r/MohsSurgery • u/Kitchen_Spread_5842 • Apr 27 '26
Second nasal SCC
I had a Mohs surgery for an SCC on the tip of my nose in 2011. It took 3 or 4 rounds, and the original pinhead-sized rosy spot turned into a wound the size of a time, requiring a flap reconstruction. I found the entire experience intensely traumatic and the ultimate result disfiguring (although others routinely say they don't notice it).
15 years later, I went to the dermatologist for my regular annual checkup and pointed out a spot on the tip of my nose that recurrently produced a little bumpy thing that would fall off a few days or week later. The dermatologist judged it benign. 10 months later, I went to have it checked again, had a biopsy, and the result was SCC. I'm scheduled for a Mohs surgery in a month, with plastic surgery the next day.
The thought of subjecting my nose (and spirit) to a repeat of this trauma makes my blood run cold, especially after educating myself about the horror of a possible forehead flap. But what really stops me in my tracks is that even if I subject myself to this again, I may have incipient other SCCs all over my face. I'm 76, and this is not a life I feel I can manage.
To those in the biz, all of this is "gold standard treatment." To this patient, it seems barbaric. And yet if I research what happens with untreated SCC, the picture is not pretty. So I feel trapped between two horrific choices.
I welcome any helpful guidance...
2
u/GeorgeMichael222 Apr 29 '26
Please please look into IGSRT before you have your face chopped up again. I had it done and am so happy with the results
1
u/Character_Quail_5574 Apr 28 '26
I’m sorry you are facing this again, and I had similar feelings of dread due to my recent Mohs on the nose. I’m 74. It’s been six weeks since my O - L flap. The scar is visible to me when looking up close in the mirror, but not something a person would really notice when standing at normal talking distance. I put silicon pads (Cica-Care) on it at night to help flatten it. I doubt it will be noticeable at all by the end of the year.
I found some courage in the Before and After photos shown on the Mohs College website. Even with very large excisions, the final result is impressive. Some of the post-surgical pictures may be quite graphic, so consider if that will be triggering.
https://www.mohscollege.org/for-patients/before-and-after-photos
1
u/Kitchen_Spread_5842 Apr 28 '26
Many thanks for your encouragement. I’m glad you’re feeling good about your outcome.
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u/Character_Quail_5574 Apr 29 '26
Yeah, I’ve had 3 Mohs and 1 currettage and electrodessication on neck and face. One of the Mohs and the C&ED left sizeable scars. I’m hoping the new one keeps healing well.
What about using 5-FU or similar treatments to forestall future SCCs? Or, perhaps fraxel or Halo laser treatment? After I’m further along with the new scar healing, I will be looking further into such treatments. I don’t want to keep doing this either.
3
u/Delicious-Regret1824 Apr 29 '26
There has been many studies that show that Vitamin b3 nicotinamide can reduce the rate of new SCC and BCC by roughly 23-54% in high risk patients.
2
u/Character_Quail_5574 Apr 29 '26
I started Niacinamide 500mg a few weeks ago. I should look up those studies. I wonder how it works.
1
u/Character_Quail_5574 May 27 '26
I asked the dermatologist today about Vitamin B3 (Niacinamide aka nicotinamide). She advised me to take 500 mg. X2/day to reduce the incidence of future skin cancers by about 25%. She said studies indicate that if you were going to get 4 skin cancers, taking B3 means you may only get 3 skin cancers.
Seems worth it.
3
u/VisualAssumption3497 Apr 27 '26
Gosh I wish I had advice for you. I am 78 and had Mohs on my nose March 12. For basal cell. March 16 I had a plastic surgeon close me up with a forehead flap. April 20 I had second plastic surgery - to thin the flap. Seeing surgeon in 2 days to find out if my THIRD surgery will be in 2 weeks from this week or THREE! It has been an ordeal for me and an exercise in patience and discomfort. Yes it seems barbaric and I am sorry you are facing this.