About Skin Cancer
The three major types of skin cancer are melanoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC). Each type is named according to the type of skin cell it affects. When cells at the base of the epidermis are affected, it is a basal cell carcinoma. When the cells in the upper layers are affected, it is a squamous cell carcinoma. Melanoma, the most aggressive type of skin cancer, affects the pigment cells of the skin. It appears as a black or brown mole. At Pacific Skin and Cosmetic Dermatology San Francisco, we are so proud to provide our patients with the most advanced and effective skin cancer treatments available. Tracy Evans, M.D. is a dermatologist specializing in skin cancer and is fellowship-trained to perform Mohs surgery.
Skin Cancer Reviews
"Dr. Evans and her team are the best! I am only 32 and recently found out that I had a Basal Cell skin cancer on my face. Dr. Evans immediately put me at ease and explained every step of the of the Mohs Surgery that she would perform to remove it. She is an expert in that procedure and I am so thankful, because after further research I found out that Mohs is the most accurate way to remove the cancer cells and leaves the least amount of scarring. Even though Basal Cell Carcinoma is a very minor form of skin cancer, it can be a stressful thing to go through and Dr. Evans was phenomenal! In addition, her office is pristine, and her administrative team is friendly, efficient, and organized. Her medical assistants and nurses also make you feel incredibly comfortable. Anytime I have questions about products like sunscreen, moisturizers, etc they have given me some great recommendations and samples...but I have never felt pressure to buy anything that I don't want. I love that this practice is the perfect blend of skilled medical dermatology expertise, but pays attention to what we are all looking for cosmetically as well."- B.H. / Yelp / Oct 13, 2015
"I feel extremely fortunate to have found Dr. Evans. She is on every potential skin cancer and has found issues others have ignored. She is through and highly professional. Dr. Evans recently saw both of my teenage sons on short notice to accommodate their school schedules. She was approachable and positive with them. She and the staff provided a very upbeat experience. I recommend her highly for all ages."- J.H. / Yelp / Jan 06, 2016
"I was referred by my dermatologist to Dr Evans for Moh's surgery for basal cell carcinoma on my nose. Since I had already seen my derm and had biopsy results she immediately scheduled me for the in office surgery. She is trained in this special surgery where the first layer is removed and then her tech prepares a slide for the tissue to be viewed by Dr Evans. If there is still any cancerous tissue she goes back and removes that select area. In my case this occurred but after the second tissue removal all of the carcinoma was removed. This both ensures the least tissue is removed and the highest success rate of other procedures. She was very gentle with the needle when injecting the numbing agent. Fortunately, they were able to remove so little that a graft was not necessary...they just closed it together. She answered all my questions as did her staff. I had some heavy bleeding but she was on top of it. Do expect to spend several hours in the office as they have to prepare the slide after each layer is removed. I had some issues at the pharmacy that evening filling a pain Rx, but she and I text and she had her staff call to assist me. She then even followed up with a phone call as well. My copay for the surgery was only an office copay. When I went back today for the wound check there was no copay--in my experience this is unheard of. I was worried I might have a slight infection so they swabbed it and will culture it and call me with the results. Meanwhile, they suggested the sutures stay in another 3 days. They gave me additional instructions for minimizing the scar. At no time did anyone try to sell me any derm products. I will definitely refer others to Dr Evans. She emphasized the importance of skin cancer checks every 3 months and said she would be willing to do it or I could return to my original Derm (who doesn't do Moh's surgery). Thank you Dr Evans and staff for your great care! Update, there is a charge for f/u appointments if the doc sees you. Had 2 such appts due to healing problems. Was sold some special facial soap, but no more expensive than at Walgreens. Both times I was told/encouraged to come back for laser-scar removal."- S.J. / Yelp / Feb 07, 2017
"My experience with Dr Bramlette was nothing short of perfect. She performed a fairly major removal of a skin cancer on my nose, explained clearly what was going on without ever being patronizing. She told me that in 3 months you would barely be able to see the scars and she was right. Do not hesitate to work with her, she is a professional."- J.K. / Yelp / Oct 11, 2010
