As board-certified dermatologists, we are well trained in surgical procedures of the skin. Although we refer to these as “surgical” procedures, most of what we do here in the office are simple, outpatient procedures that are well tolerated. Most procedures take less than 30 minutes.
- Cryosurgery: Liquid nitrogen is applied to the lesion(s) in question. This destroys the lesion(s) and may result in a small blister that heals with a small scar or discolored spot. There is minimal discomfort with this procedure. Lesions regularly treated by this method include warts, molluscum, actinic keratoses, sun spots, and seborrheic keratoses.
- Biopsy: The site is anesthetized, and a small sample of the lesion or rash is submitted to the laboratory for pathologic diagnosis. This procedure is often used to determine the cause of a rash or to confirm the diagnosis of skin cancer or atypical moles.
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- Shave removals: The lesion is anesthetized and a surgical blade is used to remove the clinically benign or harmless lesions.
- Excisions: The area of skin is anesthetized with local numbing medication. The lesion in question is surgically removed, and sutures are used to close the resulting wound. This procedure takes approximately 30 minutes and is well tolerated. Excisions are commonly performed on skin cancers, atypical moles, dermatofibromas, or cysts.
- Electrodessication and Curettage: A small “scoop” or curette is used to “scrape” and remove the lesion. In some cases, the area is then electrodessicated with a hyfrecator or small electrical needle. This procedure results in minimal discomfort and a small scar depending on the original size of the lesion. This procedure is most commonly used for skin cancers, but is sometimes also used for warts, molluscum, or other benign lesions.
- Photodynamic Therapy (PDT): PDT is a procedure used for the treatment of precancerous lesions. A photosensitizing medication is applied to the affected area and allowed to absorb for 1-3 hours depending on the location. The affected area is then exposed to a blue light for 17 minutes. This may result in a stinging and burning sensation. Redness and discomfort often begins soon after treatment and lasts about 24 hours, but may last longer. The skin will then be red and will peel, especially in areas with precancerous lesions. Despite a little discomfort, this treatment is well tolerated. Patients must completely avoid sun exposure for 24 hours after PDT treatment.
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