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Microneedling, An Excellent Way To Rejuvenate Skin And Reduce Wrinkling

Microneedling, An Excellent Way To Rejuvenate Skin And Reduce Wrinkling

Microneedling is one of several technologies that markedly rejuvenates the skin and reduces wrinkling.  Here we will discuss those technologies and other things that you can do to improve the quality and appearance of your skin.

Retinol/Retin-A

The cornerstone of skin care to prevent wrinkles has been, for many years, the use of a retinol or tretinoin (Retin-A) after the age of 30.  This is because the skin stops continually making collagen, the substance that thickens the skin, at around 30 years of age.  If the skin is not stimulated to continue the process of collagen production, the dermis, the support layer of the skin, thins and multiple crinkles and wrinkles result.  If you have failed to use these in the past and have developed significant crinkles and wrinkles, then use of the more potent tretinoin is still the mainstay of skin rejuvenation.

Peels & Laser Resurfacing

Once you had developed aged appearing skin, the only treatment that could correct the wrinkling/crinkling was a leveling peel or laser resurfacing that removed the surface of the skin between the wrinkles to the level of the bottom of the wrinkles and allowed the skin to grow a new surface epithelium over a smoother dermal base.  The problem with this is that, because of limitation of the body’s ability to resurface the skin, they became the procedures with the longest downtime of any of the modern plastic surgical procedures.  Although we could push the body some, the minimum downtime where the skin is somewhat raw and oozing with either of these technologies is about 1 ½ to 2 weeks.

Intradermal Filling

Although fillers have been called “dermal fillers” for many years, until recently no one actually injected the filler into the dermis, the support layer of the skin.  If they did, frequently a greenish or bluish line would appear when light reflected off the injected filler.  Only in the last 10 years have we had fillers that did not cause this blue line, the Tindal effect.  Belotero Balance® introduced in 2011 was the 1stJuvederm Volbella®, equally as good if not better, was approved in 2016.  These allowed us to actually inject fillers into the dermis elevating the surface of the wrinkle to reduce or eliminate it.  We have also discovered that if the product is placed just at the bottom or under the dermis perpendicular to the wrinkles, it can prevent further wrinkling of the skin and allow the tretinoin to use some of the product to thicken and stiffen the skin.  Other than some mild swelling and occasionally minimal bruising that could be covered with camouflage makeup, there is essentially no down time with this technique.

Microneedling/Fraxel Laser

The one thing that leveling peels and laser did was markedly stimulate the dermis to build significant new collagen at a faster rate than it did with just the use of tretinoin.  The 1st improvement to markedly improve the rate of the skin’s collagen production was development of the Fraxel Laser, a laser that, instead of removing the surface of the skin, simply poked holes in it.  Since injury to the dermis is the one thing that causes the skin to markedly produce collagen, this significantly turned on the body’s healing processes.  This laser, however, is quite expensive and uncomfortable.  Microneedling was developed to answer these problems.  It does the same thing by using small needles that create holes in the dermis and also turns on the body’s healing processes, markedly stimulating collagen production.

The procedure, done in a physician’s office, uses a device that pushes the needles absolutely perpendicular so that there is only a very minute entry point.  Because of the marked success of this process, “Microneedling” rollers are now being sold for home use.  The problem is that they do not produce uniform holes to the proper depth in the dermis and, instead of entering and leaving absolutely perpendicular, they enter and exit at an angle actually tearing the skin.

No Downtime Skin Rejuvenation

These latter two developments have allowed us to now achieve skin rejuvenation comparable to leveling peels and laser but without the significant downtime.  Our present protocol for rejuvenation of sun damaged, wrinkled, crinkled skin is beginning tretinoin, injection of the wrinkles to reduce as much as we can using Volbella®, and then doing a series of Microneedling procedures, all with minimal to no downtime.

If you are interested in rejuvenating your skin, schedule a consultation with Dr. Buchanan at our Highlands, NC office. Call (828) 526-3783 today.

Understanding Skin Aging Leads to Beautiful Skin

Over the years, we have come to understand  aging of the skin and how we can interact with this process to lead us to beautiful skin for much longer. Not long ago, we had only two options: age naturally or undergo plastic surgery to tighten weak, sagging tissue. The development of scientific based skin care, laser treatments, injectables, and even some plastic surgery procedures is still relatively recent. These techniques and technologies have become common and could only be created from a place of knowledge. Sure, skin aging is, to some extent, related to simple biology. However, from the study of twins with different lifestyles or different treatments, we have learned there are other factors involved. The more we understand them, the better we get at maintaining beauty at every age.

