FAQs

Is psoriasis contagious?

No! Psoriasis is an autoimmune disease. That means that it is actually caused by “faulty programming” of your immune system. As you know, the immune system is designed to protect us from infections and cancer. It does so by monitoring for foreign invaders like viruses and bacteria, and then attacking and destroying them.

Sometimes, for reasons not fully understood, the immune system becomes confused. Instead of attacking the “bad guys,” it begins to attack your own body. So, if the attack targets the joints, the result is rheumatoid arthritis. If it is against the nerves, that causes multiple sclerosis. Against the insulin-producing cells in the pancreas—that’s Type I diabetes. In psoriasis, the attack is on the skin. The rash that you see is really the skin, trying to heal from this damage. But unlike a cut or a burn, the damage keeps going, day after day, so the healing, and the rash, never stop. Frustrating—yes. But contagious—NO.

Can psoriasis ever be cured?

Not yet. Sometimes, psoriasis will just go away by itself for long periods, or even permanently. But we do not yet have the treatment to actually permanently cure psoriasis. Therefore our treatments are designed to control the disease. As a result, they typically have to be used continuously, or at least regularly.

Fortunately, newer treatments have finally given us tools to fully control the most severe cases. Drugs like Enbrel, Humira, and Stelara, can completely clear the skin, making it possible to wear shorts and short sleeves without any visible skin rash. Incidentally, Dr. Ling was directly involved in the development of all three of these new drugs though his research company, MedaPhase.

Does diet make me break out?

That’s an interesting question, as the answer has gone back and forth over the years. 50 years ago, diet, particularly sweets and chocolate, were thought to worsen acne. Then, research suggested that they did not have much effect at all, and chocolate lovers rejoiced. Only recently however, new studies have begun to suggest that there may indeed have been some truth to the old wisdoms. There are indeed suggestions that excessive amounts of sweets, particularly ones like high fructose corn syrup, may have some mild effect. Diet may also help acne: there are some data suggesting that omega 3 fatty acids may help acne, along with your heart.

But, still, far and away the most potent cause of acne is hormones, particularly the major changes in hormones that occur during puberty.

If I wash my face more, will my acne get better?

Maybe, a tiny bit. The idea is good: to unblock all those blocked pore blackheads and whiteheads that are the beginning of the acne process. The problem is that cleansers, washcloths, Buf Pufs, etc are not really capable of opening up the deep blockages seen in acne. To do that successfully requires medications, like the vitamin A derivatives such as Differin or Retin A, which penetrate deep into the skin to dislodge the plugs blocking the pores.

Skin Cancer FAQs

I don't see anything after my biopsy; it looks like the skin is healing. Do I still need to be treated?

Yes, treatment is still needed. Following a biopsy, your skin cancer may no longer be visible to you. However, the surface lesion that was removed can represent the "tip of an iceberg." More tumor cells may remain in the skin. These can continue to grow like roots of a tree, downward and sideways in the skin. These "roots" are not visible with the naked eye. If they are not removed, the tumor will likely reappear, continue to grow and require more extensive surgery.

Does skin cancer treatment require painful surgery?

No, especially when diagnosed early. Most skin cancers can be treated in the office with local anesthetic. No further treatment is usually needed once the skin cancer has been removed. Early diagnosis and treatment lead to quicker healing time and smaller scars.

How serious is melanoma?

When recognized and treated early, melanoma is nearly 100 percent curable. But when diagnosed later, the cancer can advance and spread to other parts of the body, where it requires extensive surgery and can be fatal.

Mohs surgery FAQs

What are my chances for cure following Mohs surgery?

There is a 99% cure rate for most skin cancers with Mohs surgery, even when other forms of treatment have failed. Other methods of treatment offer only a 50% chance of success if previous treatments have failed. The high cure rate means fewer return visits and less need for additional treatment

Will I be hospitalized for my surgery?

No. Mohs surgery is performed in a relaxed outpatient surgical enviroment using local anesthetic. You will be not be put to sleep. You may return home the same day of surgery.

Will there be a scar from my Mohs surgery?

Yes. Any treatment for skin cancer will leave a scar.
Mohs surgery preserves as much normal skin as possible thus minimizing the scar as much as possible. Once the Mohs surgeon has completely removed your skin cancer, optimizing the final cosmetic result of your surgery becomes our highest priority. The sutures remain in the skin one to two weeks depending on location. Generally, a surgical scar improves with time and may take up to one year to fully mature.

How will the surgery area be repaired?

Immediately after the cancer is removed, we may choose (1) to leave the wound to heal itself, (2) to repair the wound with stitches, or (3) to reconstruct the wound with a skin graft or flap. This decision is based on the safest method that will provide the best cosmetic result.

How long will the surgery last?

The length of surgery depends on the size of the tumor. Plan on spending at least 2 – 4 hours. Much of the time is spent waiting for tissue to be processed. Bring such things as reading materials, work, or needlework with you to help pass the time.

Should I eat before surgery?

Yes. You should eat your regular breakfast/lunch before surgery.

Should I take my regular medications on the morning of the surgery?

Yes. Take your regular medications as they have been prescribed.  Do not stop any blood thinners before surgery without consulting your regular doctor as this could lead to a serious medical problem. We operate on a daily basis on patients taking blood thinners.

:)