Mary Brady, MD, FAAD

Actinic Keratosis, also known as solar keratosis, is a scaly or crusty lesion on the skin that develops slowly and indicates the presence of sun damage. It is most commonly found on parts of the body frequently exposed to the sun including the bald scalp, face, ears, lips, backs of the hands or forearms, neck, and shoulders.

Actinic keratosis improves just two days after a freezing removal treatment.

Actinic keratoses are considered precancerous and can develop into a type of skin cancer called squamous cell carcinoma. In fact, some 40 to 60 percent of squamous cell skin cancers begin as untreated actinic keratoses.

Because of this, your doctor should be diligent in diagnosing, treating and monitoring actinic keratosis.

Annual Skin Examinations are yearly scheduled skin exams with a dermatologist. Did you know that skin cancer is the most common form of cancer in the U.S.? In fact, it is estimated that one in five Americans will develop skin cancer in their lifetime. Sun damage to the skin is cumulative over a person’s lifetime, so the average risk of skin cancer also increases as our life expectancy gets longer.

Just as you schedule your annual physical or trip to the dentist, it is important to conduct a self-examination of your skin each month and schedule a professional annual skin examination once a year. Skin cancer is a treatable condition, but early detection is key.

Basal Cell Carcinoma, also known as basalioma or basal cell cancer, is the most common type of skin cancer and carries the least amount of risk, though it still requires attention. If caught and treated early, basal cell carcinomas are not likely to be life-threatening, but they do have the potential to cause disfigurement of the skin tissue.

Almost one million new cases of basal cell carcinoma are diagnosed each year in the U.S., and up to 30% of Caucasians may develop basal cell carcinomas in their lifetime.

Basal cell carcinoma can be treated by removing the affected area.

Skin cancer is considered low risk when the affected cells remain clustered in a single group. Both basal cell carcinoma and squamous cell carcinoma are rarely life-threatening. Though it is unlikely to spread to other parts of your body, if left untreated, basal cell carcinoma can move into nearby bone or other tissue.

Basal cell carcinoma typically begins as a small, shiny bump on the face, although it can occur on any part of the body.

Cryotherapy, or “cryosurgery,” is a simple, non-invasive procedure in which liquid nitrogen is used to freeze and destroy growths on the surface of the skin. This is an effective treatment for precancerous skin lesions (actinic keratoses), as well as other skin conditions such as warts, skin tags and moles.

Applying liquid nitrogen to skin lesions allows dermatologists to target the damaged skin cells and destroy them at the cellular level. After freezing, the affected area may blister and scab over, and should heal within three to six weeks.

Our dermatology team uses cryosurgery to treat a wide range of conditions. It offers a number of advantages: Cryotherapy is a simple, affordable outpatient procedure, the discomfort level is minimal, and there is a low risk of infection.

In cryotherapy treatment, liquid nitrogen is applied to the skin to freeze and destroy the affected tissue.

Melanoma, the deadliest of skin cancers, only accounts for about 4 percent of all skin cancer cases, but causes about 79 percent of skin cancer deaths.

Melanoma is a cancer of the skin that begins in the melanocytes, which are the cells that produce the pigment melanin. It is the leading cause of cancer death in women 25 to 30 years old and the second leading cause of cancer death in women 30 to 35 years old.

In some cases, melanoma occurs in melanocytes throughout the body, even if those parts have never been exposed to the sun.

Skin cancer is a common concern in the U.S.  Estimates reported by the American Academy of Dermatology suggest one in five people in the U.S. will develop some form of skin cancer. Merkel cell carcinoma is among the rarest forms of skin cancer, wherein estimates by the Skin Cancer Foundation suggest that only one in 130,000 people in the U.S. will be diagnosed with Merkel cell carcinoma. Like melanoma, Merkel cell carcinoma is an aggressive form of skin cancer with a high mortality rate.  As with most potentially aggressive malignancies, early detection is the best way to decrease the risk of death associated with Merkel cell carcinoma. You can learn more about diagnosis and treatment options for Merkel cell carcinoma on this page.

