Services

Our Services

From rashes to melanoma, Integrated Dermatology of Fairfax LLC is equipped to handle all your dermatological needs. To help you understand your options, we've included descriptions of some of our leading services on this page.

• Full Body Skin Exam
• Acne
• Boils
• Chicken Pox (Herpes Varicella )
• Eczema (Dermatitis)
• Skin Growths and Cysts
• Mohs
• Moles (Nevi)
• Poison Ivy, Poison Oak, Poison Sumac
• Psoriasis
• Rashes
• Rosacea
• Shingles (Herpes Zoster)
• Skin Cancers
• Warts
• Wrinkles

We also offer services on:

• Fillers
• Botox
• Chemical Peels
• Mohs Surgery for skin cancer
• Narrow Band Phototherapy for Psoriasis, Vitiligo, and Other Skin Conditions
• Xtrac Eximer Laser for psoriasis, vitiligo, and other skin conditions
• DermaGlow Skin Care Products
• Latisse
• Treatment for skin cancer

Acne

Acne is a common skin condition caused by the blockage of hair follicles by sebum (oil), dead skin cells, and bacteria. The blocked pores lead to whiteheads, blackheads, inflammatory papules or nodules (red, tender bumps), pustules (pus-filled bumps), and even cysts. Acne breakouts can occur at any age but are most common during the teenage years. Hormonal changes, certain medications, and the use of oily or greasy products are some factors that can contribute to breakouts. Acne breakouts most typically occur on the face, chest, back, and shoulders. Numerous treatment options are available, including but not limited to: over-the-counter products, prescription topical medications, oral prescription medications, photodynamic therapy, chemical peels, and laser therapy.

 

Microneedling

Microneedling is a minimally invasive procedure used to soften fine lines and wrinkles, improve skin laxity and texture, even skin tone, and diminish scars and signs of premature aging. Also known as collagen induction therapy, microneedling incorporates the use of a specialized pen with tiny motorized needles to stimulate the skin's natural healing process. Collagen is a vital protein which gives our skin strength and elasticity. Collagen synthesis begins by creating micro-injuries in the skin, and the end result is smoother, firmer, younger-looking skin. This procedure is performed in a safe and precise manner with the use of a sterile needle head, and it is normally completed within 15-30 minutes, depending on the required treatment and anatomical site. Best results are achieved after a series of microneedling treatments.

Integrated Dermatology of Fairfax uses the Strata MicroPen (previous known as Skin Stylus). Unlike other popular automated microndedling systems, the Strata MicroPen is the only micro therapy system that can be autoclave sterilized. The Strata MicroPen seven step safety system prevents cross-contamination between patients and incorporates the patent-pending Biolock cartridge. Safety is our priority!

While micro needling has many applications, it is most popular in our practice as a treatment for acne scarring. Call to schedule your consultation today!

 

Mohs Surgery

“1 IN 5 AMERICANS WILL DEVELOP SKIN CANCER IN THEIR LIFETIME”

What Can I Expect After Mohs Micrographic Surgery?

Following your surgery, we will discuss postoperative care with you and give you detailed written instructions on the care of your wound. You will leave with a compression bandage over the operative site that will stay in place for at least 48 hours. Swelling and bruising are common following Mohs surgery. A black eye is common with surgery around the eye or on the forehead and can be reduced by sleeping with your head elevated and using an ice pack. You should plan on wearing a bandage and avoiding strenuous physical activity for several weeks. Most patients experience minimal discomfort that responds to acetaminophen. You may experience tightness or tingling in the area of the surgery. Complete healing of the surgical scar takes over 12-18 months. Gentle massage of the area starting 1 month after the surgery will speed the healing process.

If you have sutures, you will need to return for suture removal. You may also need to return within one to three months after the surgery to ensure that the healing process is progressing smoothly.

About Our Staff and Dr. Kelley Pagliai Redbord

Our Mohs micrographic surgery unit is staffed by a team that includes a Mohs micrographic surgeon, surgical technicians, laboratory histotechnicians, and office staff who are here to serve you.

Dr. Kelley Pagliai Redbord is a board-certified dermatologist who specializes in Mohs micrographic surgery, skin cancer, and dermatologic surgery. Dr. Redbord, born and raised in Rockville, Maryland, received her Bachelor of Science degree at Duke University where she graduated cum laude and her medical degree from Johns Hopkins School of Medicine. After completing her dermatology residency as chief resident at the University of Cincinnati, Dr. Redbord completed a fellowship in Mohs Micrographic Surgery and Procedural Dermatology at the Laser and Skin Surgery Center of Indiana under the mentorship of Dr. C. William Hanke. Dr. Redbord is a member of the American Academy of Dermatology, the American College of Mohs Surgery, and the American Society for Dermatologic Surgery. She has presented original research at local and national conferences and written many articles on dermatology and dermatologic surgery. When Dr. Redbord is not practicing dermatology you can probably find her running. Dr. Redbord has completed 27 marathons and counting.

