An interesting fact: 100% of the population suffers with some form of acne at some stage in life.

Severe forms of acne are damaging, with long term consequences such as scarring. As such, acne is very much a condition best treated early.

Dr Sheridan and the specialist team at SDSL will guide you through correct treatment including:

1.Prevention: Skin care, diet and lifestyle measures

2.Chemical peels and dermabrasion

3.Comedone extraction

4.Prescription antibiotics and topical creams

5.Prescription Isotretinoin (a form of Vitamin A)

6.Laser and light therapy

7.Scar revision

Acne Rosacea is a chronic disorder, primarily of the facial skin, characterised by flare-ups and remissions. It is different to acne vulgaris. Acne rosacea typically begins around the age 30 and manifests as transient facial flushing and brushing; progressing to fixed redness and then broken vessels of the nose, cheeks, chin and forehead. On occasion, rosacea may also occur on the neck, chest, scalp and ears.

Left untreated, acneiform papules and pustules develop, and in severe cases the nose may become swollen and distorted. The eyes may also become gritty, bloodshot and irritable.

Rosacea affects all segments of the population, with fair skinned individuals and those with excessive sun exposure at especial risk.

While the exact cause is unknown, medical and laser therapy is available to control and reverse the signs and symptoms. Individuals who suspect they may have rosacea will benefit from a consultation with a specialist Dermatologist to ensure early diagnosis and appropriate treatment.

Classification of acne rosacea:

1. Vascular/erythematotelangiectatic rosacea: flushing, persistent redness, and visible blood vessels.

2. Inflammatory/papulopustular rosacea: persistent redness with acneiform lesions and pustules.

3. Phymatous rosacea: skin thickening, often resulting in enlargement of the nose lymphoedema.

4. Ocular rosacea: dry and gritty eyes, tearing and burning, swollen eyelids, recurrent styes and potential corneal damage and reduced vision.

Many patients experience characteristics of more than one subtype, in parallel or quick succession. While rosacea may or may not evolve from one subtype to another, each individual sign or symptom tends to be progressive. Early diagnosis and treatment are therefore essential.

Treatment of acne rosacea:

Dr Sheridan and the specialists at SDSL will assess your individual presentation and guide you along the correct management pathway.

1.Wholistic lifestyle measures: diet, exercise, skin care and daily sun protection

2.Prescribed creams including retinoids and antiflushing agents

3.Prescribed tablets including low dose antibiotics and retinoids

4.Laser, Light, IPL and SWT therapies

5.Cosmetic camouflage until areas of unsightly redness, flushing and broken vessel formation have been cleared. Green-tinted foundations may be used to counter redness. This can be followed by a skin-tone foundation with natural yellow tones; avoiding those with pink or orange hues which tend to emphasise redness.

Skin Cancer Types:

The most common skin cancers are basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and Melanoma. Less common types of skin cancer include aggressive and potentially dangerous cancers such as sebaceous carcinoma, merkel cell carcinoma, malignant fibrous histiocytoma (MFH), atypical fibroxanthoma (AFX) and dermatofibrosarcoma protruberans (DFSP).

Dr Sheridan and the Specialists at SDSL are skilled in the accurate diagnosis, correct management and effective prevention of skin cancer; including rare and dangerous subtypes.

Self examination:

It is important to note that skin cancers are often first identified by patients, their family and friends. Individuals are well attuned to their own skin, and are thus best placed to notice suspicious lesions. It is therefore important to keep a close watch upon your own skin. It is recommended that you spend at least 5 minutes at the change of each season (three monthly) examining your skin closely for new, changing or symptomatic skin lesions.

Be sure to to check your back with the aid of 2 mirrors; or ask a family member or friend to help.

It is a good idea to take and store baseline photographs of your skin (pose front, back and side-on in your underwear) for comparison with your current skin at each self examination session. You may also elect to bring relevant photos with you to your doctor’s appointment for shared reference.

It is especially important to check yourself regularly if you have had a skin cancer removed in the past, as you will be at increased risk of new or recurrent skin cancers. All treatments, no matter how advanced, have a failure rate. This even applies to Mohs Surgery. Check the post surgical scar and operative zone for new lumps and skin changes; and remain alert for unusual persisting symptoms in the area such as pain and tingling. If you have had a skin cancer removed from the head or neck region, also check yourself for enlarged lymph nodes. These are usually felt as firm grape-like lumps beneath the skin around the ears, under the jawline and chin, and the sides of the neck. Should you detect any such changes arrange an urgent review with your Dermatologist or GP.

