Cosmetic Dermatology

Actinic Keratosis

Also known as precancerous lesions, actinic keratoses, (or AK’s), can continue to grow and develop into skin cancers. These cancers may spread, which is why it is so important to have them removed. They are often a result of sun exposure and can be treated to prevent their progression. Your general dermatologist may treat these with prescription creams, freezing with liquid nitrogen (cryotherapy) or laser photodynamic therapy. If however they do not respond well to these treatments and your doctor is concerned about them progressing later in life to skin cancer, they may refer you to Dr. Shelton to have a medium-depth chemical peel or laser or plasma resurfacing.

Keloids

Keloids are scars that have formed after bug bites, ingrown hairs, surgery, burns, cuts, ear piercing and even acne. They can become painful and irritating, resulting in itching and impairment of function depending on their severity. There is often a genetic / inherited component to the susceptibility of patients developing keloids. It is important for patients to address these for both health and cosmetic concerns, and speak to a dermatologist such as Dr. Shelton to learn about the methods of addressing keloid scars.

Melasma

Melasma is a skin condition that typically affects women during pregnancy or can be brought on by taking oral contraceptive medication because of the estrogen influence on pigmentation. It is caused by hormones and sun exposure, and is often called the “mask of pregnancy” as this is when it most often occurs. However, melasma is seen in men too, for unexplained reasons. It can be addressed with avoidance of the sun, chemical peels, topical creams, and even laser procedures. A proper diagnosis is essential for treating this condition appropriately. The reality is that once someone has melasma, it means they were susceptible to it and it might have been awakened by a procedure or sunburn, etc. If the melasma improves with treatment, the susceptibility is still there and the slightest sun exposure can bring it right back. Treatment should be thought of as ongoing maintenance, not a cure.

Rosacea

Rosacea can be a very embarrassing, chronic skin disorder. This disorder can cause redness and bumps on the skin, specially the face. It might look like acne, but will not respond to the same treatments. Instead, a dermatologist may suggest a specific medication regimen to allow patients to improve the condition.

Often patients are referred to Dr. Shelton after their dermatologist has improved the acne component of the rosacea for laser treatment of unwanted facial redness. This is done with the V-beam laser, usually a series of monthly treatments. Some may need as few as three treatments and others, more than five. There is currently no cure for this condition, but it can be controlled.

Skin Cancer

Skin cancer is a serious concern for patients who have a high risk of developing it or have had excessive exposure to the sun or tanning beds in the past. Patients may develop one of the three most common kinds of skin cancer, BCC (basal cell carcinoma), SCC (squamous cell carcinoma), or malignant melanoma. Many patients are referred to Dr. Shelton and his associates for Mohs micrographic surgery of Basal Cell Carcinoma and Squamous Cell Carcinoma. This is a special technique to provide the greatest conservation of normal skin, keeping the defect after surgical removal as small as possible, while providing the highest chance of cure by examining 100% of the surgical margin. This is accomplished while the patient waits comfortably in the waiting room with a dressing in place during the laboratory analysis of the specimen. Further removal in designated areas might be indicated based on the laboratory results. This proceeds until all margins are clear and then reconstruction can commence the same day. This may involve stitching the skin together or doing a skin graft or a skin flap. The differences will be discussed with the patient during the visit. Sometimes, the wound can be allowed to heal over several weeks without needing surgical reconstruction. Patients who receive a diagnosis of skin cancer must work with a dermatologist to determine the best way of removing the cancerous skin cells and attaining a cancer-free body.