Ageing Spots


Often known as liver spots, these are an all too visible reminder of the passing of time. Age spots appear in people over 40 although younger people can be affected as well. If you have noticed several flat brown or black spots on your face, hands, arms and shoulders then these are likely to be age spots.

The ageing process is the main reason but they also occur from years of exposure to direct sunlight, often as a result of sunbathing or heavy use of sunbeds. Constant exposure to ultraviolet (UV) rays changes the colour of skin, turning it to a light or dark brown colour. This is fine when you are young, but as you get older your skin is less effective at regeneration as a result of sun exposure which leads to the formation of age spots. Also, your skin is thinner and more fragile as you age which increases this risk. Genetics also play a part. If your parents or a close family member has age spots, then you will have directly inherited this condition.

Age Spots are often an inevitable part of growing older, but if you find these unsightly to live with then there are remedies for dealing with these spots.

At 152 Harley Street, our expert Consultant Dermatologists offer various highly effective treatments for age spots, including:

  • Skin camouflage creams and lotions, which gradually fade away the spots
  • Retinoid creams
  • Chemical peels and microdermabrasion
  • Laser therapy and cryotherapy
 
 

Eczema


What is Eczema?

Eczema, also known as dermatitis, is a condition in which the skin barrier is weaker. This means the skin is dry as it retains less moisture and is more susceptible to irritation and infection. It is an extremely common condition, with almost 1 in 5 children and almost 1 in 10 adults suffering from eczema. The severity varies significantly with time and from person to person, and it is a highly individual condition. There are several different forms of eczema. It is not contagious, so you cannot catch it from someone else.

In mild cases of eczema, the skin is dry, scaly, red and itchy. In more severe cases, there may be weeping, crusting and bleeding. Scratching causes the skin to split and bleed and leaves it open to infection.

You can inherit a tendency to develop the related ‘atopic’ conditions of eczema, asthma and hay fever.

Although eczema can flare up for no clear reason, you may notice certain triggers that make your atopic eczema worse. Common triggers may include:

  • Infections caused by bacteria such as Staphylococcus aureus;
  • Allergens, such as pollen, house dust mites, mould or pet dander (fur or hair);
  • Irritants, such as detergents, soaps or shampoo;
  • Rough clothing fabrics, such as wool;
  • Sweating;
  • Stressful periods;
  • If you’re a woman, changes in hormone levels, for example, at different times in your menstrual cycle or if you’re pregnant.

There are many treatments available to help alleviate the symptoms of eczema. 

There is no one-size-fits-all approach, as the condition can vary greatly in severity and type from person to person. Some people may find relief with lifestyle changes or over-the-counter medications, while others may require prescription medication.

At 152 Harley Street, our Consultant Dermatologists are able to diagnose and treat eczema, offering a variety of treatments depending on each case and the severity of the condition. These include; emollients, steroid creams, topical immunosuppressants, antibiotics, oral antihistamines and steroids. Our consultants can also educate, assess and treat patients with immunosuppressant medications, including new targeted agents and light treatment.

 

FAQ about Eczema

What are the symptoms of eczema? 

Various signs and symptoms are associated with eczema, ranging from mild to severe. The most common symptoms include itching, redness, dryness, and skin flaking. The skin may crack, bleed, or become infected in more severe cases. Eczema can also be associated with other conditions such as asthma and hay fever.

What causes eczema?

Although the exact reason why eczema may develop is unknown, it is thought to be triggered by a combination of genetics and environmental factors. We now know that the breakdown in the skin barrier is integral to the development of eczema. 

Eczema flare-ups may be due to irritant or allergen triggers that generate a response from the immune system, leading to skin inflammation.

Is eczema contagious?

Eczema is not contagious. It is not caused by an infection and cannot be spread from person to person. 

How is eczema diagnosed?

Health visitors, practice nurses, and doctors can usually quickly diagnose eczema simply by examining the skin. Blood tests or skin tests are rarely required. Occasionally, it may be necessary to swab the skin by rubbing a sterile cotton bud on it to check for bacterial or viral infections.

What are emollients?

An emollient is a non-cosmetic non-perfumed thicker moisturiser that soothes and softens the skin. You can use it to relieve the dryness, scaling, and itching associated with eczema. Emollients work by temporarily restoring the skin barrier, which helps to lock in moisture and keep out irritants.

Emollients are available in various forms, including creams, lotions, gels, and ointments. There are also emollient-containing products, such as gentle soaps, shower gels, and shampoos. 