Photo Credit: Academic Dermatology of Nevada

Merkel cell carcinoma is a rare form of skin cancer that arises from Merkel cells, cells that reside deeper in the skin and function to send ‘touch’ signals from outside the skin to the inside of the body.  The diagnosis of Merkel cell carcinoma is ultimately made by an assessment under the microscope after a skin biopsy has been performed.  Skin biopsies are interpreted by dermatopathologists, doctors who specialize in evaluating skin under the microscope.  Dermatopathologists are well equipped to make this diagnosis accurately when skin tissue is submitted in a biopsy specimen.  Unfortunately, when Merkel cells become cancerous, they also become aggressive.  Merkel cell carcinoma can metastasize (spread) quickly, making it one of the most aggressive types of cancer.  While treatment for Merkel cell carcinoma may be successful, even with treatment Merkel cell carcinoma may evade what appears to be disease remission, and recur.

Mohs surgery offers the highest cure rates for all non-melanoma skin cancers. For certain cases of the most common types of skin cancer — squamous cell carcinoma and basal cell carcinoma — the cure rate can be as high as 99 percent.

Mohs surgery is a highly specialized surgical technique used to treat non-melanoma skin cancers in which the surgeon removes all of the visible cancer, plus a small margin of the surrounding healthy tissue and examines it to ensure that all cancer cells have been removed at the time of surgery.

The Mohs surgery technique treats skin cancers by removing all of the visible cancer. Image Source: newhealthadvisor.com

During Mohs micrographic surgery — named after Dr. Frederic Mohs, who first performed it in the 1930s — cancer is removed from the skin layer by layer until all cancerous cells have been removed. This type of surgery is most commonly used for cancers that have a high risk of re-occurrence. This technique allows for complete removal of the skin cancer while minimizing the removal of surrounding healthy skin.

A rare and aggressive form of skin cancer, sebaceous carcinoma is sometimes referred to as sebaceous gland carcinoma, sebaceous gland adenocarcinoma or meibomian gland carcinoma.

Sebaceous carcinoma can develop in any sebaceous glands, which lubricate the skin, but it most often begins on or around the eyelids. If it is found and treated early, treatment is often successful. However, if sebaceous carcinoma spreads, it can be deadly.

Because sebaceous carcinoma can appear to be a benign growth such as a stye, diagnosis is often delayed, which increases the risk of death. If you notice a growth on your eyelid, it’s important to make an appointment with your dermatologist. The sooner sebaceous carcinoma is diagnosed and treated, the better the outcome.

“32-year-old cosmetologist presented with 3-month history of treatment for presumed chalazion. A) The left upper eyelid showed 2 mm of ptosis with swelling. B) Focal loss of eye lashes was appreciated (arrow).” (source: “Early Onset of Sebaceous Carcinoma” by Dr. Debashis Ghosh, creative commons license)

Skin cancer is the most common form of cancer in the U.S. with more than 3.5 million cases diagnosed each year.

Skin cancer is the result of uncontrolled growth of abnormal skin cells that takes place when skin cells suffer DNA damage and then mutate, causing them to multiply rapidly and form malignant (cancerous) tumors. Most skin cancers develop on the visible outer layer of the skin (the epidermis), particularly on sun-exposed areas such as the face, head, hands, arms and legs. They are usually easy to detect with a skin examination, which increases the chances of early diagnosis.

There are different types of skin cancer, each named for the type of skin cell from which they originate. The most common type of skin cancer is basal cell carcinoma. Almost one million new cases of basal cell carcinoma are diagnosed each year in the U.S. Most skin cancers fall into one of three categories:

• Basal Cell Carcinoma
• Squamous Cell Carcinoma
• Melanoma

There are often warning signs that cancer is developing. The most common are pre-cancerous lesions called actinic keratoses that often develop on sun-exposed areas. These tumors replace normal surrounding tissue and generally do not spread to other areas.

Skin cancer is considered low risk when the affected cells remain clustered in a single group. Both basal cell carcinoma and squamous cell carcinoma are rarely life-threatening.

Skin cancer is considered a high risk when cells have invaded surrounding tissues. The third most common skin cancer, malignant melanoma, can be life-threatening if not diagnosed and treated early.

If skin cancer is detected before it has spread to surrounding tissues, the chances of a complete recovery and cure are excellent. High-risk forms of cancer like melanoma require more aggressive treatments.

Suspicious moles should be watched closely, as they might indicate a cancerous growth.

Squamous Cell Carcinoma is a common form of skin cancer that develops in the squamous cells that make up the outer layer of the skin. Although it is usually not life-threatening, it can be aggressive in some cases.

