Laser Skin Resurfacing

shutterstock_44045680-e1556681633718-230x300 Laser Skin Resurfacing Houston DermatologistLaser resurfacing treatment enhances the appearance of the skin. It uses a laser to deliver brief pulses of high-energy light. Water and substances in the skin, known as chromophores, absorb this light. This light is converted into heat energy.

The heat destructs (vaporizes) thin sections of skin in a layer-by-layer manner. As the injured area heals, new skin grows to replace the compromised skin that was eliminated through the laser treatment. Certain lasers only firm up the skin by delivering heat to it but do not destroy it.

 

Laser Types

The most common laser type used for skin resurfacing is known as the CO2 (carbon dioxide) laser. Also, the erbium laser is commonly used as well.

Laser resurfacing is usually quite targeted and causes minimal damage to the nearby skin and tissue. It is most often undertaken on the face. However, it can also be done on the skin in other body areas, such as the neck, hands, and chest.

Texas Surgical Dermatology, led by board certified dermatologist Dr. Tri H. Nguyen, provides advanced skin care procedures to patients in Houston, Katy, Spring, The Woodlands, Texas, and surrounding communities.

 

Newer Laser Methods

Advanced methods of laser resurfacing lead to fewer issues and offer faster healing times. Some of these methods are as follows:

Fractional Laser Skin Resurfacing

This treats microscopic skin columns. The treated skin areas are surrounded by untreated areas. The outcome is noticeable skin improvement without much scabbing or bleeding.

Plasma Skin Resurfacing

Plasma skin resurfacing involves the use of plasma energy to destruct the deeper skin layers, and it does not impact the uppermost layers of skin. This topmost layer protects the lower layers of skin as they heal.

Superficial Erbium: YAG Laser Resurfacing

This is a mild laser treatment that is most effective for minor lines and other skin issues.

Infrared Laser Resurfacing

This treatment targets the deeper skin layers with heat to smooth and firm the skin.

 

Why It Is Done

Laser resurfacing can eliminate or improve the appearance of:

  • Wrinkles
  • Superficial acne, trauma, or surgical scars
  • Pigment (color) changes or skin defects, such as port-wine stains, liver spots, or café-au-lait spots

Individuals who have lighter skin and do not get much sun exposure following the treatment often have the best outcomes. Darker skinned people may also benefit from laser resurfacing. However, their skin may not heal properly.

 

How it is Done

The treatment areas are cleaned and marked with a pen. Prior to the treatment, a nerve block or a local anesthetic is typically administered to numb the treated area. The patient may also be given medication to help them relax.

If the entire face is to be treated, they may require sedation, pain relievers, or a stronger anesthetic. At times, general anesthesia may be administered.

The patient may need to wear goggles to protect the eyes from damage during the treatment. The provider may also place wet towels around the treatment area to absorb excess laser pulses.

 

Execution

The provider will pass the laser over the skin, sending out pulses. Each pulse will last for less than a millisecond. They will wipe the skin with water, or a saltwater solution between the laser passes. This helps cool the skin and remove the tissue that has been destroyed by the laser.

The extent of the treat and type of skin will determine the number of passes necessary. Board certified dermatologist Dr. Tri H. Nguyen receives patients from Houston, Katy, Spring, The Woodlands, Texas, and nearby areas for skin treatments.
For more information on procedures and treatments offered at Texas Surgical Dermatology PA please call 832.663.6566 or click here to contact our dermatologists. Helping patients in Houston, The Woodlands, Springs, Katy and other surrounding areas of Texas.

Dermatologist FAQ: Is Psoriasis Contagious?

2edcb9a1ae4eae57b9ca2e28cbff72f538c83090 Dermatologist FAQ: Is Psoriasis Contagious? Houston Dermatologist

Psoriasis leads to the development of red, scaly patches on the skin. It can appear as a rash, so the patient may worry about giving it to someone else or passing it onto others

However, this is not a contagious condition. A person cannot develop the disease by touching someone who has it.

Texas Surgical Dermatology, led by board certified dermatologist Dr. Tri H. Nguyen, provides advanced skin care treatments to patients in Houston, Katy, Spring, The Woodlands, Texas, and surrounding communities.

 

What Causes Psoriasis?

Although the symptoms of psoriasis manifest on the skin, this condition actually is a problem with the immune system, known as an autoimmune disease. This means that the defenses of the body overreact or react at the wrong time, which impacts the body inside and out.

