FAQ - General

Sun exposure is the most preventable risk factor for all skin cancers, including melanoma. You can have fun in the sun and decrease your risk of skin cancer. Here’s how you can prevent skin cancer:

  • Seek shade when appropriate. Remember that the sun’s rays are strongest between 10 a.m. and 2 p.m. If your shadow appears to be shorter than you are, seek shade.
  • Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses, where possible.
  • Generously apply a broad-spectrum, water-resistant sunscreen with a Sun Protection Factor (SPF) of 30 or more to all exposed skin. “Broad-spectrum” provides protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Reapply approximately every two hours, even on cloudy days, and after swimming or sweating.
  • Use extra caution near water, snow, and sand because they reflect and intensify the damaging rays of the sun, which can increase your chances of sunburn.
  • Avoid tanning beds. Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If you want to look tan, consider using a self-tanning product or spray, but continue to use sunscreen with it.

Yes, sunscreen is safe to use. No published studies show that sunscreen is toxic to humans or hazardous to human health. Scientific studies actually support using sunscreen. Research shows that wearing sunscreen reduces your risk of getting skin cancer and premature aging.

What about the reported health risks associated with some ingredients found in sunscreens? Oxybenzone: This is one of the few ingredients in sunscreen that effectively protects our skin from harmful UVA and UVB rays. Here are the facts about oxybenzone:

  • Approved by the FDA in 1978.
  • No data show that oxybenzone causes hormonal problems or related conditions in humans, such as endometriosis.
  • No data show that oxybenzone causes any significant health problems in humans.
  • FDA approved for use by people 6 months of age and older.

Retinyl palmitate: This ingredient helps protect our skin from premature aging. Here are the facts:

  • No study shows that it increases the risk of skin cancer in humans.
  • Retinyl palmitate is a form of vitamin A.
  • One form of vitamin A, retinoids, helps prevent skin cancer in people who have a high risk of developing skin cancers.

The first line of defense against skin cancer starts with you. Ask a dermatologist how often you should examine your skin for signs of skin cancer and consult a dermatologist if you notice anything suspicious.

Q. My acne is very resistant to my medications. What about new therapies?

A. Photodynamic therapy for acne is very exciting and cutting edge. At less cost than Accutane, a chemical precursor of hemoglobin called amino levulinate, is placed on the skin. After a period of 30 to 60 minutes, the chemical is absorbed and selectively picked up by the problem oil glands. With eye protection, intense monochromatic blue light at 417 nm, and intense pulse light 560nm to 1200nm, is used to shut down the problem oil glands. The Photodynamic therapy shrinks overactive oil glands and sterilizes the oil gland of the problem bacteria, P. acnes.

Five treatments are performed at 2-3 week intervals. The FDA has approved the devices for acne photodynamic therapy. Study after study is showing effectiveness with stubborn acne with photodynamic therapy. It appears to have exceptional potential for those who cannot take Accutane. Unfortunately, insurance companies are slow to set up co-pay strategies for this therapy, and as yet it remains mostly uncovered, and a treatment for only those with discretionary funds. As with most new dermatology technologies, our clinic is the first to offer this new choice.

Stevenn L Harlan, MD
Medical Director
Dermatology and Dermatologic Surgery Center
515-225-8180

I thought my dermatologist could sand away my acne scars, but he said they were too deep and sanding would not “get rid of them.” What can I do ?

Unfortunately, many people believe any type of acne scars can be “removed”. They come into the dermatologist seeking to “get rid of” deep acne scars. Shallow acne scars and small superficial “ice pick” scars will respond to treatment and nearly clear, or at least improve a lot. For deep, large ice pick scars, “nothing works”, is a more accurate statement unfortunately. No reasonable affordable amount of surgery is going to make a significant difference in deep large ice pick scars. The best advice to everyone is don’t get them in the first place.

If someone is getting large deep acne scars, the process must be stopped as soon as possible. They must see a dermatologist who prescribes Accutane and find a way to stop the scarring acne. If someone can’t afford Accutane, there are programs that will get them Accutane. Many young people don’t think about the future and let their faces scar up with acne, for whatever reason. 100% of them regret it for the rest of their lives in lost confidence regarding their appearance.

We also warn women not to get pregnant with scarring acne going on. The acne may get worse during pregnancy and their faces scar up permanently because serious medication can’t be given. Women can safely become pregnant 3 months after Accutane therapy is completed and have no problems.

Stevenn L Harlan, MD
Medical Director
Dermatology and Dermatologic Surgery Center
515-225-8180

An actinic keratosis (ak-ti-nik ker-ah-TOE-sis), or AK, is a rough, dry, scaly patch or growth that forms on the skin. An AK forms when the skin is badly damaged by ultraviolet (UV) rays from the sun or indoor tanning. Most people get more than one AK.

AKs are very common and one of the most frequent reasons for seeing a dermatologist.

Anyone who has many AKs should be under a dermatologist’s care. Most people who have many AKs continue to get new AKs for life. AKs are considered precancerous. Left untreated, AKs may turn into a type of skin cancer called squamous cell carcinoma.

By seeing a dermatologist for checkups, the AKs can be treated before they become skin cancer. If skin cancer does develop, it can be caught early when treatment often cures skin cancer.

Seborrheic keratosis (seb-o-REE-ik care-uh-TOE-sis) is a common skin growth. It may look worrisome, but it is benign (not cancer). These growths often appear in middle-aged and older adults. Some people get just one. It is, however, more common to have many. They are not contagious.

Most often seborrheic keratoses start as small, rough bumps. Then slowly they thicken and get a warty surface. They range in color from white to black. Most are tan or brown.

