Dermatologic surgery refers to that subspecialty of dermatology that manages skin conditions through surgical procedures. These procedures may involve the superficial layers of the skin or extend through to the underlying layers of muscle or fat below depending on the condition being treated. At pure.dermatology, Dr. Teresa Mann excises skin cancers, moles, cysts, and other skin tumors in a comfortable office setting.
Superficial Surgical Procedures:
There are many different forms of dermatologic surgical procedures. For example, for those conditions that are on the surface of the skin, Dr. Mann will choose the best method for removal – which may include simply shaving or removing them off with a surgical scalpel or scissor, destroying them with a cold spray of liquid nitrogen or using a laser or electrical destruction medical equipment. Skin conditions that may be treated in this manner include benign issues — moles, age spots, skin tags — or cancerous conditions confined to the upper layers of the skin.
Curretage & Electrodessication
Certain skin cancers are superficial and may be treated by using a special instrument known as a curette to remove the cancerous cells from the skin surface. This is a very common treatment method that is both quick and effective. This skin is numbed so the procedure is painless and, because the treatment is superficial, it does not require stitches and heals quite rapidly. Skin cancer cells are scraped away using a special instrument called a curette and an electric current delivered via a metal tip is used to locally burn away remaining skin cancer cells
Precancers, certain skin cancers, warts and other skin lesions are commonly treated with a cold substance known as liquid nitrogen which is sprayed onto the skin. The skin is not typically numb during this procedure so there is some degree of discomfort for the patient. However, it is also a superficial treatment and involves no cutting of the skin so healing is generally rapid.
In some instances, Dr. Mann may recommend treatment with one of several available topical treatments (5-flourouracil, imiquimod, etc). These medicines may be effective for certain precancers or early skin cancers. They typically require several weeks of use and result in significant inflammation during the course of treatment. However, they may treat these lesions without leaving a scar since they avoid cutting on the skin.
Surgical Procedures That Require Excision
For those conditions that potentially involve deeper layers of the skin, Dr. Mann performs a surgical excision in which the growth is cut out and then the resulting wound is closed with sutures or medical glue. Growths requiring excision may include cysts, certain moles, fatty tumors (lipomas), and birthmarks. Excision is also commonly used for skin cancers, especially malignant melanomas.
The surgical procedures performed by Dr. Mann at pure.dermatology are all done under local anesthesia. In the past, many of these procedures were done under heavier levels of sedation or general anesthesia. However, advances in the use of local anesthetics allow most surgical procedures to occur in a safer, more comfortable outpatient setting. Performed in this setting, patients return more quickly to normal activity levels with a far lower rate of subsequent infection. In addition, most recoveries have either minimal or moderate discomfort, which can be controlled with over-the-counter pain relievers.
The tissue removed during this surgery will be sent to a lab to be evaluated by a pathologist and it may take 1-2 weeks before we receive results.