Ideal Dermatology - Boulder

Products And Services

• Mohs Micrographic Surgery

  Cures the skin cancer Mohs micrographic surgery is a very specialized and effective way to treat skin cancer. It provides the highest cure rate of any skin cancer treatment while at the same time removing the least amount of tissue. This method differs drastically from other methods by allowing the surgeon to examine 100% of the margins (edges) of the tissue and map out all of the roots and extensions of the cancer. During this procedure performed under local anesthesia, Dr. Mott removes the skin cancer in thin layers. The tissue is carefully mapped and then meticulously examined under the microscope. Dr. Mott actually draws on overlays of digital photographs of the surgical site to indicate where the cancer cells remain hidden to the naked eye. This process is repeated until not a single cancer cell or root remain. Since other surgical methods typically examine less than 1% of the edges of the cancer, this 100% examination method almost eliminates the chance of leaving a cancer cell behind, resulting in the highest cure rate possible. And without having to “guess” where the cancer cells remain, healthy tissue is spared, often resulting in smaller wounds that heal with less scarring. The Mohs technique is particularly valuable for treating skin cancers on the face, nose, ears, lips, and eyelids since achieving the highest cure rate while sparing the most healthy tissue is absolutely critical in these delicate areas. Mohs surgery is also very useful for recurrent skin cancers, large skin cancers, skin cancers with poorly visible boundaries, and skin cancers with irregular growth patterns such as infiltrating or morpheaform basal cell carcinomas. For first time treated (primary) skin cancers, the cure rate often exceeds 99%! And even for difficult recurrent skin cancers, Mohs surgery is successful at least 95% of the time. Dr. Mott is a fellowship-trained Mohs micrographic and reconstructive surgeon, and a member of the American College of Mohs Surgery (ACMS). This means that Dr. Mott completed a vigorous additional year of in depth training in skin cancer surgery and reconstruction after completing his residency in dermatology. He has over 15 years of experience performing Mohs surgery and has treated over 8,000 skin cancers with the Mohs technique.

  Link: Mohs Micrographic Surgery

• Reconstructive Surgery

  The American College of Mohs Surgery (ACMS) is a membership organization of fellowship trained skin cancer and reconstructive surgeons. As a member of the ACMS, Dr. Mott has been formally trained in all aspects of skin cancer reconstruction. A skin cancer can happen literally anywhere the sun hits the skin. It turns out the most common areas for developing skin cancer are the areas with the most cumulative exposure. Often times, these are delicate areas of the face involving the eyelids, nose, ears and lips. The repair of these difficult areas demands the formal training and experience obtained through an ACMS-certified fellowship. Dr. Mott specializes in advance repairs of the nose, eyelids, ears and lips, as well as the remainder of the face. He brings 15 years of reconstructive experience from his previous practice in Hawaii. The following examples are representative of the skill he provides to repair skin cancers. The goals are always two-fold: Cure the cancer; and make it look like the skin cancer never happened!

  Link: Reconstructive Surgery

• Skin Excisions & Biopsies

  Many skin lesions that are not cancerous often need surgical management. Dr. Mott offers his surgical expertise for removing benign growths such as unwanted moles, cysts, lipomas or other unwanted or symptomatic skin lesions. These are best managed with simple excisional surgery under local anesthesia. Certain small skin cancers in non-critical areas that do not require Mohs surgery are often managed with excisional surgery. The majority of invasive melanomas are managed with a surgery called wide local excision. This is because melanomas over a certain depth of invasion have a risk of the cells breaking free and spreading into the surrounding tissue. This requires taking an additional margin of healthy-appearing skin that has been calculated based upon the depth of invasion (Breslow depth), and reduces the risk of recurrence. Dr. Mott is also able to perform biopsies of skin lesions that involve cosmetically sensitive areas in which a diagnosis is needed while minimizing the visible scar. Skin Excisions Moles Cysts Lipomas Birth marks Skin cancers Melanoma (wide local excision)

  Link: Skin Excisions & Biopsies

• Minimally Invasive Face & Neck Lift

  For moderate to severe skin laxity of the lower face and neck, sometimes facelift surgery is the best option for many patients. Facelift surgery focuses on the negative effects gravity has on our skin, namely the accumulation of excess skin on our lower face, jawline, jowls and neck. The skin of our face is a pleasing aesthetic covering, but does not provide structural support. In order to tighten the facial skin, it can not simply be pulled tighter. The natural elastic qualities of the skin renders this approach useless. For a lasting result, most facelifts are performed by tightening and lifting a structure called the SMAS. The SMAS is a strong fibrous layer that overlays the facial muscles and provides an interface to the skin. When the SMAS is lifted in an upward vector against the effects of gravity, the overlying skin is also lifted in a natural-appearing way. This avoids the “pulled look” that resulted from older facelifting techniques. Also, with the SMAS bearing the structural support of the lift, the excess skin can simply be artfully trimmed away without any undue tension on the skin. This results in better healing and very thin scars that are usually not noticeable. How is the SMAS Lift Procedure Performed? The SMAS lift is a safe procedure that can be performed in the office under a special type of local anesthesia, called tumescent anesthesia. After carefully examining the areas with skin excess and planning the incisions, a very dilute mixture of local anesthesia is used to inflate the skin. This provides excellent anesthesia as well helps separate the skin from the underlying SMAS. Another added benefit of this method is that the anesthesia fluid helps constrict the superficial blood vessels, so that the surgery can be performed almost bloodlessly. The incisions are made and the skin is separated from the SMAS. The SMAS is resuspended to the upper cheekbone area and a strong fibrous layer behind the ear with strong absorbable suture. The skin is re-draped without tension and carefully trimmed along the planned incision lines that hide naturally in the creases that surround the ear. The skin is carefully sutured with self-absorbing suture and dressing are applied. What is the Recovery Time? The recovery time varies from patient to patient. Minor swelling, bruising and discomfort should disappear within two weeks. External sutures dissolve themselves within one week. Healing scars can remain pink to red for a few months, but can usually easily be concealed with makeup after one week. How Long do the Results Last? Since our skin is constantly under the effects of gravity, facelifts do not last forever. Facelifts usually provide improvement for a period of 7-10 years. Since no deep structures are “cut” or altered with the SMAS lift technique, this procedure can easily be redone if necessary after this period of time if desired.

