Mole screening

Moles (also called naevi) are usually harmless collections of pigmented cells called melanocytes in the skin. It can be important for patients (especially those at higher risk) to become familiar with the moles on their skin so as to be able to detect changes .

Melanomas also derived from melanocytes, but in the case of melanoma, these cells are cancerous. They have potential for spreading both locally, and systemically (metastases). Melanomas can occur in adults of all ages, but thankfully, these days, tumours are detected early and the cure rate is high.

Dermoscopy

Dermoscopy, or epiluminescence microscopy, is a non-invasive device that is used to assess moles and other skin lesions. It allows the in vivo evaluation of colours and microstructures of the epidermis, the dermoepidermal junction and the papillary dermis that is not visible to the naked eye.

Melanocytic naevi

While it is possible to diminish or remove moles by laser, it is generally not advisable, as this method does not allow for histological analysis. Although the pigment is removed from the mole, the cells remain, and have the potential to cause malignancy down the track. More importantly, it removes the signs that assist in monitoring changing moles for the purpose of melanoma surveillance.

Elliptical excision or shave removal are two commonly used techniques to surgically remove moles. Both methods allow for histological analysis of the naevi to ensure that the melanocytes are benign.

Seborrhoeic keratoses

Seborrhoeic keratoses are very common skin lesions that generally increase in frequency with age. They often have a rough, slightly oily (seborrhoeic) feel. Seborrhoeic keratoses can vary from a light brown colour, to a very dark brown. If irritated, they can appear red. Seborrhoeic keratoses are harmless and do not need to be removed. If you find them unsightly, you can discuss with your dermatologist how we may be able to reduce them for you. Treatment methods include cryotherapy (freezing), curettage (surgical scraping) or laser (pigment or resurfacing).

Keloid scarring

Scars can develop following injuries, acne and surgical wounds. Keloid are firm to hard nodular scars, which enlarge beyond the size of the original injury or wound. They are often red, raised and unsightly. Individuals with a genetic tendency towards their formation, most often develop keloids on the shoulder, chest and upper back. Hypertrophic scars refer to surgical scars that have thickened and are often quite red. Over time, these scars tend to soften, fade and become less red.

There are a range of approaches for the treatment of keloid scarring, including:

• vitamin E and other natural oils
• silicone gel or patches
• corticosteroid injections (may need to be repeated)
• pulsed dye laser or intense pulsed light systems
• surgical excision (may risk forming larger keloid)
• superficial X-ray treatment soon after surgery.

Eczema or dermatitis

Eczema is the inflammation of the top layer of the skin, called the epidermis, and is also known as dermatitis. Genetic factors can make you susceptible to eczema, but also allergies and non-allergic factors, known as irritants.

Allergies to contact agents (nickel, fragrances, preservatives), certain foods, allergens and even forms of ultraviolet light are important to diagnose, but these are not common. Non-allergic factors (irritants) are, however, very common and need to be addressed in all patients with dermatitis. Common irritants to the skin include skin dryness, soaps/detergents, friction/scratching, solvents and industrial fluids.

We tailor your eczema management plan according to the cause(s), severity and personal preferences. Treatment approaches include topical agents (moisturisers, topical anti-inflammatory creams), antibiotics, phototherapy and systemic treatments (tablets), with the latter considered in more severe cases.

Phototherapy

Phototherapy, also called light therapy, means treatment with a special kind of light. The most common type of phototherapy is narrowband ultraviolet B (UVB) light, which is the best part of natural sunlight for treating a range of skin conditions, including atopic dermatitis, psoriasis, pruritus, vitiligo, and lichen planus. Phototherapy treatment is covered by Medicare Australia for Australian residents.

Hair loss

Hair loss is a distressing condition for sufferers, with many different causes. Fortunately, most cases of hair loss resolve, either with appropriate treatment, or spontaneously.

Alopecia Areara (AA)
Alopecia Areara is an autoimmune disease. Blood cells called lymphocytes (which normally fight infection) swarm around hair follicles, causing the hair shafts to fall out prematurely. Fortunately, they do not destroy or scar the hair follicle, and in many cases, hair growth returns. Treatment methods include topical therapies, intralesional injections, topical immunotherapies and oral medications.

Telogen Effluvium (T.E.)
Telogen effluvium is a scalp disorder characterised by the thinning or shedding of hair resulting from premature entry of hair in the telogen phase. Common triggers include illness (surgery, infection, fever, trauma), childbirth, severe emotional stress, weight loss (significant), new medications. The trigger can precede the period of hair shedding by two to three months and the increased rate of hair shedding can sometimes last quite a few months. The term ‘Chronic telogen effluvium’ is used in some cases, indicating increased hair shedding for an extended period, without obvious triggers. Neither acute nor chronic forms of telogen effluvium cause baldness. In the majority of cases, hair growth completely returns to its previous state.

Androgenetic alopecia
Both men and women can suffer from gradual thinning of their scalp hair with age. The speed at which the thinning occurs varies. In males, a genetically determined sensitivity to the effect of a hormone calleddihydrotestosterone (DHT) is thought to be the cause of premature thinning in affected individuals. DHT is an enzyme that can cause the gradual miniaturisation of hair follicules. Researchers have shown that 5-alpha reductase is an enzyme that regulates production of DHT. The effect of this enzyme can be blocked by oral medications.

Rosacea and facial capillaries

The most common signs of rosacea include redness, facial capillaries, red lumps and pustules (inflammatory rosacea), and rhinophyma (late stage rosaceacan can lead to lumpiness of the nose). The inflammation of rosacea can usually be managed with topical and/or oral antibiotics, but if ineffective alternative medications can be used. Diffuse redness of the face and fine capillaries can be treated with vascular lasers and/or intense pulsed light (IPL) machines. The appearance of rhinophyma can be effectively improved with the use of resurfacing lasers.

Tips for preventing or managing rosacea

• Minimise exposure to hot or spicy foods and alcohol.
• Minimise hot showers/baths and warm rooms.
• Avoid or minimise any other individual factors that make you flush.
• Minimise thick oil-based face creams and make-up, opt water-based make-up.
• Wear hats and apply oil free sunscreen to protect your face from the sun.

Acne

Acne, commonly known as pimples or spots, is most often seen on the face, chest and back. You can develop acne when the pores on your skin become clogged up with oil, dead skin and bacteria. If you’re aged between 15 and 24, more than 8 out of 10 of you will be affected by acne. The good news is, it can be effectively treated by a dermatologist.

Camberwell Dermatology Centre uses a number of treatments for acne, tailored to your skin type and its severity. It is important to treat acne early on as it can have a significant impact on an individual’s self-esteem, in particular in the teenage years.

Scarring

Acne can cause scarring, which can improve with time, but for some acne scars can be lasting. It is important to find effective treatments for acne early on, reducing the risk of scarring.

Hypertrophic acne scarring and cysts can improve with intralesional injections, while atrophic scars are amenable to minor surgical techniques to improve the textural defect. Resurfacing lasers can improve the overall texture created by acne scarring.

Newer fractional technology has reduced the downtime of laser acne scarring treatments. Your dermatologist will offer you advice on the best treatment for any scarring.