General Dermatology

General dermatology

The Dermatology Unit is dedicated to providing individualised treatment in a professional, clean and caring environment. Run by leading dermatologists from major London teaching hospitals, the unit brings a wealth of expertise and dedication to the treatment of skin. Our caring team of highly experienced specialists and friendly support staff will ensure that your care will be of the highest standard.

We recognise the sensitive nature of skin problems, ensuring our patients are dealt with by caring staff who value you as our highest priority.

Conditions we treat

Acne

Acne is a common skin condition, particularly in teenagers and younger adults with about 80% of people aged 11 to 30 affected at some point.

It is most common in girls from the ages of 14 to 17, and in boys from the ages of 16 to 19. It generally disappears in the mid-twenties but about 5% of women and 1% of men experience problems over the age of 25. Acne most commonly develops on the face then the back and chest and, although it cannot be cured, it can be controlled with self-help techniques, creams and lotions.

Developing acne, which can range from blackheads to nodules and cysts, is normally associated with hormonal changes in puberty that cause the grease-producing glands next to hair follicles in the skin to produce larger amounts of oil. The excess mixes with dead skin cells and clogs the follicles leading to contamination.

More than 80% of adult acne occurs in women with hormone changes due to periods, pregnancy and the common condition, polycystic ovary syndrome. Other triggers for outbreaks of acne are some cosmetics, certain medications and smoking.

A GP examination can determine the severity of the acne and prescription medicines such as topical creams – an approved therapy for acne. Dermatologists are on hand at the hospital to advise on all aspects of acne as well as conduct a wide range of treatments from mild to severe and persistent outbreaks. They can manage conditions and also provide procedures to treat acne scarring.

Warts

Warts are small, rough lumps or growths that develop on the skin, most commonly on the hand, knees and feet. A wart on the sole of the foot is known as a verruca. They range in size from 1 mm to 1 cm across. They are caused by the human papilloma virus (HPV) which promotes an excess of keratin to develop in the top layer of skin.

They can be spread from person to person through direct personal contact or contaminated objects such as towels, shoes, socks and the floors surrounding swimming pools and in communal changing areas. Most people will have warts at some point in their life but they are mainly harmless and recede over time, although this can take months or even years.

Creams, gels, freezing sprays and medicated plasters can be used but a GP may recommend you see a dermatologist for expert assessment.

A stubborn wart or verruca can be surgically removed by scraping it away with a small, spoon-shaped tool, or with electrosurgery which uses an electrical current to burn it away. A dermatologist may also recommend stronger creams.

Seborrhoeic warts

These are flat-topped, rough patches of skin that can be pigmented or even appear black. They appear to be stuck onto the skin and develop from a velvety texture to a granular feel and appearance.

Their presence and frequency increases with age and seborrheic warts are believed to be a degenerative condition and their likelihood can be accelerated by exposure to the sun. This can cause irritation, pain and embarrassment, particularly as they can appear on the face and the torso, and although benign they can be removed by a dermatologist.

Skin tags

Skin tags usually occur on the neck, armpits and around the groin and can measure from a few millimetres up to about two inches wide.

They can develop in men and women and incidence increases with age and it is estimated that half the population will get a skin tag at some stage of their lives. They occur more regularly in pregnancy and are particularly common in patients with type 2 diabetes and obesity.

Their cause is not fully understood but it is believed that human papillomavirus (HPV), insulin resistance and metabolic syndrome may play a part.

They are not malignant or contagious but can cause irritation and chaffing. They are easily diagnosed by a GP but removal should be conducted by a dermatologist.

Skin tags can be snipped off with surgical scissors or treated with a laser to degrade the growth. Some can be treated with photodynamic therapy which involves an application of a chemical which is activated by a strong light resulting in the destruction of the skin tag.

They can also be frozen off or surgically removed under local anaesthetic.

Milia

Milia is often referred to as milk spots. They are cysts that often form in groups on the nose, cheeks, forehead and eyelids. They appear as white bumps and are common in newborns but usually clear up within a few weeks. Older children and adults can develop Milia, which are caused by the skin tissue protein keratin becoming trapped beneath the surface of the skin.

In newborns, it is often mistaken as baby acne but research has shown that babies are born with Milia whereas acne occurs post-birth. The causes of Milia in older children and adults are associated with skin damage such as blistering, burns, rashes, long-term sun damage.

