Hello everyone. It's Dr BCW. Welcome to Beyond Clinical Walls. I am so excited to introduce my next guest. Her name is Dr Samantha Schneider and she is an expert in skin, hair, nails, extensive dermatology. When I say extensive, I mean she does everything from whether it's traditional dermatology or Mohs micrographic surgery, and you're probably wondering what is that? So we're going to get to it, but first I want to share this amazing background of Dr Schneider.

She is a board certified dermatologist and board certified and fellowship trained Mohs surgeon. She attended medical school at Albert Einstein College of Medicine in New York. She completed her dermatology residency at Henry Ford Hospital in Detroit, michigan, and then moved to St Louis, missouri, for advanced surgical training in Mohs micrographic surgery at Washington University in St Louis. She has treated thousands of surgical patients for skin cancer removals via traditional excisions, like I mentioned before.

One thing that I really love about Dr Schneider she sees all ages. Whether you're a newborn or greater than 100 years of age, she can help you when it comes to screening examinations for evaluations such as acne, rashes, warts, dispigmentation or hair loss. That is what Dr Schneider can do and beyond. She is also an expertise in cosmetic dermatology, whether it be injections or fillers, microneedling or chemical peels. She is the independent owner of Pacific Crest Dermatology. She started her practice to be able to provide high quality, patient centered and individualized care, and when she's not seeing patients, she is heavily involved in giving back to organizations that are centered in high quality care and really accessible care, whether it's the American Academy of Dermatology or the American Society of Dermatological Surgery. She is also somebody who I have personally seen advocates for improved access to care for everyone in her specialty and beyond, so I am so excited for everyone to meet Dr Schneider. Welcome to Beyond Clinical Walls, dr Schneider. Thank you for joining me.

Thank you so much for having me, Dr BCW. This is such an honor and I'm so excited to be here and speaking to your listeners.

Well, we are excited to have you. Well, the first thing I would love for the listeners to know is why you do what you do.

Such a great question. So I love seeing patients of all ages and that's really what drew me to dermatology is that I can see kids, and then my next patient could be an elderly person with a full body rash and then I might be doing an excision or treating skin cancer, and I just I love that I have that variety and I can touch so many different people in that way. And then the other part that I really like is that patients can see the issue on their skin, so I feel like people are more interested in getting treatment and making things better, and then they're so excited we both are when we see improvement, because it's not just necessarily like a number on a lab sheet, it's their skin, they can see it clearing up or they know that the cancer has gone away, it's cured, and it's just such an honor to be able to provide that experience for patients.

And when you describe that. It's amazing to hear how you talk about patients and their health journey and being able to really be invested in their care as they're going along this journey. That is something that we don't always see. And when we talk about really improving patient-centered care and making sure patients are a part of their health care, that's what you do, from the start, to the beginning to the end and ongoing, and that is something that is so vital when we talk about health, and I'd love for the listeners to know a little bit more about you. So tell me, where does your passion and love come from?

You know, I think some of us just sort of have that within us. I don't know how to explain it. I kind of always knew that I wanted to be a doctor. I think I had that like healer inside of me, that like fixer who's trying to help make things better for other people. And I think when you have that sort of like innate urge to make things better for people, the transition to being a doctor sort of makes sense because that's what we are right. We're healers, we urge to make things better for people.

The transition to being a doctor sort of makes sense because that's what we are right. We're healers, we want to make people better in whatever area we can focus on. That's what really drew me to medicine wanting to be able to help people, which I guess in a way sounds cliche. But it's just like even now, outside of medicine, right, when I see like a friend is having a problem, like I, still I want to fix it and like it has nothing to do with medicine, it's just like that healer, that problem solver within me that wants to make things better for people around me.

When you mentioned wanting to help people and that's something that I resonate with deeply that connection, that desire to see what can I do for you, and I love how you said just wanting to fix it. Is there anything that you recall, before you became a doctor or even while you've been invested in this, that has really been transformational for you, that has kind of allowed you to think of that 360 feeling that this is why I'm doing this or this is why I picked dermatology. Is there anything that you can reflect on that you've had a moment in your life that has really been emblematic of that?

