Medical Dermatology


Many medical conditions can manifest on the skin. Skin manifestations can be the earliest signs of serious medical illnesses. Dermatologists at our clinic are the experts at diagnosis and management of these conditions. We have access to the full range of treatments including dermatologist-only medications for the more common conditions such as acne, eczema and psoriasis.

ACNE

Acne affects almost everyone during teenage years. However acne can be persistent in a significant proportion of individuals in their thirties and even forties. Some people can develop late-onset acne in adulthood. Many factors are at play in the causation of acne including sebum (oil) production, follicular occlusion (clogged pores), bacteria causing inflammation and hormonal factors. There are also increasing evidence for the role of dietary and lifestyle factors.

Moderate to severe acne can have significant impact on self-esteem and leave unattractive long-lasting scars if timely and effective treatment is not instituted. The psychological and social effects of acne scars on an individual are often underestimated. Thus it is important to recognize that acne can be effectively treated such that significant acne scars should only exist in the history books.

Acne treatment usually requires a combination of washes, creams and oral antibiotics. Some patients will also require hormonal treatments. Patients with severe acne may require oral isotretinoin which should only be prescribed by a dermatologist. Consultation with a dermatologist at our clinic is particularly recommended if your acne is severe or is not responding to treatment.

ECZEMA

Atopic dermatitis or eczema is a very common and increasingly more prevalent condition in the Western world. The cause of eczema is not precisely defined but is likely due to an interaction of genetic and environmental factors. Eczema affects children particularly and can have significant impact on their health due to itching, disrupted sleep and secondary infections. Severe eczema can cause growth delay and behavioral difficulties in the child as well as parental exhaustion and distress.

The management of eczema, like many chronic conditions, is complex. It usually requires a combination of topical care and alterations in diet and lifestyle. Patients with more severe uncontrolled disease may also require oral systemic treatment or phototherapy. Having an Eczema Management Plan tailored to the child’s specific needs is critically important in the long term. Dermatologists at our clinic can work with you and your general practitioner to develop this plan.

PSORIASIS

Psoriasis is a chronic relapsing scaly skin condition that can first appear at any age. It essentially is a genetic condition modified by environmental factors. Many sufferers only have a limited number of stable red scaly patches but the disease is occasionally more widespread or more serious such as pustular psoriasis or erythrodermic psoriasis. Moderate to severe psoriasis or psoriasis on exposed skin can significantly impact on quality of life including self-esteem, social interactions or career prospects. About 10% of psoriatics are also affected by arthritis, a debilitating problem in some patients.

The treatment of psoriasis is diverse and can include topical creams, phototherapy, oral medications or injectable biological agents. Consultation with a dermatologist at our clinic is advised for individuals with moderate to severe psoriasis or psoriasis not responding adequately to treatment as we have the full range of treatments for psoriasis.

PHOTOTHERAPY

Phototherapy involves the use of ultraviolet light to treat many inflammatory skin conditions including certain types of skin lymphoma. Doses of ultraviolet light are precisely delivered in a carefully controlled schedule to minimize risks. Phototherapy is particularly effective for psoriasis and eczema. Vitiligo can also be treated but usually requires a more prolonged treatment.

Narrow-band UVB phototherapy is used at our clinic for its effectiveness and patient convenience. We have the most advanced phototherapy units including the Waldmann UV 7002 for full body treatment as well as separate units to treat hands and/or feet only. Treatments are usually performed 2-3 times per week. The duration of treatment varies depending on the skin condition being treated.

SOLAR KERATOSES (SUN SPOTS)

Solar keratoses are common and are a marker of skin damage from previous sun exposure. They are scaly lesions that can be irritating at times. Treatment is usually recommended for these lesions as they are considered pre-cancercous and can progress to skin cancers in the longer term.

Individual solar keratosis can be treated by cryotherapy (freezing). However, patients with multiple lesions would need a field treatment. A range of field treatment options is available including imiquimod (Aldara), 5-fluorouracil (Efudix), diclofenac sodium (Solaraze), ingenol mebutate (Picato) and photodynamic therapy. Each of these treatment modalities has its own pros and cons. Dermatologists at our clinic can advise you of the most appropriate treatment for your skin.