Some common emollients include lanolin, mineral oil, glycerin, and petrolatum. Other ingredients, such as certain plant oils and butters, can also have emollient properties. 

What is the best emollient to use for eczema? 

There is no single best emollient for eczema. Emollients are moisturisers that can be applied to the skin to help reduce dryness and itching. The type of emollient you use may be determined by your individual skin type and the severity of your eczema. The most important thing to remember is to use an emollient regularly, even when your skin is not flared-up. This will help to prevent future flare-ups and keep your skin hydrated.

Should I be wary of topical steroids as an eczema treatment?

Topical steroids are an extremely safe and effective treatment for eczema when used appropriately and under medical supervision. 

The likelihood of side effects occurring is low and directly related to the potency of the preparation, where it is used, the condition of the skin on which it is used and the user’s age. Your practitioner will consider these factors when prescribing treatment. 

Side effects such as skin thinning and redness or telangiectasia only occur when potent or very potent steroids have been applied for an extended period of time to more delicate areas of skin, such as the face and neck, or parts of the body able to flex such as the backs of the knees and the armpits. These side effects are much less likely to occur when properly prescribed and managed.

How can I tell if my eczema is infected?

Eczema can become infected with bacteria, fungi or a virus. Bacterial infection is the most common of these. One way to tell if your eczema is infected is to look at the affected area. It may be infected if you have broken skin that is red, warm, or swollen. You may also see yellow crusting, pus or liquid discharge/weeping. If you have these symptoms, you should see a doctor.

How to reduce the risk of getting an infection?

Everyone’s skin is different, and what works for one person may not work for another. However, some general tips that may help to prevent eczema flare-ups from becoming infected include:

  • Avoiding known eczema triggers, such as certain dyes, fragrances, detergents or extreme temperatures);
  • Using a very gentle cleanser on the affected area;
  • Applying a moisturiser regularly to help keep the skin hydrated and less prone to cracking and infection;
  • Using a steroid cream or ointment to keep on top of severe eczema
  • Using natural and breathable fabrics 

If sweating makes eczema worse, can I still exercise?

Sweat can trigger flare-ups in some people with eczema. The body sweats in order to regulate body temperature. However, when people with eczema get hot and sweaty, the moisture evaporates, cooling them down. As the sweat evaporates, the affected skin dries out, leaving a salty residue that can irritate the affected skin and make itching worse.

However, exercise can be beneficial for eczema. This is because exercise has added nutritional health benefits and can help lower stress levels, which, in turn, can help prevent flare-ups.

If you are trying to exercise while also dealing with eczema, there are a few things you can do to make it easier. 

One of the most important things to remember is to wear loose, cotton clothing. This will help your skin breathe and will prevent you from getting too sweaty. 

You should also take regular rest breaks. This will give your skin a chance to recover. You might also find that it helps to blot sweat away with a clean towel – helping to keep your skin dry. 

When exercising with eczema, it is essential to drink water and bring extra to rinse off sweat to keep your skin hydrated.

When it is hot and when you are exercising, it may be helpful to use lighter emollients.

Can I go swimming if I have eczema?

If you have eczema, exposing your skin to chlorinated water or salt water may irritate it. 

Chlorine is a chemical irritant, which means that some people with eczema may experience irritation or drying of their skin. If you are swimming indoors, make sure to apply your usual emollient before entering the pool. It is recommended to use more cream than you usually would to ensure that it acts as an effective barrier to the water. It is also a good idea to shower straight after swimming to rinse off chlorine and salt and to use an emollient as a soap substitute in the shower and apply after showering.

If you are swimming outdoors, keep in mind the fact that emollients can increase your skin’s sensitivity to the sun. Ensure that you apply sunscreen after you have allowed the emollient to be absorbed by your skin to avoid either your emollient or sunscreen being diluted.

Salt water can also be irritating to the skin, as can sand or other particles suspended in seawater or natural pools. Again, it is best to use an emollient to protect your skin before swimming.

Can certain foods cause or worsen eczema?

Although we do not yet have a clear understanding of the exact role diet plays in eczema, there is little evidence that food can cause someone to develop eczema. 

In some rare cases, specific dietary changes may improve eczema symptoms in young children, but diet alone is not enough to manage the condition. 

If you think you or your child’s eczema may be related to their diet, it may be helpful to keep a diary of their food intake and eczema symptoms. This information can be discussed with a GP. However, any major changes to a child’s diet, such as removing cow’s milk, should be done under the guidance of a GP to ensure the child gets the nutrients they need. 

