Phoenixville Valley Forge Dermatology Associates

Skin cancer, which is the most common form of cancer in the United States, is the result of the abnormal growth of skin cells. Cancer can affect skin anywhere on the body, but most frequently appears on skin that is exposed to the sun. There are more than a million new cases of skin cancer in the United States each year. Causes of Skin Cancer Every day, skin cells die and new ones form to replace them in a process controlled by DNA. Skin cancer can form when this process does not work properly because of damage to DNA. New cells may form when they are not needed, or older cells may not die, both of which can cause a growth of tissue known as a tumor. DNA damage is often a result of ultraviolet radiation from sunlight or tanning lamps. In some cases, skin cancer affects areas of the skin that have not been exposed to the sun. Certain factors, such as fair skin, moles, a weakened immune system, heredity and age, also increase the risk of skin cancer. Types of Skin Cancer There are three major types of skin cancer, and they affect different layers of the skin. They are named for the different types of skin cells that become cancerous. Basal Cell Carcinoma Basal cell skin cancer occurs in the basal cell layer of the skin and is the most common type of skin cancer in people with fair skin. It commonly occurs on areas of the skin that have been exposed to the sun, such as the face. It rarely spreads to other parts of the body. Squamous Cell Carcinoma Squamous cell carcinoma occurs in the squamous cells, and is the most common type of skin cancer in people with dark skin, who typically get it in places, such as the legs or feet, that have not been exposed to the sun. In people with fair skin, it usually occurs in sun-exposed areas such as on the face, head, ears and neck. Squamous cell skin cancer can spread to other parts of the body. Melanoma Melanoma is the most aggressive type of cancer, and the most likely to spread to other parts of the body. Melanoma occurs in the melanocyte (pigment) cells of the skin, and can form on any part of the body, regardless of past sun exposure. Symptoms of Skin Cancer Skin cancer is often identified as a new or changed growth on the skin of the scalp, face, lips, ears, neck, chest, arms, hands or legs. Although these are common areas for skin-cancer growths to form, they can occur anywhere, and manifest themselves as the following: Pearly or waxy bump Flesh-colored or brown scar-like lesion Firm, red nodule Crusted, flat lesion Large brown spot with darker speckles Shiny, firm bumps A mole that changes shape or color can also indicate skin cancer. Diagnosis of Skin Cancer To diagnose skin cancer, a doctor reviews all symptoms, and checks the skin for any unusual growths or abnormal patches of skin. If skin cancer is suspected, a biopsy is performed on the growth or area of skin in question. Once the results of the biopsy are reviewed, the type of cancer can be determined, and a treatment plan created. Those who experience any skin changes, or have changes to existing moles or birthmarks, should see a doctor as soon as possible; early detection is key in successfully treating skin cancer. Treatment for Skin Cancer Treatment for skin cancer depends on the type, size and location of the tumor. Most options include the removal of the entire growth, and are effective forms of treatment. Removal procedures are usually simple, requiring only a local anesthetic in an outpatient setting. Some of the treatment options for skin cancer include the following: Freezing Excision Laser therapy Mohs surgery Depending on the stage and severity of the skin cancer, in addition to removal of the growth, chemotherapy and radiation may be recommended. Prevention of Skin Cancer Although not every case of skin cancer can be prevented, the best way to avoid it is to protect skin from the sun. Recommendations for preventing skin cancer include the following: Limit exposure to the skin, especially between 10 a.m. and 4 p.m. Always wear sun screen with an SPF of at least 15 Wear a hat in the sun Wear long sleeves and long pants Avoid tanning beds and salons Performing routine self-exams to spot skin changes, and seeing a dermatologist for a full-body screening on a regular basis, is also recommended.

Mohs (pronounced "Moes") surgery, also called Mohs or Mohs micrographic surgery, is a specialized treatment for removing certain skin cancers. It is the only treatment method that allows for complete evaluation of the margins (areas surrounding the visible skin cancer) while you wait in the medical office. Mohs surgery ensures that all skin cancer cells have been removed before you leave the office. What happens during Mohs surgery? The visible tumor and a thin layer of surrounding skin are removed. The tissue is examined under a microscope to see if any cancer cells remain at any of the edges. If any cancer cells remain, additional skin is removed and examined under the microscope. This process continues until no more cancer cells are found at the edges. Each review of the removed skin can take approximately an hour. Because of this, it can be helpful to bring a snack or something to entertain yourself, such as a book.

