I want to share a story about a patient that stood out to me today. She is in her early 60s and is healthy and active. She enjoys working out, travel with her husband, and time with her friends and family. Like many of us, she spent many of her younger years enjoying lots of sunshine (and many sunburns). She has strawberry blond hair and blue eyes. Her skin is fair and freckled. She has some fine lines etched around her eyes and mouth that display her love of life and frequent smiles and laughter. She has numerous scars on her face where I have removed skin cancers and reconstructed the defects with stitches following those tumor removals. And without patting myself on the back too much, I will say that her scars blend in beautifully and are minimally noticeable to those that do not know that she had surgery.
She was in today for follow-up on a recent skin cancer that we had removed on her upper lip which was healing beautifully just by allowing it heal in on its own. In the medical world, we call this second intention healing. (I can’t take any credit here…this is a demonstration of the miraculous wonder of our skin’s ability to heal itself after an injury without any sutures or guidance from us). She was thrilled with how her lip looked, but in despair about the rest of her face.
“Dr. Casey, what am I going to do? My skin is in horrible shape! I wear my sunscreen and try to stay out of the sun, but all of that damage from years ago…it’s hopeless! It’s too late to do anything about it!”
The point of this vignette: it’s never hopeless and it’s definitely never too late.
First of all, I pointed out all of the beauty that her skin shows: her energy, her enjoyment of life, her enthusiasm. And the story that her face tells about her experiences through the freckles sprinkled across her fair skin to the lines between her brows. The scars that prove that she has faced skin cancer and beat it. And I commended her for her healthy diet, her discipline in exercising regularly, and her ability to embrace life through travel, talents, and time with her husband and friends
We then discussed her skin moving forward. How does she embrace this moment and cultivate her best self as she forges ahead? I asked her to make a commitment to caring for her skin as she cares for herself. The two entities are intimately tied as our skin manifests that which is within each of us.
As her dermatologist, it’s my role to support that commitment to skin health. I prescribed my go-to fountain of youth/healthy skin cream (tretinoin) to her, using my analogy that using this daily is like regular exercise for your skin to keep it healthy and strong. We reviewed sun protective practices with a sunscreen that has SPF 30 or higher and a wide-brimmed hat and talked about trying to avoid being outdoors for long periods of time in the middle of the day. Just by implementing these two simple practices, she would see a tremendous payoff in the radiance and health of her skin. She is so young, that the habits that she employs now will affect her skin for decades to come.
I advise my patients on skin care practices that are tried and true and that have the scientific evidence to support the claims. This is just one example.
And sure, we could explore the wide range of lasers, microneedling, chemical peels, etc that would really accelerate the process of achieving clearer skin. We touched on this today, but these procedures aren’t right for everyone.
Many of you will relate to this story as you could just as easily be that patient, looking at your face in the mirror, and thinking “the damage is done,” “there’s no point in trying to fix things now,” and beating yourself up over sunbathing habits from decades ago.
Move forward, and change your habits. Start today. Take a picture of yourself and compare it a photo a year from now. I promise that with consistency and awareness, you will notice a positive change in your skin radiance.