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Dermatology is concerned with the diagnosis and treatment of diseases of the skin, hair, nails and adjacent mucous membranes. As well as medical problems, such as acne, warts and psoriasis, our dermatologists (skin specialists) are also skilled in cosmetic dermatology, treating problems such as scars and age-related skin deterioration.
The dermatology specialists at the London Bridge Hospital have the skills, experience and equipment to perform a wide range of dermatology treatments, including:
What is acne?
Acne is a very common skin disorder which usually starts around puberty. Although most of us grow out of acne, it often causes much unhappiness for young people and can sometimes last a long time, often late into adult life.
Most people with acne have a greasy skin and commonly, blackheads nodules and pus filled spots, typically of the face and back. If acne remains untreated, it can lead to permanent scarring of the skin.
What are the causes of acne?
In most cases acne is simply associated with the changes in body hormones that occur during adolescence. This is why it tends to cure itself over time. The tendency to acne also tends to run in families and severe acne often appears to have a hereditary basis.
It ‘s unusual for acne to be caused by an underlying disease although patients may need assessment by a specialist to ensure that they do not have any major hormonal problem (for example polycystic ovaries in women) or more rarely an acne reaction to an external agent such as medication or a work related chemical. Very few specialists these days believe that acne is caused by diet or a food allergy.
How can acne be treated?
In the first instance, you should seek the advice of your pharmacist. Many over the counter treatments are helpful for early or mild acne. Preparations based on Benzoyl Peroxide are of particular benefit, although you should follow the instructions to ensure that they do not irritate your skin.
For more severe forms of acne your General Practitioner (family physician), may prescribe antibiotics, usually in tablet form, which can be very effective. It may be necessary for you to take these for several months as the benefits do not appear overnight. If you are female, your doctor may also advise the use of a hormone treatment such as Dianette which works rather like the oral contraceptive pill.
If, despite treatment you are not improved, you should consider consulting a specialist dermatologist. You will have a fuller assessment of your skin and general health and any tests that you may require can be arranged. If your acne is severe, it’s quite likely that your dermatologist will suggest treatment with isotretinoin (Roaccutane/Accutane) which can be dramatically effective in curing many forms of acne. Isotretinoin is a safe, well established treatment but it can only be prescribed by dermatologists with special training in its uses and risks. Before being prescribed isotretinoin, you can expect to have a full discussion with your specialist about the side effects, cost and precautions relating to this drug.
Are there any acne treamtents which don't involve taking drugs?
Yes, there is a growing body of medical evidence showing that certain forms of intense light or laser can be helpful in improving acne - and without any major side effects. Our understanding of the correct use of these new therapies is changing all the time and you should obtain up to date advice from a specialist with experience in this field.
Liquid nitrogen treatment of various skin lesions, including verrucae, seborrhoeic keratoses, actinic keratoses.
Removal of lesions by surgical excision and the revision of scars, both under local anaesthetic.
Freckles are pale brown flat marks that develop on the skin in relation to sun-exposure. They are particularly common in very fair complexions, especially on the face and forearms. They are often seen in childhood. Freckles tend to be more prominent in the summer and may fade in winter. Freckles cannot become malignant themselves, but they are a warning of excess sun exposure and individuals with a tendency to freckle need to be extra-careful about sun-protection.
Intralesional injections for various conditions, including scars.
The medical term for a mole is a pigmented naevus. They are collections of the pigment cells (melanocytes) in the skin. Usually a mole is slightly raised and brown in colour, but they can be pink or flesh-coloured. Most individuals with European skin will have some moles. Moles may be present at birth (congenital) or develop through life (acquired). Congenital naevi tend to be darker and larger than acquired naevi and may become thickened on the surface and hairier with time.
Most people have between 10-20 moles on their body. The number of moles that an individual develops depends on genetics (how moley their family is), how fair their skin is, and how much sun-shine they have had. It is common to form new moles up until the age of about 25 years. The majority of moles are entirely harmless (benign). However, occasionally a mole may become malignant in which case it is called a malignant melanoma. Some malignant melanomas develop without a preceding mole.
Fortunately malignant melanomas are relatively rare, but none-the-less it is an important thing to be aware of, as caught early it can easily be removed and the outlook is very good. About 7,000 people a year develop melanoma in the UK, and it is increasingly common in young adults.
What should I look out for in a mole?
If a mole-
Changes in shape
Changes in colour
Changes in size significantly
or Suddenly appears
it should be checked by your doctor. If necessary they may arrange a biopsy to check that the mole is not harmful.
Other Reasons to remove a mole
Sometimes moles may be removed because they are a nuisance, rather than harmful e.g. catching on clothes and bleeding. This is a very quick and straight forward procedure with a local anaesthetic.
Occasionally people want to have a mole removed because they consider it unsightly. If a mole is removed for cosmetic reasons it is important to consider the risk of scarring and the acceptability of the end result, before the procedure. This is especially important on the face.
For further information see :
For chronic actinic damaged skin.
Provision and follow up of systemic drugs in dermatology for example, Methotrexate and Cyclosporin.
Treatment for melanomas using the latest technology, for example, Photo Dynamic Treatment.