge to make those routine medical appointments if you are able. I’ve never liked going to the doctor (I fainted the first time I gave blood!); my mother’s illness and death from ovarian cancer as well as my own experiences with IVF didn’t help matters. After a decade of trying to have, and then having, babies, I was done being poked and prodded. So, confession time: I avoided my annual visits for several years. This skin cancer experience has been a wake-up call.

And finally, if something feels off, trust your gut. As you’ll read below, it took me a minute to get an answer about the spot on my forehead. But I’m so glad I did, because catching it early made the treatment much more manageable.

Take care, friends. 💗

ICYMI: Check out the thoughtful discussion in our Trooping the Colour comment thread and my conversation with Mattie Kahn, author of Young and Restless, about the role of fashion in the activism of girls throughout history.

My Skin Cancer Story

The morning after my surgery. Thank goodness for side parts, am I right?

“What’s that?” the physician assistant asked as she squinted at my forehead. “This wasn’t here the last time I saw you. Have you noticed it before?”

I sat up anxiously, the paper liner of the medical table crinkling beneath me. It was my second visit to this Beverly Hills medical office, not for my annual skin check (as much as I wish I could say it was) but for for Botox (something I began dabbling with since moving to Los Angeles — such a cliché, I know!). Peering into the hand mirror she offered me, I spied a spot I hadn’t noticed before but could see clearly now. It was grayish and small, the size of the head of a pin. The physician assistant asked for a closer look, then surveyed the rest of my forehead. “It doesn’t look like anything else on your skin,” she said. “I’d get that checked out as soon as possible.” 

She was reluctant to say more but hinted that it could be what is called basal cell carcinoma. It is the most common form of skin cancer, according to the Skin Cancer Foundation, with an estimated 3.6 million cases diagnosed each year. 

The mere mention of that word — cancer — made my whole body stiffen. I was just 20 years old when my mother was diagnosed with ovarian cancer; she died four years later. I knew what I was facing at this moment was decidedly not that. Still, the thought that I could have cancer, any type of cancer, sent me into a spiral. 

Outside on the sidewalk, I panic texted Matt and then called the large dermatology practice near our house. Before I’d reached my car, I had an appointment scheduled. At their first available opening a few weeks later, another physician assistant came to the same conclusion. It was…probably something? But she needed more information for an official diagnosis. Instead of a traditional biopsy, she suggested I try a new high-definition camera they had in the office. She wanted to spare me (and my forehead) from an unnecessary incision and instead take a series of pictures that would be sent to a lab for a closer look.

I agreed — but regretted the decision when the time came. The camera tech pressed the lens into my forehead in a way that amped up my fears, not allayed them. She fumbled through shot after shot, and then the whole system crashed. The office assured me they got what they needed and would send the images to a lab. A few weeks later, they called with good news: The spot on my forehead was benign.

Gosh, how I wanted to believe it! But I had studied the spot daily for weeks and had come to accept what my Botox person had said: It didn’t look like anything else on my forehead. Sensing my skepticism, the physician assistant said if I didn’t like how the spot looked, I could have it removed for “cosmetic” purposes. 

My eyes widened. Was she making this into a vanity thing? It didn’t matter. My gut said something didn’t feel right. “Yes, I think I do want it removed,” I responded, hating that I had to insist on this. I scheduled the biopsy, which turned out to be quick and absolutely painless. It was over in moments, requiring only a small bandage for a week. The physician assistant said she would send it off to the lab, just to be sure. 

A couple of weeks later, she called with a new diagnosis. “It’s a basal spot,” she said bluntly. Even though I knew it — I knew it from the moment my Botox person pointed it out! — it still came as unwelcome news. “What about the camera? That said it was benign?” I asked. Her response was something about it still being new technology, and imprecise. She moved right into next steps, recommending I have something called Mohs surgery, which removes the cancer one thin layer of skin at a time.

I couldn’t hang up the phone quickly enough, desperate to find a new doctor. (Never be afraid to seek out a different route of care if you are able!) I got a great recommendation from my amazing LA-based moms’ group and was in front of a new dermatologist just a few days later. As I recounted my story, the doctor shook her head and offered up her motto: “When in doubt, take it out.”  She assured me that this type of skin cancer is common, slow growing, and relatively easy to remove. The biopsy had gotten most of what was visible from the spot; only a tiny dot remained, one we both had to hunt for on my freckle-filled forehead.

It was so small that when the time came for my surgery, I tried foolishly to get out of it. Laying on the table, staring up that the bright lights, I scrunched my nose and said, “Do I really need to have this done?” From behind her mask, she gave me a sympathetic look. “It’s cancer,” she said. “So, yes.”

The procedure itself was easier than I expected, thanks to a heavy dose of numbing medication. The most pain I felt was from the stitches to close up the incision. The recovery, however, was more intense. I had a goose-egg bump for several days, some pretty awful and intense headaches, and a wound that required more care than I anticipated. 

But mostly: Early detection meant I had among the most minimal versions of the surgery possible. The doctor only had to remove two layers of skin to get all of the cancer out. Still, my tiny freckle of a spot required a one-and-a-half-inch incision — which only would have gotten bigger if I waited. My stitches are out now and I’m amazed at how well it is healing.

So do me a favor and wear sunscreen (along with a hat whenever possible!). Keep tabs on your skin at home and schedule an annual appointment with a dermatologist. I’m happy to answer any questions about Mohs surgery, in the comments here or on email. As always, you can reach me at Hello@SoManyThoughts.com.

Read more about basal cell carcinoma from the American Academy of Dermatology Association and  the Mayo Clinic

Instead of scary incision pictures that I hate looking at, here’s a photo to remind you how cute hats can be!