Q: I’m having Mohs surgery to remove a BCC on my forehead soon. How can I prepare my young kids for any bandages, bruising, bleeding or swelling I may have — without scaring them?
Thankfully, with Mohs procedures for nonmelanoma skin cancers, you can usually go into this conversation with the knowledge that the patient, whether you, or Mom or Dad or Grandma or whoever, is probably going to be OK. If there’s no need to bring it up, especially in very young kids, I would avoid the “c” word (cancer).
Any conversation like this should be tailored to the individuals and their comfort levels. Generally, I would recommend being open and candid, unless your child has excessive anxiety. Give essential information, but not too much detail. And because you may think you look a little distorted, set some realistic expectations.
I would, however, advise against giving them details too far in advance. Give them enough time so they don’t feel surprised or blindsided, whether a few days or a week in advance. But you don’t want to start talking about it a month before, because from what I’ve seen, all that’s going to do is build up anxiety and fear.
Your conversation could start with something like, “Look, I have this spot on my face (or my arm or my leg) that the doctor is going to remove from me so that it doesn’t get bigger. Can you believe for this little thing I’m going to need this many stitches?” Exaggerate the size with your fingers, since a surgical wound is often three times as long as it is wide to avoid puckering. Also, the big pressure bandages used after some surgeries can be scary for little kids, so you might say you get a great big bandage to make it feel better.
Some kids may think they want to see the wound. But if they can’t look at themselves bleeding or you getting a cut, then clearly you’re not going to show them your wound. If they think they might want to see it, I’d ease them into it by showing them an online image so it’s not as personal but gives them a sense of what they’ll see.
Still, it is hard to predict what kids are going to feel when they see a big wound on a loved one’s face. If they have any interest in medical care, you could get them involved in it like a project. You could ask, “Do you want to come to the pharmacy with me and get the bandages that I’m going to use?”
Eventually, if you have a scar, you can use it as a teachable moment and point of pride. I might say, “A scar is a reminder that I wasn’t so careful about the sun. It can do harmful things if you don’t protect yourself. But I got it taken care of, and now I’m OK.”
About the expert:
Julie K. Karen, MD, is a Mohs surgeon and specializes in the diagnosis and treatment of skin cancer at CompleteSkinMD in New York City. She is also a clinical assistant professor in the Ronald O. Perelman Department of Dermatology at NYU Langone Medical Center.