These dome-shaped bumps, usually white or yellow, are not normally painful but can become irritated or reddened with contact to clothing or bed sheets. The Milia normally disappears in a few weeks but treatments can be applied to more persistent outbreaks and patients are advised to see a dermatologist if the condition does not clear up. They use a range of minor procedures and medications to restore the skin to normal.

De-roofing, or using a sterile needle to pick out the contents of the cyst, is a standard procedure. Diathermy, the use of electrically induced heat, is effective at clearing cysts. Experts also employ destruction curettage, which involves surgical scrapping and cauterization, and cryotherapy, which freezes the cyst. The procedures are fast, painless and are done as out-patient treatments. Medications, such as topical creams, and chemical peels can also be used.

Liver spots

Liver spots are effectively patches of skin that have been damaged by exposure to the ultraviolet rays of the sun and usually appear on the face, hands, arms, shoulders and the scalp if you are bald.

The sun causes the body’s natural pigment-making cells to over produce melanin in one spot creating a darkened patch of skin over a number of years. Liver spots tend to increase with age as the skin struggles to repair the damage of ultraviolet light.

Freckles are smaller than sunspots and can be inherited while sunspots appear on anyone. They were called liver spots because of a believed connection to the health of the liver but that theory has been disproved.

The best way to avoid sunspots is to cover up and stay out of the sun, particularly between 10 am and 1 pm when its rays are at their strongest.

Liver spots can be treated with a range of techniques such as carefully applied chemical peels which are safe and effective. A solution is applied that causes the top layer of skin to separate and peel off, leaving newer skin with a better tone and colour.

Cysts

A skin cyst is a fluid-filled lump just underneath the skin which may develop into a boil or a skin abscess. They don’t normally hurt but can be tender, sore and red if they become infected. The cyst forms a dome-shaped bump which is yellow or whitish with a small, dark plug from where pus can emerge.

They are harmless and subside in time but it is advisable to have them checked by a GP to make sure it is not something else that needs treatment. Anyone can develop a cysts but it is more likely if you have had acne or are going through puberty.

They are caused when the surface layers of skin cells move deeper into the skin and multiply rather than being shed by the body. The skin then creates a sac and produces keratin which forms a thick, yellow substance. Some cysts form around hair follicles, typically affecting middle aged adults, while others are commonly found on the face, neck, chest, shoulders or skin around the genitals and are more likely on people who have had acne.

A GP or dermatologist should be consulted if the cyst grows rapidly, ruptures or becomes infected or is troubling for cosmetic reasons. Skin cells can be scraped off and examined under a microscope or a skin sample can be sent for detailed analysis by a laboratory.

A range of treatments are available including injecting the cyst with a medicine to reduce the swelling and inflammation, a small incision to the cyst under local anaesthetic followed by the pus being gently squeezed out, and minor surgery to remove the entire cyst. A carbon dioxide laser can also be used to destroy the cyst and antibiotics may be prescribed on their own or in combination with the procedures.

Lipomas

Lipomas are non-cancerous and are caused by an excess of fat cells. They can emerge anywhere on the body but are normally found on the shoulders, neck, abdomen, arms and thighs.

They are soft and doughy to touch and, although not normally painful, they can cause discomfort and pain if they grow and press on nearby nerves. About 1% of the public will develop a lipoma but it is unusual to have one or more of them.

If you notice a swelling anywhere on your body, have it checked out by your doctor. Lipomas tend to run in families, indicating a genetic factor, but their cause is unknown. They can occur at any age but are more common between the ages of 40 and 60-years-old.

A GP will examine the lump and may remove a tissue sample in a biopsy for laboratory examination and to rule out the small chance that it might be a rare liposarcoma, a cancerous tumor of fatty tissue – these grow rapidly, don’t move under the skin and are painful so are very different to lipomas. A GP may also recommend an ultrasound scan.

Treatments for lipoma include surgical removal under local anaesthetic with a technique known as minimal excision extraction which reduces the risk of scarring.

Liposuction, using a needled and large syringe to remove the lump, can be effective or the lipoma can be shrunk with steroid injections. This does not eliminate it and the dermatologist may subsequently advise surgical removal.

Contact us

Our experts at London Dermatology Unit have many years of experience in dealing with conditions of the skin and are able to perform advanced procedures to ensure you relief from any pain or discomfort that you may be experiencing.