Dermatologic & Laser Surgery

Mohs micrographic surgery

Mohs micrographic surgery is a common and highly effective treatment for certain types of skin cancer, including basal cell cancer, squamous cell cancer and some forms of noninvasive melanoma.

Our dermatologic surgeons perform this in-office procedure using local anesthesia, so you're awake but feel minimal discomfort. They carefully remove skin, layer by layer, examining each layer under a microscope until no signs of cancer remain. We use a special diagnostic method called immunostaining that helps us accurately identify and effectively remove cancer cells.

Because Mohs micrographic surgery is so precise and delivers immediate results, it has a high cure rate of 99% for new cancers and 95% for recurrent cancers (cancer that comes back after treatment).

Mohs micrographic surgery is ideal for treating cancer in visible areas, such as the face, ears and hands. This outpatient procedure preserves as much healthy tissue as possible and offers several advantages over traditional skin cancer surgeries, including:

• Highest cure rates

• Real-time lab testing to make sure all cancer cells have been removed

• No general anesthesia

• Immediate, expert skin reconstruction following your procedure

Post-Mohs reconstruction surgery

After Mohs surgery, there are different options for closing or covering the wound. Our dermatologic surgeons are highly skilled and experienced in a variety of reconstruction techniques that deliver the best possible functional and aesthetic outcomes.

We may allow small wounds to heal naturally or repair them with stitches. For larger or more complex wounds, we can use skin flaps (tissue from an adjacent area) or grafts (skin from a more distant area) to cover the wound. For the most complex wounds, we work with plastic surgeons to perform your repair. Our Mohs surgeons are experts in selecting the approach that will give you the best possible results.

Skin cancer surgery for complex conditions

At UCSF Health, we're known for handling rare and difficult-to-treat skin cancers with excellent outcomes. In addition to treating basal and squamous cell carcinoma, we also offer surgery for:

• Melanoma in situ (melanoma that's only in the top layer of skin)

• Atypical fibroxanthoma (AFX)

• Dermatofibrosarcoma protuberans (DFSP)

• Extramammary Paget's disease (EMPD)

• Sebaceous carcinoma

• Merkel cell carcinoma

Our dermatologic surgeons also have specialized expertise in caring for people at a higher risk of skin cancer due to organ transplant surgery, weakened immune systems or certain genetic conditions. Learn more about high-risk skin cancer care.

Cosmetic dermatology and laser treatments

We use the latest research to bring the newest, most effective treatment techniques to our patients. For example, we offer laser-assisted drug delivery, which uses a laser to create microscopic channels in the skin before applying a topical medication. This helps certain medications reach the right layer of skin, so they work effectively, often with fewer side effects than systemic treatments, such as pills or injections.

Laser skin resurfacing for rejuvenation

• Non-ablative laser resurfacing. We apply heat to the deeper layers of your skin without removing the surface layer. This stimulates collagen production, improves your skin's tone and texture and reduces early signs of aging.

• Ablative laser resurfacing. We use high-energy light to remove the outer layers of your skin and heat the deeper layers. This treatment resurfaces your skin to smooth wrinkles and enhance its overall tone and texture.

• Hybrid laser resurfacing. We combine ablative and non-ablative approaches in a single treatment, tailored to your skin type and goals.

Laser treatments can improve the appearance of:

• Acne scars

• Changes in skin texture

• Fine lines and wrinkles

• Mild skin sagging (laxity)

• Rosacea (chronic facial redness and flushing)

• Small visible blood vessels on the face and body

• Sunspots and other sun damage

• Uneven complexion

We also offer other aesthetic treatments that can be used alone or in combination with laser treatments to address these skin concerns. These include:

• Neuromodulators, such as Botox

• Dermal fillers

• Injectable deoxycholic acid for double chin and jowls

• Chemical peels

• Sclerotherapy for varicose and spider veins on the legs

• Intense pulsed light (IPL) therapy, including broadband light (BBL) therapy

• Radiofrequency skin tightening, which can be combined with microneedling