General Dermatology

Surgical and Traumatic Scars

Scars, which are formed of scar tissue, are visible signs that remain after a wound has healed.

Scars generally form as a result of a prior injury, or a previous surgery, and vary in size, shape, color, and texture.

Scars and blemishes on the face and body can feel like a burden. Luckily, we offer premium facial rejuvenation treatments, laser treatments, and skin resurfacing treatments to help you feel your best.

Treatments

Surgical and traumatic scars come in a variety of shapes and sizes and no treatment is ‘one size fits all’. Your dermatologist or physician assistant might recommend topical treatments, including silicon, or retinol creams to improve their appearance. Depending on the type of scar you have, we might recommend laser treatment, surgical revision, or skin resurfacing. We’re looking forward to treating you.

• Morpheus8
• Microdermabrasion
• Microneedling
• Fractional Laser Treatment
• Intense Pulsed Light Treatment
• Pulsed-Dye Laser Treatment

Recommended Products

We offer a range of premium cosmetic products sourced from around the world to help improve and protect your skin.  Whether it be advanced healing creams from Neocutis, or perhaps sun protection from EltaMD and Isdin, our dermatology team will recommend specific products for your unique skin.

Stretch Marks

Stretch marks are linear scars that generally appear where tissue has stretched. Stretch marks tend to appear on the abdomen and chest of pregnant women, on the shoulders of weight lifters, in teenagers undergoing a growth spurt, and in people who gain weight quickly. Since everyone has unique skin, stretch marks can vary in size, quantity, shape, color, and texture.

Scars and blemishes on the face and body can feel like a burden. Luckily, we offer advanced laser treatments, skin resurfacing technologies, and other cosmetic procedures to help you achieve your unique aesthetic goals.

• Scars and Blemishes

Causes of Stretch marks

Stretch marks can form as a result of a variety of different causes. These causes include, but are not limited to:

• Pregnancy
• Weight gain
• Increase in muscle mass
• Growth spurts

Treatments

Stretch marks come in a variety of shapes and sizes and no treatment is ‘one size fits all’. Your dermatologist or physician assistant might recommend topical treatments, vitamin C, alpha-hydroxy  lotions, or prescription retinol creams. Depending on your stretch marks, we might recommend Pulsed-dye laser treatment. We’re looking forward to treating you.

• Pulsed-Dye Laser Treatment
• Fractional Laser Treatment
• Intense Pulsed Light treatment
• Microneedling

Recommended Products

We offer a range of premium cosmetic products sourced from around the world to help improve and protect your skin.  Whether it be advanced healing creams from Neocutis, or perhaps sun protection from EltaMD and Isdin, our dermatology team will recommend specific products for your unique skin.

Unwanted Hair

Everyone has unique skin and hair growth patterns. Oftentimes, unwanted hair can grow on the face, neck, back, abdomen, arms, legs and more. Unwanted hair on the body can feel like a burden, especially when summertime rolls around. Shaving provides short term results and can lead to irritated skin and ingrown hairs. To combat excessive or unwanted hair, we usually recommend laser hair removal.

At Advanced Dermatology, Mohs & Laser Surgery Center and Salonika Medspa, we use the most advanced lasers from Candela Medical and InMode to help eliminate unwanted facial or body hair at the hair follicle. Our laser technologies allow for rapid hair removal without the need for topical anesthesia for the majority of our patients. Additionally, there is little-to-no recovery time and immediate results.

Everyone responds a little differently to laser hair removal. We recommend a series of treatments to achieve optimal results. Your sessions will range in length depending on the area of your body being treated.

Veins and Blood Vessels

Veins are blood vessels that are located all throughout the body. Lots of our patients seek cosmetic treatments to help improve the appearance of their veins on their face, neck, or body. If you are frustrated with the appearance of spider veins (“broken blood vessels”), varicose veins, or thread veins, our dermatologists and physician assistants have a laser treatment solution for you.

Types of Veins

There are many different types of vessels and veins that we can treat and improve the appearance of. The three most common veins and vessels are spider veins, varicose veins, and thread veins.

Spider veins:

Spider veins are small, red or purple veins that are located just under the skin’s surface. A lot of  our patients dislike the prominent, webbed appearance of their spider veins and seek our cosmetic    treatments.

Varicose veins:

Varicose veins are enlarged veins usually found on the legs and feet. Varicose veins can be unsightly, and we offer customized cosmetic treatments to help you achieve your aesthetic goals.

Thread veins:

Thread veins are tiny dilated blood vessels that can appear anywhere on the face or body. A lot of  our patients dislike the coloration or appearance of their spider veins and seek laser treatment.

Causes of Varicose Veins, Spider Veins, and Thread Veins

Unsightly veins can appear in different sizes and shapes are known to have a list of potential causes. The causes of veins and vessels include, but are not limited to:

• Heredity
• Pregnancy
• Sun exposure (UV)
• Changes in pressure
• Hormones
• Rosacea

Treatments

Since everyone has unique skin, we might treat your unwanted veins or blood vessels with different methods. We often treat many types of capillaries and veins with our state-of-the-art laser treatments that we offer in house. We recommend that you schedule an appointment with one of our board-certified dermatologists or physician assistants to discuss your treatment options.

