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.
How do I take care of my surgical area after Mohs surgery?
It is generally required
to check with your surgeon for their specific wound-care instructions just after
surgery. Often, you will be asked to go home and take it east for the rest of
the day. A few patients like to return to work and resume
their work the day after surgery. It may be advisable to avoid heavy lifting and
exercise, especially the first 24-48 hours after surgery. Your physician will
usually give you more detailed instructions depending on the area and size of
the surgery. You will have usually have a bulky "pressure" dressing on the
surgery area for one day. You may be asked to keep the area dry for 24 hours.
Swimming pools, oceans, and Jaccuzis are usually not permitted while the
stitches are in. These may increase your chance of infection. Many physicians
allow you to shower the next day after surgery. Wound care may require cleaning
the wound with soap or hydrogen peroxide two to three times a day and applying an over-the-counter antibiotic ointment to the area. Mild swelling is not uncommon the
first day or two after surgery and can be lessened by use of an ice-bag
application, ice cubes or chips in a small Ziploc baggie, or frozen peas in
their bag. Leaving the dressing in place, use cold pack application every five
to 15
minutes every hour for the first eight to 24 hours after surgery. Swelling is more
common around for surgeries around the eyes or lips. Sleeping propped up on a
few pillows or in a reclining chair may help decrease swelling after surgery of
the head and face area.
The surgical area may ooze a little blood or clear liquid especially in the
first few hours after surgery; activity may aggravate this. Hot drinks or
bending over at the waist can also initiate or worsen bleeding of face wounds.
If bleeding occurs, firm pressure applied directly to the site for 10-15 minutes may be helpful. Most bleeding will stop if you apply enough
pressure. Your surgeon should be notified if bleeding that persists. Rarely, a
visit to the hospital emergency room may be necessary for severe bleeding.
Your surgeon will need to know if pain is increasing after one to two days after
your surgery or if you are having fever or other concerning symptoms. In such
cases, you may need to be seen at the surgeon's office. The surgical area may
need to be promptly checked for bleeding or infection. Limiting hot foods, hot
drinks, and heavy chewing for 48 hours may help decrease the chances of
postoperative bleeding for wounds around the mouth or cheek areas. Your
physician will let you know their recommended wound care.
Most patients are advised to try to avoid applying
makeup or powder directly on a fresh wound unless the surface is fully healed.
Skin-colored tape strips called Steri strips are available to minimize wound
leakage and help cover up a visible wound. It is important to follow your own
physician's instructions for wound care.
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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