Atopic eczema, also known as atopic dermatitis, is a chronic skin condition characterized by dry, itchy, and inflamed patches of skin. It often develops in early childhood and can persist into adulthood.

The exact cause of atopic eczema is not fully understood, but it is believed to be related to a combination of genetic and environmental factors. People with atopic eczema tend to have a weakened skin barrier, which allows irritants, allergens, and bacteria to penetrate the skin more easily. This can trigger an immune response, leading to inflammation and itching.

Topical Medications

These are medications that are applied directly to the skin, such as benzoyl peroxide, retinoids, and salicylic acid. They work by reducing inflammation, unclogging pores, and killing bacteria.

Oral Medications

In some cases, oral medications such as antibiotics, birth control pills, and isotretinoin may be prescribed to help manage acne.

Lifestyle Changes

Making changes to your diet and skincare routine can help prevent new pimples from forming. This may involve avoiding certain foods, using non-comedogenic skincare products, and keeping the skin clean and hydrated.

Some common treatments include:

• Topical medications: These are medications that are applied directly to the skin, such as corticosteroids, retinoids, and salicylic acid. They work by reducing inflammation and slowing down the production of skin cells. These may include ointments or creams for psoriasis.

• Phototherapy: This involves exposing the skin to ultraviolet light, which can help reduce inflammation and slow down the production of skin cells.

• Systemic medications: In some cases, oral or injected medications such as biologics and methotrexate may be prescribed to help manage psoriasis.

• Lifestyle changes: Making changes to your diet and lifestyle can help prevent flare-ups. This may involve avoiding certain foods, managing stress, and maintaining a healthy weight.

Some common Hyperhidrosis treatments include:

• Antiperspirants: Stronger antiperspirants containing aluminium chloride hexahydrate can help reduce sweating.

• Medications: Prescription medications such as anticholinergics and beta-blockers can help reduce sweating.

• Iontophoresis: This involves using a device to deliver a low-level electrical current to the affected area, which can help reduce sweating.

• Botox injections: Botulinum toxin injections can temporarily block the nerves that stimulate sweat production.

• Surgery: In severe cases, surgery may be recommended to remove or damage the sweat glands.

There are several methods of mole removal, including:

• Surgical excision: This involves cutting out the mole and surrounding skin with a scalpel or surgical scissors. This method is typically used for larger moles or those that are suspected to be cancerous.

• Shave excision: This involves shaving off the mole with a scalpel or razor. This method is typically used for smaller moles.

• Laser mole removal: This involves using a laser to destroy the mole tissue. The method of laser mole removal is not suitable for all moles and is typically used for smaller, non-cancerous moles.

After the mole has been removed, the area may be covered with a bandage or dressing. The area should be kept clean and dry, and any scab or crust that forms should be left alone to fall off naturally.

It’s important to note that mole removal should only be performed by a qualified healthcare professional. If you have a mole that you’re concerned about, you should schedule an appointment with a dermatologist or other healthcare provider to discuss your options.

Is Mole removal painful?

Mole removal can cause some discomfort, but it is typically not very painful. The level of pain can vary depending on the size and location of the mole, as well as the method used to remove it.

Local anaesthesia is typically used to numb the area before the mole is removed. You may feel a pinch or a mild burning sensation as the anaesthesia is injected, but this should only last for a few seconds. Once the area is numb, you should not feel any pain during the procedure itself.

After the procedure, you may experience some discomfort, such as a mild burning or stinging sensation, as the anaesthesia wears off. You may also experience some mild pain, swelling, or redness at the site of the removal for a few days afterward.

If you experience severe pain or any signs of infection, such as fever, pus, or increasing redness and swelling, you should contact your healthcare provider right away. They may prescribe medication or recommend other treatments to help manage your pain and promote healing.

Skin cysts are a thin lining filled with a cheese like material made of keratin.

There are many different types of cysts that effect the skin but the most common are:

• Epidermoid cysts, often incorrectly called sebaceous cysts, which are formed within the dermis arising from hair follicles. They have a central depression or punctum.

• Trichilemmal cyst, also known as a pilar cyst, is a keratin-filled cyst that originates from the outer hair root sheath. Trichilemmal cysts are most commonly found on the scalp and are usually diagnosed in middle-aged. They often run in the family. Unlike epidermoid cysts they often lack a central depression/punctum.

  
  

Cysts can become painful and on occasion are unsightly causing distress. Cyst removal surgery involves a small incision under local anaesthetic. As long as the cyst lining is fully removed it should not recur. If you are having a cyst removed ensure your surgeon is trained in the recognition and surgical treatment of cysts. Incomplete removal will allow the cyst to regrow.

Lipoma Removal

Lipomas are soft fatty lumps that form under the skin. They can become painful and often cause concern from a cosmetic point of view. Removal of a lipoma can be performed under local anaesthetic through an incision made into the skin long enough to allow the lipoma to be extracted. Some lipoma form within the superficial parts of muscles causing discomfort.

