Moles, also called nevi, begin as growths of melanocytes, the cells that give the skin its color. Virtually all of us have at least a few moles. Sometimes, they are present at birth but most develop during childhood. The size and color of moles may change during puberty or pregnancy. Sun exposure can increase the number of moles a patient may have. Most moles are benign and can easily be removed in the office. Before removal, Dr. Manley examines all lesions for signs of cancer. Some moles are raised above the skin surface and some are flat.

If a benign mole is elevated above skin level, it can often be removed by shaving it off flush with the skin after applying a local anesthetic. This procedure is quick, safe, easy, and usually results in a smooth area with little, if any, evidence the lesion was ever there. No sutures (stitches) are necessary. We routinely remove raised lesions on all areas of the body including on the face, nose, and eyelids.

Flat moles usually require an excision through the skin and closure with sutures. We can do these procedures anywhere on the body including the face. If a lesion is particularly complicated, we will not hesitate to refer a patient to a plastic surgeon for removal. We remove small facial lesions under magnification and close the opening with very tiny sutures to give the best results.

Seborrheic keratoses are one of the most common skin lesions older patients get. They usually start to appear after the age of 30 and get more and more common with age. They are usually brown or black and raised above the skin in a “stuck on” appearance. They can be itchy and bleed. Some patients may have hundreds of these lesions. Seborrheic keratoses are benign. Insurance will cover removal if they are itching, bleeding or causing some other type of problem. *

These are very common lesions that tend to occur in areas where the skin rubs together such as under the arms, between the legs and on the eyelids. We remove skin tags from any location with excellent results. We anesthetize each one before removal to minimize pain. Skin tag removal is usually not covered by insurance.

BBL™ treatment cannot be done on tanned skin or on patients with dark skin. The treatments are usually performed without the need for anesthetics by using a cool conductive gel. A series of pulses are used to treat all of the affected areas. Patients usually need 4-6 treatments at about 2 week intervals for optimal results. BBL™ treatments are not covered by insurance.

We often use the ForeverClear BBL™ protocol as developed by Dr. Patrick Bitter, Jr. His program uses a three-step process not available on other IPL devices. It is very effective in eliminating acne-causing bacteria, target redness and initiate the body’s natural healing process. 

We treat warts in a variety of ways. We usually try a simple injection of Candida yeast immediately adjacent to the wart to trick the body’s immune system into clearly the wart itself. This is sometimes called “the wart shot.” It works in about 60% of patients and makes the wart go away without any cutting, burning or freezing. If the Candida fails after two attempts,  we will use other methods to rid our patient of their warts. We are careful to try to avoid techniques that could cause loss of pigmentation or scarring. Wart treatment is usually covered by insurance. Medicare has some special rules for determining when wart removal is covered. *

Milia are tiny white or yellow cysts usually on the face. They are especially common around the eyes. Milia are sometimes confused with acne “white heads” but they cannot be easily “popped” like an acne lesion. They are benign and easy to remove in the office. Insurance will usually not cover milia removal.

The same Fractora system is very effective in clearing acne scars. 

Epidermoid or sebaceous cysts are a common problem, usually occurring on the scalp or trunk. They are basically plugged up skin glands that continue to produce secretions even though the gland is clogged. This creates a cyst that continually gets larger and larger. It may sometimes break open and exude a thick white material. It can also become infected. Cysts are easy to remove in the office by excision. Cyst removal is usually covered by insurance. Medicare has some special rules for determining when cyst removal is covered. *

Ingrown toenails are a common problem that can be treated easily in the office. Insurance always covers this treatment.

Cherry hemangiomas are very common. They are bright red 1-6 mm lesions appearing on the trunk and arms in adulthood. They are benign but can become unsightly. These lesions can usually be treated with a laser in the office. Laser treatments are usually not covered by insurance. In some cases we may excise the lesion and it can sometimes be covered by insurance. *

Venereal warts, plantar warts, molluscum contagiosum, and flat warts.