Commonly observed food triggers for eczema include eggs, nuts, cow’s milk and sesame, but many other foods can also trigger symptoms. 

Do I need to buy fragrance-free soaps, lotions, and laundry detergent if I have eczema? 

Some people with eczema may find that certain fragranced products cause them irritation, while others may not have any problems at all. 

If you have eczema, it is advisable to opt for fragrance-free soaps, lotions and laundry detergents – these may be the best options for you. 

Be sure to test any new products on a small patch of skin first before using them all over your body to ensure that they do not cause any adverse reactions.

Many plant-based products can be irritant, so it is best to discuss any topicals you are using with our team.

Can wearing certain fabrics make my eczema worse?

Wool and synthetic materials, such as polyester and nylon, can cause overheating, sweating and irritation for many people with eczema, which can set off the dreaded itch. Rough seams, fibres, fastenings and threads can also be problematic for those with sensitive skin. Your choice of clothing can have a significant impact on how your skin feels.

Cotton is the most highly-recommended fabric for people with eczema because it is absorbent, soft, and allows the skin to breathe. Blends that are mostly cotton are best, but it is important to read labels carefully to see the proportion of cotton to other fabrics.

Bamboo fabrics are also generally a safe choice. Bamboo is a soft, breathable material that is more absorbent than cotton. It is highly effective at regulating temperature, keeping you cool in summer and warm in winter. It also has antibacterial properties. 

Bamboo viscose is a processed form of bamboo that is generally used in clothing. It is usually combined with cotton and an elasticated fabric such as elastane, Spandex or Lycra to maximise comfort.

Silk is another good choice since it can help regulate body temperature and is soft and breathable. You can buy close-fitting silk garments designed for people with eczema, usually worn underneath regular clothes. 

However, silk is less practical than cotton or bamboo fabrics since it is more delicate and cannot be washed as easily. Creams are also more likely to mark it.

Can pets make eczema symptoms worse?

Some people find that pets can make their symptoms worse, while others are unaffected. 

Proteins in pet saliva or urine can trigger eczema symptoms in some people. Flakes of dead skin cells left by pets can also be a common trigger for eczema and related conditions, such as asthma.

Can stress lead to eczema flare-ups?

Although emotional stress and anxiety don’t directly cause eczema, stress can certainly make the symptoms of eczema less tolerable. 

The body releases a hormone called cortisol when it experiences stress. If an individual experiences chronic or severe stress, this can lead to an overproduction of cortisol which can then dysregulate the immune system and cause an inflammatory response in the skin, which can make eczema symptoms worse.

Can hormonal changes make eczema worse?

There is some evidence to suggest that changes in hormones can make eczema worse. For example, many women find that their eczema flares up during pregnancy or around the time of their menstrual cycle. 

The imbalance of estrogen is thought to be the main reason for this, which can occur during menopause and pregnancy, or before a menstrual cycle. It could also be due to the fact that the skin becomes more sensitive during these times, making it more prone to irritation. 

Some research has also suggested that the use of birth control pills can trigger or worsen eczema symptoms, although this is still unconfirmed and needs further research. 

Are there natural remedies for eczema?

There are many effective natural eczema treatments available. However, it is important to note that what works for one person may not work for another. It is always best to speak to a healthcare professional before trying any new treatment, natural or otherwise.

One popular natural eczema treatment is the use of probiotics. Probiotics are live bacteria that are found in certain foods, such as yoghurt and sauerkraut. They can also be taken in supplement form. Probiotics are considered beneficial for eczema sufferers as they help restore balance to the gut microbiome. This, in turn, can help reduce inflammation throughout the body, leading to fewer eczema flare-ups.

Another popular natural eczema treatment is the use of omega-3 fatty acids. These are found in fish oil supplements and some types of fish, such as salmon and tuna. Omega-3 fatty acids are considered beneficial for eczema sufferers as they can help reduce inflammation.

It is worth noting that natural remedies do not produce the same results as prescribed medication and may not provide much relief for eczema flare-ups. Occasionally, natural remedies can cause irritation or a contact allergy and worsen eczema.

 
 

Laser Treatments


Light Amplicifation by Stimulated Emission of Radiation (LASER) produces an intense beam of light of particular wavelength with insignificant dispersion over a short distance. This property is used in dermatology to treat a variety of skin disorders.

