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Skin cancer care and Mohs surgery, medical dermatology, and lasers and cosmetic treatments, explained plainly.

Written by Dr. Neera Nathan, MD, MSHS, board-certified dermatologist Last updated Sources cited Editorial policy

Skin cancer and Mohs surgery

Dr. Nathan is a fellowship-trained Mohs surgeon. She can follow a suspicious spot from first look through biopsy, treatment and long-term checks.

  • Full-body skin examinations, with extra attention to spots you're worried about
  • Biopsies of new or changing growths, with clear explanations of the results
  • Mohs micrographic surgery for basal cell and squamous cell carcinoma in higher-risk locations
  • Reconstruction after Mohs, usually on the same day
  • Treatment of precancerous actinic keratoses
  • A follow-up schedule after skin cancer, because one skin cancer raises the chance of another

Medical dermatology

Long-term conditions need a plan you can actually follow. Treatment starts with guideline-backed options and is adjusted to your skin, your schedule and your budget.

  • Acne in teens and adults, including acne that leaves marks or scars
  • Eczema (atopic dermatitis), from moisturizers to biologic injections
  • Psoriasis, including screening questions for psoriatic arthritis
  • Rosacea, flushing and visible blood vessels
  • Hair loss, including alopecia areata
  • Rashes, itch and other skin concerns that need a diagnosis

Lasers and cosmetic care

Laser medicine was a focus of Dr. Nathan's training and research. Cosmetic care here is evidence-based: realistic expectations, clear risks and no pressure to treat.

  • Fractional laser resurfacing for texture and some types of scars
  • Vascular laser treatment for redness and broken blood vessels
  • Neuromodulator (botulinum toxin) and dermal filler injections
  • A frank discussion of laser options and pigment risk on brown and Black skin
  • Skincare plans built on ingredients with real evidence

Prevention and skin health

Photoprotection, meaning protection from sunlight, is one of Dr. Nathan's long-standing interests. Prevention advice here fits every skin tone, not only fair skin.

  • Sunscreen choices for your skin type, including tinted mineral options
  • Sun-safety advice for children and families
  • Skin self-exam coaching: what to look for and how often
  • Help separating skincare marketing from the evidence

Services listed here reflect Dr. Nathan's training and the services offered by Dermatology & Skin Health. Please confirm availability, and whether a visit is covered by insurance, when you book.

Mohs surgery, layer by layer

Skin cancers can have roots you can't see. Mohs follows them precisely.

  1. Layer 1 removes the visible tumor and a thin rim of tissue, which is mapped and checked under the microscope while you wait.
  2. Layer 2 is taken only where the map shows cancer at the edge.
  3. Layer 3, if needed, clears the last root. Then the wound is repaired.

Cure rates are up to 99% for skin cancers that haven't been treated before.1

Mohs surgery, layer by layer A cross-section of skin with a tumor near the surface and a thin root growing deeper to one side. Dashed outline 1 removes the visible tumor. Outline 2 is a small extra layer taken only where the root continued. Outline 3 clears the tip of the root. 123
Illustration, not to scale. Most tumors need one or two layers.

Treatments and procedures in detail

Who each one is for, what happens, and what to expect afterward.

Full-body skin examination

Who it's for
Anyone with a new, changing or bleeding spot, a personal or family history of skin cancer, many or unusual moles, or a history of frequent sunburns.
What happens
A head-to-toe look at the skin, including the scalp, nails, palms, soles and between the toes, often with a handheld magnifier called a dermatoscope. You can ask to skip any area.
Afterward
If a spot needs a closer look, the next step is usually a photo for comparison or a biopsy.
Good to know
The USPSTF found too little evidence to recommend routine screening for people with no symptoms. That doesn't apply if you're at higher risk or have a spot that worries you.2

Skin biopsy

Who it's for
A growth that looks unusual, is changing, or doesn't heal.
What happens
The area is numbed and a small sample is removed by shave or punch. The sample goes to a dermatopathologist, a doctor who diagnoses skin under the microscope.
Afterward
A small bandage, simple wound care, and a result to discuss when the report is back.
Good to know
A biopsy is the only way to confirm skin cancer. A diagnosis can't be made from appearance alone.2

Mohs micrographic surgery

Who it's for
Basal cell and squamous cell carcinomas in higher-risk places, such as the face, ears, hands and genitals, or tumors that are large, aggressive or have come back. Appropriate use criteria help decide when Mohs is the right choice.3
What happens
The surgeon removes the visible cancer and a thin layer of tissue. The layer is mapped, color-coded and examined under the microscope while you wait. If cancer remains, another thin layer is taken from that exact spot, and this repeats until the edges are clear.1
Afterward
The wound may be closed with stitches, repaired with nearby skin (a flap) or a graft, or sometimes left to heal on its own.1
Good to know
For a skin cancer that hasn't been treated before, the Skin Cancer Foundation cites cure rates of up to 99%.1

Excision and reconstruction

Who it's for
Lower-risk skin cancers on the trunk, arms and legs, and benign growths that need removal.
What happens
The growth is removed with a margin of normal-looking skin under local numbing, and the wound is closed with stitches.
Afterward
Stitch care at home and a check of the pathology report to confirm clear margins.
Good to know
AAD guidelines describe surgical excision as an effective treatment for many low-risk basal and squamous cell carcinomas.45

