Expert skin cancer care, close to home.

Western South Dakota gives people a great deal of time outside and a great deal of ultraviolet exposure to go with it. Elevation increases UV intensity, reflection off snow and water adds more, and work and recreation here happen outdoors in every season.

The result is a population with significant cumulative sun damage — and a real benefit from regular skin examination.

Basal cell carcinoma

The most common skin cancer. It typically grows slowly and rarely spreads, but it can invade locally and cause significant tissue damage if left untreated. Often appears as a pearly bump, a non-healing sore, or a pink patch that bleeds easily.

Squamous cell carcinoma

The second most common skin cancer, usually on sun-exposed skin. Often scaly, tender or crusted. It has a greater capacity to spread than basal cell carcinoma, particularly in certain locations and in people with weakened immune systems.

Melanoma

Less common, but responsible for most skin cancer deaths because it can spread. Early detection changes outcomes substantially. Look for a mole that is new, changing, irregular in border or color, or simply different from your others.

Actinic keratoses

Rough, scaly precancerous spots from cumulative sun exposure. A small proportion progress to squamous cell carcinoma, and treating the affected area reduces that risk.

Suspicious lesions are examined with a dermatoscope, which reveals patterns not visible to the naked eye. If pathology is needed, a biopsy is performed at the same visit under local anesthetic and takes only a few minutes.

Biopsy results are typically available within 2 weeks. Dr. Gaul reviews the pathology with you, and explains what the specific diagnosis means for you rather than reciting statistics.

The best treatment depends on the type of cancer, its size, its location, its growth pattern under the microscope, your health and your priorities. Options may include Mohs micrographic surgery, standard surgical excision, electrodesiccation and curettage, topical therapy, or referral for radiation or systemic treatment in selected cases.

Mohs surgery is generally chosen for cancers on the face, ears, nose, lips, eyelids, hands, feet and genitals, for recurrent cancers, for cancers with aggressive microscopic features, and where sparing healthy tissue matters most. Read about Mohs surgery.

If the right treatment for your cancer is something better provided elsewhere, we will tell you and help arrange it.

Having had one skin cancer raises the likelihood of another, so follow-up examinations become part of your routine care. We will recommend an interval based on your history and explain what to watch for between visits.

This page is general education and is not medical advice, diagnosis or treatment, and it does not create a physician–patient relationship. Individual circumstances differ; please discuss your own skin with a qualified clinician. If you are having a medical emergency, call 911.