In psoriasis, the immune system causes the skin cells to grow much more rapidly than normal. They accumulate too fast and create thick, scaly lesions.

There are various forms of this disease, but the most commonly occurring one is plaque psoriasis. Lesions usually develop on the elbows, knees, or scalp.

However, they can occur in any part of the body. These patches may feel itchy, inflamed, sore, and may bleed or crack. Other forms of the disease may cause pus-filled bumps, small red spots, or red scaling patches all over.

 

How Does a Person Get Psoriasis?

Researchers know that certain genes are related to psoriasis. So, if someone in a person’s family has this condition, they may have the same genes and may be more prone to developing this condition.

Even with genes that predispose a person to psoriasis, they also need something that wakes up or triggers their condition. It might be something physical such as a scratch, cut, infection, or bad sunburn.

Some common triggers include medicines and cold weather (which can lead to dry, cracked skin). However, being around an individual with psoriasis is not a trigger.

Upon being triggered, psoriasis becomes a chronic condition. This means that most individuals will have it for the rest of their lives. But they may be able to manage it with drugs and other treatment.

 

What about Physical Contact?

When doctors did what caused psoriasis, they frequently confused it with leprosy. People who had this condition were believed to be contagious.

However, today it is known that this condition cannot develop by brushing up against someone who has it. It can also not pass on to another person by kissing, sexual activity, or swimming in the same water.

Individuals get psoriasis due to their genes, not because of bad hygiene, lifestyle, diet, or any other behaviors. They did not get it from anyone else, and they cannot pass it onto others.

Irrespective, there is a significant stigma associated with the condition. This can be hard on individuals with psoriasis. They may feel uneasy when people stare at their lesions or avoid touching them, and they may try to conceal their outbreaks under long clothes.

People with psoriasis can help end the misunderstandings and anxiety regarding the condition by speaking openly to family, friends, and colleagues. If you know a person who has psoriasis, ensure that they know that their condition does not influence your opinion or them or make you not want to be near them.

Board certified dermatologist Dr. Tri H. Nguyen receives patients from Houston, Katy, Spring, The Woodlands, Texas, and nearby areas for innovative and advanced dermatology treatments.
For more information on procedures and treatments offered at Texas Surgical Dermatology PA please call 832.663.6566 or click here to contact our dermatologists. Helping patients in Houston, The Woodlands, Springs, Katy and other surrounding areas of Texas.

Dermabrasion

shutterstock_116665918-200x300 Dermabrasion Houston DermatologistDermabrasion is a dermatologic treatment that enhances the appearance of the skin. It involves the use of a wire brush or diamond wheel with rough edges (known as a fraise or burr) to eliminate the topmost skin layers.

The burr or brush spins rapidly, eliminating and leveling (abrading or planing) the uppermost skin layers. This process wounds or injures the skin and causes bleeding. New skin replaces the damaged skin as the wound heals.

Texas Surgical Dermatology, led by board certified dermatologist Dr. Tri H. Nguyen, provides advanced skin care procedures to patients in Houston, Katy, Spring, The Woodlands, Texas, and surrounding locations.

 

Factors to Determine Skin Removal

Things impacting the depth of skin removal are as follows:

  • The coarseness of the burr or brush as well as its spinning speed
  • The amount of pressure applied and for how long
  • The state and characteristics of the patient’s skin

The most common area for dermabrasion treatment is the face. However, it is an effective treatment for other areas of the body as well. This procedure is often undertaken to enhance the appearance of acne scars and fine lines around the mouth. It may also be used in the treatment of rhinophyma (an enlarged nose) due to a skin condition known as rosacea.

 

Advantages

Dermabrasion creates a smooth and even skin texture as well as gives scarred skin a more uniform appearance. This is an effective procedure to soften the appearance of surface or almost flat acne scars.

Other types of treatment may be necessary for pitted acne scars along with or rather than dermabrasion. Other type of treatments for such scars includes elevation, punch grafting, or excision.

Dermabrasion may improve scars from surgery or injury when done eight to 12 weeks following the surgery or injury. However, most new scars fade away or heal by themselves for the initial six months or so.

Certain surface growths on the skin can be addressed. However, dermabrasion is rarely used in treating such growths.

