I had a thingy on my nose, and like most guys I refused to get it looked at.
After all, I’m a doctor and we’re the WORST patients. To make things worse, being a guy, it took my wife cajoling me for months before I finally made an appointment with Dr. H.L. Greenberg, a fantastic dermatologist here in Las Vegas. I had self-diagnosed with an actinic keratosis, a type of sun-related damage that can be pre-cancerous in some cases. So time to practice all that prevention I’ve been preaching and get seen.
Luckily, Dr. Greenberg was cool as heck and let me livestream the entire visit. What did he find? Let’s just say…I wish I had manscaped.
– [Logan] We’re live.
– We’re live? What’s up Z-Pac? It’s your boy, ZDoggMD. I am here with Dr. H. L. Greenberg.
– How’s it going?
– Big pimpin’ at Las Vegas Dermatology.
– Yes sir.
– That’s what it is.
– This is my clinic, thank you for coming.
– Thanks for having me, man, it’s a huge honor. Especially because I got this thing on my nose that I’ve been wanting to get looked at for like a year. And my wife was finally like, “Go and see a doctor.” I’m like, “I know what it is. It’s an actinic keratosis, and it’s fine.” And now, I’m actually gonna find out what it really is and what we do about it. And Dr. Greenberg is the man in Las Vegas, so this is real.
– Thank you. Well, we haven’t pre-rehearsed this, so I haven’t looked at it yet. I said, well, if it’s really bad, I won’t say anything, but he said to be straight, so I will be.
– So when it’s, you know, horrible, malignant.
– So hopefully it’s nothing, but this is a dermatoscope, 10 times magnification. It’s got a polarized head, and it helps me to see things better.
– Yeah, I think you’re spot on. I think that is a little actinic keratosis. It’s rough, it’s crusty, so, there you go.
– Okay, you listen to me, Dad. I told you, I could’ve done dermatology, but I did medicine because I love it, not because I couldn’t make the money. Okay? No, so, and it’s interesting ’cause it actually hurts a little.
– So when I run my finger across it, it’s tender.
– Yeah, I’m gonna take a picture of that.
– Yeah, oh see, look at that.
– Not because we’re posting it online, but because this way we monitor how you did.
– And it’s subtle. It’s gonna be hard to really get a good view.
– Yeah, it’s a tiny little thing.
– But it’s there.
– Oh yeah. That’s one on the tip, yeah? It was the other one, is that the one?
– There’s the, this little, yeah, it’s right here.
– It’s real subtle, yeah, yeah.
– There’s the one. Let’s do another one of it there. There we go.
– There we go.
– So that looks better.
– Got it.
– It’s right there.
– It’s so subtle, yeah.
– A lot of times you can feel these better than you can see these.
– I could feel it easy, yeah.
– So, I’m gonna have you take off your shirt, look at the chest and back too.
– Wait, what? I was not–
– The back’s the most common area for melanoma in a man.
– I need a manscape, I’m bloated, I had Chipotle for lunch, like what’s going on here? This is something for everybody to know, that getting a body mole check is gonna be key to preventing and catching cancer early.
– All right, we’ll start with your right arm. Each mole has a one in 20,000 or so risk to be melanoma, so the risk is low. But it’s important to at least check and make sure they’re okay. A little acne bump there, it’s like you’re 15 again.
– Ah, I knew it.
– [Logan] HK says you’re aging, ZDogg.
– I am aging, believe me that. Aging poorly too.
– Ashley says bow-chic-a-wow-wow.
– Stick ’em up. I see a lot of people, you don’t look your stated age, so that’s good.
– I look older than my stated age.
– No, younger, younger. This is a seborrheic keratosis, a brown waxy, greasy, stuck-on spot. It’s totally harmless. This one’s a little irritated. I’m happy to freeze it off. You’ll be left with a little red crust thing.
– I would love that because it is irritated, it itches and stuff.
– Perfect. Turn around and let’s see the back. On the back here, it’s a normal mole. Another seborrheic keratosis, I can freeze that one off too if you’d like. It looks okay too. It’s a little flat mole there. A couple little acne bumps. We can write you for some topical clindamycin if you’d like.
– I like having acne ’cause it makes me feel young.
– You are young. Turn around. It’s funny, ’cause we’re the same age. Grab a seat, I’m gonna look at the top of your head.
– [Logan] Christy says you’re lookin’ hot, Dogg.
– I don’t know if you noticed, but I have some mild alopecia.
– Actually, it looks pretty good.
– The options for that, Propecia is a finasteride. Decreases your risk of prostate cancer but if you get prostate cancer, it’ll be more advanced form.
– Oh, I’ll pass.
– And it may decrease your ability to get an erection or ejaculate.
– That’s something to look forward to. Take off your shoes, let me see the right foot. Thank you. It looks fine.
– [Logan] How you feelin’, Z?
– I’m feelin’ great, this is like–
– [Dr. Greenberg] Don’t put it on yet.
– Come on, the ladies are enjoying it.
– But I’m so cold. Actually you keep it nice and warm in here, it’s nice. This guy’s about patient experience.
– Okay, so I’m gonna freeze the chest one. I’ll freeze it twice.
– Oh yeah, look at this.
– Yeah, it’s gonna be about a 10 to 20 second freeze-thaw cycle.
– [ZDoggMD] Ahhhhhhhhhhhhhhh
– [Dr. Greenberg] Sorry.
– I’m kidding, it doesn’t hurt.
– All right, let’s give you a ball.
– Oh yeah.
– It helps with pain.