Hereditary factors are outside of our control. When we look at how our parents, siblings, and grandparents have aged, we get a good idea of how our process may go. Beyond that, though, we can alter our course by developing good habits and, when necessary, getting professional help.

Sun Exposure

It has become apparent from research that the sun ages the skin. As we have learned about the sun’s effect on the skin, we have also learned about the sun. The part of the sun responsible for the damage and aging is UVA, which is present all day, all year, and at every latitude. SPF does not let us know about protection from sun aging, only UVB and sun burn. We, therefore, need to apply a zinc oxide sunblock every day and reapply it if we wash or rub it off. Other sunscreens need to be applied every hour if outside or every 2 hours if indoors. It’s impossible to stay out of the sun. Even if we could, it would not be good for our health. The body needs a small dose of sunshine each day to produce vitamin D, which is essential for good immunity and bone strength. We also need it for proper sleep. Fortunately, we can get all we need even wearing sunblock.

Diet

We know that what we eat will affect our weight and our long-term health. We may minimize salt consumption to reduce our risk of heart disease. We may limit our sugar intake so we don’t gain too much weight. These habits are also good for the skin. Sugar and salt contribute to puffiness and inflammation that can cause skin sensitivities and premature aging. Skin-supporting foods include fresh fruits, leafy greens, lean protein, and healthy fats like nuts and olive oil, things good for you in general.

Smoking

Smoking, tobacco use, or vaping inhibits the oxygenation of tissues, including the lungs, other vital organs, and the skin. It does this by causing blood vessels to narrow. This reduces the production of collagen and elastin that firm and smooth the skin. It also reduces the repair system. Essentially smoking overwhelms the body’s regenerative processes and speeds aging.

Skin Care

Most people do skin care based on what their mother or a friend told them, what they have read, or what some company making skin care products have told them. One of the major changes over the last few decades is a scientific understanding of what proper skin care is and how to improve our skin. We don’t need most of what we are told we do. We need a cleanser, a pH balancer, an exfoliant and a sunblock as the basics. Moisturizers are, in fact, the worst thing we have ever done to our skin. Once we get to 25-30 we also need a retinol or tretinoin (Retin-A) and Obagi’s ELASTIderm to stimulate production of collagen and elastin respectively, as the body stops producing them naturally at about that age. If you have severe damage, we also now have treatment options based on science, though even some physicians are still peddling quackery.

What you do daily will affect your skin’s aging process. However, you don’t have to tackle aging on your own. In our Highlands, NC office, we offer a full complement of skin care and rejuvenation services as well as non-surgical treatments like Botox, fillers, and micro peels, which we include in our arsenal of skin care services. See how we can address your aging skin. Call (828) 526-3783 to schedule a visit with us.

Is Your Mask Causing Skin Problems?

Maskne from Mask WearingMaskne: A Problem of our Time

Before 2020, the term “maskne,” a term for skin problems caused by wearing a facial mask, did not exist. There was no need for a term like this before mask-wearing became the new norm. Once the threat of the novel coronavirus passes, and it will, we may go back to living our lives mask-free. For now, though, while we are masked, many people have to deal with an increase in inflammatory skin conditions. Maskne isn’t just more frequent acne flare-ups, it can also be new or worsening bouts of other dermatological problems.

It isn’t difficult to see why wearing a mask can result in these frustrating problems. When we talk and breathe under a mask, our breath creates the warm, humid environment bacteria and other flora love. Unfortunately, this problem may get worse as, because or the newer strains of the virus, we need masks that filter better, thus trapping warmth and oral bacteria more. The more microorganisms thrive in this environment, the more chance there is for skin irritation that results in physical symptoms like redness, itching, and pimples.

Can we Prevent Maskne?

Knowing that wearing a mask sets the stage for bacterial growth, we can implement a few strategies to minimize this risk.

  • If you wear a disposable mask, dispose of it regularly! Do not attempt to reuse this type of mask. If you wear a fabric mask, have a few on hand and wash them with a fragrance-free detergent often using warm water and a heated dryer.
  • Proper skin care is more important than ever. Wash your face twice daily using using an exfoliant at least once daily. Use of Vitamin-C Serum, an anti-inflammatory, can also help. It also acts as a pH balancer, which you need if you do not use Vitamin-C.
  • If you get significant irritation, you may need an antibiotic or other cream to control the problem. We are here to help with that.