They can appear almost anywhere on the skin.

Seborrheic keratoses can look like warts, moles, actinic keratoses, and skin cancer. They differ, though, from these other skin growths. Seborrheic keratoses have a waxy, “pasted-on-the-skin” look. Some look like a dab of warm, brown candle wax on the skin. Others may resemble a barnacle sticking to a ship.

Psoriasis (sore-EYE-ah-sis) is a chronic (long-lasting) disease. It develops when a person’s immune system sends faulty signals that tell skin cells to grow too quickly. New skin cells form in days rather than weeks.

The body does not shed these excess skin cells. The skin cells pile up on the surface of the skin, causing patches of psoriasis to appear.

Psoriasis may look contagious, but it’s not.

You cannot get psoriasis from touching someone who has it. To get psoriasis, a person must inherit the genes that cause it.

Types of psoriasis

If you have psoriasis, you will have one or more of these types:

  • Plaque (also called psoriasis vulgaris)
  • Guttate
  • Inverse (also called flexural psoriasis or intertriginous psoriasis)
  • Pustular
  • Erythrodermic (also called exfoliative psoriasis)

Some people get more than one type. Sometimes a person gets one type of psoriasis, and then the type of psoriasis changes.

If you are diagnosed with skin cancer, you may see a Mohs (pronounced “moes”) surgeon for treatment. A Mohs surgeon performs a type of surgery called Mohs surgery. This specialized surgery is used exclusively to treat skin cancer.

Mohs surgeon. During Mohs surgery, a Mohs surgeon uses a microscope to look for cancer cells.

How to become a Mohs surgeon

Becoming a Mohs surgeon requires many years of education. To become this type of medical doctor, a person must successfully complete the following:

  1. College, earning a bachelor’s degree.
  2. Medical school, becoming a medical doctor (MD) or doctor of osteopathy (DO).
  3. Internship, 1 year.
  4. Residency program, such as one in dermatology (at least 3 years for dermatology).

Dermatologists are exposed to Mohs surgery during their residency (training to become a dermatologist). After completing their residency, some dermatologists continue their studies and receive advanced training in Mohs surgery. Some dermatologists complete a fellowship, specializing in Mohs surgery and reconstruction. A fellowship is a medical training program that offers in-depth advanced training.

Mohs surgery has many advantages, but it is not necessarily the right treatment for everyone who has skin cancer. A dermatologist considers many factors before determining which treatment will be best for each patient. These factors include the type of skin cancer, whether the cancer has spread and where the skin cancer appears on the body.

Keeping your skin healthy and looking its best doesn’t necessarily mean breaking the bank if you follow these practical tips from leading dermatologists:

  • Cleanse, treat and prevent. Don’t let a 12-hour period go by without using some sort of treatment or product on your skin (sunscreen counts).
  • Use sunscreen 365 days a year. This helps prevent sun damage that could lead to wrinkles, age spots, or even skin cancer.
  • Get the most from your body moisturizer. In the winter, apply it to damp skin as soon as you get out of the shower to lock in the moisture.
  • Consider using petroleum jelly.This common, inexpensive product has several uses for skin care including:
    • moisturizing rough, cracked feet, elbows, and hands; dry cuticles and lips; and peeling nails;
    • preventing chafing when running or biking;
    • protecting kids’ scrapes and bumps;
    • applying as a diaper ointment.
  • Use one or two skin care product lines at a time. Limiting product lines saves money and storage space.
  • Remember, a more expensive skin care product is not necessarily more effective. Some brands contain fragrances that may lead to skin problems.
  • Consider dual-function products. Examples include a moisturizer plus sunscreen and a lip balm with sunscreen.
  • Get the most for your hard-earned money. When choosing anti-aging products, look for ingredients such as vitamin A and alpha hydroxy acid.

Dermatologists recommend the following to their patients:

  • If you see a mole on your skin that is changing, itching, or bleeding, make an appointment to see a dermatologist. These are signs of melanoma, a type of skin cancer. Caught early, melanoma can be cured. Without treatment, melanoma can spread. This can be deadly.
  • Perform self-exams of your skin. A self-exam can help you catch melanoma early.
  • Protect your skin from the sun.It is believed that being out in the sun increases the number of moles on your skin. And we know that the sun causes skin cancer. Tanning beds and sun lamps also cause skin cancer.An easy way to reduce your risk of getting skin cancer is to skip getting a tan. You also should wear sunscreen every day.
  • If you have 100 or more moles, be sure you have a dermatologist.If you answer yes to any of the following questions, you also should have a dermatologist:
    • Do you have pigment that covers a large part of your body?
    • Do you have familial atypical multiple-mole melanoma (FAMMM) syndrome or a similar medical condition?

People who have FAMMM should have a full-body screening every 3 to 6 months, beginning at puberty. Your dermatologist may recommend less-frequent screenings if your moles are stable (not changing).

First, think of any new medications or skin care products you may have taken or used within the week of developing the rash. Also, consider if you've been camping or outside, to help your dermatologist distinguish what may have caused the rash.

If the rash causes swelling that spreads to the face or throat, call 911 right away.

If the rash is mild and small in size, you can try treating it at home with a few remedies. Wash with lukewarm water and mild soap, and applying mild cream to the area, such as Cetaphil or another non-scented, hypo-allergenic lotion. Vaseline (petroleum jelly) would be another safe, hypo-allergenic topical to try for dry or irritated skin.

If these home remedies do not help, or if the affected area is large in size, you should see a Dermatologist right away to be sure it's not a more serious condition.

Credits to the American Academy of Dermatology for information regarding skin conditions.