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Dr Ian Logan and Dr Conal Perrett authored an article on the ‘Management of Advanced Skin Cancer’.

Dr Ian Logan and Dr Conal Perrett, both Consultant Dermatologists at The Devonshire Clinic, authored an article on the  ’Management of Advanced Skin Cancer’ in the current edition of Dermatology in Practice. An excellent update on this important subject.

You can read their latest article here:
http://www.dermatologyinpractice.co.uk/clinical-management-of-advanced-skin-cancer

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Consultant Dermatologists at The Devonshire Clinic contribute to research into the use of Nicotinamide in chemoprevention of skin cancer

Keratinocyte cancers are the most common type of skin cancer amongst the light skin population, with rates increasing annually. The primary cause of this form of cancer is exposure to ultraviolet radiation, though it can also be a result of genetic disorders, smoking and immunosuppression. Immunosuppression can occur as a result of viral infections such as HIV or due to drugs given to patients who have received an organ transplant to help reduce the risk of rejecting the foreign organ. The risk of skin cancer in organ transplant recipients is dramatically increased compared the normal population and is therefore a significant problem in this group of individuals.

It is already well known that Nicotinamide has a variety of dermatological benefits. It has anti-inflammatory properties which can be used to treat bullous diseases and inflammatory acne, it can improve skin barrier function, increase skin hydration and help to improve complexion. Nicotinamide is now being studied for its potential benefits in the prevention of skin cancer and has been found to reduce the incidence of Keratinocyte cancers in high risk patients.

Two of our Devonshire Clinic Consultant Dermatologists, Dr Rubeta Matin (senior author) and Dr Conal Perrett, are authors on a recent study published in The British Journal of Dermatology. This paper explores the feasibility of a trial to evaluate the use of Nicotinamide for chemoprevention of skin cancer in organ transplant recipients.

The full research paper can be found here: https://www.ncbi.nlm.nih.gov/pubmed/3211911

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The Devonshire Clinic’s latest contribution to research into skin cancer treatment

It is with great pleasure that we would like to share with you our latest contribution to research into skin cancer treatment. These findings are the result of 10 years of research led by Dr Conal Perrett, Consultant Dermatologist at The Devonshire Clinic.

This paper, published in the latest edition of Dermatologic Surgery, details a retrospective study of the sequential treatment of a type of skin cancer known as superficial basal cell carcinoma (sBCC). BCC, according to the British Skin Foundation (2018) is the most common type of skin cancer, accounting for over 80% of cases. Research into the treatment of this type of cancer is therefore important. Superficial BCCs are characterized by their appearance; often a flat, scaly, red mark on the skin (British Skin Foundation ,2018). As a result of their superficial nature, an sBCC does not penetrate as deep into the skin and is, therefore, well suited for Topical Photodynamic Therapy (PDT) as opposed to other, more aggressive forms of BCC.

The individual positive effects of PDT and imiquimod 5% cream on sBCC have been well established. In this paper, Dr Conal Perrett, Dr Ian Logan and Dr Elizabeth Kulakov explored the sequential use of MAL-PDT and imiquimod 5% cream, recording the efficacy, tolerability and cosmetic outcome of the treatment.

Patients with primacy sBCC underwent 2 cycles of topical MAL-PDT followed by 6 weeks of imiquimod 5% cream. This method of treatment was found to be highly effective with long term recurrence occurring in only 10% of patients studied. Additionally, treatment was tolerated well by patients and had positive cosmetic outcomes.

We are delighted to see our Consultant Dermatolgists at The Devonshire Clinic  at the forefront of skin cancer research, with the sole aim of improving outcomes for skin cancer patients.

References:

https://www.ncbi.nlm.nih.gov/pubmed/32011386

https://www.britishskinfoundation.org.uk/bcc

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Consumers Warned Over ‘Clean’ Skincare Products

People have been advised to make sure that they properly familiarise themselves with what constitutes a so-called clean range of skincare products before they spend their money, as it may be that they’re not necessarily better or safer than traditional products.

An editorial in JAMA Dermatology, reported on by Reuters, suggests that descriptions of products as “natural” or “clean aren’t regulated, so many items may contain high concentrations of ingredients that could lead to allergies and irritation.

