Conditions

Expert Treatment of all Skin, Nail and Hair Conditions.

Acne

Acne is a common inflammatory skin condition affecting the hair follicle and sebaceous gland, causing blockage of the follicle and inflammation. Acne affects males and females and is commonly seen in adolescents and young adults, with 85% of 16 to 18-year-olds affected. It may sometimes occur in children and adults of all ages. The severity of acne and length of duration varies from patient to patient.

Dr.Slater will assess your Acne carefully and tailor treatment to each individual patient with an aim to treat the Acne and minimise its impact on your quality of life.

Acne Vulgaris on the face of a young lady.
Demonstrates a young child with eczema,itchy red scaly patches on the skin.

Eczema

Eczema is a very common skin condition that can affect anyone at any time in their lives. Eczema causes the skin to become red, dry and itchy, which can sometimes progress to become weepy, blistered, crusted, scaling and thickened. It can have a profound impact on a patients quality of life.

Atopic eczema is the name given to a particular presentation of eczema that often starts in childhood. One in every five children in the UK is affected by eczema at some stage. It may also start

later in life in people who did not have Atopic Eczema as a child. Other forms of eczema include pompholyx eczema, asteatotic eczema, discoid eczema, contact dermatitis and seborrheic dermatitis. Treatments revolve around the use of Emollients and certain topical treatments such as Topical steroids and Calcineurin Inhibitors. Dr.Slater will provide a personalised treatment plan that explains how and where to use the various topical therapies. More severe cases of eczema may require other treatments such as Phototherapy or Systemic agents such as Methotrexate.

Psoriasis

Psoriasis is a common skin condition affecting approximately 1 in 50 people, and occurs equally in men and women. Psoriasis can appear at any age, and is a long-term condition which may come and go throughout your lifetime. The cause of psoriasis is complex and likely to involve a number of genetic factors, with family history also playing a part in the condition.

There are a number of different types of psoriasis including chronic plaque psoriasis, guttate psoriasis and palmoplantar psoriasis. Psoriasis can also affect the nails and the joints as well as the skin. Psoriasis can be itchy and painful, and certain sites such as the scalp, lower legs and groin can be particularly itchy. If

psoriasis affects the hands and feet, painful fissures (cracks) can sometimes develop.

Treatment of psoriasis depends upon your individual circumstances and Dr.Slater can offer a number of very effective treatment options. Milder cases often respond very well to topical treatment or Phototherapy. More Severe cases of psoriasis may require systemic medications such as methotrexate or ciclosporin.

Red scaly plaques on the elbows of a patient.
Lichen plants on the wrist of a patient.

Lichen Planus

Lichen planus is a very common itchy skin rash that can affect any part of the body, and present in many different ways. It most commonly presents as an itchy rash that consists of clusters of shiny, small, slightly raised pink or purple-red spots. A close look may show fine white streaks on their surface, a so called lace-like pattern. It is thought to be an autoimmune disease, where the immune system over-reacts to various external stimuli producing a characteristic rash.

Treatments largely centre around a range of topical therapies. Sometimes in more severe cases, systemic treatments are used such as Prednisolone.

Hair Loss

Hair loss can cause a huge degree of emotional distress and loss of self confidence. There are a number of conditions that can affect the scalp and hair, and Dr.Slater can diagnose the type of hair disorder and advise on the most effective form of management.

Common causes of hair loss include conditions such as Alopecia, which usually results in localised patches of hair loss. This is an autoimmune condition where the body’s immune system makes an immune response to the hair follicles. A number of treatments have proven to be effective, in particular injections into the patches with a substance called triamcinolone.

A condition called frontal fibrosing alopecia (FFA) has become more apparent in the recent years. This causing scarring and hair loss to the eyebrows and frontal scalp. It usually affects women around the menopause. As it’s a scarring condition, it is vitally important that treatment is started early.

Men can suffer from a condition called androgenic alopecia, with a loss of hair on the top of the scalp. The condition responds to a number of conditions such as topical minoxidil lotion or systemic medications such as finasteride.

A correct diagnosis is very important to diagnosing and managing any hair disorder, and Dr.Slater can advise on the most effective management options and monitoring strategy.

Photo of a lady suffering from hair loss.
The back of a young lady with moles.

Moles

A normal mole can be skin coloured in appearance, brown or a mixture of two colours. Moles are composed of skin cells called melanoctyes, which produce a brown pigment called melanin. If these cells produce a minimal amount of melanin they produce a skin coloured mole. If they produce a lot more melanin pigment, the mole tends to be dark brown or have a mixture of dark brown and black pigment.

Keeping a close eye on your moles is very important. A change in size or appearance of a mole is an important sign and it is essential to make an appointment with a dermatologist for the mole to be checked. Dr.Slater will perform a full skin check using a Dermatoscope to highlight and manage any abnormal moles. If your mole is showing any concerning changes then the mole should be surgically removed and sent for a biopsy.

Benign moles that are causing symptoms such as catching on your clothes, or are highly visible affecting your self confidence, can be removed by Dr.Slater in a more straightforward way by a shave excision.

