What is surgical dermatology?
Surgical dermatology focuses on diagnosing and treating skin diseases using both surgical and non-surgical procedures. If you’re dealing with precancerous moles, Mohs surgery, or earlobe repair, you’ll likely see a surgical dermatologist for treatment.
Some cosmetic cases require surgical solutions. Surgical dermatology improves the function and appearance of your skin by removing or modifying skin tissue. Most dermatological surgeries are minimally invasive procedures that are localized to the part of the skin affected by the condition or disease.
The surgical dermatology department offers a variety of surgical solutions for your skin, including the removal of cysts, sebaceous tumors, and skin cancers. In our clinic, our skin surgeons perform a precise technique of removing skin cancer known as Mohs surgery. This surgery removes cancer from one small layer at a time until healthy skin is accessed, minimizing damage to the surrounding tissue.
Procedures of a surgical dermatology
Microscopic Mohs surgery (known as MMS surgery or Mohs surgery) mainly treats the most common forms of skin cancer, basal cell carcinoma, and squamous cell carcinoma. Mohs surgery enables your surgeon to remove tissue in stages, accurately identifying and removing tumor cells while preserving healthy surrounding tissues. Cure rates for Mohs technology are close to 98 percent, the highest cure rates for skin cancer.
Fellowship-trained dermatology surgeons perform Mohs surgery on an outpatient basis. In many cases, patients only need two or three repeated operations. Some may require further treatments to completely remove the cancer cells and possibly repair the surgical wound.
As with any surgical procedure, Mohs surgery leaves a scar. After the tumor is completely removed, your doctor evaluates the wound and discusses treatment options with you, including:
- Allow the wound to heal naturally
- Wound repair with surgery
We use photodynamic therapy (PDT) to treat carcinomas and non-melanoma skin cancers. Our doctors can perform this light therapy in their office.
Our specialists apply a photosensitizing agent to the skin around and around the growth area. When the agent penetrates tissues, it is absorbed into rapidly dividing, precancerous cells. Your doctor then activates the agent by exposing it to light and stimulating the topical agent to destroy the tissues in that specific area. PDT shrinks safely and effectively or eliminates precancerous or precancerous growths.
Radiation therapy (RT) uses high-energy rays or particles to kill, shrink, or slow cancer cells. This treatment is effective for very large tumors or in locations that are difficult to treat with surgery. It is also beneficial for patients who are in poor health and who cannot tolerate surgery.
RT may be used alone or in combination with other treatments. Our Surgical dermatology surgeons work closely with the department of radiation oncology at the University of California, Los Angeles to develop individualized treatment programs for patients suitable for this treatment.
Surgical excision involves removing the visible melanoma lesion as well as a small amount of surrounding tissue for examination. Surgical excision can be used for:
- Remove the lesion completely to treat cancer with surgery
- Taking a sample of tissue from a suspicious lesion for biopsy
Our surgical dermatology experts perform surgical excision procedures in ways that increase cosmetic results and reduce scarring and functional impairment. Surgical excision is a common removal treatment:
- Basal cell carcinoma
- Squamous cell carcinoma
- Malignant melanoma
- Other benign or malignant skin tumors on the trunk or extremities
Our surgeons usually remove skin cancers and other tumors in the head and neck with Mohs surgery.
Topical skin cancer therapy
Precancerous skin growths can be treated with topical melanoma agents. Skin-based agents preserve the healthy tissue around the growth while treating the growth in one of two ways:
- Direct targeting of cancer cells (chemotherapy agents)
- Stimulating the immune system to destroy cancer cells (biological agents)
Our surgical dermatology specialists use anti-cancer agents formulated as creams, gels, or lotions that are applied directly to areas of the skin for a specific period of time. As the agents work, the affected areas of skin may become red, scaly, or crusty and may itch, sting, or burn. After treatment, normal skin cells quickly heal the affected areas.
Treatment and removal of cancerous moles
Cancerous moles are very dangerous. Cancerous moles are usually treated by a surgical dermatologist through circumcision. Cancerous moles are cut out of the skin, including a large border around the mole to ensure it is completely removed. The wound will be closed with stitches.
The removal of cancerous moles may be performed by a surgical dermatologist as an outpatient procedure.
Earrings are trendy, but they can also cause health problems! A torn earlobe is common due to large and heavy earrings, or jewellery that gets tangled in clothes or pulled by children. Whatever the cause, when it comes to a ruptured earlobe, earlobe repair is essential.
Using local anesthesia, surgical dermatologists perform earlobe repair by reattaching the split earlobes with sutures. After a period of successful earlobe repair and healing, patients who wish to have their ears pierced again may be able to do so. Consult your dermatologist about your options!
Cryosurgery involves applying a freezing agent, the most common liquid nitrogen, directly to the skin to destroy skin growth. Liquid nitrogen damages tissues through freeze-thaw cycles. Then it replaces the normal skin cells and naturally heals the area. Temporary redness and stinging may occur briefly over the treatment area as the lesion crusts and crusts over a period of one to two weeks.
Our doctors usually use cryosurgery for:
- Benign neoplasms such as seborrheic keratosis, vulgar wart, warty keratosis, and flor
- Possible growth of cancer such as actinic keratosis
- Some cases of non-melanoma superficial skin cancer, basal cell carcinoma, and squamous cell carcinoma
Curettage and electrosurgery
Curettage is a surgical treatment that involves mechanical scraping of tissue with a sharp object. Electrosurgery uses heat from an electrical current to burn, cut, or coagulate tissue. Our skin surgeons use these two treatments together:
- Non-melanoma skin cancer (basal cell carcinoma, squamous cell carcinoma)
- Other benign lesions on the trunk or extremities
Using curettage and then electrosurgery targets the entire lesion as well as a margin of surrounding tissue to treat the affected area effectively. The resulting wound will heal naturally within a few weeks without the need for stitches.
Laser resurfacing and chemical peels
Exfoliation of the top layers of the skin can effectively treat cancerous skin growths and, in some cases, precancerous skin growths. Types of peeling:
- Chemical peels: Alpha or beta hydroxy acids
- Laser light resurfacing: Erbium or carbon dioxide
Treatments target the affected skin by either local dissolving (chemical peeling) or excising the treatment area (laser peeling). Treatments remove tissue deep beneath the origin of the abnormal cells. Chemical peels and laser resurfacing are commonly used to treat abnormal growths on the face, scalp, and lips.
After peeling, the underlying and adjacent skin cells help rejuvenate your skin. Some patients require a series of treatments. During the recovery phase, patients may suffer:
- Mild swelling
Surgical dermatology is also available for people who need help removing and healing scars, peeling skin or lesions, removing birthmarks, and countless other conditions. If you have a skin condition or problem and want to treat, cure, or eliminate it, contact a qualified and professional surgical dermatologist. Your skin needs to remember when you think about your health, so don’t delay seeking treatment if you suspect there is a problem.