"I have been seeing Doctor Evans and her excellent PA, Lauren, for over 2 years. I switched dermatologists in late 2016 as a previous PA failed to diagnose skin cancer on my nose. Another doctor, my GP, noticed the spot and recommended that I immediately get a second opinion. I was lucky enough to get in to see Lauren straight away who moved quickly to biopsy the troublesome area. Unlike the other PA, Lauren was concerned about my symptoms, the length of time I was dealing with them and appearance of the spot. Her depth of knowledge and confident, yet caring demeanor helped put me at ease. Unfortunately, the spot turned out to be aggressive basal cell carcinoma. I was diagnosed in mid Dec and Dr. Evans moved mountains to help book me for Mohs surgery before the Holidays. She also went above and beyond to line up an excellent plastic surgeon in the event my surgery was challenging to close. I am forever grateful as my surgery was quite extensive. At the age of 38, I had 5 rounds of scrapping in a single Mohs surgery which left me with a hole the size of a quarter on my nose. Dr. Evans performed the surgery with skill and ease in her office ensuring I was comfortable throughout the 5-hour operation. I feel incredibly lucky to have seen Lauren and Dr. Evans. It was an emotionally draining process with an unforeseen outcome, but I was given unbelievable care and support from Dr. Evans and her entire staff. Once I healed, they've since helped with regular skin checks and laser treatments to help reduce the appearance of the scar. It has healed beautifully! I've recommended many friends to their practice. While I know at times you can wait for an appointment to begin, to me, it's worth it to ensure I am given superb care."- K.D. / Yelp / Jun 11, 2018
Most cases of skin cancer are triggered by ultraviolet radiation damage to the DNA within skin cells that controls their turnover and growth. This type of UV-ray damage is caused by overexposure to the sun and the use of tanning beds. You may have heard that "there is no such thing as a safe tan," and this is unfortunately true. Skin cancers may also develop without any UV-ray damage; having fair skin, many moles, or a family history of skin cancer are also risk factors. The most important things you can do to prevent skin cancer are to avoid long-term sun exposure, wear sun-protective clothing, use a broad-spectrum sunscreen, never use tanning beds, and have annual skin exams.
It is important to know the different indicators and symptoms of skin cancer so you know what to look for in self-checks:
- Crusty or scaly spots or patches anywhere on the body that is often exposed to sunlight
- Pearly or flesh-colored bumps
- Lesions that look like scars but are new
- Firm, shiny bumps
- Non-healing sores
The ABCDE list is a helpful guide to check for melanomas:
- A: Asymmetrical mole (one side is a different size or shape than the other)
- B: Borders (malignant moles do not have defined borders)
- C: Color (a malignancy won't be uniform in color)
- D: Diameter (malignancies typically grow larger than 6 millimeters in diameter)
- E: Evolving (malignant moles evolve and change in appearance)
The treatment selected for your unique case will depend on the size, location, depth, stage, and type of skin cancer. Most of the options provided at Pacific Skin and Cosmetic Dermatology San Francisco involve the full removal of the growth, which is the most effective form of treatment. Our removal procedures are typically quite simple and are performed on an outpatient basis with local anesthesia. Below are some of the skin cancer treatments provided at Pacific Skin and Cosmetic Dermatology San Francisco:
- Mohs surgery is a very effective removal method for many types of skin cancer. This procedure can take a bit longer than other surgical methods because the lesion or tumor is removed in layers, and each layer is examined under a microscope on-site to check for cancerous cells.
- Surgical excision is used for smaller, easy-to-reach skin cancers. We will administer a local anesthetic, and then the cancer will be excised using a scalpel and horizontal cuts around the growth and surrounding tissue. Small excisions can be sewn closed while larger excisions may need a skin graft to close up the wound.
- Laser therapy is performed with a Fraxel laser, commonly associated with more cosmetic treatments, and is primarily used to treat actinic keratoses. Sometimes combined with other topical treatments, this procedure can be effective in reducing cancerous and precancerous lesions on the skin.
- Topical treatments in the form of creams, gels, or ointments may be used to help treat precancerous cells or skin cancer, depending on the site, size, and diagnosis. This can be an effective option for many individuals, but Dr. Evans will perform a thorough assessment and biopsy to determine if this is the best treatment option for you.
Protect your skin
To reduce your overall risk of skin cancer, it is important to avoid excessive sun exposure, always use a broad-spectrum sunscreen, and never use tanning beds. It is also best to have skin cancer screenings at least once a year — or twice a year if you have a family history or personal past with skin cancer. Visit Dr. Tracy Evans at Pacific Skin and Cosmetic Dermatology San Francisco for exams, detection, and treatment from an experienced specialist.