Dermatology FAQ

You can have up to 5 Dermatology visits per year without a referral.

Not all skin cancers are the same, melanoma has the greatest potential to spread quickly and be fatal.

Melanoma represents five percent of skin cancers but causes 85% of the skin cancer deaths. Treatment is almost always surgical excision and may combine radiation therapy and chemo therapy.

Squamous cell carcinoma (SCC) (from the Latin scaly, looks like fish scales under microscope) is the next most dangerous as it can also spread internally and can spread to skin from an internal cancer. This can also arise from the transformation of an actinic keratosis to SCC. Treatment can be surgical or cryosurgery depending on the tumor stage. In rare advanced cases of squamous cell carcinoma other adjuncts are used.

Basal Cell Carcinoma (BCC) is usually localized and in very rare instances can spread internally. BCC can be treated by surgical excision, electrodessication and curettage and superficially with topical chemotherapy.

The key to successful treatment is early diagnosis, frequent self screening and skin cancer surveillance by a board certified Dermatologist at an interval determined by the patient’s history, family history and sun exposure history.

A cherry angioma is a benign vascular lesion that typically forms on the trunk area and increase in number with your age. They typically are not treated, but may be removed if they continue to bleed or get irritated.

A seborrheic keratosis is a benign growth on the skin, sometimes known as “barnacles” or “wisdom spots.” They may increase in size and color. They are typically not removed unless in a location that causes them to get irritated or inflamed.

Actinic keratosis is an atypical growth that may be pre-cancerous. It is called pre-cancer because a small percentage of lesions over time may become a squamous cell cancer. Actinic keratosis appear as scaly, firm papules that are usually more felt than seen. They may be treated with different methods, including cryotherapy or topical prescriptions.

The survival of skin cancer is based on the type and variant. Non-melanoma skin cancer (basal cell and squamous cell cancers) typically do not metastasize and often are able to be treated with excision and close monitoring in the future. Melanoma has a higher risk of metastasizing and a higher mortality. The earlier a melanoma is found, the better. Besides excision, melanoma may require chemotherapy and more extensive therapies.

A dysplastic nevus is not a cancer, but rather an atypical nevus. Depending on its type and appearance, your physician may recommend an excision to ensure its complete removal.

Mohs is a surgery performed to conserve tissue and ensure the cancer is removed by looking at it microscopically before the area is closed up. The procedure takes several hours since the surgeon will take small amounts of tissue until the cancer is no longer seen at the edge of the specimen. Most of the time for the patient is spent in the waiting room while the tissue is processed and evaluated. Once the cancer is removed, the area is typically closed.

On the day of surgery, you should take your medications as directed, wear warm clothing (rooms get cold), bring some food to eat, and bring something to occupy your time, if desired (i.e., book, magazine, etc.). Plan to stay 4-5 hours at the clinic.

Typically, you will stop any aspirin or herbals before a surgery, unless a physician has recommended you take the medication due to your medical history. If you do take aspirin or ibuprofen, you should inform your physician, and normally will not prevent the surgery.

Psoriasis is an autoimmune disorder which causes the skin to form scaly, erythematous plaques; usually on the elbows and knees.

Acne is an inflammation of the hair follicle. It is often due to various factors including genetics, skin type, sebaceous oil production, hormones, etc.

Tinea pedis and onychomycosis (toenail fungus) are usually treated with antifungal creams. For persistant and severe infections, oral antifungals may be prescribed but will require blood work and close monitoring by your physician.

Accutane is an oral retinoid used typically to treat severe cystic acne. The risks are numerous especially since it is teratogenic. Discuss this medication with your physician to determine if it is appropriate for you.