If you have suffered with skin cancer, your relatives may also be at heightened risk. Encourage them to engage in sensible sun protection activities and regular self examination. They may also benefit from a careful assessment by a Specialist Dermatologist.

Nothing beats prevention. Engage in daily sun safe behaviours; key of which are an SPF 50+ broad spectrum sunscreen, sunglasses and hat. Certain treatments reverse established photodamage, and in doing so may reduce the risk of progression to skin cancer.

Explore the links at the bottom of this page to respected Colleges and Associations for further information regarding self examination and the signs of skin cancer to look for. Alternatively explore the Mohs College patient education site for further helpful information: www.skincancermohssurgery.org

Prevention and Treatment:
1. Broad spectrum UVA/UVB SPF 50+ sunscreen, wide brimmed hat, sunglasses and protective clothing

2. Antioxidants, retinoids and DNA repair agents

3. Prescribed agents targeting photodamaged and malignant cells: 5 Fluorouracil (Efudix), Imiquimod (Aldara), Ingenol mebutate (Picato)

4. Chemical peels

5. Dermabrasion

6. Photodynamic therapy (PDT)

7. Medical IPL

8. Fractionated laser (ie Fraxel)

9. CO2 laser resurfacing

10. Radiotherapy

11. Surgery

While many consider wrinkles to be the key marker of skin damage and ageing, an uneven complexion is just as significant. Frequently encountered pigmented lesions include seborrhoeic keratoses, lentigines, dermatosis papulosa nigricans and melasma. These disfiguring lesions are often challenging to treat; especially in those with darker skin types: Asian, Eurasian, Mediterranean, Latino and African American.

Dr Sheridan and the specialist team will carefully assess your skin, to determine the exact diagnosis and to guide correct and safe treatment selection. This is important to minimise the risk of worsening existing pigmentation through harsh or improperly applied treatments. Correct diagnosis is also essential to avoid the inappropriate management of skin cancers including melanoma.

Treatments:

1. Healthy lifestyle measures

2. Appropriate skin care and broad spectrum sunscreen application

3. Prescription fading creams and antioxidants

4. Chemical peels

5. Radiofrequency (RF)

6. Medical IPL

7. Lasers: pigment laser, vascular laser, fractionated (Fraxel) laser

Visit our media section for further articles and information regarding treatment of melasma.

We are all human, mortal and must therefore age. Fortunately there are many measures available to sensibly reduce the rate of ageing, and to prevent accelerated ageing. Dr Sheridan and the SDSL nursing staff can help you discover the best approach for your particular situation.

Essential preventative measures:

1.Healthy balanced diet and lifestyle measures; including fostering mental health

2.Daily cleansing and moisturising regime

3.Daily sunscreen and sensible sun/visible light protection

4.Skin support measures including antioxidants, retinoids, DNA repair agents, stem cell activators and growth factors

5.Active avoidance of damaging lifestyle choices – especially smoking, excessive alcohol and stress

Treatments:

1.Prescription topicals: Retinoids, DNA repair agents, stem cell activators and growth factors

2.Chemical peels

3.Dermabrasion

4.Injectables: Wrinkle relaxants, soft tissue fillers and platelet rich plasma

5.Radiofrequency (RF)

6.Ultrasound skin tightening

7.IPL and Vascular Laser

8.Fractionated laser

9.CO2 laser resurfacing

10.Surgery

Scar types vary according to causation – ie post traumatic vs post surgical vs post acne. Common types are: atrophic, pigmented, erythematous, ice pick, hypertrophic (raised and prominent) and keloid (raised, prominent, symptomatic and extending beyond the site of causative trauma) scars.

Effective treatment flows from correct diagnosis and sub-classification, which guides correct treatment selection. Combination treatments are often required and include:

1. Elimination and prevention of causative factors

2. Supportive skin care and taping

3. Prescribed topical and intralesional medication

4. Radiofrequency (RF)

5. Light therapies: IPL, LED, PDT

6. Lasers: Vascular, pigment, non ablative fractionated (Fraxel) and ablative lasers

7. Surgery

8. Radiotherapy

Your Specialist Dermatologist will determine and discuss the most appropriate treatment(s) for your particular scars, in your particular skin.

