Dr. Alai is an actively practicing medical and surgical dermatologist in south Orange County, California. She has been a professor of dermatology and family medicine at the University of California, Irvine since 2000. She is U.S. board-certified in dermatology, a 10-year-certified fellow of the American Academy of Dermatology, and Fellow of the American Society of Mohs Surgery.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Where can I have Mohs Surgery, and how long does the surgery take?
Mohs micrographic surgery is usually
performed in an outpatient setting like a doctor's office and under local
anesthetic (lidocaine). Sometimes the procedure may be performed in an
outpatient surgical center with the assistance of an anesthesiologist. Rarely,
it is performed in an inpatient hospital setting.
You are generally in the medical office for several hours (average two to
seven
hours) on the day of your Mohs procedure. Depending on how large or difficult
your skin cancer is, different numbers of levels may be required to achieve
clearance. Mohs requires your patience and your doctor's careful effort and
skill. It is not always possible to predict ahead of time how many hours your
specific procedure will take. Most patients leave their day's schedule open to
allow for adequate time to complete their Mohs.
What kind of physician can perform Mohs surgery? Where can I find a doctor board-certified in Mohs?
Most Mohs surgeons are specially-trained dermatologists.
There are also some plastic surgery, or ear, nose, and throat (ENT) surgeons
who are also trained to perform Mohs.
There is no current board certification for Mohs surgery.
There are two nationally recognized and respected national Mohs specialty groups
called the American College of Mohs Surgery and the American Society for Mohs
Surgery (ASMS).
Both of these medical groups have specialty training and certification exams
for their members. Members of the American College of Mohs Surgery usually have
completed an additional one to two years of Mohs training. Members of the American
Society for Mohs Surgery are also trained and required to actively participate
in an annual quality control Mohs slide peer review.
Skin cancer is the most common form of cancer
in humans. There are three main types of skin cancer; basal cell carcinoma and
squamous cell carcinoma (the nonmelanoma skin cancers), and melanoma.
Melanoma is a type of skin cancer which begins in skin cells called melanocytes and affects more than 53,600 people in the United States each year. These melanocytes can grow together to form benign moles which, after a change in size, shape, or color can be a sign of melanoma. Caused by sun exposure, early detection becomes extremely important to avoid a spread to other areas of the body. Diagnosis is confirmed through a biopsy of the abnormal skin and treatment depends on the extent and characteristics of the patient.
A keloid is a scar that doesn't know when to stop. When the cells keep on reproducing, the result is an overgrown (hypertrophic) scar or a keloid. A keloid looks shiny and is often dome-shaped, ranging in color from slightly pink to red. It feels hard and thick and is always raised above the surrounding skin.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Signs and symptoms of penile cancer include a lump on the penis and redness, irritation, or a sore on the penis. Risk of penis cancer is higher in uncircumcised men, due to a higher risk of HPV infection. Other risk factors include being over 60, having phimosis, having poor hygiene, using tobacco products, and having many sex partners. Prognosis and treatment depend upon the tumor's location and size, the stage of the cancer, and whether the cancer was recently diagnosed or if it recurred.
Scar formation is a natural part of the healing process after injury. The depth and size of the wound incision and the location of the injury impact the scar's characteristics, but your age, heredity and even sex or ethnicity will affect how your skin reacts.
Sunburn is caused by overexposure to UV radiation from the sun. UV rays can also damage the eyes. Repeated overexposure to UV rays also increases the risk for scarring, freckles, wrinkles, and dry skin. Symptoms of sunburn include painful, red, tender, and hot skin. The skin may blister, swell, and peel. Sun poisoning (severe sunburn) include nausea, fever, chills, rapid pulse, dizziness and more. Treatment for sunburn depends upon the severity. Sun protection and sunscreen for an individual's skin type is recommended to decrease the chance of sunburn.
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