The Following Conditions are Managed at The Dermatology Room

        • Acne
        • Actinic Keatoses
        • Autoimmune Skin Disorders
        • Eczema
        • Dermatomyositis
        • Disorders of Pigmentation – Melasma, Sun spots, Sun sensitivity, post-inflammatory, Pigmentation, hypopigmentation
        • Hidradenitis Supparitva
        • Hyperhidrosis
        • Keratosis Pilaris
        • Lichen Planus
        • Lupus Erythematosus
        • Millia
        • Periorificial Dermatitis
        • Pityriasis Rosea
        • Pseudofolliculitis Barbae
        • Psoriasis
        • Rosacea
        • Scars
        • Scleroderma
        • Seborrheic Keratosis
        • Skin Infections
        • Skin Tags
        • Urticaria/ Wheals
        • Vitiligo

Acne

Acne, also known as: acne vulgaris, pimples, breakouts, folliculitis, cysts, blemishes, spots, zits, blackheads, whiteheads or comedones,  is a skin condition that affects the face and possibly the body.

Acne is very common among adolescents (approximately 85% experience the condition) and adults (55%), especially among adult females.

Hormones play an important role in acne. Increased hormone levels stimulate sebaceous glands to produce more sebum (oil). Sebum combines with dead skin cells to form a blackheads or whiteheads, known medically as comedones, and this can be likened to a plug in the skin. Comedones may rupture, allowing sebum to seep into the surrounding skin causing inflammation. The inflammation causes the bumps or pustules you see on your skin’s surface. Inflammation may also be quite deep-seated which may then be appreciated as nodules and cysts below the skin’s surface.

Dr Lev will first clinically assess your acne presentation and will then customise a skin care regimen for you. This may include:

Topical medication options include:acne

  • Benzoyl Peroxide
  • Salicylic Acid.
  • Retinoids
  • Topical antibiotics
  • Azelaic acid

Systemic medication options include:

  • Antibiotics
  • Oral contraceptives and hormonal medications
  • Isotretinoin

There are additional in-office procedures and therapies that can help with Acne. These include chemical peels, intralesional steroid injections, microdermabrasion, microchanelling and light therapies.

Acne Scarring

Acne scarring can be outlast the acne lesions themselves and this can be frustrating. The aftermath of acne can really affect how the affected individual feels about themselves, their self-confidence and even influence personal and social interactions.

There are different types of acne scarring. These include:

  • Depressed (“atrophic”) scars presenting as depressions or dips in the skin’s surface
  • Raised (“hypertrophic”) scars
  • Treatment Options

Treatment options for depressed scars may include:

  • Microneedling
  • Laser resurfacing procedures
  • Radiofrequency treatment

Raised acne scars may be treated with:

  • Intralesional steroid injections
  • Topical scar creams and dressings

Actinic Keratosis

Actinic Keratosis presents as a crusty, flesh-tones to pinkish red, scaly change on the skin surface caused by damage from exposure to cumulative ultraviolet (UV) radiation. These changes are commonly found on exposed skin surfaces.

Early treatment is the best course of action to prevent possible development of skin cancer. Treatment options include:

  • Freezing off or cryosurgery
  • Topical treatments –5-fluorouracil or imiquimod
  • Laser – fractional laser

Atopic Dermatitis/ Atopic Eczema

Atopic dermatitis is commonly seen in families where other members have components of the atopic triad – allergies, hay fever and/or asthma.

Symptoms include:

  • Itching
  • Dry, scaly skin
  • Redness

Exacerbating factors may include:

  • Dry skin
  • Chemical irritants
  • Stress
  • Hot/cold temps and perspiring
  • Infections
  • Allergens from the environment including pollen, dust mites, pet dander and mould

Depending on the severity of symptoms, atopic dermatitis can be treated with topical medications, which are applied to the skin; phototherapy, or oral medication.

Cellulitis

Cellulitis is a bacterial infection of the skin and tissue just below the skin. It is common to be found on the lower legs, however it can occur anywhere on the body. While it is most common among middle-aged and elderly, it can occur in people of any age.

Symptoms include:

  • Red, painful skin that may blister
  • Fever and chills
  • Swollen glands or lymph nodes

Contact Dermatitis

Contact dermatitis is an itchy, red rash caused by direct contact with a substance or an allergic reaction. It can be caused by an irritation or an allergic process.

Signs and symptoms of contact dermatitis include:

  • A red rash
  • Itching
  • Dryness
  • Bumps and blisters
  • Swelling, burning or tenderness

Treatment may include:

  • Eliminating exposure to irritants
  • Topical steroids
  • Oral antihistamines

Epidermoid Cyst

Epidermoid cysts are small, hard lumps that develop under the skin. Occasionally they become inflamed and rarely may become infected. If they become bothersome, they may be excised, injected with intralesional steroid, and sometimes may be treated with antibiotics.

