We have included some information below on common skin conditions and problems that are regularly seen and treated at Hope Dermatology, South Melbourne.
Please contact us on (03) 9039 5644 to make an appointment to discuss your condition further with one of our dermatologists.
Commonly affecting teenagers and adults, acne is caused by an overproduction of skin sebum (oil) from sebaceous glands, which then blocks pores, leading to pimples, blackheads, white-heads and nodular acne lesions. In some cases, the severe acne lesions may lead to scarring and hence it is important to gain control of acne quickly before this happens.
Mild acne can be treated with over-the-counter products and topical agents. Some mild acne can even be treated with skin peels and cosmeceuticals which are available at our clinic. More severe acne will need treatment with oral medications such as anti-inflammatory topical or oral antibiotics, topical vitamin A preparations, the oral contraceptive pill, anti-androgen tablets and isotretinoin (oral vitamin A tablets). In Australia isotretinoin prescriptions are restricted for dermatologists to prescribe only.
Acne scarring affects approximately 30% of those with moderate or severe acne. It can be quite cosmetically upsetting for some patients and it is therefore important to start patients on treatment for acne quickly to avoid scarring. Options for acne scarring include cosmeceuticals, skin peels, skin needling, radio frequency and laser treatments. It is best to speak with your dermatologist or cosmetics nurse to determine the best treatment for your skin.
This is a pre-cancerous growth that may occur because of repeated sun damage over a lifetime. These can occur on any part of the body and usually are small, scaly, red patches. Treatments for these include liquid nitrogen (freezing treatment), curettage (scraping) and, cream treatments such as Efudix (5-fluorouracil), Aldara (imiquimod) and Picato (ingenol mebutate) gel.
This is a hypersensitive reaction by the immune system to a substance, food, object or chemical, which causes a skin rash and other symptoms. Skin prick testing may be useful in determining what allergies you might have. We work closely with immunologists/allergists to determine any potential allergies.
As dermatologists, we do see allergic contact dermatitis, which is where there is a reaction on the skin to a compound you may be allergic to; such as a cosmetic cream or sunscreen etc. To investigate allergic contact dermatitis, our experienced dermatologists may want to send you for patch testing which may be able to pin-point the exact allergens that you need to avoid.
A skin condition resulting in hair loss. Causes can be multifactorial and include hereditary, autoimmune, non-scarring or scarring and stress response. Our dermatologists will assess your hair loss thoroughly and this will include taking a full personal and family history, medication history and examination. Depending on the type of hair loss, blood tests and a scalp biopsy may be relevant to determine the type of hair loss you are suffering from. Treatments for hair loss do depend on the underlying condition causing your hair loss and this will be explained to you in the detailed consultation. Treatments including topicals, tablets and also cosmetic camouflage techniques.
Our 2 experienced dermatologists and cosmetics nurse will be able to help you navigate through your individualised treatment plan. Dr Hope Dinh has a sub-specialty interest in hair loss and is able to accept new patient referrals.
Basal cell carcinoma (BCC)
This is the most common type of skin cancer in Australia. There are different sub-types of BCC and some can be confused with sunspots or inflammatory conditions like a bite or acne. As such, it is very important to have BCCs diagnosed early to avoid extensive skin surgery. Depending on the subtype of BCC and also if the BCC is detected early, treatment may involve the use of a cream or surgery or radiotherapy. We work closely with plastic surgeons, Mohs surgeons, radiation oncologists and oncologists to ensure the best outcome for your individual case of BCC.
Benign means mild, harmless, having good prognosis and not malignant (non-cancerous).
These are also known as biologic therapies or biological response modifiers. They are drugs that are formulated to target specific areas of the inflammatory pathway to treat and prevent immune-mediated inflammatory disorders and cancers. In Australia, dermatologists are the only specialists authorised to prescribe biologics for severe psoriasis. To qualify for biologics for psoriasis, patients must have their assessments done by a dermatologist and need to be regularly reviewed for side effects and medication effectiveness.
The current biologics for psoriasis on the PBS include - infliximab (Remicade), etanercept (Enbrel), ustekinumab (Stelara), adalimumab (Humira) and secukinumab (Cosentyx). Enbrel, Humira and Remicade block a factor involved in the inflammation pathway called TNF-alpha (tumour necrosis factor). Stelara blocks a protein called interleukin 12/23. Cosentyx is an IL17-A inhibitor.
Another biologic medication (Omalizumab) has recently been approved (late 2017) on the PBS for chronic idiopathic urticaria via dermatologists holding public hospital provider numbers. Both Dr Georgina Lyons and Dr Hope Dinh are able to assess and prescribe biologics to eligible patients.
