What is Dermoscopy?

Dermoscopy uses a specialized magnified light to allow visualization of structures beneath the skin surface, including pigment patterns and blood vessels. This improves diagnostic accuracy during skin examinations and can help reduce unnecessary biopsies.

Dermoscopy is used alongside clinical examination, medical history, and individual risk factors. It is an important tool, but only one part of a comprehensive skin exam.

Common Diagnoses:

  • Actinic Damage & Actinic Keratoses
    • Actinic keratoses are rough, scaly spots caused by cumulative sun exposure. They are considered precancerous because a small percentage can progress to squamous cell carcinoma.Treatment may involve freezing individual spots or using topical or light-based therapies to treat broader sun-damaged areas. Ongoing sun protection and routine skin exams help reduce future risk.
  • Basal Cell Carcinoma (BCC)
    • Basal cell carcinoma is the most common type of skin cancer and usually develops in sun-exposed areas. It typically grows slowly and only rarely spreads to other parts of the body, but it can continue to enlarge and damage nearby skin if left untreated.Treatment depends on the size, location, and subtype of the cancer and may include surgical removal, scraping and cautery (ED&C), topical medications, or referral for Mohs surgery. Early diagnosis allows for simpler treatment and better cosmetic outcomes.
  • Squamous Cell Carcinoma (SCC)
    • Squamous cell carcinoma often arises from sun-damaged skin or precancerous lesions called actinic keratoses. It may appear as a scaly patch, firm bump, or a sore that does not heal.Some SCCs can behave more aggressively than basal cell carcinoma and, if untreated, may spread. Treatment typically involves surgical removal, with other options considered based on depth, location, and risk features. Prompt evaluation is important.
  • Melanoma
    • Melanoma develops from pigment-producing cells (melanocytes). While less common than other skin cancers, it can spread quickly if not detected early.When confined to the top layer of skin (melanoma in situ), outcomes are excellent with appropriate treatment. Deeper melanomas may require wider surgery and, in some cases, coordination with surgical or medical oncology. Regular skin exams and attention to changing moles are critical.
  • Atypical Melanocytic Hyperplasia (AMH)
    • Atypical melanocytic hyperplasia refers to an abnormal growth of pigment-producing cells that does not meet full criteria for melanoma but falls into a borderline category.Because these lesions can behave unpredictably, they are typically treated with surgical excision, similar to very early melanoma.
  • Dysplastic Nevi (Atypical Moles)
    • Dysplastic nevi are moles with irregular shape, color variation, or border asymmetry. They are graded as mild, moderate, or severe based on microscopic features.Mildly and moderately atypical moles often do not require further treatment if adequately sampled. Severely dysplastic nevi are usually removed because their appearance can overlap with melanoma, making long-term behavior difficult to predict. People with many dysplastic nevi have a higher lifetime risk of melanoma.
  • Seborrheic Keratoses
    • Common, harmless skin overgrowths that may appear waxy or “stuck-on.” Treatment is not required unless symptomatic.
  • Cherry Angiomas
    • Benign blood vessel growths that appear as small red spots. No treatment is required.
  • Benign Nevi (Moles)
    • Normal pigment growths. Most do not require treatment unless changing.
  • Lentigines (“Sun Spots”)
    • Flat brown spots from sun exposure. Benign but should be monitored for change.

Post-Procedure Instructions

Post-procedure instructions are also available in our office. These materials are for informational purposes only and are not intended to substitute for individualized medical evaluation, diagnosis, or treatment provided during your visit.