This procedure can improve color changes in the skin, especially when undertaken with a bleaching agent and tretinoin (Retin-A). Dermabrasion can improve the efficiency of the bleaching agent.

This procedure will not have a significant impact on deeper wrinkles, but it may bring about improvements in fine lines surrounding the eyes and mouth.

 

How it is Done

The provider will clean and mark the treatment areas. They will use a local anesthetic (such as lidocaine) to numb the skin. Ice packs may also be placed on the skin for up to 30 minutes.

The provider may use a freezing (cryogenic) spray to harden the skin for deeper abrasions if the ice packs and anesthetic do not tighten the skin adequately.

The patient may require stronger anesthesia, sedation, pain killers, or general anesthesia for deeper abrasions, or if their entire face is undergoing treatment.

The provider will treat one small area at a time. If necessary, they will apply the freezing spray to the face for a few seconds. Subsequently, the rotating brush or burr will eliminate the uppermost layers of the skin.

The provider will use gauze to stop any bleeding and then cover the region with a clean dressing or ointment. This procedure is almost always undertaken in the doctor’s office or on an outpatient basis.

 

What to Expect

The size and depth of the treated area will determine the time it takes to heal after dermabrasion. A person who has had a full-face treatment will take a longer time to heal in comparison to someone who has undergone treatment in just a small skin area. Abrasions that are deeper take more time to heal.

Board certified dermatologist Dr. Tri H. Nguyen receives patients from Houston, Katy, Spring, The Woodlands, Texas, and nearby areas for skin treatments.
For more information on procedures and treatments offered at Texas Surgical Dermatology PA please call 832.663.6566 or click here to contact our dermatologists. Helping patients in Houston, The Woodlands, Springs, Katy and other surrounding areas of Texas.

Dermatologist FAQ: What is Psoriasis?

shutterstock_85912321-199x300 Dermatologist FAQ: What is Psoriasis? Houston DermatologistPsoriasis is not just a superficial skin condition. In fact, it actually develops underneath the skin.

Psoriasis is a chronic or long-lasting condition of the immune system that can range from mild to severe. This condition can sometimes be linked to diseases such as psoriatic arthritis, Type 2 diabetes, and cardiovascular disease.

Texas Surgical Dermatology, led by board certified dermatologist Dr. Tri H. Nguyen, provides advanced skin care treatments to patients in Houston, Katy, Spring, The Woodlands, Texas, and surrounding locations.

 

How Psoriasis Develops

The psoriasis symptoms that manifest on the surface of the skin are only a part of the story. With healthy skin, the body takes nearly 28 to 30 days to produce new skin cells and discard old cells.

In plaque psoriasis, the immune system becomes hyperactive causing skin inflammation. This leads to faster production of skin cells than normal. The new skin cells are pushed to the skin’s surface in three to four days instead of the standard 28 to 30 days.  

But the body cannot discard the new skin cells at such a fast rate. This causes the dead, old skin cells to accumulate over each other as new skin cells are rapidly being produced.

The rapid production of new skin cells causes the old ones to be pushed to the surface of the skin. This creates itchy, red, thick, and flaky patches known as plaques.

But the exact cause for psoriasis continues to remain unknown.

 

Psoriasis Types

Many individuals are not aware that there exist different types of psoriasis. However, a patient typically only has one type of the condition at a given type. Each form of psoriasis has distinct symptoms and can manifest on the skin in various ways.

It is crucial to understand and share with other people that regardless of where psoriasis is located on the body or what it looks like, it is not contagious.

Plaque Psoriasis

This type of psoriasis is characterized by raised, swollen, red lesions that are covered by silvery white scales. Plaque psoriasis typically develops on the elbows, knees, scalp, and lower back. This type of psoriasis occurs most commonly, with 80 percent of all psoriasis patients experiencing this form of the condition.

Guttate Psoriasis

Guttate psoriasis often starts in childhood or young adulthood. This condition manifests in the form of small, pink, individual spots on the legs, arms, and torso. These spots are usually not as thick as plaque lesions.  

Inverse Psoriasis

This form of psoriasis develops in regions such as the armpits, groin, under the breasts, and in other skin folds such as those around the genitals and buttocks. Inverse psoriasis appears as bright-red lesions that are smooth and shiny.

Pustular Psoriasis

Pustular psoriasis usually develops in adults, and it is characterized by the presence of blisters of noninfectious pus surrounded by red skin. It can be localized to a particular area of the body such as feet and hands, or cover a more substantial part of the body.