The definition of ‘clean’ can be open to interpretation but it’s generally viewed as being a way of saying that something is free from ingredients that could be a cause for concern. But because there is no standardised definition, different brands and different people can interpret ‘clean’ in their own way.

Report authors Dr Bruce Brod, dermatologist with the University of Pennsylvania, and dermatologist Dr Courtney Blair Rubin explained that they had noticed a trend in recent years of people coming to them with allergic reactions to natural beauty products, such as contact dermatitis and itchy rashes.

These conditions have been linked to natural or botanical ingredients in beauty products, Dr Brod confirmed. “Many of these products are marketed and sold to consumers who are misled to think the products are superior. We support free enterprise but want to make sure patients have all the available knowledge at their fingertips and choose products with their eyes wide open,” he went on to say.

Dr Brod also noted that the commercial personal care products industry is held to high standards, explaining that products are created to stop adverse reactions from happening, with preservatives and synthetic ingredients intended to prevent such complications.

So-called miracle skincare products come onto the market all the time but it’s important that you know your skin type and what you may or may not respond to before you buy. It’s also important to familiarise yourself with the ingredients in certain products so you can make informed decisions and not risk damaging your skin.

Speaking to a qualified and reputable dermatologist is the first step to ensuring that you are investing in the right kind of products for you and your skin. A good dermatologist will be able to advise you on the different treatments available to you as well as recommending a good home skincare regime.

There are numerous options available, from wrinkle injections, laser/IPL rejuvenation (to treat signs of sun damage on the skin like thread veins, pigmentation and uneven texture) to chemical peels, microneedling and laser skin resurfacing.

The team of expert dermatologists here at The Devonshire Clinic have extensive experience in treating skin diseases and medical conditions, so they have a deep understanding of the biology of your skin. We have the necessary expertise to deliver the most effective treatments while optimising the cosmetic outcome.

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Winter Sun Safety

It’s easy to associate stringent skin protection with the spring and summer months, and also winter holidays in the sun. With temperatures plummeting, winter in the U.K. firmly here, fewer hours of daylight and overcast days, it is still vital to employ vigilant sun protection, regardless of the weather or time of the year.

Even on the coldest of days the UV rays that cause skin ageing and skin cancer are reaching your skin. In the right conditions you can sustain skin damage just as easily as in the summer sun. Additionally, skin cancer detection rates are lower during the winter months, as people pile on the layers for colder weather, and neglect their essential skin health checks.

UVB rays, which are the main cause of sunburn, are the strongest in summer, however, UVB rays can burn your skin all year round. This is more prevalent at higher altitudes and on reflective surfaces such as snow and ice. Snow reflects up to 80 per cent of the sun’s UV light, which means that the harmful rays hit you twice, increasing the risks of skin cancer and premature ageing.

UVA rays are constant all year round, and can penetrate through clouds and fog. They can also penetrate glass resulting in possible skin damage while staying indoors on a bright winter day. Some studies have noted that UVA has an 80 per cent risk of causing premature ageing. UVA causes age spots, and destroy collagen which leads to skin sagging.

Unlike UVB rays, which cause sunburn, UVA rays penetrate deeper into the skin, causing invisible damage. The feeling of being burned by the sun is not present with UVA, and the side effects are slow acting, resulting in being unaware of the damage that is being done.

UVA makes up 95 per cent of the sun’s rays, making it all the more vital to protect against it in winter. It can, and will, create mutations in the DNA that can lead to aggressive basal and squamous cell carcinoma skin cancers.

The first line of defence in winter is clothing, not only as protection from the cold. Do not forget to adequately protect the face, head, and neck all year round, as this is where most skin cancers occur. UV-blocking glasses and a wide-brimmed hat are advised before heading out in to the sun. Sunglasses or ski goggles protect your eyes from snow glare, and a hat will protect your scalp, while keeping your head warm.

