Skin Conditions
We can treat the following skin conditions:
Psoriasis
Psoriasis is a chronic inflammatory skin condition characterised by clearly defined, red and scaly plaques (thickened skin).
Psoriasis usually presents with symmetrically distributed, red, scaly plaques with well-defined edges. The scale is typically silvery white, except in skin folds where the plaques often appear shiny and they may have a moist peeling surface. The most common sites are scalp, elbows and knees, but any part of the skin can be involved. The plaques are usually very persistent without treatment.
Itch is mostly mild but may be severe in some patients, leading to scratching and lichenification (thickened leathery skin with increased skin markings). Painful skin cracks or fissures may occur.
When psoriatic plaques clear up, they may leave brown or pale marks that can be expected to fade over several months.
Treatment:
Depending on the severity there are a variety of treatments
that may be used alone, or in a combination designed to suit the individual.
These include topical creams, oral medications, Intralesional steroid injections, and targeted photodynamic
therapy.
Eczema (Dermatitis)
Dermatitis affects about one in every five people at some time in their lives. It results from a variety of different causes and has various patterns.
The terms dermatitis and eczema are often used interchangeably. In some cases the term eczematous dermatitis is used. Dermatitis can be acute or chronic or both.
Acute eczema (or dermatitis) refers to a rapidly evolving red rash which may be blistered and swollen.
Chronic eczema (or dermatitis) refers to a longstanding irritable area. It is often darker than the surrounding skin, thickened (lichenified) and much scratched.
Treatment:
LED light therapy can be used to improve the appearance of eczema.
Depending on the severity there are a variety of treatments that may be used alone, or in a combination designed to suit the individual.
These include topical creams and oral medications
Warts
Warts are tumours or growths of the skin caused by infection with Human Papillomavirus (HPV). More than 70 HPV subtypes are known.
Warts are particularly common in childhood and are spread by direct contact or autoinocculation. This means if a wart is scratched, the viral particles may be spread to another area of skin. It may take as long as twelve months for the wart to first appear.
Treatments:
Electrosurgery
- is used for particularly large and annoying warts. Under local anaesthetic, the growth is pared away and the base burned by diathermy or cautery.
Other treatments include
- Chemical treatment - pastes and creams
- Cryotherapy - The wart is frozen with liquid nitrogen
Vitiligo
Vitiligo is an acquired de-pigmenting disorder of the skin, in which pigment cells (melanocytes) are lost. It presents with increasing numbers of white patches.
Vitiligo affects 0.5–1% of the population. In half of sufferers, pigment loss begins before the age of 20. In one fifth, other family members also have vitiligo. Males and females are equally affected.
Even though most people with vitiligo are in good general health, some of them face a greater risk of having autoimmune diseases such as diabetes, thyroid disease, pernicious anaemia (B12 deficiency), Addison disease (adrenal gland disease) and alopecia areata (round patches of hair loss).
Treatment:
Dermapen can be used in combination with specialized creams to improve this condition.
Roseacea
Rosacea is a chronic rash involving the central face that most often affects those aged 30 to 60. It is common in those with fair skin, blue eyes and Celtic origins. It may be transient, recurrent or persistent and is characterised by its colour, red.
Treatments:
Other treatments
- Chemical treatment - pastes and creams
- Antibiotics
- Combination treatments of the above as prescribed.
Hidradenitis Suppurativa
Hidradenitis suppurativa (HS) is a common, chronic skin disease characterized by clusters of abscesses or subcutaneous boil-like "infections" that most commonly affects the underarms, under the breasts, inner thighs, groin and buttocks. The disease is not contagious.
HS outbreaks are painful in tender areas and may persist for years with interspersed periods of inflammation, often culminating in sudden drainage of pus. This process often forms open wounds that will not heal and frequently leads to significant scarring.
Treatment:
Photodynamic
therapy
Lamprobe
(Clinical Skin Clear)
Surgical removal
Other treatments include:
- Oral antibiotics and Creams, lifestyle modifications
- Combination treatments of the above as prescribed.
Acne and Acne Scarring
Acne is a common chronic disorder affecting the hair follicle and sebaceous gland, in which there is blockage of the follicle and inflammation.
Who gets acne?