This is an early form of skin cancer that appears as a persistent, slow-growing, red and scaly skin patch. It is considered to be a more pronounced actinic keratosis. Treatment for Bowen’s disease (also known as SCC in-situ) include topical creams and surgery. A small proportion of Bowen’s disease lesions will progress to SCC and hence it is important to treat these as early as possible.
A bulla is a large fluid-filled blister greater than 1 cm in diameter. It may be a single compartment or multiloculated (made of a few blisters all joined together). There are many underlying causes of blisters including trauma, autoimmune skin conditions or allergic reactions. Blisters can be benign or serious and life-threatening. Some blistering conditions need to have extensive assessment with a skin biopsy.
Is a substance derived from the blister beetle “Cantharis Vesicatoria” used by dermatologists to treat common viral warts and molluscum contagiosum. It is a compound that creates the formation of a blister when applied topically, causing the wart to lift off the skin and fall off once the blister has healed. The mechanism of action is confined to the epidermal cells (top layer of skin) reducing risk of scarring as the basal (deep) layer of skin is unaffected. The treatment is generally painless with the resultant blister causing mild discomfort.
Also known as melasma, this is dark skin discolouration on the face, usually affecting pregnant women or those on the oral contraceptive pill. It can be difficult to treat but strict photo-protection is always advised with SPF 50+. Additional treatments include tablets or, more commonly, creams to help fade the brown areas. Additionally, some treatments such as peels and laser may also be appropriate.
We stock various selected skin care ranges in our clinic including Rationale, La Roche Posay, Ego/QV ranges, O Cosmedics and DP Dermaceuticals. You are welcome to book for a appointment with our cosmetics nurse to discuss your skin care needs. Call (03) 9039 5644 for appointment bookings.
A skin condition of patch, greasy and scaly rash that can occur on the scalp of new babies. It is caused by excessive production of sebum. In some cases the rash will resolve by itself. Treatment of cradle cap is with regular washing with mild baby shampoos and soft brushing to help remove the scales. Occasionally the rash may need medicated treatments such as shampoos containing ketoconazole and hydrocortisone cream for any red or inflamed areas.
Is a treatment where your dermatologist will use liquid nitrogen to freeze lesions off the skin. The dermatologist will spray the liquid nitrogen to the skin for a few seconds and sometimes the treatment will need to be repeated. Cryotherapy is a good way of removing certain skin lesions such as Actinic keratosis, viral warts and Seborrhoeic keratosis. Cryotherapy can also sometimes be used to treat superficial skin cancers such as superficial basal cell and in situ squamous cell carcinomas (Bowen’s Disease), these must be monitored closely as it is not always successful in some cases.
Curettage is a procedure in which your dermatologist uses an instrument to scrape off a skin lesion. The curette is a spoon shaped or curved blade and can be used to both diagnose and treat lesions such as Seborrheic keratoses, Bowens disease (in situ squamous cell carcinoma), Basal cell carcinomas, Viral warts, Keratoacanthoma, Actinic keratoses, Pyogenic granuloma and skin tags.
This is a very common skin condition, affecting about 1 in every 5 people at some time in their lives. There are multiple underlying factors contributing to eczema including hereditary and environmental factors. Eczema results in dry, red, itchy skin, which may crack and bleed, and may be quite uncomfortable for patients. Eczema can also sometimes become secondarily infected. We are able to treat eczema with creams, UV phototherapy and tablets. Occasionally an allergy may be the underlying cause and we maybe able to test for this. Dermatologists are experts in treating eczema.
Wet dressings can also be helpful for eczema control. We have a video on the technique of wet dressings here.
An epidermoid cyst is a benign cyst usually found on the skin. It does not usually need any treatment unless it is of a cosmetic concern to patients or if it becomes repeatedly irritated and infected.
A widespread rash that can be associated with systemic symptoms such as fever and headache. It is often caused by an infection or drug.
Refers to peeling skin. Usually denotes very superficial skin peeling.
A thin split or crack within the skin (epidermis), and can be due to excessive dryness.
Genital skin problems can be common and often cause distress, embarrassment and be painful or itchy, interfering with relationships, self-image and sexual functioning. Some genital disorders are contagious, including sexually transmitted diseases however there can be many other causes. Diagnosis is made via detailed patient history and skin examination and may include blood tests, skin biopsy or swabs from the affected area.
This is a condition characterised by itchy red spots on the trunk, most often in older men. It is generally seen in sun damaged skin and is sometimes associated with heat/sweat. It is also known as “transient acantholytic dermatosis.” Treatments include keeping cool, moisturising creams, oral antibiotics to settle down the inflammation and other tablets and also UVB phototherapy, which is available at our clinic.