Apply a broad spectrum sunscreen to protect against both UVA and UVB rays, with a bare minimum of SPF-30 or higher repeatedly to all exposed skin throughout the day, ensuring that often missed spots, such as tops of ears, the hairline, and around the eyes. A moisturising sunscreen with ingredients such as lanolin or glycerin will also help combat dry winter skin.

No matter your location, also choosing a waterproof sunscreen is advisable, for the rain in England, snow while skiing, or the sea on sunny holidays. A lip balm with an SPF-30 will protect your lips, especially the lower lip, which is vulnerable to the sun’s rays. Avoid the sun when it is at its strongest, typically between 11am and 3pm.

Do not visit tanning booths to work on a ‘base tan’ before heading off to sunny winter holidays, as this exposure does not protect you from the harmful UVB rays, and it will actually increase the risk of skin cancers and premature ageing. There is a 20 per cent increase in melanoma with exposure to UV radiation from indoor tanning. Remember, there is no such thing as healthy tanning.

Certain creams and medications, for example retinol products and chemical peels can make the skin more photosensitive. Tetracycline-based antibiotics, including those used for acne treatment can increase the skin’s sensitivity to sunlight.

While paler skin is a factor in sun sensitivity, even those with darker skin can get damage from harmful rays. They might not suffer the effects as quickly due to having natural protection, but that certainly does not mean they cannot get skin cancer.

The sooner a skin cancer is detected, identified and treated, the better the chance of avoiding surgery or, in the case of melanoma or other skin cancers, potential disfigurement or even death. It is important to know your skin, develop a regular routine of checking your skin for any changes to existing moles or freckles.

Make sure you check your entire body as skin cancers can occur on parts of the body not exposed to the sun, such as the soles of the feet, between fingers and toes and under nails. Undress completely and make sure you have good light. Use a mirror to check hard to see areas such as the back and scalp.

It is important to consult a doctor or dermatologist immediately if any abnormal changes are discovered, and never ignore any of the warning signs such as the change in colour or shape of existing spots, raised, firm to the touch, bleeding or crusty moles. If left untreated, they can spread to other areas of the body.

It is not suggested that the darker winter months be spent in hibernation away from daylight entirely. The body requires vitamin D, of which sunlight is an excellent source. It is essential for a healthy body, teeth, and bones, and helps fight depression.

Staying safe, and protected from harmful sunlight is vital all year round, whatever the weather, and whatever the season, and not only yourself, but your family, and especially children. Keep covered, use high SPF factor sunscreen, and a little forward thinking will make sure you remain healthy and happy.

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8 Winter Skincare Tips For A Healthy Glow

Winter is upon us and as wonderful as this time of year can be, with all those festive parties and nights out celebrating in style with friends and family, it can really take its toll on our skin, leaving it looking and feeling dry, discoloured and even painful if we’re not careful. It’s not just the partying – the weather can have a big impact as well, leaving your skin feeling red, itchy and irritated.

The good news is that there’s a lot you can do to make sure that your skin takes the winter weather in its stride, no matter how many nights out you go on and no matter how much the wind, rain and snow tries to break you. You do have to be on top of it, however, so here are a few tips to help you make sure your skin stays looking healthy and glowing from now right through until spring.

Stay hydrated

Hydration will always be your skin’s first line of defence and you must make sure that you drink enough water each day to keep you well hydrated. If you wait until you’re thirsty, then you’re already dehydrated so try to have six sips of water or so each hour to keep you properly hydrated throughout the day.

Your skin will really thank you for this as drinking water can help to flush out toxins in your body that can result in breakouts, acne and dry skin. Remember that if you’re exercising you should drink an extra one to two litres of water per hour of exercise to keep your hydration levels up.

Take your makeup off

Again, this rule applies no matter what time of year it is but it’s perhaps especially important during the festive season when you’re likely to be out and about more, celebrating with loved ones. Always make sure that you take your makeup off at the end of the night before you get into bed, even if you can’t quite get it together enough to do your full nighttime skincare routine.

Remember that if a job is worth doing well, it’s also worth doing poorly – so always do the most that you’re able to at a particular moment in time, even if it’s just wiping your makeup off at 2am before falling fast asleep. Your skin will thank you for it in the morning, we promise.

