Whenever a dermatologist found a suspicious spot, that meant there was a good chance some skin was coming off. But that’s no longer the case for the patients of Dr. Orit Markowitz, board-certified dermatologist and Founder of OptiSkin in New York City, who can go home after receiving treatment for skin cancer without so much as a Band-Aid. That’s because Dr. Markowitz has pioneered unique noninvasive techniques for diagnosing and treating basal and squamous cell skin cancers that promise to leave patients scar-free.
Dr. Markowitz’s passion is detecting and treating skin cancer without cutting, instead relying on lasers and other technology that allows her to deliver the same clearance rates as surgery. During a skin check, if Dr. Markowitz sees a red flag with her dermatoscope, for imaging she’ll use a non-cutting biopsy device called a confocal microscope to diagnose the tumor. For pretreatment, she’ll use a noninvasive laser called optical coherence tomography, in which she is the foremost expert in the US. In lieu of surgery, she’ll use a combination of non-ablative lasers to remove most skin cancers sans any cutting. Patients will have their skin check and procedure done in the span of a few hours. And it’s typically all covered by insurance. “It’s the one time you’re going to get a Fraxel and not have to pay for it,” she says.
But Dr. Markowitz wants to prevent any of that from happening in the first place. That’s why she’s all about educating patients and people in the medical field alike. “When we talk about melanoma being less than a millimeter in diameter and feeling relatively safe for patients, we forget that that means the tip of a pencil,” she says. “When the depth of the melanoma is about the size of a pencil eraser, which is still pretty small, then we’re talking about less than 50% five-year survival, so people don’t fully capture how aggressive melanomas can be. They’re the number one cause of cancer in patients in their 20s.”
Most people are familiar with the ABCDEs of melanoma—asymmetry, border, color, diameter and evolving—but Dr. Markowitz stresses that regular annual skin checks done with a professional are the way to go instead of relying on that method. “I’m telling everyone, please don’t use the ABCDEs because it means you’re coming in too late,” she says. “We’re in 2021; it’s time to move on. I want patients to see me because they see a new little dark spot. I tell patients to not wait for evolution—you see something, it’s new and I want to see it because I have tools now (to check it).” A dermatoscope enables her to see potential issues instantly. “The goal is to get more people involved in dermatoscopy, because if you’re going to see your doctor you want it caught at this stage, right?” Dr. Markowitz says. “I think of a dermatoscope to a dermatologist like a stethoscope to a cardiologist. This should be something that you expect in your exam. You wouldn’t go see a cardiologist who comes and puts his ear on your chest; you’d probably walk out of the office and you should do the same with a dermatologist that doesn’t have a scope. It is not the same as a magnifier.” A dermatoscope allows dermatologists to see details that they can’t with the human eye, such as very fine vessels, yet less than 50% of dermatologists are utilizing it, she says.
At the onset of the pandemic, Dr. Markowitz was an early adapter of telemedicine and still continues to see many patients via teledermatology with HIPAA-compliant video visits. To make a virtual appointment as close as possible to an in-person one, patients can purchase an at-home dermatoscope (which typically costs less than $100) that attaches to their phone and send detailed photos to Dr. Markowitz for analysis. That means that people who live outside of New York City—and those in rural areas where access to a dermatologist can be limited—can still take advantage of her cutting-edge methods. “This is something I’m going to work on this coming year with one of my imaging fellows, to reach out to primary care doctors and get them the dermatoscopes,” Dr. Markowitz says. “If you only have access to your primary doctor, the primary doctors can take these images and can send it to any experts and we can do a consult virtually. These primary care doctors are probably cutting what they don’t need to cut. That’s something that we’re definitely going to work on now that the virtual world allows for this, which is relatively new.” Dr. Markowitz hopes that within the next 10 years, these non-invasive methods will be the standard of care.
To keep an eye on suspicious spots, Dr. Markowitz recommends that people ask their hairstylists to let them know if they see anything on their scalp when they’re getting a blowout or haircut. It’s also important to get regular checkups with an optometrist, since eyeballs need to be checked as well. Always practice sun safety basics, including applying sunscreen every two hours, or sooner if you’ve been swimming and sweating. “A tan is not safe, so always remember that,” Dr. Markowitz says. “The best way to get vitamin D is through a bottle. In terms of what kind of sunscreen to wear, mineral/physical works right away. Chemical takes 20 minutes; I recommend a combination of both because often people don’t like to put on the mineral because it’s a little sticky. But I like it as a base layer.”