Below are some of the laser treatments we may offer to improve your veins and blood vessels.

• Intense Pulsed Light treatment
• Pulsed-Dye Laser Treatment
• GentleMax Pro

Recommended Products

We offer a range of premium cosmetic products sourced from around the world to help improve and protect your skin.  Whether it be advanced healing creams from Neocutis, or perhaps sun protection from EltaMD and Isdin, our dermatology team will recommend specific products for your unique skin.

Cellulitis

Cellulitis is a common bacterial skin infection that is caused by either Staphylococcus or Streptococcus bacteria. Both of these bacteria occur naturally on the skin. A break or cut in the skin allows bad bacteria to enter the body, which can lead to an active infection. Cellulitis can appear anywhere on the body, but usually appears on the face or legs.

Causes of Cellulitis

• a skin cut, break or trauma.
• cracking or peeling skin between the toes.
• insect bites or stings.

Common Symptoms

• Chills, fever, muscle ache, fatigue, pain or tenderness in an area with a skin rash or sore.
• The redness increases in size as the infection spreads. It typically comes on suddenly and spreads quickly.

Preventing Cellulitis

To prevent cellulitis, we recommend cleaning any cut or break in the skin with soap and water as soon as possible. Cover your wound with a bandage until it scabs over. If you notice redness, tenderness, drainage or pain, these are often signs of an infection.

Treatment

If you think you have cellulitis, give us a call to schedule an appointment with one of our dermatologists or physician assistants. After assessing your skin, we will treat you accordingly.

Chicken Pox

Chicken pox is a common illness that primarily affects children. It is characterized by itchy red spots or blisters all over the body. Chicken pox is caused by the Herpes Varicella Zoster virus. It is highly contagious, but most cases are not dangerous. Oftentimes, chicken pox spreads from exposure to infected people who cough, sneeze, share food or drinks or by touching the blisters.

Chicken pox can be passed on from two to three days before the rash appears until the blisters are crusted over. The incubation period (from exposure to first appearance of symptoms) is 14 to 16 days. When the blisters crust over, they are no longer contagious and the child can return to normal activity. This normally takes about 10 days after the initial appearance of symptoms.

Common Symptoms

• headache
• sore throat
• fever
• Red blisters
•  

Treatments

Though Chicken Pox is common, it is largely preventable through the widely accepted chicken pox vaccine. If you have chicken pox, soak in a cool bath to relieve itching and avoid scratching the skin. Scratching blisters will result in scarring and slow down the healing process. To reduce your fever, over-the-counter analgesics may help.

Herpes

If you have Herpes, you are not alone. Herpes is one of the most common viruses in the world and affects over 67% of people. Herpes is characterized by a group of viral infections that cause sores on the mouth (oral herpes) or genitals (genital herpes). Since there are two types of the Herpes Simplex Virus, symptoms and treatments do vary.

Symptoms of Herpes

You can get Herpes from a variety of different sources. Generally, Herpes is passed from carrier to host through saliva or bodily fluid while they have an active outbreak.  The symptoms of Herpes include, but are not limited to:

• Canker sores or cold sores around the mouth and lips
• Enlargement of lymph nodes
• Small pimples or blisters on the face or genitals

Types of Herpes

Herpes Simplex Virus Type 1

Herpes Simplex Virus Type 1 is the most common form of herpes and affects a large majority of people at least once during childhood. This form of the Herpes virus is passed from person-to-person through saliva. Herpes Type 1 causes the formation of cold sores and canker sores around the mouth and lips. It may also cause an enlargement of lymph nodes in the neck.

Herpes Simplex Virus Type 2

About one in five adults in the U.S. has this form of the herpes virus, although many people don’t know they have it. Herpes Simplex Virus Type 2 is a sexually transmitted virus that infects the genital area or the mouth. The infection is characterized by sores that look like small pimples or blisters which can break open easily and ooze fluid. This is followed by a period of crusting over and scabbing until the lesions finally heal, which can take up to four weeks.

Herpes Simplex 2 spreads to areas of skin that come into contact with secretions from the blisters. The lesions most frequently appear on the vagina, vulva, penis, scrotum testicles, thighs or buttocks. They may be accompanied by a fever, swollen glands, headache or painful urination. Many people with genital herpes experience sensations of itching, tingling, burning or pain in areas where lesions will develop. If you think you have genital herpes, it can be diagnosed through a viral culture test of the blister fluid and through a blood test. Unfortunately, there is no known cure to genital herpes.

Preventing outbreaks

On average, adults with genital herpes have about four or five outbreaks a year. The first outbreak is usually the most severe and more outbreaks occur the first year than the years to come. Generally, symptoms begin to appear about two weeks after transmission. The virus takes root in nerve cells, lying dormant until it sparks another outbreak.

Outbreaks are known to be triggered by stress, illness or excessive sunlight. It is important for people with genital herpes to avoid sexual contact during an active outbreak to reduce the risk of passing the infection on to a sex partner. However, herpes simplex virus type 2 can be transmitted a few days before the appearance of any lesions. We encourage the practice of safe sex and use of condoms at all times.