Avoid foaming face wash

Your skin is likely to be drier at this time of year and if you find yourself really suffering, you might want to change the face wash you’re using, as this could be having an impact on the look and feel of your skin.

If you find yourself really struggling with dry skin right now and are worried that it’s only going to get worse, avoid foaming face washes like the plague. While these do make your skin feel incredibly clean, they strip it of all its natural moisture – which you really need during the winter months.

Instead, use an oil-based cleanser to take your makeup off and follow it up with something like this Ultra Facial Cleanser from Kiehl’s, which features avocado oil, vitamin E and apricot oil to keep your skin feeling soft and well hydrated.

Don’t forget the sun cream

You might think you don’t need to wear sun cream at this time of year but you’d be wrong… you should always make sure that you include sun cream in your skincare regime somewhere to make sure you’re protecting your skin from harmful UV rays. The easiest way of doing this is investing in a day cream that already has SPF in it, so you don’t even have to think about it.

Remember that if you’ve gone away for a snow holiday that snow can reflect the sun’s rays and increase your risk of exposure, so always make sure you protect your skin properly – even if you think it’s a bit of a grey day and the risks are minimal.

Eat healthily

Temptation is rife at this time of year and you should never feel guilty for overindulging on the cake, sweets and chocolates… but bear in mind that your skin may well reflect your dietary choices over the next few weeks so try and balance the gluttony out with lots of fresh fruit and vegetables as well.

Use a humidifier

Never forget that the drier the air at home, the drier your skin will be so you may want to increase the amount of water in the air. You can do this easily by using a humidifier either in the living room or the bedroom (or wherever you spend most of your time at home). This will increase moisture levels in the air and help your skin stay properly hydrated.

Try some light exfoliation

Exfoliation is essential for healthy skin and if you suffer from dry skin, you won’t be able to get rid of it easily without a bit of buffing each week. Go for a gentle product to help get rid of all those dead skin cells and make sure that you use soft gentle movements while exfoliating to avoid damaging the skin itself.

Exfoliate once or twice a week and remember that doing it more than this can actually have a negative impact on your skin and even make your skin look older than it is.

Don’t forget nighttime skincare

Make your products work hard for you even as you sleep, hydrating your skin without you even having to think about it. Anything with avocado in it will really help give you a hydration boost and you could even go for an overnight hydrating mask to make sure you wake up looking fresh as a daisy, no matter what the weather is doing outside.

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Here’s How Best To Apply Your Skincare Products

There are all sorts of different skincare products out there on shop shelves these days, so many in fact that it can be difficult to decide which ones are best for you and your skin type – although your London dermatologist can certainly help advise you as to what ingredients to look out for and what your skin will respond to best.

Once you’ve gone out and done your shopping, and have whisked all your new products back home to take pride of place in the bathroom cabinet, you can have fun trying them out and seeing what effect they have on your face, hands and body.

But did you know that there’s an optimum way to apply your products, especially on your face? There’s no hugely right or wrong way to go about it and whatever you put on your skin will be absorbed no matter what order you use your products in, but you could find that they’re more effective when used in a certain manner.

A good rule of thumb to adhere to is to make sure you apply your thinnest products first, finishing with the thickest, so serums and oils are applied early on in your skincare regime and your day and night creams should be used towards the end.

When you wake up in the morning, make sure you use a gentle cleanser to get rid of any excess oils that may have built up over night and to ensure that you’ve removed any traces of makeup that you may have missed in your nighttime cleanse.

For people with combination skin, one of the most important aspects of any skincare regime is toner so if you are both oily and dry, make sure you don’t miss this step out. Toner helps to rebalance the pH levels in your skin and will close your pores, getting your skin ready for serums and moisturiser.

Once you’re all toned up, you can start to apply your serums. Only use a tiny bit, about the size of a grain of rice… you don’t want to over-apply as this can clog your skin and the added benefit is that your products will last you for longer.

Follow this up with a touch of eye cream. Bear in mind that the skin around your eyes is thinner and more delicate, so find a product that will help fight the signs of ageing, with ingredients such as hyaluronic acid, a substance that’s naturally produced by the body, with its main function being to retain water and keep your skin nice and hydrated.

