Dermatologists are medical doctors who take care of your skin, hair, and nails. Their work can involve everything from treating uncomfortable and itchy allergic rashes, to injecting Botox and removing wrinkles, to performing surgery to remove life-threatening skin cancers.
Dermatology is divided into several branches. A dermatologist may perform all of these services in his or her daily work, or he or she may specialize and focus on just one field.
Dermatopathology deals with the identification of skin diseases. Dermatopathologists diagnose skin problems, usually by taking scrapings of skin and examining them under a microscope.
Cosmetic dermatology is the branch of dermatology that works to improve the appearance of the skin. This can include wrinkle reduction, liposuction, hair loss treatment, or the treatment of scars.
Dermatological Immunology is a subspecialty that deals specifically with immune related problems of the skin, such as eczema or lupus.
Pediatric dermatologists treat newborns and children with skin disorders. They also provide help to families with inherited skin problems.
Mohs surgeons are specialized dermatologists who can remove skin cancers using a microsurgery known as Mohs technique, where slides of the tissue are examined as they are removed. This is a very exact surgery with an extremely high cure rate.
Your skin is extremely important: it covers and protects everything in your body. A dermatologist helps keep it healthy, as well as looking and feeling good.
What is MOHS-Micrographic Surgery?
Mohs micrographic surgery is a surgical treatment for skin cancer that was developed by Dr. Frederick Mohs in the 1930’s. It is the most effective technique for removing the most common types of skin cancer. For the two most common types of skin cancer, basal cell carcinoma and squamous cell carcinoma, Mohs has a 98-99% cure rate. The remarkable thing about Mohs is that it manages to be extremely good at removing all of the cancer cells while at the same time leaving behind most of the healthy tissue, so there is a smaller wound. This makes the procedure safer, speeds up the the recovery time, and minimizes scarring.
During Mohs surgery, skin around the cancer site is mapped out and removed in thin layers. Then each layer is examined under a microscope for cancer cells, while the surgery is in progress. If cancer cells are detected, the surgery continues and another layer is removed. If the skin is clear, the surgery can be stopped. This eliminates the guesswork for surgeons. There is no need to estimate the borders or roots of the cancer and no need to remove a margin of healthy tissue to ensure that all of the cancer is removed.
Even though Mohs has a high cure rate, is safer than other treatments, and takes less tissue, not every skin cancer is treated with Mohs. First, Mohs takes quite a bit longer than traditional surgery because each layer of skin must be carefully cut, prepped, and examined. It is also more expensive and may not always be covered by insurance. In addition, for smaller or less aggressive cancers that are easier to treat, the cure rate for non-Mohs treatments is close to that of Mohs; thus, the extra time and cost of Mohs might not be justified. Other kinds of skin cancer, such as melanoma, are hard to see under a microscope. Since melanoma is so dangerous, Mohs has traditionally not been used to treat it, as there is too much risk for missed cancer cells being left behind in the body. However, recent developments in stains (which make cancer cells more visible under a microscope) may change the role of Mohs in melanoma treatment.
Mohs microsurgery has changed the way doctors treat skin cancer in the past 80 years, and it continues to gain in popularity as it increases the effectiveness and safety of skin cancer treatment.
What is Surgical Dermatology?
Dermatologic surgery is skin surgery to correct medical issues or improve appearance. Specialists in dermatologic surgery are called surgical dermatologists.
One of the most important procedures performed by surgical dermatologists is called Mohs surgery. Mohs surgery is an extremely precise type of cancer removal that leaves healthy tissue behind. It has the highest success rate of all skin cancer surgeries.
Beyond Mohs surgery, dermatologic surgeons may perform reconstructive surgery to restore function and appearance to skin damaged by trauma or a previous surgery. They can treat or remove growths and marks on the surface of the skin, including scars, moles, skin tags, and birthmarks. Most dermatologic surgeons also offer cosmetic treatments, which may include:
Laser hair removal
Laser resurfacing to treat sun damage, age spots, or wrinkles
Sclerotherapy to treat varicose veins
Liposuction to remove unwanted fat
Anti-aging treatments such as Botox, injectable fillers, or chemical peels
There is a great deal of overlap between surgical dermatology, medical dermatology, and cosmetic dermatology. Some procedures apply to more than one subspecialty. For instance, mole removal can be medically necessary to lower the risk of skin cancer, but it also may improve appearance, especially if the mole is large or in a prominent position. Most dermatologists offer services in all areas.
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