Erythrodermic Psoriasis

This is a particularly inflammatory form of psoriasis that affects most of the body’s surface. It is characterized by the presence of periodic widespread, red skin, and the shedding of scales in sheets.

Psoriasis and Joint Pain

In case a patient has psoriasis and experiences swelling, pain, or stiffness in and around their joints, they may be experiencing the symptoms of a condition associated with psoriasis, called psoriatic arthritis.

Board certified dermatologist Dr. Tri H. Nguyen receives patients from Houston, Katy, Spring, The Woodlands, Texas, and nearby areas for innovative and advanced dermatology treatments.
For more information on procedures and treatments offered at Texas Surgical Dermatology PA please call 832.663.6566 or click here to contact our dermatologists. Helping patients in Houston, The Woodlands, Springs, Katy and other surrounding areas of Texas.

Surgical Excision of Melanoma

iStock_000010649746Medium-300x192 Surgical Excision of Melanoma Houston DermatologistSurgery to excise (remove) a melanoma eliminates the entire melanoma along with a margin (border) of healthy skin.

The depth of the melanoma will determine the width of the border of healthy skin removed. In addition, more tissue, typically fat and skin, is removed from under the melanoma as well.

 

Proper Outlook

If the excision is small, it may be closed with sutures and heal without any issues. On the other hand, excisions that are large or those located on the face, hands, or feet may need a skin graft to seal the wound after the procedure.

The size and location of the melanoma will determine the type of anesthetic necessary for the surgery. Only a local anesthetic will suffice for small and easy to reach melanomas while general anesthesia may be necessary for larger melanomas.

Texas Surgical Dermatology, led by board certified dermatologist Dr. Tri H. Nguyen, provides advanced skin care procedures to patients in Houston, Katy, Spring, The Woodlands, Texas, and surrounding locations.

 

Why it is Done

The most common treatment for melanoma is surgery. At times, lymph nodes may be eliminated simultaneously to evaluate them for cancer. In addition, surgery may be done to excise lymph noses that are cancerous or to eliminate tumors that may have spread to other body areas.

 

How Well it Works

Melanoma removal surgery typically cures melanoma if it is detected early. It may also cure melanoma if the cancer is only in the surrounding lymph nodes.

Surgery may also be used in the treatment of metastatic melanoma. This cures cancer only in a few cases. However, surgery offers the most effective and sustainable relief of symptoms.  

 

How is elliptical excision performed?

The most common way to excise a tumor is elliptical excision. In this procedure, the dermatologist will draw a margin around the tumor. This margin may be as narrow as 4 millimeters (mm) for a low-risk melanoma skin cancer.

However, in the case of a thick melanoma, the margin may be as wide as two cm. For patients undergoing excisional biopsies, the doctor will mark the margins from the biopsy scar.

The dermatologist will cut an elliptical, or football shape around the margin. This type of cut helps remove more skin relative to a circular cut, and also results in a better-looking scar. After the procedure, the doctor will seal the incision with sutures. The scar will appear as a thin, flat line.

 

How are tumors excised from complex areas?

It can be tricky to excise tumors on certain areas of the body such as the face, scalp, ear, foot sole, toes, and fingers.

Once tumors are excises from these regions, it may not be possible to stretch the skin over the area to seal it. The patient may require surgical repairs. Repair procedures may include skin grafts or flaps. In these areas, margins may be smaller.

 

Excision for High-Risk Non-Melanoma Skin Cancer

Excision is a treatment option for high-risk BCC or SCC as well. High-risk BCC is more likely to recur while high-risk SCC is more likely to recur or spread.

For this reason, the doctor will use wider margins to excise these cancers. In addition, a pathologist may evaluate the excised tumor while the patient is still in surgery. The surgeon will not seal the incisions until they get clear margins.

The recovery after a procedure to remove melanoma will depend on the site and extent of the procedure. The healing may be more extended if the patient undergoes reconstructive techniques such as skin grafts.

Board certified dermatologist Dr. Tri H. Nguyen receives patients from Houston, Katy, Spring, The Woodlands, Texas, and nearby areas for skin treatments.
For more information on procedures and treatments offered at Texas Surgical Dermatology PA please call 832.663.6566 or click here to contact our dermatologists. Helping patients in Houston, The Woodlands, Springs, Katy and other surrounding areas of Texas.