Photodynamic therapy

Who it's for
People with many actinic keratoses (rough, sun-damaged precancerous patches), especially on the face and scalp.
What happens
A light-sensitizing solution is applied to the skin, left to absorb, and then activated with blue light.
Afterward
Treated skin is red and sensitive for several days and must be kept out of the sun, as instructed.
Good to know
Actinic keratoses are worth treating: most squamous cell carcinomas begin as one.6

Fractional laser resurfacing

Who it's for
Uneven texture, some acne and surgical scars, and sun damage, in people without recent isotretinoin use or a tendency to keloids.
What happens
A laser treats tiny columns of skin, either removing the surface (ablative) or heating beneath it (non-ablative), so the skin heals in from untreated areas.7
Afterward
Ablative treatment usually means 7 to 10 days of healing, and redness can last longer. Non-ablative treatment has little downtime but usually needs two to four sessions.7
Good to know
Brown and Black skin has a higher risk of long-term pigment change, so laser settings and choice of device matter.7

Neuromodulator and filler injections

Who it's for
Adults who want to soften lines or restore volume, after a conversation about goals, anatomy and risk.
What happens
Neuromodulators relax specific muscles. FDA-approved fillers add volume in approved areas, such as the cheeks, lips and chin. Both are injected in the office.8
Afterward
Bruising, swelling and tenderness are common for a few days. Fillers can rarely block a blood vessel, which needs urgent care.8
Good to know
The FDA warns against needle-free filler devices, buying fillers online and self-injection.8

Prescription treatment plans

Who it's for
Acne, eczema, psoriasis, rosacea and alopecia areata that over-the-counter care hasn't controlled.
What happens
A plan built from the current AAD and AAD–NPF guidelines, from topical therapy to pills, light therapy or biologic injections when needed.91011
Afterward
Follow-up visits to check how well treatment is working, adjust the plan and monitor medicines that need lab tests.
Good to know
Bring a list of everything you've already tried, including how long you used it. It saves time and avoids repeating what didn't work.

A balanced approach to cosmetic care

Cosmetic dermatology should leave you better informed, not just treated. Every cosmetic visit covers what a treatment can realistically change, how many sessions it usually takes, the downtime, and the risks for your skin tone. Saying no, or waiting, is always an option.

This site doesn't show before-and-after photos or promise results, because outcomes vary from person to person.

Read the guide to lasers and injectables

Questions worth asking

  • What can this change for my skin, and what can't it change?
  • What are the risks for my skin tone, and how will they be reduced?
  • How many sessions, how much downtime and what total cost?
  • Is the product or device FDA-approved or cleared for this use?
  • Who do I contact if something doesn't look right afterward?

Sources

  1. The Skin Cancer Foundation. Mohs Surgery. Updated October 2025. View source
  2. US Preventive Services Task Force. Screening for skin cancer: US Preventive Services Task Force recommendation statement. JAMA. 2023;329(15):1290-1295. doi:10.1001/jama.2023.4342 (final recommendation, April 18, 2023) View source
  3. Connolly SM, Baker DR, Coldiron BM, et al. AAD/ACMS/ASDSA/ASMS 2012 appropriate use criteria for Mohs micrographic surgery. J Am Acad Dermatol. 2012;67(4):531-550. doi:10.1016/j.jaad.2012.06.009 View source
  4. Work Group; Invited Reviewers; Kim JYS, Kozlow JH, Mittal B, et al. Guidelines of care for the management of basal cell carcinoma. J Am Acad Dermatol. 2018;78(3):540-559. doi:10.1016/j.jaad.2017.10.006 View source
  5. Work Group; Invited Reviewers; Alam M, Armstrong A, Baum C, et al. Guidelines of care for the management of cutaneous squamous cell carcinoma. J Am Acad Dermatol. 2018;78(3):560-578. doi:10.1016/j.jaad.2017.10.007 View source
  6. The Skin Cancer Foundation. Actinic Keratosis. View source
  7. Mayo Clinic. Laser resurfacing: about (tests and procedures). View source
  8. U.S. Food and Drug Administration. Dermal Fillers (Soft Tissue Fillers). Content current as of July 6, 2023. View source
  9. Reynolds RV, Yeung H, Cheng CE, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2024;90(5):1006.e1-1006.e30. doi:10.1016/j.jaad.2023.12.017 View source
  10. Sidbury R, Alikhan A, Bercovitch L, et al. Guidelines of care for the management of atopic dermatitis in adults with topical therapies. J Am Acad Dermatol. 2023;89(1):e1-e20. doi:10.1016/j.jaad.2022.12.029 View source
  11. Menter A, Strober BE, Kaplan DH, et al. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics. J Am Acad Dermatol. 2019;80(4):1029-1072. doi:10.1016/j.jaad.2018.11.057 View source
  12. Davis DMR, Drucker AM, Alikhan A, et al. Guidelines of care for the management of atopic dermatitis in adults with phototherapy and systemic therapies. J Am Acad Dermatol. 2024;90(2):e43-e56. doi:10.1016/j.jaad.2023.08.102 View source
  13. Elmets CA, Korman NJ, Prater EF, et al. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with topical therapy and alternative medicine modalities for psoriasis severity measures. J Am Acad Dermatol. 2021;84(2):432-470. doi:10.1016/j.jaad.2020.07.087 View source

Something on your skin you'd like looked at?

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