Dermatology is the subspecialty of medicine devoted to the diagnosis and treatment of all diseases of the skin, hair, and nails. Dermatologists are highly trained medical doctors who have at least 12 years of formal education after high school in order to become certified by the American Board of Dermatology. This training includes 4 years of college, 4 years of medical school, a 1 year internship, and a 3 year dermatology residency. At the end of this training and after successfully passing a qualifying examination, dermatologists become board certified or Fellows of the American Academy of Dermatology (FAAD).

If you have a specific skin complaint, the dermatologist will provide a visual diagnosis classifying your condition as a tumor (benign or malignant), an infection (bacterial, viral, fungal, or parasitic), or an inflammatory disorder. Each of these categories then can be separable into conditions which are curable, controllable with medication, or no effective treatment exists.

The dermatologist is the unchallenged expert in the diagnosis and treatment of skin disorders. Although doctors from many different specialties treat skin conditions, it is our opinion that the dermatologist provides the most cost-effective, rapid, and accurate solutions for your skin problems. The dermatologist can often provide a visual diagnosis and treat skin conditions without a potentially unnecessary and expensive skin biopsy.

The certification process is designed to assure the public that a certified medical specialist has successfully completed an approved educational program and an evaluation, including an examination process, designed to assess the knowledge, experience and skills requisite to the provision of high quality patient care in that specialty.

It is extremely likely that our experienced dermatologists can make an accurate visual diagnosis of your skin cancer during a routine complete skin exam. It is our policy to remove classic skin cancers without a preliminary biopsy. In many offices all suspected skin cancers first receive a biopsy. Next, after the pathology report confirms the diagnosis, a second separate procedure is performed to remove the cancer. Under most circumstances our patients have only one procedure during which the cancer is completely excised and pathology is sent to the lab for a definitive diagnosis and verification of the surgical margins.

A very common misconception is that skin lesion removal by a plastic surgeon will leave an “invisible” scar.  As dermatologic surgeons, we are the unchallenged experts in removing small skin lesions.  In general, plastic surgery is appropriate for repairs of major facial trauma, breast augmentation, face lifts, etc.  It is our opinion that the scars from dermatologic surgery or plastic surgery are identical.

Patients with too many face and scalp actinic keratoses (AKs) for control with cryotherapy (freezing) may respond to photodynamic therapy (BLU-U or “Blue Light” therapy). A photosensitization chemical (Levulan ™) is applied to the areas of AKs followed by exposure to our “Blue Light”. In many patients marked clearing of the AKs will occur.

Most patients consult a dermatologist for new or changing skin growths. For all adult patients it is useful to have a baseline comprehensive skin exam to answer three questions: What is the status of my skin? How do I protect my skin? Do I need a regular skin exam?

Patients who need a regular skin exam often have a history of skin cancer, actinic keratosis, or multiple large and abnormal moles. Patients over 50 who have blue eyes plus very fair skin and/or severely sun-damaged skin, and patients taking immunosuppressive medication also need an annual comprehensive skin exam from a board-certified dermatologist.

You will need an appointment with one of our physicians or our physician assistant. After your skin had been examined, your provider will discuss the options for removal and the costs.

I have a small bluish-black or coal -black mole which has been unchanged for many years.  Do I need to worry that this mole is a malignant melanoma?

Most small (less than 6mm or pencil-eraser size) black or blue-black moles are blue nevi. These are harmless tumors and have only a remote chance of becoming a malignant mole. Malignant melanomas are only very, very rarely coal-black lesions. The dermatologist is the most qualified physician to make the correct visual diagnosis and decide whether a biopsy or removal is needed.

The lesions are Cherry Angiomas. These are harmless tumors of blood vessels which are very common in patients more than 30 years old. The only reason to remove these growths is for cosmetic improvement. Cherry angiomas can be easily removed with our lasers if desired.

These are dilated oil glands, aka Sebaceous Hyperplasia. They are the result of genetics and age. These growths do not require treatment since they are completely harmless. However, removal can be performed for cosmetic reasons. They occasionally resemble basal cell carcinoma, especially to a non-dermatologist, but they can almost always be diagnosed visually without a biopsy.

Although many doctors treat warts, the dermatologist possesses the largest repertoire of treatments for these common viral-induced tumors. In children approximately 75% of patients only need a single dermatology office visit plus a home treatment program to induce the antibody response which leads to resolution of the warts. In adults warts can be more difficult to eradicate. If freezing fails we may use the following therapeutic modalities: salicylic acid plasters, Cantharone, Aldara, injections of Candida Antigen, formaldehyde soaks, DNCB sensitization, injections of Bleomycin, etc.

Please call your pharmacy rather than our office. The refill request will be faxed to our office and when approved the pharmacy will contact you. Even if you have no refills left you should call the pharmacy first.

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