Skin Cancer

More than 210,000 cases of non-melanoma skin cancer are diagnosed annually in the UK each year, and that rate is predicted to reach almost 400,000 by the year 2025. There are over 16,000 cases of melanoma diagnosed each year, and rates of skin cancer in general are increasing faster than any other cancer in the UK.

The commonest form of skin cancer is basal cell carcinoma. They presents as a scab that fails to heal and occasionally bleeds, or a more raised pink nodule. There are a number of medical treatments available such as Efudix and Aldara, and surgical options such as curettage and cautery, and excision.

Squamous cell carcinoma often develops from areas of sun damage and presents as a firm lump which may be crusted or scaly, and are often tender. They tend to develop more rapidly then Basal Cell Carcinomas and have the potential to spread into lymph nodes and also into other areas of the body.

Melanoma is a dangerous type of skin cancer with risk factors including family history of melanoma, multiple moles, multiple abnormal moles, fair skin and a history of sunburn/sunbed use. Signs that indicate a mole is changing include rapid change in size of the mole, multiple colours, an irregular edge, bleeding, itching or being very different to a patients other moles (Known as the ugly duckling sign). If a mole is suspected to be melanoma then Dr.Slater will remove the lesion by surgical excision and the lesion will be sent for a biopsy. Early identification of a changing mole is vital in which case melanoma excision is curative.

Photo shows a facial skin cancer called Basal Cell Carcinoma.
Photo shows the red face of a young lady suffering from Rosacea.

Rosacea

Rosacea is a common skin condition, that predominantly affects fair-skinned individuals aged 30 to 60 years of age. Rosacea usually develops on the central face but can occur at other sites including around the eyes (peri-occular rosacea), around the mouth (peri-oral rosacea). Rosacea can present suddenly at any time of life and resolve with treatment. In other patients it can be a chronic condition with repeated flares requiring maintenance treatments.

The clinical features include redness of the affected skin on the cheeks, forehead, chin and nose, that can be slightly itchy, and is often followed by the development of small, red, inflamed spots. In more persistent cases the redness becomes more fixed and can be accompanied by dilated superficial blood vessels called telangiectasia. Some patients also develop inflammation of their eyelids (blepharitis).

Despite being a very common skin disorder, we do not fully understand the cause of rosacea. It is thought that many factors contribute to the development of rosacea including an overgrowth of an otherwise harmless skin mite called Demodex, an overgrowth of bacteria in the gut, and genetic factors that affect the body’s immune responses.

Rosacea can be treated with a combination of topical creams and tablets with Dr.Slater providing a tailored individual approach to treatment. Occasionally a medication called Isotretinoin is used and is an extremely effective treatment. The redness/flushing of rosacea can be treated with a cream called Mirvaso, but the results can be unpredictable. The more fixed redness is treated with Intense Pulsed Light (IPL), that Dr.Slater performs at certain clinic locations.

Sun Damage

The commonest form of sun damage is called Actinic Keratosis, also known as solar keratosis. These patches present as dry, scaly skin, which may cause itching and irritation. They commonly occur on the scalp, face, ears, forearms, and back of the hands in fair skinned patients who have had a lot of sun exposure during their lifetime.

Bowens disease is a closely related condition which can be thought of as a thicker form of solar keratosis with a slightly different appearance. Both Solar keratosis and Bowens disease are pre-cancerous lesions that can develop into a skin cancer called squamous cell carcinoma. Typical warning signs of cancerous change are pain and soreness developing in a lesion or rapid growth of the skin lesion.

There are a number of different methods for treating these forms of sun damage. These include cryotherapy, skin surgery and various topical therapies such as Efudix cream. Efudix cream is used each day for 3-4 weeks and results in a lot of inflammation, which gradually resolves over 2-3 weeks. It is a fairly effective treatment and is a good treatment for larger areas of solar keratosis termed field change.

Photo shows the face of an elderly gentleman with sun damaged skin.
Wart on the hand of a patient.

Warts

Warts and Verrucas appear as small rough lumps on the skin caused by infection with the human papillomavirus (HPV). They can occur anywhere but most common on the hands and feet. Many patients find them a source of embarrassment and discomfort and seek treatment to remove them.

Warts and verrucas can be spread through skin to skin contact and also indirectly from contaminated surfaces such as a swimming pool. They usually resolve spontaneously with time or with over the counter topical treatments. If the warts are not clearing then Dr.Slater can provide treatments such as Cryotherapy or Surgery.

Urticaria

Urticaria is a condition where you get short-lived, itchy skin swellings known as hives that usually clear within 24 hours, although the overall rash may last for longer.

Angioedema is a form of urticaria in which there is deeper swelling in the skin, and the swelling may take longer than 24 hours to clear.

Urticaria is very common and 20% of people would have had urticaria at some point in their lives. A typical example of acute, short lived urticaria is a food allergy or medication allergy. Urticaria can also be caused by physical triggers such as: exercise, sun light, pressure, heat or cold. In many cases of urticaria, the trigger is not obvious and often never found.

In the chronic form of Urticaria (Chronic Spontaneous Urticaria) patients develop the hives continuously and this can be very debilitating.

The first line of treatment for all forms of urticaria in adults and children is with an oral antihistamine. There are a number of second line options that Dr.Slater can also prescribe.

Photo shows Urticaria with typical Hives on the back and scratch marks from itching.

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