Dermatologic surgery is the practice of dermatology that specializes in surgical procedures and minimally invasive methods and techniques to improve the health, function and appearance of your skin.
Most dermatological surgical procedures require only local or regional anesthesia. Dermatological surgery is performed more commonly for the removal of skin cancers, but also benign skin growths and tumors that may interfere with the body’s normal function, or may cause symptoms such as pain, itching or bleeding.
Dermatologists are unrivaled specialists in the diagnosis, removal, closure and overall treatment of skin cancer.
Treatment of skin cancer varies according to the location, size, and aggressiveness of the tumor and the overall health of the patient. In most cases, the dermatologist will need to perform a biopsy (removing a small piece of the abnormal growth for evaluation). To determine whether it is benign or malignant, the tissue is examined by another physician (called a dermatopathologist) under the microscope. Malignant tumors require additional treatment.
Your dermatologist will select the most appropriate treatment for a particular skin cancer, or precancerous condition, from among the following procedures and techniques:
Excision may be used to treat both primary and recurrent tumors by surgically removing the tumor and an area of healthy looking skin (margin) around the tumor. In some cases, the wound does not require treatment and is allowed to heal on its own. When closure is necessary, the wound may be closed with stitches, skin from another area of the body (skin graft), or healthy skin moved from a nearby area (skin flap). After surgery, the excised tissue is examined under a microscope to see if any cancer cells were present in the skin that appeared cancer free.
Curettage and electrodesiccation may be used to treat small basal cell and squamous cell tumors by scraping the tumor with a curette (a surgical instrument shaped like a long spoon) and then using an electric needle to gently burn or “cauterize” the remaining cancer cells and a margin of normal-looking tissue.
Cryosurgery may be used to treat some small primary basal cell and squamous cell tumors, as well as a few recurrent lesions. Cryosurgery involves freezing the tumor. The frozen cancer cells are destroyed by the freezing and slough off, allowing the underlying normal skin to heal.
Laser surgery may be used in certain cases to vaporize superficial and multiple basal cell carcinomas and to excise or destroy squamous cell carcinoma. Laser surgery does not destroy cancer cells found deeper in the skin, so close follow-up with a dermatologist is important.
Mohs micrographic surgery involves first removing the visible tumor and then successive layers of skin one at a time until no more cancer cells are shown on microscopic examination. Once skin cancer is no longer visible, the surgical wound is treated as needed. Methods include allowing the wound to heal naturally, closing the wound with stitches, covering the surgical site with skin from another area of the body (skin graft), and moving healthy skin from a nearby area to cover the surgical wound (skin flap).