  Link: Minimally Invasive Face & Neck Lift

• Blepharoplasty

  Eyes are a prominent facial feature. It is the surrounding skin, rather than the eyes themselves, that conveys emotion. The tissue, muscle, fat, hair and lashes all contribute to the wide array of expressions. Age, sun exposure and hereditary factors all contribute to wrinkles, deep lines and puffiness around the eyes. The aging process can cause unwanted changes in expression, causing us to look permanently fatigued and older than we really are. These changes in appearance can cause emotional distress and sometimes even visual impairment. An eyelid lift, or blepharoplasty, is designed to restore a more youthful appearance to your eyes. It may involve the upper lids, the lower lids, or both. New & Traditional Techniques Traditional Blepharoplasty: An incision is made in the crease of the upper lid toward the temples. Once healed, it is not noticeable when the eye is open. On the lower lid, the incision is made along the lash line toward the temples, and is hidden by lashes when healed. The Transconjunctival Approach: This is a newer technique for lid blepharoplasty, involving an incision inside the lower lid. Fat can be removed through this incision, but excess skin cannot be eliminated. Laser resurfacing of the eyelids is a non-surgical alternative that may delay the need for a surgical blepharoplasty. It results in significant tightening of the skin around the eyes, but will not effect the fat around the eyes and may even accentuate it. Dr. Mott is happy to discuss which procedure may be right for you. The Surgery Local anesthesia is given around the eyes. During the procedure you will be awake but comfortable and relaxed. Dr. Mott may prescribe an oral sedative to help you relax if needed during this brief surgery. This procedure is performed on an outpatient basis at our surgical center. It is important to arrange for care after the surgery. Someone must drive you home and be available to care for you for the first 24 hours. Complications are unlikely when performed by a surgeon with experience in blepharoplasty. These include: bleeding and swelling, delayed wound healing, infection, drooping of eye upper or lower eyelid, asymmetry, double vision and dry eyes. Recovery: What to Expect The area surrounding the eyes will remain swollen in the days following the surgery. It should begin to subside after the first day. Some vision blurring is normal. Dr. Mott uses self-dissolving sutures almost exclusively. Transconjuncitval blepharoplasties require no stitches at all. Swelling and bruising will persist for about 10 days, but you can begin wearing makeup to help conceal these concerns. You may expect to resume normal activity within a week to 10 days, and start enjoying your new look within approximately 10-14 days. It may take about 6 months for the scars to lose their redness. Wrinkling will recur later in life, however it is unlikely that the “bags” will recur because the fat has been removed. Deeper wrinkles around the outer eye extended onto the temple are not greatly affected by the eyelid lift. These areas may be treated with laser resurfacing.

  Link: Blepharoplasty

• Scar Revisions

  Scars whether due to trauma, injury or surgery will gradually improve over time. After about one year, however, the majority of scars have completed their maturation, and do not significantly improve. If the scar continues to be disfiguring or more visible than desired, it may benefit from scar revision treatment. Some scars, especially traumatic scars, may improve by converting them to a precise surgical scar. Other scars need to be reoriented to blend in with the natural skin creases and lines. A technique called z-plasty can benefit these scars. Sometimes the scar does not require further surgery, but needs to be blended into the surrounding skin through dermabrasion, derma sanding, or fractional laser resurfacing. Scars that remain red can be treated with a vascular laser to reduce the number of blood vessels and the blood flow to the scar. Depressed scars, as seen as the result of severe acne, can be treated with skin fillers, subscision, popup grafts or skin grafts followed by dermabrasion. Keloid scars and Hypertrophic scars are a special type of scar tissue in which the skin has not controlled the normal healing process and continues to make an excess of collagen. If a new wound is created, even more scar tissue will form. These scars are best managed with cortisone injection (to turn off the exaggerated healing), and lasers to shrink the blood vessels. The last category of “scars” is when there is a permanent alteration of the skin’s pigment or color. Dark scars or “hyper- pigmented scars,” can be a normal part of the healing process and will naturally fade over time. This can often be hastened with good sun protection, bleaching creams, and occasionally lasers or IPL. White scars, or “hypopigmented” scars, are due to a loss of melanocytes that manufacture pigment. This loss is usually permanent, but can sometimes be improved by fractional laser resurfacing, which allows some of the pigment cells to migrate back into the lighter-colored skin areas. Alternatively, micro punch grafts of normal skin can be placed into the skin devoid of pigment to assist with the repigmenting process. This procedure is usually followed by laser resurfacing or dermabrasion. Scar Revision Treatments Re-excison Z-plasty Dermabrasion Fractional laser resurfacing Injections Skin grafting Vascular lasers Bleaching creams

  Link: Scar Revisions

• Acne Scars

  Millions of people suffer the disfigurement of acne scars long after the teenage years have passed and the acne has finally cleared. Inflammatory acne, the most severe form, can leave sufferers with deep permanent scars. Acne typically results in two types of scars-“icepick,” or pitted scars, and depressed, or “crater-like” scars. Treating Scars The goal of acne scar treatment is to improve the appearance of scars, resulting in a boost of self-esteem. There are a variety of safe and effective acne scar treatments available. Dermabrasion. In this procedure, the skin is anesthetized with local injections, and either a sterile type of sandpaper or a rotary instrument is used to “abrade” the surface of the skin. The skin undergoes a “remodeling” process as it heals, resulting in a smoother appearance with less visible scarring. Excision and Punch Replacement Grafts. A depressed acne scar is surgically removed with an instrument called a skin punch and replaced with a new punch of skin from a scar-free area. After healed, the area is usually treated with dermabrasion or laser resurfacing. Punch grafts can assist in re-pigmenting scars that have lost their pigment and turned white. Subcision. After the skin is anesthetized, a small scalpel blade not much larger than a needle is used to make incisions beneath the acne scar tissue, allowing the skin to re-drape similar to lifting a piece of carpeting. Soft Tissue Fillers. Depressed scars can be temporarily filled with hyaluronic fillers, calcium hydroxyappntitie fillers or silicon. Laser Resurfacing. The Fraxel Restore 1550 laser has been revolutionary in the treatment of acne scars. Multiple fractionated treatments with minimal downtime can be performed as a series with gradually replacement of essentially the entire skin surface. Microneedling. Collagen induction therapy, also known as microneedling, dermarolling, or skin needling, is a cosmetic procedure that involves repeatedly puncturing the skin with tiny, sterile needles.

