Services
Understanding Dermatological Disorders
Discover all you need to know about treatments and procedures we perform here at Carlisle Dermatology Group. If you find that you have any other questions unanswered, please don't hesitate to call.
Step into the world of dermatological treatment services, where skillful precision and advanced techniques blend to enhance skin health and beauty. From intricate skin cancer treatments to transformative cosmetic procedures, our surgeries heal and empower—restoring confidence and patient well-being one treatment at a time.
Mohs Micrographic Surgery
Mohs Micrographic Surgery is a specialized and highly effective technique for the removal of skin cancer.
This procedure differs from other skin cancer treatments in that it permits the immediate and complete microscopic examination of the removed cacncerous tissue, so that all "roots" and extensions of the cancer can be eliminated. Due to the methodical manner in which tissue is removed and examined, Mohs surgery has been recognized as the skin cancer treatment with the highest reported cure rate.
Some skin cancers can be deceptively large—far more extensive under the skin than it may appear from the surface. These cancers may have "roots" in the skin or along blood vessels, nerves, and/or cartilage. Skin cancers that have recurred following previous treatment may send out extensions deep under the scar tissue that has formed at the site. Mohs Surgery is specifically designed to remove these cancers by tracking and removing the cancerous "roots". For this reason, before the procedure, it is impossible to predict precisely how much skin will have to be removed. The patient should bear in mind that Mohs Surgery removes ONLY the cancerous tissue, sparring the normal, healthy tissue.
Insurance coverage
Most insurance policies cover the costs of Mohs surgery and the reconstruction of the resultant surgical defect. Please contact us if you have questions regarding insurance coverage or to see if your insurer requires you to have a referral. You may also need to contact your insurance company directly about benefits and coverage.
It's important to note that Mohs surgery is not an appropriate treatment for all skin cancers. It is selectively recommended for skin cancers that have recurred after previous treatments or those at high risk for recurrence. It is particularly suitable for cancers located in sensitive areas like the nose, ears, eyelids, lips, hairline, hands, feet, and genitals, where preserving healthy tissue is critical for both cosmetic and functional reasons.
Mohs Surgery is typically performed as an outpatient procedure in our office. Patients remain awake throughout, and discomfort is minimal and comparable to routine skin cancer surgeries.The Mohs cases can be completed in three stages or fewer, typically requiring less than four hours. However, due to the unpredictable nature of the skin cancer's depth, we recommend allocating a full day for the procedure in case additional layers need to be removed.
If the wound is closed with stitches, they'll need to be taken out after the healing process (usually 1-2 weeks after the procedure), otherwise the body will heal on its own naturally. Your surgeon will explain proper aftercare. Most patients report minimal pain, with common side effects including bruising, swelling, and slight bleeding around the wound. Should any symptoms be severe, contact your doctor right away.
Mohs Surgery (Video) originally published by American Society for Mohs Surgery.
The American Society for Mohs Surgery (ASMS) has a brief video explaining the Mohs technique and answers common patient questions.
Have another question? Call Carlisle Dermatology Group now! Click Here.
*Patient education and preparation are crucial for medical procedures. It's essential to address any remaining questions or concerns with your Mohs surgeon before the procedure.
Cutaneous Excisional Surgery
Cutaneous Excisional Surgery (sometimes called Surgical Excision), involves the removal of skin cancers, cysts, abnormal moles, and other lesions.
Cutaneous Excisional Surgery is a surgical procedure performed under local anesthesia to remove moles, cysts, skin cancer, and other skin growths. For treating skin cancer, the surgeon utilizes a scalpel to meticulously remove the entire tumor along with a margin of surrounding healthy tissue to ensure complete removal. This type of surgery is often used to treat skin cancer or other skin conditions that require more than just surface-level treatment.
Occasionally, the surgical site is left to heal as a secondary intention—meaning a wound will be left open (rather than just stitches) and left to heal by itself, filling in and closing naturally.