– Okay, here we go.
– And this one, the nose is much more…
– Oh sore.
– Well, yeah, there’s more nerves there than the other.
– Especially mine ’cause my nose is big.
– Point to your spot again, feeling it.
– It’s right here.
– Let me see.
– It’s real subtle. Let me see if I can, right under my tip of my finger. Yeah, you might, yeah, it’s real subtle.
– Oh, that’s it.
– Yep. That’s it for that one.
– Oh yeah. Let me see, so right here, yeah? Yeah.
– Take a look.
– Feels right. Yeah, feels a little different than the spot.
– It was this red–
– This red guy right here?
– That’s the one I hit.
– Awesome, sweet.
– We’re gonna have to do the rewind and make sure.
– Yeah, I love it.
– Let me see this one here. We’re gonna hit this one more time. There you go.
– [ZDoggMD] I love it.
– I’ll get the other one that you had. If you look back here, you can see it. This is a mole and this is seborrheic keratosis. That one’s normal and this one is just a sign that he’s gone around the sun a couple more times. That’s all it is.
– I’ve been around the solar system a couple times.
– [Logan] You’ve got a thousand, 1.1 people.
– A thousand people watching me get my mole burned off? H.L. Greenberg, you are a superstar.
– Thank you.
– When I anaphylax to liquid nitrogen, though.
– I know, I’ve never seen that happen. Actually, it’s funny, I haven’t lost one yet.
– Oh, amazing. It’s a high risk procedure.
– Risks are blisters.
– I love it. So that’s the–
– That’s it.
– That’s the thing. So I have no sort of melanoma-looking things, the moles look good.
– Yeah,, did I see your underarms? Let me see, yeah, I did. Looks great.
– And I put deodorant on today, for once, which is good. And so, these actinic keratoses, they can be pre-cancerous skin lesions?
– Ten percent risk over ten years become cancer. They are not a cancer today.
– Got it.
– Oh, here, this is some shameless plug. A headband for you when you work out and do your– ♪ Let’s get physical, physical ♪
– I love it, this is fantastic.
– In terms of anything else, I know that there may be some cosmetic concerns. Do you have any?
– I’m old, I’m like all wrinkly.
– [Logan] Show him the circles.
– I got these dark circles. Is there anything magical I can do for any of that? The Z-Pac expects me to look terrible.
– Best thing you can do is stay out of the sun.
– That’s number one. Grab a seat, let’s be super critical.
– Oh,here we go. I love it.
– All right, if you look at my face you can see all these little pock marks, the redness and the crusting. See that?
– A couple here, yeah.
– And you see on the back of my hands some crusty sores? So on Tuesday, after work, I came in and I burned off some little spots on me ’cause I didn’t like them. So if we look on you, you’ve got this little red dot here, that’s cherry angioma, totally harmless. A little oil gland there, little oil gland here. This one’s a sebaceous hyperplasia, that one’s a little milia. They’re harmless but as we are taking more trips around the sun, then it becomes obvious that something’s a little bit off. So when you burn these spots off, and somebody had told me, this woman that I knew was dating a guy, he said he looks for age on the back of the hands. So burn those little spots off her hands and then the guys didn’t know how old she was.
– So, on your face you can burn these little ones off, if they bother you.
– I like to show people that I’m older because then they trust me more.
– That’s fair, I get that.
– This was fantastic.
– This is my handout for moles, it tells you what to look for. Each mole, like I said, has a one in 20,0000 risk of being melanoma. So, you can take a photo of your moles. Every three months you look at that photo. So just print it out but don’t look at it every day, you’ll drive yourself insane.
– That’s pretty moly, holy moly.
– [Logan] Mary says part two pants down.
– Oh my God
– ‘Kay let’s look for those perirectal…
– This is great. So guys, it’s pretty clear this guy not only knows what he’s doing, but we met for the first time today, but we kinda feel like we know each other through social media. He’s amazing doctor, so if you’re in Las Vegas, definitely and you need dermatologic help, like Logan, he needs a face transplant.
– [Logan] I do.
– Oh, yeah, well we can’t offer that part. We have chemical peel, hydro-facial, micro-derm abrasion. There are little things, laser facials, but like I said, staying out of the sun, and it’s hard in Vegas. But, that’s probably the best thing.
– This is great. Everybody, let’s give it up for H. L. Greenberg.
– Thank you guys.
– He is the man. I’m deeply appreciative and my wife will appreciate that my nose is not gonna kill me. She probably wanted me to get a nose transplant.
– Oh, here, we have these handouts. So this is the handout on seborrheic keratosis.
– That’s excellent. Let’s get a shot of that.
– If you look in here, so this was seborrheic keratosis, that’s the brown waxy stuck-on splat. The actinic keratosis is the pre-cancerous spot. It can become a squamous cell cancer over time. A lot of these things can look similar, so some people say, well why does that look? Don’t these look the same? Or, doesn’t it look the same? And, to me they all look a little bit different. Sometimes it can be a little challenging.
– And sometimes feel is important and seeing it in three dimensions.
– And this dermatoscope helps a lot.
– Oh yeah, yeah, yeah. I need to buy one of those on Amazon. Do they just sell ’em on Amazon?
– They do.
– Awe, sweet. I’m gonna be checking everything. My kids and all that.
– All right sir.
– Thank you sir.
– Thank you for coming.
– Really a pleasure. What up Pac? Hit share on this, hit like, check out Las Vegas Dermatology. Check out your moles, stay out of the sun, wear sunscreen, cover up and we out.