Dermatology is the area of medicine that deals with conditions affecting the hair and skin. According to the NHS, 15% of GP consultations are related to skin diseases. Skin conditions can be debilitating and affect self-esteem, our team at North Downs Hospital in Surrey are here to help diagnose and manage your skin condition.
Our dermatologists treat a range of skin conditions such as eczema, psoriasis, dermatitis, acne, warts and moles. We are also familiar with skin biopsies and diagnosis of cancerous skin lesions.
At North Downs Hospital we take pride in our specialist dermatologists who are some of the top medical professionals in the UK. We specialise in a variety of surgical and non-surgical treatments of skin diseases which are adapted to fit your lifestyle and individual requirements.
Dermatological Treatments Available
Cryotherapy involves the treatment of skin lesions through a freezing technique. There are a lot of different types of cryotherapy which include the use of liquid nitrogen, dimethyl ether and propane (DMEP) and carbon dioxide snow. Here at North Downs Hospital we specialise in the use of liquid nitrogen. Cryotherapy is used to treat forms of keratosis and warts, amongst other types of skin lesions. It is most effective in the treatment of malignant lesions.
Using liquid nitrogen, cryotherapy is performed with the use of a cryoprobe, cotton-tipped applicator or cryospray. The temperature of the Nitrogen is set to around −196°C and applied to the lesion for a few seconds. In severe cases the treatment is repeated, for example, in resistant viral warts.
Excision of Skin Lesions (Punch biopsy & Curettage)
The excision of a skin lesion is a form of minor surgery. There are various types of excision and here, at North Downs Hospital, we specialise in the punch biopsy and the curettage of skin lesions. The excision of skin lesions can be used on various skin conditions and is dependent on your diagnosis – for example you may treat a wart with curettage.
A punch biopsy is used as a diagnostic process that removes a skin lesion for inspection of the dermatitis. Using a circular blade of 2-7 mm or 3-4mm (depending on the size of the lesion) the surgeon “punches” the skin and removes a cylindrical section of tissue. The wound is then stitched up and the biopsy is sent to a pathology lab. This procedure is usually done under local anaesthetic.
A curettage of a skin lesion involves the use of a curette in order to “scrape” or “scoop” a predominantly epidermal superficial skin lesion. The curettage procedure can be followed by cryotherapy.
Steroid Cream (Topical Corticosteroids)
Topical corticosteroids also known as topical steroids are used in the treatment of a variety of skin conditions such as eczema, seborrheic dermatitis and psoriasis. They are commonly prescribed as gels, creams or ointments and are used to reduce inflammation.
Topical steroids should only be applied to the affected areas of the skin, your doctor will prescribe you a medication suited to your condition. Depending on the severity of your condition you may only need to apply the topical steroid a few times a day for a period of days or weeks. It is also possible that you may apply the topical steroids less throughout the day but for a longer overall duration. It is important to follow the advice of your associated doctor – who will advise you on how often to use topical steroids to treat your skin condition.
Acne Treatment with Isotretinoin (Roaccutane)
Isotretinoin known as 13-cis retinoic acid is an effective acne treatment. Usually the course of medication lasts between 4-6 months and for the initial week you may see a worsening of your condition before it settles down.
The treatment is taken orally in tablet form. Due to the nature of the drug it can only be prescribed by a specialist doctor or dermatologist. Here at North Downs Hospital in Surrey we have the expertise to treat acne with isotretinoin.
Isotretinoin has anti-inflammatory properties, shrinks the sebaceous glands and inhibits the growth of acne bacteria as it reduces the moisture of the affected skin.
Mycology – fungal toes/hands
In order for medical professionals to diagnose a fungal infection, tissue samples are taken from the nail, skin and hair. The samples are taken for microscopy and culture in order to identify the organism causing the infection; the study of fungi is known as mycology.
Specimen collection can be done through a variety of different methods:
- After cleaning the skin with alcohol, scale may be scraped from the edge of the rash
- Using hair samples with the hair root in tact
- Skin scraped from under the nail e.g. in an infected toe nail
- A biopsy
- The stripping of skin via tape which is then transferred to a glass slide for testing
After the sample has been collected it can be directly examined microscopically or using a culture (mycology). During a culture the specimen is examined in order to distinguish the unique organism causing the infection and subsequently formulate a treatment plan.
Growing the fungus itself may take several weeks whilst incubated at a set temperature. The rate of the fungal growth is dependent on the organism causing the infection.
We are very proud to be working alongside some excellent dermatology Consultants who are highly respected in their speciality and come highly recommended by previous patients. All of our consultants go through regular validation to ensure that they work to the highest possible standards and remain up date with current practice.
Dr S Cliff
Dr N Cowley