  Link: Acne Scars

• Skin Cancer

  Skin cancer is the most common form of cancer in the United States. More than 5 million new cases are reported each year — and the incidence is rising faster than any other type of cancer. While skin cancers can be found on any part of the body, about 80% appear on the face, head, or neck, where they can be disfiguring as well as dangerous. Who gets skin cancer … and why The primary cause of skin cancer is ultraviolet radiation — most often from the sun, but also from artificial sources like sunlamps and tanning booths. In fact, researchers believe that our quest for the perfect tan, an increase in outdoor activities, and perhaps the thinning of the earth’s protective ozone layer are behind the alarming rise we’re now seeing in skin cancers. Anyone can get skin cancer — no matter what your skin type, race or age, no matter where you live or what you do. But your risk is greater if … Your skin is fair and freckles easily. You have light-colored hair and eyes. You have a large number of moles, or moles of unusual size or shape. You have a family history of skin cancer or a personal history of blistering sunburn. You spend a lot of time working or playing outdoors. You live closer to the equator, at a higher altitude, or in any place that gets intense, year-round sunshine. You received therapeutic radiation treatments for adolescent acne. Types of skin cancer By far the most common type of skin cancer is basal cell carcinoma comprising 80% of all skin cancers. Fortunately, it’s also the least dangerous kind — it tends to grow slowly and rarely spreads beyond its original site. Though basal cell carcinoma is seldom life threatening, if left untreated it can become very destructive, growing deep beneath the skin and into the underlying tissue and bone, causing serious damage (particularly if it’s located near the eye). Squamous cell carcinoma is the next most common kind of skin cancer making up about 15% of all skin cancers. It most commonly develops on the lips, face, or ears. Although in most cases it is slow to spread and is easily treated, It sometimes behaves aggressively with rapid growth and spread to distant sites, including lymph nodes and internal organs. Squamous cell carcinoma can become life threatening if not treated. A third form of skin cancer, malignant melanoma, is the least common, representing only 4-5% of skin cancers, but is the most deadly and accounts for the majority of deaths due to skin cancer. If discovered early enough, it can be completely cured. If it’s not treated quickly, however, malignant melanoma may spread throughout the body and is often deadly. Other skin growths you should know about Two other common types of skin growths are moles and keratoses. Moles are clusters of heavily pigmented skin cells, either flat or raised above the skin surface. While most pose no danger, some — particularly large moles present at birth — or those with mottled colors and poorly defined borders — may develop into malignant melanoma. Moles are frequently removed for cosmetic reasons, or because they’re constantly irritated by clothing or jewelry (which can sometimes cause pre-cancerous changes). Solar or actinic keratoses are rough, red or brown, scaly patches on the skin. They are usually found on areas exposed to the sun, and sometimes develop into squamous cell cancer. Recognizing skin cancer Basal and squamous cell carcinomas can vary widely in appearance. The cancer may begin as small, white or pink nodule or bumps; it can be smooth and shiny, waxy, or pitted on the surface. Or it might appear as a red spot that’s rough, dry, or scaly; a firm, red lump that may form a crust; a crusted group of nodules; a sore that bleeds or doesn’t heal after two to four weeks; or a white patch that looks like scar tissue. Malignant melanoma is usually signaled by a change in the size, shape, or color of an existing mole, or as a new growth on normal skin. Watch for the “ABCD” warning signs of melanoma: Asymmetry — a growth with unmatched halves Border irregularity — ragged or blurred edges Color — a mottled appearance, with shades of tan, brown, and black, sometimes mixed with red, white, or blue Diameter — a growth more than 6 millimeters across (about the size of a pencil eraser), or any unusual increase in size. If all these variables sound confusing, the most important thing to remember is this: Get to know your skin and examine it regularly, from the top of your head to the soles of your feet. (Don’t forget your back.) If you notice any unusual changes on any part of your body, have a doctor check it out. Diagnosis and treatment Skin cancer is diagnosed by performing a biopsy– removing all or part of the growth and examining its cells under a microscope. It can be treated by a number of methods, depending on the type of cancer, its stage of growth, and its location on your body.

  Link: Skin Cancer

• Basal Cell Carcinoma

  Basal cell carcinoma (BCC) is the most common form of cancer, with over one million new cases estimated in the US each year. One in four Americans are likely to develop a basal cell carcinoma. Basal cells line the deepest layer of epidermis. The growths are malignant tumors that arise in this layer of skin. BCCs occur most frequently on sun-exposed regions of the body. Although this skin cancer rarely spreads to other organs of the body (i.e., metastasizes), it can cause destruction of surrounding tissue. However, 5-10% of BCCs can be resistant to treatment or be locally aggressive, which damages the skin around them and sometimes invades bone and cartilage beneath. When not treated quickly, they can be difficult to eliminate. Thus early detection and treatment are needed. Most basal cell carcinomas are caused by chronic sun exposure, especially in people with fair skin, light hair and blue, green or grey eyes. In a few instances, there are other contributing factors such as burns, exposure to radiation, arsenical intoxication and stasis dermatitis of the legs. Basal cell carcinoma may have several different appearances on your skin. Some warning signs that may indicate basal cell carcinoma are an open sore, a reddish patch, a growth with an elevated border and a central indentation, a bump or nodule and a scar-like area. After a biopsy has been taken and the diagnosis confirmed by a dermatopathologist, treatment is required. Several effective methods are available to treat this tumor. Dr. Mott will recommend the best treatment option depending on the size, location and subtype of the basal cell carcinoma encountered. Your age, general health, and scar visibility are also taken into consideration. The more common treatment options include curettage, excisional surgery, electrosurgery, radiation therapy and Mohs micrographic surgery.

  Link: Basal Cell Carcinoma

• Squamous Cell Carcinoma

  Squamous Cell Carcinoma (SCC) is the second most-common skin cancer (Basal Cell being the most), affecting more than 250,000 Americans each year. Squamous cell carcinoma is a major type of cancer that arises from the superficial layer (epidermis) of the skin and mucous membranes and occurs most commonly on areas exposed to the sun. When identified early and treatment promptly, SCCs are not serious. However, if overlooked, they are harder to treat and can cause disfigurement. While 96-97% of SCCs are localized, the small percentage of remaining cases can penetrate, destroy underlying tissue and spread to distant organs (metastasize) and become life-threatening. Chronic sun exposure is the leading cause of squamous cell carcinoma, especially in people with fair skin, light hair and blue, green or grey eyes. Other factors which may contribute to the development of this type of cancer include burns, scars, exposure to radiation or chemicals, chronic inflammatory conditions and immuno-suppression. Although less likely to develop than in fair-skinned individuals, squamous cell carcinoma may occur in dark-skinned people, especially at sites of pre-existing inflammatory conditions or burns. Signs which may indicate the presence of a squamous cell carcinoma include scaly red patches, elevated growth with central depression, wart-like growths, nodules and open sores. All of these types of lesions may develop a crusted surface or bleed. After a biopsy has been taken and the diagnosis confirmed microscopically by a board certified dermatopathologist, treatment is required. Several effective methods are available to treat this tumor. Dr. Mott will recommend the best treatment options depending on the size, location, depth of penetration and type of squamous cell carcinoma encountered. Your age, general health, and potential for scarring are also taken into consideration. The more common treatment options include curettage, excisional surgery, electrosurgery, radiation therapy and Mohs micrographic surgery. When properly treated the cure rate for squamous cell carcinoma is approximately 95%, and up to 99% with Mohs micrographic surgery.

