As Massage Therapists, you have a unique opportunity to address a health issue that many physicians do not pay much attention to – the skin.
Obviously, dermatologists develop a keen awareness to different types of skin conditions that may save a person’s life, but most patients do not really pay attention until there is an obvious problem.
Think about it, how often do you look at that freckle or mole on your back? As a health care provider myself, I can attest that with the ever increasing pressures placed on traditional health care providers to see more patients more quickly, the skin often takes a back seat during an evaluation unless there is an obvious problem.
Massage Therapists see and examine the skin throughout sessions with your clients. A brief synopsis of the top three skin cancers is provided, as more thorough analysis should be made with experts trained to evaluate suspicious skin lesions.
Malignant Melanoma: The leading cause of death due to skin disease. Appear on sun-exposed skin, back, lining of the mouth, palms and soles, genitals and even nail beds. Clinical features to watch for include ABCDE; each letter representing a warning sign.
Asymmetry of the lesion where one half can look different than the other half. Border irregularity that can be jagged or uneven. Color variegation having multiple colors within the same lesion, including pink, blue, gray, white, and black. Diameter is usually greater than 6mm or larger than the eraser on the end of a pencil. Evolution or a change in color or shape of a lesion over time.
Melanoma can often be mistaken for a brown or black mole or birthmark. They can be partially raised and partially flat. Skin containing the melanoma can bleed or become swollen, red or crusty. Moles that standout from other moles may be a melanoma, often called the “ugly duckling sign”. Dark skinned individuals have a higher frequency of melanoma on their hands, feet, nails, palms, soles and nail beds.
Basal Cell Carcinoma (BCC): The most common form of cancer. Occurs on sun-exposed skin. Usually occurs in fair-skinned persons. These lesions usually present as a small, raised nodule that may have a central scab or erosion usually greater than 6mm to about 1-2 cm or larger after years of growth.
They grow slowly. The appearance can be red, shiny, scaly, waxy, or “pearly” and often have tiny blood vessels, called telangiectatic vessels, running through the lesion. When the skin is stretched, the lesions can seem translucent. BCC can present as a sore that won’t heal.
Squamous Cell Carcinoma (SCC): Occur most often in sun exposed skin, in fair-skinned persons and organ transplant recipients. SCC and BCC can appear similarly. SCC present as small, red or pink hard nodules that ulcerate. They can also be pink, warty and scaly in appearance. They can bleed, look like an open sore or appear as a non-healing ulcers.
Any mole that changes, bleeds or produces an ulcer should be referred to a dermatologist immediately. These features require that referrals should be given early as skin cancers can spread causing potential death.
As well informed Massage Therapists, you can support the effort of good skin care. You can offer sunscreen in rooms to protect the skin after a massage, especially after facials. Broad-spectrum sunscreens help reduce the damaging effects of ultraviolet light on our skin. Fair-skin complexions should use a sunscreen with SPF of at least 15, and preferably SPF of 30-40 every day.
Advise patients to stay out of the sun in the middle of the day from 10am to 4pm when UV light is at its strongest, and to wear wide-brimmed hats, long-sleeved shirts, and/or long pants. Suggest sunless tanning lotions be used instead of tanning beds, as tanning beds increase the risk of melanomas.
You can also offer to take pictures that contain a measuring a tool containing millimeters, along with suspicious skin lesions to follow the progression of skin lesions. This can be taken with the patient’s own phone or camera as not to raise feelings of inappropriateness with newer clients; with long-term clients offer to keep a record and re-measure every 6 to 12 months to follow the progression, or lack of change, with a lesion you are concerned about. This simple and quick service can help build trust with clients and provide services not offered by other practices that may improve repeat client visits.
If recorded and maintained, these simple acts may prove valuable to a dermatologist to provide documentation of progression of a skin lesion that may be cancerous. Massage therapists can try to assist traditional health care providers by performing simple skin analyses, in hopes that in the future the gap between traditional medicine and alternative therapies narrow.
Ariana Reynolds is a Physician Assistant working in Indianapolis, IN. A graduate of Butler University’s College of Pharmacy and Health Sciences, Ariana serves in both a GI practice and in a hospital Emergency Department and sees a broad spectrum of patient issues.
When not helping her patients, she enjoys movies, reading, travel, and spending time with her husband and their adorable cat.