Acne affects males and females of all races and ethnicities. It is prevalent in adolescents and young adults, with 85% of 16-18 year olds affected. However, it may sometimes occur in children and adults of all ages.
Treatments:
Lamprobe
(Clinical Skin Clear)
Other treatments include:
- Oral medications and specialized creams
- Combination treatments of the above as prescribed.
Sun Damaged Skin (uneven skin pigmentation)
The sun has a profound effect over years of exposure on the skin, causing premature skin aging, skin cancer, and many other skin changes. Exposure to ultraviolet (UV) light from the sun accounts for most premature skin aging. Many skin changes that were commonly believed to be due to aging, such as easy bruising and uneven pigmentation are actually a result of prolonged exposure to the sun.
Skin texture changes caused by UV exposure (eg, from sunbathing, tanning) include thick skin in coarse wrinkles, especially on the back of the neck (cutis rhomboidalis nuchae), and thinning of the skin causing fine wrinkles, easy bruising, and skin tearing, particularly on the forearms and back of the hands.
Blood vessel changes lead to bruising with only minor trauma in sun-exposed areas. The sun also causes the appearance of tiny blood vessels (telangiectasias) in the skin, especially on the face.
Skin color changes caused by sun exposure are common. The most noticeable sun-induced pigment change is brown spots (solar lentigos). Light-skinned people are particularly prone to freckles. Large freckles, also known as age spots or liver spots, can be seen on the backs of the hands, chest, shoulders, arms, and upper back. UV exposure can also cause small white spots on the legs, backs of the hands, and arms (guttate hypomelanosis) as well as red areas on the sides of the neck (poikiloderma of Civatte).
Moles (nevi) are usually seen in sun-exposed areas. Although it is normal to acquire new moles from childhood through young adulthood, their formation is stimulated by the sun. Most moles are normal; atypical moles, which are seen in non-sun-exposed areas and are larger and more irregular than normal moles, serve as an indicator that the person with these types of moles may be prone to developing melanoma, a type of skin cancer.
Treatment:
Other treatments include:
- Daily use of appropriate sunscreen
- Medically proven creams and healthy lifestyle.
- Combination treatments of the above as prescribed.
Folliculitis
Folliculitis is an inflammation of the hair follicles. Each hair on your body grows out of a tiny pouch called a follicle. You can have folliculitis on any part of your body that has hair. But it is most common on the beard area, arms, back, buttocks, and legs.
Causes
It may be caused by bacteria. It also can be caused by yeast or another type of fungus.
You may get folliculitis if you have damaged hair follicles. Shaving or wearing clothes that rub the skin can irritate the follicles, which can lead to folliculitis. They also can become blocked or irritated by sweat, machine oils, or makeup. When the follicles are injured, they are more likely to become infected.
Treatment
Dr Flora will prescribe the best treatment depending on the cause and severity.
Sebaceous Hyperplasia
Sebaceous hyperplasia is the term used for enlarged sebaceous glands seen on the forehead or cheeks of the middle-aged and elderly. Sebaceous hyperplasia appears as small yellow bumps up to 3 mm in diameter. Close inspection reveals a central hair follicle surrounded by yellowish lobules. There are often prominent blood vessels, best seen using dermoscopy.
Sebaceous hyperplasia is a form of benign hair follicle tumour. The lesions are sometimes confused with basal cell carcinoma.
These damaged oil glands can become enlarged and clogged in a very specific manner, displaying a soft or firm white or yellowish outer rim with a depressed center. The depressed center of these bumps is one of the primary ways you can tell you're dealing with sebaceous hyperplasia, and not with something else such as a whitehead (milia).
It's not uncommon to have several of these bumps at once, sometimes spaced apart, but they can be clustered, too. Sebaceous hyperplasia is most often seen on the forehead and central part of the face, but can appear anywhere on the body, especially in areas where the skin has more oil glands.
Treatment:
Skin Tags
Skin tags are made up of loosely arranged collagen fibres and blood vessels surrounded by a thickened or thinned-out epidermis.
Skin tags develop in both men and women as they grow older. They are skin coloured or darker and range in size from 1mm to 5cm. They are most often found in the skin folds (neck, armpits, groin). They tend to be more numerous in obese persons and in those with type 2 diabetes mellitus.
