• Examine your skin. Your doctor may look at your skin to determine whether your skin changes are likely to be skin cancer. Further testing may be needed to confirm that diagnosis.
• Remove a sample of suspicious skin for testing (skin biopsy).Your doctor may remove a small sample of suspicious-looking skin for laboratory testing. A biopsy can determine whether you have skin cancer and, if so, what type of skin cancer you have.

Determining the extent of the skin cancer
If it is determined by our doctor that you have skin cancer in most cases additional tests will be ordered to determine the extend and stage of the skin cancer. Because superficial skin cancers such as basal cell carcinoma rarely spread, a biopsy which removes the entire growth often is the only test needed to determine the cancer stage. But if you have a large squamous cell carcinoma, Merkel cell carcinoma or melanoma, your doctor may recommend further tests to determine the extent of the cancer.

Doctors use the Roman numerals I through IV to indicate a cancer’s stage. Stage I cancers are small and limited to the area where they began. Stage IV indicates advanced cancer that has spread to other areas of the body.

The skin cancer’s stage helps determine which treatment options will be most effective.

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• Laser treatments. In laser resurfacing, a laser beam destroys the outer layer of skin. As the wound heals, new skin forms. Less intense lasers cause less damage, but are also less effective.
• Other energy-based procedures. Pulsed light sources and radio-frequency devices help create new skin without damaging the outer layer of skin. After several treatments, acne scars may appear less noticeable.
• Dermabrasion. This procedure involves removing the top layer of skin with a rapidly rotating wire brush. Surface scars may be completely removed, and deeper acne scars may appear less noticeable.
• Surgery. In some cases, surgery to remove deeply indentedacne scarsis an option. A minor procedure, called punch excision, cuts out individual acne scars. Stitches or a skin graft repairs the hole left at the scar site.
• Tissue fillers. Injecting collagen or fat under the skin and into the acne scars can fill out or stretch the skin, making acne scars less noticeable. Results are temporary, so you’d need to repeat the injections periodically.

To determine what’s best for you, discuss the pros and cons of each procedure with your doctor or dermatologist.

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• Atypical moles or dysplastic nevi. These moles are the largest of the three types and have a characteristic irregular shape and color. These moles are hereditary or genetic moles that may have an increased risk for developing into a cancerous lesion.
• Congenital moles or congenital nevus. These moles are present at birth and may be at a risk of developing into cancerous lesions. Around 1% of people have these moles from their birth.
• Acquired moles. These moles are the most common type of moles, developed throughout childhood or early adulthood. Acquired moles remain smaller than a quarter inch, and typically appear after excessive exposure to the sun. These moles typically don’t develop into cancerous lesions.

If you have concerns about your mole, a skin doctor or our dermatologist San Diego can assist you. A suspicious looking skin lesion like a mole can be considered a sign of malignant melanoma, one of the more life-threatening forms of skin cancer.

If you are considering adermatologist in San Diego they will recommend to examine your skin regularly to check for irregular or new skin moles. You can also see a dermatologist for regular checkups and evaluations of your skin, if you have a family history of moles or harbor a large amount of moles on the surface of your skin.

To tell if a mole or strange skin lesion is cancerous, doctors and/or dermatologists in San Diego use a technique called the five steps or the ABCDEs of the condition melanoma:

• Asymmetry, or if one side of your mole doesn’t look like its opposing side.
• Border or irregular border, if the border of your skin lesion looks irregular or poorly defined.
• Colors that vary, or if your mole have more than one shade of color, like brown, black or red.
• Diameter, or if your mole has a diameter larger than that of a pencil eraser.
• Evolution, if any part of your mole changes or evolves over time.

A doctor or dermatologist in San Diego will remove a suspicious skin mole if it fits any of the criteria above. Many serious skin conditions, like melanoma, are diagnosed after having the suspicious skin and/or tissue examined by a pathologist.