If your skin is already showing signs of irritation from your mask, don’t wait to get help. Contact our Highlands, NC office. We may be wearing masks for a bit longer, but that doesn’t mean our skin has to suffer. Call (828) 526-3783 today to schedule your visit.

Common Sunscreen Mistakes: Are You Making Them?

Sunscreen UseIn spite of the skin being the largest organ in the body, we tend to forget about it. We only notice it when we encounter a problem like a sunburn or rash or when we we begin to see the signs of aging. The fact that there are about 300 million skin cells, and that cellular turnover occurs approximately every 30 days does not preclude us from the consequences of sun damage. One unhealthy cell is enough to cause concern. We, therefore, talk with our patients about ways they can prevent and treat skin cancer and the effects of aging. Here, we discuss common sunscreen mistakes we hope you will avoid.

  •      Using sunscreen only when “in the sun.” It might seem odd to read a blog about sunscreen smack dab in the middle of winter. If this seems odd, it because most of what people believe about the sun is wrong. There are not times at which sunscreen is necessary and times it is not. Sunscreen should be worn every day, all year, rain or shine. We have been told that UVB, which is strongest in the summer, down south, and mid day, is the bad guy. It does cause sunburn, but it is UVA, which is present morning, noon, and evening, summer, winter, indoors and outdoors, even in the shade, that causes cellular injury leading to aging and skin cancer.
  • Looking for SPF when buying sunscreens. Unfortunately, all SPF tells you is that you are protected from sunburn caused by UVB. It says nothing about protecting you from UVA damage. Companies cannot call themselves a sunscreen or sunblock unless they also block UVA, but they can use SPF even if they don’t.
  • Not knowing how to use Sunblock. One of the most common mistakes we see people make when it comes to sunscreen is that they do not apply enough, nor do they reapply sunscreen often enough when using most. A sunscreen, not a product that says SPF, should be applied to otherwise unprotected skin first thing every morning. The face needs about a dime-sized amount. For a whole-body application, you need about a shot glass full of lotion. If the sunblock you are using contains zinc oxide, you need to reapply it whenever you wash or rub it off. For ALL other sunscreens, you should reapply it hourly if outside or every 2 hours if inside.
  • Limiting your options. Sun protection does not end with sunscreen use. To significantly decrease your risk of skin cancer and premature aging, think outside the tube. Wear long-sleeves and pants designed as sun protective. normal clothing does not protect from UVA. Wear a wide-brimmed hat or hat with a sun protective flap that covers the back of the neck. Also, wear sunglasses to protect your eyes.

Stay Protected by Staying Informed

We are proud to serve patients from the Highlands, NC area and beyond. In addition to plastic surgery procedures, we offer a variety of skin services to prevent and treat sun damage. To schedule a visit with us, call (828) 526-3783.

What to Expect at Your First Botox Appointment

Botox has been used for around 30 years for cosmetic purposes. After the FDA approved this drug for cosmetic rejuvenation, the first of its kind, in 2002, adults interested in looking younger have relied on Botox to achieve anti-aging goals of reduced wrinkles. While Botox is not magic, it does accomplish amazing results when treating dynamic wrinkles. We consider it a valuable adjunct to good skin care and maintaining a youthful appearance. If you have been on the sidelines and are ready to give Botox a try, you may be wondering what it will be like to get this injectable treatment. Here, we walk you through the process.

Your Botox Consultation

Because Botox has been around for so long, new patients tend to schedule visits with this treatment in mind. Regardless, an experienced provider will begin the appointment with a brief consultation. To know if Botox is right for you, we have to know what concerns you have and what you would like to achieve. Botox is a great treatment for crow’s feet, forehead lines, frown lines, and a droopy brow line. If you have concerns beyond these, such as depressed mouth corners or creases around your nose and mouth, we can discuss how to address those, as well.

Treatment

If you so choose, we can perform your Botox treatment right after your consultation. We usually use a topical anesthetic to make the injection as painless as possible. Also the injections are administered with a very small needle. You may feel tiny pinching sensations with each injection, though this is not painful. Each sensation lasts only a moment. Depending on the purpose of treatment, several injections may be given.

Recovery and Results

Botox is well-known for its convenience and safety. After treatment, most people experience nothing more than slight swelling and redness where injections have been given. Adverse side effects are rare. The most common is a slight bruising. A rare patient may develop a slight headache that may last a few hours or body aches that feel like the flu that generally disappear within 24 hours.

Full effects from the injections usually occur form about 6 hours to 6-7 days. Improvement typically lasts from 3 to 6 months. Touch-ups can be scheduled as needed.

