Acne Rosacea is a chronic and quality of life disrupting disorder, primarily of the facial skin, characterized by flare-ups and remissions. It is different from acne vulgaris. 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 should consult with a specialist Dermatologist to ensure early diagnosis and appropriate treatment.
The recognised subtypes of acne rosacea are:
1. Vascular/erythematotelangiectatic rosacea: flushing which evolves into persistent redness, and visible blood vessels.
2. Papulopustular rosacea: persistent redness with transient bumps and pimples.
3. Phymatous rosacea: skin thickening, often resulting in an enlargement of the nose and thickening of the cheeks and chin.
4. Ocular rosacea: ocular manifestations such as dry irritated eyes, tearing and burning, swollen eyelids, recurrent styes and potential vision loss from corneal damage.
Many patients experience characteristics of more than one subtype at the same time, and these often may develop in parallel or quick succession. While rosacea may or may not evolve from one subtype to another, each individual sign or symptom may progress from mild to moderate to severe. Early diagnosis and treatment are therefore recommended.
Dr Sheridan and the specialist team at SDSL will assess your individual presentation and guide you along an individualised treatment pathway:
1.Lifestyle measures: diet, exercise, skin care and daily sun protection.
2.Prescription creams including retinoids and anti-flushing agents.
3.Prescription tablets including low dose antibiotics and retinoids.
4.Vascular laser, IPL, PDT and Radiofrequency (RF) based therapy.
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.
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
1.Prescription topicals: Retinoids, DNA repair agents, stem cell activators and growth factors
4.Injectables: Wrinkle relaxants, soft tissue fillers and platelet rich plasma
6.Ultrasound skin tightening
7.IPL and Vascular Laser
9.CO2 laser resurfacing
While many consider wrinkles to be the key marker of skin damage and ageing, an uneven complexion is just as significant. There are many types of pigmented lesions. Those such as seborrhoeic keratoses, lentigines, dermatosis papulosa nigricans and deep dermal melasma may be disfiguring and challenging to treat; especially in those with tanned and darker skin types: Asian, Eurasian, Mediterranean, Latino and African American people.
Dr Sheridan and the specialist team at SDSL will carefully assess your skin to determine the exact diagnosis and subtype of your pigmented lesions. This guides correct treatment selection and minimises the risk of worsening the existing areas of pigmentation through harsh or improperly applied treatment. Correct diagnosis is also essential to avoid the incorrect management of important skin cancers including melanoma.
1. Healthy lifestyle measures
2. Appropriate skin care and sunscreen application
3. Prescribed topicals: Retinoids, fading creams, antioxidants and DNA repair creams
4. Prescribed systemic agents such as Tranexamic acid
5. Chemical peels
7. Medical IPL
8. Laser: Q switched and picosecond pigment lasers
Visit our media section for further articles and information regarding treatment of melasma.
We understand that acne scarring is unsightly, distressing and may result in reduced self esteem.
There are several types of acne scarring and each requires specific targeted management. Treatment of acne scarring is therefore a highly specialised area of Dermatology. Several techniques are of benefit:
1.Prescribed retinoids (Vit A) and DNA repair creams
5.Lasers: Non-ablative fractionated (ie Fraxel) laser; CO2 laser; Vascular laser; Pigment laser
6.Soft tissue fillers and Platelet rich plasma (PRP)
7.Surgery: Subscision and excision
Dr Sheridan and the specialists at SDSL will carefully assess your particular type of scarring to develop the best action plan for you.
Broken vessels and vascular lesions of the face, legs and other areas are unsightly, may easily bleed with minor trauma such as cleansing and shaving, and may result in uncomfortable sensations such as stinging and burning.
Fortunately, effective treatments exist. Dr Sheridan and the specialist team at SDSL will help you discover the most effective of these for you:
1. Medical IPL
2. Vascular laser
7. Cosmetic concealment while awaiting treatment
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.
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
5. Photodynamic therapy (PDT)
6. Medical IPL
7. Radiofrequency (RF)
8.Ultrasound skin tightening
9. Fractionated laser (ie Fraxel)
10. CO2 laser resurfacing
Skin laxity is one of the most obvious and troubling manifestations of skin ageing and photodamage. The most visible areas are the cheeks, jowls, neck, chest, back of the hands and forearms.
Fortunately, there are now effective treatments to tighten and firm lax and sagging skin.
Essential preventative measures:
1.Healthy balanced diet and lifestyle
2.Daily gentle cleansing and moisturising
3.Daily broad spectrum 50+ UVA/UVB sunscreen application with sun smart behaviours
4.Skin support measures including prescribed antioxidants, retinoids, DNA repair agents, stem cell activators and growth factors
5.Avoidance of damaging lifestyle choices – especially smoking, alcohol, recreational drugs, stress and extreme exercise
1. Prescribed retinoids, antioxidants and DNA repair agents
2. Chemical peels
3. Laser and light therapy
4. Radiofrequency (RF)
5. Ultrasound skin tightening
Benign skin lesions do not threaten overall health, but can prove uncomfortable and unsightly. They may therefore benefit from expert treatment. Such lesions include viral warts, seborrhoeic keratoses, dermatosis papulosa nigricans, cutaneous cysts, milia, skin tags, chondrodermatitis nodularis of the ears, pearly penile papules; and benign appendageal tumours such as sebaceous hyperplasia and syringomata.
Your Specialist Dermatologist will correctly diagnose your lesions and exclude important differentials such as skin cancer; and will then guide you in selecting the most effective solution for your particular lesions:
4.Photodynamic therapy (PDT)
6.Preventative skin care, peels and presciption medications
Hair is a primary mode of expression for most people. There are rarely two identical hairstyles in the room.
Unwanted hair can be a source of inconvenience, consternation and distress. That said, unwanted hair usually represents a variant of normal. Your specialist Dermatologist can help exclude important medical causes such as polycystic ovarian syndrome and other endocrine abnormalities.
The highly qualified and experienced doctors and nurses at SDSL will assist you in discovering the best treatment to address your particular presentation of unwanted hair. Options include:
1. Bleaching, Waxing, Shaving, Plucking
2. Depilatory creams
3. Prescription tablets and creams
5. IPL and Laser hair removal