Dermotology

BCC starting image

What is a BCC?

What is Basal Cell Carcinoma?

 

Basal cell carcinoma (BCC) is the most prevalent form of cancer in the world, with millions of people diagnosed with a BCC every year. It is by far the most common type of skin cancer seen in Australia.  But there are measures you can take to minimise your chances of being part of the stats. The key to doing this is to first understand what basal carcinoma is and how it comes about.

 

How does basal cell carcinoma come about?

Our skin cells slough off everyday. Whether it’s because of mechanical friction or chemical exfoliation, every human leaves behind a wake of dead skin cells. But if our skin sheds continuously, why do we never see the deeper, raw layers?

 

For that, we can thank our basal cells. These form the deepest part of the most superficial layer of the skin called the epidermis. Basal cells divide steadily in order to replace the skin cells we slough off everyday so we are always protected.

 

The problem is when basal cells divide abnormally fast due to cancerous changes. They spread upwards to the surface of the skin causing noticeable lesions. If left to their own devices, these cells can also spread in the opposite direction, going deeper into the skin and damaging structures such as blood vessels, nerves, and bone.  The good news is that BCC’s rarely spread and cause nasty problems.  

 

 

BCC cross section of skin

Risk factors of BCC

So what causes basal cells to go berserk and start dividing uncontrollably? Well, the answer is mutations.  Whilst these mutations can be inherited from one’s parents, the bulk of mutations occur from exposure to DNA-damaging factors. And you guessed it, the culprit is most often ultraviolet rays from the sun. Chronic, unprotected exposure to the sun causes problems with DNA repair systems and induces mutations. 

 

People who have mutations in the genes responsible for the hedgehog signalling pathway (yes, that is an actual medical term) are predisposed to cancers including BCC. This system is essential in regulating cell growth. When the genes here run amok, cells grow unchecked and tumours result.

 

Symptoms of BCC

Because BCC’s present on the surface of the skin, it makes it easy to detect with the naked eye. With knowledge of abnormal skin lesions and daily observation of one’s skin, it’s possible to catch the early stages of BCC’s.  Catching BCC’s in its early stages may mean avoiding surgery, or if surgery is required, having a smaller scar.  This is particularly important for BCC’s on the face which can encroach on important structures like your eyes and nose.

 

Keep an eye out for patches of skin that look different from the surrounding area and appear to grow bigger over time (keeping in mind that BCC’s in general are slow growing). Look for changes in color, texture, or elevation. Some BCCs present as skin wounds that don’t seem to heal and bleed, some as red rough patches and others as smooth skin-coloured or pink humps, bumps or sometimes divots in the skin.

 

Note that other skin lesions may be confused with BCC, especially to untrained eyes. But remember that it’s better to be safe than sorry. If you find something on your skin that looks suspicious, visit a doctor for an expert opinion. 

 

How to minimise the risk of BCC

The association between chronic exposure to UV radiation and basal cell carcinoma has long been established. Consistent and proper use of sunscreen, wearing sun-protective clothing and accessories, seeking shade and limiting time spent under the sun are simple measures that can effectively minimise your chances of getting this disease.

 

For the young, start being vigilant with sun protection early.  For those of us who have received plenty of UV rays in our lifetime, be vigilant about looking out for new and different spots and seek medical attention early.

 

Resources:

 

https://dermnetnz.org/topics/basal-cell-carcinoma/

https://www.aad.org/public/diseases/skin-cancer/types/common/bcc

https://dermnetnz.org/topics/genetics-of-basal-cell-carcinoma

 

 

The information presented on this website is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.

Psoriasis on knees

The 101 on Psoriasis

Covering the basics of psoriasis

Itchy, painful, embarrassing, unsightly – these are just some words that sufferers use to describe the condition known as psoriasis. It may seem insignificant to some, but the impact psoriasis can have on one’s quality of life can be significant. From the physical marks, to the psychosocial effects, it can indeed be a difficult disorder to live with.

However, with a general understanding of psoriasis, effective medical treatments and appropriate lifestyle strategies, psoriasis can be effectively kept in-check. 

