Minor surgery:

Dermatology is a medical and surgical specialty and we often use techniques such as skin biopsy to establish a diagnosis, excision of ingrown toenails, drain abcesses, excise foreign bodies, excision of cancerous and pre cancerous skin lesions, excision of cysts and benign tumors, etc.  Of course not every dermatologist will perform every possible type of treatment but we can certainly refer you for a colleague who can provide the services you need.

	•	Warts

	•	Molluscum

	•	Skin tags

	•	Dermatofibroma

	•	Nevus ( moles, "beauty marks" )

	•	Scar treatment

	•	CROSS technique

	•	Subcision

	•	Cysts

	•	Boils

	•	Ingrown toenails

	•	Lipoma

	•	Tattoo removal

Dermatologic surgery should only be practiced by physicians who specialize in this discipline.

It is worrisome to see  techniques such as microdermabrasion, chemical peels, laser, treatment of blemishes and pigmented lesions practiced by persons without medical training in "beauty centers" that are completely unregulated. The practice of medicine by unqualified persons can have unfortunate consequences for patients.

Would you ask a cook to repair your car in the hope of saving money? No. So why would you let non physicians practice  dermatologic surgery techniques on you? It makes no sense.

Diagnosis and treatment of skin cancer

Malignant melanoma

The photo above shows malignant melanoma, the most dangerous of skin cancers.

Its incidence is increasing every year.

Skin tanning machines and sunburn are an important risk factor.

If you have pigmented skin lesions, it would be prudent to have them checked by a dermatologist, especially if they have changed over the past few months or if they have the ABCDE criteria for suspicion of malignancy. (Table)

A	Asymmetry: both sides are unequal
B	Border, irregular
C	Color, black or two colors such as red, black, blue, brown, white in combination
D	Diameter more than 6 mm (or rapid growth  E= Evolution)

Dermatologists play an important role in the diagnosis and treatment of skin cancer.

Any suspicious lesion should be biopsied.

Scar treatment

	•	Surgical scar excision

	•	Laserbrasion with Erbium laser

	•	Pulsed dye laser for inflamed and red scars

	•	Photodynamic therapy for collagen skin remodeling

	•	CROSS technique

	•	Subcision

	•	Topical or injectable corticosteroids

	•	Imiquimod

	•	Cryosurgery

	•	Silicone dressings

	•	Radiotherapy

	•	Interferon

	•	Injections of fillers to compensate loss of tissue in atrophic scars (Artecoll, etc)

(CROSS technique and subcision are described in the acne section)

Depending on the type of scar, treatments may be used alone or in combination. Several treatments may be required.

This is the art of medicine.

This is a very challenging aspect of dermatology. Each scar problem requires an individual approach.

Personally, I find  one of the most rewarding aspects of my practice is treating acne scars. Improvement of physical scars will often improve psychological suffering that affects many patients.

Excessive sweating: Hyperhidrosis

Many persons suffer from excessive perspiration of axilla and hands that is embarrassing at work or social situations, where the simple act of shaking hands becomes a humiliating ordeal. Sweat can also damage paper and jewelry and delicate electronics and may interfere with many occupations. Many treatments exist, from topical prescriptions to surgical. Did you know that the same Botox used for wrinkles is often used successfully to treat this condition?