Excision For Non-Melanoma Skin Cancer

shutterstock_80403592-e1554349029879-293x300 Excision For Non-Melanoma Skin Cancer Houston DermatologistThe removal of skin cancer along with some healthy tissue surrounding it (margin) is known as excision. A local anesthetic is used in this procedure to numb the site.

Once the malignant area is excised, the incision is sealed with sutures. The patient may require a skin graft or flap if the incision is large. They may also require reconstructive surgery if the excision procedure leads to a scar.

Mohs micrographic surgery differs from standard excision. Mohs surgery involves the removal of skin cancer layer-by-layer, and each layer is analyzed under a microscope promptly. In Mohs surgery, the surgeon excises the cancer cells while sparing as much healthy skin as possible.

Texas Surgical Dermatology, led by board certified dermatologist Dr. Tri H. Nguyen, provides advanced skin care procedures to patients in Houston, Katy, Spring, The Woodlands, Texas, and surrounding communities.  

 

Why it is Done

Standard excision is an effective procedure to remove basal cells and squamous cell carcinomas. However, this surgery is more effective for certain skin cancers in areas, such as the face, where it is vital to preserve as much skin as possible.

The meaning of excision is simply “to cut out.” Surgical excision helps treat non-melanoma skin cancer, and it is also known as “wide excision.” This occurs as the tumor is excised along with some normal skin surrounding it.

This healthy skin is known as a margin. The removal of margin is undertaken to eliminate any cancer cells that may have spread in the nearby tissue.

The tumor size, type, and location will determine the complexity of the excision. The most common and simplest technique to remove a tumor is known as elliptical excision. For tumor on the foot, scalp, and other tricky areas, excision and repair are more complex.

Upon excising a tumor, a pathologist studies the tissue that was taken to ensure that all cancer cells are gone.

 

How Well It Works

The standard excision treatment for basal cell carcinoma is below 20 mm (0.8 inches) and has cure rates as high as 95 out of 100 patients when performed with mm (0.2 inches) margins.

This technique has a cure rate of 92 out of 100 people when used to treat squamous cell carcinoma. Mostly, Mohs micrographic surgery has cure rates that are slightly higher than the cure rates of excision.  

 

Risks

Excisions to remove skin cancers include the following risks:

  • The wound may bleed, leading to pain, or become infected.
  • There may be scarring.
  • A skin graft may not heal.
  • All cancer cells may not be eliminated, leaving a margin containing cancer cells.

 

Things to Remember

The edges or margins of the skin where skin cancer was eliminated will be evaluated in a laboratory by a pathologist to understand if any cancer cells still exist outside the area of the eliminated skin.

Ensuring that the entire skin cancer is removed is extremely crucial to reducing the chances of recurrence. The area of the excision and the amount of skin removed will determine the recovery from skin cancer.

Board certified dermatologist Dr. Tri H. Nguyen receives patients from Houston, Katy, Spring, The Woodlands, Texas, and nearby areas for skin treatments.
For more information on procedures and treatments offered at Texas Surgical Dermatology PA please call 832.663.6566 or click here to contact our dermatologists. Helping patients in Houston, The Woodlands, Springs, Katy and other surrounding areas of Texas.

Skin Biopsy

shutterstock_116665918-200x300 Skin Biopsy Houston DermatologistIn case the doctor suspects that a suspicious spot on the skin might be melanoma, they will order a skin biopsy. In this procedure, the suspicious looking area will be excised and sent to a lab for evaluation under a microscope.

Texas Surgical Dermatology, led by board certified dermatologist Dr. Tri H. Nguyen, provides advanced skin care procedures to patients in Houston, Katy, Spring, The Woodlands, Texas, and surrounding locations.

 

Choosing the Appropriate Biopsy Technique

Various techniques are available to perform a skin biopsy. Aspects such as the size of the impacted area as well as its location on the body will determine which dermatological treatment will be chosen by the doctor. Any biopsy may cause a small scar, and different types of scars will occur due to different types of techniques.

For this reason, it is important that the patient discuss the possibility of scarring with their doctor before undergoing the biopsy.

Irrespective of the biopsy done, the objective should be to excise as much as the suspicious-looking region as possible to allow the pathologist to conclude the correct findings.