If left untreated, squamous cell carcinoma can grow large or spread to other parts of your body, causing serious complications.

Your dermatologist will be able to examine your skin for signs of squamous cell carcinoma.

If you’ve noticed new skin growths, lumps, or bumps, chances are you’re dealing with a lesion. But, to know whether or not the lesion is benign, you’ll need to consult with a professional. At U.S. Dermatology Partners, our skilled dermatologists can partner with you to determine the type of lesion and help you decide if treatment is necessary for your condition. To get started, simply fill out our online scheduling request form, and a U.S. Dermatology Partners team member will be in touch to finalize the details of your visit.

What Are Benign Lesions?

Benign lesion is an umbrella term that may reference any number of non-cancerous lesions of the skin. These lesions may develop on any part of the body with soft tissue. They are classified (named) according to their specific sets of features, where they develop, and other characteristics. Determining if a lesion is non-cancerous requires an accurate diagnosis from a dermatologist.

Cysts are pockets of tissue (sacs) that may become filled with pus, fluids, skin cells, and even air.

They are fairly common on the skin and can appear anywhere on the body. Cysts may feel like a pea under the surface of the skin, but without removal, they can grow significantly larger over time. In most cases, cysts are not painful, and they grow slowly. There are different types of cysts as we’ll discuss in the next section, and the vast majority of these skin growths are benign (not cancerous). Not all cysts will require treatment, but it is vitally important to have any lump under the skin evaluated and diagnosed by a board-certified dermatologist because some soft tissue malignancies (growths that are cancerous) can present like a cyst. Before recommending removal or other cyst treatments, your dermatologist will examine the growth to determine whether it is likely to cause you pain, become infected, or otherwise lead to skin health issues.

Skin cysts, which can appear anywhere on the body, are usually painless and grow slowly.

Epidermoid cysts are the most common type of cyst. They are normally benign and do not typically cause any serious health concerns. However, if epidermoid cysts are in an unfortunate spot or they’re painful, infected, or inflamed, your dermatologist, at U.S. Dermatology Partners, may recommend treatment. You can learn more about epidermoid cysts on this page or by getting in touch to schedule a visit. You can get started by completing our simple online scheduling form whenever you’re ready.

Lipomas: Understanding & Addressing Benign Fatty Growths

A lipoma is a benign fatty growth, most often located in the deep aspect of the skin (subcutaneous tissue).  These growths arise from the normal fat cells in our subcutaneous tissue and are benign (non-cancerous).  However, there is a very rare form of cancer called liposarcoma, which is a malignant growth from these fat cells.  Lipomas are relatively common, impacting about 1% of people.  However, researchers suspect that lipoma incidence is significantly underreported.

Atypical moles, also known as dysplastic nevi, are unusual-looking benign (noncancerous) moles.

A dysplastic mole is one that, when viewed on a cellular level, has features unlike those of a healthy, benign mole. A benign mole will have a regular pattern of coloration and pigment, even borders, symmetry, and a tan or pink color. Dysplastic moles can be asymmetric, have indistinct borders, or contain multiple colors or very dark pigment.

Dysplastic moles are often spotted as the “ugly duckling” on a patient’s skin. Any departure from the typical mole a person’s skin makes may be dysplastic. They can appear anywhere on the body, but in most cases are found on the back, chest, buttocks, breasts, or scalp.

People with atypical moles are at a higher risk of developing melanoma.

Sebaceous hyperplasia is a benign bump on the skin that forms as a result of over-productive oil glands. When oil glands are damaged, they can become enlarged and clogged, leading to this condition. It is primarily a cosmetic concern rather than a medical problem.

Sebaceous hyperplasia is a benign bump on the skin that forms as a result of over-productive oil glands.

Seborrheic keratosis is one of the most common noncancerous skin growths found in older adults. It most commonly appears as a brown, black or light tan growth on the face, chest, shoulders or back. Although they are not cancerous, they can look like skin cancer.

Seborrheic keratosis is also known as seborrheic verruca or a senile wart.

The sun can age and burn your skin, and it can also cause damage on the cellular level, leading to skin cancer. The good news is, the U.S. Dermatology Partners team can help you formulate a plan to prevent sun damage and repair the effects of the sun’s UV rays so that you can go out and enjoy a sunny day. Learn more on this page or contact U.S. Dermatology Partners to schedule an appointment with us.