Acne is a common condition that causes blocked pores, pimples, cysts and other lesions on the skin of the face, neck, chest, back, shoulders and upper arms. Although teenagers are often affected, adults of any age can suffer from acne. Acne is not life-threatening, but can lead to physical disfigurement and emotional distress. There are several effective treatment methods that improve the skin‘s appearance and prevent future breakouts. Causes of Acne Acne develops when pores become clogged, either from an overproduction of oil, a buildup of bacteria or a shedding of dead skin cells. When oil, bacteria or dead skin cells build up in the hair follicle, they form a soft plug that forces the follicle wall to bulge and protrude from the skin, causing a lesion. The cause of excess oil production is unknown, but is believed to involve a combination of several factors, including hormones, bacteria, heredity and, in some cases, the use of certain medications. Contrary to popular belief, chocolate, greasy foods and dirty skin do not cause acne. In the first few months of life, some infants have acne. This is a common condition caused by exposure to maternal hormones in the womb; it clears up on its own within a few weeks or months. Symptoms of Acne Although they can appear anywhere, symptoms of acne usually appear on the face, neck, shoulders, back or chest. Symptoms of acne may include the following: Blackheads Whiteheads Cysts Nodules Pustules Redness Swelling These symptoms can come and go, and may flare up at certain times as a result of hormonal or environmental triggers such as pregnancy, menstrual periods, high levels of humidity, using oily cosmetics or hair products, and taking certain medications. Severe cases of acne may cause scarring, which can have a damaging emotional effect on the sufferer. If acne symptoms do not respond to over-the-counter treatments, or if scarring develops as the acne clears up, a dermatologist should be consulted. Acne Treatments Treatment methods for acne aim to reduce oil production and increase the speed of skin-cell turnover to prevent new blemishes from developing. Acne treatment also focuses on reducing inflammation to help treat current symptoms. Treatment may include a combination of topical creams and ointments, and prescription medications that include antibiotics and oral contraceptives. Topical Treatments Topical creams and ointments applied to the affected area are often the first form of treatment used to treat acne. Over-the-counter creams and ointments, which are used to treat mild forms of acne, may contain benzoyl peroxide, salicylic acid or lactic acid as their active ingredient. Prescription topical treatments may contain higher concentrations of these active ingredients, as well as retinoic or azelaic acid. Oral Prescription Medications Moderate cases of acne can often be treated with prescription oral antibiotics, which reduce bacteria and inflammation. They are often combined with topical treatments. Isotretinoin may be prescribed for severe cases of acne that do not respond to other treatment methods. In some cases, oral contraceptives are prescribed for women to treat moderate cases of acne. Scar Treatment Certain procedures may be recommended to treat scarring caused by acne. They include skin fillers, dermabrasion, microdermabrasion and laser treatment. Many patients experience effective results from these types of treatments, which help to smooth the skin and remove the scars created by severe acne. It may take up to 8 weeks before results from treatment are apparent, and acne may get worse before getting better. Preventing Acne Although acne cannot always be prevented, there are certain ways to reduce the risk of breakouts. They include the following: Avoiding heavy or oily cosmetics Removing makeup before going to bed Using mild cleansers Avoiding sun exposure Avoiding constant touching of the skin Patients should also avoid picking or squeezing blemishes, and should be aware of anything that comes in contact with the affected area, because it may contain unwanted bacteria.