Treatments

For Herpes Simplex 1, most cases don’t require treatment and go away within seven to ten days. For some cases, we might prescribe oral medications. For Herpes Simplex 2, treatment is designed to reduce pain and encourage healing. We might prescribe an antiviral medication. For people with more severe or frequent outbreaks, your dermatologist may prescribe a stronger antiviral drug.

Impetigo

Impetigo is a common and highly contagious skin infection that mostly affects children and infants. Impetigo usually takes the form of single or multiple blisters filled with pus, which pop easily, look irritated, and might crust over. Impetigo can either be caused by group A Streptococcus bacteria, Staphylococcus aureus bacteria, or both.

Symptoms of Impetigo

In most cases, Impetigo first appears near the nose and then spreads through scratching to other parts of the face, arms or legs. Here are some common symptoms of Impetigo.

• Red, itchy sores that break open.
• Pus-filled sores that form “honey-colored” scabs.

Types of Impetigo

There are three common forms of Impetigo.

Ordinary Impetigo

Ordinary Impetigo is caused by Streptococcus bacteria. This form of Impetigo appears as red sores that rupture quickly, ooze fluid, and then crust over. It primarily affects children from infancy to age two.

Bulbous Impetigo

Bulbous Impetigo appears as fluid-filled blisters caused by Staphylococcus bacteria. This highly contagious form of Impetigo is carried by the fluid that oozes from the blisters.

Ecthyma

Ecthyma, not to be confused with Eczema, is a more serious form of Impetigo that penetrates to the second layer of skin (dermis). Ecthyma causes painful sores, that might be filled with pus, that tend to break open and scab over. Ecthyma can also cause swollen lymph glands in the affected area.

Treatments

After meeting with your dermatologist or physician assistant, your treatment for Impetigo will begin after you are diagnosed. Impetigo is generally treated with a seven to ten day course of prescription oral antibiotics and/or topical antibiotics. Please make an appointment with one of our dermatologists to come to see your treatment options.

Intertrigo

Intertrigo, not to be confused with Impetigo, is an inflammatory skin inflammation that generally appears in folds of the body where two areas of skin chafe. Intertrigo most commonly appears on the inner thighs, armpits, groin, and between creases of fat.  Intertrigo can be caused by a bacterial, yeast or fungal infection.

Causes of Intertrigo

• Moisture between folds of skin
• Friction between folds of skin
• Heat

Symptoms of Intertrigo

• Reddish-brown rash that looks raw, oozes, or itches
• Cracked, crusty, or bleeding skin
• Foul odor

Treatments

If you think you have Intertrigo, we recommend keeping the affected area dry and making an appointment with one of our board-certified dermatologists or physician assistants so we can properly diagnose you.  Depending on your unique skin, we might prescribe steroid creams, oral antibiotics or antifungal medications (depending on the cause of the infection) to relieve itching and promote healing. Please schedule an appointment to see your treatment options. We’re looking forward to treating you.

Lyme Disease

If you recently got a tick bite, have a bullseye around the bite, and have fever, chills, or fatigue, you might have Lyme disease. Lyme disease is an inflammatory disease caused by bacteria spread through tick bites.  bacterial illness (and an inflammatory disease) that spreads through tick bites. Signs and symptoms of Lyme disease often appear in creases of the body like armpits, the nape of the neck, or the back of knees. If left untreated, Lyme disease can cause abnormalities in the skin, heart, joints and nervous system.

Symptoms of Lyme disease

• Bullseye on the skin with an expanding ring of redness or coloration.
• Fatigue
• Chills
• Swollen lymph nodes
• Sore throat
• Muscle or joint stiffness

Phases of Lyme disease

There are three distinct phases of Lyme disease. If you believe you have Lyme disease, you should seek treatment immediately. Contact our office to make an appointment.

Early Localized Phase

During the initial phase of Lyme disease, the skin around the bite develops an expanding ring of redness. The ring may have a bullseye appearance with a bright red outer ring surrounding clear skin in the center. Most people don’t remember being bitten by a tick. Also, more than 1 in 4 patients never gets a rash. Skin redness may be accompanied by fatigue, chills, muscle and joint stiffness, swollen lymph nodes and/or headaches.

Early Disseminated Phase

Weeks to months after the rash disappears, the bacteria spread throughout the body, impacting the joints, heart and nervous system. Symptoms of this phase of Lyme disease include pain in the joints, neck ache, tingling or numbing of the extremities, enlarged lymph glands, sore throat, abnormal pulse, fever, changes in vision or fatigue.

Late Disseminated Phase

Late in the dissemination of the disease, patients may experience an inflammation of the heart, which can lead to heart failure. Nervous system issues might develop, such as paralysis of facial muscles (Bell’s Palsy) and diseases of the peripheral nerves (peripheral neuropathy). It is also common for arthritis and inflammation of the joints to appear, which cause swelling, stiffness and pain.