And you don’t need to be a sufferer of psoriasis to be taking some interest in the condition.  A little understanding from the general public on this condition can also go a long way to help sufferers deal with the condition.

In this article, we give you a bird’s eye view of this complex condition.

 

What is psoriasis?

Psoriasis is an immune-mediated disorder that causes skin lesions seen as well-defined, red and scaly patches on the skin.  People may think that the effects of psoriasis are limited to the body’s surface, but this is a disorder that can affect multiple systems. As such, psoriasis may come hand-in-hand with other medical complaints such as joint pains (which may be due to psoriatic arthritis), nail problems (called psoriatic nail disease) and in some cases, heart problems.   It is also worth mentioning that whilst many people are not bothered by their psoriasis, for some, it can impact on the quality of life.

 

What causes psoriasis?

We do not fully understand how psoriasis comes about, but it is likely to be multifactorial in nature. Genetics plays a role, as multiple cases within families are common. There appears to be genetic abnormalities common between people diagnosed with psoriasis, particularly with respect to genes that code for parts of the immune system. Researchers are still trying to find the connection between genetics, inflammatory reaction and unregulated production of skin cells that causes the visible lesions associated with the condition.  Psoriasis is not due to infection and is not contagious. 

The effect of environmental factors cannot be discounted. Many psoriasis patients report that their symptoms are exacerbated by cold, dry weather, smoking, weight gain, and stress. 

It is likely that the manifestation of psoriasis is a combination of both internal and external factors.

 

What does psoriasis look like?

Psoriasis lesions on the skin can present in different ways. Note that people may present with more than one type of psoriasis.

One way to classify psoriasis is by the appearance of the lesions. The most common form is chronic plaque psoriasis.  This presents as elevated red patches of inflamed skin with a silvery scale that can occur almost anywhere on the body. On the other hand, flexural or inverse psoriasis is seen as smooth, red, raw skin found in skin folds such as the armpits groin or other skin creases. Yet another form is guttate psoriasis, which appears as small, round, red spots mostly on the trunk and is often triggered by a throat infection.

Psoriasis can also be classified according to the affected body part. There is scalp psoriasis, nail psoriasis, and palmoplantar psoriasis (psoriasis of the palms and soles).

 

What is the treatment for psoriasis?

Treatment varies depending on the severity of symptoms. Mild cases can be treated with medicated lotions and creams that control inflammation, dryness, and excessive production of skin cells. Moderate to severe psoriasis may require treatment in the form UV light (narrow band UVB or phototherapy) or with medications.  Medication options are considered case-by-case and can be in the form of tablets or injections in specific cases.

Chronic psoriasis may require lifestyle changes. Using gentle skincare and avoiding triggers may be just as important as medical treatment in controlling the condition.  Weight loss (if overweight or obese), physical activity and a care for the mind as much as the body can be important additional measures to manage psoriasis.

 

Last thoughts

Psoriasis is very common.  Treatment may not always be required but should be pursued if there is an impact on one’s quality of life. Whether it is lifestyle changes, creams, phototherapy, tablets or specialised injections, there is almost always a a treatment option for psoriasis.  

 

The information presented on this website is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.

Tips for Healthy Winter Skin

 

As the temperature drops and the nights grow longer, your skin may shift to a dry and flaky texture in winter. The low temperature and humidity of this season causes our skin to become more dry, resulting in poor barrier function of the skin, flares of eczema and dermatitis, increased sensitivity and itch, and more prominent appearance of fine lines and wrinkles (if that matters).  

But there are ways to counter the skin changes brought on by the cold. With these simple skin hacks, you can keep your skin supple and healthy despite the freeze.

 

Moisturise, moisturise, moisturise

Counter the dry winter chill with a heavy-duty moisturiser. Shift from your airy, lightweight summer moisturiser to something with a thicker and creamier consistency. This will leave your skin feeling supple for longer, putting up a worthy fight against the cold and dry environment. 

Moisturisers in their chemical properties come as three types;

  1. Humectants which draw water to the skin
  2. Occlusives which prevent water escape from the skin, and
  3. Emollients which fill in the cracks between your skin.