A local anesthetic, or numbing medicine, is used while performing a skin biopsy. The medical professional will use a fine gauge needle to inject this drug into the area. The patient will likely feel a small prick and a stinging sensation as the drug enters the bloodstream. But the biopsy should be pain-free after receiving the anesthetic.

 

Shave (Tangential) Biopsy

This biopsy involves shaving off the topmost layers of skin using a surgical blade. The doctor will apply an ointment on the area of the biopsy. This chemical helps stop the bleeding. Alternatively, they may use a small electric current to cauterize the wound.

A shave biopsy helps diagnose multiple skin conditions and sampling moles with a low risk of melanoma. This type of biopsy is generally not undertaken if the possibility of melanoma is high unless the biopsy blade goes deep enough to get underneath the suspicious region.

At times, the biopsy sample may not have enough thickness to measure the depth of the cancer spread in the skin.

 

Punch Biopsy

In this type of biopsy, the doctor will use an instrument that looks like a small round cookie cutter to remove a deeper skin sample. The doctor rotates the punch biopsy instrument on the skin until it penetrates all of the layers of the skin. The sample is excised, and the edges of the biopsy wound are typically sealed using sutures.

 

Incisional and Excisional Biopsies

A doctor will need to undertake an incisional or excisional biopsy to analyze a tumor that might have grown into the deeper skin layers. Such biopsies involve the use of a surgical knife to penetrate the entire thickness of the skin. This procedure excises a slice or wedge of the skin for evaluation. The edges of the wound are usually sutured together.

In an incisional biopsy, only a part of the tumor is eliminated. On the other hand, excisional biopsy excises the entire tumor. This makes it a preferred biopsy technique for suspected melanomas wherever possible. But an excisional biopsy may not always be possible, and the patient may require another type of biopsy.

 

Laboratory Tests of Biopsy Samples

The samples from the biopsy are sent to a lab, where a doctor (pathologist) will analyze these samples under a microscope to detect the presence of any melanoma cells. In general, a dermatopathologist, who is an expert in evaluating skin samples, will assess biopsy samples.

Board certified dermatologist Dr. Tri H. Nguyen receives patients from Houston, Katy, Spring, The Woodlands, Texas, and nearby areas for skin treatments.
For more information on procedures and treatments offered at Texas Surgical Dermatology PA please call 832.663.6566 or click here to contact our dermatologists. Helping patients in Houston, The Woodlands, Springs, Katy and other surrounding areas of Texas.

Mohs Surgery Sequence

iStock_000006884488XSmall-225x300 Mohs Surgery Sequence Houston DermatologistMohs surgery is considered the foremost treatment for specific skin cancers. For the best outcomes, it is vital to identify a qualified and experienced Mohs surgeon.

At the time of the pre-operative consultation, the Mohs surgeon will inform the patient of the steps involved in the surgery.

Texas Surgical Dermatology, led by board certified dermatologist Dr. Tri H. Nguyen, provides medical and cosmetic dermatology procedures to patients in Houston, Katy, Spring, The Woodlands, Texas, and surrounding locations.

 

Sequential Steps in Mohs Surgery

Step 1

Depending on the location of their skin cancer, the patient may be able to wear their regular clothing or may need to put on a hospital gown.

The Mohs surgeon will assess the site where the patient had their biopsy and demarcate if with a pen for reference. They will then position to the patient to gain access to the treatment area, including having them sit up or lie down.  

A surgical drape will be placed over the treatment area. If the cancer is on the face, the patient may be unable to view the proceedings. But the surgeon will talk them through it. They will then inject a local anesthetic to numb the area entirely. The patient will remain awake throughout the procedure.

 

Step 2

The surgeon uses a scalpel to remove a thin skin layer with visible cancerous tissue. In some types of skins cancers, this may only be the “the tip of the iceberg.” This means that they have roots or extensions that are not visible from the surface.

The ensuing lab analysis will establish whether this is the case. The surgeon will bandage the wound temporarily, and the patient can relax as the lab work begins.

 

Step 3

The surgeon will dissect the tissue into multiple sections and color code them using dyes. They will also create a map of the surgical region. The lab technician will then freeze the dissected tissue and slice it into very thin horizontal strips similar to a layer of cake.

Subsequently, these slices are mounted on microscopic slides, stained, and covered. This is a laborious and time-consuming process.

