A mole is a common skin lesion due to a proliferation of pigment cells on the skin. The number of moles a person has depends on many factors including genetics, sun exposure and immune status.
It is important to have all of your moles mapped and the size recorded as any new mole or change to an existing mole may be a sign of a life-threatening skin cancer called Melanoma. ABCDE Characteristics are often used to help identify potentially malignant moles (Asymmetry, Border irregularity, Color Variation, Diameter >6mm, and Evolution over time).
Any suspicious mole should be biopsied to check for malignancy.
A epidermoid cyst is a dome-shaped, firm, skin-colored nodule that is freely movable and sometimes has a small pore-like opening. Occasionally, a thick, cheesy material with a foul odor can be expressed.
Cysts can be located almost anywhere but are common on the face, neck, scalp, or trunk.
For patients who desire removal, cysts can be excised to ensure complete removal of cyst wall. If a cyst becomes infected it may need to be incised and drained and antibiotics prescribed.
Lipomas are benign (non-cancerous), fatty tumors that grow just below the skin. They are usually painless, smooth, round, and mildly flexible. They have a semi-soft, rubbery texture when pushed. Lipomas can occur anywhere on the body including the back, abdomen, arms, legs, scalp and face. They range in size from 0.5 cm to over 7 cm.
Most people have small, undetectable lipomas that do not bother them. If a lipoma is overlying a sensitive area or if it grows to be large, it can be surgically removed. Other less common treatment methods include liposuction, aspiration, or injections.
A keloid (key-loid) is a type of raised scar. Unlike other raised scars, keloids grow much larger than the wound that caused the scar.
Not everyone who gets a scar will develop a keloid. If you have keloid-prone skin, however, anything that can cause a scar may lead to a keloid. This includes a cut, burn, or severe acne. Some people see a keloid after they pierce their ears or get a tattoo. A keloid can also form as chickenpox clear. Sometimes, a surgical scar becomes a keloid.
In very rare cases, keloids form when people do not injure their skin. These are called “spontaneous keloids.”
A keloid usually takes time to appear. After an injury, months can pass before this scar appears. A keloid can also form more quickly.
Once it begins, a keloid can enlarge slowly for months or years.
A skin tag is a small piece of soft, hanging skin that may have a peduncle, or stalk. They can appear anywhere on the body, but especially where skin rubs against other skin or clothing.
- Skin tags are benign tumors of the skin.
- They commonly occur in creases or folds of the skin.
- They are not dangerous, but they can be removed for aesthetic and cosmetic reasons.
- Methods of skin tag removal include over the counter (OTC) therapies, excision, and cryotherapy.
They may appear on the:
- under the breasts
- upper chest
- neck, in the case of papilloma colli
They often go unnoticed, unless they are in a prominent place or are repeatedly rubbed or scratched, for example, by clothing, jewelry, or when shaving.
Some people may have skin tags and never notice them. In some cases, they rub off or fall off painlessly. Very large skin tags may burst under pressure.
The surface of skin tags may be smooth or irregular in appearance. They are often raised from the surface of the skin on fleshy peduncles, or stalks. They are usually flesh-colored or slightly brownish.
Skin tags start small, flattened like a pinhead bump. Some stay small, and some grow bigger. They can range in diameter from 2 millimeters (mm) to 1 centimeter (cm), and some may reach 5cm.
Seborrheic keratosis (seb-o-REE-ik care-uh-TOE-sis) is a common skin growth. It may seem worrisome because it can look like a wart, pre-cancerous skin growth (actinic keratosis), or skin cancer. Despite their appearance, seborrheic keratoses are harmless.
Most people get these growths when they are middle aged or older. Because they begin at a later age and can have a wart-like appearance, seborrheic keratoses are often called the “barnacles of aging.”
It’s possible to have just one of these growths, but most people develop several. Some growths may have a warty surface while others look like dabs of warm, brown candle wax on the skin.
Seborrheic keratoses range in color from white to black; however, most are tan or brown.
You can find these harmless growths anywhere on the skin, except the palms and soles. Most often, you’ll see them on the chest, back, head, or neck.
Seborrheic keratoses are not contagious.
Full-body Skin Check
Dr. Scheel will check your skin from head to toe for irregular moles and lesions, and chart these findings on your mole map. This will be referred to in future exams.
Dr. Scheel uses non-invasive instruments such as a Lumio light and 3G Dermatascope to check and photograph suspicious skin lesions. With the use of Melafind we are able to look under the skin’s surface to further assesses suspicious moles. We will also discuss recommendations for skin care products and procedures to prevent future problems.
Things to Know
- Head to toe exam, if you’re modest wear a bathing suit or trunks
- Your findings will be charted and used for future reference and to evaluate therapies
- Recommendations will be made for skin care and wellness
Cryotherapy uses liquid nitrogen to freeze and slough the skin cells. We can treat precancerous lesions as well as warts, tags and benign growths. Patients may experience a temporary sensation of burning or stinging.
After being treated the crusting/scab will peel off and heal within a week. Most growths require 1 to 3 treatments, with 2 to 8 weeks between each treatment.
Things to Know
- Site can be tender, sting or burn for a couple hours
- Usually does not scar. Can blister or scab.
- Treatment is quick and done in the office
- You may require more than one treatment
Surgical Excision and Biopsy
The removal of a portion of a growth, or the entire growth from an area of skin. This is done by sterilizing the skin and numbing it with an injection of lidocaine. The injection is given with a small needle and reduces the feeling of pain during the procedure, it may feel like a “stick and a burn”.
After the biopsy, the bleeding will be stopped and an antibiotic ointment and band-aid will be placed on the site. This area may feel like a scrape a few hours later.
Things to Know
- Your tissue will be sent to the pathologist for diagnosis
- Be sure to tell Dr Scheel of any medications you are taking
- Aspirin and anti-inflammatory medications may increase bleeding and bruising
- Stitches will remain in place between 7-14 days depending on the excision site
- Depending on the diagnosis further treatment may be necessary
From Our Patients
If is was not for Dr Monica Scheel Dermatology Office, I would still not know that I had Melanoma on my leg. The spot was so small that I had not noticed it, and was discovered when I had my full body cancer screen check at Monica’s Office, with their professional and caring dedication to the customers.
Mom and I wanted to say MAHALO for all you did for us today!!!
When I called this morning to make an appointment for Mom, I was thrilled when Danielle said there was an opening at 11:45am. We felt a sense of relief since she has been in pain for a while. It was comforting to know there is no pressure sore or something skin related going on.
Your immediate glance to my arm was heartwarming. You cared so much to interrupt Mom’s appointment to look at my lesion. Taking the time to do the biopsy and explaining the next steps was the absolute best. It made me stop worrying about the unknown and know I’m taking steps in the right direction with your guidance.
Patient Care Coordinator Gia was also helpful and kind to both of us today – MAHALO Gia!!!
Dr. Scheel – your warm and friendly manner, combined with your professional expertise is such a gift. You exude genuine caring, confidence and competence. We feel so fortunate you are here in Kona.
THANK YOU so much for everything you did for us today !!!
While Melasma can be an extremely difficult skin condition to treat and can reoccur at any time – one that I may have to battle with for the rest of my life – I now feel that I have learned enough from Dr. Scheel to not let it get out of control as I allowed it to before.
Thank you Dr. Monica Scheel for taking the time to care and making me feel beautiful again from the inside-out. And thank you for helping me to believe that there is hope for Melasma.