Prevention

The best form of prevention is to avoid tick bites. We recommend wearing long sleeves and pants when outdoors. After going into the woods, check your skin and the skin of others for any tick bites.  If you do find a tick, don’t panic. Use tweezers to disengage the tick from the skin. Grab the tick by the head or mouthparts as close as possible to where the bite has entered the skin. Pull firmly and steadily away from the skin until the tick disengages. Clean the bite wound with disinfectant and monitor the bite mark for other symptoms. You can place the tick in a jar or plastic bag and take it to your dermatologist for examination.

Diagnosis and Treatment

30,000 cases of Lyme disease happen per year in the United States, so you are not alone. Lyme disease is diagnosed through a combination of a visual examination and a blood test for Lyme bacteria antibodies. If you have Lyme disease, we will prescribe medications accordingly. Please contact our office to schedule an appointment immediately if you think you have Lyme disease.

Ringworm

Ringworm is a common fungal infection, especially among athletes and kids, that appears on different parts of the body. Ringworm usually looks like ring-shaped, scaly and itchy patches on the skin. In many cases, the patches may blister or ooze fluid. Ringworm is highly contagious and can be passed from person to person or through contact with contaminated personal care products, clothing, or linens. Pets, particularly cats, can also pass on the infection to human hosts.

Symptoms of Ringworm

• Scaly, itchy ring-shaped patches on the skin
• Red or scaly patches

Treatments

We recommend that you keep the affected area clean, dry, and apply over-the-counter anti-fungal powders, lotions, or creams. Also, be sure not to have skin contact with others as you will most likely spread  the infection. At your appointment, one of our dermatologists or physician assistants may recommend prescription antifungal medications and antibiotics.

Shingles

Shingles is a painful rash that is caused by the Varicella zoster virus, or the same virus that causes Chicken pox. After having chicken pox, the virus lies dormant in nerve tissue underneath the skin. Years later, and with no known reason, it reactivates and causes shingles.

Shingles is contagious and can easily pass through touching from one person to another. The virus develops into shingles for people who have had chicken pox and develops into chicken pox for those who have not had it.  It usually appears as a band or strip of blisters on one side of the body that goes from the spine around the front to the breastbone. However, shingles can also appear on the neck, nose and forehead.

Shingles appears most frequently among older adults (age 60+) and in people with compromised immune systems. Generally, a person only gets shingles once.​

Symptoms of Shingles

• Pain, burning, numbness or tingling on one side of the body.
• A rash that appears a few days after the pain. It may be itchy.
• Blisters that break open and then crust over.
• Fever, aches, or headaches.

Diagnosis and Treatments

To diagnose Shingles, we will examine your medical history and your rash. If you suspect you may have shingles, it is important to contact your dermatologist as quickly as possible. Early treatment can reduce the pain and severity of the episode. If you have shingles, we might prescribe antiviral drugs (acyclovir, valacyclovir and famciclovir), pain medicines, or topical creams.

Shingles usually heals in about 2 to 3 weeks without any problem. However, a small percentage of patients over 50 who get Postherpetic neuralgia, or pain that lasts a month after the healing period. Some patients may experience pain that lasts beyond one month after the healing period.

The U.S. Food and Drug Administration has approved a vaccine, called Zostavax, for the prevention of adult shingles. It is approved for adults age 60 or older who have had chicken pox. Essentially, the vaccine delivers a booster dose of chicken pox. The vaccine has proven to be very effective in reducing the incidence of shingles and postherpetic neuralgia.

At Advanced Dermatology, Mohs & Laser Surgery Center, we are committed to treating your Shingles. Book an appointment with one of our dermatologists or physician assistants to discuss your treatment options.

Yeast Infections (Candidiasis)

On the surface of your skin, you have a variety of bacteria and fungus that protect your skin from foreign invaders. Occasionally, these bacteria and fungus can multiply uncontrollably and cause infections. Yeast infections, or candidiasis, are types of fungal infections that typically appear in creases of skin.

Causes of Yeast Infections

• Warm weather
• Poor hygiene
• Obesity
• Moist skin
• Weakened Immune system

Symptoms of Yeast Infections

• Rash
• Redness and itchy skin
• Blistering or cracked skin

The symptoms of Yeast infections can also resemble the symptoms of other skin conditions and disorders.

• Ringworm (button)
• Contact dermatitis (button)
• Psoriasis (button)
• Herpes (button)
• Seborrheic dermatitis (button)
• Eczema (button)

Types of Yeast Infections

Oral candidiasis (Oral thrush)

Oral thrush is characterized by lacy, white patches on top of reddened areas that occur on the tongue, throat, or mouth. Oral thrush is usually accompanied by a fever or diarrhea. This form of candidiasis can be painful and lead to a burning sensation in the mouth. People who are diabetic, have suppressed immune systems, patients undergoing antibiotic or chemotherapy treatment and denture wearers are more susceptible to this infection. It is particularly important to catch it early in infants and children. Because of the discomfort caused by oral thrush, they may stop eating and/or drinking.

Diaper rash

Candidiasis breeds in warm, moist environments and in the natural creases of the skin. Some diaper rashes are bacterial, but many are caused by yeast infections. To treat diaper rash, use over-the-counter powders and ointments and antifungal creams and lotions. Plan on frequent diaper changes to give the skin a chance to be exposed to air regularly. If diaper rash doesn’t abate in seven to 10 days, contact your dermatologist.