Stay safe this summer by slathering on these top sunscreens:
Vacation by Poolside FM Classic Lotion SPF 30
Accurately named, a whiff of this sunscreen will instantly transport you to a tropical vacation. It has that old school beachy smell courtesy of notes like banana and coconut, but with a very modern, lightweight formula. The whole brand is all about vintage vibes, from the scent to the packaging to its campaign imagery, and it’ll make you feel like you’re on a getaway in the golden age of travel in the best way. The formula has niacinamide to hydrate, vitamin E to replenish, aloe vera to soothe and coconut oil. $20, vacation.inc (available June 2)
Colleen Rothschild Triple Defense Sunscreen Broad Spectrum SPF 40
Mineral sunscreens can get a bad rep for leaving a white cast, but this facial one disappears, only leaving the perfect matte finish. The multitasking protector safeguards skin from UVA and UVB rays, blue light and pollutants while moisturizing, too. It’s chock full of antioxidants like stabilized vitamin C for additional anti-aging powers. $48, colleenrothschild.com
SkinCeuticals Daily Brightening UV Defense Sunscreen SPF 30
Those who are prone to hyperpigmentation will want this sunscreen in their shelfie. In addition to UV protection, it prevents and reduces pigmentation for a more even skin tone, with 1% tranexamic acid and 2% niacinamide. Skin is left brighter looking, plus there’s also 7% glycerin to keep skin hydrated all day long. $54, SkinCeuticals.com (available May 23)
Evereden Sheer Botanical Facial Sunscreen SPF 30
The list of good-for-you ingredients is super impressive. The non-nano zinc oxide formula includes sunflower seed oil to strengthen the skin barrier; jojoba oil to hydrate and nourish with vitamins A, E and D; and antioxidant-rich rose extract to guard from free radicals and soothe inflammation. $28, ever-eden.com
Cetaphil Sheer Mineral Sunscreen Broad Spectrum SPF 50
Beloved by derms, Cetaphil just released their very first sunscreen line, Sheer Minerals, and it was worth the wait. The 100% mineral active sunscreen is designed for sensitive skin and preserves the skin’s natural microbiome. It’s spiked with prebiotics and vitamin E for an extra dose of nourishment. $13.99, amazon.com
Neogen Dermalogy Day-Light Protection Airy Sunscreen Broad Spectrum SPF 50
True to its name, this K-beauty facial sunscreen feels weightless on skin. It sinks right into skin without leaving any white cast, making it great under makeup. In addition to protecting your complexion from UV rays, it also deeply hydrates, soothes and keeps excess oil in check with 20 types of plant extracts. $32, neogenlab.us
Olay Regenerist Mineral Sunscreen Broad Spectrum SPF 30
This twofer delivers the perks of a mineral sunscreen and moisturizer in one bottle. The 100% mineral-based sunscreen is infused with zinc oxide, glycerin, vitamin B3, peptides and vitamin E for the ultimate anti-ager that is invisible on all skin tones. $28.99, olay.com
Rodan + Fields Reverse Brightening Defense Fluid Lotion Broad Spectrum SPF 50
Dark spots and dullness won’t stand a chance against this brightening formula. It contains the brand’s exclusive patented RF3 Antioxidant Complex that helps skin stand up to environmental triggers that lead to discoloration, as well as licorice extract to brighten. $40, rodanandfields.com
Sun Bum Face Mist Broad Spectrum SPF 45
Reapplying sunscreen to your face throughout the day, especially if you’re wearing makeup, can be tricky. That’s where Sun Bum’s Face Mist comes in. Simply spritz on the lightweight mist and you’re good to go. The gentle formula will help relieve minor skin irritations and soothe with calming Witch Hazel. $15.99, sunbum.com
Éminence Organic Skin Care Lilikoi Daily Defense Moisturizer SPF 40
Save yourself a few steps by slathering on this lightweight daily moisturizer that also protects from UVA and UVB rays, blue light exposure and environmental pollution. The all-natural, completely organic formula relies on zinc oxide and titanium dioxide, with cocoa seed extract and satsuma mandarin peel to give skin health an overall boost. $68, eminenceorganics.com/us
Mustela Mineral Sunscreen Spray SPF 30
Made with the whole family in mind—including sensitive baby skin—this broad-spectrum, non-nano mineral sunscreen spray makes application a cinch, saving you lots of sunscreen struggles with little ones. The gentle formula also soothes and hydrates skin with naturally-derived ingredients such as aloe vera, calendula, chamomile flower extract and sunflower oil. Free of fragrance and harsh chemicals, it even has the seal of approval from National Science Foundation (NSF) and National Eczema Association (NEA). $20, MustelaUSA.com
Coola Classic Body Sunscreen Peach Blossom SPF 70
The peach blossom scent will make you want to keep reapplying this organic formula. Despite its SPF 70 protection, it feels incredibly light on skin. The farm to face formula is infused with peach flower extract for a dose of antioxidants, as well as Coola’s Plant Protection complex with buriti oil and prickly pear extract to nourish and fight free radicals, respectively. $28, coola.com
Peter Thomas Roth Max Mineral Tinted Sunscreen Broad Spectrum SPF 45
When you’re looking for a little coverage along with your sun protection, this all-mineral tinted formula does the trick. Its universal vanishing tint helps neutralize redness. Formulated with zinc oxide and titanium dioxide, it’s also infused with safflower extract and vitamins C and E to feed skin. $34, ulta.com