1. What moles should I be concerned about?
One method that is used is the ABCD rule;
A – Asymmetry: a mole that does not appear to be identical on both halves, up/down or side/side.
B – Borders: a mole that has borders that are hazy, red or lighter color than the skin surrounding the mole or a wavy/irregular border.
C – Color: a mole that has 2 or more colors in it.
D – Diameter: a mole whose diameter is equal to/greater than the diameter of a pencil eraser.
Of course this does not limit any concern that you might have. Any mole that has changed in appearance or has any symptoms of itching, pain, or bleeds should also be examined.
2. Is skin cancer hereditary?
Dermatologists believe that skin types can determine the chance for most skin cancers. If you have had a parent or sibling with fairer skin and a positive history of skin cancer, there is a chance you might have a skin cancer within your lifetime. With melanoma, there is a definite hereditary factor. If you have had a parent or 1st degree sibling with melanoma, you and your immediate family should have a total body skin examination.
3. How often should I have my moles checked?
If you have had a history of skin cancer, frequently changing moles or recurrent sun burns, it is important to have a body skin examination at least 1 to 2 times per year. If you have not had a history of skin cancer, your dermatologist may recommend an examination once a year.
4. What are my options for mole removal?
There are several options for mole removals. Your dermatologist will examine the mole and the area it is located on to determine the best option for removal. Most moles can be removed during an office visit. Options include local anesthesia and “shaving” the mole with a scalpel, or using a surgical tool to “core” the mole and then stitches are used for closure. Sometimes based on the location or size of the mole, your dermatologist might recommend a plastic surgeon. All options will be carefully weighed and discussed with you during your visit.
All moles or lesions that are removed are sent for examination to dermopathologists. They are physicians that specialize in skin tissue examination. All reports will be discussed with you during your follow up visit.
5. What is Mohs Micrographic Surgery?
Mohs surgery is an outpatient surgery used to treat basal cell carcinomas and squamous cell carcinoma. Mohs is most commonly done on the face and fingers; anywhere conservation of normal skin is very important. The most common location is on the nose, followed by the ears, lips and eyelids. The 5 year cure rates are typically 96-99%. Dr Beer is one of the very few Mohs surgeons in the East Bay who has completed a fellowship and training with Mohs and reconstructive surgery.
6. What can I expect to happen during a Mohs surgery appointment?
Expect to be here for 4 hours. The site is numbed and then a layer of tissue is removed and the margins/borders are examined in our lab (processing time is about 45 min to 1 hour per layer) If any of the margins are positive, then an additional layer is removed in the positive area only. The process is repeated until all margins are clear. Time depends on how many layers are processed, but plan your visit for 4 hours. Usually, you can drive yourself to and from your appointment. We’ll see you again in 1-2 weeks for suture removal and to monitor the healing.