I would say I really like. I said I really like problem solving and actually fixing things. And so that's what drew me to dermatology, because in dermatology, granted, there's a lot of things we can't fix right. We can make better, but we can't completely fix them. But we can greatly improve them, and I can see that and patients can see that. And then there's some things that we can actually fix, like if someone has a skin cancer, we can cut it out and now it's gone. Now does that mean they're not going to get another one? Doesn't necessarily mean that, but that has been fixed, I don't know.

So I'm thinking back to like events that happened, I think having a younger brother, I think having a younger sibling. I'm an older child, probably fed into some of that, wanting to, like take care of him when we were younger. My mom tells this story about how he relied on me, two or maybe even a little bit older, and it was like I would help him. We had our own language, our own way of communicating, so he would point at things or talk in nonsense. I guess I don't remember it that well, but I wanted to fix it right and be like, oh, he wants this or oh, he wants that, let me help him. So part of me thinks that that probably fed into some of that. But I think some of this for me is just like it's just part of who I am. It's just deeply ingrained to want to help and fix things.

It's interesting because when we look back at some of our experiences through childhood or even preteen or adulthood, how that part where you already have something that is a part of your fabric, but how those experiences can really help blossom or kind of lead you into those journeys or reinforce what you're supposed to do in life. And as you were talking about how you helped your brother, that could have been something where you didn't even decide to do that, but you automatically were like, oh, I'm going to help him. And then to hear the story from your mom that, yeah, he depended upon you. And now what you get to do every day is help people.

And sometimes it's in really vulnerable situations when you talk about your brother not being able to talk at that age and all those things. When you have patients who have cancer or have these really trying times in their life and they're vulnerable, you, dr Schneider, are that conduit. You are that person to be able to help them along this journey and sometimes be their voice. To the point, when you mentioned, it's beyond just a lab, it's their skin, it's something that they see every day. I think that's very powerful of something that you're doing every single moment when you see patients.

Well, I think that's a great point. I mean people, patients come to the office and they are vulnerable, and especially when you're talking about healthcare in general, but also, I think, when you're talking about your skin. Right, like when I see people, they have to disrobe. Often they have to show me parts of their body that maybe they haven't shown anybody else, depending on their relationships, or maybe only a few people in their life, and then they have to have the courage and the trust to also tell me why they're here, what's the real reason, because it's very easy to come in and say, oh, I have this spot on my arm I'm worried about, and much harder to admit that there's something under the clothing or something that they've maybe let grow for a long time. That's much bigger or, you know, even things like rashes. I mean the impact on patients' psyche, on their confidence, on their symptoms, so on just feeling okay, I mean you can hide a lot of things on your skin with clothing, but that doesn't mean that it's not taking a toll on you mentally, like knowing that it's there, and so it is very vulnerable.

I think, to tell your doctor anything, depending on what it is, but certainly when it has to do with your skin, and I would say part of that, too is, in this world of getting so much information online, I think there is a level of vulnerability. Admitting what you might be doing at home to treat whatever your issue is because some of these things don't have a lot of science and we learn about them online, and so I always appreciate that when patients tell me, like honestly, what they're using or what they're trying, because it does make a difference in terms of determining is this making it worse? Is this making it better? Like how do we and where are you coming from? Like what's, why are you choosing what you're choosing to put on your skin, so that we can come up with the right solution that makes sense without making somebody feel uncomfortable? And I think it's a real privilege to be in this role, where patients do come and share these very vulnerable moments very, you know, personal moments with somebody hoping for help.

Absolutely, and when you think about your skin, whether you have areas that are impacted that you can cover up or areas that on your face, that it's your external introduction to the world every moment, and how that could really be hard on your psyche if you are dealing with something.

So, whether it's something that's covered or uncovered that you cannot, this specialty being within dermatology is such an important piece of medicine, and I'm not saying others aren't, but I love to kind of highlight that piece that often isn't shared.