Treatment:
Other treatments can include:
- Cryotherapy (freezing)
- Surgical removal
- Electrocautery / Electrosurgery
Melasma
Melasma is a chronic skin disorder that results in symmetrical, blotchy, brownish facial pigmentation. It can lead to considerable embarrassment and distress.
The cause of melasma is complex. The pigmentation is due to overproduction of melanin by the pigment cells, melanocytes, which is taken up by the keratinocytes (epidermal melanosis) and/or deposited in the dermis (dermal melanosis, melanophages). There is a genetic predisposition to melasma, with at least one-third of patients reporting other family members to be affected. In most people melasma is a chronic disorder.
Known triggers for melasma include:
- Sun exposure and sun damage — this is the most important avoidable risk factor
- Pregnancy — in affected women, the pigment often fades a few months after delivery
- Hormone treatments — oral contraceptive pills containing oestrogen and/or progesterone, hormone replacement, intrauterine devices and implants are a factor in about a quarter of affected women
- Certain medications (including new targeted therapies for cancer), scented or deodorant soaps, toiletries and cosmetics — these may cause a phototoxic reaction that triggers melasma, which may then persist long term
- Hypothyroidism (low levels of circulating thyroid hormone)
Melasma commonly arises in healthy, non-pregnant adults. Lifelong sun exposure causes deposition of pigment within the dermis and this often persists longterm. Exposure to ultraviolet radiation (UVR) deepens the pigmentation because it activates the melanocytes to produce more melanin.
Treatment:
Milia
A milium is a small cyst containing keratin (skin protein); they are usually multiple and are then known as milia. These harmless cysts present as tiny pearly-white bumps just under the surface of the skin.
Milia are common in all ages and both sexes. They most often arise on the face, and are particularly prominent on the eyelids and cheeks, but they may occur elsewhere.
Milia may not need to be treated unless they are a cause for concern for the patient. They often clear up by themselves within a few months.
Treatment:
Other treatments can include:
Seborrhoeic Keratoses
Seborrhoeic or seborrheic keratoses are very common harmless skin lesions that appear during adult life. Seborrhoeic keratoses may also be called basal cell papillomas, senile warts or brown warts.
Seborrhoeic keratoses are harmless and rarely or never become malignant.
They begin as slightly raised, skin coloured or light brown spots. Gradually they thicken and take on a rough, warty surface. They slowly darken and may turn black. These colour changes are harmless but may result in the lesion looking like a melanoma (a type of skin cancer).
They appear to stick on to the skin like barnacles. Seborrhoeic keratoses appear on both covered and uncovered parts of the body, and there may be one or many of them.
Seborrhoeic keratoses can easily be removed. The usual reason for removing a seborrhoeic keratosis is your wish to get rid of it. For example it may be unsightly, itch or rub against your clothes. Occasionally your doctor may recommend its removal because of uncertainty of the correct diagnosis.
Treatment:
Other treatments can include:
Cryotherapy
Cholesterol Deposits (Xanthelasma)
Xanthomas are skin lesions caused by the accumulation of fat in macrophage immune cells in the skin and more rarely in the layer of fat under the skin.
Some types of xanthoma are indicative of lipid metabolism disorders (e.g. hyperlipidaemia or high blood fats), where they may be associated with increased risk of coronary artery heart disease and occasionally with pancreatitis.
The main aim of treatment for xanthomas that are associated with an underlying lipid disorder is to identify and treat the lipid disorder. In many cases, treating the underlying disorder will reduce or resolve the xanthomas. In addition, treating hyperlipidaemia will reduce the risk of heart disease, and treating hypertriglyceridaemia will prevent pancreatitis. Dietary and lifestyle modifications with or without medication are used to treat lipid disorders.
Dietary measures should include:
- Prepare most meals from vegetables, salads, cereals and fish
- Minimise saturated fats (found in meat, butter, other dairy produce, coconut oil, palm oil)
- Minimise intake of simple, refined sugars found in fizzy drinks, sweets, biscuits and cakes
- If obese or overweight, aim to slowly reduce weight by reducing caloric intake and increasing exercise.
Treatment:
Fibromas
Fibromatosis is a condition where fibrous overgrowths of dermal and subcutaneous connective tissue develop tumours called fibromas. These fibromas are usually benign (non-cancerous).
