Medical Dermatology

Our services include - 

  • Skin cancer detection and full body mole checks
  • Rashes eg. eczema, psoriasis
  • Infections eg. tinea, warts, molluscum, impetigo
  • Acne and rosacea
  • Hair and nail diseases
  • Oral and genital mucosal diseases (male and female)
  • Paediatric, geriatric and pregnancy related rashes
  • Vitiligo and pigmentary disorders
  • Injections for armpit sweating (Hyperhidrosis) – partially rebatable from Medicare
  • Full body UVB phototherapy
  • Hand & Foot UVB phototherapy

Skin Tumours

Basal Cell Carcinoma

Basal Cell Carcinoma (BCC) is the commonest type of skin cancer in Australia, frequently diagnosed and treated by dermatologists in Australia. Risk factors include fair skin and sun exposure history. Common sites for BCCs are the face (in the eye-mask distribution) and also on the trunk and limbs.

BCCs can vary in appearance and may be seen as a slight pinkish, pigmented or skin-coloured flat area or a lump. They may even be brown in colour; mimicking melanoma. They may ulcerate and bleed and are generally slow growing tumours. To the untrained eye, they can be easily missed as these tumours are usually painless.

Prompt diagnosis is essential to allow for minimally invasive management. Although excision remains the gold standard, certain forms of BCC (such as the superficial subtype) may be treated with non-surgical methods (such as cream, cryotherapy or gentle scraping/curettage). Sometimes radiotherapy is appropriate; avoiding the need for surgery.

Our Dermatologists at Hope Dermatology are experts in diagnosing skin cancers such as BCCs and will be able to advise you on the best management option(s) tailored to your personal circumstances. We work closely with a team of specialists including plastic surgeons, radiation oncologists and pathologists to give you the best outcome possible.

It is important to have your skin regularly checked once you have been diagnosed with one basal cell carcinoma as likely more will appear with time.

Squamous Cell Carcinoma

Squamous Cell Carcinoma is the 2nd commonest type of skin cancer, again related to sun exposure. These can grow quickly and feel like a hard and often painful lump. Commonly affected areas include the hands, forearms, face, scalp, lips and ears.

With SCCs there is a small risk of spread (metastasis); although this risk is higher in those with a weak immune system or those who take immunosuppressants (e.g. organ transplant recipients).

Treatment options include creams or cryotherapy (freezing) for in-situ (localised) forms of SCC. For other forms of SCC treatment options include surgery, curettage or radiotherapy.

Melanoma

Although rare in general, Australia has the highest incidence of melanoma in the world.

Usually, melanomas are pigmented. Lesions that we worry about include the “ugly-duckling” mole, or moles/lesions that are changing using the ABCDE rule - asymmetry, irregular border, irregular colour, large diameter, and elevation (becoming more raised from the surface). However not all melanomas are pigmented and some may be a red patch or a blue lump.

Worryingly, melanoma has the ability to spread and hence it is critical that melanomas are diagnosed and treated early.

All of our dermatologists have been trained in specialised tertiary hospitals managing melanomas. Treatment for melanoma may need to be also co-ordinated with other specialists including general surgeons, plastic surgeons, oncologists, radiation oncologists etc. For advanced melanoma, there are new treatments available offering hope to previously unsalvageable cases.

Once diagnosed with a melanoma, patients will require regular skin surveillance. This is to ensure the melanoma has not recurred or spread, but also to look for any new primary melanomas. Once you have been diagnosed with one melanoma, there is a 10-20% lifetime risk of another primary melanoma appearing elsewhere on the body.

Actinic Keratosis and Bowen’s Disease

Actinic keratoses (AKs) are considered pre-cancerous spots and have a small chance of progressing on to skin cancer. Bowen’s disease can be thought of as thicker AKs. Both these conditions do warrant treatment for cosmesis and to reduce the risk of cancerous change.

Treatment options we would consider include creams, photodynamic therapy, freezing / cryotherapy and curettage.

Other Skin Tumours

Benign skin lesions which can appear more with age include seborrhoeic keratoses (age spots), angiomas (Campbell de Morgan spots) and dermatofibroma. These do not require treatment until cosmetically unacceptable.

There are other rare malignant skin tumours which often can be mistaken for a benign lump. Dermatologists are well trained at differentiation between benign and malignant tumours and prompt management.

Skin Infections

Viral Warts

Viral warts commonly present to us in our clinic when treatments available to patients over-the-counter have been ineffective. Treatment options include liquid nitrogen (cryotherapy) treatments, immno-contact therapy, strong keratolytic creams, irritant drops, oral tablets and rarely local chemotherapy injection for difficult and resistant cases.

Molluscum

Molluscum contagiosum is a benign pox virus infection very commonly seen in young children. The cases we see at Hope Dermatology are the treatment-resistant ones. We are able to offer a variety of treatments including liquid nitrogen and other physical therapies, immune-contact therapy (in the forms of highly potent prescription creams) and irritant lotions.

General Dermatology

Acne

Acne is a potentially permanently scarring condition with most cases occurring during puberty, correlating with hormonal changes. Other medical conditions can also contribute to acne such as polycystic ovarian syndrome certain medical conditions.