  • General Wound Care Instructions
    • Proper wound care helps reduce infection risk and supports optimal healing and cosmetic outcome. Download & Print
    • First 24-48
      • • Keep the original bandage in place.
      • • Keep the area clean and dry.
      • • Avoid strenuous activity, heavy lifting, bending, or stretching that places tension on the wound.
      • • Avoid smoking or nicotine products, which can delay healing.
    • After 24-48 Hours
      • • Remove the bandage (often easiest in the shower).
      • • Gently clean the area once daily with mild soap and water.
      • • Pat dry — do not scrub.
      • • Apply a generous layer of plain petroleum jelly (or prescribed ointment).
      • • Cover with a clean, non-stick bandage.
      • • Continue daily wound care until fully healed.
    • Bleeding
      • • Mild oozing is common.
      • • If bleeding occurs, apply firm, continuous pressure for 20 minutes without checking.
      • • If bleeding continues, repeat once.
      • • Contact the office if bleeding does not stop.
    • Pain Control
      • • Acetaminophen 975–1000 mg every 8 hours as needed (unless contraindications).
      • • Ibuprofen 400 mg may be used if approved (unless contraindications).
      • • Avoid alcohol for at least 48 hours unless otherwise directed.
    • When to Call the Office
      • • Increasing redness, warmth, swelling, or pain
      • • Pus-like drainage
      • • Fever ≥100.4°F
      • • Wound edges separating
      • • Bleeding that does not stop with pressure
  • Surgical Excision Would Care
    • Download & Print
    • Sutures
      • • Follow General Wound Care Instructions above.
      • • Keep sutures clean and covered until removed or dissolved.
      • • Avoid soaking the wound (baths, pools, hot tubs) until cleared.
      • • Limit movement across the surgical site.
      • • Sutures may be dissolvable or require removal — you will be told which applies.
    • Scar Care
      • • Scars continue to mature for up to 12 months.
      • • Once healed:
        • • Apply sunscreen SPF 50+ daily.
        • • Silicone gel or sheets may help improve appearance.
  • Shave or Punch Biopsy Wound Care
    • Download & Print
    • No Sutures
      • • Keep the bandage in place for 24 hours.
      • • After removal, clean daily with soap and water.
      • • Apply petroleum jelly and cover with a bandage until healed.
      • • Do not allow a scab to form.
      • • Bleeding can occur — apply firm pressure if needed.
      • • Healing typically takes 1–3 weeks.
  • Hidradenitis Suppurativa (Hs) Unroofing Wound Care
    • Download & Print
      • • Leave the bandage in place until the morning after the procedure.
      • • Shower daily; allow water to run gently over the area.
      • • Do not scrub.
      • • Apply petroleum jelly and cover with a clean bandage daily.
      • • Prevent scab formation for optimal healing.
      • • Bleeding is common — apply firm pressure if needed.
      • • Healing may take several weeks.
      • • Protect the area from sun exposure once healed.

 

Vinegar (Acetic Acid) Soaks

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(Only if instructed) Vinegar soaks may help reduce bacterial burden and support healing.

  • Instructions
    • • Mix 3 tablespoons white vinegar with 1 quart of room-temperature water.
    • • Refrigerate the solution.
    • • Soak clean gauze or a washcloth in the mixture.
    • • Apply to the area for 3-5 minutes, up to 3 times daily.
    • • Rinse with water, pat dry and apply a thick moisturizer (e.g., petroleum jelly).
    • • Continue for 1 week, unless instructed otherwise.
    • • Stop if irritation occurs.
  • Skin Self-Exams & Warning Signs
    • Regular self-exams help detect changes early.
    • Watch for:
      • •  A new or changing spot
      • •  A sore that does not heal or repeatedly bleeds

      ABCDEs of Moles

      • A – Asymmetry
      • B – Border irregularity
      • C – Color variation
      • D – Diameter larger than ~6 mm
      • E – Evolving over time

      Contact the office if you notice concerning changes.

  • Actinic Keratoses & Sun Damage
    • Actinic keratoses are rough, sun-damaged spots considered precancerous. Some may progress to squamous cell carcinoma if untreated.
    • Treatment options may include:
      • • Cryotherapy (freezing)
      • • Topical field treatments
      • • Light-based therapy

 

Actinic Keratoses & Sun Damage

Actinic keratoses are rough, sun-damaged spots considered precancerous. Some may progress to squamous cell carcinoma if untreated.

Treatment options may include:

  • Cryotherapy (freezing)
  • Topical field treatments
  • Light-based therapy

Isotretinoin (Accutane®) – Patient Acknowledgment Summary

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Isotretinoin is a highly effective treatment for severe acne and requires strict adherence to federal safety regulations.

  • Key Points
    • • Baseline laboratory testing is required before starting therapy, with periodic follow-up labs during treatment.
    • • Monthly follow-up appointments are required.
    • • Prescriptions must be filled within a 7-day window.
    • • You must register in iPLEDGE and answer your questions in a timely fashion.
    • • Missed appointments or missed prescription windows will delay treatment.
    • • Medication may run out before the next visit — this does not affect treatment effectiveness.
    • • New prescriptions cannot be issued early.

  • Pregnancy Prevention (If Able to Become Pregnant)

    • • Two negative pregnancy tests are required before starting.
    • • Monthly pregnancy testing is mandatory.
    • • iPLEDGE confirmation and patient questionnaires must be completed on time.

    • If transferring care, must transfer providers in iPLEDGE

      By continuing treatment, you acknowledge understanding and compliance with these requirements.

QUESTIONS OR CONCERNS?

If you have questions about wound care, medications, or healing, please contact our office. If you experience severe bleeding, signs of infection, or urgent concerns, seek medical attention.