An Ask the Expert Q&A About Skin Cancer with Medical Dermatology Expert Michael Housley, PA-C

May is a time for us to get to know and share the facts about skin cancer. For Skin Cancer Awareness Month Michael Housley shares what you need to know about skin cancer, from causes and treatment to prevention.  


Q: What is skin cancer? 

A: Skin cancer is when normal skin cells become damaged, usually by ultraviolet rays (UV) from the sun and become a cancerous cell that begins to rapidly divide and grow. 

Q: What does skin cancer look like?   

A: Depending on the type it can look like a shiny, pink sore, a red crusted lesion, or an asymmetrical, multicolored dark mark. 

Q: What should I be looking for to help detect skin cancer?  

A: A dark lesion that is new or changing, or a sore that won’t heal. 

Q: How is skin cancer treated?  

A: Usually we will biopsy the site to confirm the diagnosis, then remove it by a simple excision. Sometimes more extensive removal is required if the lesion is in a sensitive area or has grown deep into the skin. 

Q: What types of skin cancer are there? 

A: The three most common are: Basal Cell Carcinoma, Squamous Cell Carcinoma and Melanoma. 

Q: Who is more at risk for skin cancer? 

A: Anyone with a family history of skin cancer or who has a history of excessive sun exposure or any tanning bed history. 

Q: Are there any medical conditions that can increase our risk for skin cancer?  

A: There are some pigment disorders that increase risk and some medications that increase the sensitivity to the sun which can result in higher likelihood of skin cancer. 

Q: What constitutes sun damage?  

A: Any sun exposure that causes the skin to change color, whether that is tanning, burning, or even freckling. 

Q: What does sun damage do to the health of skin beyond skin cancer?  

A: It can cause early aging and irregular pigmentation to occur. 

Q: Is skin cancer hereditary?  

A: Melanoma has a hereditary component, if you have a first-degree relative that has a history of melanoma, you have a higher overall risk of melanoma too.  

Q: Where can skin cancer be found? 

A: Often skin cancer is found on the face, neck, arms, chest, and back, but really it can be found anywhere, which is why we advocate for full-body skin exams each year at minimum. Those who have a family history of skin cancer or who have previously been diagnosed with skin cancer should see their Medical Dermatology Provider more often. 

Q: What do I need to bear in mind if I have a family history of skin cancer?  

A: That you are at a higher risk for skin cancer and at the very minimum you should have a yearly Full Skin Exam. I would also recommend monthly self-exams. It is also incredibly important for you to cover your skin outdoors and use UPF clothing if you can, but at the very least, hats with wide brims, long sleeves, and pants. Wear sunscreen every single day no matter the weather or season, and remember to apply sunscreen liberally and reapply frequently. 

Q: What does a Full Skin Exam entail?  

A: After a Medical Assistant documents a brief medical history, patients are asked to remove as much clothing as they are comfortable with and to don a medical gown. Once they have changed into a gown, the Medical Provider and Medical Assistant will come back into the exam room to begin the exam. The exam is done in a systematic manner to avoid missing any areas. Care is taken to keep the patient as comfortable and modest as possible, while also making sure to give a thorough exam. 

Q: What are the most unusual places that you’ve detected skin cancer on a patient?  

A: The buttocks, groin area, and feet. I have found skin cancer truly everywhere. 

Q: Can I get a Full Skin Exam as part of my annual physical from my Primary Provider?  

A: You can, and often your Primary Provider will refer you to us when they notice something that concerns them. That said, as Medical Dermatology Providers all we focus on day in and day out is skin health, so when you come to see a dermatology expert you are seeing someone who is specialized in detecting, diagnosing, and treating cancer. Since our focus is just on the skin all the time, in our opinion seeing a specialist for your skin exam is the preferred method. 

Q: What are my next steps if a Medical Provider discovers skin cancer?  

A: Depending on the site and severity, we will make a plan to remove the skin cancer entirely. Many times it is a simple excision performed in our office done with local numbing, you are awake the whole time and can drive yourself home. 

Q: What is Mohs Micrographic Surgery?  

A: It is a tissue sparing procedure that is used in sensitive areas like the face, nose, or ears, but also on the hands and feet at times. The tissue removed is immediately reviewed and more is taken if needed before closing the wound. It is a highly specialized surgery that is reserved for the areas and cancers that require it. 

Q: How long does a typical Mohs Surgery take?  

A: Most are between two to five hours, occasionally they can go longer if the cancer is bigger than expected. 

Q: Will I have a scar after Mohs surgery?  

A: Anytime a surgery is performed there will be a scar. That said, Dermatologic Surgeons take care to limit scarring. 

Q: How effective are skin cancer treatments?  

A: Very effective, especially if we find the cancer early. According to the Skin Cancer Foundation, when melanoma is detected early the five-year survival rate is 99 percent.  

Q: What skin cancer prevention tips do you most often suggest – other than “wear sunscreen”? 

A: Wear a wide-brimmed hat and long sleeves whenever you can and check your skin once a month for new or changing lesions. If you find something unusual see your Dermatology Provider as soon as possible. 


Michael Housley has been seeing patients at Dermatology Clinic of Idaho in Boise since 2016. He has Diplomate Fellow status from the Society of Dermatology Physician Assistants and is certified by the National Committee on Certification of Physician Assistance (NCCPA). Schedule your appointment with Michael to learn more about skin cancer here.