“MOHS HAS THE HIGHEST CURE RATE OF ANY TREATMENT OF SKIN CANCER”

MOHS MICROGRAPHIC SURGERY INFORMATION

WELCOME TO INTEGRATED DERMATOLOGY OF FAIRFAX

We are pleased that you have chosen our office for your surgical care. Our goal is to provide you with the highest quality care for the treatment of your skin cancer. You have been scheduled for treatment with Mohs micrographic surgery.

What is Mohs Micrographic Surgery?

Mohs micrographic surgery (“Mohs surgery”), named after Dr. Frederic Mohs who developed the technique in the 1940’s, is a precise treatment for skin cancer in which cancerous cells are removed in stages, one tissue layer at a time. A skin cancer often grows downward and outward into the skin like the roots of a tree. These “roots” are not visible with the naked eye, but can be seen under a microscope. Once a tissue layer is removed, the edges are marked with specially colored dyes, and a map of the specimen is created. The tissue is then processed onto microscope slides and carefully examined under the microscope by our Mohs surgeon, Dr. Kelley Redbord. When cancer cells are seen, an additional tissue layer is removed only in areas where the cancer cells are still present, leaving normal skin intact. The entire process is repeated until no tumor is found. This allows Dr. Redbord to save as much healthy skin as possible.

Mohs surgery allows for the selective and complete removal of the skin cancer while preserving as much normal tissue as is possible. Mohs surgery is useful for large tumors, tumors with unclear borders or extensive roots, aggressive tumors, tumors near vital structures, and tumors where other forms of treatments have failed. Mohs surgery is safe, reliable, and has a significantly higher cure rate than any other available treatment. No treatment can guarantee 100% chance of cure, but with Mohs surgery the cure rate for new basal cell and squamous cell carcinomas exceeds 98%.

Mohs surgery is done as a same-day outpatient surgical procedure that eliminates the need for general anesthesia, and operating room or hospital fees. Mohs surgery is performed by a physician who is both the surgeon and the pathologist and has received specialized training and certification in this technique and reconstruction.

Not all skin cancers require Mohs surgery. Skin cancer can be treated with electrodessication and curettage, cryosurgery, standard surgical excision, radiation therapy, topical immunomodulating agents, and photodynamic therapy. Your doctor has referred you for Mohs surgery based on special considerations regarding your skin cancer.

“SKIN CANCER ACCOUNTS FOR NEARLY 50% OF ALL CANCERS COMBINED”

What is Skin Cancer?

Cancer is an abnormal growth of cells at an uncontrolled rate. Left alone, cancerous cells will continue to grow and destroy surrounding normal tissue and can be potentially life threatening and disfiguring. The most common cancers that occur on the skin are basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. In general, basal cell carcinoma is the skin cancer type least likely to spread to other parts of the body. Squamous cell carcinoma tends not to spread, or metastasize, if treated early. However, if treatment is delayed or neglected, this skin cancer can spread to lymph nodes and other body areas. Malignant melanoma is a skin cancer that can be life threatening if not treated at its earliest stages. If untreated, melanoma has the greatest chance of spreading to other organs. Fortunately, this type of skin cancer is less common than basal and squamous cell carcinoma. Excessive exposure to sunlight is the single most important factor associated with developing skin cancers. Other factors, including genetics, radiation exposure and trauma can also contribute to the development of skin cancers.

Studies show that once you develop a skin cancer, there is an increased risk of developing others in the years ahead. For this reason, it is important for you to continue seeing your primary dermatologist at regularly scheduled intervals and to schedule an appointment if you are concerned about new or changing growths on your skin. The best way to minimize the risk of developing more skin cancers is to protect your skin from the sun’s damaging rays.

How Do I Prepare for the Day of Surgery?

1. The best preparation for Mohs micrographic surgery is a good night’s rest followed by a normal breakfast (this is not the type of surgery where you will need to have an empty stomach).

2. You should expect to spend the entire day with us. You may wish to pack a light lunch, snacks and/or beverages. You may also wish to bring a book or magazine to read or another quiet activity since there is waiting time between stages of surgery. Because the day may prove to be tiring, you can bring a companion to accompany you on the day of surgery.

3. Shower normally the night before or the morning of your appointment since your wound and bandage must remain dry for 48 hours after surgery. Do not apply perfume, aftershave, or cologne. Do not wear makeup or facial moisturizer if your skin cancer is on or near your face. Because you may leave with a bulky dressing, please wear loose clothing to facilitate undressing and redressing.

