Q: What does a “Board-Certified Skin Specialist” mean and why is it important?
A “Board-Certified” provider has been certified by a medical specialty’s Board organization which helps assure the public that the provider has successfully completed an approved educational program and an evaluation, including an examination process that assesses their knowledge, experience & skills necessary to provide high quality care.
Currently, the Board certification for Dermatology is time-limited and is only valid for a period of time, at which point, the dermatologist must become re-certified. During their certification period, the dermatologist accomplishes specific requirements including patient and peer communication surveys, annual continuing education and periodic self-assessments. Although a Board certification is not a warranty for competency, it does attempt to ensure a high standard for a “Board-Certified” Dermatologist and ensure the provider meets specific periodic requirements.
For more information on Board certification, please visit the American Academy of Dermatology website.
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Q: What is a Dermatologist?
A Dermatologist is a doctor (MD or DO) who has been specially trained in the treatment of disorders affecting the skin, hair, nails, and mucous membranes. After residency, many Dermatologists also meet specific requirements and testing to become a Board-Certified Dermatologist. A Dermatologist is trained in treating skin conditions, surgical procedures, lasers, phototherapy, cosmetic procedures and many other skills during their training.Click here for more information→
Q: How do I schedule an appointment?
Depending on your insurance, you can contact our office directly or you may require a consult from your Primary Care Provider. To schedule an appointment, you can contact our office by phone or use the “Contact Form” on the Website.
Q: Do I need to arrive early for my appointment?
We recommend you arrive 15-20 minutes early if a new patient; and 5-10 minutes early for an established patient. This enables us to get any paperwork completed, get you in the examination room and into a gown, if needed. In order to save you time, you can complete much of the paperwork prior to your visit either online at our website or by obtaining the paperwork by fax.
Q: Do you do a complete skin exam on every new patient?
A complete skin exam involves examination of the skin by the Provider and is great opportunity to have skin lesions evaluated by a trained specialist. This type of skin exam is recommended, especially for new patients, follow-up patients with a history of skin cancer or if the patient desires it. A thorough skin exam ensures there are not other lesions that you may not be aware of at the time and allows the provider to determine the extent of a skin condition.
Q: Will I see a doctor or physician’s assistant (PA)?
At this time, Advanced Dermatology has primarily Board-Certified Dermatologists seeing patients, so you will likely see a doctor during your visit. In the future, we may add PA’s; but you will always be able to request evaluation by a doctor, and we will do our best to accommodate your request. Often you can be evaluated sooner by a PA,if your insurance allows, since the doctor’s schedule often fills up rapidly; but it is the patient’s preference. Typically, our aim and goal for all new patients is to see a doctor on their initial visit.
Q: What is cryotherapy?
Cryotherapy is the use of liquid nitrogen to freeze the skin in order to treat benign and malignant lesions. It is often used to treat warts, seborrheic keratoses, lentigenes (or “age spots”), pre-cancerous actinic keratosis and superficial non-melanoma skin cancers. The procedure basically causes a superficial “freeze-burn” that will result in some redness then scaling and crusting in the area. Cryotherapy risks include blister formation, hypopigmentation and scarring in the area.
Q: What is a biopsy?
Based on the suspicion of a skin lesion, a biopsy may be recommended by your Provider. A biopsy involves cleaning the area and numbing the local area with an injection. The injection typically stings initially, but in a few seconds should go away as the area becomes numb. The Provider will then use a blade or punch biopsy to remove the lesion. A punch biopsy is a round, “cookie-cutter-like” instrument that will make a circular hole in the skin around the lesion. A suture is often placed if a punch biopsy is performed.
Q: What is the “electrodessication and curettage” procedure?
Electrodessication and curettage (ED&C) is a procedure used to remove both benign and malignant skin lesions. It is a “burning-and-scraping” technique of the lesion, which is accomplished after it is numbed locally. The Provider will use a round blade called a curette to scrape the lesion off the skin and then use an electrical instrument that will cause a mild burn to the skin. This technique is usually accomplished several times to ensure the lesion is removed. After the ED&C procedure, the area will have a round, crusted scab. This scab will take 1-2 months to come off the area and a round, often white, scar will remain.