Candidal Intertrigo

This type of yeast infection occurs in moist overlapping skin folds, such as areas in the inner thighs, armpits, under the breasts, under the belly, behind the ears and in the webbed spaces between the fingers and toes. It is more common among people who are overweight. Candidal Intertrigo is characterized by red, raw skin surrounded by scaling and, in some cases, lesions that itch, ooze or hurt. Candidal intertrigo is treated with medicated topical creams.

Treatments

If you think you have a Yeast infection, we recommend keeping the affected area dry and making an appointment with one of our board-certified dermatologists or physician assistants so we can properly diagnose you.  Depending on your unique skin, we might prescribe antifungal creams (depending on the cause of the infection). Please schedule an appointment to see your treatment options. We’re looking forward to treating you.

Actinic Keratosis

Actinic keratosis affects more than 12 million Americans and is characterized by rough (and dry) lesions or patches that appear on sun-exposed areas of the skin, such as the face, back of hands, arms, scalp or shoulders. These precancerous growths on the skin are caused by overexposure to the sun over a long period of time.

Actinic keratosis is more common among fair-skinned people and those who have had years of exposure to ultraviolet light. Actinic keratosis can develop into malignant cells, typically squamous cell carcinoma, which is a type of skin cancer. If you think you have Actinic keratosis, we recommend making an appointment with one of our dermatologists or physician assistants.

Causes of Actinic Keratosis

Actinic keratosis generally forms as a result of sun damage from ultraviolet light from the sun or tanning beds.

Treatments

After a physical examination and biopsy of the lesion, your dermatologist or physician assistant might decide on one of the following treatments to remove the growth:

Cryosurgery: Which freezes off the growth using liquid nitrogen.

Surgical excision: The doctor scrapes off the lesion and bleeding is stopped by electrocautery.

Chemical peels: Chemical peels remove the top layer of the skin.

Photodynamic Light therapy: A dye is applied that sensitizes the skin to light and the area is then exposed to light via a laser or another light source.

If you think you have Actinic keratosis, we recommend making an appointment with one of our board-certified dermatologists or physician assistants so we can properly diagnose and treat you.  At Advanced Dermatology, Mohs & Laser Surgery Center, we are dedicated to treating Actinic keratosis and preventing the development of skin cancer. We’re looking forward to treating you.

Boils

Boils, or skin abscesses, can form as a result of a bacterial infection inside a cut or break in your skin. Boils are usually red, tender, painful, and filled with pus. Usually, boils appear near hair follicles or sweat glands that are exposed to friction. Boils can be quite painful and appear on your face, neck, armpits, under the knees, and on the buttocks.

At Advanced Dermatology, Mohs & Laser Surgery Center, we are committed to helping treat your boils. Our board-certified dermatologists and physician assistants are highly trained experts that will assess your skin, educate you about your treatment options, and treat your skin condition effectively.

Causes of Boils

Anyone can get a boil. Boils grow quickly and are quite painful for many, especially when draining them. They can form as a result of friction and/or in areas of the face and body that are exposed to extra oils. People with weakened immune systems are more susceptible to boils than the general population.

Types of Boils

Cystic Acne

These boils are situated more deeply into skin tissue than the more superficial forms of acne. It typically occurs among teenagers.

• Acne

Furuncle or Carbuncle

These abscesses are caused by the Staphylococcus aureus bacterium. A furuncle is an individual boil; carbuncles are deep clusters of boils that most often form on the back of the neck, shoulders or thighs.

Pilonidal Cyst

An infected hair follicle around the buttocks area caused by long periods of sitting. Pilonidal cysts almost always require medical treatment.

Hidradenitis Suppurativa

These are multiple abscesses that form from blocked sweat glands in the armpits or groin areas.

Treatments

Many boils respond well to home remedies and will naturally come to a head and burst open, allowing the pus to drain and the skin to heal. Apply hot compresses to your boil to encourage healing. Make sure to keep the area clean, apply over-the-counter antibiotics (if neccesary) and then cover with gauze (after the boil has bursted). It’s very important to keep boils clean because they can lead to further infection.

If your boil does not go away within two weeks, is accompanied by a fever or is painful, contact us to schedule an appointment with one of our dermatologists or physician assistants. At your appointment, we will clean, lance and drain your boil and prescribe an antibiotic to alleviate the infection.

Granuloma

Granuloma is a generic term that refers to a small nodule (or growth) on the skin. It can be any type of nodule, from benign to malignant. Granulomas occur throughout the body. There are two types of granuloma that apply expressly to the skin.

Causes of Granuloma

Granuloma can form as a result of a variety of different causes. The causes and triggers of Granuloma include, but are not limited to:

• Bacterial, fungal, or viral infections
• Environmental triggers
• Stress or trauma to the skin
• Sun exposure (UV)
• Animal (or insect) bites
• Drugs

Types of Granuloma 

Pyogenic Granuloma

Pyogenic granuloma looks like small, reddish bumps on the skin that tend to bleed. It is caused by an injury to the skin. It is most frequently found on the hands, arms and face. In some cases, the nodule will spontaneously disappear. More often, the lesions need to be removed by surgery. There may be some scarring as a result of these treatments.