When we talk about dermatology and what you get to do as far as helping people and you know that really leads me into it's Skin Cancer Awareness Month and when we talk about all the things that you mentioned were something you know a rash, a lesion, something that has been bothering you or something that you just noticed, or you're like am I supposed to get something checked out? What am I supposed to do to keep to stay healthy, to keep to make sure that all areas of my skin don't have any sort of lesions, and so forth? And so that's why I'm so glad that we're talking during this month and we're going to a little. I'm going to drop this little teaser. We're going to continue this conversation and continue to share health information from a dermatological point, because I think it is much needed when we talk about skin cancer. Dr Schneider, can you kind of just give a couple of things that people can think about and for their own health when it comes to skin cancer?

Absolutely, and I echo that. I think it's so great we're having this conversation, since May is Skin Cancer Awareness Month and skin cancer is extremely common. One in five Americans will develop skin cancer by the age of 70. So this is important information for everybody to think about because it is so prevalent in our society. So what I always recommend is there's a couple of things.

So, first of all, kind of getting to know your body, right. So looking in the mirror. I usually tell my patients to try and look in the mirror once a month, front and back easier to do, like before showering and get a sense of like where are your moles, where are your growths? Where are things that you know? What does your body look like? So that you every, every month, when you're looking, you can notice if something is different, like, oh well, that's weird, I don't remember that one being that color, that's a new one. Or, huh, that one looks bigger. What's going on? Because certainly, dermatologists find any number of skin cancers, but patients find their own too, like patients at home, notice new growths and come in saying, hey, this thing is on my shoulder and I don't remember it before. And so I think, taking a look at your body and getting a sense of what your baseline is what do you look like, so that you know when things are changing can be very helpful.

Yeah, and the other thing is that the most common risk factor for skin cancer is exposure to ultraviolet radiation, whether it be from the sun or whether it be from tanning beds.

So learning how to protect yourself from the sun because we have hopefully all of us have a lot of time to be on this earth and exposed to UV radiation and as we get more birthdays, the repair machinery, the like little I think of them as like little construction guys that are going up and down our DNA, that fix errors that happen to all of us just from being exposed to the environment, to ultraviolet radiation, to pollution, to so many different things. And they run up and down our DNA and they're like Ooh, this is not correct. And they fix it. But as they get older, you know, as we all get older, it just doesn't work as well anymore. It's like anything in life our phones, our washing machines, as they get more use and they just don't work as well, and so that's when things can start to appear, not to say that you cannot have a skin cancer as a younger person, because you absolutely can. But learning how to protect yourself from the sun will help lower decrease your risk of developing skin cancer.

And you know people are often surprised because they are like, oh, with some health topics they're like, oh, I'll have a sign or I'll know about it. And when we talk about skin cancer, there are often no signs or subtle signs, and by the time you notice it could be a situation that added more complications, could be life ending or shortening. And so that's why screening is so important, because once you have the ability to know, or to your point, let's start that playbook, let's start that foundational piece of what my body looks like, what, what, what am I starting with? I starting with, then you can identify when new things pop up and then have it checked out which could be make the difference of your overall outcome. And so I think that's so important for everyone.

When we talk about skin cancer of where to start from, one thing you and I, you know, share our love for accessibility, diversity and health literacy and really broadening that approach when it comes to all races, all ethnicities. Anybody can get skin cancer and you know I recently posted about acral lentiginous melanoma, which is a mouthful. I think I've said it right. I hope so. You sure are Faithful. I think I've said it right. I hope so.

I am Okay, and we talked about how you know, there's this notion that if you are someone of color, that melanin protects you, and it does give a little bit of protection, but it is not 100%. And so you know, from a personal, I remember hearing oh you're black, you can't get sunburned, you can't get skin cancer. And it's important for us to highlight yes, you can. And so the one that I just mentioned, alm, I like to give a celebrity, because sometimes that kind of helps people kind of you know, connect the dots. Well, bob Marley died of skin cancer, and so this skin cancer is present often in those areas that are not sun areas I'm not saying as well as you will Sun exposed areas between the fingers, the toes, all of those things and so it's very important that we check it out and I'm going to let you take the lead on this and share even more information.