Individuals who are prone to sunburn are thought to be genetically predisposed to skin cancer. Risk is also increased when exposure to UV rays is excessive. Sunscreen helps prevent the damaging effects of ultraviolet radiation, including skin aging and skin cancer like melanoma and squamous cell carcinoma.

Sunscreens are rated and labeled with a sun protection factor (SPF) that measures the fraction of sunburn-producing UV rays that reach the skin. The higher the SPF, the greater the protection.

Sunscreen is a topical product that is used to reflect or absorb some of the ultraviolet rays from the sun.

Birthmarks are common, benign skin conditions, and for the most part, their only negative effect is to mar the cosmetics appearance of the skin. If you or your child have a birthmark that causes you concern, a dermatologist can examine it to ensure it isn’t a more serious skin condition and provide treatment to remove or diminish the appearance of the birthmark. On this page, you can learn more about the different types of birthmarks and the available treatment options.

Botox, the commercial brand name for botulinum toxin (BTX), is an injectable cosmetic dermatology treatment that reduces the appearance of fine lines and wrinkles on the face.

Unlike injectable wrinkle fillers, which work by filling a crease in your skin with another substance, Botox actually relaxes targeted muscles to reduce the look of lines in the face. This results in smoother skin with a more youthful appearance.

Each Botox injection relaxes key facial areas by temporarily paralyzing specific muscles. This temporarily removes wrinkles and improves the look of laugh and frown lines, skin bands on the neck, crow’s feet, forehead creases and more.

Botox is a quick procedure that is done in just minutes in your doctor’s office.

Although it was originally developed to treat eye muscle disorders, Botox has become popular cosmetically and this is now its primary use. In fact, Botox injections are now the most common cosmetic treatment in the U.S., with 6.3 million procedures done in 2013. Because Botox inhibits the release of certain neurotransmitters, it is also sometimes used to treat chronic migraines.

Looking to improve and recover your skin’s youthful appearance?

As we age, our skin naturally loses collagen and elasticity. At the same time, repetitive movements and expressions can create facial wrinkles. In addition to comprehensive medical procedures, dermatologists also provide a wide range of minimally-invasive, low impact treatments designed to address a number of aesthetic desires to help you look and feel your best.

While many conditions from unwanted hair and tattoos to wrinkles and rosacea may not be physically harmful, they can be uncomfortable and even cause emotional distress. Cosmetic dermatology offers a wide range of cosmetic surgery and non-surgical services focused on giving you the results you want without the pain, worry, and downtime.

Cosmetic dermatology focuses on aesthetic issues such as skin tone and overall appearance.

Loss of facial fullness and volume is one of the many age-related changes that people want to address with their dermatologist. From store-bought topical treatments to advanced dermatologic and surgical procedures, there are numerous cosmetic dermatology treatments available to help restore youthful volume. However, dermal and soft tissue fillers are often the most conservative and impactful solutions to restore volume without undergoing more invasive treatments. There are many different types of dermal and soft tissue fillers, and each one is formulated to address a specific area or issue related to volume loss. You can learn more on this page.

At U.S. Dermatology Partners we offer premier dermatology services for patients of all ages. Book your appointment today to find the best facial filler treatment for you and your skin, using our simple, online scheduling request form.

The procedure for dermal fillers can usually be done in less than an hour.

Dysport is a prescription injection used for the temporary improvement in severe frown lines between the eyebrows. As the muscles relax and prevent contractions, wrinkles in and around the brow and frown area will disappear.

Dysport, also known as Reloxin, is made from a neurotoxin produced by the bacterium Clostridium botulinum; it is the same neurotoxin used in BOTOX Cosmetic.

Jeuveau (pronounced Jū vō) is a new way of tackling frown lines between the eyebrows that tell the stories of your years of smiling, squinting, concentrating, and yes, even frowning. The story of our lives may be written on our faces in the form of fine lines and wrinkles, but it doesn’t have to stay that way thanks to Jeuveau. If you’re ready to look and feel your very best, it’s time to sit down for a consultation with one of our knowledgeable dermatology professionals. Our teams are dedicated to offering the latest and most effective treatment options for any dermatological need to ensure your skin’s health and vitality for life.

