When skin cell DNA develops mutations due to genetics or environmental factors, the resulting abnormal proliferation of cells usually becomes cancerous, initially affecting the epidermis, or top layer of the skin. Comprised of squamous cells, basal cells and melanocytes, the epidermis receives the full brunt of sun’s ultraviolet radiation, a type of electromagnetic radiation containing photons powerful enough to change the structure of a molecule’s chemical bond.

Melanoma, Basal Cell Carcinoma, Squamous Cell Carcinoma

Although a few people are genetically susceptible to suffering skin cancer, most are diagnosed with melanoma due to years of excessive exposure to sunlight or tanning beds. Further exacerbating the risk for experiencing skin cancer are people with a light to fair natural tone, those who sunburn easily and having more than three or four moles on the body. Additionally, an immune system weakened by serious medical conditions or immunosuppressant drugs cannot fight the negative effects of radiation as much as a healthy immune system can. As the most common form of skin cancer, basal cell (pre-cancerous) carcinoma appears as a waxy, pearly bump that is light brown to flesh-colored and does not usually spread like true melanoma. Some basal cell cancers will become crusty, itch and bleed but is considered much less dangerous than melanoma. Basal cell lesions are frequently seen on areas of the body consistently exposed to the sun, such as the face, neck and back.

Basal cell carcinoma, which grows more slowly than melanoma and is less likely to spread, is the most common type of skin cancer. Appearing in the form of pink or white irritated patches or pearly bumps, Basal cell cancer can cause skin to bleed and crust over, and can damage tissue surrounding it. However, like squamous cell carcinoma. Basal cell carcinoma is much less likely to be life-threatening than melanoma.

Squamous cell carcinoma is also found on the face, neck, hands and ears and can appear as a reddish, firm nodule or a scaly lesion that is flat with a crusted surface. Unlike basal cell lesions, squamous cell lesions grow and spread rapidly, which necessitates immediate testing of such  lesions by people discovering these growths.

While basal and squamous cell carcinoma are considered “pre-cancerous” growths, melanoma is genuinely cancerous and needs aggressive treatment measures involving surgical removal of the melanoma, chemotherapy, radiation therapy or a combination of all three. If melanoma is not detected in its early stages, it can metastasize and spread to the body’s internal structures.

Possible warning signs of melanoma are:

  • Moles that change in size, have irregular edges or bleed when touched
  • Abnormally large brown spots with darker-colored speckles inside the spots
  • Lesions with ragged borders that exhibit an aberration to the natural tone of the skin or appear bluish, blue-black, reddish or off white.

MOHS Surgery

For treating the different kinds of skin cancer that has not metastasized, Mayoral Dermatology offers MOHS, an acronym for micrographic surgery that has a 99 percent cure rate for specific types of precancerous and cancerous skin tumors.

Performed under local anesthesia, the MOHS involves Dr. Iriondo removing the tumor in addition to a thin piece of surrounding tissue. After preparing it and placing the tissue on a slide, Dr. Iriondo then examines the specimen for signs of cancer cell activity. If he detects the presence of cancer cells, another tissue specimen is taken and examined.

MOHS is a surgical technique that minimizes removal of healthy tissue since only cancerous tissue is excised. In general, the majority of tumors only need one, two or three excisions before cancer cells are eliminated.

Age/Liver/Brown Spots

Men and women over the age of 50 will begin to notice the emergence of these commonly seen discolorations of the skin on the hands, face, chest and back. Liver, age or sun spots all represent the same kind of skin condition and are easily removed by one of several treatments provided by Mayoral Dermatology..

Caused by exposure to sunlight over a long period of time, age, liver or sun spots all represent the same type of skin condition that also includes freckles, moles and lentigos. Wherever concentrated amounts of melanin have collected in the skin is where you will likely find these harmless but unattractive brown spots.

Eliminating brown spots or diminishing the darkness of age spots is easily accomplished with acid peels, microdermabrasion,  DermaSweep™MD, photodynamic therapy or Medilux IPL™.


Unwanted Hair

Although excessive and unwanted hair growth is not a serious health condition, it can be inconvenient, uncomfortable and, most of all, embarrassing. Factors contributing to an overgrowth of hair include heredity, hormonal changes (especially in menopausal women), medications, abnormalities of the endocrine system and stress. Men often want excess back, chest or shoulder hair removed to appear more well-groomed while women frequently desire hair removed from the upper lip, chin, bikini area and legs.

To safely remove unwanted hair, Mayoral Dermatology uses the revolutionary GentleYAG™ Laser System that targets hair follicles with a high-intensity light beam that radiates therapeutic heat. Combined with a burst of cool cryogen that shields the skin’s upper layers from the beam, GentleYAG™ is also effective at smoothing wrinkles and vascular lesions. For permanent removal of unwanted hair, patients will need several GentleYAG™ sessions due to the necessity of treating hair follicles only when they are in their active growth phase.