Granuloma Annulare

This type of nodule can occur in any person, but is more common in children and young adults. It is characterized by a ring-shaped lesion that is round and firm; red, white or purple skin around a clear crater of normal skin. It can appear individually or in groups. Most often, it appears on tops of hands and feet, elbows and knees. Most people have no other symptoms, but some may experience itchiness at the site of the lesion.

Granuloma Annulare can be localized, generalized, or under the skin. “Localized,” the most common form of Granuloma Annulare, involves circular bumps that can appear on the hands, feet, ankles, and wrists. “Generalized” involves itchy, red bumps on most of the body. Granuloma can also appear under the skin although it is very rare.

Treatments

Granuloma annulare usually resolves itself and might disappear over time without treatment. However, if the incidence is widespread or aesthetically undesirable, we might prescribe you steroids (cream or injection) to speed healing. Another successful treatment is PUVA, in which a medication called psoralen is given and then the area is treated with ultraviolet light. When you come in for your appointment, your dermatologist or physician assistant will assess your skin, diagnose you, and then develop a treatment just for you.

Seborrheic Keratosis

Seborrheic keratoses are small, brown (or black) noncancerous skin growths that tend to appear on the head, neck, chest or back. These growths start out as small, rough areas but can develop into a thick growth.  Although these growths look like melanoma to an untrained eye, they are not harmful and usually a product of aging skin. If you think you have a seborrheic keratosis or any irregular growths, you should schedule an appointment for a full-body skin check to ensure that you don’t have any form of skin cancer.

Common Symptoms

• Round or oval shaped growth that is flat or slightly raised
• Brown, beige, or black in appearance.
• Itchy

Causes of Seborrheic Keratosis

Seborrheic keratoses can form as a result of a variety of different causes. The causes and triggers of these skin growths include, but are not limited to:

• Heredity
• Aging skin
• Sun exposure (UV)

Treatments

Seborrheic keratoses are harmless growths and usually do not require treatment. If they are of cosmetic concern, we offer a wide range of leading laser treatments to help you achieve your aesthetic goals. If you think you have a seborrheic keratosis or any irregular growths, you should schedule an appointment with one of our board-certified dermatologists or physician assistants for a full-body skin check to ensure that you don’t have skin cancer.

Moles

Moles are brown or black growths, usually round or oval, that can appear anywhere on the skin. Moles can be rough or smooth, flat or raised, single or in groups. Moles occur when cells that are responsible for skin pigmentation, known as melanocytes, grow in clusters instead of spreading out across the skin.

Generally, moles are less than one-quarter inch in size and rarely develop into skin cancer. Most moles appear by the age of 20, although some moles may appear later in life. Although most moles are harmless, a change in size, shape, color or texture could be indicative of a cancerous growth. If your mole or growth seems irregular, you should schedule an appointment with one of our dermatologists or physician assistants immediately.

Types of Precancerous Moles

Although there are many types of Moles, these types of  moles have a higher chance of becoming cancerous.

Congenital Nevi

Moles present at birth. The larger their size, the greater the risk for developing into a skin cancer.

Atypical Dysplastic Nevi

Irregularly shaped moles that are larger than average. They often appear to have dark brown centers with light, uneven borders.

• Skin cancer

Monitoring Moles

People with fairer skin tend to get more moles. If you have 50 or more moles, you are at greater risk for developing skin cancer. In some cases, abnormal moles may become painful, itchy, scaly or bleed. It’s important to keep an eye on your moles so that you can catch any changes early. We recommend monthly full-body skin checks to monitor your moles. If you develop skin cancer, we can catch it early.

Use the American Academy of Dermatology’s ABCDEs as a guide for assessing whether or not a mole may be becoming cancerous:

American Academy of Dermatology’s ABCDEs

Asymmetry: Half the mole does not match the other half in size, shape or color.

Border: The edges of moles are irregular, scalloped, or poorly defined.

Color: The mole is not the same color throughout.

Diameter: The mole is usually greater than 6 millimeters when diagnosed, but may also be smaller.

Evolving: A mole or skin lesion that is different from the rest, or changes in size, shape, or color.

Treatments

We recommend monitoring your moles using the American Academy of Dermatology’s ABCDEs and frequently getting full-body skin checks . If your moles appear irregular, please make an appointment to see one of our dermatologists or physician Assistants at your nearest convenience.

Our Mohs micrographic surgeon, Dr. Sabatino Ciatti, might biopsy your mole to determine whether the growth is cancerous or not. We are looking forward to treating you.

Skin Cancer

In the United States, skin cancer is the most commonly diagnosed form of cancer. With an estimated 1,000,000 new cases every year, skin cancer is highly common and can affect anyone. The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma.

If you suspect you have skin cancer or a precancerous growth,  please make an appointment to see one of our dermatologists right away. We may do a biopsy of the mole to determine if it is or isn’t cancerous or may surgically remove it. Mohs micrographic surgery is an advanced surgical technique that offers the highest cure rate for skin cancer. Mohs surgery is primarily used in the removal of basal cell and squamous cell carcinomas.

