Surgical Procedures

Small cysts do not usually need treatment, but can be removed through a minor surgical procedure. When possible, a minimal incision surgical technique is used to remove the cyst, including the cyst sac and its contents. This allows the cyst to be removed leaving a smaller scar and has the advantage of faster recovery for the patient. This procedure is performed using local anesthesia and may require stitches which are removed one to two weeks later. Occasionally cysts recur and need additional treatment.

Lipomas are localized collections of fat cells below the surface of the skin that feel rubbery to the touch. Lipomas are generally harmless but can be removed if they are growing, painful or bothersome to a patient.

Lipomas can be removed surgically with an excision, which is performed using local anesthesia. Lipomas can also be treated non-surgically, through a process called injection lipolysis, which uses Kybella (deoxycholic acid) to dissolve the growth. This technique has the benefit of no scarring. More than one session may be required.

Most moles do not require treatment. A mole that would be removed includes a mole that:

• Bothers a patient (rubs against clothing, etc.)
• A patient finds unattractive
• Could be skin cancer

A mole can be removed during an office visit. A few moles will require a second visit. Whether it’s during 1 or 2 visits, a mole can be easily and safely removed using one of these procedures:

• Surgical Excision
  • The mole is cut out entirely and the skin is stitched closed.
• Surgical Shave
  • A surgical blade is used to remove the mole without stitches. This can leave a portion of the mole if the mole has a deeper dermal component.

If a mole grows back, immediately make another appointment to have it evaluated as this can be a sign of melanoma, a type of skin cancer.

The approach to traumatic or surgical scars is multifaceted, often requiring several treatment modalities. Approaches used include:

• Ablative or nonablative fractional resurfacing
• Botulinum toxin injections
• Intralesional Kenalog
• Kenalog with 5- fluorouracil
• Pulsed dye laser therapy
• Topical prescription skin care
• Subcision
• Radiation therapy

Some treatments are covered by insurance, and others are not. The best approach is determined for each individual patient factoring in patient skin type, age, functional and aesthetic goals, and budget.

A skin tag is a small growth of skin that is not cancerous and is usually not harmful. Skin tags are caused by the rubbing together of the skin and are usually found on the armpits, neck or between the legs. Anyone can develop a skin tag but those who have gained or lost a large amount of weight are more likely to have skin tags. Skin tags may be frozen, burned or cut off the skin. The treatment of choice is determined based on location, skin color, and size. Topical or local anesthesia may be required.

Basal cell carcinoma is the most common type of skin cancer. It can appear anywhere on the body, but most often appears on skin that is often exposed to the sun, such as the face, scalp, neck, hands, and arms. Basal cell carcinoma typically grows slowly. It may look like a:

• Reddish patch of dry skin that does not heal
• Flesh-colored, pink, red, or brown pearl-shaped lump
• Pimple that does not clear
• Sore that bleeds, heals, and then returns
• Scar that feels waxy and is skin-colored, white, or yellow
• Group of slow-growing, shiny pink or red-growths that look like sores (often scaly and bleed easily)
• Flat or sunken growth that feels hard and may be white or yellow

A dermatologist will carefully examine growths, moles, and dry patches. After careful consideration, treatment plans such as immunotherapy, cryosurgery, chemotherapy applied to the skin, chemotherapy, photodynamic therapy, radiation therapy, or surgical treatments can be pursued. A person can prevent skin cancer by regularly applying sunscreen and avoiding sun exposure when possible.

Source: American Academy of Dermatology

Source: Skin Cancer Foundation

Squamous cell carcinoma is a very common type of skin cancer. It often appears on skin that gets lots of sun, such as the face, ears, bald scalp, neck, or arms, but it can appear elsewhere – even inside the mouth, on the lips, or genitals. Too much sun is often the cause, but it is not the only one. Squamous cell carcinoma can appear on skin that was badly burned, had lots of radiation, such as x-rays, or was exposed to strong chemicals. Squamous cell carcinoma often has a reddish color and can grow deeply if left untreated. The cancer can spread to other parts of the body and it can be deadly. It often looks like a:

• Hard (scaly or crusty) reddish bump, patch, or pearl-shaped growth
• Open sore that itches and bleeds; it can heal and return
• Scaly patch on the lip; the skin on the lip can get thick

If the dermatologist finds something that looks like skin cancer, the dermatologist will remove it (or part of it). The removed skin will be sent to a lab and diagnosed. There are many effective treatments for skin cancer, such as immunotherapy, cryosurgery, chemotherapy applied to the skin, chemotherapy, photodynamic therapy, radiation therapy, or surgical treatments can be pursued. A person can prevent skin cancer by regularly applying sunscreen and avoiding sun exposure when possible.

Source: American Academy of Dermatology

Source: Skin Cancer Foundation

Melanoma often appears in an existing mole or looks like a new mole. By knowing where you have moles on your skin, you can find melanoma when it first appears. Here is what to look for:

• A mole on the skin that is growing, changing shape, or changing color
• A mole that looks scaly, oozes, or bleeds
• New dark spot on the skin that looks like a mole, but grows quickly
• Pain, itch, or bleeding in a new spot on the skin
• Streak (usually brown or black) underneath a fingernail or toenail
• Bruise on the foot that does not heal

Your treatment depends on how deeply the melanoma has grown into your skin, whether the melanoma has spread to other parts of the body, and your overall health. Treatment often starts with surgery, and while the melanoma is in stage 0—growing in the outer layer of skin—the cure rate is nearly 100%. Treatment may also involve immunotherapy, radiation therapy or chemotherapy.

Sun exposure is the most preventable risk factor for all skin cancers. Regularly apply sunscreen, wear protective clothing, and avoid sun exposure when possible.

Source: American Academy of Dermatology

Source: Skin Cancer Foundation

Mohs surgery is a precise surgical technique used to treat skin cancer. During Mohs surgery, thin layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains.

The goal of Mohs surgery is to remove as much of the skin cancer as possible, while doing minimal damage to surrounding healthy tissue. Mohs surgery is usually done on an outpatient basis using a local anesthetic. This is an improvement to standard surgery (local excision), which involves removing the visible cancer and a small margin of surrounding healthy tissue all at once. Mohs surgery allows surgeons to verify that all cancer cells have been removed at the time of surgery. This increases the chance of a cure and reduces the need for additional treatments or additional surgery.

Mohs surgery is used to treat the most common skin cancers, basal cell carcinoma and squamous cell carcinoma, as well as some kinds of melanoma and other more unusual skin cancers. One of the advantages of Mohs surgery is that you know your results right away, and you usually do not leave your appointment until all of the skin cancer has been removed. You may have a follow-up visit with your surgeon or referring doctor to monitor your recovery to make sure your wound is healing properly.

Source: Mayo Foundation for Medical Education and Research