Commercially available moisturisers come in different chemical makeup and good ones will have all three types ticked off.  The key is to try different moisturisers until you find one that you like best.  If you need a moisturiser that is just right for you in its texture and moisturising properties, this can be made for you in an affordable manner at some compounding pharmacies specialising in skin.

Consider a humidifier at home

If a humectant moisturiser is Batman, a humidifier would be Robin.

The hygroscopic (water absorbing) property of a moisturiser is maximised only when the air around you contains moisture. Winter air is dry, add to this the use of heaters indoors and you have a great set of conditions for dry air in your house, classroom or workplace. 

Consider adding a humidifier in the indoor spaces you spend the most time in, such as your bedroom or office. Use a product with humectant ingredients and give your skin relief from arid conditions. 

 

Avoid irritating ingredients

The biting cold is already a handful for our skin to manage, so let’s not give it any other reason to stress out. Irritating ingredients like alcohol in some serums, astringents in some creams, soaps and strong fragrances can push our already damage-prone skin over the edge.

Instead, go for products that are labelled as

  • “gentle”
  • “mild”,
  • “soap-free”,
  • “non-irritating” or;
  • “for sensitive skin”.

This will give your skin the TLC it deserves for protecting us against the elements.

 

Protect your skin from abrasive clothing

Chemical ingredients in skincare products aren’t the only things that cause our skin additional distress. Abrasive fabrics can rub against our skin, leading to friction that could irritate your skin.

Wear a layer or two of light, comfortable clothes, ideally made from cotton, that sit directly on your skin. Then pile on however many layers of heavy-duty winter clothing you need to stay warm.

And the same principle goes for mittens. Wearing glove liners made of silk or cotton under your wooly mittens can protect dry hands from further irritation.

 

Protect your skin from snow-reflected UV rays

An overcast winter day might make you think that you don’t need sunscreen, but the snow that falls down from it is definitely a reason to worry. Fresh snow can double a person’s UV exposure because it is just so good at reflecting the sun’s rays.

Thankfully, the winter chill has your body covered with heavy clothing that prevents UV rays from seeping in, but you have to protect every other part of your body left exposed–including your eyes!

Snow blindness, also known as photokeratitis, is basically getting your eyes sunburned. It is as painful as it sounds. To avoid this, wear UV-protective sunglasses or winter goggles with a UV rating.

 

Don’t turn up the heat too high

If the cold makes our skin dry and irritated, then turning up the heat will make it all better–right?

Wrong.

Our attempts to compensate for the low temperature by cranking it up could be doing more harm than good. 

A long, hot bath may sound luxurious, but your skin would much prefer a quick, lukewarm shower. Keeping your heater to a comfortable 20-22°C keeps you from shivering without shocking your skin.

 

Some last thoughts

As a dermatology practice, we see a rise in patients seeking assistance with eczema, hand dermatitis and psoriasis in the winter months.  With cold and low levels of humidity, we need to counter-act the drying effects of these conditions by avoiding irritants getting to our skin and being liberal and frequent with the use of moisturisers. 

Interestingly, what we see less of in winter is patients seeking skin checks for skin cancers.  The saying ‘out of sight, out of mind’ may explain this phenomena well, however skin cancers don’t just wait for warmer weather to appear.   Check your own skin regularly for any new or changing lesions and see your GP or dermatologist if you have a concern.

Look after your skin in all seasons of the year, at all times.

 

The information presented on this website is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.

Acne Treatment

Acne Fighting Treatments

For those of us that deal with acne, it can be hard to pin down a skin routine/treatment plan that is effective. There are a lot of options out there and figuring out what works for you and your skin issues may feel like a mammoth task. You may find yourself asking, is oil-free the way to go? Would a chemical exfoliant be too harsh? Is it my hormones? Fear not though, we are in this together. So, today we are going to break down some of the available acne-fighting options and how they may or may not be what you need to treat your own acne. Less conventional and other physical treatments such as chemical peels, lasers and in-clinic treatments are not discussed in this article.

