About a year ago, Gibson Miller noticed a tiny spot under her left eye. The pink blemish looked like a pimple, but it never went away. She was worried, so she went to the dermatologist for a skin check. Her instinct was right: She had a stage 1 basal cell carcinoma.
“No one else would notice it. It was very small. It was pearlized,” the 24-year-old middle school teacher in Manhattan told TODAY. “I was going back and looking at old pictures. I had that spot for three years. But I didn’t really think about it until a year ago.”
Miller is part of a worrisome trend among young women. Skin cancers are increasing at a rapid rate in women ages 18 to 39. Research shared at a recent meeting of the American Academy of Dermatology found that from 1970 to 2009 melanoma rates have increased 800% for this group. Melanoma, the most fatal skin cancer, is the second most common cancer in young women. Rates of other skin cancers, such basal cell and squamous cell carcinomas, have also skyrocketed, by 145% and 263%.
Not "consistent" with sunscreen use
Since Miller was 9 she played tennis and continued through high school and most of college, which meant she “was constantly outside.” While she started using sunscreen her senior year of high school, she admits that she wasn’t always consistent.
“I applied it more to my face and shoulders,” she explained. She didn’t like visors and sunglasses, so the areas surrounding her eyes did not have as much protection.
“I wore a hat a little bit. I didn’t really care for them,” she said.
Dr. James Chelnis, an oculoplastic surgeon at New York Eye and Ear Infirmary of Mount Sinai, who treated Miller, said he often sees patients who have cancer near their eyes because they forget to protect them.
“Around the eyes, you are not typically putting a heavy dose of sunblock and it is exposed,” he told TODAY. “It is true that a hat and sunglasses do help. But, it is important to pick the right sunblock.”
He urges people to use sunscreens with zinc oxide and titanium, which provide physical blockers from the sun and offer more protection. But he stresses that people must put sunscreen around their eyes and actually on their eyelids.
“Protecting yourself still matters,” he said. “Sunblock is a staple of skin care.”
He said he has treated people with cancer on their eyelids, which they developed because they simply did not think about using sunscreen on that part of their body.
“I have performed surgery where they have had a cancer on the entire eyelid,” he said.
That means in some rare cases he has had to remove eyelids to help the patient, which can lead to other complications.
“The eye is a really unique structure,” he said. “It’s difficult to appreciate that such a small part of your body can have such a large impact on health and overall functioning.”
Signs of skin cancer near the eye:
Experts urge people to look for the ABCDEs of skin cancer:
- Borders: The borders of an early melanoma tend to be uneven.
- Color: A variety of colors is a warning sign of skin cancer.
- Diameter: Melanomas are usually larger than the eraser on a pencil.
- Evolution: If a mole starts to evolve, change (size, shape, color) or bleed, that is a warning sign.
But Chelnis said that skin cancer around the eye might be slightly different.
“Some patients have a chronic red eye or tearing on one side verses the other,” he said. “A lot of people come in just with an area that is red and doesn’t clear up.”
Treating cancer so close to the eye
When Miller first learned that she had cancer, she worried.
“I was grading my kids’ math final. I went into the other room and started saying the ‘f word’ a lot,” she said. “I am very much a logical person. I thought ‘What are my next steps?’”
So she began researching treatment options. The spot’s proximity to her eye made removing it challenging. Not only did a surgeon need to remove the tiny spot, but they also had to make sure there were clear margins in the surrounding tissue under her eye. Then she’d need a doctor that could close it without creating a large unsightly scar below her eye.
On June 20, she underwent surgery to remove the cancer. The next day, she underwent reconstructive surgery with Chelnis.
“What can look like a small cancer can actually have spread to a bigger area,” he explained.
Only weeks later, Miller’s scar is healing. Now, she wears both hats and sunglasses when she goes outside and covers herself in sunscreen.
“My face does not get sun,” she said. “I tell everyone to wear sunscreen all the time. I tell them it is not worth it.”
She added: “The stigma around seeing sunscreen on someone is outdated. Sunscreen is sexy.”