The laser stimulates high quality new tissue growth, its cellular effects discourage scar tissue build up and with it can smooth and relax existing scarring, lessening redness for better cosmetic effect.

It is effective to differing degrees across a number of skin conditions such as acne, psoriasis and eczema, both in terms of reducing bouts and improving previous scarring. There appears to be both anti-bacterial and anti-viral effects, since both acne and the herpes simplex virus are effectively treated with laser therapy.

At 152 Harley Street, our wide selection of lasers enables the following clinical and cosmetic procedures to be carried out:

  • Pigmented Lesions – brown marks, facial and backs of hands
  • Hair reduction
  • Vascular – facial blood vessels and birthmarks
  • IPL/Limelight/Acutip – photo-rejuvenation
  • Titan – deep infra red skin tightening
  • Sciton Erbium Yag – microlaser peels
  • UltraPulse Co2 Laser by Lumenis – acne scarring, scars & burns, fine lines, deep wrinkles, dramatic rejuvenation & skin tightening
 
 

Psoriasis


Psoriasis is an immune condition, which causes symptoms on the skin and sometimes the joints. When a person has psoriasis, their skin replacement process speeds up, taking just a few days to replace skin cells that usually take 21-28 days. This abundance of skin cells builds up to form raised ‘plaques’ on the skin, which can also be flaky, scaly, red on caucasian skin, darker patches on darker skin tones, and itchy. Psoriasis can occur on any area of the body, including the scalp, hands, feet and genitals.

Treatment aims to clear the rash as much as possible. However, as psoriasis tends to flare up from time to time, you may need courses of treatment on and off throughout your life. There are various treatments options available with creams, ointments and light therapy.

 
 

Rhinophyma


Rhinophyma is a condition that affects the nose, most commonly in the context of an inflammatory skin disease called Rosacea. It typically presents with textural irregularities with areas of thickened skin and enlarged prominent pores, together with an irregular contour giving rise to the term “cauliflower” nose. The condition can occur in conjunction with other signs and symptoms of rosacea, such as spots on the cheeks or chin, associated with redness that typically flares up with alcohol consumption, stress and heat.

Whilst Rhinophyma does not generally give symptoms of pain or itching, it can be severely debilitating and can lead to social embarrassment and isolation. Unfortunately, the condition does not improve spontaneously and in many cases can slowly progress and worsen.

At 152 Harley Street, treatment for both Rhinophyma and Rosacea is possible with one of our expert Consultant Dermatologists, who specialise in cosmetic and laser surgery.UltraPulse Laser (also referred to as CO2 laser) can prove to be a highly effective and life changing treatment in many cases, for both women and men. Laser treatment for Rhinophyma is a very safe and effective process if performed by a well-trained Consultant Dermatologist and laser specialist. 152 Harley Street is a Centre of Medical Excellence and all of our UltraPulse specialists are Consultants and leaders in their field.

 
 

Surgical Removal of Skin Lesions


Skin lesions are lumps or bumps such as moles, cysts, warts, skin tags and lipoma’s (fatty lumps).

Most skin lesions don’t cause serious problems and are benign, but you may want to have them removed for practical or cosmetic reasons.

There are different methods to remove skin lesions – the type of procedure you have will depend on the type of skin lesion you have. If you have benign (non-cancerous) warts for example, you can be treated with non-surgical procedures. Larger skin lesions or ones that needs a precise removal may need to be surgically removed under local anaesthetic or sedation.

 
 

Cosmetic & Aesthetic Dentistry


Often, our patients are not completely happy with the way their smile looks. They may feel that their teeth are discoloured or stained, that their smile is too “gummy”, or they may even just wish they could start all over again with a great new smile.

Cosmetic and aesthetic dentistry can help with all of these problems.

Sometimes patients only need a relatively simple and affordable treatment, at other times they may opt for a complete smile makeover, where we use a number of treatments in combination, in order to provide them with the smile they have always wanted.

At 152 Harley Street, our expert cosmetic and aesthetic treatments include:

  • White cosmetic fillings
  • Crowns
  • Veneers
  • Bridges
  • Smile improvements
  • Tooth whitening
  • Dentures
  • Dental implants
  • Orthodontic treatment
  • Plastic periodontal surgery
 
 

Dental Hygienist Therapy


Dental hygienist therapy plays a vital role in helping to keep your teeth and gums healthy by avoiding gum disease, or keeping it under tight control.

