Appearance‐related psychosocial distress after facial non‐melanoma skin cancer surgery: A 1‐year prospective study

Abstract

AbstractObjectivePatients undergoing Mohs Micrographic Surgery (MMS) for facial non‐melanoma skin cancer (NMSC) experience appearance‐related psychosocial distress due to its post‐surgical esthetic changes. However, little is known about its development over a longer follow‐up period. This study prospectively assessed appearance‐related psychosocial distress in patients undergoing MMS for facial NMSC over a 1‐year follow up period.MethodsPatients who had MMS for facial NMSC between September 2020 and October 2021 were invited to answer the FACE‐Q Skin Cancer ‐ appearance‐related psychosocial distress scale preoperatively, 2 weeks, 6 months, and 1 year after surgery.ResultsA total of 217 patients completed the questionnaire at baseline. In addition, 158 (72.8%), 139 (64.1%), and 120 (55.3%) questionnaires were successfully answered 2 weeks, 6 months, and 1 year after surgery, respectively. Patients with a peripheral lesion presented higher appearance‐related psychosocial distress scores at baseline than patients with a central lesion (p = 0.02). There was a decreasing trend in appearance‐related psychosocial distress over time, but without a significant result (baseline—2‐week; p = 0.73, 2‐week—6‐month; p = 0.80, 6‐month—1‐year; p = 0.17, baseline—1‐year; p = 0.23). Patients with secondary intention healing and graft reconstruction methods experienced more appearance‐related psychosocial distress over time than patients with primary wound closures (p = 0.03).ConclusionsPatients still experience appearance‐related psychosocial distress 1 year after MMS. These patients may benefit from targeted counseling. Additionally, predictors of more appearance‐related psychosocial distress, such as secondary intention healing and graft reconstruction methods, may benefit from additional psychological care.