  Link: Squamous Cell Carcinoma

• Malignant Melanoma

  Melanoma is the most serious form of skin cancer and accounts for the vast majority of deaths due to skin cancer. The good news is that melanoma is curable if diagnosed at an early stage. The most important prognostic factor in melanomas is something called the Breslow depth. The Breslow depth is simply the measurement reflecting the depth of invasion of the deepest melanoma cell seen under the microscope. “Thin” melanomas, less than 1 mm thick, have an excellent prognosis and can be cured with excision surgery about 95% of the time. Thicker melanomas with deeper invasion have a higher chance of spread beyond the original tumor. Once the cancer advances and metastasizes (spreads) to other parts of the body, it is hard to treat and can be deadly. During the past 10 years, the number of cases of melanoma has increased more rapidly than that of any other cancer. Over 51,000 new cases are reported to the American Cancer Society each year, and it is probable that a great many more occur and are not reported. What Is Melanoma? Melanoma is a malignant tumor that originates in melanocytes, the cells which produce the pigment melanin that colors our skin, hair, and eyes and is heavily concentrated in most moles. The majority of melanomas, therefore, are black or brown. However, melanomas occasionally stop producing pigment. When that happens, the melanomas may no longer be dark, but are skin-colored, pink, red, or purple. Some Are More Dangerous The physician will tell you whether the melanoma is early or advanced by describing it as either in situ or invasive. “In situ” is Latin and means “in one site” or “localized.” Melanomas in situ occupy only the uppermost part of the epidermis, the top layers of the skin. Invasive melanomas are the more serious, as they have penetrated more deeply into the skin and may have traveled from the original tumor through the body. The Four Basic Types Superficial spreading melanoma (SSM)is by far the most common type, accounting for about 70 percent of all cases. This type of melanoma usually exhibits a horizontal growth pattern, in which the cells spread on the surface before invading deeply into the skin. This usually allows more time in diagnosis for the patient to recognize a change before it becomes deadly. The first sign is the appearance of a flat or slightly raised discolored patch that has irregular borders and is somewhat geometrical in form. The color varies, and you may see areas of tan, brown, black, red, blue, or white. Sometimes an older mole will change in these ways, or a new one will arise. The melanoma can be seen almost anywhere on the body, but is most likely to occur on the trunk in men, the legs in women, and the upper back in both. Most melanomas found in the young are of the superficial spreading type. Lentigo maligna (LM) is a type of melanoma in situ. They are usually slow growing, and typically appear as a flat or mildly elevated mottled tan, brown, or dark brown discoloration. This type of melanoma is found most often in the elderly, arising on chronically sun-exposed, damaged skin on the face, ears, arms, and upper trunk. Lentigo maligna is the most common form of melanoma in Hawaii. When an untreated lentigo maligna becomes invasive, it is called a Lentigo maligna melanoma, or LMM. The third type of melanoma, acral lentiginous melanoma (ALM), also spreads superficially before penetrating more deeply. It is quite different from the others, though, as it usually appears as a black or brown discoloration under the nails or on the soles of the feet or palms of the hands. This type of melanoma is sometimes found in dark-skinned people. It is the most common melanoma in African-Americans and Asians, and the least common among Caucasians. Unlike the other three types, nodular melanoma (NM), is usually invasive at the time it is first diagnosed owing to its vertical growth pattern. The malignancy is recognized when it becomes a bump. The color is most often black, but occasionally is blue, gray, white, brown, tan, red, or skin tone. The most frequent locations are the trunk, legs, and arms, mainly of elderly people, as well as the scalp in men. This is the most aggressive of the melanomas, and is found in 10 to 15% of cases. What Treatment Is Available? The very best treatment is early detection. A quick look from the trained eye of a dermatologist can confirm whether or not a lesion is suspicious for melanoma. If so, the next step is to perform a biopsy. The area is anesthetized, and a portion, or the entire lesion is removed for examination under the microscope. This simple, quick procedure is performed in our office. If a melanoma is detected, treatment is guided by how deep in the skin the melanoma is.

  Link: Malignant Melanoma

• Aging and Sun Damaged Skin

  The natural aging process gradually produces lines, wrinkles, age spots, broken capillaries, dull texture and color, and loss of skin tone with sagging. All skin types are susceptible to this natural aging process, and the effects increase with advancing age. Exposure to the sun and ultraviolet radiation, however, is the number one cause of premature aging of the skin. In fact, there is a tremendous difference between natural, or chronological aging, and premature aging from sun exposure, known as photoaging. A simple glance at the difference in the skin quality between your inner and outer arm is an excellent demonstration of the effect of photoaging. The skin on the inside of the arm is normally smooth, without spots or discolorations, regardless of the person’s age. With sun exposure as is seen on the outer arms, the skin because uneven in color, dull, dry and rough. Both these areas of the skin are the same chronological age, but look drastically different in someone who has had a lot of sun exposure. Think of it as your body’s own odometer–your sun exposure mileage counter! Corrective Procedures Sunscreen. Sun protection is absolutely critical to any treatment intended to reverse or diminish the appearance of sun damage. It can be said that if no effort is made to protect the skin from the ravages of sun exposure, most treatments will be unsuccessful. Non-ablative Resurfacing. Non-ablative resurfacing devices wound the skin precisely in vertical columns of heat that stimulate replacement of the collagen and cell layer. Downtime is minimal, and results can be dramatic if multiple treatments are done over a period of time. Laser Resurfacing. Laser resurfacing employs fractionated carbon dioxide and erbium lasers to vaporize or ablate the undesired tissue. This higher degree of controlled wounding results in a greater upside in terms of rejuvenation of sun damage with slightly longer healing times. Botulinum toxin. Botulinum type A selectively weakens muscles that contribute to excessive wrinkles in areas of sun damage and facial expression. The treatments are simple, safe and effective, particularly for frown lines and crow’s feet lines. Soft tissue fillers. Soft tissue fillers involve injecting a variety of substances under the skin to “fill in” or “plump up” lines, wrinkles and sagging. The substances most commonly used are inert and based on naturally-occurring substances already present in the skin like hyaluronic acid. When combined with resurfacing procedures, botulinum toxin or peels,, the results can be very dramatic. Facelift surgery. This is a well-known procedure to remove sagging and redundant skin, particularly from the lower third of the face and neck. The majority of facelift procedures work by tightening a structure known as the SMAS, and can be safely performed under local anesthesia in the office. Now more than ever, patients of all ages and skin types can look their very best and take corrective measures to combat the ravages of time and sun exposure. These procedures can be performed either alone or in almost any combination to produce dramatic results, many without significant recovery time. Our clinic provides the most up to date skin procedures available anywhere.