Gum disease is extremely common, and is caused by plaque, a constantly-forming, sticky film of bacteria. Initial symptoms of gum disease include sore or bleeding gums and bad breath. If left untreated, it can eventually lead to tooth loss.

At 152 Harley Street, our expert periodontal services include:

  • Preventive dental disease
  • Scaling and teeth polishing
  • Periodontal treatment
  • Teeth whitening
  • Maintenance of the mouth following treatment
 
 

Dental Implants


Dental implants are extremely realistic, permanent replacements for one or more missing teeth. They look and feel very natural, and enable you to eat and speak with confidence, as well as improving the way your smile looks.

The implant itself is a small titanium rod, which is carefully and gently placed into your jawbone. Over time, the bone and implant bond together, forming a strong and permanent base, very much like a false tooth root.

Implants can have crowns or bridges fitted on top, replacing one or more missing teeth. Patients with many missing teeth can be fitted with special dentures, held firmly in place by implants, thus making it much easier to eat and speak without embarrassment.

At 152 Harley Street, we offer a wide choice of implant treatments. These include the Teeth-in-an-Hour™ and Teeth in a Day™ and All on Four systems, all of which enable suitable patients to have their implants placed in just one appointment and to eat with their new teeth later that same day.

We also offer guided implant surgery for more complex cases. This involves taking a CT Scan of your jaw area, with our in house Cone Beam CT  scanner so we can ensure that before surgery, you have adequate bone available for an implant and can plan the implant placement with incredible accuracy. Where there is inadequate bone, our specialists are noted for their ability to regenerate the missing bone tissue using a variety of techniques (including bone grafting from other sites) when necessary.

In many cases it is possible to remove the tooth that is unsalvageable and following thorough curettage and cleaning of the socket with a drill, create an osteotomy site that allows the implant to be placed directly. In some cases it is possible to allow the implant to emerge through the gum tissue on the same day in order to provide a temporary crown in a type of resin or composite material. Treatment can be carried out under local anaesthesia, sedation, or rarely under general anaesthetic depending on the complexity of the case.

Once the implant has fully integrated with the jaw bone over a few months, an impression can be taken and the final crown can be constructed and fitted onto the implant.

In some instances, especially where grafting is necessary to build the jaw bone to the right shape, the implant is left beneath the gum and allowed to osseointegrate to the jawbone over a period of time. Once this is done the implant can be exposed, a healing abutment fitted and a ceramic crown constructed and fitted onto the implant. This is either screwed or cemented down onto the implant. Sometimes it is advantageous to wear a temporary acrylic crown whilst the soft tissue moulds itself around the provisional crown.

The All On Four technique:

The All On Four technique allows for the placement of four implants (but sometimes five or six are required) and for a bridge to be constructed and fitted on the same day as the implant placement.

This effectively allows the patient to leave the clinic with an implant restoration in their mouth. Cone Beam CT scan imagery allows for three dimensional reconstruction of the jaw bone to be made on the computer and for virtual implants to be placed into that jaw bone. Soon after examining the patient, a CT scan can be taken where it is needed for a rapid assessment to be made to allow the patient to know if they are a candidate for this technique.

 
 

Oral Surgery


Oral surgery is used to correct a variety of problems in the mouth, teeth and jaw area. This can include removal of wisdom teeth and impacted teeth, removal of unsalvageable teeth placement of implants and reconstruction of jawbone to enable implants to be placed. It can also include more complex surgery, for example when severe damage has been caused by accident or severe disease or surgical correction of malformed jaws or deformities.

At 152 Harley Street, we appreciate that many of our patients feel nervous about such procedures and we will do our utmost to help you feel calm and relaxed. We offer IV Sedation or general anaesthetic and will advise you if we feel this is the best way to handle your treatment. Our anaesthetists are all Consultant Anaesthetists and experts in Sedation Techniques and General Anaesthesia.

Our oral surgery services (some of which are covered by medical insurance) include:

  • Removal of teeth and fractured roots
  • Removal of impacted and buried teeth
  • Exposure of buried teeth
  • Investigation of oral pathology
  • Investigation and treatment of mouth diseases
  • Biopsies
  • Reconstruction of missing jawbone
  • Jawbone reconstruction for implant placement
  • Implant placement
  • Removal of salivary gland stones
  • Investigation and treatment of pain in the face
  • Jaw correction surgery (orthognathic surgery)
  • Oral surgery under sedation
  • Oral surgery under general anaesthesia
  • Oral surgery designed to accelerate orthodontic treatment (Wilcko technique)