Medical dermatology includes the diagnosis and treatment of diseases of the skin, hair, and nails. Providers in this specialty receive training to spot skin cancer and other disorders, manage chronic conditions impacting these areas and address discomfort due to skin infections, rashes or other concerns. Treatments may include topical or oral medications, surgical procedures or other therapies. A plan is formulated with your dermatology provider to determine the best course of action to address your specific concerns.
It is recommended that patients visit a dermatologist at least once a year to undergo a complete skin check as part of their routine care.
Surgical procedures may be required to remove benign skin growths such as cysts, moles, and fatty growths called lipomas, as well as some skin cancers. These procedures are performed in-office under sterile conditions and require little or no topical anesthetic.
- Cryosurgery is the use of liquid nitrogen to destroy a wart or pre-cancerous lesion.
- Curettage and electrodesiccation is a treatment for skin cancer that involves the removal of a cancerous lesion with a sharp, round instrument called a curette, followed by the cauterization of the remaining cancerous skin cells to destroy them.
- Excision involves using a scalpel to remove an abnormal growth which is then sutured closed.
- Grafting is the process of transferring skin from another part of the body to repair a defect caused by the surgical removal of a lesion.
- Scar revision can be accomplished by surgical means, but often non-invasive treatments are more appropriate.
- Mohs Micrographic Surgery is a highly specialized surgical procedure and has the highest cure rate of any treatment for the most common skin cancers. Performed under local anesthesia, the doctor removes only the cancerous skin and leaves all the healthy skin so that the final cosmetic result of the repair is optimized.
Cosmetic dermatology includes a variety of modalities designed to improve one's appearance beyond services that are deemed medically necessary. From skin tone to wrinkles, and from tattoo removal to body contouring, these services are recommended after careful consultation with one's provider, and a shared understanding of a patient's individual aesthetic goals.
- Correcting skin tone
- Smoothing wrinkles
- Removing hair on the face or body
- Tightening skin
- Removing tattoos
- Treating cellulite
- Treating acne and scars
- Body contouring
All cosmetic procedures, regardless of complexity, are performed by individuals with certifications and experience specific to the service. These providers include board-certified dermatologists who have received additional training in cosmetic procedures, cosmetic-trained nurse practitioners and physician assistants; injection specialists, certified aestheticians and technicians with specialized training in lasers and other devices.
Mohs Micrographic Surgery is a specialized, highly effective technique used in the removal of certain types of skin cancer. It’s different from other skin cancer treatments because the entire examination and removal of the cancerous tissue are completed in one visit. It has the highest reported cure rate for basal cell carcinoma and squamous cell carcinoma, the two most common types of skin cancer. This procedure is performed by a specially-trained Mohs surgeon.
When is Mohs Surgery Indicated?
While some non-Mohs treatments may have satisfactory cure rates, certain subgroups are more difficult to treat with traditional methods. Your provider may refer you to Mohs depending on the type or location of the cancer, or if there is concern about recurrence or cosmetic outcome from another treatment. Mohs surgery may be indicated for tumors on the head and neck, including the scalp; or for large tumors on the trunk and extremities, recurrent tumors, or others whose pathology indicates they are aggressive.
What can I expect at my Mohs appointment?
Mohs surgery is a step-by-step process to remove skin cancer that can take up to several hours. First, the surgeon will mark the skin cancer site and numb the area with a local anesthetic. Then, the cancer will be removed surgically, including a small 1-2 mm margin surrounding the area. The removed tissue is then processed in our on-site Mohs lab and the surgeon examines it under a microscope (this takes about 45 minutes each time.) If the surgeon sees skin cancer cells on the margins of the tissue sample, he or she will remove more tissue in that area. The process is repeated, including tissue processing in the lab and examination under a microscope, until no skin cancer cells are detected.
Once all the skin cancer is removed, the surgeon will discuss closure and reconstruction options. Most often, sutures are placed the same day but, in some locations, and when large areas of tissue have been removed, the surgeon may discuss alternatives including reconstruction by plastic surgery.
Mohs surgery (and most resulting reconstruction) is completed in-office under local anesthesia. The procedure can take several hours, depending on the number of cancers removed, the size of the tumor, and how many layers are removed from each spot. On rare occasions, the surgery can take an entire day.
Patients will receive detailed pre- and post-operative instructions if they are scheduled for Mohs surgery. A person’s downtime and recovery following the procedure depends on a number of factors that will be discussed with you by the surgeon and staff.
Is Mohs surgery expensive?
Mohs surgery and resulting reconstruction are generally covered by insurance, but it’s a good idea to check with your insurance company to confirm your surgical coverage. The office will also obtain prior authorizations, or referrals for you prior to your visit, but individual reimbursement benefits are specific to your individual plan.
An allergy occurs when your body’s natural defenses overreact to exposure to a particular substance, sending out chemicals to defend against it. An allergist-immunologist is a physician who specializes in the diagnosis and treatment of allergies, asthma, and immunological diseases, and is uniquely trained to identify the factors that trigger allergies or asthma and recommend treatment.
If your allergies or asthma interfere with your daily life, you should consult an Allergist-Immunologist. An Allergist-Immunologist often acts as an expert consultant with primary care providers to co-manage a number of diseases and conditions. An Allergist-Immunologist also tests for and treats adverse reactions to drugs, foods and insect stings.
Through skin and blood testing, provocative challenges or therapeutic interventions, an Allergist-Immunologist can provide definitive diagnoses.
Immunotherapy (Allergy Shots)
Allergies may affect many parts of the body and organ systems, including the skin, lungs, gastrointestinal system, eyes, ears and sinuses.
Allergy shots help your body get used to allergens, which are the substances that trigger an allergic reaction. The shots contain tiny amounts of the substance you’re allergic to and gradually increase over a period of time until your body is used to it. The shots don’t cure allergies, but eventually, your symptoms will get better and you may not have allergic reactions as often.
Unsightly veins — often greeted with as much joy as wrinkles — bring both cosmetic and physical problems. Genetics, hormones, and trauma contribute to their appearance, but there are steps you can take to minimize their occurrence and lessen discomfort.
Elegant new technologies have almost completely replaced conventional vein stripping and the need for large incisions. Our improved treatments require no incisions and rapid return to normal activities.
Treatment times are brief — most procedures require between 10-45 minutes. All of our surgical procedures are performed on an outpatient basis.
Vein Issues and Treatments
Varicose veins are enlarged, twisted, and dilated veins that can be seen just below the skin surface of the legs and feet.
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Reticular veins (sometimes called Feeder Veins) are veins visible beneath the skin that do not usually protrude. These veins feed spider veins and usually have a connection to the deep venous system.
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Spider veins are small, damaged blood vessels that occur just beneath the skin's surface. Spider veins are most frequent on the legs and face (also called Facial Veins) but can develop elsewhere on the body.
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Deep Vein Thrombosis
Deep Vein Thrombosis, or DVT, is the formation of a blood clot in one or more deep veins. These clots can travel to your lungs and cause dangerous conditions like Pulmonary Embolism (PE). PEs are responsible for killing around 50% of patients who experience them without prompt treatment with anticoagulants such as heparin.
Vein Care Plan
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