 

Step 4

The surgeon will assess all the sides and the underside of the tissue mounted on the slides. If any cancer cells remain, they will mark the location on the map. After this, the surgeon will let the patient know if they will need to have another layer of tissue removed.

 

Step 5

The doctor will administer more local anesthetic in the operating room if necessary and eliminate another skin layer in the area where the cancer cells remain based on the map. Then the patient will wait again as the lab work commences. This process will be repeated until no more cancer cells remain.

 

Step 6

Depending on the location and size of the treated area, the surgeon may leave the wound open to heal or suture it after no more cancer cells remain. At times, the wound may need reconstruction using a skin flap. The surgeon will move the nearby tissue into the wound or use a skin graft.

For most patients, the Mohs surgeon will repair the wound immediately after attaining cancer-free margins. But sometimes they may repair the wound working with another specialist.

 

Step 7

The patient may need to spend several hours on this surgery, especially if more than one or two rounds of skin removal are necessary. The benefit of this precise technique is that it has the highest rate of cure of any treatment technique and preserves the most amount of healthy tissue possible while leaving behind the smallest scar.

Board certified dermatologist Dr. Tri H. Nguyen receives patients from Houston, Katy, Spring, The Woodlands, Texas, and nearby areas for advanced dermatology procedures.
For more information on procedures and treatments offered at Texas Surgical Dermatology PA please call 832.663.6566 or click here to contact our dermatologists. Helping patients in Houston, The Woodlands, Springs, Katy and other surrounding areas of Texas.

What is Non-Melanoma Skin Cancer?

shutterstock_134285489-203x300 What is Non-Melanoma Skin Cancer? Houston DermatologistNon-melanoma skin cancer initiates in the cells of the skin. A malignant (cancerous) growth refers to a group of cancer cells that can develop into and destroy the surrounding tissue.

It can also metastasize (spread) to other areas of this body. However, this is a rare occurrence with non-melanoma skin cancer.

Texas Surgical Dermatology, led by board certified dermatologist Dr. Tri H. Nguyen, provides medical and cosmetic dermatology procedures to patients in Houston, Katy, Spring, The Woodlands, Texas, and surrounding locations.

 

Types of Non-Melanoma Skin Cancer

There are two primary types of non-melanoma skin cancer:

  • Basal cell carcinoma (BCC)
  • Squamous cell carcinoma (SCC)

 

Basal Cell Carcinoma

BCC is the most commonly occurring type of skin cancer and comprises 75 to 80 percent of all skin cancers.

BCC initiates in basal cells of the skin, which are circular cells found in the top or outer skin layer (epidermis). This type of cancer tends to grow slowly, and it rarely spreads to other areas of the body. However, it may grow into surrounding tissue if left untreated.

BCC commonly develops on the face, head, and neck areas. It is usually diagnosed in middle-aged or older individuals. However, it can also occur in younger people.

There are various subtypes of BCC, including:

Nodular BCC is the most commonly occurring subtype. It often develops in facial areas that are exposed to the sun. Nodular BCC has the appearance of a round, elevated, pink, pearly white or red lump or an area with wide blood vessels apparent on top.  

 

Squamous Cell Carcinoma

SCC is the second most common form of skin cancer. It makes up around 20 percent of all skin cancers.

SCC initiates in squamous cells of the skin. These flat cells are located in the outer part of the dermis. SCC often develops gradually, but faster than BCC. BCC also has a higher likelihood of growing deeper into the skin and spread.

Upon being detected early on and only in the epidermis, SCC is known as SCC in situ. This condition is an early form of SCC and is not typically life-threatening. But if left untreated, SCC in situ may develop into invasive SCC.

This means that the cancer can develop into surrounding tissue or deeper skin layers. SCC in situ is also known as Bowen’s disease or intraepidermal SCC.

SCC often develops on skin areas that are exposed to the sun. While less common, it can also occur on inflamed or injured areas of the skin, such as burns, scars, and sores or ulcers that do not heal. This type of skin cancer can also occur on the skin around the vagina and the anus.

There are various subtypes of SCC, such as desmoplastic SCC and adenosquamous carcinoma of the skin. These types of cancers present a high risk of recurrence after treatment.