If you’re new to Botox, you will appreciate our conservative, gentle approach. To schedule a consultation at our Highlands, NC office, call(828) 526-3783.

It’s Time to Care for Winter Skin

It’s time to care for winter skin. When the temperature dips, and we have many months of cold weather ahead, it’s time to start thinking about the skin. Low temperatures affect the skin just as much as hot, humid weather. In this case, the skin on the face, hands, and body can get so dry and flaky that painful itching or cracking occurs. Here, we offer a few tips on caring for your winter skin so you can avoid unnecessary stress and discomfort.

Moisten the Air to Nurture Your Skin

When we worry about getting dry skin, we often think about what we use topically. During the winter months when the air naturally gets drier, daily lotion application is not the answer. The skin is moistened from what we put into the body and the air. To care for winter skin, dermatologists suggest drinking more fluids to sustain adequate hydration. The skin loses moisture when the air is extremely dry. Experts have long talked about the benefits of using a humidifier during the winter months, especially when the heater is running more often than not, as furnaces dry the air.

Switch up Your Products

The skin is more prone to irritation during the winter months due to the dryness of the air. Therefore, there is a need for gentler products. A foaming wash can be optimal most of the time, but a gentle cleanser may be best in the winter. Going from a 15 or 20% Vitamin-C to 10% or switching from one sunblock to another frequently helps. Adding Hydrate to an Obagi protocol can help some people.

Skip the Exfoliating

We usually tout the efficacy of exfoliation for maintaining healthy, glowing skin. This practice of loosening dead and damaged skin cells for faster turnover can be beneficial in the right circumstances. Reducing exfoliation can allow slightly more dead cells that reduce some of the evaporation from the skin into the dry air..

Dry Skin Thoroughly Before Going Outside

Whether you’re running errands and wash your hands or need to run the trash out after you’ve washed the dishes, it is necessary to avoid going out into the cold with damp skin. The cold air interferes with the integrity of your skin’s natural barrier, increasing the risk of chapping. On the same note of skin getting chapped more easily, it is also necessary to avoid licking your lips when outdoors in cold weather. Instead, maintain moisture with Jane Iredale’s Lip Drink (that also protects them from sun damage).

Our practice offers several skincare and medspa services to help you nurture your skin any time of year. To schedule an appointment, call | (828) 526-3783.

Photoaging: What It Is and What to Do About It

Skin aging, including that from the sun (photoaging), is inevitable. However, we do have some degree of control over how the skin changes over time and it is treatable. One of the fastest ways to age healthy, firm, youthful-looking skin is to spend too much time in the sun. Sunlight is made up of a spectrum of different rays. Some of these, the UVA rays, can even penetrate through a thick layer of clouds, penetrate into shade and buildings and cars, and are present all the time. These rays also get absorbed into the skin, causing cellular changes that result in what is called photoaging.

Photoaging is simply aging that is caused by exposure to UV light. This may come from sunlight and also from tanning beds. Signs of photoaging and their cause include:

  • Spots and hyperpigmentation. These may look like freckles, flat moles, large spots, or general blotchiness from injury of the melanocyte (the pigment producing cell).
  • Fine lines and wrinkles from loss of collagen thinning the support layer of the skin and from loss of elastin. This is increased past 30 years of age since the body normally stops making collagen and elastin about then.
  • Telangiectasia or increased red vascularity from the body constantly turning in its healing, which dilates blood vessels near the injury to bring in the immune/healing system. After continually doing this, the vessels just stay.
  • Precancerous lesions that look red and rough or scaly from more severe injury of the cells. These are referred to as actinic keratoses.

Photoaging affects any area where the UVA rays can reach, and they can penetrate most clothing. It is, therefore, also commonly seen on the hands, arms, shoulders, legs, back, chest, ears, nose, lips, and other parts of the face.

What to Do About Photoaging

Our best advice for our patients is to try and prevent photoaging by avoiding as much sun exposure as possible. Even on a cloudy day, it is wise to wear broad-spectrum zinc oxide sunscreen on all exposed areas and wear sun protective clothing. Zinc is the only practical sunblock as it need to be reapplied only if you wash or wipe it off. All the others last at most 2 hours, and only an hour if outdoors. You can make normal clothing sun protective by washing them in Rit Sun-Guard. See our Info Sheet.