Benign skin lesions do not pose any threat to your overall health, but may be uncomfortable and unsightly. They may therefore benefit from expert treatment. Such lesions include viral warts, seborrhoeic keratoses (senile warts), dermatosis papulosa nigricans, sebaceous and pilar cysts, milia, skin tags, chondrodermatitis nodularis, pearly penile papules; and benign appendageal tumours such as sebaceous hyperplasia and syringomata.

Dr Sheridan and the Specialists at SDSL will correctly diagnose your lesions, and carefully exclude important differentials including skin cancer. They will then guide you in selecting the most effective treatment for your paricular lesions:

1.Cryotherapy

2.Curettage

3.Laser ablation

4.Excision

Dilated pores, especially of the nose, cheeks and forehead can be troubling as they ‘age’ the skin and act as an unsightly repository for environmental debris and cosmetics.

Fortunately, helpful treatments exist:

1.Prescription medications

2.Chemical peels

3.Dermabrasion

4.Radiofrequency (RF)

5.Laser (CO2 and Fraxel) and Light

6.General preventative measures

The specialist medical and nursing staff at SDSL will help guide you through the best treatment options for your particular skin type.

Excessive and unrelenting sweating of the axillae, palms and soles is uncomfortable and highly inconvenient; and may exert a negative impact upon self esteem and interpersonal relationships.

It is important to identify and correctly manage hyperhidrosis, to circumvent it’s negative impacts. Effective treatments include:

1. General preventative measures

2. Medical grade antiperspirants

3. Iontophoresis

4. Prescription anticholinergic agents

5. Botulinum toxin (Botox) injections

6. Laser

7. Surgery: liposuction of the axillae and transthoracic sympathectomy

Your Specialist Dermatologist will carefully assess your particular presentation and subtype of hyperhidrosis, and thereby determine the most safe and effective treatment for your individual situation.

Hair, nails and mucosal surfaces (oral and genital) are all elements of the skin, and are therefore the domain of Specialist Dermatologists.

Your Dermatologist is the expert in the management of hair and scalp conditions such as male and female pattern baldness, alopecia areata, telogen effluvium, folliculitis decalvans and hair shaft defects.

The Specialist Dermatologists at SDSL can aid in the management of nail disorders including onychomycosis (fungal nail infection), psoriasis, lichen planus, and melanoma of the nail bed.

The nails also offer valuable clues to internal health issues such as lung, bowel, heart, liver, kidney and haematological issues. Your Dermatologist will make note of any tell tale signs indicating a need for wider analysis and care.

Various forms of light therapy are beneficial in the treatment of skin conditions such as photodamage, precancerous skin changes, dermatitis, psoriasis and disorders of pigment (ie vitiligo).

Treatment modalities include photodynamic therapy (PDT), LED therapy, narrow band UVB and PUVA. Your Dermatologist will diagnose your condition and prescribe safe and effective treatment specific to your condition.

Photodynamic therapy (PDT) is an effective therapy for pre-malignant skin lesions as well as selected skin cancers.

The area to be treated is gently prepared with a curette, and a photosensitising cream (ALA) is then applied to the target and a dressing placed over the area. The cream is then actively absorbed by precancerous and cancerous cells over the ensuing 1-3 hours. It is not taken up by normal cells, so a concentration gradient is established with the ALA selectively targeting abnormal cells. After three hours the dressing is removed and the ALA cream is activated by a red light or laser source over 6-8 minutes. Activated ALA destroys the abnormal cells that have taken it up over the preceding three hours.

PDT is a well tolerated, non scarring option in the treatment of precancerous damaged skin and selected types of skin cancer such as SCC in-situ and superficial BCC.

Clear, blemish free, sun protected skin has always been a symbol of beauty and health. Historically, tanned photodamaged skin signalled a careless or laboured outdoor lifestyle. Over recent years a worrying trend has emerged; the erroneous association of a tan with outdoor recreation; and thereby affluence, health, and attractiveness.

It is important to dispel this notion and understand that a tan is the skin’s ‘last ditch’ protective mechanism against the sun’s harmful ultraviolet rays. Furthermore, it does not afford significant protection from further sun damage.

Worse still, a sunburn signifies overexposure to the sun’s damaging rays with DNA damage and heightened skin cancer risk.