Is an immune response modifier, produced as the topical cream Aldara. It works by stimulating the immune system and is used to treat superficial Basal cell carcinoma (BCC), Actinic keratoses (solar keratoses or AKs), Bowen’s disease and viral infections such as genital warts or common warts.
A highly contagious skin condition. It usually occurs on the face, neck, and hands of young children and infants. Impetigo is most commonly caused by two bacteria — streptococcus pyogenes and staphylococcus aureus.
This is a physical reaction by the body’s immune system which causes redness, heat, pain and swelling in a particular area of the body, e.g. the skin.
This is a benign red-yellowish lesion seen on the face, scalp and upper torso. They are found in babies and toddlers and will self resolve.
This is a structural protein found within the nails, hair and skin.
Laser is an acronym for Light Amplification by Stimulated Emission of Radiation. We are able to offer our patients vascular and pigment laser treatments and also Laser Genesis. Please contact our cosmetics nurse for an appointment.
LPL – LED Therapeutic Light
LPL LED light therapy is the newest and most advanced LED light system available. Originally developed for wound healing, LED light therapy is a wonderful adjunct therapy when undergoing any cosmetic or injectable procedure as it aids to relieve pain and improve healing time post surgery, as well having benefits in treatment and management of active acne, skin rejuvenation and skin health.
Also known as “Hutchinson’s melanotic freckle” is a slow growing melanoma in situ, that is commonly seen in the elderly, on the face.
A lesion is any single area of altered skin. It may be solitary or multiple.
An inflammatory condition of unknown cause, that commonly presents as itchy purple flat- topped papules. The mouth and genitalia may also be involved.
Oral Lichen Planus
Lichen planus affecting the mouth presents as white lacy like areas usually on the tongue and the inside of the cheeks. It can be painful and uncomfortable, making it difficult to eat spicy and sour foods.
Phototherapy is a treatment of the skin using ultraviolet light on a regular basis. We use ultraviolet B light to treat skin conditions. It is used to treat a range of different skin conditions such as atopic dermatitis, psoriasis and urticaria (hives). At Hope Dermatology we have the latest in computerised Waldmann UV technology and we have both the Full Body Cabinet as well as the Hand & Foot Machines for your convenience. All phototherapy treatments are fully bulk billed; meaning no out of pocket costs for our patients for the actual phototherapy sessions.
Refers to the colour of the skin and is determined by the level of melanin, produced by melanocytes. Melanin production is determined by racial origin and sun exposure. People with dark skin produce more melanin than those who are fair skinned. Disorders of pigmentation can have a number of origins and can be classed as generalised or localised hyperpigmentation (increased skin colour), hypopigmentation (reduced skin colour), or achromia (absent skin colour).
We offer a variety of skin peels at our clinic. Our cosmetics Nurse, Kristie, is able to perform a detailed assessment of your skin and recommend a tailored skin care solution.
This is a chronic, genetic condition that causes well-defined large red, scaly plaques to appear on the skin. These red areas have a silvery superficial appearance and develop on the elbows, knees, scalp and chest. The nails and joints can also be involved. Treatments include steroid creams, creams containing vitamin D, UV phototherapy treatments, oral tablets and the newest in injectable biologic medications. Our dermatologists are experts in psoriasis diagnosis and management.
Scabies is a skin infestation caused by parasitic mites leading to red, itching bumps or blisters on the skin. It is highly contagious and hence it is important to treat this condition promptly to avoid spread to others. Treatments include creams and tablets and anti-itch soothing creams.
A skin swelling arising from a sebaceous gland, typically filled with yellowish/oily sebum.
Skin cancer occurs when skin cells are damaged, for example, by overexposure to ultraviolet (UV) radiation from the sun. Most skin cancers can be prevented by sun protection including sunscreens from an early age. Taking nicotinamide (vitamin B3) can also reduce the risk of non-melanoma skin cancers.
There are three main types of skin cancer:
Skin Care Ranges
We stock various selected skin care ranges in our clinic including Rationale, La Roche Posay and Ego/QV ranges.
We are pleased to perform skin surgery on-site in our comfortable purpose-built clinic assisted with our procedural nurses. Our dermatologists are highly skilled at surgical procedures to treat benign and cancerous skin conditions; including surgical repair with primary closure, grafts and flaps.
Common, soft harmless lesions that appear to hang off the skin. They are commonly found in the skin folds (neck, underarms, under the breasts, in the groin etc). Factors leading to skin tags include friction from chafing such as tight pants, necklaces and collared shirts etc. Treatments include cryotherapy (freezing), surgical excision (with snip excision) and diathermy (electro-surgery).
