Washington University physician Becca Joy Chibnall, MD, is a dermatologist who specializes in skin cancer, women’s health, vulvovaginal disorders, and general dermatology.
She sees patients at Center for Advanced Medicine – South County, 5201 Midamerica Plaza, Suite 2300, St. Louis, MO 63129.
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What happened in the course of schooling to influence you to choose your specialty?
When I was 14 years old, my grandfather was diagnosed with cutaneous squamous cell carcinoma.
Unfortunately, his case was atypical compared to most cutaneous squamous cell cancers. He had a lot of sun exposure in his life, especially during World War II, and ended up developing a very aggressive squamous cell carcinoma. He died from skin cancer when I was 16 years old.
Because of my grandfather, I learned very early in life about the risks of sun exposure and UV light. I know the importance of educating people on those dangers – which includes tanning beds.
In medical school I liked the way that dermatology combined both medicine and surgery. The specialty allows me to see patients throughout the full spectrum of life –from infancy all the way through late adulthood. Dermatology has been a long love story for me.
What brought you to Washington University?
I grew up in Las Vegas. When it was time to go away to college, my dad told me I could not go east of the Mississippi River. So being a sassy 17-year-old, I went to the Mississippi River and came here for my undergraduate degree.
I absolutely fell in love with the support of the administration at Washington University, the research opportunities here, and St. Louis, as a city, in general. The people are really friendly – it is a great community. It also helped that my husband is from St. Louis, and we met at Washington University!
I went back to the West Coast for medical school at the University of Southern California. I chose to go there for medical school because of the clinical opportunities at the Los Angeles County Hospital -- I’ve always had an interest in helping the underserved and in public health.
During medical school at USC, I did an away rotation at Washington University. The division of dermatology here is phenomenal.
It was always my desire to come back to St. Louis to do my dermatology training and hopefully join the faculty here. Because my husband is from here and this is where his family is, he was very excited to come back to St. Louis.
Which aspect of your practice is most interesting ?
That is hard because I delve into a lot of different areas of dermatology. With general dermatology I’m doing skin cancer checks, and managing chronic skin conditions such as psoriasis and eczema.
Once per week I cover our hospital in-patient dermatology consult service.. As one of the largest in-patient consultation dermatology services in the country, we are brought in to help diagnose and manage skin conditions in the acute setting. For example, we often see cancer patients who may suffer from rashes or infections as a result of their treatments.
I also treat women in my vulvovaginal disorders clinic who have problems such as chronic itching, chronic pain, or inflammatory diseases of the vulva and vagina. These are conditions that are not very well recognized, and vulvovaginal disorders is an underserved part of dermatology.
What new developments in your field are you most excited about?
I am most excited about the opportunities for targeted therapy. One of the most promising areas is new drug development, especially for atopic dermatitis and melanoma.
We have options for patients that we didn’t have before. Promising new treatments for melanoma include targeted therapies based on specific mutations that might be found within the cancer cells in melanoma. There are also combination treatments that take two new drugs and put them together.
Targeted therapy looks for specific gene mutations in certain types of melanoma. We use chemotherapy to target those cells that have those gene mutations. There are also therapies that help to build up the patient’s own immune system to fight the melanoma.
We are seeing an increased survival time in patients with stage 4 melanoma. It is really incredible to see patients who were given a very short time to live, now have an extension of life as a result of these new treatments. It’s been revolutionary.
If there is one thing you could say to a teenage girl about tanning beds, what would it be?
I would say - DON’T DO IT. It is not worth it. Our culture emphasizes that getting a tan is “beautiful.” But in fact, a tan is your skin’s response to damage to the DNA in your skin cells.
It causes mutations that, down the line, will not only make you age faster, have more wrinkles and more sun spots -- it will also put you at increased risk for melanoma.
We know that just one tanning bed use puts you at an increased risk for melanoma in your lifetime. And not just melanoma, but also squamous cell carcinoma -- which is what killed my grandfather.