  Link: Aging and Sun Damaged Skin

• Skin Discoloration

  Skin discoloration is a common condition that occurs mostly from sun exposure, and leads the skin to become darkened in certain areas or patches. These areas, usually brown, are a collection of pigment called melanin. Melanin is produced by the skin, and absorbs ultraviolet rays to protect the body from the sun. Increased melanin leads to increased discoloration. Anyone can be affected by skin discoloration, but generally lighter-skinned individuals are at greater risk for discoloration and cancer. Some common forms of skin discoloration include freckles, melasma, and age spots: Freckles: Freckles, medically known as are small brown spots found on the skin, most commonly on the arms and face. Freckles are extremely common, especially among light-skinned people, and those with red or light hair. Freckles are caused by genetics and sun exposure, and tend to darken in the summer or when exposed more often to the sun. People with a lot of freckles should avoid the sun and always wear sunscreen, as they are more susceptible to skin cancer. Because freckles are harmless, they do not need to be treated. However, if you are unhappy with the appearance of your freckles, there are several steps you can take to prevent further development, and to fade existing freckles. Talk to Dr. Mott about available treatment plans for freckle-fading, and remember to always wear sunscreen. Protecting yourself in the sun will prevent freckles from darkening, and new freckles from developing. Melasma (“Pregnancy Mask”): Melasma is a dark skin discoloration that occurs on sun-exposed areas of the face. It is generally characterized by a brown color over the cheeks, forehead, nose and/or upper lip. It is often symmetrical, matching on both sides of the face. Melasma is sometimes referred to as “pregnancy mask,” because it has been linked to the female hormones estrogen and progesterone. Therefore, pregnant women, or those taking some forms of birth control pills are most likely to develop melasma. For these women, melasma generally disappears after delivery, or when pill taking is terminated. If melasma does not go away n its own, it can be treated with chemical peels, and some creams or topical steroids. These measures are not generally necessary, and wearing sunscreen and protecting the face during sun-exposure can help prevent melasma. Age Spots: Age spots are flat gray, brown or black spots found on the skin, and caused by sun exposure. Please refer to the Age Spots tab under the Dermatology section of our website for more information.

  Link: Skin Discoloration

• Moles

  Moles, medically known as nevi, are growths on the skin that are usually brown or black. They can appear anywhere on the body, alone or in groups. Moles occur when the cells in the skin grow in clusters instead of spreading evenly throughout the skin. These cells are what give skin its pigment, so moles appear darker than the skin. Many moles will darker over time, when exposed to the sun, and during pregnancy. It is also common for hairs to grow on the mole. Individuals with lighter skin tend to have more moles than those with darker skin, and most people with moles have between 10 and 40. Moles are generally harmless, but it is important to know that melanoma, the most serious form of skin cancer, can develop in or around a mole, so knowing your moles is essential to catching signs of cancer early. Types of Moles: There are several types of moles, and some carry greater risks of developing into melanoma than others. Congenial Mole: Congenial moles are moles that a person is born with. About 1 in 100 people are born with one or more moles. These moles range in size, color and shape. Congenial moles that are considered large or giant are larger than 20 centimeters, and have been found to carry a greater risk of leading to melanoma. Atypical Mole: Known medically as dysplastic nevi, atypical moles are usually larger than average (more than ¼ inch), and irregular in shape. They may contain uneven colors, or colors not typical of moles. Atypical moles tend to run in families, and they carry the greatest risk of developing into melanoma. Acquired Mole: An acquired mole is one a person develops after birth. They are generally harmless, but people who acquire more than 50-100 moles are at greater risk for melanoma. Treatment: If Dr. Mott tests a tissue sample and finds it to be cancerous, the entire mole and part of the tissue surrounding the mole will need to be removed. Or, if you would like a mole removed for cosmetic purposes, the same procedure will be performed. Mole removal surgery is very common and usually painless. There are two ways to remove moles, and both can be performed in Dr. office. One method for removing the mole is called “shave excision.” Dr. will numb the area around the mole, and use a small blade to cut around and beneath the mole, removing it. This technique is generally used for smaller moles, and does not require stitches. The other method is called “excisional surgery.” Dr. will cut other mole and the surrounding area of skin with a scalpel. This technique is usually used to remove potentially cancerous moles, and does require stitches to close the skin. Prevention: The best way to identify potential problems is to know the pattern and placement of your moles, and to examine them often. When monitoring your moles, remember the “ABCDE” method of self-examination. That is: “A” stands for asymmetrical shape. Watch for moles with asymmetrical shape, such as two very different looking halves “B” is for border. Look for moles with irregular, ragged or blurred borders. This is one of the characteristics of melanoma. “C” is for color. Look for moles that do not have the same color throughout, or contain shades of brown, black, blue, or white, or red. “D” is for diameter. Watch for moles that are larger than the eraser of a pencil. “E” is for evolution. Look for changes over time, such as a mole that grows or changes shape or color. If you notice any of the above irregularities in your moles, you should contact Dr. right away. To further prevent moles from becoming cancerous, you should avoid the sun at peak hours, always wear sunscreen, and cover up moles with clothing when exposed to the sun.