Topical anesthetic is offered to patients who are pain sensitive or if unwanted hair is dark and very thick. Slight reddening may occur following a procedure, with the natural tone of the skin returning in two to three hours after treatment.



When skin is damaged by injuries resulting from severe acne, chemical burns, surgical incisions or deep cuts, scars may form as part of the natural healing process. A scar represents an accumulation of extra collagen that contributed to the healing of wound, although the body’s response may seem exaggerated since that much collagen may not have been needed. Additionally, the reaction your skin has to the injury depends on factors like the size and depth of the wound as well as where the injury occurred. Immediately treating the wound may also prevent or reduce scarring if treatment is applicable.

Highly visible scars occur when the injury is severe and the skin has suffered extensive damage. Most scars tend to fade in time, becoming lighter in color and less uneven if they contain texture. Fortunately, noticeable scars that do not diminish in time can have their discoloration and roughness improved by effective dermatological treatments provided by Mayoral Dermatology.

For scar reduction purposes, we use one of several techniques: Smoothbeam™ Laser, DermaSweep™MD / Microdermabrasion or Blue Ultraviolet Light Photodynamic Therapy™.


Vascular Lesions

Broken capillaries or ruptured blood vessels often create discolorations called vascular lesions. Port wine stains, or birthmarks, are also included in the vascular lesion category, which are noticeable at birth and remain on the body throughout the individual’s life. Usually purplish red or  pinkish red in color, port wine stains tend to deepen in color as the person ages, sometimes developing soft tissue hypertrophy or angiomatous bleeding bumps on and around the port wine stain.

Spider veins (spider angioma) are much redder than the natural tone of the skin and consist of a small, irregular spot with spidery lines projecting from the center. Development of spider veins is common among pregnant women or women who take oral contraceptives. Other risks contributing to the emergence of spider veins are smoking, excessive exposure to UV rays, obesity, heavy drinking and untreated hypertension. Although spider veins are generally harmless, they can be conspicuously visible on the legs and face and often promote the loss of self-esteem or social phobia in people who are concerned about their appearance.

Our providers offer several, effective treatments to diminish the visibility of vascular lesions, such as Alma Harmony (IPL) and the Vbeam® Perfecta Pulsed Dye Laser.  Sclerotherapy, Vbeam® Perfecta Pulsed Dye Laser and the GentleYAG™ Laser are frequently used to reduce unsightly spider veins. Sclerotherapy is especially successful because it involves a simple injection of a solution that collapses damaged veins which prevents causes them to become invisible. In addition, sclerotherapy also eases night cramping, burning and inflammation symptoms sometimes caused by spider veins.



Appearing on the cheeks, forehead, chin and nose as a red, fiery-looking, bumpy rash, rosacea is a chronic disease primarily affecting people over 30 years old. Dermatologists have not yet pinpointed the exact cause of rosacea but know that it may be a non-bacterial skin irritation exacerbated by “triggers”that force the expansion of blood vessels and the emergence of classic, deep red, rash-like rosacea blotches.  These triggers include exposure to wind and sun; hot showers; alcohol, stress and extreme temperature changes.

For reducing the visibility of rosacea outbreaks, we employ several treatment techniques such as  Photo Dynamic Therapy™ and the Vbeam® Perfecta Pulsed Dye Laser. Most rosacea patients experience an 80 to 90 percent reduction in the intensity of the redness as well as relief from the burning and stinging suffered by some patients. Topical medications to help rosacea involve creams, lotions, serums and cleansers that improve natural tone and replenish nutrients vital to skin health.



Although acne is primarily prevalent among adolescents, it can still affect anyone at any age and is often a source of extreme psychological issues preventing someone affected by acne from living a full, rich life. Comprised of whiteheads, blackheads, pustules, cysts and nodules, acne can be mild or severe enough to cause noticeable scarring on the face, back, shoulders and neck. Like rosacea, dermatologists have not yet found the reason why some people develop acne and other do not but know that diet, stress, hormonal imbalances, genetics and certain vitamin deficiencies exacerbate acne flare-ups by increasing the amount of oil secreted by sebaceous glands.

Mild cases of acne can be treated with topical or oral medications while moderate to severe acne can be greatly improved by cutting-edge therapies provided by Mayoral Dermatology. Glycolic peels, blue ultraviolet light, PDT (photodynamic therapy), and the Candela Smoothbeam® laser can reduce the severity of active lesions and smooth away scarring created by previous acne outbreaks.


Enlarged Pores

Large pores on and surrounding the nose not only look unattractive but also create conditions favorable for the development of inflamed blemishes. Because enlarged pores present a deeper reservoir in which oil, dirt and dead skin cells easily accumulate, trying to maintain clear, beautiful skin is difficult when pores remain wide open. By using glycolic acid peels, Beta peels and TCA skin therapies, we can shrink those ugly, large pores, smooth your skin and replace blemishes with a healthy, natural tone that takes years off your real age.