Basal Cell Carcinoma

This is the most common form of skin cancer. Basal cells reside in the deepest layer of the epidermis, along with hair follicles and sweat ducts. When a person is overexposed to UVB radiation, it damages the body’s natural repair system, which causes basal cell carcinomas to grow. These tend to be slow-growing tumors and rarely metastasize (spread).

Signs of Basal Cell Carcinoma

Basal cell carcinomas can present in a number of different ways:

• Raised pink or pearly white bump with a pearly edge and small, visible blood vessels.
• Pigmented bumps that look like moles with a pearly edge.
• A sore that continuously heals and
• A flat scaly scar with a waxy appearance and blurred edges.

Despite the different appearances of the cancer, they all tend to bleed with little or no cause. Eighty-five percent of basal cell carcinomas occur on the face and neck since these are areas that are most exposed to the sun.

Risk Factors

Risk factors for basal cell carcinoma include having fair skin, sun exposure, age (most skin cancers occur after age 50), exposure to ultraviolet radiation (as in tanning beds) and therapeutic radiation given to treat an unrelated health issue.

Diagnosing Basal Cell Carcinoma

Diagnosing basal cell carcinoma requires a biopsy which usually involves an excision or an incision. During an excision, the entire tumor is removed along with some of the surrounding tissue. During an incision, only a part of the tumor is removed (used primarily for large lesions).

Treating Squamous Cell Carcinoma

1. Simple excision (Cutting and Suturing)
2. Curettage and electrodessication (Scraping and burning with an electric needle)
3. Mohs micrographic surgery (microscopically controlled excision).
4. Radiotherapy (x-ray)

Although any of the above methods can be used to treat basal and squamous cell carcinomas, Mohs micrographic surgery is by far the most superior. Mohs surgery offers the highest cure rate (up to 99%), the lowest chance of regrowth, the lowest potential for scarring and disfigurement, and the most exact and precise means of removal (only skin cancer is removed, normal tissue is spared). Melanomas are almost always treated by wide-excision. However, some melanomas in sensitive cosmetic areas can be treated with Mohs surgery.

• Mohs
• Dr. Ciatti

Squamous Cell Carcinoma

Squamous cells are found in the upper layer (the surface) of the epidermis. They look like little fish scales under a microscope and present as a crusted or scaly patch of skin with an inflamed, red base. They are often tender to touch. It is estimated that 250,000 new cases of squamous cell carcinoma are diagnosed annually, and that about 1 percent of these cases are fatal.

Signs of Squamous Cell Carcinoma

Squamous cell carcinoma can develop anywhere, including inside the mouth and on the genitalia. It most frequently appears on the scalp, face, ears and back of hands. Squamous cell carcinoma tends to develop among fair-skinned, middle-aged and elderly people who have a history of sun exposure. In some cases, it evolves from actinic keratoses, dry scaly lesions that can be flesh-colored, reddish-brown or yellow black, and which appear on skin that is rough or leathery. Actinic keratoses spots are considered to be precancerous.

• Actinic Keratosis

Risk Factors

Risk factors for squamous cell carcinoma include having fair skin, sun exposure, age (most skin cancers occur after age 50), exposure to ultraviolet radiation (as in tanning beds) and therapeutic radiation given to treat an unrelated health issue.

Diagnosing Squamous Cell Carcinoma

Diagnosing squamous cell carcinoma requires a biopsy which usually involves an excision or an incision. During an excision, the entire tumor is removed along with some of the surrounding tissue. During an incision, only a part of the tumor is removed (used primarily for large lesions).

Treating Squamous Cell Carcinoma

1. Simple excision (Cutting and Suturing)
2. Curettage and electrodessication (Scraping and burning with an electric needle)
3. Mohs micrographic surgery (microscopically controlled excision).
4. Radiotherapy (x-ray)

Although any of the above methods can be used to treat basal and squamous cell carcinomas, Mohs micrographic surgery is by far the most superior. Mohs surgery offers the highest cure rate (up to 99%), the lowest chance of regrowth, the lowest potential for scarring and disfigurement, and the most exact and precise means of removal (only skin cancer is removed, normal tissue is spared). Melanomas are almost always treated by wide-excision. However, some melanomas in sensitive cosmetic areas can be treated with Mohs surgery.

• Mohs
• Dr. Ciatti

​Melanoma

Malignant melanoma is a skin cancer that can be life threatening if it is not diagnosed and treated early. Although melanoma is the least common type of skin cancer, it is by far the most dangerous. Melanoma is actually the most common form of cancer among young adults aged 25 to 29. Melanocytes are cells found in the bottom layer of the epidermis. These cells produce melanin, the substance responsible for the pigment of your skin. That’s why melanomas often look like little dark brown or black spots on the skin.

Melanomas can spread rapidly to internal organs and the lymph system, making them quite dangerous. When melanomas are discovered and treated early, they are nearly 100% curable. For all of our patients, we recommend frequent full body skin checks.