After you’ve used your serum, you can then use any facial oils you have, followed up by your day cream or moisturiser. If your creams don’t have SPF included, you’d be wise to apply something that can protect your skin from the sun as well. This should be the last step in your daily skincare regime.

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10 Essential Facts About Skin Cancer

Melanoma skin cancer is fifth most common type of cancer in the UK. Cases of melanoma have doubled in the last ten years with around 16,000 new cases every year. Whether you’re worried about a mole or just want to be informed, it’s good to know the facts about melanoma and other forms of skin cancer – especially since it can often be safely treated if it’s detected early.  

US study found that women who had five painful sunburns between the ages of 15 and 20 were 80% more likely to develop melanoma.

1. 86% of skin melanoma cancer cases are preventable.

Protecting yourself from the sun is the most effective way to prevent melanoma skin cancer. A US study found that women who had five painful sunburns between the ages of 15 and 20 were 80% more likely to develop melanoma. You can protect yourself by using sunscreen with at least SPF 30, seeking shade when it’s sunny and avoiding sunbed use. Newborns should avoid sun exposure.
Source

2. 90% of people survive melanoma skin cancer for 10 years or more.

Skin cancer is most safely removed with early detection. A Consultant Dermatologist can perform a biopsy on a mole that has recently changed its appearance to determine whether it’s benign or malignant. If results show it’s malignant, it may require further surgery to complete treatment
Source

3. 9 in 10 melanoma skin cancer cases are caused by the sun.

Exposure to UV rays from the sun can damage your skin cells and cause them to start growing out of control. You’re at risk of unprotected exposure to UV rays even while you’re sitting in your car. Getting a sunburn just once every two years can triple your risk of developing melanoma, so it’s important for children to protect their skin using sunscreen or protective clothing.
Source

4. 6 people die from melanoma skin cancer every day.

There are around 2,400 deaths from melanoma skin cancer in the UK every year. Melanoma accounts for 1% of all cancer deaths in this country, making it the 20th most common cause of cancer death. More men than women die from melanoma, although the mortality rate is highest in elderly people, especially in people aged 90 plus.
Source

5. Smoking can cause skin cancer.

A recent Leiden Skin Cancer Study of 1,126 people found that smoking is associated with an increased risk of squamous cell carcinoma, the second most common form of skin cancer. The study also found that smoking tobacco in higher doses – such as smoking pipes – lead to a higher risk than smoking cigarettes.
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6. 1 in 10 of melanoma cases run in the family.

About 10% of all melanoma skin cancer cases came from multiple-case families according to the National Cancer Institute. The study looked at a variety of determining factors in each case, including skin fairness, history of sunburns, excessive sun exposure, moles, weakened immune system and exposure to certain substances (like arsenic).
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7. There are three common types of skin cancer.

Most people don’t realise this. They are:

Basal cell carcinoma

Basal cell carcinoma, also known as rodent ulcer, is the most common form of skin cancer. They grow very slowly and do not spread to other areas of the body. They can be treated in almost every case, but treatment becomes more complicated if they have been neglected for a long period of time, so early detection is important.
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Squamous cell carcinoma

Squamous cell carcinoma is the second most common form of skin cancer, but it’s more dangerous since it can spread to the tissues, bones and nearby lymph nodes. Early intervention is critical because if squamous cell carcinoma spreads to other regions in the body it becomes much harder to treat.
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Melanoma

Melanoma is the least common form of skin cancer, but it poses the largest health risk. It’s becoming more common in the UK due to increased exposure to intense sunlight on holidays abroad. If melanoma is diagnosed and treated at an early stage, surgery is usually successful. It’s safest to see a Consultant Dermatologist if you’re worried about melanoma.
Source

There is no such thing as healthy tanning.

8. Sun beds increase your risk of melanoma by up to 20%.

Melanoma skin cancer can develop in areas that have been damaged by UV rays, which is what sun beds emit to give you a tan. They’re often marketed as a safe way of getting a tan, buts they’re not – in fact, using sun beds regularly can damage your skin more quickly than the sun, leaving it wrinkled and leathery. Cancer Research UK states: “There is no such thing as healthy tanning.”
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9. Skin cancer can occur anywhere on the body.

