Q: I have a lot of brown spots, brown pigment, and sun damage in my skin. Which treatment would be best for me?

A:We recommend the Fraxel Restore Dual laser to our patients who want to improve their brown spots and abnormal brown pigment in their skin. Treatments with the Fraxel Restore Dual result in the rapid clearance of abnormal brown pigment from the skin, including the pigment found in brown spots, brown patches, and sun spots. In addition, skin color following the treatment is much more uniform and much less blotchy.

The Fraxel Restore Dual laser works by delivering laser energy into the top layers of the skin where the abnormal brown pigment is located. This results in rapid clearance of the pigment from the skin. As a result, significant reduction in abnormal brown pigment can be achieved in only one or two treatments sessions.

Fraxel Restore Dual laser treatments are very well tolerated and are performed using only numbing cream. There is no sedation or other anesthesia required. Following the laser treatment, there will be a mild flaking-off of the treated skin, which will be replaced with fresh new skin. There is no pain or recovery downtime following Fraxel Restore Dual laser treatments, and normal activities may be resumed immediately following the treatment. Skin care after the laser treatment consists of only the use of a sunscreen and moisturizer.

Our office has been performing Fraxel laser skin resurfacing since 2004, when the Fraxel laser was first introduced for skin rejuvenation. As a result, we have extensive experience with Fraxel laser skin treatment. Dr. Anterasian has performed nearly 2000 Fraxel laser procedures with consistently excellent results.

We personally welcome all patients to our office who wish to look younger without surgery, and who might be considering a skin rejuvenation procedure.

Q: I recently noticed a new mole on my arm. I have had it for about two weeks now. What should I do?

A:Not all changes in the skin are dangerous, but you should see a dermatologist if you notice changes in your skin that last longer than two weeks.

Moles are very common. The average Caucasian has about 20 moles on his or her body. Most moles are harmless, but it is important to know when a mole exhibits signs that suggest it may be a dangerous mole.

A normal mole has a sharp margin, a uniform color, a symmetrical shape, and a smooth outline or contour. Usually, they are less than ¼ inch in size and of a single uniform color.

The ABCD warning signs can often identify dangerous moles.

A: Asymmetry, where one half does not match the other half. (Normally, each half should be a mirror image of the other half.)

B: Border irregularity, where the edges are ragged or blurred, and not sharp

C: Color, in which the pigmentation and color are not uniform throughout

D: Diameter, where the width of the mole is greater than ¼ inch

There is also the ugly duckling sign, in which the mole in question looks or acts differently than all of the other moles on the body. This would include moles that ulcerate, bleed, change shape, change color, or itch.

Other warning signs include any of the following:

• A new growth not previously present on the skin
• Scaliness, oozing, or bleeding from a bump or nodule in the skin
• An area of skin that stays irritated, red, or itchy
• An area of skin that keeps cracking or bleeding
• A colored or dark spot that is getting larger

Skin cancer is almost always curable when found early, but can be deadly if the diagnosis is delayed. Both doctors and patients play important roles in discovering skin cancers early in their course.

Skin cancer is the most common of all cancers. It accounts for nearly half of all cancers in the United States, and over one million cases of skin cancer are diagnosed in this country each year.

The risk factors for skin cancer include unprotected or excessive exposure to the sun's ultraviolet radiation, fair complexion, occupational exposure to various toxic substances, family history of skin cancer, history of severe sunburns as a child, and multiple or atypical appearing moles.

Over 90% of skin cancers are basal cell cancers. This is the least aggressive type of skin cancer. These cancers almost never spread to other parts of the body. However, they can cause damage by growing and invading surrounding tissues. Squamous cell cancer occurs about 25% as often as basal cell cancer. Squamous cell cancers can spread to other parts of the body. This most commonly occurs when the squamous cell cancer involves the lower lip. Melanoma is the most serious and aggressive type of skin cancer. Melanomas have the potential to spread to other areas of the body. Melanomas become life threatening when they act in this manner. Approximately 60,000 new melanomas will be diagnosed in the United States during 2005.

Skin cancer is almost always curable when found early. Both doctors and patients play important roles in finding skin cancers early.

What are the signs and symptoms of skin cancer?

Because the skin is completely visible, skin cancers can often be found early. If you have any of the following symptoms, it might indicate the presence of a skin cancer, and you should see your doctor for an evaluation.

• Any change in the size or color of a mole or other darkly pigmented growth or spot
• A new growth, not previously present on the skin
• Scalincess, oozing, or bleeding from a bump or nodule on the skin
• A mole or a mark with an irregular border, with pigment spreading past the edge of the mole or mark
• A rough, red, or bumpy area that's bigger than the head of a match and doesn't clear up
• An area of skin that stays irritated, red, or itchy
• An area of skin that keeps cracking or bleeding
• A colored spot that gets bigger
• A brown or black spot that's wider than 1/4 inch (the size of a pencil eraser) or that changes color or size.

Not all changes in the skin are cancer, but you should see your doctor if you notice changes in your skin that last longer than two weeks. And don't wait to feel pain, since skin cancers seldom cause pain.

What about my moles?

Moles are very common. The average Caucasian has about 20 moles on his or her body. Most moles are harmless, but it is important to know when a mole exhibits signs that suggest it may be a "dangerous mole."
A normal mole has a sharp margin, a uniform color, a symmetrical shape, and a smooth outline or contour. Usually, they are smaller than a pencil eraser and of a single color, usually pink to tan to dark brown.

When looking at a mole, remember the "ABCDE" warning signs that the mole could be a "dangerous mole."

• A: Asymmetry, where one half does not match the other half
• B: Border irregularity, where the edges are ragged or blurred and not sharp
• C: Color, in which the pigmentation is not uniform. The appearance may be mottled or splotchy
• D: Diameter, where the width of the mole is greater than six millimeters (larger than the size of a pencil eraser)
• E: Elevation, in which the mole appears elevated or raised above the skin

There is also the "ugly duckling" sign. The "ugly duckling" is a mole that looks or acts differently than all of the other moles on the body. This would include moles that ulcerate, bleed, change shape, or change color.

What is the best way to examine my skin?

The best time to examine your skin is after a bath or shower, while your skin is still wet.
Use a full-length mirror if you have one. Start at your head, and work your way down, looking at all areas of your body. Try to check your skin once a month. When it comes to the health of your skin, it is a good idea to be proactive and keep an eye out for dangerous moles.