 

Rare Non-Melanoma Skin Cancers

The below mentioned non-melanoma skin cancers occur rarely, and comprise around one percent of all skin cancers:

  • Cutaneous T-cell lymphoma
  • Merkel cell carcinoma
  • Soft tissue sarcomas, such as dermatofibrosarcoma protuberans and angiosarcoma
  • Kaposi sarcoma
  • Microcystic adnexal carcinoma (also known as sweat gland cancer)

Board certified dermatologist Dr. Tri H. Nguyen receives patients from Houston, Katy, Spring, The Woodlands, Texas, and nearby areas for advanced dermatology procedures.
For more information on procedures and treatments offered at Texas Surgical Dermatology PA please call 832.663.6566 or click here to contact our dermatologists. Helping patients in Houston, The Woodlands, Springs, Katy and other surrounding areas of Texas.

Mohs Micrographic Surgery For Non-melanoma Skin Cancer

shutterstock_93812107-300x300 Mohs Micrographic Surgery For Non-melanoma Skin Cancer Houston DermatologistIn Mohs micrographic surgery, the surgeon removes skin cancer layer-by-layer and analyzes these layers under a microscope right after they are removed.

This procedure enables the Mohs surgeon to examine each skin layer to detect cancerous cells. It involves minimal tissue removal while ensuring that all cancer cells are eliminated.

A local anesthetic will be injected into the skin prior to the procedure. Subsequently, the doctor will remove the skin cancer and a tiny margin of healthy tissue, one layer at a time.

 

Finality

Each layer of tissue is prepared and analyzed under the microscope for malignant cells. When the surgeon does not detect any more cancer cells under the microscope, the procedure is complete.

Texas Surgical Dermatology, led by board certified dermatologist Dr. Tri H. Nguyen, provides Mohs micrographic surgery to patients in Houston, Katy, Spring, The Woodlands, Texas, and surrounding communities.

 

Why it is Done

Mohs micrographic surgery is appropriate for the removal of skin cancer that:

  • Has a likelihood of returning. Mohs micrographic surgery is more successful in acquiring clear margins for cancer types that have uneven borders and a history of removal and redevelopment.
  • Is located in noticeable areas the skin, making it is necessary to preserve tissue, such as the nose, ears, or eyelids.
  • Is spreading rapidly.
  • Has a high level of risk of spreading to other body areas, such as in certain squamous cell carcinomas (SCCs).
  • Develops in children.

 

How effective is it?

Mohs micrographic surgery is an effective skin cancer treatment and one that helps preserve as much surrounding healthy skin as possible.

Dermatologists usually recommend this technique for squamous cell carcinoma due to the highest cure rate that it offers as well as its ability to preserve healthy tissue. This technique is also considered the best treatment for basal cell carcinoma as it spares healthy tissue and prevents recurrence.

 

Risks

The risks associated with this procedure include:

  • Scarring
  • Infection of the wound
  • Pain or discomfort
  • Bleeding

 

Things to Keep in Mind

Mohs micrographic surgery is the most effective procedure to preserve skin tissue around the cancer. However, this procedure requires special training and equipment. For this reason, Mohs surgery should only be undertaken by a trained and experienced surgeon.

 

After the Surgery

After eliminating all the cancerous tissue, the surgeon will inform the patient on their options for wound healing. They will undertake one of the below, depending on the patient’s circumstances:

  • Suture the wound closed.
  • Allow the incision to heal on its own.
  • Take a skin flap from another area of the body to help cover the wound.
  • Take a skin graft from another area of the body to help cover the wound.
  • Close the wound temporarily and set for reconstructive surgery at a later date.

The patient will likely return home with all their skin cancer eliminated as the surgeon will be able to see the outcomes immediately after removing tissue. But they will need to follow up with their doctor to ensure that the recovery is on track.

Discomfort, redness, bleeding, and inflammation are some common side-effects of Mohs surgery. However, these issues will resolve by themselves over time. The doctor will provide the patient with guidelines on how to clean the wound and regarding any medications that they need to take.

Board certified dermatologist Dr. Tri H. Nguyen receives patients from Houston, Katy, Spring, The Woodlands, Texas, and nearby areas for Mohs micrographic surgery.
For more information on procedures and treatments offered at Texas Surgical Dermatology PA please call 832.663.6566 or click here to contact our dermatologists. Helping patients in Houston, The Woodlands, Springs, Katy and other surrounding areas of Texas.

Contact Us

Texas Surgical Dermatology PA
21009 Kuykendahl Rd, Ste A
Spring, TX 77379

Tel: 832.663.6566
FAX: 832.663.6550