A freckle inside your eye might be ocular or eye melanoma; the eyelid is a common area for skin cancers like basal cell and squamous cell. While your legs and your trunk are most at risk from developing melanoma, skin cancer can be found in areas that never see the sun, such as the buttocks, inside the vagina and underneath the penis. When a dermatologist does a check up, they may ask you to spread your toes to see if skin cancer has formed there.
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10. The signs of skin cancer

The lumps and moles on your body may vary in their size, shape and texture, but it’s important to know the signs that a lump could be cancerous. Here’s what to look for:

  • Asymmetry – Half of the mole or spot doesn’t match the other half.
  • Border irregularity – The edges aren’t smooth but are ragged or notched.
  • Color – The coloration may be a mixture of tan, brown, and black. There may also be moles that are red, white, and blue in color.
  • Diameter – A mole that is larger than ¼ inch (6 mm).
  • Evolution – The mole may change in size, shape, and color. It may also become itchy and tender or the surface may change. Often, it will start to bleed. The color of the mole may change as well.
  • Melanomas can look less like a mole and more like a pimple that never heals. There may be symptoms like it oozes, bleeds, or hurts.

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Detecting skin cancer early makes it much easier to treat. If you notice any new lumps or changing moles on your skin, you should see your doctor as soon as possible. A qualified and reputable Consultant Dermatologist will be able to perform a biopsy on the lump or mole and provide the most effective treatment if it is malignant. Patients can self-refer directly to a Dermatology Clinic or ask their GP for a referral.

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Are Skin Diseases Contagious?

Skin diseases can be contagious or noncontagious and it is sometimes difficult to tell which condition you have from the symptoms. There are successful treatment options for both contagious and noncontagious skin diseases and a qualified Consultant Dermatologist can expertly diagnose and treat the condition for you.  

What makes a skin disease contagious?

A skin disease is contagious when it can be easily transmitted through contact with other people. There are five infectious agents that make a skin disease contagious: viruses, bacteria, fungi, protozoa and parasites such as worms. The disease spreads when these agents move from one host and begin to replicate inside another one.

“Skin diseases can be contagious or noncontagious and it is sometimes difficult to tell which condition you have from the symptoms.”

Contagious Skin Diseases

Impetigo 

Impetigo is a common skin infection that may cause sores, blisters and scabs, usually around the mouth and nose. It is caused by bacteria entering the skin through a cut or open wound and it can be spread to others through direct contact with the infected area. Impetigo can be caught at any age but is very common in small children. A Dermatologist will give your child antibiotics which are usually able to clear it up within 7-10 days but bear in mind that they will be contagious until the infection is gone.

Molluscum contagiosum 

Molluscum contagiosum is a viral skin infection that can occur at any age, although it usually affects children. It’s caused by a virus which is spread through contact: directly touching someone infected with the virus, touching objects contaminated with the virus and sexual contact. Typically, the only symptom is the appearance of painless but itchy spots in clusters that start to spread around the body. These spots typically appear in the armpit, behind the knees or on the groin and are often identified by the characteristic dimple in the middle of them. If you decide to seek treatment for molluscum contagiosum, your Dermatologist will typically treat the infection by giving you a gel or cream to apply to the affected areas. They can also remove the spots through cryotherapy (freezing treatment) or minor surgery.

Scabies

Scabies is a highly contagious condition caused by tiny mites that lay eggs in the skin. The first sign of scabies is an extreme itchiness which gets worse at night and often begins between the fingers, although it can occur anywhere on the body. It can be easy to identify visually from its distinct appearance: a raised line across the skin with a dot at one end, followed by a rash that spreads across the body and turns into small red spots. Scabies is easily spread through direct contact with the skin so it needs to be treated as soon as possible. Your Dermatologist will give you a cream to apply over your whole body, to be repeated within one week.