Once you have photoaging damage, there are several ways to correct it, including:

  • Using quality skincare. Basic skin care includes an exfoliant to remove the excess cells caused by sun damage and time. It also includes a good sunblock to prevent further damage. To this, you can add ingredients like antioxidants like Vitamins-C to combat the breakdown of collagen caused by free-radicals. At 30, or if you have wrinkles,you add a retinol or tretinoin (Vitamin-A) and Obagi’s ELASTIderm to stimulate collagen and elastin production. If you have spots, we add hydroquinone. If you need all, the best option is Obagi’s Nu-Derm System.
  • Antioxidants are also consumable and are found in citrus fruits and leafy green vegetables.
  • Light chemical peels. Regardless of how pricy your skincare products are, they are of little value if there is a layer of dead skin cells blocking their absorption. Chemical peel treatment gently sloughs off this layer of cellular debris to reveal healthier, more uniform skin.
  • Microdermabrasion does the same thing as a light chemical peel, it removes the uppermost layer of nonvital skin cells. This procedure works through gentle ablation using microparticles that dislodge cellular debris so it can be suctioned away from the epidermis.
  • Microneedling can also help produce collagen and reduce light wrinkling.
  • Significant wrinkles can be treated by filler injection using a hyaluronic acid filler that will stimulate collagen production.
  • Leveling peels and laser smooth the skin and increase the collagen production. They are useful for severely wrinkled skin.
  • Ellipse IPL® treatment is a form of light therapy that breaks up red or brown discoloration in or beneath the skin. It can treat both brown pigmentation and red telangiectasia. IPL, intense pulsed light, is a popular treatment for photodamage due to its effectiveness with little to no downtime.

We can help you address photoaging with a treatment program tailored to your needs. Call our Highlands, NC office at (828) 526-3783 to schedule your consultation.

How to Make Your Skincare More Effective

“Skin care” is a term that we use in two ways. We use it to describe the products that we apply to cleanse and treat the skin, and also to describe the act of caring for the skin. Because the term is interchangeable, there is a risk of blurring the lines between the two. People who wash their face and apply moisturizer or a serum or two often believe that this is sufficient effort to get the results they want. It’s not. Here, we discuss the common mistakes that people make with skin care and what needs to be done instead.

Mistake Number One

The most common mistake that people make in caring for their skin is not knowing exactly what their skin even needs. This is no fault of their own. Manufacturers of mass-produced cleansers, moisturizers, and specialty products are savvy about promoting the benefits of their items without acknowledging the lack of clinical efficacy or even making them seem efficacious when they are not. The only way to get clinical results from products is to use medical-grade products that have been picked out for your unique cosmetic and dermatologic needs by a medical professional.

Mistake Number Two

In addition to choosing products based on the marketing seen on television and in magazines or what your mother or grandmother told you, what many people mistakenly do is use those products routinely for months or years on end. The problem with this approach is that most of what is sold either does not do what the skin needs or actually does more harm than good.If professional treatments are utilized, they are usually chosen without any thought of how they fit one’s total skin care needs.

We Can Help You Correct These Mistakes

We divide ski care into Basic, Basic Plus, and Rejuvenative. Basic is what everyone needs, no matter their age, essentially from birth. It consists of a cleanser, a pH balancer (cleansing disturbs the normal pH, which causes the skin not to function well for a while), and a good practical sun block (we prefer clear zinc oxide). The pH balancer can be a simple acidic toner or an acidic serum, like Vitamin-C or something similar, depending on your other needs. Once a teenager, an alpha hydroxy product to remove thickened outer dead cells is added to Basic Skin Care. Professional treatments like chemical peels and microdermabrasion are inexpensive, convenient, and comfortable and can help remove built-up dirt, oil, bacteria, and dead skin cells.

The body stops continually making new collagen to thicken the dermis, the support layer of the skin, and elastin that provides the skin its elasticity around 30 years of age. Therefore, Basic Plus adds retinol or Retin-A to continue the skin making collagen and Obagi’s ELASTIderm to stimulate elastin somewhere around 30 years of age. Although there are thousands of products available, this is all most people need, unless they have significant damage from the sun or other insults.

With problems, modifying skin care to address the specific problem is all most people will need. However, it takes an expert in skin care and rejuvenation to determine what will work best with the least effort and expense.

At the Center for Plastic Surgery in Highlands, NC, we help patients manage their skin in ways that get results. We use only medical-grade products products that have been proven to achieve results. We also have professional treatments like peels, microdermabrasion, IPL light treatments, and laser resurfacing to provide a full spectrum of care.

Get the help you need to keep your skin resilient through the aging process. Call  (828) 526-3783.

