Surgical Dermatology

Skin Cancer Treatment

Skin cancer is an abnormal growth of malignant skin cells. The American Academy of Dermatology estimates that 1 in 5 people will develop skin cancer in their lifetime. More than 1 million new cases of skin cancer will be diagnosed this year. People with fair skin, frequent sun exposure, history of sunburns, higher number of moles, and a family history of skin cancer are at greatest risk.

If detected early, the prognosis is excellent with a greater than 95% cure rate. The key to early detection is for everyone to perform periodic self-examinations and see their Dermatologist regularly. Having a partner help you with this is a good idea.

The most common skin cancers include:

Basal cell carcinoma – 85% of all skin cancers. Basal cell carcinomas usually occur on sun-exposed skin of fair-skinned people. This includes the head, neck and upper body. If detected early, it is easily treated with excellent cure rates. However, if neglected for many years, basal cell carcinoma may invade deeply and cause extensive tissue destruction in the muscle and bone or very rarely death.

Squamous cell carcinoma – 10% of all skin cancers. Squamous cell carcinomas are also typically found in fair-skinned people in sun-exposed areas. This type of skin cancer can become invasive and spread (metastasize) to other parts of the body without the proper treatment. With early diagnosis and surgical excision, the cure rate is over 95%. Treatments vary depending on the location and type of tumor.

Treatment options for these types of skin cancer include:

  • Excision
  • Mohs Micrographic Surgery (indicated for more severe lesions, or in sensitive locations)
  • Electrodessication and Curettage (“scrape and burn”)
  • Cryosurgery with Liquid Nitrogen (for non-invasive skin cancer)
  • Topical Creams
  • Levulan® with BLU-Light (photodynamic therapy)
  • Superficial radiation therapy

Melanoma – 5% of all skin cancers. Melanoma, the most serious form of skin cancer, is highly curable when found and treated early. However, it can be deadly if undetected as more than 75% of skin cancer deaths are due to melanoma. 1 in 58 men and women will be diagnosed with melanoma during their lifetime.

Melanoma may appear suddenly on normal skin or begin within an existing mole. If you see any changes in your existing moles or appearance of a new mole, a Dermatologist must examine it. See the ABCDE’s of melanoma detection in the “Moles & Birthmark” section. You can also visit the website at skincancer.org.

Treatment options for melanoma can vary depending on the severity, but include:

  • Excision
  • Mohs Micrographic Surgery (for poorly defined lesions or sensitive locations)
  • Possible referral for imaging or lymph node sampling (in more severe cases)

If skin cancer is suspected, a biopsy will be taken to identify the specific type of lesion. Treatment will then be tailored by Dr. Lambert based on several factors, including type of cancer, size, depth and location on the body. The most important factor determining success of treatment of skin cancer is early detection. Most skin cancers can be treated successfully in our office, and we do not charge an extra fee for a surgery center.

Benign Growth Removal

Skin growths are very common dermatologic complaints. They encompass a wide variety of lesions including benign moles, cysts, age spots and skin tags. The majority of skin growths are benign and many do not require treatment. However, certain instances may arise when a patient would like for these lesions to be removed. This can be due to recurrent trauma to a lesion (i.e. a skin tag rubbing or snagging on clothing), pain (i.e. ruptured cyst), or for cosmetic purposes (such as removal of age spots).

The treatment for benign growths is tailored to the specific type of lesion. Mole removal techniques are varied and can be as simple as surgical shaving with a scalpel blade, or may be more involved with either elliptical or punch excision and stitches. The choice of treatment depends on the type, size, and depth of mole. It is important to remove the entire mole to prevent recurrence, especially if removal is for cosmetic purposes.

Cysts are usually removed in their entirety through a small surgical excision using a local anesthetic. It is important to remove the entire cyst to prevent recurrence. Stitches will be used to close the skin after removal.

There are several different ways to effectively remove skin tags, including freezing, burning, or removing with scissors. Small tags may be removed without the use of anesthesia, but larger ones may require a local anesthetic to prevent discomfort. These treatments are usually effective in removing the skin tags, but may cause temporary skin discoloration or mild bleeding.

Age spots, such as seborrheic keratoses (crusty brown spots), can be effectively removed by either freezing with liquid nitrogen, or in larger lesions, with a shave technique followed by gentle skin scraping. A slight discoloration of the skin may result, and usually evens out over time.

Wart & Molluscum Destruction

Warts and molluscum are skin growths caused by viruses, and can therefore be contagious. These lesions can affect individuals of any age, but some types (especially molluscum) are more commonly found in children. Both warts and molluscum have the potential to disappear on their own without treatment, but may take months to years. For this reason, many patients seek treatment by a Dermatologist.

Wart removal can involve many different treatment options (see other section on “Warts”), and must be customized to each patient based on location, size, number of warts, and previous treatments. To name a few, warts can be treated by freezing with liquid nitrogen, injection of immune-stimulating therapy, or shave removal with electrodessication and curettage (in more resistant cases). Some treatments can be more painful than others, and therefore must also be considered when choosing a treatment, especially in the pediatric population.

Molluscum can be treated successfully by methods very similar to warts. Given that these lesions are common in younger patients, are not harmful to overall health, can be very numerous, and usually resolve on their own in 1-2 years, a parent may opt to not treat the lesions. Regardless of treatment chosen, Dr. Lambert can counsel and customize a treatment plan for each patient.

Brown Spot Treatment

Also known as age, sun, or liver spots, these lesions are flat, painless areas that are light brown to black in color. Brown spots tend to appear on parts of the body that have a higher degree of sun exposure. They vary in size, but are larger than typical freckles that present in childhood. Brown spots are very common in people over the age of 30. While brown spots are usually not dangerous to overall health, many people find them cosmetically unappealing. There are numerous treatments available to remove or reduce the appearance and help patients achieve clearer skin once again. These treatments can include freezing with liquid nitrogen, skin bleaching creams, chemicals peels and IPL therapy. Depending on the location and amount of lesions present, Dr. Lambert will customize a treatment plan to achieve your goals.