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Medical Dermatologic Procedures





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Dr. Cook performs a variety of in-office procedures related to medical dermatology. Photodynamic Therapy and XTRAC Excimer Laser Treatments are administered by a trained staff member. See below for a brief description of some of the procedures offered through the

Maui Medical Group Dermatology Department



Dr. Cook uses cryosurgery to remove troublesome, unwanted skin lesions by applying liquid nitrogen to the skin with a sprayer.  A stinging or burning sensation that usually lasts only 20-30 minutes is often felt and the lesion treated will turn red. After an hour or two usually no further discomfort is felt. Some patients experience a slight tenderness for several days. A blister often forms within 24 hours of the treatment.  On the hands, fingers, feet, and toes this could look like a blood blister, this is a normal response. It is not necessary for a blister to form for the treatment to be effective. Liquid nitrogen will leave a white scar.  Sometimes more than one treatment is needed to remove a large or deep lesion. 


Click here for post cryosurgery care instructions



Electrodessication is the use of an electric current to cause local destruction to the skin surface. This procedure is utilized to treat superficial skin cancers, along with other unwanted skin lesions.  This procedure usually requires a small amount of local anesthesia to prevent discomfort during the treatment process.    


Click here for post electrodessication care instructions



Levulan® Kerastick® (aminolevulinic acid HCl) for Topical Solution, 20% (LEVULAN KERASTICK) plus blue light illumination using the BLU-U® Blue Light Photodynamic Therapy Illuminator (LEVULAN KERASTICK and BLU-U PDT) is indicated for the treatment of minimally to moderately thick actinic keratosis of the face or scalp. Actinic keratoses (AKs) are rough-textured, dry, scaly patches on the skin that can lead to skin cancer. ​The procedure involves the in-office application of the Levulan to the specific skin surface being treated and allowing to absorb on the skin for a time period between 1-3 hours. During this time the patient remains in-office. After the incubation period the specific skin surface is then exposed to Blue Light for a period of 16 minutes. Slight burning/stinging can be felt during the 16 minutes of treatment. A second FDA approved medication, Ameluz® (aminolevulinic acid hydrochloride) gel, 10% for the lesion-directed and field-directed photodynamic therapy of actinic keratoses of mild- to-moderate severity on the face and scalp may also be used. We our now offering a combination of PDT + IPL. The Intense Pulsed Light or IPL treatment is not covered by insurance and estimated out of pocket cost is $300. The IPL treatment targets discoloration such as sun spots or brown spots and the outcome is in incredible.  Feel free to contact our office for more information. 


Click here for post photodynamic care (blue light) care instructions



A skin biopsy is taking of tissue from living skin for the purpose of tissue examination and cell identification.  Three different types of biopsy options depending on the specific concern are available.  The three types of biopsies are: shave, punch, or excisional biopsy.  All three options involve numbing the skin with local anesthesia. Minimal discomfort is experienced post procedure.   


Click here for post biopsy care instructions



Incision and drainage is a procedure to treat skin cysts that have turn into an abscess.  This procedure involves anesthetizing the skin, creating an opening to the lesion, and removing the debris from the abscess. In some cases packing is necessary to ensure proper healing.  In addition patients may be given an oral antibiotic. 


Follow care instructions provided to you at appointment



An intralesional injection is used to treat a variety of conditions including psoriasis, keloids, prurigo nodularis, alopecia areata, some forms of acne, along with other dermatologic conditions.  This procedure involves injecting a small amount of corticosteroid directly into the lesion.  



Intramuscular injections can be helpful to treat specific types of dermatites or allergic reactions. 



The XTRAC Excimer Laser is used to treat psoriasis. Currently Maui Medical Group is the only location on Maui for this treatment. The treatment is painless. involves no systemic side effects, and requires no downtime.  Treatments take about 10 minutes depending on how large of an area is being treated. Optimal results are seen when patients are treated twice a week for a minimum of five weeks.  The XTRAC Excimer Laser can also be used to treat Atopic Dermatitis and Vitiligo but these two conditions are not always covered by medical insurance. Visit for more information.

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