These lesions are also known as actinic keratosis. They are small scaly skin growths which are pre-cancerous and caused by prolonged sun exposure. Treatment of these lesions is usually advised to prevent progression onto skin cancer.
UV (Ultraviolet) Index
Is a simple and accurate way of forecasting the daily danger risks of UV radiation. It gives you a good guide as to how strong the sun radiation is when the day may not feel that hot it may still have a very high UV index. For example, it can be overcast and still have a UV index of 10.
Being Sunsmart means keeping an eye on the UV index to ensure you have adequate sun protection (clothing and SPF). In Melbourne in particular, cold grey skies do not mean that the UV index is low (we can get burnt on overcast days in Melbourne!) We recommend downloading the SunSmart App to your phone so that you are up to date with the weather conditions. You can download the APP for free here.
Is the energy and sunlight from the sun that is invisible to the naked eye. It is the biggest cause of skin cancer, premature aging, tanning, sunburn and eye damage. Ultraviolet radiation is made up of 3 types of wavelengths, UVA, UVB and UVC. You can’t feel or see this radiation so it’s important to wear sunscreen even in the winter months!
Is a specialised machine treatment at dermatology clinics that uses short bursts of ultraviolet light to help resolve skin conditions such as eczema/dermatitis, urticaria (hives) or psoriasis. This narrowband ultraviolet B light can help reduce itch, calm inflammation and increase the ability for the immune system to heal. Patients are usually advised to come 3 times a week to obtain the best results. This treatment can be done when the rash is all over the body or just localized (hands or feet) when topical treatments have failed. At our clinic, the actual phototherapy treatments are fully bulk billed which means no out-of-pocket costs for the treatment sessions for our patients.
This is also known as hives. It is a skin condition where there are small itchy red bumps on the skin that are migratory and self-resolve after hours to a few days. It can be acute or chronic. There may be an underlying medical reason associated with urticaria and patients may need blood tests to exclude these. Treatments include avoidance of precipitating factors, creams, moisturiser, anti-histamines, UVB phototherapy and tablet medications to soothe the body’s immune response.
Omalizumab (a biologic injectable medication) has recently been approved (late 2017) on the PBS for chronic idiopathic urticaria via dermatologists holding public hospital provider numbers. Both Dr Georgina Lyons and Dr Hope Dinh are able to assess and prescribe this biologic to eligible patients.
Vitiligo is a chronic auto-immune skin condition where areas of the skin lose their pigmentation. The pale, depigmented areas are prone of burning with sun exposure. There are various sub-types of vitiligo including localised, generalised and segmental. Treatment depends on the location of the vitiligo and how extensive the condition is. Treatments include creams, UV phototherapy, laser therapies, cosmetic camouflage and surgical correction procedures.
Our female dermatologists Dr Hope Dinh and Dr Georgina Lyons are well trained to diagnose and manage vulval conditions such as vulval lichen sclerosus, vulval lichen planus, vulval dermatitis and vulval skin cancers.
See Genital conditions under "G" for more information
These are very common, small hard, scaly lesions, caused by a viral infection. The most common location of warts will be on the hands and feet. Children will commonly be affected by warts due to their immature immune system and also direct spread of warts between children.
Treatments for these warts include cryotherapy, diathermy, wart paint treatments and immunotherapy cream treatments. Viral warts can also occur in the genital areas and can be treated with a variety of modalities as above also. In the case of genital warts, it is also advisable to have a full STD screen.
Dry skin commonly seen in those with atopic eczema or the elderly. It is where the outermost layer of the skin becomes dehydrated. The skin loses its suppleness and then this leads to flaking or scales. The skin may also become red and itchy. It may be exacerbated by the cooler months where heated indoors conditions can dry out the skin. Over-washing can also lead to xerosis. Some commonly prescribed medications can also lead to exacerbation of dry skin.
These are cholesterol deposits around the eyelids, reflecting elevated blood lipids in half of cases. They are usually painless yellow/orange plaques. Treating the underlying lipid disorder may reduce the clinical appearance of the lesions. Cosmetic treatments for any residual skin lesions include peels, diathermy, laser and excision.
Zinc Deficiency and the skin
Zinc deficiency can look like eczema (atopic dermatitis) in the early stages but unlike eczema, it does not respond to topical steroids and moisturising creams. The skin around the mouth, napkin area and hands can be affected with a dry, cracked appearance and other areas on the body may be affected as well including hair and nail changes and also diarrhoea. The cause of zinc deficiency may be hereditary or due to poor dietary intake of zinc. Zinc replacement is usually very successful in clearing up the skin changes.