Conditions: Skin Diseases: Aetiology and Affect on Well-being
At Thames Valley Scar Clinic, we specialise in treating a wide range of skin conditions, not just scars. We understand that these conditions can have a similar impact on a person’s well-being and quality of life, and there is significant overlap with the treatments. It’s important to us that all aspects of your concerns are explored, and we take a multidisciplinary team approach to your treatment just like we would for somebody with a scar. Here are some common skin conditions we treat.
Vitiligo
What is Vitiligo (and hypopigmentation)?
Hypopigmentation is a general term for loss of the pigmentation called melanin in the skin. This results in patches in the skin that are white, with complete pigment loss in the affected area.
The main cause of this, other than trauma or burns is Vitiligo. Vitiligo is a chronic condition (can also be called leucoderma) where the cells in the skin that produce melanin (melanocytes) are attacked by the patient’s own body. This is a type of autoimmune condition. It can be associated with other autoimmune diseases or there may be a family history.
What are the Key features?
Patches of white skin or pink skin or hypopigmentation due to pigment loss. There are two types of vitiligo, one mainly affects one area of the body (segmental); conversely, the other can affect multiple areas (non-segmental).
What are the possible affects on well-being?
Patchy loss of pigmentation, regardless of the cause, can have a significant impact on an individual’s quality of life and self-esteem, particularly in relation to their appearance-related concerns.
What are the Treatment options for Vitiligo (or hypopigmentation)?
- Skin Camouflage (longer lasting waterproof creams designed to blend areas of pigment loss)
- For Stable Vitiligo lesions, Carbon Dioxide Laser plus ReCell is an FDA-approved treatment. An alternative to the laser for resurfacing would be dermabrasion.
- Please note there are various options for active Vitiligo such as ointments and drugs that are usually managed by a dermatologist, you should discuss with your GP if you are in this group. We do not manage active Vitiligo.
Rosacea
What is Rosacea?
Rosacea is a long-term skin condition that mainly affects the face. It leads to redness, pimples, swelling and the formation of small dilated blood vessels.
What are the Key features?
Rosacea is characterised by redness across the cheeks and nose mainly, but can affect the whole face. There are often small and superficial dilated blood vessels. It can become pustular and different presentations require a different approach. In its most severe form, it can lead to the formation of rhinophyma.
What are the possible affects on well-being?
The main impact is that it can cause a burning or stinging sensation when active. It can be unpredictably activated e.g. due to changes in temperature, certain foods or beverages resulting in some social avoidance. It may result in a negative impact on self-esteem due to appearance-related concerns.
What are the Treatment options for Rosacea?
- For established disease with redness and textural changes, Carbon Dioxide Laser and M22 Laser are effective.
- Please note for active disease, topical and oral agents, as prescribed by a dermatologist are often utilised. We do not treat active disease.
Benign Lesions
What are benign lesions?
There are a number of skin lesions, including benign dermal naevi and seborrheic keratoses, which present as harmless, non-cancerous skin growths.
What are the Key features?
These lesions present in different colours – from pale to dark, can be waxy, scaly, rough or crusty, are usually raised or have a ‘stuck-on’ appearance, and can range in size.
Please note, any skin lesion that has any concerning features – including asymmetry, irregular border, multiple and changing colours, increasing diameter, and evolving (e.g. starts to itch and bleed) must first be reviewed by your GP and a dermatologist.
What are the possible affects on well-being?
Can be both unsightly and uncomfortable. Can get caught on clothing or during shaving if in hair bearing areas.
What are the Treatment options for benign lesions?
- Carbon Dioxide laser
- Shave Excision
Rhinophyma
What is Rhinophyma?
Rhinophyma is a disorder causing development of a large, bulbous nose due to excessive sebaceous glands and tissue. This is part of the spectrum of rosacea.
What are the Key features?
Gradual changes to the appearance of the nose leading to a swollen, bulbous shape. There are many visible oil glands, large skin pores, and a reddish colour. The precursor can be acne rosacea, starting with a breakout of pimples. This can then progress to Rhinophyma. If the affected tissue becomes very enlarged, it can obstruct the nostrils and therefore affect breathing.
What are the possible affects on well-being?
People with Rhinophyma may be adversely affected due to appearance related concerns. In addition, in severe cases, there may be breathing difficulties.
What are the Treatment options for Rhinophyma?
- Carbon Dioxide Laser
- Please note for active disease, topical and oral agents, as prescribed by a dermatologist are often utilised. We do not treat active disease.
Vascular lesions
What is a Vascular lesion?
This is a broad term for any lesion related to abnormal blood vessels which can occur anywhere in the body. These can be congenital, or acquired later in life as a result of trauma, infection or other conditions. Common examples are spider naevi or thread veins.
What are the Key features?
Features can include anything from changes in colour, (blue, purple, red) to changes in texture. Superficial small vessels may be visible and in larger lesions there may also be swelling.
What are the possible affects on well-being?
It is possible these lesions may bleed or be uncomfortable. In addition many people have appearance related concerns due to the prominent nature of the lesions.
What are the Treatment options for Vascular lesions?
- M22 Laser (IPL and Nd:Yag) for vessels and redness
- Carbon Dioxide Laser for any textural changes
- Surgical debulking in rare cases or if excess skin
“These are a diverse group of conditions that can vary from being an annoyance to a patient, to causing a really significant affect on well being.”
Alex Atkins-Murray