Whilst most fibromatoses are benign tumours and do not metastasise (spread to other parts of the body), the desmoid tumours although they do not metastasise like malignant cancers can be locally aggressive. They can grow quickly into large tumours that can obstruct vital structures such as major blood vessels, nerves and organs
Treatment:
Solar Keratoses (Sun spots)
Rough scaly spots on sun-damaged skin are called actinic keratoses. They are also known as solar keratoses.
Actinic keratoses are a reflection of abnormal skin cell development due to exposure to ultraviolet radiation. They are considered precancerous or an early form of squamous cell carcinoma.
They appear as multiple flat or thickened, scaly or warty, skin coloured or reddened lesions. A keratosis may develop into a cutaneous horn.
Actinic keratoses are very common on sites repeatedly exposed to the sun especially the backs of the hands and the face, most often affecting the nose, cheeks, upper lip, temples and forehead. On the lips they are often called actinic or solar cheilitis. They are especially common in fair-skinned persons or those who have worked outdoors for long periods without skin protection. Sun-damaged skin is also dry, discoloured and wrinkled.
Actinic keratoses themselves are harmless, but they can be uncomfortable and unsightly.
The main concern is that actinic keratoses can give rise to a type of skin cancer called squamous cell carcinoma. The risk of squamous cell carcinoma occuring in a patient with more than ten actinic keratoses is about 10 to 15%.
Actinic keratoses are usually removed because they are unsightly or uncomfortable, or because of the risk that skin cancer may develop in them. If a actinic keratosis becomes thickened or ulcerated get it checked; it may have become a skin cancer. Squamous cell cancers often look like volcanoes erupting within the skin.
People with keratoses should visit their doctor regularly for examination as they are also at risk of developing basal cell carcinoma and malignant melanoma.
Treatment:
Other treatments can include:
- Specialized creams like - Aldara, Picato Gel, Efudix
- Surgical Removal
- Cryotherapy
The treatment will be tailored to the individuals needs and expectations.
Cherry Angioma
Cherry angiomas may develop on any part of the body but they appear most often around the midtrunk. They can be red, blue, purple, or almost black. Cherry angiomas increase in number from about the age of 40. Their cause is unknown.
Cherry angiomas are also known as Campbell de Morgan spots.
Cherry angiomas are made up of clusters of capillaries at the surface of the skin, forming a small round dome ("papule"), which may be flat topped. They range in colour from bright red to purple. When they first develop, they may be only a tenth of a millimeter in diameter and almost flat, appearing as small red dots. However, they then usually grow to about one or two millimeters across, and sometimes to a centimeter or more in diameter.
As they grow larger, they tend to expand in thickness, and may take on the raised and rounded shape of a dome. Multiple adjoining angiomas are said to form a polypoid angioma. Because the blood vessels comprising an angioma are so close to the skin's surface, cherry angiomas may bleed profusely if they are injured
Treatment:
Other treatments can include:
- Surgical Removal
- Electrocautery
Age Spots (Liver spots)
Age spots — also called liver spots and solar lentigines — are flat tan, brown or black spots. They vary in size and usually appear on the face, hands, shoulders and arms — areas most exposed to the sun.
Age spots are very common in adults older than age 50. But, younger people can get them too, especially if they spend a lot of time in the sun.
Although age spots can look like cancerous growths, true age spots are harmless and don't need treatment. For cosmetic reasons, age spots can be lightened with skin-bleaching products or removed. However, preventing age spots — by avoiding the sun and using sunscreen — may be the easiest way to maintain your skin's youthful appearance.
Treatment:
Sebaceous Cyst
A cyst is a sac-like pocket of membranous tissue that contains fluid, air, or other substances. Cysts can grow almost anywhere in your body or under your skin.
There are many different types of cysts. Most cysts are benign, or noncancerous.
Whether a cyst requires treatment depends on several factors:
- the type
- the location
- if the cyst is causing pain or discomfort
- whether the cyst is infected
When removing a cyst, we aim to remove it completely, as the cyst might form again if part of the sac wall remains under the skin.
Infected cysts may require further treatment.
Cyst removal at our office involves:
- a local anesthetic, to numb the area
- antiseptic swabs, to prevent the area from becoming infected and to stop infections spreading
- using a blade and other instruments to remove the cyst