Pre-cancerous skin spots cause look back at lifelong over-exposure to the sun

By Don DoranMarch 11, 2009

KAISERSLAUTERN, Germany -- Any of my friends and acquaintances who've seen me lately has asked "What's wrong with your face'" or at least wondered it.

Actually, it looks as if I have an awful disease, or I've been bitten by a venomous spider or something on both sides of my face. And believe me, it felt nearly as bad as it looked.

The cause of this awful appearance is that I am undergoing treatment for over-exposure to the sun during my youth and young adulthood. Now, according to my dermatologist, I have extensive sun damage to my skin, resulting in pre-cancerous areas (Actinic Kerasotes).

Oh, I also have similar spots on my wrists and hands that were usually exposed during the same times I was being sunburned on my face and neck.

For the last few years, once or twice per year, my family doctor would freeze these scaly, pre-cancerous spots with liquid nitrogen, in hopes that they would not return or at least reduce the risk of developing into full-fledged skin cancer later on.

During my last physical exam, the doctor suggested maybe it was time to see a dermatologist and get these spots checked out a little more thoroughly.

When I met with Dr. Paul Bostrom at Landstuhl Regional Medical Center, he suggested one of two possible courses, which involved applying an ointment (choice of two different medications) to either quickly, or over a longer term, chemically treat this condition.

He warned that in using the stronger medication, many people might ask, "What's wrong with your face'" However, considering the dead of winter, I thought better to get it over with during cool weather, when it would be less painful and less visible (under coat and hat).

Well, I can report this was miserable, and I'm sure glad I made it to the follow-up appointment. I sure hope this does the trick for a long time.

The ointment seems to have found (and attacked) all these sun-damaged spots and turned my face into a raw, itchy, scaly mess. After two weeks (into a three- to four-week treatment) I was calling Dr. Bostrom back to ask "Does this sound right' I feel like I'm having an allergic reaction, with my skin blistering, peeling and feeling like I've been splashed with acid or something." "

Oh, this is about normal," he said, and I'm left wondering if I can endure another week or more of this.

Finally, I make it to the follow-up appointment with Dr. Bostrom to confirm how the treatment worked. I'm waiting in the treatment room thinking, "Hurry up. I can't stand another minute of this. Give me the stuff to start the healing." He soon walks in and asks me how I'm doing, to which I reply "other than feeling like an open wound from my shoulders to my hairline, OK." He looks me over and says, "It looks like you've responded well to the treatment." I say, "Thank God," and, "You promised to give me some stuff to clean all this up quickly."

He starts filling out the prescriptions, and I ask for a little more detail on this condition. Dr. Bostrom conveys the following: Especially people with fair complexions are susceptible to skin damage (and eventually skin cancer) from over-exposure to the sun. Of course, everyone has a different tolerance, but some people are naturally more likely to develop symptoms of sun damage that can develop into full-fledged skin cancer.

And unfortunately, much of this over-exposure can occur early in life, and it stays with you forever. For that reason, parents should take precautions for their children like avoiding long periods out in the direct sun, using sun-block products and providing frequent breaks under shade protection.

Young adults, of course, enjoy the beach, sports and other outdoor activities, which are likely to result in over-exposure (sunburn). Also, occupations that require daily or frequent prolonged outdoor activity can be the cause of similar over-exposure and provide the same results.

The problem is that since this has a cumulative effect, all the exposure one receives early in life can result in big problems long after one participated in the original "fun in the sun" activities.

Through early identification and treatment, most skin cancer deaths and severe skin cancer trauma can be prevented or eliminated. If you notice odd looking or odd feeling spots (especially in areas of skin normally exposed to the sun), consult your doctor to get them checked out.

And, don't put it off until later.

(Editor's Note: Don Doran is the environmental protection specialist with the U.S. Army Garrison Kaiserslautern's Directorate of Public Works. Dr. (Air Force Lt. Col.) Paul Bostrom, from Landstuhl Regional Medical Center's Dermatology Clinic, assisted with this article.)