Introduction

Facial skin cancers are a subset of skin cancers that occur on the face such as the face, lips, ears and neck. Skin cancer is caused due to excessive exposure to ultraviolet radiation in sunlight, environmental toxins and radiation. Facial skin cancers usually manifest as ulcers or lesion on the skin, and can be diagnosed by a skin specialist or cosmetic surgeon with a specialisation in oncology. As is the case with all cancers, facial skin cancers, if detected early, can be treated effectively. If not detected and treated in time, skin cancers can spread and metastasize to other parts of the body. The most commonly encountered types of facial skin cancers are squamous cell carcinoma, basal cell carcinoma, and  sebaceous gland carcinoma.

Causes & Risk Factors

Facial skin cancers are caused by extended exposure to ultraviolet radiation from sunlight, tanning beds and lamps. Facial cancers can also be caused by other environmental factors such as carcinogens or radiation.

Signs & Symptoms

Facial cancers can begin as a variety of spots, lesions, and bumps on the facial skin. Each different type of  facial cancer can manifest as a specific kind of lesion. Some of the most common forms of symptoms of facial cancers are as follows:

  1. Solid red nodules, which may bleed.
  2. Flat lesions which may have a scaly appearance
  3. A lesion or ulcerated sore in the genital regions
  4. A white scar
  5. Brown, scaly patches which increase in size
  6. Hard painless nodules on the eyelid

Types of facial skin cancer

  1. Squamous cell carcinoma – Squamous cell carcinoma is a type of facial cancer that can be treatable if diagnosed early. If squamous cell carcinoma is not treated in a timely manner, it can grow and metastasize to other tissues in the body.
  2. Basal cell carcinoma – Basal cell carcinoma is the type of facial cancer that affects the basal cells in the deeper layers of the skin. This type of skin cancer is also caused by exposure to UV radiation, environmental toxins, and UV light from tanning and radiation beds.
  3. Sebaceous gland carcinoma – Sebaceous gland carcinoma is the most rare form of facial cancer. It affects the sebaceous glands of the skin, most commonly in the eyelids. Sebaceous gland carcinoma has a high likelihood of metastasizing to other parts of the body.

Diagnosis of facial skin cancers

Facial skin cancers can often begin as innocuous looking symptoms such as lesions or bumps. However, if the lesion or lump or ulcer persists for a prolonged period of time, then it is necessary for it to be examined by a dermatologist or specialist. A examination of the lump or ulcer by a specialist can give indications about the type of cancer it is. The dermatologist may take a small sample of skin  biopsy to examine the tissue and further diagnose the type of facial skin cancer.

How are facial skin cancers treated?

The treatment rationale for facial skin cancer is to excise or remove all the cancerous facial skin or tissue and destroy the cancer cells to prevent further spread and metastasis of the cancer. One or more of the following techniques can be used to remove the cancerous facial skin tissue.

  1. Surgical excision – The cancerous portion of the facial skin is surgically removed and the adjoining skin is stitched together. This is a very effective way of removing the cancerous tissue, and can prevent further spread of the cancer.
  2. Electrodessication and curettage – In electrodessication, the cancerous layers of the facial skin are scraped away using electric current. This allows for the destruction of even the smallest amount of cancerous tissue that remains in the lesion. Electrodessication is best effective when facial skin cancer is superficial and not very deep in the skin.
  3. Cryosurgery – Cryosurgery or cold surgery is a specialised procedure in which extremely low temperature is used to kill the cancerous cells present in facial skin.
  4. Anti-cancer medication – In the case of very early detection of the cancer where the cancer is still superficial, topical application of cytotoxic drugs can also be used to treat facial skin cancer.
  5. Photodynamic therapy – Photodynamic therapy involves the use of an intense beam of light of a certain wavelength to target and kill cancerous cells in the skin. Photodynamic therapy is also best used for superficial facial skin cancers.
  6. Radiation – As with other cancers of the body, radiation therapy can also be employed to treat facial skin cancers. Highly targeted radiation can be used to target cancer in a specific area with minimal damage to the surrounding regions.

Facial skin cancers are treatable if diagnosed early, and a wide range of treatment options are available. If you notice any changes in your skin, lesions or bump which persist for prolonged periods of time, it is important to consult a doctor who can advise you on the nature of the skin abnormality.


About Dr. Debraj Shome

Debraj Shome-2
Debraj Shome, MD, DO, DNB, FRCS (Glasgow), FICO (USA), MNAMS, MBA (Healthcare Management, Vanderbilt University, USA), is Consultant Facial Plastic Surgeon, Oculoplastic Surgeon & Cosmetic Surgeon at Nova Specialty Surgery, Mumbai, India..Read more

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