While sun exposure is important for generating vitamin D, there are significant risks when exposure is excessive. Sunlight is responsible for accelerated ageing, wrinkling, blotchy pigmentation, flushing and broken vessels and ‘leathering’ of the skin. Furthermore, virtually all skin cancers result from long-term cumulative sun damage. Blistering sunburns, especially in childhood, are linked to an increased lifetime risk of melanoma.

It is important to be aware of the effects of ultraviolet radiation and to balance the benefits and negative effects. Protecting the skin minimises the risk of both cosmetic deterioration and risk for skin cancers. It is never too late to start protecting yourself from excessive sunlight, as the damage to your skin is cumulative throughout life.

With some simple common sense you may continue to enjoy a healthy outdoors lifestyle. Wear a hat, protective clothing and sunglasses. Avoid direct exposure to the sun during the peak UV hours of 11am-3pm. Seek shade when outdoors in strong sunlight. A hat is portable shade. Sunscreens must provide broad spectrum 50+ UVA/UVB protection, and should be applied to all areas of exposed skin 15 minutes before going outdoors, They should be reapplied according to the prevailing environmental conditions and your physical activity.

Dr Sheridan and the SDSL staff will help guide you in the selection and implementation of appropriate preventative strategies and treatments to reverse established photodamage.

Treatments:

1. Prescribed antioxidants, retinoids (Retinol and Tretinoin) and DNA repair agents

2. Prescribed anti cancer creams: 5 Fluorouracil (Efudix), Imiquimod (Aldara), Ingenol mebutate (Picato)

3. Chemical peels

4. Dermabrasion

5. Photodynamic therapy (PDT)

6. Medical IPL

7. Radiofrequency (RF)

8.Ultrasound skin tightening

9. Fractionated laser (ie Fraxel)

10. CO2 laser resurfacing

11. Surgery

Dr Sheridan and the highly qualified nurses at SDSL are experts in managing skin, hair and nail conditions in both adults and children: eczema, psoriasis, acne, rosacea, hyperhidrosis (excess sweating) and disorders of skin pigment.

We offer the latest and most effective treatments and will assist you in the selection and application of those most suitable for your particular condition and situation.

Many of us wish to address troublesome cosmetic concerns, and this need not be a daunting and confusing process. It is important to have a clear and structured approach that allows you to cut through to important information relevant to your situation; and to filter out unhelpful information overload and ‘marketing noise’.

Dr Sheridan and the expert nurses at SDSL will help you identify those issues which are of most concern to you; and plan the safe and effective treatment of these.

At SDSL we strongly believe in a multidisciplinary approach, as this ensures the best outcomes for our patients. There are certain instances where Dr Sheridan and the nursing team will call upon a carefully selected network of skilled and ethical Plastic Surgeons, Oculoplastic Surgeons and Cosmetic Physicians to assist in your care.

Popular Cosmetic Dermatology Treatments:
1. Personalised skin care: bio-active cleansers, antioxidants, retinoids, DNA repair agents
2. Chemical peels
3. Dermabrasion
4. Wrinkle relaxants
5. Soft tissue fillers

Laser and related treatments:
1. Medical IPL
2. Radiofrequency
3. Photodynamic therapy: PDT and LED
4. Vascular laser
5. Pigment laser
6. Fractionated (Fraxel) non-ablative laser
7. CO2 laser
8. Laser hair removal
9. Cosmetic surgery

Call our friendly and informative staff for more information, and to make an appointment.

There are several important measures you can take to prevent and reduce the impact of skin conditions including photodamage, accelerated ageing, pigmentation, acne, rosacea, facial flushing and skin cancer.

Dr Sheridan and our highly qualified nursing team will develop a personalised system of preventative strategies to help you maintain and improve the health of your skin, such that you may enjoy the benefits of this into the future.

Essential measures:

1.Healthy balanced diet and lifestyle to build and maintain your physical and mental health
2.Daily cleansing and moisturising
3.Daily 50+ broad spectrum sunscreen and smart sun behaviours
4.Skin repair measures including prescribed antioxidants, retinoids, DNA repair agents, stem cell activators and growth factors
5.Avoidance of damaging lifestyle choices – especially smoking, excessive ultraviolet light, alcohol and stress

Visit our media section for a selection of useful articles, penned for various publications by Dr Sheridan, addressing this topic.

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