Lipomas can be numerous. When a person has multiple lipomas that become painful your doctor should consider a rare condition called Dercum’s disease.

Keloids can develop anywhere on the body, but are more common on the chest, shoulders, upper back, and earlobes. They may also develop in people with darker skin tones or a family history of keloids.

Treatment for keloid scars may include:

• Corticosteroid injections: These are injections of corticosteroid medication into the keloid to help reduce inflammation and flatten the scar.

• Silicone sheets or gels: These are placed over the keloid and help to soften and flatten the scar.

• Cryotherapy: This involves freezing the keloid with liquid nitrogen, which can help shrink the scar.

• Laser therapy: This involves using laser technology to reduce the size and thickness of the keloid.

• Surgical removal: In some cases, surgical removal of the keloid may be necessary, but there is a risk of the keloid returning or becoming larger.

• Radiation therapy: This is a less commonly used treatment, as it can increase the risk of cancer, but can be effective in reducing the size of keloids.

Imiquimod, also known as Aldara, is a cream that can be used to treat low risk superficial skin cancer and precancerous lesions and therefore avoid the need for surgery. Response rates are inferior to surgery and therefore its use should be limited to low risk lesions where recurrence is not going to be of a major concern. The cream comes in small sachets that are typically applied daily for up to 6 weeks depending on the lesion. Side effects are common and can be marked ranging from skin inflammation around the lesion to flu-like illness with muscle aches and pains. Your doctor should fully inform you of these side effects before commencing treatment

Efudix cream is licensed for treating solar keratoses. Efudix selectively destroys all precancerous cells in the top layers of the skin thereby avoiding the need for surgery. Typically it is applied twice a day for 3 weeks producing a red rash at the site of application. The end result is a crusted area that slowly returns to normal healthy skin over a further few weeks. It is usually prescribed in the winter months as the cream can increase your risk of sunburn if applied during the summer.

Photodynamic therapy (PDT) is a medical treatment that involves the use of a special light-activated medication, known as a photosensitizing agent, to destroy abnormal or cancerous cells in the body.

Over a certain amount of time the drug is absorbed by the cancer cells. Then light is applied to the area to be treated. The light causes the drug to react with oxygen, which forms a chemical that kills the cells. PDT can be used to treat superficial variants of BCC, actinic keratosis, squamous cell carcinoma-insitu (Bowens disease).

Daylight photodynamic therapy (PDT) is a type of PDT that is performed without the need for a special light source. Instead, it utilizes natural sunlight to activate the photosensitizing agent.

During daylight PDT, a photosensitizing agent is applied to the affected area of the skin. After a certain amount of time, the patient is instructed to go outside and expose the treated area to natural sunlight for a specific duration. The light from the sun activates the photosensitizing agent, which then targets and destroys abnormal or cancerous cells.

Compared to traditional PDT, daylight PDT has some advantages. It can be more convenient for patients, as it does not require a special light source and can be performed outdoors. It can also be less expensive, as it does not require the use of expensive light sources.

As with any medical procedure, it’s important to talk to your healthcare provider to determine if daylight PDT is the right option for your specific skin condition.

After the procedure, you may experience some redness, swelling, and discomfort at the treatment site. These side effects are usually temporary and should resolve within a few days to a week. In some cases, additional PDT sessions may be required to achieve the desired results.

Also referred to as liquid nitrogen or freezing therapy. Liquid nitrogen is delivered using a precise spray directly onto the skin lesion. It can be used to treat both benign and cancerous lesions. Depending on the lesion treated the area will be left with a white (depigmented) scar. In the initial 24 hours a large blister often forms. Pain is minimal after 48 hours. The advantage of cryosurgery is being able to treat a large number of lesions in one clinic and its relative inexpense to invasive procedures.

Performed under local anaesthetic C&C is a simple technique used to remove benign warts, seborrheic keratosis, actinic keratosis, squamous cell carcinoma insitu (Bowens disease) and low risk basal cell carcinomas. Depending on how it is performed C&C wounds are often slow to heal over several weeks, painful at first eventually leaving a hypopigmented scar.

Excision biopsy is performed under local anaesthetic typically to remove concerning skin lesions that are either skin cancer or possible skin cancer. This technique aims to remove the entire lesion to allow accurate diagnosis and also definitive treatment. Excision biopsy is the preferred treatment for most basal cell carcinomas off the face (for facial lesions consider Mohs micrographic surgery), squamous cell carcinomas, suspicious or changing moles and other types of skin cancer.

MMS is considered the ‘gold standard’ treatment for basal cell carcinoma skin cancer on cosmetically sensitive sites such as the central face or in situations where persevering as much normal healthy skin as possible is crucial such as on fingers and genitals. To understand the technique please watch the patient video produced by Dr Toby Nelson for the American College of Mohs Surgery.