Scar revision reduces the prominence of scars that result from injury or previous surgery. Although many scars fade over time and become barely noticeable, disruptions to the healing process can cause them to become red, raised, indented or otherwise deformed. The prominence of a scar depends on the type and severity of the injury that caused it, and the patient‘s age, overall health and ability to heal. For people who are unhappy with or embarrassed by their scars, there are a number of procedures available to make scars less apparent. Scar-Revision Treatments Scars are by definition permanent, but certain treatments can narrow, fade and otherwise make them less noticeable, which is especially helpful when they form on conspicuous areas such as the face and hands. Although there are many surgical scar-revision methods, including surgical excision, skin grafts and flap surgery, not all are appropriate for treating all types of scars. The best procedure for scar revision varies depending on the location and severity of the scar, the age and overall health of the patient, and the extent of revision the patient wants. Subcision Subcision is a procedure for treating scars that are indented. A needle is directed into the skin to break up the fibers that attach the scar to below-the-surface tissue, raising it back to the elevation of surrounding skin. It also promotes healing by creating new connective tissue that repairs and smooths the skin. Excision Surgical excision is most often used for severe contracture (skin-tightening) scars, and involves using a scalpel to surgically cut away the scar and surrounding damaged tissue. A skin flap or graft may be used to restore the appearance of the skin in the treated area, and also improve movement and flexibility that may have been affected by the contracture. Punch Elevation Particularly effective for certain types of acne scars, punch elevation uses a punch tool rather than a typical scalpel to precisely remove small quantities of tissue without affecting nearby skin. The punch tool is used to elevate the base of the scar, making it appear much less recessed or pronounced. Surface Treatments Many cosmetic procedures, such as microdermabrasion, chemical peels and skin bleaching, effectively treat discolorations and mild surface irregularities by gently removing the top layers of skin and rejuvenating the underlying layers. Multiple treatments may be needed, however, to achieve noticeable results. Laser Treatments Similar to surface treatments, laser treatments gently remove damaged layers of skin to reveal new unblemished skin underneath, while stimulating collagen production for further gradual improvements. The precision of laser treatments ensures that only damaged tissue is treated, while healthy surrounding tissue remains intact. Fillers Dermal fillers are quite successful at “filling in” depressed scars and creating a smoother skin surface. Fillers are U.S. Food and Drug Administration-approved, and safe for most patients. Many fillers are made from substances found naturally in the body, or are synthetically made to mimic natural substances or stimulate collagen production. Fillers are injected directly into the skin of the targeted area to restore volume to the scar. However, results from fillers are not permanent, and followup injections are necessary to maintain the improvement they provide. Prior to undergoing scar revision, patients are advised to stop smoking, and to avoid any medications that can cause an increase in bleeding. Results and Recovery from Scar Revision Most scar-revision treatments are minimally invasive, and do not require any downtime, although there may be mild swelling, discoloration and discomfort in the treated area for 1 to 2 weeks. Results are often immediate and noticeable, although it may take several months for maximum results to be achieved. The effectiveness of scar revision depends on a number of factors, including the nature of the injury, the body‘s healing ability, the size and depth of the wound, and the thickness and color of the skin.

Moles are growths on the skin that are usually brown or black; they may be located, alone or in groups, anywhere on the body. A birthmark is a colored mark that appears soon after a baby‘s birth. Although many moles and birthmarks are completely benign and pose no health risk, some people choose to remove them because they consider them unattractive. Regularly using a strong sunscreen, and monitoring birthmarks and moles for changes, is highly recommended. Types of Moles and Birthmarks There are many types of moles and birthmarks, including the following: Congenital mole (dark and irregularly shaped) Atypical mole (irregular color and undefined borders) Cafe-au-lait spot (light-brown patch) Mongolian spot (flat, bluish and irregularly shaped) Hemangioma (reddish-purple patch or raised dots) Salmon patch (reddish patch, usually on the upper eyelid) Port-wine stain (dark red and flat) Most moles and birthmarks are harmless. However, some atypical moles have the potential to be or become malignant. Atypical moles may be asymmetrical, or have irregular borders and uneven coloring; they can be located anywhere on the body, including areas not exposed to the sun. Diagnosis of Moles and Birthmarks A thorough physician-performed examination of the skin is necessary to determine whether a mole or birthmark needs immediate treatment or simply to be checked on a recurring basis. When a mole is diagnosed as atypical, it may need immediate treatment. A patient with an atypical mole may have a personal or family history of melanoma, which increases the possibility of malignancy. A mole should be examined by a physician if it is: Larger than 6 millimeters Itching or bleeding Rapidly changing color, size or shape Multicolored Located in a difficult-to-monitor area (such as the scalp) Most birthmarks are benign, but some have the potential to become malignant or may indicate systemic disease. A large congenital mole that is present at birth has a greater risk of becoming malignant; this is especially true if the mole covers an area larger than the size of a fist. Café au lait spots can indicate a number of rare systemic diseases, such as Maffucci syndrome or Gaucher disease. Treatment of Moles and Birthmarks Depending on its depth, location and color, as well as factors that include the patient‘s skin type and age, treatment for a benign mole or birthmark includes: Laser or pulsed-light therapy Microdermabrasion Surgical removal If a mole is irregular and needs to be evaluated further, either the entire mole is removed, or a small tissue sample taken, in order to biopsy it. If only a small section of tissue is taken and it is diagnosed as malignant, the entire mole will be removed, along with a margin of normal skin around it. Cutting into a malignant mole will not cause cancer to spread. If the malignancy is caught early enough, this may be the only treatment needed. A melanoma that has spread beyond the skin requires more aggressive treatment, which may include: Surgery to remove affected lymph nodes Radiation therapy Chemotherapy Biological therapy to boost the immune system Targeted therapy (attacks vulnerabilities in cancer cells) Depending on the type and severity of the malignancy, a combination of treatments may be used. Possible, although rare, complications of surgical removal of moles and birthmarks include infection, allergic reaction to the anesthetic used, and nerve damage. Risks Factors for Malignant Moles Certain factors may increase the risk of melanoma, including: Fair skin History of sunburn Family history of melanoma Excessive UV-radiation exposure from the sun or tanning beds Living close to the equator or at higher elevations Having several moles or unusually shaped moles Weakened immune system Surgical removal leaves a scar, the severity of which depends on the size, location and type of birthmark, mole or melanoma. Prior to treatment, a patient should be informed about the type and location of a potential scar.