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1. Avoid the sun, or protect yourself with sunscreen. The sun is the single largest cause of wrinkles.  Many studies have been conducted which have concluded that sun exposure is directly related to the formation of wrinkles, especially to those on the face.  If you are going to be out in the sun, make sure to wear sunscreen and if you are sweating reapply it regularly.  Skin exposure is also known to cause skin cancer.  If you have any concerns about your sun exposure, or sun damage our expert dermatologists would be happy to give you a consultation.
2. Don’t smoke. While some research regarding this is still controversial, many medical studies have confirmed that cigarette smoke ages skin.  This is due to an enzyme that breaks down collagen which gives skin its elasticity.  Studies on sibling conducted at St. Thomas Hospital in London found the brother or sister who smoked generally had more wrinkled skin, and it was nearly 40% thinner than that of the non-smoker.
3. Eat lots of fish. Salmon is a particularly good choice because salmon, and many other cold water fish are not only a great source of protein which is an essential  building block for great skin.  Salmon and other fish are also good sources of omega-3 fatty acids.  Fatty acids are known to nourish skin, and help to keep it plump and youthful looking, this is a wrinkle prevention standard.
4. Sleep on you back, and make sure to get enough sleep. When you don’t get adequate rest, the body produces an excess of cortisol.  Cortisol is a hormone that breaks down skin cells, while conversely when you get enough sleep you are more likely to produce more Human Growth Hormone which aids skin remain thick, elastic, and less prone to wrinkles.  The American Academy of Dermatology has warned that sleeping in certain positions night after night leads to sleep lines.  These sleep lines can become wrinkles, which can become etched into the surface of the skin and they won’t disappear once you’re up. If you sleep on your side, it can increase wrinkles on the cheeks as well as the chin.  If you sleep face down you can get a furrowed brow. The best way to reduce wrinkle formation is to sleep on your back.
5. Eat lots of fruits and vegetables.  Fruits and vegetables are high in antioxidants, which fight damage caused by free radicals.  These free radicals are capable of damage cells.  The result is that these antioxidants helps skin look younger , and can protect against aging from the sun.
6. Substitute cocoa for coffee. In a 2006 study in the Journal of Nutrition, researchers found that cocoa containing high levels of catechin and epicatchin which can not only protected skin from sun damage but improve circulation to skin cells.  This can increase hydration which makes the skin feel smother and look younger.
7. 12. Don’t wash your face too much. In a study conducted by the University of Maryland, plain old tap water can strips your skin of its natural oils and moisture that help to protect against wrinkles. If you wash off these oils too often you are actually washing away your skins natural protection.  If your facial soap does not contain any moisturizes you should use a cleanser instead.  You should also use moisturizes to replenish your skins moisture and keep it young looking.
8. Numerous studies have shown that the following ingredients can help to reduce wrinkles.  Most of which are found in both skin care treatments(prescription and over the counter).  The short list is shown below:
   1. Pentapeptides- can increase collagen production
   2. Idebenone- a powerful antioxidant
   3. Alpha Hydroxy Acids- lift away dead skin cells, reducing the appearance of fine lines and wrinkles
   4. Topical Vitamin C- been found it can increase collagen production, protect against damage from both UVA and UVB rays
   5. Retinoids- FDA-approved topical treatment for wrinkles
9. Medical Treatments such as Botox, and wrinkle fillers.  Wrinkle fillers such as collagen, Restylane, and Juvederm actually fill the voids where skin beneath wrinkles has become thin, and reduce the appearance of wrinkles.  Botox temporarily weakens muscles which can be causing wrinkles.
10. Laser Resurfacing and Dermabrasion. Energy from a high power light source removes the top layer of skin.  This results in an unnoticeable skin wounding.  The result is that the skins  natural collagen-production system goes into overdrive which yields smoother, more wrinkle-free skin.  In microdermabrasion  a vacuum suction device is used in conjunction with a chemical crystal.  This removes the top layer of skin cells, this results in the reduction of fine lines and wrinkles due to the production of new skin.

With the use of these wrinkle prevention tips and techniques you can prevent the formation of wrinkles and reduces the chances of new wrinkles forming.  If you have any questions on anything mentioned here the professional staff of Boughton Dermatology would be happy to help you.  We employ only board certified dermatologist, and can help you answer and questions, or address any concerns you may have.  If you have and skin cancer concerns we recommend you see a dermatologist to have them addressed.  We are one of San Diegos top dermatologists and have been serving San Diego for decades.

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Skin cancer is the most prevalent type of cancer, with over 3.5 million diagnoses per year in the US (that’s more than all other cancers combined).  The good news is that the majority or skin cancers are preventable.  The dermatologists at Boughton Dermatology recommend that you follow a few simple steps to reduce your chances of developing skin cancer.  We also recommend regularly visiting your dermatologist, because early detection of skin cancer is key!  If you see any suspicious areas on your skin we urge you to see a physician immediately to have it examined.
While it is recommended to avoid skin exposure to the sun we know that for active people that is not very practical.  However, you can reduce your exposure to UV rays by trying to follow these easy steps:

1.  Use sunscreen.  A recent survey from The Skin Cancer Foundation revealed that 49% of men and 29% of women say they have not used any sunscreen in the past 12 months.  Even low SPF sunscreen is better than no sunscreen.  Whatever you have, make sure you use it.  Also, don’t forget to reapply it, most sunscreens should be reapplied every 2 hours.

2.Cover up–wear clothing to protect your skin as much as possible.  Most clothing provides a higher SPF than any sunscreen, and it doesn’t wear off if you sweat!

3.  Wear a hat and sunglasses when possible.  According to the Vision Council, if you aren’t wearing your sunglasses you are risking an increased chance of cataracts, macular degeneration and skin cancer on the eyelids.  While skin cancer of the eyelids may sound strange it actually accounts for nearly 10 percent of all skin cancers.

4.  Limit direct sun exposure during midday.  This is when the suns rays are the strongest, and as such, damage from the sun in accelerated during exposure.

5.  Avoid tanning beds.  After all the recent reports about UV exposure from tanning beds it is highly recommended that they be avoided.

7.  Protect your children’s skin from the sun.  Children are very prone to sunburn due to their fair skin, so do them a favor and keep them protected with sunscreen and  hats.

If you have any questions or concerns about your skin please feel free to contact Boughton Dermatology for a consultation.  We have been serving San Diego for many years, and our board certified dermatologists are experts in diagnosing and treatment of melanomas and skin cancer.  Our La Jolla based dermatologists are friendly, highly trained and ready to help.

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