Learn more about the different forms of treatment available for the following conditions…
The causes of rashes are many and varied. The first step is to diagnose the rash. Most rashes can be diagnosed clinically and appropriate investigation and treatment recommended. However some rashes may require a biopsy to try to confirm the diagnosis.
Acne is a very common condition that usually affect the face or upper chest and back of young adults. However acne can occur at any age. It is usually first treated with topical preparations bought over the counter. If these are ineffective the next option is antibiotics taken by mouth over a period of 3-6 months. If this is ineffective then Isotretinoin (also known as Roaccutane) can be used. Although a lot has been written about this drug the side effects are generally predictable and reversible. It has to be prescribed by a dermatologist.
Rosacea is commonly referred to as “adult acne” but it is different from acne in several respects. First it usually affects adults between ages of 30 and 50. It can cause spots similar to acne spots. The other aspect of rosacea is flushing and redness of the face. Both the spots and the redness require different approaches to treatment and this would have to be discussed at a consultation.
Eczema and dermatitis mean the same thing. This is a type of rash which has many different causes and calling it eczema or dermatitis does not define the precise cause or likely prognosis of the skin problem.
Psoriasis is a very common skin disease affecting up to 4% of the population. Most people with psoriasis have fairly mild disease and treat their skin with over the counter preparations or prescriptions from their GP. Some people with psoriasis need more specialised treatment and are referred to see a consultant dermatologist. There is a range of treatments available from hospital based dermatology departments depending on the severity of the disease.
Urticaria is a common skin condition that causes weales on the skin that appear and resolve within 24 hours. In chronic urticarial that persists longer than two months it is very unusual to find an underlying cause. It is usually treated with antihistamines.
Hyperhidrosis means increased sweating. It is important to consider an underlying cause for hyperhidrosis if it is of sudden onset. Most people do not have a medical cause and treatment is the priority. There are various antiperspirants that can be successful. Botox is a safe and effective way of controlling under-arm sweating.
Basal cell carcinoma, sometimes called rodent ulcer is the most common of all cancers. In some Western countries it is more common than every other cancer put together. It is caused by long-term sun exposure in people with pale skin. Basal cell carcinoma usually occurs on the head and neck although it can also appear on the back and chest. There is no risk of it spreading to other parts of the body. It is usually removed by excision biopsy. Occasionally they can be difficult to remove, especially at difficult cosmetic sites such as around the nose or eye. The gold standard method of removing basal cell carcinoma is by Mohs’ micrographic surgery.
Melanoma affects about 1,200 of the Scottish population per year. It is thought to be due to intermittent sun exposure in susceptible individuals. Sunbeds have also been shown to increase a person’s risk of developing melanoma. Some melanomas arise from pre-existing moles but they often appear in previously normal skin. Usually they appear as dark brown irregular moles but the important thing is that they tend to be changing over time is size shape and colour. They should be removed by excision biopsy as soon as possible. Thereafter further treatment is offered on the basis of the pathology noted from the first excision.
Actinic keratoses are common scaly patches or papules on sun exposed parts of the skin. They are due to long-term sun exposure and are often referred to as a barometer of sun damage. They commonly occur on the hands, face and scalp but can occur anywhere that has been exposed to the sun. There is a very small risk of actinic keratosis developing into a squamous cell carcinoma. There are various treatments available that can be discussed at the time of your appointment.
Squamous cell carcinoma is the second most common skin cancer after basal cell carcinoma. Around 3,000 cases occur annually in Scotland. Most squamous cell carcinomas occur on the head and neck as a result of cumulative sun exposure. People who are immunosuppressed such as those who have had a renal transplant are at increased risk from squamous cell carcinoma.
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Excision biopsy is a method of removing a skin sample under local anaesthetic. It involves an injection of local anaesthetic into the skin to numb the area. The sample to be removed is normally cut out in an ellipse. The defect is then stitched and left to heal for about 5 to 14 days before the sutures are removed.
Shave biopsy is a non-invasive way of removing a mole or other benign skin lesion. Local anaesthetic is injected into the skin below the mole. It is then shaved off parallel to the skin and sent for histological examination to determine the precise diagnosis. The base of the wound is then cauterised to prevent bleeding. When healed this usually gives a very good cosmetic outcome.
This method of removing a skin lesion is non-invasive and does not require stitches. Local anaesthetic is used to numb the area. The lesion is removed by scraping the lesion level with the skin and cauterising the base to prevent bleeding. It usually heals well with very little residual scarring.
Lasers can be used for treating a variety of skin conditions. Vascular lasers can be used for removing redness and small blood vessels. Pigment lasers are for hair removal, tattoo removal and for skin pigmentation treatment. Resurfacing lasers are used for ablating skin lesions such as benign moles, and for removing scarring and wrinkles. Details of these treatments are available through SK:N which houses the best collection of lasers in Scotland.
This is a new group of drugs licenced for treating advanced basal cell carcinoma.
Botox is a very effective way of reducing under-arm sweating. It is administered by giving multiple injections of Botox into the skin under each arm. It can be a little uncomfortable but results in reduced sweating for 3 to 6 months. It can then be repeated if desired. To arrange Botox treatment contact Ross Hall Hospital on.
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I had just been told after attending the Mole Clinic at my local pharmacy that I could potentially have a melanoma on my right leg. Obviously I was very worried and upset by this and when I met Dr. Herd he did his best to try and reassure me. The mole was removed and after a few anxious weeks my results came back fine. I have since seen Dr. Herd on a regular basis over the years for annual skin check ups and I find that his calming and friendly manner gives me peace of mind.