There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma. Unfortunately, these cancers tend to occur in highly visible areas of the body such as the face, neck, chest, upper back, arms and legs. Surgery has historically been the mainstay of treatment for these cancers and is an area of expertise for Dr. Hooman Khorasani; however, even the greatest surgeons are not able to produce a scar-free surgery. This prospect of scarring can add considerable angst to an already scary diagnosis of skin cancer.
Laser therapy has revolutionized the treatment of superficial skin cancers in cosmetically sensitive areas. If you have been diagnosed with actinic keratosis (pre-cancer spots), squamous cell carcinoma (SCC) in situ (cancer limited to the top layer of skin), or a superficial basal cell carcinoma (BCC), you may be a candidate for minimally-invasive laser surgery. Our office uses a specialized CO2 laser known as PreciseFX, to vaporize the cancer while preserving the surrounding healthy skin. The PreciseFX technology coupled with Dr. Khorasani’s skin cancer and cosmetic surgery expertise, can provide you with a successful treatment that optimizes your medical needs and aesthetic goals.
Your skin is composed of millions of cells. Sun exposure, age, genetics, stress and other factors can cause some of these cells to mutate and behave abnormally. These mutated cells multiply rapidly and form cancerous tumors in the skin. The specific type of cell involved in this abnormal growth pattern determines if the cancer is a basal cell carcinoma (BCC), squamous cell carcinoma (SCC), or melanoma. Skin cancer is the most common malignancy in the United States and will impact one in five adults by the age of seventy. You are not alone in this battle!
Treatment of your skin cancer depends on its type, stage (as determined by your dermatologist and pathologist), location, and your overall health. Melanoma, the most dangerous of skin cancers, must be treated aggressively with surgery, chemotherapy, and/or radiation. The more mild pre-cancers and cancers like actinic keratosis (AK), basal cell carcinomas (BCC), and squamous cell carcinomas (SCC) can be addressed with a broader array of therapies.
Mohs micrographic surgery is best suited for non-superficial basal cell carcinomas and squamous cell carcinomas in cosmetically sensitive areas. As a board-certified and fellowship-trained Mohs micrographic surgeon, Dr. Khorasani has treated over sixteen thousand skin cancers with medical integrity and advanced technical proficiency. His commitment to optimizing health and aesthetic outcomes has earned him an international reputation of excellence and multiple peer-reviewed research publications.Learn more about Mohs micrographic surgery with Dr. Khorasani.
Actinic keratosis (pre-cancer cells), superficial basal cell carcinomas, and squamous cell carcinomas limited to the most superficial layer of the skin (in situ) may be candidates for removal with PreciseFX laser therapy.
The PreciseFX laser passes electricity through a gas-filled chamber to produce powerful light energy. This energy is then directed to the superficial and deep layers of the skin to the target area. PreciseFX is an ablative laser, meaning that the light energy completely removes the outermost layer of skin. In this case, these ablative properties are used to eliminate your superficial skin cancer or precancer cells in their entirety. Additionally, the light energy from PreciseFX selectively heats the deep layer of skin to stimulate the production of collagen.
This collagen is then used to replace the lost superficial layer with healthy, scar-free skin. The aesthetic outcomes from PreciseFX are enhanced by the precision of the laser, as the light energy does not impact the surrounding healthy skin. Consequently, this laser allows for the treatment of the smallest area possible and also provides a healthy cushion around the treated area to facilitate the recovery process.
Traditionally, the gold standard for treatment of superficial skin cancers has been electrodesiccation and curettage (ED&C). Unlike PreciseFX, an ED&C procedure is not depth selective and tends to cause more collateral damage to the healthy surrounding tissue. This results in delayed wound healing and potentially a higher risk for an unsightly scar.
The key benefit of the PreciseFX device is the ability to determine the exact depth of penetration. Using the precision of laser energy, PreciseFX is able to eradicate these superficial skin cancers with minimal scarring.
The scar from the PreciseFX laser is not comparable to the scar after traditional surgery. The most noticeable change in your skin is hypopigmentation (loss of pigment) in the area of treatment. Additionally, the recovery period from surgery is more prolonged and associated with a greater risk of infection than PreciseFX therapy. Consequently, surgical interventions may lead to a more pronounced disruption of your everyday life. PreciseFX allows for targeted therapy that maximizes your aesthetic outcome with minimal risk or downtime allowing you to get back to your routine much faster.