Signs of Melanoma

• Large brown spots with darker speckles located anywhere on the body.
• Dark lesions on the palms of the hands and soles of the feet, fingertips toes, mouth, nose or genitalia.
• Existing moles that begin to grow, itch or bleed.
• Brown or black streaks under the nails.

Melanomas look like irregular moles and can grow inside existing moles. That’s why it is important for you to conduct regular self-examinations of the skin in order to detect any potential skin cancer early, when it is treatable.

American Academy of Dermatology’s ABCDEs

Asymmetry: Half the mole does not match the other half in size, shape or color.

Border: The edges of moles are irregular, scalloped, or poorly defined.

Color: The mole is not the same color throughout.

Diameter: The mole is usually greater than 6 millimeters when diagnosed, but may also be smaller.

Evolving: A mole or skin lesion that is different from the rest, or changes in size, shape, or color.

Risk Factors

Risk factors for squamous cell carcinoma include having fair skin, sun exposure, age (most skin cancers occur after age 50), exposure to ultraviolet radiation (as in tanning beds) and therapeutic radiation given to treat an unrelated health issue.Most melanomas are caused by overexposure to the sun beginning in childhood. This cancer also runs in families.

Diagnosing Melanoma

Diagnosing melanoma requires a biopsy which usually involves an excision or an incision. During an excision, the entire tumor is removed along with some of the surrounding tissue. During an incision, only a part of the tumor is removed (used primarily for large lesions)

Treatments for Skin Cancer

1. Simple excision (Cutting and Suturing)
2. Curettage and electrodessication (Scraping and burning with an electric needle)
3. Mohs micrographic surgery (microscopically controlled excision)
4. Radiotherapy (X-ray)

Although any of the above methods can be used to treat basal and squamous cell carcinomas, Mohs micrographic surgery is by far the most superior. Mohs surgery offers the highest cure rate (up to 99%), the lowest chance of regrowth, the lowest potential for scarring and disfigurement, and the most exact and precise means of removal (only skin cancer is removed, normal tissue is spared). Melanomas are almost always treated by wide-excision. However, some melanomas in sensitive cosmetic areas can be treated with Mohs surgery.

Warts

Warts are small, harmless growths that appear most frequently on the hands and feet. Sometimes they look flat and smooth, other times they have a dome-shaped or cauliflower-like appearance.

Warts are highly contagious growths caused by different forms of Human Papilloma Virus (HPV). They occur in people of all ages, can spread from person-to-person, and can hop from one body part to another. Warts are benign (noncancerous) and usually painless.

Types of Warts

The location of a wart is often the key to diagnosing what kind of wart it is.​

Common warts

Common Warts can appear anywhere on the body, although they most often appear on the back of fingers, toes and knees. These skin-colored, dome-shaped lesions usually grow where the skin has been broken, such as a scratch or bug bite.

Facial warts (Filiform warts)

Filiform warts look like a long, narrow, flesh-colored stalk that appears alone or in groups around the eyelids, face, neck, or lips. They are sometimes called facial warts. They may cause itching or bleeding, but are easy to treat with over-the-counter medications.

Flat warts

Flat warts appear on the face and forehead. They are flesh-colored (or white), are usually slightly raised, and they usually appear in multiples. Flat warts are more common among children and teens than adults.

Genital warts

Genital warts, which are the result of Herpes Simplex Virus 2, appear around or inside the genital and pubic areas. The lesions, which usually grow in clusters, start small and soft but can become quite large. Genital warts are both sexually transmitted and highly contagious. In fact, you should avoid sex with anyone who has a visible genital wart. Genital warts should always be treated by a physician.

• Herpes

Plantar warts

Plantar warts appear on the soles of the feet and can be painful since they are on weight-bearing surfaces. Plantar warts have a rough, cauliflower-like appearance and may have a small black speck in them. They often appear in multiples and may combine into a larger wart called a “mosaic wart.” Plantar warts can spread rapidly.

Subungual warts and Periungual warts

Subungual and periungual warts appear as rough growths around the fingernails or toenails. They start as nearly undetectable, pin-sized lesions and grow to pea-sized with rough, irregular bumps with uneven borders. Subungual and periungual warts can mess with healthy nail growth. Because of their location, they are difficult to treat and should be assessed by your dermatologist.

Treatments

Most warts respond well to over-the-counter treatments, like Non-prescription freezing products (dimethyl ether) and salicylic acid. Salicylic acid dissolves the keratin protein  that makes up the wart and the thick layer of skin that covers it. It comes in gels, pads, drops and plasters and takes 4 to 6 weeks to eradicate the warts.

Some warts will require medical attention and treatment.

Cryotherapy: Cryotherapy freezes off the wart using liquid nitrogen or nitrous oxide.

Electrosurgery:  Electrosurgery sends an electric current through the wart to kill the tissue.

Laser surgery: Laser surgery involves heating up the wart with a laser until the tissue dies and the wart eventually falls off. Dr. Ciatti is a highly trained laser surgeon.

If over-the-counter treatments don’t resolve your warts, schedule an appointment with one of our dermatologists or physician assistants to see your treatment options.