Chemical peels remove damaged outer layers of skin to make skin smoother, reduce scarring and remove blemishes. Ranging from mild to strong, there are three types of chemical peels: alphahydroxy acid (AHA), trichloroacetic acid (TCA) and phenol. The strength of each peel is tailored to the patient. Peels can be combined with other procedures, such as facelifts, for additional improvement to skin. Chemical peels may be covered by insurance if they are performed for medical rather than cosmetic reasons. Chemical peels are performed in a plastic surgeon‘s or dermatologist‘s office, or an outpatient surgical center. Anesthesia is not required because TCA and phenol have anesthetic properties, and AHA produces only a slight stinging. Chemical Peel Procedure During a TCA or phenol peel, the skin is cleansed and the solution is applied, which may cause a brief stinging sensation. Petroleum jelly or a waterproof adhesive tape may be put on the skin following a phenol peel. During an AHA peel, the skin is cleansed and the solution applied; there is no need for post-peel ointment or covering. Side Effects of Chemical Peels A phenol or TCA peel can result in tingling or throbbing, reddened skin, a crust or scab, and significant swelling that lasts, depending on the strength of the peel used, about a week. With a phenol peel, eyes may be swollen shut at first, and the patient may be put on a liquid diet and advised to keep talking to a minimum. Any tape used is removed after a day or two. AHA peels can cause temporary stinging, redness and irritation, as well as flaking or crusting. After a chemical peel, it is essential that the skin be protected from the sun.

BOTOX® Cosmetic is a prescription drug that, when injected, temporarily paralyzes muscles. It contains a purified and safe form of botulinum toxin A, which is produced by the microbe that causes botulism. Manufactured by Allergan, Inc., it is used to treat permanent furrows and deep wrinkles in the skin that are formed by the continual contraction of facial muscles. In addition to its cosmetic applications, it is used to treat a number of medical problems, including excessive sweating, overactive bladder, neck spasms, crossed eyes, chronic back and jaw pain, and migraines. Applications for BOTOX Cosmetic Although originally approved by the U.S. Food and Drug Administration for the treatment of eye and muscle spasms, BOTOX Cosmetic was quickly recognized for its cosmetic value. Properly placed injections of BOTOX Cosmetic block nerve impulses sent to muscles, weakening them to the point where they cannot contract, and temporarily eliminating moderately severe furrows and lines. BOTOX Cosmetic is used to treat the following: Forehead furrows Frown lines Crow‘s feet Skin bands on the neck According to Allergan, BOTOX Cosmetic has been “extensively researched, with approximately 2500 studies.” BOTOX Cosmetic Procedure and Results Using a very fine needle, BOTOX Cosmetic is injected directly into facial muscles that are causing furrows and lines. Receiving the injections requires no anesthetic, but some doctors choose to numb the area to be injected with ice packs or a topical anesthetic cream. Results can usually be seen within a few days of treatment, and typically last up to four months, although areas that are treated on a regular basis may retain results longer. Injections should be given only by qualified medical professionals. Side Effects of BOTOX Cosmetic Injection-site side effects of BOTOX Cosmetic are usually mild and temporary, and include the following: Pain Infection Inflammation Tenderness Swelling Redness Bleeding Bruising Normal activities may be resumed immediately after receiving injections

