In our last blog, we reviewed the top 10 most common skin spots that we see in dermatology (https://www.midlandsderm.com/top-ten-common-skin-spots/). All of these can be removed. Now we would like to share with you some more information about the options for unwanted skin spots removal, as well as the details on what these procedures entail. Which procedure goes best for each spot heavily depends on the size and depth of the skin growth.
Unwanted Skin Spots Removal
The best dermatologists know that there are a number of other factors that will weigh into the selection of a procedure to remove certain skin spots—including:
- location of the spot
- patient age
- potential costs of the procedure
- patient preference
At Advanced Dermatology of the Midlands, all our dermatology providers have vast experience working with our patients to make the best treatment selection for unwanted skin spots.
Insurance Covered vs Non-Covered Procedures
Before going into the details of each procedure type, it is important to discuss the difference between insurance covered vs non-covered procedures. Typically, if a skin spot is rapidly growing, spreading, concerning appearance due to the possibility of skin cancer, or causing symptoms (such as itching or pain), then insurance will often cover the cost of the medical procedure to remove the spot(s). One notable exception to this is the case of skin tags (acrochordon). Usually, insurance plans do not cover their removal.
Skin tags can still be treated. In fact, we remove many skin tags. However, just like an unwanted mole that a patient wants removed to improve their appearance, this situation would be considered cosmetic and is generally an out-of-pocket expense. We also have extensive experience working with our patients and understanding the ever-changing insurance landscape regarding skin spot removals.
Our staff is also highly skilled at obtaining prior authorizations at the time of appointments for many of our patients. We are seeing an increasing number of cases needing these authorizations (we reach out directly to the insurance company while a patient is in the office hoping to have a procedure performed).
Unwanted Skin Spots Removal Common Procedure Options
Hot cautery involves the use of a medical cauterization device (hyfrecator) where a wire electrical loop is powered by a special battery. The tip of this device gets so hot that it can be used to burn off spots on the top layer of skin. This works especially well for small skin spots, such as small skin tags, milia, and sebaceous hyperplasia (enlarged oil glands).
Liquid Nitrogen Cryotherapy
Liquid nitrogen is an extremely cold substance that has been used for decades in dermatology and medicine in general to treat various skin growths. An old-fashioned way of using it is to dip a Q-tip in the liquid nitrogen for a period of time and then set this extremely cold Q-tip against the skin spot to treat it. Even more effective is to deliver the liquid nitrogen directly to the spot on the skin with a device such as a liquid nitrogen sprayer (Cry-Ac).
All our dermatology providers have extensive experience using this liquid nitrogen device and are generally treating dozens if not hundreds of skin growths with that every day. Liquid nitrogen cryotherapy is commonly used for warts, seborrheic keratosis spots, but may also be used for virtually any other unwanted spot in the skin, aside from moles.
For spots that are more protuberant or hanging off the skin, sometimes it is easiest to literally clip them. To accomplish this, we often start by prepping the area and sterilizing it with isopropyl alcohol. Following that, using sterile instruments, the skin lesion is lifted and then snipped at the base. This too could be very effective for a number of lesions, most notably skin tags. One of the potential problems that can occur during the removal of skin tags can be bleeding. At Advanced Dermatology, we have several different approaches that we can take to stop bleeding if it does occur.
For larger or deeper spots, using a biopsy technique is sometimes better. There are two main types of skin biopsies that are used in the majority of cases that we see. These are the shave biopsy and the punch biopsy. Shave biopsy is an excellent way to remove unwanted moles and seborrheic keratosis spots. This is an especially good technique when we have any doubts about the behavior of the skin spot. Another way to say this is if we have any suspicions about what a spot might be, we may perform a shave biopsy on it to remove the spot and/or to reserve a portion of the skin growth for microscopic analysis so that the diagnosis can be verified.
Some spots on the skin may be even larger or deeper than can be removed with any of the above simple techniques. For these spots, we may perform an excisional surgery. This is where, once an area is anesthetized using a local anesthetic, a scalpel used to surgically incise the skin around the spot so that the spot may be removed in its entirety. Following this, the area is then brought back together using sutures or staples.
Advanced Dermatology of the Midlands | Best Dermatologist Omaha & Council Bluffs, IA | Board Certified Dermatologists
As you can see, there are many ways in which unwanted skin spots can be removed. Other treatments may include intense pulsed light treatment, which is similar to laser treatments or chemical peels. Daily in all our clinics, we are performing these procedures for patients with dark spots, age spots, and brown spots. To prevent such spots, our dermatologists recommend using sun protection and limiting sun exposure when possible. If you have spots on your skin that you either have concerns about or would like to have removed, please consider seeing us in consultation. We can review all the appropriate options with you and work with you to determine whether or not insurance would cover the removal of your spots. In many cases for smaller spots, these removals can be performed the same day we see you. For larger spots requiring excisional surgery, in most cases, we will schedule a special surgical time to perform the procedure in the office. Also keep in mind, any of these procedures can potentially leave behind aftereffects on the skin including potential scarring.
We have two clinics in Omaha, including a new clinical location at 156th & Maple. We also have clinics in Council Bluffs, as well as outreach locations in rural community medical centers in Eastern Nebraska and Southwest Iowa. Call us at (402) 933-3770 for more information or contact us to schedule a consultation.