 

Some of the main contributors to acne is our skin producing excess oils (sebum), dead skin clogging pores, inflammation caused by bacteria, and imbalanced hormones. Therefore, the ingredients used to treat acne help combat those risk factors. These treatments can be applied topically, meaning it goes directly on the surface of your body in a specific area, or orally, which means by mouth with ingestion. While the treatments in this article are mainly topical, know that there may be cases where oral acne treatment makes more sense. That decision will be something for you and your dermatologist to work out.

Acne treatment creams

 

Acne treatments for oil production and exfoliation

When dealing with mild acne, looking for treatments that are aimed at reducing oil and banishing dead skin is a good first step. Below is a list of ingredients that do just that.

 

Salicylic Acid

A beta hydroxy acid or BHA, as some may refer to it. This acid is a go-to ingredient commonly found in products that are used for treating acne because its main function is to dissolve excess oil and shed away dead skin layers aka exfoliate. It is very important to pay attention to the levels of this BHA that are being used; too low a concentration and can be ineffective used alone and too high a concentration can be damaging to our skin. Also, this ingredient can help decrease the inflammation that makes acne stand out so much on our skin.

 

Glycolic Acid

An alpha hydroxy acid or AHA for short. This acid has similar functions to the beta form. You can think of glycolic acid as salicylic acid’s younger sibling who wants to be in all the same extracurriculars. Glycolic acid is considered a top tier ingredient for exfoliating skin. Not only will this ingredient shed skin layers, but it can help fade acne marks that pesky pimples have left behind. Be careful though, because this ingredient has been known to irritate skin more easily than BHAs.

 

Sulfur

If you can get past the strong rotten egg smell, sulfur has some great acne-fighting benefits. This chemical ingredient is mainly an exfoliant helping to remove dead skin layers – out with the old, in with the new. In addition, sulfur can kill bacteria and reduce the amount of oil in our skin. Best of all, sulfur is safe for daily use!

 

Retinoids creams

You may recognize this ingredient by its more common alias, Vitamin A. This ingredient can actually occur in our bodies naturally, but it is also used in a more concentrated form for skincare.  Similar to the others listed, this ingredient encourages dead skin to not overstay its welcome. Retinol is great for reducing oil and helping pores stay unclogged as well.

 

Niacinamide

Niacinamide is a form of Vitamin B3 and is also known as Nicotinamide.   Niacinamide is a very important component of acne treatment.  It works to battle acne primarily by reducing inflammation and controlling oil production. There are many other benefits of niacinamide including reducing pigmentation, minimising sun-damage and helping with the barier function of the skin.  Our favourites are The Skincare Company Vitamin B3 and Propaira Skin Defence.

 

Oral retinoids

When acne is more severe or cystic and leaving behind scars, stronger acne treatments may be required. Oral retinoids help reduce oil in our skin when some other acne-treating ingredients may not be as effective. These are prescribed by dermatologists only in certain cases.

 

Acne treatments for fighting bacteria

For those of us who may feel our oil levels are under control but continue to have acne breakouts, we may need to look into ingredients that target acne-causing bacteria as well. So, the treatments below speak to that.

 

Benzoyl Peroxide

Benzoyl Peroxide is a topical treatment that is great for targeted use on skin. While this ingredient does help minimise oil and shed skin cells, its main claim to fame is killing the bacteria that gets trapped in our pores.

 

Antibiotics

People take antibiotics for a lot of reasons and sometimes bad acne is one of those reasons. Antibiotics are a type of medication specifically designed to go after bacteria by killing them or stopping their growth. You and your dermatologist may decide that this treatment is the best way to help your skin and that is perfectly okay.

 

Acne treatments for hormone control

Sorry men, this one is for the ladies.  Sometimes, there is a clear hormonal pattern to acne which is well worth targeting.  If you fall into this category it may be worthwhile discussing with your GP or dermatologist whether conditions like polycystic ovarian syndrome needs to be considered.  In either case, below are some treatments that may help with hormonal acne.

 

Birth Control

This acne treatment can be used when acne breakouts (mild or severe) are brought on by the hormone changes that happen around a woman’s period. The ingredients in birth control can help reduce androgens, which are the sex hormones your body produces that get you through puberty. These hormones can greatly increase the amount of oil your body produces, which can result in acne-prone skin. But beware, some birth control pills are ineffective for acne whilst others can make it worse!