Folliculitis

Folliculitis is an inflammatory change affecting the hair follicles presenting as red and swollen bumps anywhere on the body with hair follicles, but most commonly in areas that are shaved frequently. While folliculitis may be inflammatory, bacteria or pityrosporum are also to blame in some cases.

Causes of folliculitis include:

  • Infections- bacterial, fungal
  • Skin products like moisturizers with oils that block hair follicles
  • Hair removal like shaving, waxing, plucking

Fungal infections

Fungal infections of the skin are very common and include athlete’s foot, jock itch, ringworm, and yeast infections.

Hidradenitis Suppurativa

Hidradenitis Suppurativa (HS) usually begins as bumps on the skin, generally in hair bearing areas, including under the arms and groin. If left untreated the bumps can grow deeper into the skin and become painful, and rupture or form sinus tracts.

Treatment options include:

  • Warm compress
  • Antibiotics – oral and topical
  • Corticosteroids – intralesional
  • Oral retinoids – acitretin and isotretinoin
  • Hormone therapy – oral contraceptive pill or spironolactone
  • Botulinum Toxin
  • Surgical ablation for extensive involvement

Hives

Hives present as the sudden appearance of swollen, red bumps or plaques (wheals) on the skin. Hives usually itch and may burn or sting. They can last up to 24 hours before settling.

Hives form in response to histamine – a chemical released by cells in response to injury and in allergic and inflammatory reactions. Triggers may include allergic reactions, certain foods, insect stings or medication. They may also occur following a physical stimulation including cold, heat, sun, pressure, and sweating.

Hyperhidrosis

Hyperhidrosis or excessive perspiring most often affects the palms, feet, underarms, face or head. This may interfere with everyday activities. Hands can be so sweaty that it becomes difficult to hold a pen or use a computer. Sweat from the underarms may soak through clothes, causing obvious sweat marks

Treatment depends on the type of hyperhidrosis and where the excessive sweating occurs on the body. These may include:

Antiperspirants
Botulinum toxin injections
Oral medication eg: glycopyrrolate or oxybutynin

Hyperpigmentation

Hyperpigmentation presents as patches of skin that are darker in colour than the normal surrounding skin. This occurs when excess melanin, the brown pigment that contributes to our skin colour, deposits in the skin. People with darker skin tones are more prone to hyperpigmentation.

Triggers include sun exposure, medication, hormonal change, inflammatory skin changes trauma and insect bites.

Types of hyperpigmentation include:

  • Freckles
  • Solar lentigines (liver spots)
  • Melasma or chloasma – hormonally influenced and commonly triggered by pregnancy
  • Post-inflammatory hyperpigmentation resulting from a skin trauma such as acne, a insect bites or other injury or inflammatory event

Treatments include:

  • Topical skincare and prescription medication
  • Chemical peels
  • Microdermabrasion
  • Microchanelling
  • Intense Pulse Light
  • Laser treatment

Impetigo

Impetigo is a common, contagious skin infection most frequently occurring in infants and children. It is commonly seen on the face, especially around the nose and mouth. Impetigo presents as red sores that burst, ooze and develop honey-coloured crusts.

Keloid

A keloid is a  raised scar that forms on the body at the site of skin injury. In some individuals the skin may overproduce new tissue as it heals creating a raised scar. They are most commonly seen on the chest, shoulder, back, earlobe and cheek. Keloids may feel itchy or burn.

Treatment options include:

  • Corticosteroid injections
  • Cryotherapy (freezing with liquid nitrogen)
  • Silicone gel or patches

Keratosis Pilaris

Keratosis pilaris presents as small bumps usually on the upper arms. Other areas that may be involved include the  thighs and buttocks and cheeks. The bumps are usually rough in texture, and light pink to red in colour.

Keratosis pilaris is caused by a buildup of keratin – a protein that protects the skin. The excess keratin forms a plug that blocks the opening of a hair follicle. Patients with dry skin and those with eczema are more prone to developing keratosis pilaris.

Treatment options include:

  • Topical exfoliants like alpha-hydroxy acid, lactic acid, salicylic acid
  • Topical urea
  • Topical retinoids – vitamin A

Lentigines

Lentigines are commonly referred to as “liver spots”  or “sun spots.”  They are benign changes that develop as a result of repeat sun exposure on exposed areas of the body. Lentigines result from the increased production of melanin in the superficial layers of the skin.

Sun protection is the best method of prevention. Treatment options include:

    • Cryotherapy (freezing with liquid nitrogen)
    • Chemical peels
    • Laser treatments

Lichen Planus

Lichen planus may affect the skin, mucosa (oral and genital), hair and or nails. It presents on the skin it  as itchy flat-topped, purple, or reddish bumps.