Intense pulse light or IPL is a laser treatment that is used to treat skin conditions and remove signs of photoaging like uneven texture, spots, and wrinkles. As one of the most popular non-invasive treatment options out there, it’s no wonder that more and more patients keep coming back for more. How Many IPL Treatments Will I Need? Depending on your skin type and your concerns, we usually recommend that patients undergo a series of five treatments that are spaced about four weeks apart. In some instances, we may recommend some additional sessions but we will go over all of that in detail during your initial consultation. How Long Does Each Session Take? Is IPL Right For Me? Does IPL Work On All Skin Types? How Does IPL Work? What Can IPL Treat? What Is Recovery Like? Are There Side Effects of IPL? Is IPL Expensive Depending on the provider that you end up going with, it will determine how expensive it is going to be. Overall, IPL is more affordable than other treatments. To learn more about IPL and whether or not it’s a good treatment for you, schedule a consultation appointment at our office today and we will get you taken care of.

PRFM, is a non-surgical alternative to hair restoration, naturally stimulating stem-cell development and extending the growth cycle. It can also rejuvenate the skin by restoring volume and radiance, while softening wrinkles and fine lines caused by the aging process. Naturally contained within your blood are platelets, which play an important role in your body’s healing process. These platelets contain crucial growth elements that have been shown to stimulate tissue generation and repair. When the blood is purified to its highest levels using the PRFM process, the platelets become highly concentrated, providing the greatest healing benefits possible. This sustained production of new cells and renewed blood flow delivers unmatched results that can give you the natural results you’ve been looking for.

Sculptra® Aesthetic injectable is used to reverse the signs of facial fat loss that occur with aging. By restoring collagen, which decreases as the body ages, it fills out shallow-to-deep wrinkles and folds that run from the sides of the nose to the corners of the mouth (nasolabial folds). It is not appropriate for use in the eye and lip areas. Sculptra Aesthetic‘s main component is an alpha hydroxy acid called poly-L-lactic acid (PLLA), which is a safe and long-lasting synthetic (artificially created), biocompatible (can be used harmlessly in the body), biodegradable (able to be broken down by the body) substance. PLLA has been used for more than 20 years in many surgical products, including dissolvable sutures and soft-tissue implants. Benefits of Sculptra Aesthetic Facial Injectable U.S. Food and Drug Administration-approved for the treatment of nasolabial folds, Sculptra Aesthetic is considered safe and effective for most patients. Because it works gradually, patients achieve a more youthful, natural-looking appearance with subtle, yet noticeable, results. Although not FDA-approved to treat them, according to manufacturer Valeant Aesthetics, Sculptra Aesthetic can be used on marionette lines (at the corners of the mouth) and chin wrinkles. Because it contains no animal, human or bacterial components, allergy testing is not necessary prior to treatment. There is little-to-no downtime after receiving Sculptra injections; most patients return to their normal activities immediately. Treatment and Results of Sculptra Aesthetic Facial Injectable Sculptra Aesthetic injections are designed to be a one-time treatment. A patient can have up to 4 injection sessions, which are spread 3 weeks apart. When injected into shallow-to-deep folds and lines, the additional collagen that is produced smooths them out, and adds volume to the skin. Results of Sculptra injections vary but, in a clinical study, their effects were shown to last for up to 2 years in most patients. Side Effects of Sculptra Aesthetic Facial Injectable Possible side effects of Sculptra injections include localized bleeding, tenderness, discomfort, redness, bruising and swelling. Side effects usually fade within a few days, although can last longer. According to Valeant Aesthetics, “Other side effects may include small lumps under the skin that are sometimes noticeable when pressing on the treated area. Larger lumps, some with delayed onset with or without inflammation or skin discoloration, have also been reported.”