The length of the surgery will vary and depend on the extent of the skin cancer; you should expect to be in the office a minimum of one hour. The incision is usually closed with stitches that will need to be removed once healed in about 1-2 weeks post-surgery. Most wounds aren't painful after the surgery, but sometimes there is slight discomfort.
Phototherapy Treatment
Phototherapy is a dermatological treatment that uses specific wavelengths of ultraviolet (UV) light to treat various skin conditions. It is a controlled, safe form of light therapy administered by our healthcare professionals to reduce inflammation, slow skin cell production, and alleviate symptoms associated with multiple skin disorders.
Benefits
- It is Non-invasive.
- Effective for chronic and difficult-to-treat skin conditions.
- Can reduce the need for systemic medications.
- It is particularly beneficial for patients who haven’t responded well to topical treatments or other therapies.
Conditions treated
- Psoriasis - Reduces scaling, redness, and itching.
- Eczema (Atopic Dermatitis) - Alleviates itching and inflammation.
- Vitiligo - Stimulates repigmentation of the skin by activating melanocytes.
- Seborrheic Dermatitis - Reduces inflammation and flaking.
- Pruritus (Itching) - Relieves itching associated with various skin conditions.
UVB Phototherapy
UVB Phototherapy is a form of phototherapy for the treatment of psoriasis.
Natural sunlight emits a wide range of ultraviolet (UV) rays of different wavelengths, including UVA, UVB, and UVC rays. UVB rays have been found to penetrate the skin and slow down the growth of new skin cells, which can reduce the redness and flakiness of psoriasis lesions.
UVB Phototherapy is particularly effective with guttate psoriasis. Generalized plaque psoriasis may require more treatments.
Although UVB rays can be obtained through sunlight, it is safer and more effective to use a specialized light that can control the duration and intensity of UVB rays exposure. Treatment involves exposing affected areas of skin to the UVB light source for a specific length of time on a regular schedule. The UVB light may be used in the doctor’s office or at home with a home phototherapy unit obtained by prescription.
Types of UVB light treatments
- Broadband - A type of light therapy that uses a broad range of UVB light wavelengths to treat various skin conditions. It is one of the earliest forms of UVB therapy and is effective in reducing symptoms of skin disorders by slowing down abnormal skin cell growth and reducing inflammation.
- Narrowband - Emits a limited range of UVB light compared to broadband UVB lights. This type can clear up psoriasis lesions faster and provide longer remissions than broadband. This is the most commonly used form of UVB phototherapy since it targets specific layers of the skin to slow abnormal skin cell growth and reduce inflammation. It also has fewer side affects and improved efficacy.
Your doctor will recommend a UVB light suited to your particular needs. Treatment is usually repeated 3-5 times per week until lesions clear. Maintenance therapy with less frequent treatments may be recommended after as many as 25 or more treatments to get the psoriasis under control. UVB phototherapy may be combined with other psoriasis treatments, such as Soriatane® or biologics, to increase effectiveness and reduce the required medication.
Phototherapy is considered a second-line treatment and is used only for patients who haven’t had success with other measures. A special light machine is used to deliver targeted bands of UV light just where it’s needed.
Nearly 70% of patients who are treated with phototherapy have positive results, but it’s important to note that this treatment is not for everybody.
The doctor needs to determine what type of UV light is right for you to time the treatments and avoid risks to your health. The amount of light exposure is timed and increased as treatment progresses.
Phototherapy may start with very short sessions, delivered often, making it difficult for some people to fit this into their busy schedules. Some areas may not have phototherapy readily available and accessible. Talk with your doctor. A trip to the tanning bed is not a replacement for phototherapy
Phototherapy for Eczema
Phototherapy, also called light therapy, can reduce inflammation that is a part of eczema.
It can both lessen the itch and help boost the body’s bacteria-fighting abilities. It can be used in specific areas that aren’t responding to other treatments, or over the entire body if needed.
Phototherapy is an in-office procedure conducted by either an allergist or dermatologist. It involves exposing the skin that is affected by eczema to ultraviolet (UV) light.
