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Frequently Asked Questions

How do I make an appointment?

Please call 406.756.7555 to schedule with our receptionists.

Do I need a referral for a Dermatology appointment?

It is always best to check with your insurance company. Most commercial HMO’s require referrals from their primary care doctor.

Why am I being billed for a 20 minute visit per CPT code but I only talked to my doctor for 10 minutes?

Dermatology Associates does not bill a “skin exam” as a preventative/wellness code or visit. As a “Specialty Practice” we bill according to what is diagnosed. Our physicians bill by medical decision making that initiates your treatment plan not by time.

What is Mohs surgery?

Mohs is a surgery performed to conserve tissue and ensure the cancer is removed by looking at it microscopically before the area is closed up. The procedure takes several hours since the surgeon will take small amounts of tissue until the cancer is no longer seen at the edge of the specimen. Most of the time for the patient is spent in the waiting room while the tissue is processed and evaluated. Once the cancer is removed, the area is typically closed.

On the day of surgery, you should take your medications as directed, wear warm clothing (rooms get cold), bring some food to eat, and bring something to occupy your time, if desired (i.e., book, magazine, etc.). Plan to stay 4-5 hours at the clinic.

What causes acne?

Acne is an inflammation of the hair follicle. It is often due to various factors including genetics, skin type, sebaceous oil production, hormones, etc.

When can you take Accutane? What are the risks?

Accutane is an oral retinoid used typically to treat severe cystic acne. The risks are numerous especially since it is teratogenic. Discuss this medication with your physician to determine if it is appropriate for you.

Five Ways to Prepare for a Dermatology Appointment

  1. Compile Some Background Information.
  2. Write Down All Your Questions.
  3. Find Photos of Previous Flare-Ups.
  4. Wear Loose Clothing (and Minimal Makeup)
  5. Remove Your Nail Polish.

How often should I visit the dermatologist?

It is recommended that a person visit a dermatologist on an annual basis to have a full body exam.

If you have a history of skin cancer or a close relative that has had skin cancer, you should visit the dermatologist every 6 to 12 months.

Are all skin cancers the same?

Not all skin cancers are the same, melanoma has the greatest potential to spread quickly and be fatal.

Melanoma represents five percent of skin cancers but causes 85% of the skin cancer deaths. Treatment is almost always surgical excision and may combine radiation therapy and chemo therapy.

Squamous cell carcinoma (SCC) (from the Latin scaly, looks like fish scales under microscope) is the next most dangerous as it can also spread internally and can spread to skin from an internal cancer. This can also arise from the transformation of an actinic keratosis to SCC. Treatment can be surgical or cryosurgery depending on the tumor stage. In rare advanced cases of squamous cell carcinoma other adjuncts are used.

Basal Cell Carcinoma (BCC) is usually localized and in very rare instances can spread internally. BCC can be treated by surgical excision, electrodessication and curettage and superficially with topical chemotherapy.

The key to successful treatment is early diagnosis, frequent self screening and skin cancer surveillance by a board certified Dermatologist at an interval determined by the patient’s history, family history and sun exposure history.

What is the survival and risk of metastasis with BCC, SCC and melanoma? How do you treat the various cancers?

The survival of skin cancer is based on the type and variant. Non-melanoma skin cancer (basal cell and squamous cell cancers) typically do not metastasize and often are able to be treated with excision and close monitoring in the future. Melanoma has a higher risk of metastasizing and a higher mortality. The earlier a melanoma is found, the better. Besides excision, melanoma may require chemotherapy and more extensive therapies.

What are actinic keratosis (AK’s)?

Actinic keratosis is an atypical growth that may be pre-cancerous. It is called pre-cancer because a small percentage of lesions over time may become a squamous cell cancer. Actinic keratosis appear as scaly, firm papules that are usually more felt than seen. They may be treated with different methods, including cryotherapy or topical prescriptions.

What are seborrheic keratosis (SK’s)?

A seborrheic keratosis is a benign growth on the skin, sometimes known as “barnacles” or “wisdom spots.” They may increase in size and color. They are typically not removed unless in a location that causes them to get irritated or inflamed.

What are your suggestions for healthy skin?

  • Protect yourself from the sun
  • Eat a healthy nutrient rich diet
  • Don’t smoke
  • Cleanse twice a day
  • Hydrate or moisturize twice a day
  • Get plenty of rest