Q: What is “Blue-Light” Therapy?
“Blue-Light” or Photodynamic Therapy (PDT) is used to treat multiple skin conditions. Typically, it is used to treat pre-cancerous lesions called actinic keratosis (AK) that cover broad areas of the skin. A chemical is placed on the area to be treated and the patient will wait for a period of time in the office (often approximately one hour or more).
After this wait period, the patient is exposed to a light source, either a suntan booth-type device or a hand-held light device. The light will activate the chemical that is absorbed by particular cells in the skin and cause them to be destroyed. The patient will typically feel some tingling and slight warmth to burning sensation on the skin during and after the procedure. In the days after the procedure, the patient should avoid sun-exposure, especially the first 24-48 hours. The patient should expect to get red and scaly in the treated area. Click here for more information→
Q: What is a Mohs Procedure?
Dr. Frederic Mohs developed the Mohs Procedure as a tissue-sparing procedure to remove skin cancers. Specially trained Dermatologists use this technique to remove certain skin cancers when in areas or situations where the least amount of tissue should be removed, while also ensuring the cancer is removed appropriately.
During the Mohs Procedure, the patient is awake during the procedure and is numbed up similar to when the lesion was biopsied. The Dermatologist will remove the lesion with a very small border and then have the patient wait with a bandage. During the next 20-40 minutes, the Dermatologist will have the tissue prepared with a freezing technique so they can visualize the peripheral and deep margins under a microscope. After evaluating the tissue, the Dermatologist will determine if the lesion is removed or if another section has to be removed. Additional sections will be taken only in the specific areas that still have concern for cancer remaining. Usually, the Dermatologist will repair the site on the same day, or if a complex repair is required, the patient may follow-up with another specialist or a following day.
On the Mohs Procedure day, you should expect to be at the office for 2-4 hours. As a result, it is recommended to bring some warm clothing since offices may be cool, something to do (e.g., book, computer, tablet), and some snacks. Click on the following link for more information Click here for more information→
Q: What types of skin cancer are there?
There are 3 basic types of skin cancer that are divided into melanoma and non-melanoma skin cancer. Melanoma is a skin cancer that forms from malignant melanocytes, the pigment cells in the skin. This is the most dangerous skin cancer with the potential to metastasize and can be deadly.
The non-melanoma skin cancers are basal cell carcinoma and squamous cell carcinoma. This group of skin cancers has a much lower risk of metastasizing and death. Diagnosing skin cancer is important as early as possible since it is much easier to treat and has a higher success rate. If you have a history of skin cancer, it is recommended to practice sun-avoidance, perform periodic self-skin exams and have periodic skin exams by a Provider (typically your Dermatologist). Click here for more information→
Q: Can children or teenagers get skin cancer?
Although not common, children and teenagers can develop skin cancers. If you notice a changing lesion or non-healing lesion, contact your Provider or Dermatologist to have it evaluated.
Q: If my parents have melanoma, should I get a skin exam?
If you have a close relative with a history of melanoma (parent or sibling), you may be at an increased risk of developing melanoma. It is recommended you practice good sun-protection, perform self-skin exams and consider periodic skin exams by a Provider.
Q: What is an actinic keratosis?
An actinic keratosis is considered a pre-cancerous lesion since a small percentage of these lesions over time may develop into a skin cancer, usually a squamous cell carcinoma. Due to its pre-cancerous features, your Dermatologist can treat the lesion by various methods to destroy the lesion before it becomes a skin cancer.Click here for more information→
Q: What is a dysplastic nevus?
A dysplastic or atypical nevus is a benign mole that has atypical architecture and cells. The diagnosis of dysplastic nevus is made by performing a biopsy and from the Pathology report; although a Provider can have a suspicion based on its clinical appearance. Your Provider will discuss the pathology and the treatment options, which may include monitoring the lesion or removal of the lesion, if concerning or recurs.
If you have dysplastic nevi, it is considered a risk marker for skin cancer. For example, if you have numerous dysplastic nevi, you are at a higher risk of developing skin cancer vs. an individual with no atypical nevi. Your provider will discuss the plan, and often includes periodic skin exams by a Provider along with good sun-protection and periodic self-skin exams. Click here for more information→