Skinterview with Mohs Surgeon & Dermatologist, Dr. Jayne Joo

Dr. Jayne Joo is a board-certified cosmetic dermatologist and fellowship trained Mohs micrographic surgery.  She received her undergraduate degree from Harvard University and her medical degree from UCLA.  She is currently Director of Mohs micrographic surgery at the Sacramento VA Medical Center and Director of Cosmetic Dermatology at UC Davis. To wrap up our 2016 Mohs series, we asked Dr. Joo to do a Skinterview with us to discuss skin cancer, sun protection, and sunscreen!

Dermveda: What inspired you to become a dermatologist and specialize in Mohs Micrographic surgery?

Dr. Joo: For me, it’s not a "what" but a "who." My inspiration was Dr. Summer Youker, who is a fabulous Mohs surgeon and former program director of UC Davis dermatology residency. I actually started in otolaryngology, a surgical specialty focused on the head and neck area. But when I was introduced to Mohs, I knew instantly it was what I was meant to do. I’ve always liked working with my hands. Even as a child, I liked to sew and fix things, and I suppose Mohs micrographic surgery was a natural segue of my childhood inclination. And it has definitely helped having the background in head and neck surgery.

Dermveda: What has been the most challenging part of practicing dermatology? The most inspiring?

Dr. Joo: The biggest challenge has been insurance-related issues. As a physician, there is nothing more frustrating than a patient not being able to get the medication or procedure they need because they’re not able to afford it. The problem is multifold and includes rising cost of medications, high deductible plans, and insurance coverage that is growing more and more sparse. I’m inspired daily by the patients whose skin cancers I cure. There is a sense of immediate gratification, which the patients and I can both appreciate.

Dermveda: What should our followers look for in sunscreens and skin care products to avoid skin cancer?

Dr. Joo: I recommend sunscreens that have broad-spectrum coverage. Broad spectrum means there is good protection against UVA, in addition to UVB. Because there is 10-20 times as much UVA as UVB in sunlight and UVA penetrates more deeply into the dermis, a broad spectrum sunscreen is best. When it comes to sunscreens, there are physical blockers and chemical absorbers. In general, sunscreens that are physical blockers (i.e., zinc oxide and titanium dioxide) provide the best broad-spectrum coverage.  

Dermveda: How often should our followers get checked for skin cancer?

Dr. Joo: It depends on your risk factor and skin color. If there is a strong family history of skin cancer, it is recommended that you get a full skin check done every 1 to 2 years. If you are fair skinned and have had a lot of sun exposure, then yearly skin checks are recommended. After you have been diagnosed with a skin cancer, the recommended frequency of skin checks goes up to every 6 months. That’s because there is a higher chance of developing another skin cancer after the first one has been diagnosed. After a few years, if no additional skin cancers are found, you can go back to annual skin checks. However, if you have a melanoma, it is recommended that you go in for skin checks every 3 months for the first couple years after diagnosis. After that, it can gradually be decreased to every 6 months, then every 9 months, then yearly thereafter. I also recommend doing self-skin checks at home. I have found people have a good hunch when it comes to skin cancers and although dermatologists are the best at finding skin cancers, I recommend doing self-skin checks on a monthly basis.

Dermveda: What do you wish more people knew about their skin?

Dr. Joo: Like any organ of the human body, the skin requires maintenance and protection from the elements. As you age, your skin does, too.  Many of the age-related changes of the skin are caused by ultraviolet radiation from the sun. To keep your skin looking youthful, protection from the sun is essential. Also, as your skin ages, the nutrients it needs change. While water intake is important for internal hydration, drinking more water does not equate to better skin hydration. The skin needs external hydration with moisturizing emollients to prevent it from drying out, which is a universal phenomenon with skin aging. 

Dermveda: If you could give our followers one piece of skin care advice, what would it be?

Dr. Joo: Wear sunscreen. Make it a daily habit – rain or shine, winter or summer.