LASER AND SKIN CARE SERVICES


MOLES, SKIN CANCERS
AND
RECONSTRUCTIVE SURGERY OF THE FACE


MOLES AND KERATOSES : Most people have moles, spots or keratoses present on their skin. Most of these growths are benign.

  • MOLES : These growths appear as clusters of heavily pigmented skin cells that may be flat or raised above the surface of the skin. While most pose no danger, some may develop into malignant melanoma, particularly those that have mottled colors or irregular edges. If there is any doubt, a biopsy is performed to determine if the mole is benign or malignant. Often, moles are removed for cosmetic reasons, or because they are irritated from constant rubbing against clothing and jewelry.
  • KERATOSES : These rough red or brown patches on the skin are usually found on areas exposed to the sun. They sometimes can develop into squamous cell carcinomas. Most are treated either with hydrocortisone creams or with simple shave excision.

Treatment of moles and skin lesions : In most instances, raised moles or keratoses can easily be treated in the office treatment room by performing a shave excision. This involves removing the mole at the level of the skin. Then the base of the mole is cauterized. A scab forms over the site and new skin grows back leaving an area that is undetectable. The mole is always sent to the pathologist to rule out any microscopic evidence of skin cancer.


SKIN CANCERS :

Skin cancer is the most common form of cancer and its incidence continues to grow. Although skin cancers can occur on any part of the body, 80% appear on the face, head or neck where they may be disfiguring as well as dangerous. If the skin cancer is small, the procedure can usually be performed quickly and easily in an outpatient setting. In many cases, the resulting scar is barely visible, or will be concealed within the natural folds and contours of the face.

  • TYPES OF SKIN CANCERS :There are primarily 3 different types of skin cancers. These are basal cell carcinoma, squamous cell carcinoma and malignant melanoma.
    1. Basal Cell Carcinoma : This is the most common and least dangerous form of skin cancer. It tends to grow slowly and rarely spreads beyond its original site. There are also different forms of basal cell carcinoma, such as the sclerosing type that requires more specific treatment.
    2. Squamous Cell Carcinoma :This is the second most common type of skin cancer. Squamous cell carcinoma frequently appears on the lips, face or ears. If it is allowed to expand and not properly treated, it may spread to distant sites including lymph nodes and other internal organs.
    3. Malignant Melanoma : This is the least common, but the most dangerous form of skin cancer. If discovered early enough, it can be completely cured. If not treated quickly, however, malignant melanoma may spread throughout the body and become life threatening.
  • APPEARANCES : Basal cell carcinomas can vary in appearance: as a small white or pink nodule or bump; a rough, dry or scaly red spot; a firm red lump; a sore that bleeds recurrently and doesn’t heal, or other one of a variety of other appearances. Malignant melanoma is usually signaled by a change in the size, shape or color of an existing mole, or new growth on normal skin.

PROCEDURES :

The method used to remove skin cancers depends largely on the type of cancer, the stage of growth and location on the body. If the cancer is small, it can be removed by simple excision, leaving a thin, barely visible scar. There are other non-surgical methods which include radiation therapy, cryosurgery (freezing the cancer cells), and topical chemotherapy, (application of anti-cancer ointments and creams to the skin). Moh’s surgery is a procedure in which the cancer is shaved off one layer at a time and examined under the microscope until the margins are clear. If the cancer is larger in size, or if it has spread to the lymph nodes, a larger more complex surgery may be required.

GRAFTS AND FLAPS :
When large defects occur from either trauma or the removal of benign or malignant tumors, skin grafts and flaps are considered as a treatment modality.

GRAFTS : Skin grafting involves the transfer of skin from a healthy part of the body (donor site) to cover the injured area. The graft is said to "take" when new blood vessels and scar tissue form in the injured area. All grafts leave some scarring at the donor and recipient sites. Composite grafts usually involve taking 2 types of tissue in one graft. For example, the removal of a portion of the ear, which contains both skin and cartilage, can help reconstruct missing parts of the nose.

Flap surgery is a complex procedure in which skin, along with the underlying fat, blood vessels and sometimes the muscle, is moved from an adjacent area near the defect or from another healthy part of the body. In some flaps the blood supply remains attached at one end to the donor site. In other flaps, the blood vessels in the flap are reattached to vessels at the new site using microvascular surgery. In general, flap surgery produces better cosmetic results than skin grafts.

POSTOPERATIVE COURSE : After you have been treated in the Spalding Outpatient Surgery Center, you will return for regular follow-up visits to ensure that there is no recurrence of your skin cancer.

The following precautions should be taken:

  • Avoid prolonged exposure to the sun, especially between the hours of 10 a.m. and 2 p.m. and during the summer months. Remember that ultraviolet rays pass right through clouds and reflect off sand, snow and water.
  • If your are outdoors for any extended period of time, wear protective clothing such as wide-brimmed hats and long sleeves.
  • Use a sunscreen with an SPF (sun-protection factor) of at least 25. Reapply it frequently.

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