Treatment options include

  • Steroids – oral, topical or injected
  • Ultraviolet light therapy
  • Immunomodulatory oral medication

Melanoma

Melanoma is the most dangerous and life-threatening form of skin cancer. Melanomas often resemble moles, and the majority are black or brown, but can present as skin-colored, pink, red, purple, blue or white. If melanoma is found and treated early, it is usually curable, but if not, it is very aggressive and can spread and metastasize resulting in fatality.

When examining the moles on your skin, use the following techniques:

Know your ABCDEs:

  • A- Asymmetry: if the two halves of a mole do not match in appearance (color, shape or size) it is a warning sign
  • B – Border: the borders of an early melanoma tend to be uneven, the edges may even appear scalloped or notched
  • C – Colour: a mole with a variety of colors is a red flag. These could be a range of brown, tan, black, red, white or blue.
  • D – Diameter: melanomas are often larger in diameter than a pencil eraser (1/4 inch).
  • E – Evolving: any change in size, color, shape, elevation, texture or symptom (bleeding, itching, crusting) is a reason to be seen by your Dermatologist right away.

Surgical excision (cutting the melanoma out) is the most common method of treatment.

Molluscum Contagiosum

Molluscum contagiosum is a skin condition caused by a virus that is contagious, most commonly seen in children. Skin to skin contact and sharing of towels and clothing can spread the virus. It presents as pink or skin-coloured bumps. The changes may be painless, but occasionally may be itchy.

Treatment options may include:

  • Topical acids and blistering solutions (cantharidin)
  • Topical retinoids or antiviral medications
  • Electrocautery

Nail Disorders

Nails can be affected by many disorders that can cause changes in nail shape and/ or nail texture

Causes of nail disorders:

  • Infection
  • Injuries
  • Internal diseases (lung disease, diabetes, cancer, impaired kidney or liver function, et)
  • Birth deformities
  • Medications
  • Tumours
  • Autoimmune Disease

Psoriasis

Psoriasis is an hereditary, inflammatory skin condition. Triggers may include stress, skin injury, infection and certain medications. It presents as red, raised, scaly patches.

Some patients may also be affected by joint involvement.

Treatment options include:

  • Topical creams and shampoos
  • Phototherapy
  • Oral medication

Rosacea

Rosacea  presents with redness, pimples, skin thickening and eye irritation. Common triggers include:

  • Sunlight
  • Heat
  • Stress
  • Alcohol
  • Spicy foods
  • Wind and cold
  • Some skincare/cosmetics

Treatment options may include:

  • Topical treatments: Metronidazole, Azelaic acid, Brimonidine
  • Oral antibiotics
  • Intense Pulse Light

Vitiligo

Vitiligo is a condition presenting as patches of skin that lose pigment. Patients may have a family history, and/or have an accompanying autoimmune disease.

Treatment options include:

  • Topical creams
  • Ultraviolet light and excimer laser therapies
  • In very rare cases, skin grafting may be recommended

Warts

Warts are skin growths that appear when a virus called human papillomavirus, infects the skin. Warts are contagious and may be spread by contact with the wart or something that touched the wart.

Treatment options may include:

  • Chemical exfoliation
  • Cryotherapy: freezing with liquid nitrogen
  • Electrocautery
  • Excision

Skin Cancer

Non-melanoma skin cancers include basal cell carcinoma and squamous cell carcinomas. These are uncontrolled growths of abnormal cells arising in the skin cells.

Non-melanoma skin cancers are mainly caused by cumulative ultraviolet exposure. These may occur on all areas of the body including the mucous membranes and genitals, but are most common in areas frequently exposed to the sun.

Non-melanoma skin cancers detected at an early stage and removed promptly are almost always curable and cause minimal damage. A small percentage metastasize to local lymph nodes, distant tissues, and organs and can become fatal.

Diagnosis requires a skin biopsy.

Paediatric Dermatology

Dr Lev is experienced in assessing and managing skin concerns in children. Some skin conditions affect children more commonly. The Dermatology Room is proud to be a practice offering skincare services for your entire family.

Hair

  • Alopecia Areata
  • Acne Keloidalis Nuchae
  • Central Centrifugal Cicitricial Alopecia
  • Ingrown Hairs
  • Folliculits Decalvans
  • Lichen Planopilaris
  • Male and Female Pattern Hair Loss
  • Pseudofolliculitis Barbae
  • Telogen Effluvium
  • Traction Alopecia

 

Hair Treatments

Restorative Hair Treatments

Male and Female Hair Loss

Dr Lev has carefully created comprehensive management programmes incorporating topical, oral and procedural components. Patients are first required to undergo a clinical examination and depending on the assessment and biochemical parameters subsequently assessed , Dr Lev will make you aware of the treatment options that you may clinically benefit from in a safe and effective manner.

Alopecia Areata

Alopecia Areata is a hair loss disorder based on an underlying autoimmune pathology. It usually presents as discrete areas of hair loss exposing a smooth, non-inflamed scalp. Early intervention with intralesional steroids, together with a topically medicated management plan can improve prognosis in facilitating regrowth of your hair.