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David Himmel is the Editor-in-Chief of Chicago Health magazine and also somewhat of a self-proclaimed hypochondriac. As such, he’s certainly not shy about asking questions or taking action when it comes to his health. So, if it gives you any indication of just how minor the bump on his face initially appeared, David did nothing about it. That innocuous red mark on his right cheek didn’t seem cause for alarm.

“I just kind of sat on it and then I finally made the appointment.

That little red spot turned out to be basal cell carcinoma.

Dermatologist Dr. Emily Keimig explain basal cell like this, “It’s the most common type of skin cancer that we see, by far. We diagnose over 3 million of them annually here in the U.S. and a lot of patients will have more than one. So risk factors for a basal cell carcinoma are chronic sun exposure, so those sun exposed areas face, ears, hands, upper back. A lot of times patients say it’s a pimple that won’t heal. The basal cell carcinoma is very slow growing and only in the rarest of rare circumstances does it spread to other parts of the body or as we call it metastasize. So treatment really is surgical for most patients.”

But basal cell carcinomas are kind of like icebergs—often much of their mass is below the surface, and doctors don’t discover the full extent of the spot until the surgery to remove it. Dr. Keimig explains, “We’re looking for what we call clear margins, meaning that there isn’t any cancer at the edges of what you’ve cut out. So some of these basal cell carcinomas will have that top component so that little bump or that little scaly spot on the surface and then when we start looking, and going for those clear margins, we’ll see little strands that are just kind of underneath the surface. We show patients pictures after we’ve removed the skin cancer and it can be dramatic and quite frankly a little bit scary.”

And David turned out to be one of those patients whose post-surgical pictures could definitely fall under the category of scary. He had a hole in his face slightly larger than a quarter. While plastic surgery has made the damage nearly invisible a year later, he has certainly changed his lifestyle—including sunscreen every day.

David shared his story in Chicago Health magazine. Check it out here and see more of his story in the video below.