A Pimple That Was Actually Skin Cancer Brianne Morin, PharmD, RPh

Brianne Morin, PharmD, RPh

My story began in 2017 when I noticed a “pimple” on my nose that wouldn’t go away. It would go through different phases of bleeding and scabbing over, but it never quite healed. After the first month, I knew something wasn’t right about it. One year later, at the age of 38, my first visit to a dermatologist was to evaluate that spot on my nose, and he took a biopsy that day. A few days later, I received the call that it was basal cell carcinoma – the “good” skin cancer. I would need Mohs surgery, and he also recommended I contact a plastic surgeon because of the location on the tip of my nose. This would later turn out to be a very valuable piece of advice. When scheduling the Mohs surgery, the agent pushed back on my request for a plastics consult, but I was adamant.

During the consult, the plastic surgeon seemed optimistic as he talked about the different ways he could repair the hole depending on the severity. At a minimum, it sounded like I was going to have a pretty significant scar on my nose. Worst-case scenario, he briefly mentioned a forehead flap. I remember calling my husband, crying and unable to get the words out about what had to be done to my face. After the consult, I did some online research on Mohs surgery. Most cases didn’t seem too bad (a 98% cure rate), and the scars weren’t noticeable. It didn’t feel like a big deal – it was the “good” cancer.

Six weeks after the biopsy, I would finally have the Mohs surgery. It took three “rounds” to find clear margins. Each round consisted of very painful shots in the nose, cutting layers of tissue, bandages and waiting. I had a hole the size of a nickel on the side/ tip of my nose. The plastic surgeon came in and immediately said that I would need forehead flap surgery the next morning.

I didn’t really understand what a forehead flap surgery entailed until I went home and had to change the bandages. I almost passed out when I saw my face. It looked like an elephant trunk, with stitches, swelling and oozing fluid. A dozen stitches ran down from a deep hole in my forehead that was packed with gauze. The skin/tissue that originated from my forehead now was now twisted and stitched to the tip of my nose to provide blood supply for the next three weeks. I felt like a monster. There was dried blood in my hair for a week because I couldn’t shower or wet my face. The next few months would be the hardest and darkest time of my life.

The daily cleaning and bandaging filled me with tears. I wanted to go into hiding but was forced to keep up daily activities like taking my son to daycare and grocery shopping. Strangers would ask, “What happened?” After two weeks, I returned to work with bandages on my face to cover up my “elephant trunk.” I had to go to meetings and give two presentations in front of 200-plus students. I was becoming overwhelmed with feelings of anxiety and depression. Emotionally exhausted, I didn’t want to get up and go to work or talk about it. People tried to be supportive, but it seemed that no one could say the right thing. The worst thing for me to hear was, “You look good,” because I definitely didn’t feel that way. I had a total of seven surgeries after Mohs. Looking in the mirror made me sad. I felt guilty because I felt like I was being vain. I knew it would look better eventually, but my face was changed forever.

The past 18 months have been a variety of emotions – fear, uncertainty, weakness, guilt, anger. As I thought about what I was going to write in this article, I kept getting very emotional, and I realized it is still very painful for me. The scars on my face are a daily reminder of this experience, and I’m just starting to view them as a symbol of strength. Looking back, I realize the courage and strength it took for me to get through those first several weeks. I have spent a lot of time reading other people’s stories, which has helped me to not feel alone anymore. By sharing my journey, I hope that I can help someone else who is going through this. I would encourage them not to wait to see a dermatologist. I let a lot of fear and procrastination prevent me from going to the dermatologist sooner. I am truly grateful that it wasn’t worse; however, I can’t help but wonder if the results would have been different if I had the spot checked out earlier.

Brianne Morin, PharmD, RPh, is a coordinator of pharmacy experiential education and assistant professor at MCPHS University-Worcester/Manchester. Brianne.Morin@mcphs.edu.