Treatment options for acne include over the counter products or prescription topical medications. Oral medications include antibiotics, hormonal therapy and oral isotretinoin (vitamin A tablet). In Australia, only specialist dermatologists are authorized to provide isotretinoin therapy.

Our Dermatologists at Hope Dermatology will tailor an acne management plan for the best result. 

Eczema

Eczema, or atopic dermatitis, is a common complaint in our patients, especially with Melbourne’s dry weather and can affect people of all ages. Triggers include environmental factors, such as dust mites, pollen, grasses, sweat, overheating, and many other substances. Eczema can also coincide with asthma and hayfever.

Research has shown that a genetic mutation of fillagrin, leading to poor skin barrier function is the key in the appearance of eczema. Treatment needs to be systematic and targeted and includes stopping excess soap use and changing to more moisturising products to restore the skin barrier. Prescription treatment ranges from creams and tablets to settle down the inflammatory process to UV (light) phototherapy. Occasionally antibiotics may also be needed to treat any secondary infection. For more severe cases, oral immunosuppression may be required and this needs to be undertaken with an experienced dermatologist for the best outcome.

Dermatologists at Hope Dermatology are experts in eczema care plans for you and your family.

Hair Loss

There are a number of conditions that can cause hair loss. Generally speaking hair loss can be divided into either non-scarring or scarring hair loss conditions. The distinction between these two groups is important as there is potential for regrowth with the non-scarring conditions. With the scarring conditions, the aim of treatment is to prevent the condition from worsening; but unfortunately with scarring hair loss, once the hair is gone it is gone forever. Occasionally in the same patient there can be both non-scarring and scarring processes happening.

Conditions we commonly see in terms of hair loss include the following: telogen effluvium ("shedding response hair loss"), androgenetic alopecia (female pattern and male pattern baldness), alopecia areata (autoimmune hair loss), scarring hair loss (discoid lupus erythematosus, lichen planopilaris, folliculitis decalvans).

Sometimes the diagnosis is quite clear on history and examination. But sometimes a scalp biopsy is needed to help guide the diagnosis and dictate treatment. Our dermatologists are expertly trained in the early diagnosis and treatment of hair loss conditions. Dr Hope Dinh has published extensively on hair loss conditions and this is her area of sub-specialisation and interest.

Melasma

Melasma (or chloasma) is a common skin disorder, which presents with darkening of the facial skin, usually on the cheeks, forehead and around the mouth. Multiple contributing factors are thought to be at play including genetics, darker skin type, ultraviolet exposure and hormones (from pregnancy and hormonal contraceptives).

Treatment options include topical bleaching creams, strict sun protection with SPF 50+ broad spectrum sunscreen and cessation of contributing hormonal contraceptives. Recently, oral tranexamic acid tablets have been successful in reducing pigmentation. Peels and laser can also be cautiously used.

Speak to our dermatologists and cosmetic nursing team about the most suitable options for your skin.

Psoriasis

Psoriasis can be very cosmetically distressing for our patients. Recent research has revealed that in patients with psoriasis, the inflammatory process may not just be localised to the skin and hence it is even more important to diagnose and treat this condition promptly.

Treatment options include creams, ultraviolet phototherapy, and a few different types of tablets (such as methotrexate, cyclosporin or acitretin). More recently, injections of Biologics are available and highly effective. In Australia, only Dermatologists can prescribe PBS (Pharmaceutical Benefits Scheme)-funded Biologics for skin psoriasis.

Rosacea

Rosacea is a common and debilitating issue of adults. There are a host of underlying contributing factors, including genetic factors, exposure to UV light, poor quality skin care, drying soap use, heat, alcohol and sometimes steroid creams.

Patients usually complain of flushing, heat, redness, and acne-like skin lumps. In severe cases, the eyes may be involved and nose can develop permanent lumpiness ("rhinophyma")

Treatment is complex and can involve a combination a suitable set of skin care regime, creams, oral antibiotics or Vitamin A tablet (isotretinoin) and possibly laser treatments. Many patients are able to keep the symptoms under control with good, tailored skin care and dermatologist-prescribed medication. Our cosmetics nurse Kristie will also be able to assist you in choosing appropriate skin care and discuss options including laser.

Skin Allergy

Skin allergy or contact dermatitis is quite common. The common culprits that we see at our clinic in South Melbourne include cosmetic products, baby wipes, hair dyes, perfumes, cosmetics and household products such as rubber/leather gloves, glues, paints and sprays.

If you have a persistent skin rash and you suspect allergy, please come for a full assessment by our Dermatology team. Dr Georgina Lyons has previously worked with the Contact Dermatitis Team at the Skin and Cancer Foundation Inc and has published her work on contact allergens. Dr Hope Dinh also works alongside the Patch Testing Team at the Alfred Hospital in outpatients clinic.

Vitiligo

Vitiligo refers to depigmented skin where the cells producing our skin colour have been attacked by the body’s own immune system. Vitiligo can affect all ages; from children to adults. Vitiligo can occur with other autoimmune conditions such as thyroid disease, pernicious anaemia or diabetes.

Treatments include creams, injections, UV phototherapy or Excimer laser treatments. Exciting new developments in vitiligo include pigment cell grafting but this is reserved for more severe cases. Our team of expert dermatologists have many years of experience in treating vitiligo and understand  its cosmetic impact. We welcome new referrals.