May 2014 Plastic Surgery Practice

Michelle Henry, MD, makes skin cancer prevention a priority

By Amy Di Leo

oblique view 2 (4)New York City dermatologist Michelle Henry, MD, doesn’t let her cosmetic patients leave without a crash course on skin cancer prevention. May is National Skin Cancer Awareness Month, but the Mohs surgeon makes sure she gets the message out all year ’round to her patients regardless of age, ethnicity, or primary reason for their visit.

Henry got her medical degree at Baylor College of Medicine in Houston, and served as chief resident in dermatology at Mount Sinai Hospital in New York City. She completed a fellowship in cutaneous oncology, Mohs Micrographic, and reconstructive surgery with the Harvard Medical School Department of Dermatology at the Lahey Clinic in Boston.

Plastic Surgery Practice talked skin cancer, skin care, and hot topics in dermatology with Henry. Here’s what she had to say:

1. How big is skin cancer treatment/prevention in your practice?

As a Mohs surgeon, a large part of my work is surgically removing skin cancers. When I am not operating, I generally find ways to teach my patients about sun protection, the ABCDE (Asymmetry, Border, Color, Diameter, Evolving) criteria for melanoma, and the horrors of tanning.

2. Mohs has been controversial lately. Any thoughts on whether it is overused?

When done appropriately, in the outpatient setting, the Mohs procedure is cost-saving. It provides a 99% cure rate, and nothing is better for the treatment of non-melanoma skin cancer. There is an epidemic of skin cancer in this country with more than 3.5 million new cases of non-melanoma skin cancer projected each year.

3. What’s the greatest advance in treating skin cancer you have seen in your career?

I am excited by the potential of the hedgehog pathway inhibitor, Vismodegib. Understanding the genetics of non-melanoma skin cancer will allow for more targeted treatments in the future and could potentially allow us to cure skin cancers medically without the use of a scalpel.

4. How do you counsel patients on skin cancer prevention?

I counsel all of my patients the same way—the more they hear over their lifetimes, the better. I recommend a sunscreen of SPF 30 or higher for daily use and a sunscreen with SPF 50 for prolonged sun exposure. I teach my patients to do monthly skin checks and quiz them often, trying to make it fun. In my older patients, I reinforce that skin stores damage over a lifetime, causing their risk to increase with age.

5. How do you educate patients on the “color-blind” nature of skin cancer?

I remind my patients of color that they are not immune to skin cancer. I educate them on acral melanomas and tell them that reggae artist Bob Marley died of it. Many of my patients of color have been misinformed that their skin inherently has sufficient SPF, but black skin is only around SPF 13.

6. What is your favorite cosmetic procedure?

I love injecting dermal fillers. Beauty is all about balance, and it is amazing what a few millimeters of perfectly placed volume can do to maximize a woman’s (or man’s) appearance. Injecting is really artistic; it’s like sculpting. There is minimal downtime for the patient, and many fillers are reversible with hyaluronidase.

7. What cosmetic trends are you seeing in your practice?

I have seen a surge in requests for noninvasive fat removal. The two I use are the Liposonix treatment and CoolSculpting/Zeltiq.

8. What products do you use on your own skin?

I love creams containing retinoids, and I will admit to being a product junkie. I also love chemical peels.

9. Are you concerned about the Affordable Care Act (ACA) and ICD-10 conversion, and how it will affect your practice?

I am hopeful that the ACA will provide real access to more patients. The ICD-10 does have the potential to provide our field with epidemiological information that can be useful. Adjusting to the changes could be very burdensome for physicians. However, if a reasonable timeline is in place and efforts to avoid the centralized bureaucracy of other nations is taken, they both have the potential to be positive changes.

10. Why did you decide to specialize in dermatology?

I am a visual learner who pays obsessive attention to details. I think many dermatologists can describe themselves that way. I have a long-standing interest in infectious diseases, and I desired a career that would allow for versatility in terms of practice. Dermatology is the perfect collision of medicine and surgery, so for me, it was the best choice for a specialty.

Amy Di Leo is the associate editor for Plastic Surgery Practice magazine. She can be reached at adileo@allied360.com.

Original citation for this article: Di Leo, A. 10 things. Plastic Surgery Practice. 2014; May 42.