General Dermatology

Acne is a very common skin condition that usually begins in adolescence. The hair follicle and its associated oil (sebaceous) gland become blocked and inflamed. Whiteheads, blackheads and inflamed pus-filled spots develop on the face, neck, back and chest.

What causes acne?

Hormones.

Hormones gradually increase during puberty. The sebaceous glands respond to androgens by producing more sebum and sometimes whiteheads (closed comedones) may develop.

Sebaceous gland blockage.

The skin cells lining the upper part of the hair follicle are not shed as normal but accumulate and form a plug (comedone). The oil is trapped behind it.

Bacteria and inflammation.

Increased numbers of acne bacteria (Propionibacterium acnes) accumulate in the hair follicle duct and contribute to the inflammation that develops.

Genetics.

Hereditary factors contribute, however it is not known exactly how this works.

Stress. The adrenal glands produce more androgens when an individual is stressed and this can make acne worse.

Diet.

Certain diets may contribute to the development of acne.

Occupation.

In rare cases people working in certain industries may develop occupational acne.

Acne can lead to negative self-esteem and some individuals may withdraw from social and sporting activities. Having clear skin can improve confidence in young adults and improve quality of life.

How is acne treated?

There are many safe and effective acne treatments.

These include topical treatments, antibiotics, hormonal therapy and systemic retinoids

A consultation with your dermatologist can help determine which treatment is best for you.

Rosacea is a common, chronic skin disorder affecting the central face. It is an episodic and variable condition but classically presents as acne-like bumps (papules and pustules), red or pink patches and broken capillaries. Rosacea is common in people with fair skin and blue eyes who are of Celtic or English ancestry.

The symptom initially noticed is blushing (facial flushing) which becomes more frequent and eventually leads to persistent facial redness which fluctuates in intensity. Small blood vessels dilate and become visible as telangiectasia (broken blood vessels) and the continual or episodic blushing may promote inflammation, causing red bumps to appear which can resemble teenage acne. The cheeks, chin and nose are most commonly affected. Rosacea is more common in women and typically presents between the ages of 30 to 50.

What causes rosacea?

The exact cause of rosacea is unknown. There could be a combination of factors involved including hereditary (genetic), environmental, vascular and inflammatory factors as well as reaction to the demodex mite (microscopic mite that lives on human skin, commonly called ‘eyelash mite’).

A number of factors can trigger or aggravate rosacea by dilating blood vessels and therefore increasing blood flow to the surface of the skin. These include:

  • Hot food or beverages
  • Spicy foods
  • Alcohol
  • Temperature extremes
  • Sunlight
  • Stress, anger or embarrassment
  • Strenuous exercise
  • Hot baths or saunas
  • Oral and topical corticosteroids
  • Drugs that dilate blood vessels such as blood pressure medications
  • Inappropriate use of skin care products such as facial creams and oils.

 

Treatment of Rosacea can involve a number of general measures and a combination of topical and oral treatments. Vascular lasers can be useful in some patients.

A consultation with your dermatologist can help determine which treatment is suitable for you.

Benign skin growths such as seborrhoeic keratosis, sebaceous hyperplasia and milia cysts

Sebaceous hyperplasia is a benign growth of the sebaceous (oil) glands. It most commonly occurs in middle-aged or older people. It presents as single or multiple yellowish white bumps on the forehead, cheeks and nose. 

Seborrhoeic keratoses are benign “wart-like” growths on the skin. Seborrhoeic keratoses affect all racial groups and most commonly appear after the age of 40 years although some people may develop them earlier. Seborrhoeic keratoses are benign (non-cancerous) growths of the skin. Their appearance is thought to be part of the normal ageing process of the skin.

Milia cysts are small, white bumps that typically appears on the nose and cheeks. The cysts occur when keratin becomes trapped beneath the surface of the skin. Milia can occur in people of all ages. They are typically found on the face, eyelids, and cheeks.

Eczema or atopic dermatitis is a common condition that causes dry, scaly skin with small itchy bumps and red patches. Eczema often appears on the hands, feet, face, neck and chest and behind the elbows and knees. It is common in infants and children but affects people of all ages.

The exact cause of eczema is unknown. It may be caused by dry skin, genetic factors, irritants like soap and water, bacteria (e.g., Staphylococcus aureus) or environmental conditions.

There are new injectable medications available on the PBS that may help chronic severe eczema, these can be prescribed by a dermatologist. Speak to your dermatologist about treatment options that may be suitable for you.

Skin cancer screening usually involves a Dermatologist performing a skin examination to identify any lesions of concern. A thorough skin examination will be performed with the aid of an instrument called a dermatoscope. The dermatoscope has a special lens which allows the Dermatologist to see structures underneath the top layers of the skin, so that abnormal moles and other skin lesions can be identified. Dermatologists are experienced in using the dermatoscope for the early detection of skin cancer and this also reduces the need for biopsy of benign (harmless) skin lesions.

Psoriasis is a chronic skin condition that occurs when the skin receives an abnormal immune signal to speed up skin cell growth and cause thick scaley, red plaques to appear on the skin. The cause is not known but genetics and environmental factors play a role.

Psoriasis can affect men and women at any age. Many people, but not all, have a family history of psoriasis.

Psoriasis on the skin may take various forms. Most commonly, psoriasis spots are dry, raised and red, with thick, silvery scaly areas. There may be a few spots or multiple large areas of skin involved. They can appear anywhere on the body. Most commonly, psoriasis is seen on the elbows, knees and scalp.

The Guttate form of psoriasis usually occurs after a sore throat, and appear as numerous small teardrop-shaped spots on the body. 

There are treatments available for psoriasis ranging from topical treatments, oral treatments and injections called biologic drugs for severe psoriasis. Unfortunately, there is currently no cure for psoriasis but it can be managed with treatments.

Port Wine stains (PWS) are capillary malformations made up of thousands of abnormal blood vessels that lie below the surface of the skin. They can occur on the face or any part of the body.

Early PWS can be pink but they can become dark red/purple or blue. They may become lumpy in areas called nodules. These can appear as PWS as a person grows older

The V Beam vascular laser, is the gold standard for port wine stains treatment. Deeper port wine stains (older stains or lumpy stains) are treated with Nd:YAG laser which uses a wavelength that penetrates into the deeper layers of the skin.

Multiple treatment sessions (4-8 on average) are necessary to fade port wine stains. Some patients may require annual maintenance treatments to keep their PWS light in colour and minimise nodules.

Dr Ciconte has been treating PWS for over 10 years and can help you achieve a reduction in size and fading of colour of your PWS. Please note there is 7-10 day down time post treatment as bruising occurs after each laser treatment.