Ringworm 

Ringworm is a fungal infection – not a worm – that can be spread through direct contact with infected people, animals and objects which have been touched by an infected person. The main symptom of ringworm is a red or silver rash that’s scaly, dry, swollen or itchy and can appear anywhere on the body. If it appears on your scalp, it’s possible to lose hair on the affected area. Your Dermatologist can clear up the infection by giving you antifungal medication to kill the fungus in your body. This might include cream, tablets or shampoo if the ringworm is on your scalp.

Fungal infections 

Fungal infections are a broad term for a range of different skin diseases including athlete’s foot and yeast infection. They can be contracted in a variety of ways, such as direct contact with an infected object or by breathing in with fungal spores. Fungal infections usually grow best in slightly acidic environments, which is why they are often found on damp surfaces like the area around a swimming pool or shower. Your Dermatologist can treat most fungal infections with antifungal medicines, including creams and tablets.

Non-contagious Skin Conditions

Many skin conditions are non-contagious but still need medical attention. If you’re experiencing signs and symptoms of a skin condition, the safest option is to see a Dermatologist for a check-up.

Psoriasis

Psoriasis is a non-contagious chronic disease that causes red patches covered with silvery scales to appear on the skin. It’s thought to be caused by a problem with the immune system. People with psoriasis make and replace skin cells much more quickly than normal, reducing the process from the usual 3-4 weeks to just 3-7 days. This quick build-up of skin cells is what creates the patches on the skin. In most cases, your psoriasis symptoms will be mild until something triggers a flare-up, with the triggers varying from person to person. To identify your triggers and the specific type of psoriasis you’re experiencing, your Dermatologist will take a detailed history and examine your skin. This will help them decide on the best treatment, such as topical creams or phototherapy.

Hives

Hives are either a rash or a number of itchy red spots that can appear anywhere on the skin at any age. It’s not contagious but it can be very itchy, sore and uncomfortable. It’s not always possible to prevent hives appearing: they are caused by a wide range of triggers including food allergies, medicine, bug bites and even changes in light or temperature. However, your Dermatologist can give you antihistamines that will help to improve the condition.

Eczema

Eczema is a skin condition characterised by dry, red, itchy and uncomfortable patches. It can occur at any age and on any part of the body, although people with eczema typically have their first symptoms when they’re young – it affects around 20% of all children in the UK. Eczema can be exasperated by a variety of factors, including changes in water softness, strong detergents, smoking, stress and allergies. You Dermatologist can’t cure your eczema, but they can help keep your symptoms to an absolute minimum by giving you the right topical treatments and, in some cases, prescribing tablet medication.

Who should check your skin condition for contagiousness?

It’s important to know that many skin conditions share similar symptoms and are easily confused with each other, so checking the affected area visually is not likely to identify the condition accurately. The most qualified person to determine whether your skin condition is contagious or non-contagious is a Consultant Dermatologist. A qualified professional like a Consultant Dermatologist is the safest choice for identifying and treating your skin condition. You can either refer yourself directly to a reputable Dermatologist or ask a GP to refer you to a Dermatology Clinic.

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Everything you need to know before having a mole removed

Mole removal is a safe and common procedure with thousands of moles removed every year in the UK for both medical and cosmetic reasons. Whatever the reason for having your mole removed, it’s good to be informed, to know why and when removal is best advised and what to expect.

Medical reasons for mole removal

The main reason for removing a mole is when there is a suspicion it may be a skin cancer. The majority of cancerous moles come from new spots: the American Academy of Dermatology states that less than one-third of melanomas come from an existing mole. By removing the mole and an area of normal skin around it, the chances of any cancerous or precancerous cells being left behind are reduced and the chances of preventing further growth are increased.

Cosmetic reasons for mole removal

A mole may be benign (noncancerous), however, you may wish to have a benign mole removed for cosmetic reasons. Perhaps the mole is on an exposed area of your body such as your face, neck arms and hands or another area of your body that causes discomfort or embarrassment. Removing a mole for cosmetic reasons is increasingly common: a 2015 study found the number of British people seeking removal of a benign mole for cosmetic reasons  had increased by 127% in just one year. Scarring from mole removal can vary, however, with todays’ advanced techniques and a skilled surgeon, scarring is generally minimal.