Tanning beds need to be regulated. We’ve made some progress in that direction because parental approval in now needed in Missouri if you are under the age of 17 and want to use a tanning bed. But there is still room for improvement. Ideally, tanning beds would be banned completely, but I think that banning the use for children 18 and under would also prevent a lot of skin cancers in the future.
Where are you from?
My family is from Las Vegas, they moved there in the 1950s. Yes, people actually do live there and grow up there. My family is some of the few true Las Vegas natives. My father is a practicing OB/GYN, and my mother is a special education teacher. My dad has always wanted me to come back to Las Vegas, but St. Louis has had too much of a pull on me.
When I was born, Las Vegas was a very small town. It grew by over 1,000,000 people in my lifetime. It has been incredible to see all the changes in the city.
What is a “must see or do” for someone who is visiting Las Vegas?
The food is some of the best in the world – Las Vegas attracts some of the greatest chefs.
I have always loved the Bellagio Fountains. When I was in high school, we used to just sit on the railing of the Bellagio and watch the fountains for hours at night time. Even if it had been really hot during the day, the desert cools down quickly at night – it was a great way to spend an evening.
Is there a particular award or achievement that is most gratifying?
The achievement I’m most proud of is one I received when I graduated from medical school -- I was tied for #1 in my class and awarded top clinical medical student. I worked very hard during my 3rd and 4th year rotations to make sure I was taking excellent care of my patients -- and my hard work paid off.
What is the best advice you’ve received?
I would say that the best advice I’ve received in terms of dermatology is to wear sunscreen, SPF 30 or higher, every single day. That is the secret to preventing skin cancer and pre-cancers, fine lines, wrinkles, and sun spots. Even if you work in an office, you end up getting quite a bit of sun exposure just walking to your car, walking to the mail box, or going out for lunch. Wearing sunscreen every day can make a significant impact and prevent sun damage to your skin over time.
In my personal life, the best advice I’ve ever received is probably from my dad. When I had my first baby, he told me that with your children, you can’t take too much credit, but you can’t take too much blame. They are their own people.
If you weren’t a doctor, what would you like to be doing?
If I wasn’t a doctor, I would be a farmer. I love to vegetable garden and would farm a small piece of land in the Midwest -- because things grow much more easily here than in Las Vegas. I would have my rows of corn, green beans, and tomatoes. I would sell my vegetables at a farmer’s market because outside of my job and my children, my garden gives me the most satisfaction in life.
One last question, on your bio page under your areas of interest, ‘diaper need’ is listed. What is diaper need?
Oh, I could talk about diaper need for hours! Diaper need is when a family does not have enough diapers to change a baby as often as they would like. In the United States, there is minimal federal assistance for families who have difficulty affording diapers and one study found that 1 in 3 families suffered from diaper need.
For most of us, until we have a baby, we think that diapers grow on trees.They don’t. They are really (really) expensive. You cannot use WIC (Women, Infants and Children) or SNAP (Supplemental Nutrition Assistance Program) to purchase diapers. To deal with diaper need, many families “stretch” the number of diapers they have, so they will leave the disposable diaper, soiled, on the baby for prolonged periods of time. In dire circumstances, they will wipe the solids out of a diaper and put that diaper back on the baby, or they simply leave the baby naked.
Over the last several years, I have become more aware of diaper need through some of the volunteer work I’ve done with a local cloth diaper bank called Share the Love through the Fenton, MO company Cotton Babies, Inc. For two years during residency, I volunteered as a “host.” This meant that I met with families with diaper need and supplied them with 15 cloth diapers to use for the first three years of their baby’s life. For a lot of these families, it was completely empowering for them to know that no matter what situation they were experiencing, they had the ability to safely and hygienically diaper their children.
I’ve done a lot of work as an advocate to get diapers to families-in-need. A lot of people say that cloth diapers are not a good option because you are “creating more stress and more work.” I think that families should have the independence and the ability to choose how they want to diaper their baby. If you want to cloth diaper your baby, more power to you -- let’s get you the resources to do that. If you want to use disposable diapers, more power to you -- let’s get you resources to do that.
Diapers are not a luxury item. There is not a single baby out there who doesn’t need a diaper -- they are as essential as food and shelter.