One and Done Beauty: Is it Possible?

Non Surgical Procedures Highlands, NCWe hear this question quite often. “Will one treatment be enough to achieve results?” Unless your cosmetic objectives can be met with a surgical procedure alone, this is an unlikely accomplishment. Even in the case of injectables and soft tissue fillers, which do achieve immediate results, improvements require maintenance every year or so.

To understand the role of professional treatments in ongoing beauty at every age, it can help to think of the skin the same way you do the body. Your skin needs to be “fed” quality products every day to rebuild itself just like your body relies on healthy foods to maintain vitality. Similarly, as much as we would like it to be true, we cannot work out one time and develop six-pack abs. Just like we won’t slim down after one healthy meal or strenuous workout, our skin will not look many years younger after one nonsurgical treatment.

One Way to Feed the Skin

In reality, there are several ways to feed the skin, but there is one objective that may trump all others: collagen and elastin production. By age 30, fibroblasts, the cells that produce collagen and elastin, begin to slow down. Not just a little, but a lot. Some studies suggest that fibroblasts go dormant, into a state of sweet slumber that allows the signs of aging to creep in. With the body wearing out its existing supply of collagen and elastin at a rate of about 1 to 2% a year, we typically see noticeable changes in the skin by age 40 and continually for the rest of our life. The key to managing aging skin, then, is to encourage the fibroblast cells to continually produce more collagen and elastin.

Professional treatments like fillers correct the signs of aging, which is certainly advantageous. However, injectables alone are not enough to effectively manage the signs of aging. By that, we mean to keep them from worsening. To do this, we recommend adding retinol or Retin-A and ELASTIderm to basic skin care starting around age 30.  The retinol or Retin-A (tretinoin) stimulates new collagen. The ELASTIderm by Obagi is the only product on the market that stimulates conversion of some of that collagen to elastic tissue. Other periodic collagen-inducing treatments like micro needling, actual dermal or just sub-dermal injection of the proper hyaluronic acid filler, peels or laser skin resurfacing can also help. Depending on where you are on the spectrum of collagen degradation, you may need one treatment a year, several treatments a year, or one treatment every few years.

If you are interested in reversing and managing the signs of aging, come talk with us. We may not be able to promise a one and done treatment for every concern, but we can promise that we are committed to long-term results and personal care for each of our patients.

Call (828) 526-3783 to schedule your visit to our Highlands, NC medical spa and plastic surgery office.

Diagnosis and Treatment of Skin Cancer

Is lesion a skin cancerThree groups of physicians see and evaluate patients with skin cancers, family physicians, dermatologists and plastic surgeons. We as plastic surgeons do so because we treat other skin problems related to sun damage and aging, we are good at excising lesions, and many skin cancers occur on the face and hands, areas where we have significant experience and are asked to treat by the other specialities.

Types of Skin Cancers

There are three main types of skin “cancers.” The least common (fortunately) is melanoma, a true, aggressive cancer of the pigment cells. Next is squamous cell carcinoma, also a true cancer that destroys the local tissue and can spread to other parts of the body. The most common is basal cell, a tumor that destroys local tissue but does not spread except by direct extension. There are also multiple other cancers that can occur on the skin, mostly related to skin appendages like glands or metastatic from other areas. These, however, comprise only about 0.5% of skin cancers.  Each requires different evaluation and treatment.

Evaluation of Skin Cancers

The problem with skin cancers is that they can look like each other or other entities. The first thing that must be done is recognizing what may be a skin cancer. That is where dermatologists and plastic surgeons excel. Once the possibility is recognized the exact nature of the lesion needs to be determined. This is usually accomplished with a biopsy, removing a piece for pathological evaluation. Shaving a piece of the lesion is the most common method of biopsy  This takes a week or 2 to heal with several times a day antibiotic care. We prefer a punch biopsy that takes a small full thickness piece of the lesion. This heals quickly and takes no care, important if the lesion is not a cancer. It is also the best way to sample a melanoma, as lesion thickness is important in determining treatment. Once diagnosed, further tests may be required to decide on treatment, especially if the lesion is melanoma.

Treatment of Skin Cancer

The lesion determines the treatment. We treat basal cells multiple different ways including chemotherapy, freezing, and excision depending on its characteristics. Squamous cell is treated similarly, but more aggressively. Melanoma always requires excision and may also need lymph node biopsy or excision.

If you have a lesion that you are concerned about or know needs treatment, call us at our Highlands, NC office at 828-526-3783.