 

Anti-androgenic tablets

You may not have known, but besides birth control pills, there are other types of anti-hormonal tablets that can be used to treat acne. Just another thing to have a chat to your dermatologist or GP about!

Acne treatment tablets

Other treatments

Other treatments that can help take care of our acne-prone skin include niacinamide (Vitamin B3) used topically (directly on your skin) and azelaic acid.  Both these creams have the additional benefit of fighting against pigmentation that can occur in darker skin types once a pimple goes away. Talk about being multiskilled!

 

Seeking acne treatment

Although we addressed each of these treatments/ingredients in an isolated manner, a lot of the time these ingredients can be used alongside each other if you have multiple acne symptoms that you need to be addressed. That stated, you must be careful because some of these ingredients should never be used together because they can interact negatively within our bodies. Please always consult a pharmacist, dermatologist or GP before making any treatment decisions about acne.

 

The information presented on this website is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.

adult male acne

Adult Acne vs. Teen Acne

While getting acne in your teens may seem like an inevitability, you will be happy to know that it is not one of life’s guarantees. In fact, some teenagers and young adults (those aged 12-24) may not experience acne at all in their formative years – around 15% to be exact. That stated, those of us who don’t develop acne in our teens or young adulthood are not completely off the hook. In fact, we can actually still experience adult acne. Today, we are going to dive into what exactly adult acne is, and whether there are notable differences between acne during those precious teen years and adulthood.

 

However, before we can address acne in teenagers, we must discuss something that is an actual inevitability, puberty.

Acne puberty

 

 

Puberty and acne in your teens

 

Puberty is a process of changes that happens inside everyone’s body that can affect our outward appearance when we begin to mature out of childhood.

 

For girls, puberty usually happens between the ages of 10 and 14, while it can occur between the ages of 12 and 16 for boys. A key bodily change that happens during puberty, which can affect our skin, is an increase in androgens or female/male hormones. Androgens play a large role in our bodies development and as a result can make our skin’s oil glands larger while increasing their oil production.

 

Since some of the main contributing factors to acne is excess oil production, hormones, and stress; it makes sense that we are more likely to deal with breakouts as teens and during puberty. Being a teenager can be a stressful time; throw hormones and enlarged oil producing pores into the mix, and you have a perfect storm for acne to make its debut.

 

In addition to the puberty hormones, other things like sweat, cosmetics, or friction from your pillowcase/clothes can all contribute to acne forming on your skin. Don’t fret though, because millions of people deal with acne each year and there are treatment options available if your acne is more severe.

Cleansing face with acne

 

 

 

Adult acne

 

For those of us who thought we made it safely to the other side of adolescence acne-free, mother nature decided to throw us a curveball in the form of adult acne.

 

Adult acne, which is defined as acne that develops after the age of 25, can be a continuation of the acne we experience in adolescence or it can be brand new for those of us who did not have acne-prone skin as teens. While it may be frustrating to suddenly develop (or continue) acne breakouts as you start your descent into adulthood, there is information out there to help you help your skin.

 

Causes for adult acne

 

You may or may not find it reassuring that the same factors that can cause acne in our teens/young adulthood are responsible for acne in adulthood as well. The main sources being excess oil production, dead skin cells clogging pores, bacteria/inflammation, and hormones.

 

However, the list above is not exhaustive and there are certainly other things that could be creating the ideal environment for pimples on our skin.

 

Additional risk factors for adult acne include;

  • Poor diet
  • Stress
  • Menstrual cycles in women
  • Hair/skin products, and
  • Medications that we might be taking

It may seem overwhelming that there are so many variables affecting our skin’s health, but there are also solutions to help keep adult acne in check.

 

Stress and acne

 

 

Acne prevention/treatment for teens and adults

 

As you can see above, there is not a huge amount of difference in how our skin behaves with teenage acne versus adult acne. The main point of separation between adult and teen acne is that puberty hormones play a larger role in causing our skin to change, but the resulting acne fares the same. Therefore, the methods for treatment overlaps as well. Here we offer some tips for prevention and treatment of both adult and teen acne.