That's such a good point, yeah, so acral lentiginous melanoma is, it's not a common type of melanoma. First of all, I guess I should say melanoma. There's three main types of skin cancer, so there's basal cell, there's squamous cell and then there's melanoma. There are other types of skin cancer, for example, merkel cell, which Jimmy Buffett died of to give another celebrity shout out, but the three main ones are basal cell, squamous cell, which Jimmy Buffett died of to give another celebrity shout out but the three main ones are basal cell, squamous cell and melanoma. Melanoma is the third most common type of skin cancer and it is the kind of scary one, the one that when we hear about, we're like, oh no, this one could be bad. Fortunately, we are finding melanomas earlier, and so getting a diagnosis of a melanoma does not necessarily mean it is going to be a bad situation. That's why screening, like you mentioned, is so important, so we can find skin cancers earlier. Now, acral lentiginous melanoma is a very small subset of melanoma, but it makes up a very high proportion of melanoma in patients with skin of color. And you're right, there is this misconception out there that when you have more melanin in your skin I think of melanin and melanocytes. It's like they're holding these little umbrellas over the cells underneath and kind of protecting the skin. However, you still can get skin cancer and certainly acral lentigigenous melanoma.

That tends to be a bad one, as you mentioned with Bob Marley's passing, because it happens in some harder to see places. In his case it was on his foot and a lot of people you know how often do you look at the bottom of your feet? Not often. Exactly, I mean I don't either. I will say when I see patients, I mean that's one thing we talk about.

I, when I do a skin exam, we look at the palms, we look at the soles and if I see any moles on the bottom of anyone's feet, I tell them hey, did you know you have a mole on the bottom of your foot? It looks fine. Unless it doesn't, then I tell them we need to biopsy it. But if it looks fine, they say you have one on the bottom of your foot. It looks okay. But I want you to know you do have a mole on the bottom of your foot Because, like I mentioned, with those exams, when you at home looking at your skin, ideally you would look at your feet, your palms too, but there are places that are hard for us to see, like looking at the top of your head, I mean, you know.

So getting professionally screened is important and certainly if you have any changes or things you're concerned about or a family member who has had skin cancer, that it's even more important to come in and get screened Absolutely, and you know there is a study that showed Black individuals are on the high level of getting diagnosed late onset, and part of that story is often this notion that I brought up that oh, I can't get skin cancer.

And so there's also from the patient side, but there's also from the clinician side where we also have to do better in making sure, when a patient of color comes in, adding that to the conversation, because that part whatever race you are, there should be that screening. I am so excited about this conversation and what we are going to be able to do, moving forward and really highlighting different topics, different access points when it comes to just skin cancer and all areas of dermatology. So I'm going to go ahead and tease up. Our next convo will be about hair loss, so make sure you check in with our next episode when I have Dr Schneider, who will provide insights about hair loss and how that can really be another level of debilitating kind of topic that is often shunned or not talked about. So, dr Schneider, thank you so much for joining Beyond Clinical Walls. This was a fantastic conversation. I would love for the listeners to know how can they get in touch with you.

Thank you again for having me. It's been so lovely speaking with you and talking to your listeners. Thank you again for having me. It's been so lovely speaking with you and talking to your listeners. To get in touch with me, so my website is wwwpacificcrestdermatologycom, my Instagram handle is at Pacific Crest Dermatology and my TikTok is at Pacific Crest Derm. We'd be happy to get in touch.

Yes, please reach out to her. This was such a joy just to connect and share information, so thank you again for having me. As always, I always end each episode with a level of gratitude. Thank you to everyone who took the time to listen. Please share this information because when you share, you're helping others know more about their health. This is Dr BCW. Thank you for listening to Beyond Clinical Walls.