Non-surgical options such as topical medications or cryotherapy may also be used to treat actinic keratosis, superficial basal cell carcinomas, and squamous cell carcinomas in situ. These therapies, however, require multiple sessions and may have unintended side effects. PreciseFX laser therapy is a one-time treatment with focused efficacy that yields optimal medical and cosmetic results.
PreciseFX uses cutting-edge light energy therapy to provide targeted removal of superficial skin cancers and precancerous lesions. This procedure is best suited for patients with these types of cancer who want to maximize their health and aesthetic outcomes in a timely fashion.
During your initial consultation, Dr. Khorasani will carefully evaluate your skin cancer to determine if you are a candidate for treatment with the PreciseFX laser. This may require more than one visit, as this process often requires retrieving the original biopsy from the pathologist. These steps are essential to ensure that your skin cancer can be effectively treated with laser therapy, as Dr. Khorasani will review the specimen under a microscope to re-confirm the original diagnosis and cancer depth. Once he has determined that laser therapy is safe and appropriate for your skin cancer, you will be scheduled for treatment.
If you suffer from a non-superficial cancer, we offer expert Mohs micrographic surgery and cosmetic reconstruction that capitalizes on Dr. Khorasani’s decade-plus long career as a dermatologic and cosmetic surgeon. Find out more here if Mohs micrographic surgery can provide you with the best medical and cosmetic results for your skin cancer.
This minimally-invasive therapy boasts an excellent cure rate; however, as with all forms of cancer, it is important to regularly follow-up with your dermatologist to monitor for recurrence.
On the day of your procedure, Dr. Khorasani will meticulously mark the cancer site with a specialized surgical pen. The treatment area will then be numbed with a local injection of lidocaine, which may sting for five to ten seconds as it is being administered. After you are numbed, you should not experience pain; however, you may experience sensations of heat as the laser targets the treatment area. If at any time during the procedure this heat becomes too uncomfortable, please inform Dr. Khorasani and he will provide you with additional measures to ensure your comfort. These include our in-office Pro-Nox system which employs nitrous oxide (“laughing gas”) to reduce anxiety and the experience of pain. Pro-Nox can be self administered by you as needed, to address any discomfort.
The longest part of the procedure is the precise marking and numbing process, which requires ten to fifteen minutes to complete. The laser treatment itself requires less than five minutes.
After your procedure, we will carefully cover the treated area with a thick layer of Aquaphor. DuoDERM®, a highly specialized dressing that facilitates optimal wound healing, will then be used to bandage the treated area. During your recovery period, you will continue this same regimen 4-5 times per day. It is of utmost important to keep the treatment site moist at all times to maximize your aesthetic outcome. Fortunately, the DuoDERM bandage can be tailored to the exact shape and size of your wound, allowing for minimal disruption of your daily routine. Since there is no cutting involved you will not have any sutures. This means that you can go back to your normal routine after a few days.
Most wounds require two to eight weeks to recover from the PreciseFX laser, although redness of the site may linger for six months or more. Additionally, the treated area will appear depressed where the cancer tissue was removed. This indentation will slowly improve over the course of your recovery. Occasionally, Dr. Khorasani may recommend the use of Acell on your wound in order to boost the healing process. Acell is an FDA approved xenograft, or tissue graft, which has the ability to recruit cells to the wound for faster recovery and cell regeneration.
Patients that want to speed up the resolution of redness will likely benefit from a treatment with Vbeam, a specialized laser that selectively targets the small blood vessels responsible for the red appearance of healing skin. Find out more about Vbeam on our Vascular Lasers for Redness and Veins page.
As a quadruple board-certified, fellowship-trained skin cancer and cosmetic surgeon, Dr. Hooman Khorasani has spent over a decade treating skin cancer using innovative surgical and non-surgical techniques to provide optimal medical and aesthetic outcomes. His dedication to clinical excellence and constant innovation has led to numerous accolades and publications in premier medical journals. He is considered an international expert in skin cancer treatment and has spent a majority of his career training the next generation of dermatologic, skin cancer and cosmetic surgeons.
Armed with this clinical and academic proficiency, Dr. Khorasani is able to provide you with a tailored therapy plan that addresses your individual needs and employs the latest therapeutic advances. Additionally, his knowledgeable office staff provide personalized care and are available 24/7 to answer any questions you may have before, during, and after your treatment.
Dr. Khorasani and his highly-specialized team look forward to working with you to transform your medical or aesthetic goals into reality. To expedite a request for a consultation, message us securely, or contact Dr. Khorasani’s Manhattan office by phone at 212-230-3378. For more information about how to get in touch:CONTACT US