  Link: Moles

• Age Spots

  Age spots, sometimes referred to as “liver spots” or solar lentigines, are flat gray, brown or black spots found on the skin. They vary in size and usually appear on the face, hands, shoulders, and arms. Age spots are caused by consistent exposure to the sun, and therefore generally occur in adults older that 40, though they can affect younger people as well. Most age spots are harmless and do not require treatment. Treatment: If you are unhappy with the appearance of age spots, there are a variety of treatment options aimed at lightening or removing age spots. Because the pigment causing the discolored skin is located at the topmost layer of skin, or the epidermis, treatments intending to lighten age spots must penetrate this layer of skin. Some of the available treatment options include: Fraxel re pair SST Dr Richard Fitzpatrick.001 Medications: Prescription bleaching creams applied over several months may gradually fade age spots. While undergoing this treatment, sun protection is strongly advised. Laser Therapy: Laser therapy destroys extra melanocytes that create the dark pigment. This treatment does not damage the skin’s surface and has few side effects. Today’s lasers are able to minimize healing time, and improvement can be seen in just two treatments. Freezing (cryotherapy): During cryotherapy, liquid nitrogen or another freezing agent is applied to the age spots to destroy extra pigment. The skin appears lighter as the area heals. Cryotherapy is generally effective, though it does pose the risk of scarring or permanent skin discoloration. Dermabrasion: This procedure involves “sanding down,” or planing the surface layer of your skin with a rotating brush. It removes the skin surface, and a new skin layer grows in its place. Side effects may include scabbing and temporary redness and irritation. Prevention: Age spot are very easily prevented by limiting sun exposure, and protecting the skin at all times when exposed. This may include wearing sunscreen at all times, wearing protective clothing such as hats, and remembering to protect skin even when sun damage does not appear to be a risk, such as on a cloudy day, or while driving. It is never too late to begin wearing sunscreen and protecting skin, even if some damage has already occurred. FAQ about Age Spots: Are age spots cancerous? Though age spots are generally harmless, it is important to never assume a skin lesion is benign. See Dr. Mott if you notice a lesion on your skin, and especially if it changes in color or shape. Will my insurance cover treatment? Because age spot treatments are considered cosmetic, your insurance may not cover it. Does tanning cause age spots? Tanning does contribute to age spots. Tanning is extremely unhealthy, because “a tan” is your body’s way to tell you your skin has been damaged, and is its attempt to protect itself from further damage. Aside from age spots, tanning can lead to a host of problems for your skin, including skin cancer. Dr. Mott recommends you never expose your skin to tanning beds, and always wear sunscreen in direct sun exposure.

  Link: Age Spots

• Actinic Keratosis

  The term “precancerous” is used because these abnormal areas of skin are more likely to turn malignant than healthy skin. Precancerous growths (lesions) are visible to the naked eye, and they look different from normal cells when examined under a microscope. They are important to recognize, because they are a warning sign of potential skin cancer. Photodynamic therapy.001Actinic keratoses (AKs) are rough, dry and scaly patches of skin that develop on the outermost layer of the skin after years of exposure to ultraviolet (UV) rays of the sun. Often they feel like sandpaper or crusts of dry skin. These lesions typically range in color from skin-toned to reddish brown and in size from that of a pinhead to larger than a quarter. Occasionally, a lesion has a rapid upward growth and resembles an animal horn and is called a “cutaneous horn.” A dermatologist should evaluate anyone who is suspicious that may have developed AKs. These lesions are considered to be the earliest stage in the development of skin cancer and can progress to squamous cell carcinoma, a type of skin cancer that can be fatal. Having AKs makes one more susceptible to other forms of skin cancer, including melanoma. Melanoma is considered the most lethal form of skin cancer because it can rapidly spread to the lymph system and internal organs. AKs are most likely to appear on the face, lips, ears, scalp, neck, backs of the hands and forearms, shoulders and back — the parts of the body most often exposed to sunshine. AKs usually appear after age 40 because they take years to develop. However, even teens can have AKs when they live in areas that receive high-intensity sunlight year round, such as Florida and Southern California. Millions of Americans have AKs, and the number continues to grow. In fact, AKs are so common today that treatment for these lesions ranks as one of the most frequent reasons people consult a dermatologist. Treatment Options for Actinic Keratoses There are three main categories of treatment for actinic keratoses. Destructive treatments. Most commonly, individual actinic keratoses are frozen or “burned” off with liquid nitrogen. This eliminates that focus of abnormally growing cells. Occasionally, the disorganized layer of cells can be electrodessicated with an instrument called a hyfercator, or removed with an ablative laser. Thick lesions, more common on the scalp and extremities can be scraped away under local anesthesia with a curette. Regardless of the treatment, only the visible actinic keratoses are treated with these methods, and damaged cells not visible to the naked eye soon develop into new actinic keratoses. Topical chemotherapy creams and immune response modifiers. Topical chemotherapy creams (Efudex, Carac) most commonly contain 5-FU, a fake DNA building block that is incorporated into rapidly dividing cells and leads to their destruction. Imiquimod works by stimulating the immune system to recognize the presence of these abnormal actinic keratoses cells, and the immune system eliminates them. Both of these treatments have the advantage of treating subclinical lesions–abnormal skin cells that have not yet developed into visible actinic keratoses. Photodynamic Therapy (PDT). Photodynamic Therapy uses a combination of a photosensitizing medicine and visible light to destroy the precancerous cells. A medication, Levulan, contains a by-product of red blood cells called porphyrin. Porphyrins naturally cause an intense destructive reaction in cells that lack an enzyme to break them down metabolically. It turns out that precancerous actinic keratoses lack the enzyme to metabolize porphyrins. These cells absorb the medication when it is applied to the skin, but they are simply not able to clear it like normal cells. Consequently, when the skin is exposed to visible blue light the abnormal cells are targeted and are eliminated. PDT also is capable of treating invisible (subclinical) damage as well.

  Link: Actinic Keratosis

• Dysplastic Nevus

  Dysplastic nevi, also known as atypical moles, are unusual benign moles that may resemble melanoma. People who have them are at an increased risk of melanoma. The larger the number of atypical moles, the greater the risk. Individuals with 10 or more of them have 12 times the risk of developing melanoma as members of the general public. Heredity plays a part, and people with a family history of melanoma (two or more close blood relatives) as well as atypical moles are at the highest risk. However, those with atypical moles and no family history still have a 7 to 27 times higher risk than the general public. The classic atypical mole syndrome has the following characteristics: 100 or more moles One or more moles greater than 8mm (1/3 inch) or larger in diameter One or more moles that look atypical Normal Moles vs. Dysplastic Nevi The average young adult has about 10-20 normal moles or growths. Generally, normal moles have the following characteristics: Shape: symmetrical, round, or oval Border: regular, sharp, and well-defined Color: usually tan, brown, or skin color Diameter: usually 6 mm (1/4 inch) or smaller — about the size of a pencil eraser Location: often concentrated on sun-exposed areas, such as the face, trunk, arms and legs. Onset: early childhood through age 40 Uniformity: resemble one another Even normal moles increase the likelihood of malignancy, provided they are numerous. The greater the total number of moles on the body, the greater the overall danger of melanoma. Dysplastic Nevi vs. Melanoma It is sometimes difficult to tell the difference between dysplastic nevi and melanoma. A mole that appears suspicious–changes in size, shape or color–or if a new mole appears after 40, the doctor will remove the entire mole or a part of it for microscopic examination. Sometimes a melanoma begins within a dysplastic nevus. Sometimes, melanomas will begin within the mole itself. Dysplastic nevi usually have the following characteristics: Shape: asymmetrical; a line drawn through the middle would not create matching halves Border: irregular or poorly defined Color: variation with shades of tan, brown, dark brown, or black, or mixed Diameter: generally but not always larger than 6 mm Location: most commonly on the back, chest, abdomen, extremities and scalp; may also occur on normally unexposed areas such as buttocks, groin or female breasts Growth: enlargement of a previously stable mole or appearance of a new mole after age 40 should raise suspicion Surface: central portion is flat to slightly raised Appearance: greatly varied; dysplastic nevi often look different from one another Number: from a few to well over 100 More Serious Warning Signs Some dysplastic nevi display more serious warning signs of melanoma: itching, elevation, crusting, oozing, a bluish-black color, pain, bleeding, swelling and ulceration. If any of these warning signs appear on your own skin or that of a friend or family member, consult a dermatologist right away. It could be the first sign of skin cancer.