Juvederm is a group of injectable dermal filler gels made from hyaluronic acid and used to correct for moderate to severe facial wrinkles and folds or to provide contour. Different types of Juvederm are:

• Juvederm Voluma XC – designed to add volume to the cheeks
• Juvederm Volbella XC – used to smooth lines and wrinkles around the mouth
• Juvederm Vollure XC – softens moderate to severe facial lines and wrinkles around the nose and mouth
• Juvederm Ultra XC – created to add volume to the lips
• Juvederm Ultra Plus XC – used for adding volume to the lips and face

Juvederm is delivered via injection.

Kybella is an injected treatment that targets fat stores below the chin (double chin). It is one of the best available, non-surgical treatments for double chin, and the knowledgeable dermatologists at U.S. Dermatology Partners are proud to offer this minimally invasive cosmetic dermatology option for our patients who are interested in improving the appearance of their jaw and facial structure without undergoing unnecessarily invasive surgical interventions. If you’re interested in learning more about Kybella, please take a few moments to fill out our appointment request form to schedule a consultation. One of our team members at the office nearest you will be in touch to discuss the details of your visit.

Laser rosacea therapy is a way to treat a rosacea complexion. One of the most common and effective treatments is the pulsed dye laser (PDL), which targets visible blood vessels and can reduce redness and flushing by destroying the lining of the inflamed blood vessels.

Rosacea on facial skin is treatable with laser rosacea therapy.

Laser skin resurfacing is a treatment used to reduce facial wrinkles and skin conditions including acne, scars, warts, enlarged glands on the nose and more.

The process vaporizes the upper layers of skin, which creates a wound that encourages the body to produce new collagen. The collagen and elastic fibers tighten as they heal, and the tightened skin eliminates wrinkles as it pulls together.

Laser skin resurfacing reduces facial wrinkles and treats skin conditions.

Laser treatments work by using specific wavelengths of light to interact with tissue, which can positively affect pigment, blood vessels, hair follicles and moisture in the skin. The result is improved skin tone and texture, as well as the tightening of loose skin.

Lasers can also be tuned to very specific frequencies to perform different tasks and can even be used in surgery to allow doctors to work on a very precise area with less pain, swelling and scarring than traditional surgery.

Cosmetically, lasers can be used for skin resurfacing and to treat such things as acne, wrinkles, rosacea and more.

Latisse is a product designed to help grow eyelashes and has been on the market since earning FDA approval in December 2008. It is designed to help grow longer, lusher eyelashes and is available only by prescription.

Latisse eyelash enhancement helps eyelashes to grow longer and lusher.

Restylane is an injectable dermal filler gel made from hyaluronic acid to produce volume and fullness in the skin. This reduces the appearance of wrinkles and can also create fullness in the lips.

• Restylane – this is the original Restylane product. This versatile dermal filler can be used to add volume to any pits and grooves in the skin. The original Restylane product is recommended for improving the appearance of nasolabial folds, the deep grooves and wrinkles around the nose. It can also be used for lip enhancement.
• Restylane Silk – this innovative hyaluronic acid filler material is specially formulated to address fine lines around the mouth as well as creating smoother, plumper lips. It is the first FDA approved product specifically designed to help you achieve the perfect pout.
• Restylane Lyft – as we age, natural fat cells are depleted, and the production of collagen and elastin slows. This leads to loose skin, wrinkles, and volume loss in the hands and face. Restylane Lyft is designed to replace volume and firmness in both the hands and the cheeks.
• Restylane Refyne – this is the ideal dermal filler to improve the appearance of mild to moderate laugh lines, including the nasolabial folds that appear from the nose to the corner of the mouth and marionette lines that form from the corner of the mouth to the chin. Restylane Refyne provides support for the skin, creating a smooth appearance while allowing you to maintain all of your facial expression.

Restalyne helps smooth away wrinkles and fine lines.

We all want healthy, beautiful skin. But scars, a natural part of the healing process, leave a lasting mark and cause some people to struggle with the negative impact on the appearance of their skin and in some cases, limitations in function or other concerns. If you’re unhappy with the appearance, texture, or health of your skin after an injury, surgery, or other damage that leads to scarring, the U.S. Dermatology Partners team can offer treatment to improve the appearance of scarring.