SURGICAL DERMATOLOGY When lasers just aren't enough

Sometimes surgery is a necessity when it comes to the management of skin cancer and skin conditions like tumors, moles and cysts that require more aggressive treatments.

Skin Cancer Screenings

Skin Cancer is the most prevalent of all cancers. It is estimated that approximately 700,000 Americans develop skin cancer every year.

The best defense to skin cancer is sun avoidance
Medical experts agree that the primary cause of skin cancer is over-exposure to sunlight, especially when it results in sunburn and/or blistering. Other factors include: Scarring from disease or burns; repeated x-ray exposure, and family history. Because UV-rays are the number one contributor to skin cancer, we suggest limiting exposure to the sun and always applying sunscreens with at least a 15 SPF rating.

Early detection is key to finding and treating skin cancer
You should regularly inspect your body for any skin changes. If any mole, growth, sore or discoloration suddenly appear or begin to change, we suggest you make an appointment as soon as possible.

Precancerous skin conditions
We ask patients to regularly check themselves so that they may also detect precancerous lesions, known as actinic keratosis. These small scaly spots are typically found on the face or the back of the hand of fair skinned individuals. If left untreated, these spots can develop into skin cancer and then require more extensive treatment. If diagnosed in their early stages, these lesions can be removed by cryotherapy (freezing), or other outpatient procedures.

There are three types of skin cancer:

Basal Cell Carcinoma
This skin tumor usually appears as a small, fleshy bump on the head, neck and hands. Basal cell carcinomas rarely occur in dark skinned persons; they are the most common skin cancers found in Caucasians. Typically this cancer is found on people with light hair and eyes with fair complexions. This type of cancer usually does not spread quickly and may take months or years to grow in diameter. Left untreated, this type of cancer will bleed, crust over, and then repeat the cycle. Without proper care, this cancer can cause considerable local damage.

Squamous cell carcinoma
These tumors typically appear as red, scaly patches or nodules. It is usually found on the face, lips and mouth, and rim of the ear. This cancer will develop into large masses. Unlike basal cell carcinomas, this type of cancer can spread quickly. Non-melanoma cancers kill an estimated 2,300 Americans annually. Yet the cure rate for both basal and squamous cell carcinomas is 95 percent, when properly treated.

Malignant melanoma
It is estimated that 32,000 Americans develop melanoma each year, and 6,800 Americans will die from this aggressive cancer annually. It is important to note that the rate of death from this cancer is declining, as patients are seeking treatment more quickly. The positive news is that even melanoma is almost always curable in its early stages.

Melanomas typically appear in mixed shades of brown, tan and black, as they are caused by an overproduction of melanin. It may appear suddenly, or it may develop in or near a mole or other dark spot. This is why we stress the importance of knowing the appearance and location of moles on your body, so any changes will be quickly noticed.

You may be at higher risk for melanoma if you have a family history or atypical moles on your body. Dark skinned people are more likely to develop this type of cancer on the palms of their hands, soles of the feet, under nails or in the mouth, making routine checks essentially, as these growths might otherwise go unnoticed.

Other warning signs include: changes in the size, texture or appearance of moles; scaliness, oozing or bleeding; spread of pigment; and change in sensation including itchiness, tenderness and pain.

How to treat skin cancer

If we determine an area is cancerous, we have many treatment options, depending upon the needs of the individual patient. Early detection and removal are always your best defense against skin cancer. Most skin cancers, including malignant melanoma can be treated successfully if found in the early stages. To protect yourself from skin cancer, we suggest periodic self-exams. Get to know your skin and be aware of any change in the number, size and shape of your freckles, moles, and beauty marks. If you notice any changes, make an appointment to be seen as quickly as possible.

  Periodic Self-Exams
Examine the front and back of your torso in a mirror. Then examine your right, then left side, with your arms raised.
Look carefully at your forearms, upper arms, and palms. Make sure to check both the front and back of each.
Next examine your legs and feet. Be sure to look at both the front and back, spaces between the toes and the soles of your feet.
Look at the back of your neck and scalp with a hand mirror.
Finally, check your lower back and buttocks with a hand mirror.

  The ABCDs of Melanoma
Asymmetry- One half of a mole doesn't match the other half.
Border Irregularity- The edges are ragged, blurred or notched.
Color- The pigmentation is not consistent or uniform. Shades of brown, tan or black are present. Spots of red, white, and blue may also be present.
Diameter- Any mole larger than six millimeters (about the circumference of a pencil) should be checked out, as well as any mole that increases in diameter.

Surgery may also be helpful for the removal of tumors, moles, cysts, age and liver spots