4 . If you have been instructed to take antibiotics before dental procedures or surgery, take your first dose of antibiotic one hour before your appointment. If you do not have a prescription, please call us as soon as possible before your surgery date so that we may call in a prescription to your pharmacy.

5 . You should take all of your daily medications as usual on the morning of your surgery. Additionally, if you are taking aspirin or prescription blood thinners (Coumadin/warfarin, plavix, etc) for a history of heart problems, stroke, blood clot, or other medical conditions, DO NOT discontinue unless specifically advised to do so by your prescribing physician.

6 . Please do not take any aspirin, vitamin E, gingko, ginseng, garlic, fish oil, herbal supplements, or anti-inflammatory pain medications (such as ibuprofen, Advil, Motrin, Aleve, Nuprin, etc.) for two weeks prior to your surgery unless #5 applies to you. These medications cause thinning of the blood, which can result in increased bleeding and bruising. Tylenol (acetaminophen) does not contribute to increased bleeding and can be used for pain relief.

7. Alcohol use may increase bleeding and should be stopped for 3 days before and after surgery.

8. Smoking causes changes in the bloodstream that interfere with the process of normal wound healing. This can negatively affect the cosmetic outcome of your surgery and limit our options for repairing your wound. Please make every attempt to quit smoking for at least 2 days before and 2 weeks after surgery.

9. You will have restrictions on your activity for approximately 1-2 weeks after surgery. This includes avoidance of heavy lifting, bending at the waist, swimming and strenuous activity (i.e. golf, exercise, yard work, etc.)

What Happens on the Day of Surgery?

You should plan on spending the entire day with us. The area around the site of your skin cancer will be numbed with a local anesthetic. Once the area is numbed, a thin layer of tissue will be removed and any bleeding will be controlled. The tissue will be mapped, color-coded, and sent to our on-site Mohs laboratory to be processed onto microscope slides. A bandage will be placed over the wound, and you will return to the waiting area.

On average, it takes an hour for the slides to be prepared and studied. Occasionally, tissue requires special attention and may take longer for processing or examination. If cancer is still present, an additional layer, or stage, is taken. The entire process is repeated until no tumor cells are seen. Although there is no way to tell how many stages will be necessary to remove your cancer, most Mohs surgery cases are completed in two to three stages. Therefore, Mohs surgery is generally completed in one day. Occasionally, however, a tumor may be extensive enough to necessitate continuing surgery a second day.

Once the skin cancer has been cleared, Dr. Redbord will discuss your options with you on the best method for treating the wound created by the surgery. At this point, optimizing the wound healing and final cosmetic result of your surgery becomes our highest priority. The wound can be treated by letting the wound heal by itself, closing the wound side to side with stitches, or closing the wound with a skin flap or graft. Rarely, a consultation with a reconstructive surgeon may be necessary.

Step 1
Skin cancer may have roots which extend beyond the visible tumor.

Step 2
Dr. Redbord surgically removes the visible tumor.

Step 3
Dr. Redbord divides the skin into layers and ‘maps’ the layers to the surgical site, using reference marks on the skin.

Step 4
The lab processes the tissue, so Dr. Redbord can microscopically examine the undersurface and edges of every section.

Step 5
If any cancer cells remain, Dr. Redbord will ‘map’ the location. She precisely removes another layer where the cancer remains.

Step 6
The tissue examination and removal stop when there is no evidence of remaining cancer.

What are the Risks of Mohs Micrographic Surgery?

1. Mild bleeding or oozing at the surgical site is fairly common. If you experience bleeding, you should move to a seated position and apply constant pressure on a gauze pad over the bleeding point for 20 minutes (timed); do not lift up or release the pressure at all during that period of time. If bleeding persists after continued pressure for 20 minutes, remain seated and repeat the pressure for another 20 minutes with an ice pack. If this fails, call our office or call the phone numbers provided on your postoperative instructions.

2. There will be a scar. Mohs surgery will leave you with the smallest wound possible thus creating the best opportunity for optimal cosmetic results. Dr. Redbord is available for you throughout the healing process to discuss any concerns that arise.

3. Itching and redness around the wound can indicate an allergy to bandage materials such as tape adhesive or antibiotic ointment. If you experience itching or a rash on the rest of your body after you have started an oral antibiotic or pain medication, this may indicate a medication allergy. If this occurs, please discontinue the medication and immediately call our office.

4. The skin cancer may be larger and deeper than expected and the wound may be larger than envisioned. The skin cancer may be near vital structures such as the eyelids, nose, or lips. If the tumor involves these areas, it may result in cosmetic or functional distortion.

5. There is a small chance that your tumor will regrow after surgery particularly if it was treated before, if it is large, or was present for a long time.