  Link: Dysplastic Nevus

• BOTOX® Cosmetic

  BOTOX® Cosmetic almost single handedly started the revolution in cosmetic dermatology. Although it has been around since 1980, it ‘s earlier uses were limited to selectively weakening muscles around the eye for the medical conditions of cross-eyedness and eyelid spasm. Eventually (in the later 1980s) an astute ophthalmologist and her dermatologist husband, Jean and Alastair Caruthers, discovered the potential for treating frown lines between eyebrows. Since then, BOTOX® Cosmetic treatment has evolved into the number one cosmetic procedure performed world wide. Dr. Mott has been performing BOTOX® Cosmetic treatments since 1998, and learned directly from the Caruthers, themselves. He was also an active member in Allergan’s NEF program, the National Education Faculty, which was responsible for educating physicians nationwide on the safety and proper administration of BOTOX® Cosmetic. What is Botulinum Toxin? Botulinum toxin is a purified toxin that when given in large amounts, blocks nerve transmission and causes a generalized paralysis called botulism. When injected in miniscule amounts (less than one-one thousandth of the toxic doses), it causes a very localized weakness limited to the treated muscle. This relaxation effect results in improvement in wrinkles caused by excessive or repeated muscle contraction. It is used to temporarily improve the look of wrinkles mainly between the eyebrows (frown lines) and the corners of the eyes (crow’s or squinting lines). The BOTOX® Cosmetic Procedure BOTOX® Cosmetic injections are performed without anesthesia because it is virtually painless. Only a very small sting is felt when the injections are made. The effects are not permanent and may need to be repeated two to three times per year to retain the effects. Research has suggested, however, that long term use of the injections leads to a longer duration of each treatment’s effect. Patients over the age of 65 may not experience as dramatic of results. BOTOX® Cosmetic is only useful in treating expression lines and cannot be used to repair sagging skin caused by aging. Post-Treatment Information After the procedure, patients may experience slight bruising around the area that quickly fades. Normal activities can be performed immediately. Possible side effects are temporary weakness of nearby muscles or in rare cases an eyelid may droop. BOTOX® Cosmetic is completely reversible so any side effect is only a temporary condition. Overall, BOTOX® Cosmetic is an extremely safe and effective treatment, explaining why it is the #1 most performed cosmetic treatment in the world.

  Link: BOTOX® Cosmetic

• Juvéderm™

  Juvéderm™is the one of the latest dermal fillers introduced to the U.S. market by Allergan, the company which manufactures Botox. It is a hyaluronic acid based filler similar to Restylane. However,Juvéderm™ injectable gel employs its unique manufacturing process to provide the highest concentration of cross-linked hyaluronic acid of any currently available hyaluronic acid dermal filler for long-lasting results. This advanced manufacturing process also creates a smooth consistency gel that flows consistently and easily into the skin and provides a smooth, natural look and feel. Recently approved by the FDA, Juvéderm™ injectable gel is a “next-generation” dermal filler. The smooth consistency gel helps to instantly restore your skin’s volume and smooth away facial wrinkles and folds, like your “smile lines” or “parentheses” (nasolabial folds — the creases that run from the bottom of your nose to the corners of your mouth). With Juvéderm™, the results are immediate with minimal downtime. Juvéderm™ can be used virtually anywhere on the face, with most success in the lips, nasolabial folds (lines from the nose to the corners of the mouth), and the marionette lines (lines from the corners of the mouth downward to the jawline).

  Link: Juvéderm™

• Lip Augmentation

  History Of The Procedure Augmentation of the lip has been performed for cosmetic reasons for ages. Women of all ethnic and social backgrounds have applied cosmetics to their lips to define or alter their appearance since the Stone Age. Tribal ceremonies involving the introduction of various materials in the lips to alter their shape, usually with the intent to enlarge them, have been practiced in Africa for centuries. Enhancing the lips is one of the procedures that can be done, which can have a huge impact on the overall youthful rejuvenation of the entire face. By restoring the volume that has naturally been lost over time, a refreshed and youthful appearance can be achieved. Etiology Cosmetic deformities of the lips include both congenital and acquired etiologies, and some patients never develop adequate fullness in their lips. Atrophy (loss of that plum baby fat) develops in the lips and lower face of other patients as they age. Hyaluronic acid is the sugar-based gel that naturally supports the cells in our skin, is a major component in the fluids that lubricate our joints, and gives our eyes there spherical structure. As we age, our body produces less and less hyaluronic acid, especially in the cells located in the lower face, around the mouth and in the lips. Other factors which contribute to aging of the lower face and lips are sunlight, ultraviolet tanning beds and environmental toxins such as pollution and cigarette smoke. Treatment Every patient has a thorough exam of their facial structures and then spends time with Dr. Mott discussing the treatment options and desired results. Some patients have had thin lips all their lives and they would like to enhance their lips to bring them to a more “normal” size, in artistic symmetry with the rest of their face. Other patients simply would like to have their lips accentuated for the purpose of making them more full or voluminous. Still other patients would like to have correction of lip lines or “smoker’s lines”, although they may not have necessarily have been caused by smoking. Products & Procedures For many who undergo lip augmentation, atrophy or loss of hyaluronic acid in the lip is the primary reason for treatment. Dr. Mott often uses Restylane or Juvederm, as pure forms of hyaluronic acids. Because the lips are one of the most sensitive areas of the body, many patients prefer topical or local numbing. This takes only a few extra minutes and makes the procedure almost entirely painless. Some patients do extremely well with ice application for numbing. Side Effects Short-term swelling and redness lasting 24 hours is common, although often there is no down time at all. Sometimes transient bruising lasting a few days occurs. In order to reduce the risk of bruising, we recommend that all blood thinners and vitamins/herbs are stopped if medically cleared by your primary care doctor. Because of the nature of the procedure the injected material can be felt, sometimes as tiny bumps which are naturally smoothed out by the body within a couple of days.