Phototherapy often provides relief from the itching, swelling, and tenderness of eczema, with fewer potential side effects than some other treatments. Phototherapy often allows the skin time to heal, although it does not make eczema go away permanently. Patients should always talk with their doctor to see if phototherapy is right for them.
Phototherapy, when done under the direction of a doctor, is considered safe, but several side effects can occur. As with any exposure to UV light, the skin can get sunburned or appear to age more rapidly. There are some reports this treatment can lead to skin cancer.
One important precaution to take is to wear appropriate goggles to prevent injury to the eyes. Moisturizers must be applied following therapy since the procedure can dry out the skin.
Phototherapy for Vitiligo
PUVA is a form of phototherapy for the treatment of psoriasis that combines a psoralen medication with ultraviolet A light. (UVA rays).
Psoralen + UVA = PUVA
PUVA is a well-established and effective psoriasis treatment. It slows down the excessive skin cell growth and after several sessions can provide prolonged clearance of psoriasis lesions.
Multiple treatments are required for optimal results. When used appropriately, PUVA clears psoriasis in nearly 85% of cases and results in long remission times. Maintenance treatments may be recommended 1-2 times per month to remain clear.
PUVA is especially useful for people with moderate to severe plaque psoriasis, guttate psoriasis, and psoriasis of the palms and soles of the feet . Erythrodermic psoriasis also responds to PUVA, but not as well as these other forms.
PUVA may be used in combination with other psoriasis treatments. Rotating treatments may recommended to reduce the total exposure to UVA rays and reduce the cahnces of developing long-term side effects. PUVA may be used for 12-24 months and then replaced with Soriatane®, cyclosporine, or biologics.
- UVA light - The UVA is administered in a light unit lined with ultraviolet lamps. Most uva units are big enough to allow standing within the box so that the most of the body is exposed to uva rays. A large light unit may be called a light box. Smaller uva units are available for treating specific regions opf the body, such as hands and feet. For people starting puva therapy, the prescribed exposure to uva rays is very short and may vary from 30 seconds to several mins. The exposure time is gradually increased to 20 mins or longer. Because oral psoralen can sensitize the eyes as well as the skin ,uva-blocking goggles must be worn during treatment.
- Psoralen - Psoralen sensitizes the skin to light. It is applied to the surface of the skin or taken by mouth before being exposed to UVA light. The UVA light is ineffective without the initial use of psoralen. For optimal results, the exposure to UVA rays must occur when the psoralen levels in the skin are highest. If psoralen is taken orally, this is usually 1-2hrs after ingestion. If the psoralen is applied to the skin (“paint” or “soak”), the UVA exposure should occur within 15 mins. Your doctor may recommend the use of topical or oral Psoralen depending on several factors. Topical PUVA is often suggested for people with resistant patches of psoriasis because it provides a higher concentration of Psoralen on the lesion. And some people cannot tolerate the nausea and itching associated with the oral. However, topical PUVA increases the risk of the skin being burned during treatment. And since it is more labor intensive, topical Psoralen may not be appropriate for people with limited abilities.
Photodynamic Therapy Treatment
Photodynamic Therapy (PDT) is an innovative, non-invasive dermatological treatment designed to address a wide range of skin conditions, including sun damage, acne, precancerous lesions (like actinic keratosis), and even certain skin cancers.
The procedure uses a light-sensitive solution combined with specific wavelengths of light to precisely target and treat damaged or abnormal skin cells, while leaving the surrounding healthy tissue unaffected.
PDT is a highly customizable treatment tailored to your specific needs. Whether you’re looking to refresh your skin’s appearance or address a more serious condition, Photodynamic Therapy can help rejuvenate your skin for a healthier, clearer look.
Benefits
- Effective results - Treats the source of the issue by targeting problem cells.
- Non-invasive - No incision, injections, or systemic medications required.
- Minimal downtime - Recovery is generally quick, with mild redness or peeling, similar to a sunburn.
- Addresses a variety of concerns - Including cosmetic and medical skin conditions.