6. Infection following surgery is uncommon. A small amount of drainage on the bandage is to be expected.

7. In most cases, patients experience little discomfort after Mohs surgery. Tylenol (acetaminophen) does not contribute to increased bleeding and can be used for discomfort. We request that you do not take aspirin or ibuprofen-containing drugs for pain control. Additional pain medication may be prescribed if needed.

8. It is common for the area around the surgery site to feel slightly numb to the touch. This numbness may persist for several months before returning to normal or near normal. In rare instances, the area can stay numb permanently. In addition, some areas may be sensitive to temperature changes (such as cold air) following surgery. This sensitivity improves with time.

 

Moles (Nevi)

A mole, also known as a nevus (plural: nevi), is a very common skin growth. Moles develop as a result of clusters of melanocytes (pigment producing cells) in the skin. Although a mole can be present at birth (called a congenital nevus), most nevi appear during childhood and adolescence. Most people have between 10-40 moles. Moles can vary in size, shape, and color. Common moles are typically round or oval in shape. Though they can be various colors (pink, flesh colored, tan, brown, blue or black), most moles are uniform and homogeneous in color. Moles can be flat or raised and occur anywhere on the body. Some people can have moles which are more atypical in appearance - commonly referred to as atypical moles or dysplastic nevi. Atypical moles can be larger in size, more irregular in shape, and with more color variation. Though atypical moles are benign and not cancerous, they can be more difficult to differentiate from a deadly form of skin cancer called melanoma. Visit your dermatologist if you notice any new, unusual, changing, or symptomatic moles.

 

Psoriasis

Psoriasis is a skin condition that creates red patches of skin with white, flaky scales. It most commonly occurs on the elbows, knees and trunk, but can appear anywhere on the body. The first episode usually strikes between the ages of 15 and 35. It is a chronic condition that will then cycle through flare-ups and remissions throughout the rest of the patient's life. Psoriasis affects as many as 7.5 million people in the United States. About 20,000 children under age 10 have been diagnosed with psoriasis.

 

Rashes

"Rash" is a general term for a wide variety of skin conditions. A rash refers to a change that affects the skin and usually appears as a red patch or small bumps or blisters on the skin. The majority of rashes are harmless and can be treated effectively with over-the-counter anti-itch creams, antihistamines and moisturizing lotions.

 

Rosacea

Rosacea is a common skin condition which presents with redness of the face, small visible blood vessels on the nose and cheeks, and pimple-like breakouts. Rosacea can also affect the eyes (ocular rosacea) presenting with symptoms such as dryness, redness, burning, and itching of the eyes. Rosacea most typically affects middle-aged women. Though the cause is unknown, treatment options are available including: prescription topical medications, prescription oral medications, and laser therapy.

 

Skin Cancers

Skin cancer is the most common form of human cancers, affecting more than one million Americans every year. One in five Americans will develop skin cancer at some point in their lives. Skin cancers are generally curable if caught early. However, people who have had skin cancer are at a higher risk of developing a new skin cancer, which is why regular self-examination and doctor visits are imperative.

 

Warts

Warts are non-cancerous, benign growths on the skin that are caused by infection from viruses known as human papillomavirus (HPV). The most common type of warts include: common warts, plantar warts (warts that appear on the soles of the feet), flat warts, and genital warts. Warts can present as rough, raised, hard bumps with tiny black dots or cauliflower like growths. Warts are highly contagious and can easily spread by direct skin to skin contact or through contact with a contaminated object. Young children or people with weakened immune systems are most at risk for getting warts. Various treatment options for warts are available, ranging from at home remedies to treatments done in a doctor’s office.

 

Wrinkles

Wrinkles are a natural part of the aging process. They occur most frequently in areas exposed to the sun, such as the face, neck, back of the hands and forearms. Over time, skin gets thinner, drier and less elastic. Ultimately, this causes wrinkles - either fine lines or deep furrows. In addition to sun exposure, premature aging of the skin is associated with smoking, heredity and skin type (higher incidence among people with fair hair, blue-eyes and light skin).

Treatment for wrinkles runs the gamut from topical creams and moisturizers to cosmetic procedures. The most common medical treatments are:

• Alpha-hydroxy acids, preparations made from "fruit acids" that produce subtle improvements in the appearance of wrinkles.
• Antioxidants , creams consisting of Vitamins A, C and E and beta-carotene that improves the appearance of wrinkles and provides some additional sun protection.
• Moisturizers , which temporarily reduce the appearance of wrinkles.

Cosmetic procedures include:

• chemical peels
• fillers
• plastic surgery

The best prevention for wrinkles is to keep the skin moisturized and use sunscreen and sunblock to prevent additional damage from the sun.