 

Prevention

When it comes to our skin, sometimes the best defence is a good offence. What we mean by this adage is that taking steps for prevention can be a big help with our skincare. So, things like face washing with the right cleanser, thorough make-up removal with a non-comedogenic product and using oil free/non-pore-clogging products can improve our skin before we even begin treating it.

 

Treatment

In terms of treatment, there are topical therapies that can be picked up at a pharmacy such as Skin Plus Compounding Pharmacy, which may be sufficient to help improve skin issues for many. However, if you find that the over-the-counter treatments are not doing the job, you can always reach out to a dermatologist. Dermatologists are medically trained to help diagnose and treat skin issues. They can work with you to define the severity of your acne and create a personalised treatment plan.

 

The information presented on this website is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.

Acne 101

At some point in roughly 85% our lives, we are going to wake up and spot an unwelcome visitor on our skin in the form of a pimple. Whether you feel it coming or it pops up as a complete surprise (pun intended), having a pimple is the symptom of one the most common skin conditions, acne.

People throw around the word acne a lot, but have you ever wondered what exactly is happening on our skin that causes those pesky pimples to arrive? In this article we are going to talk a little bit about what acne is, where it comes from and options there are for treatment.

What is acne? 

The formation of pimples has a lot to do with our pores, which are the tiny holes seen on our skin that connect to oil producing glands deeper in the skin. A gland is a fancy term for an organ in our body that releases certain chemicals/substances for specific uses. The glands connected to our pores, produce an oily substance called sebum that protects and moisturises our skin.

 

Now, to get the sebum from our glands up to the skin’s surface, the body uses hair follicles as a pathway. Inside our follicles, the sebum oil will also carry dead skin cells to the skin’s surface to be shed off. However, sometimes the hair inside the follicle, dead skin cells, and sebum oil will get stuck together and become plugged up underneath our skin. Then, bacteria grow, which causes the plug to swell and eventually break down. The plug breaking down from all this commotion under our skin is what causes a pimple to develop.

 

What causes acne?

There are a few factors that can contribute to our bodies having acne breakouts. Three of the four main factors were listed above, which are;

  • hair follicles being clogged by oil and dead skin cells
  • an over-production of oil
  • bacteria growing in our pores.

The last main factor is our hormones – these are chemicals in our body that help with managing behaviour and mood.

 

Other risk factors for acne include;

  • our family history (genetics)
  • stress, causing hormonal changes and
  • pore clogging creams, makeup and oils

What types of acne are there?

The word pimple is often used as a catchall phrase, but the pimples we experience with acne can actually be categorised by type. The type of acne we have is based on how the plugged-up follicle behaves on or under our skin. Each type is listed below:

 

  • Whiteheads: the plugged pore is closed and the pimple stays under the surface of the skin
  • Blackheads: the plugged pore is open and the pimple rises to the skin’s surface and appears black
  • Papules: small red or pink bumps that are typically tender
  • Pustules: papules that are red at the bottom and have pus at the top
  • Nodules: solid, large, and painful pimples that are deep within the skin
  • Cysts: deep, painful, pus-filled lumps that are beneath the skin’s surface; typically cause scarring.

In addition, acne is not limited to just showing up on our faces. Pretty much anywhere we have pores is fair game for acne. That stated, acne will typically appear on our face, neck, chest, back, and shoulders.

Acne types

Who can get acne?

Now that you are intimately familiar with what causes acne and how to classify pimples, you may be interested in who is susceptible to acne’s pore plugging agenda. Well, the answer is everyone, even babies!

 

While acne does not discriminate, teens and young adults are the age group that is most commonly dealing with acne and its symptoms. It is estimated that 80% of people between the age of 11 and 30 will deal with acne breakouts at some point in their lives.

 

How can acne be treated?

Acne is usually not a cause for serious concern in terms of overall health and there are many products available to help keep breakouts at bay in your local pharmacy.

 

However, if you find that the over-the-counter treatments are not doing the job, it may be time to reach out to a GP or dermatologist. Dermatologists are medically trained skin specialists who diagnose and treat skin issues. They can work with you to define the severity of your acne and create a treatment plan.

 

The information presented on this website is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.