  Link: Lip Augmentation

• Skin Resurfacing

  Laser skin resurfacing to improve cosmetic flaws such as facial wrinkles, acne scars, and sun-damaged skin, is one of the most exciting and innovative breakthroughs in skin rejuvenation. What Is A Laser? Laser stands for Light Amplification by the Stimulated Emission of Radiation. Lasers work by producing an intense beam of bright light that travels in one direction. The laser beam can precisely target unwanted tissue or selectively wound skin components such as collagen, pigment, or blood vessels so that the skin is replaced with new, healthier cells and tissue. Laser light penetrates to a very precise, controlled depth, making the procedure safe and predictable, while reducing the risk of scarring or pigmentation problems. Laser skin resurfacing is bloodless, and is performed right here in our office under local or topical anesthesia. As a result of this treatment, you can achieve a more youthful looking skin. Dr. Mott uses four different resurfacing lasers for different types of rejuvenation. Fractionated lasers (Fraxel) target only a “fraction” of the skin at a time, leaving surrounding tissue untouched for rapid healing. Erbium:Yag: Uses a wavelength of light that focuses on water within skin cells to precisely remove thin layers of skin. Useful for superficial wrinkles, scars, and skin lesions. Fraxel Restore 1927: Uses a fractioned thulium laser beam and improves skin tone and texture. Fraxel Restore 1550: Uses a fractionated erbium fiber beam that penetrate more deeply into the skin for targeting deeper wrinkles and scars. Fraxel Repair C02: Uses a high-powered carbon dioxide beam that vaporizes water and ablates tissue. This results in more wounding and healing time, but produces the most dramatic results in terms of skin tightening and wrinkle reduction. What Conditions Can Laser Resurfacing Treat?feature-fraxelrepair Erase or soften fine lines and wrinkles on the face Smooth and tighten eyelid skin Improve crow’s feet around the eyes Soften pucker marks and frown lines Remove brown spots and even skin color and tone Improve and flatten acne, traumatic and surgical scars Repair smoker’s lines around the mouth Improve skin tone and texture Benefits of Laser Treatment Laser resurfacing can be used as an alternative to chemical peels and dermabrasion. The benefits of using this technique are typically less pain and a faster recovery time. Resurfacing can also work in conjunction with other cosmetic procedures like Botox, fillers, as well as surgical and non-surgical skin tightening procedures for a more powerful result. Before Laser Resurfacing Prior to laser skin surgery, Dr. Mott will discuss your desired goals for facial improvement. After determining the most appropriate procedure to use, we will fully describe the procedure, what results to expect and the costs. The skin is usually pretreated prior to surgery to improve the healing time. With some laser cases, antiviral medications to prevent cold sore outbreaks and oral antibiotics are prescribed. The Procedure The majority of laser resurfacing is performed with a combination of topical and local anesthetic. Discomfort is usually minor during the procedure. Some lasers require eye shields to protect the eyes during treatment. What Can Be Expected Post-Procedure? The skin is typically red or pink and may be covered with a fine crust. The treated areas are usually kept moist with cool soaks and an application of healing ointment. The treated sites must be protected from sun exposure after the procedure. Once healing is complete, sunblock should be applied. In some cases, a pink surface color may remain for several days. Redness of this skin is typically longer with CO2 resurfacing. Make-up can be worn typically in one week post procedure.

  Link: Skin Resurfacing

• Photodynamic Therapy

  Photodynamic Therapy (PDT), uses a combination of a photosensitizing medicine and visible light to destroy precancerous cells in actinic keratoses . The medication, Levulan, contains a substance similar to a by-product of red blood cells called porphyrin. Porphyrins naturally cause an intense destructive reaction in cells that lack an enzyme to break them down when exposed to light. It turns out that precancerous actinic keratoses lack the enzyme to metabolize porphyrins. These cells absorb the medication when it is applied to the skin, but they are simply not able to metabolically clear it like normal cells. Consequently, when the skin is exposed to visible blue light the abnormal cells are targeted and are eliminated. PDT also is capable of treating invisible (subclinical) damage as well. This results in typically a longer period of clearance of actinic keratoses in the treated area. levulan_2 The PDT Procedure The skin is thoroughly cleansed with a degreasing agent like alcohol or acetone and the Levulan is applied directly to the skin. After about one hour of incubation, the treated area is activated with exposure to blue light from a BLU-U light source for about 15 minutes. The combination of Levulan plus the blue light destroys the abnormal actinic keratoses cells. This results in a “sun-burn” type reaction, but it is limited to the abnormal cells. Post Procedure The photosensitizing effect of the Levulan last 24-48 hours, so it is absolutely critical to stay out of the sun for that period of time. Sun block, hats, scarves and remaining in a dark room are all beneficial to avoid an over reaction. The healing time is very similar to a sun burn, and takes about a week. Advantages Of PDT vs. Chemotherapy Creams Short contact therapy of one hour vs 2-4 weeks with creams Reaction peaks in 24 hrs instead of weeks later Full treatment and healing in about 1 week vs 4-6 weeks

  Link: Photodynamic Therapy

• Sensus SRT-100

  Non-Surgical Skin Cancer Treatment We are pleased to announce a new and effective non-invasive treatment for non-melanoma skin cancers. Superficial Radiotherapy (SRT) is a proven non-surgical treatment for both basal cell carcinomas and squamous cell carcinomas in which surgical intervention is declined, unadvisable, or potentially associated with significant cosmetic or functional limitations. As a leader in surgical treatment of skin cancer with Mohs surgery, Dr. Mott is pleased to be the first facility in the Denver-Metro region of Colorado to offer superficial radiotherapy in a dermatology practice. This gives patients two effective options to treat difficult skin cancers-Mohs surgery and SRT. SRT is performed with a series of short 30 second treatments that are safe, painless and produce little to no wounding of the skin. The cure rate of this treatment is as high as 95-97% and results in little or no scarring. Our facility is certified for radiotherapy and meets all building and code requirements for this form of skin cancer treatment. Now patients with skin cancer who do not wish to have surgery have a viable option for difficult to treat areas such as legs, scalps and difficult to that facial areas. While SRT is an attractive option for removing skin cancers, it is not suitable for all types of skin cancers or patients. Some of the factors affecting whether radiation therapy can be used include: Type of cancer Site of cancer Patient preference Suitability of other treatments Prior use of radiation therapy

  Link: Sensus SRT-100