“A 2015 study found the number of British people seeking the removal of a benign mole for cosmetic reasons had increased by 127% in just one year”

Mole Biopsy

Checking your moles often for any visual changes can help you spot risk factors early, but the safest option is to see a Dermatologist for regular check-ups, also known as mole screening. If your Dermatologist wants to check a mole for skin cancer or melanoma, they will perform a biopsy. The mole is removed in a procedure under local anaesthetic. You will be given a local anaesthetic by an injection at the place on your body where the biopsy will be taken from. The local anaesthetic may sting a little when it is injected, however the skin will then go numb and the operation should be pain-free.

The mole is then sent for examination under the microscope by a specialist pathologist who will determine if the mole is malignant or benign.

Methods of mole removal

The most common forms of mole removal are:

 Shave excision

This procedure is best for raised moles that aren’t too deep in your skin.

  • The lesion is scraped or shaved off using a very sharp blade, leaving a graze or small depression in the skin
  • The bleeding is stopped using an electric cautery machine. This procedure does not require stitches
  • A scab will form over the surgery site and may take up to two weeks to fully heal
  • This procedure usually leaves a pink scar which fades into a faint white scar

Excision with stitches

This is for moles that lie flat on the surface.

  •  The entire mole is removed with a small amount of normal skin around the edge.
  • There will be several stitches both above and below the skin surface.
  • The biopsy normally heals as a straight line that is usually three to four times the length of the lesion being removed.

What are the risks of having a skin biopsy?

All treatments and procedures have risks. The risks associated with having a skin biopsy are:

Pain

Local anaesthesia is usually effective for about two hours. The wound often feels tender after this time. Paracetamol tablets may be taken for pain relief as directed.

Bleeding

It is normal for a small amount of blood to come through the dressing. Any heavier bleeding can be stopped by applying firm pressure to the dressing for 15 minutes. If bleeding continues, you need to seek medical assistance.

If you have a large swelling under the wound, you may have had a more significant bleed. Any large swelling after surgery needs medical attention quickly, so go to your nearest Accident and Emergency department.

Bruising

It is normal to have some bruising around the surgery site, which will settle. The forehead, scalp and eyelids often bruise more easily than other sites.

Infection

Rarely a wound can become infected, and this will show up as increased pain, swelling, discharging pus and redness at the site of the wound 48-72 hours after surgery. If you are concerned that the wound has become infected, you should contact your Doctor. Infections can be treated with antibiotics. It is important that infected wounds are properly examined and treated.

Scarring

You will always have a scar following a skin biopsy as it is impossible to cut the skin without leaving a mark. The aim is always to leave you with the smallest scar that is possible for the procedure. Individuals will vary in the way they heal so not all scars will look the same.

The stitch line is likely to be red initially but this redness fades over a period of weeks to months. You will be left with a permanent scar in the area, the length and width depends of the type on operation performed and can sometimes be larger than the lesion being removed.

Some patients will produce a scar that is thicker than expected; this is called a hypertrophic or keloid scar. Certain areas such as the chest and back are more susceptible to this type of scarring.

Reducing scarring following removal of a mole

Your Dermatologist will provide advice with regards to minimising the risk of scarring and how to protect your skin during the healing process:

  • Minimise sun exposure and where possible avoid sun exposure completely.
  • Keep the area moist and clean. Petroleum jelly under a bandage may reduce scarring while the wound heals. Once the scar tissue has formed, it may be recommended to use a silicone gel or silicone strips for a few hours daily.
  • Once the wound has healed and the scab or crust is gone, you can massage the area gently. This invigorates the skin which stimulates collagen and aids the healing process.
  • In some cases, your Dermatologist may also suggest laser therapy or corticosteroid injections.

Who should remove your mole?

The most qualified person to decide if a mole should be removed is a Consultant Dermatologist. Only a  suitably qualified professional such as a Consultant Dermatologist or Plastic surgeon who specialises in surgical skin procedures should remove a mole. This helps minimise the risk of scarring or anything being missed during the diagnosis and removal stages. Patients can either self refer direct to a reputable Dermatologist or Dermatology Clinic or be referred by their GP.