Procedures

Botulinum toxin injections are approved for hyperhidrosis affecting the armpits. Used to reduce or stop sweating for three to six months. Used off-license for localized hyperhidrosis in other sites such as palms. Topical botulinum toxin gel is under investigation for hyperhidrosis

A peel removes several layers of sun damaged skin cells, leaving fresh skin, which has a more even surface and color. It may stimulate new collagen to be formed improving skin texture. Peels may result in superficial, moderate depth or deep skin injury.

A nurse or aesthetician may perform superficial peels. A dermatologist or plastic surgeon usually performs moderate to deeper peels.

Peels can be repeated as necessary; some people have superficial peels every few weeks. It is wise to wait 3 to 6 months before repeating a moderate depth peel.

Glycolic acid, salicylic acid and Jessner peels result in superficial skin injury and are well tolerated – the ‘lunchtime’ peel. They remove thin lesions on the skin surface, reducing pigment and surface dryness. The result of the first peel may be disappointing, but after repeated peels, significant improvement is usually evident.

Trichloracetic acid (TCA) is the most common chemical used for a medium depth peel. The results depend on its concentration, usually 20 to 35%. The treatment is painful and treated areas are swollen, red and crusted for the next week or so. It can lead to an impressive improvement in skin texture with a reduction in blotchy pigmentation, freckling and actinic keratoses (dry sunspots). Although fine wrinkles and some acne scars are less obvious, the TCA peel has no effect on deep furrows.

Cryotherapy refers to a treatment in which surface skin lesions are frozen. The most common cryogen is liquid nitrogen. It is used to kill unwanted skin such as warts, precancerous lesions, or benign growths such as skin tags.

Ear lobe repair can correct torn, ripped, drooping and stretched-out earlobes. This is not to be confused with ear surgery (otoplasty), which is typically performed to correct large, protruding or deformed ears.

Electrodesiccation and Curettage (ED&C) is a surgical procedure used to removal certain skin lesions such as warts, angiomas, actinic keratosis, basal cell skin cancers and squamous cell skin cancers. After local anesthetic is placed, the surgeon removes the abnormal cells by scraping down to a layer of uninvolved tissue. Finally, desiccation (electrosurgery) is performed with a small, metal instrument used to widen the margin and cauterize the wound to minimize bleeding. The wound is left to heal without sutures and typically heals over several weeks.

Dermatologists apply patch tests in patients with dermatitis, to find out whether their skin condition may be caused or aggravated by a contact allergy. Patch tests are not the same as skin prick tests, which are used to diagnose hay fever allergy (house dust mite, grass pollens and cat dander). Skin prick tests have very limited value for patients with skin rashes.

Photodynamic therapy (PDT) is treatment used mainly for superficial types of skin cancer and pre-cancers.

Pulsed dye lasers are used to treat blood vessels in the skin such as those associated with rosacea, and birth marks. This treatment pulses visible light at a wavelength of 585 or 595 nm with pulse durations of the order of 0.45–40 ms. Often, many treatments will be needed.

Electrodesiccation and Curettage (ED&C) is a surgical procedure used to removal certain skin lesions such as warts, angiomas, actinic keratosis, basal cell skin cancers and squamous cell skin cancers. After local anesthetic is placed, the surgeon removes the abnormal cells by scraping down to a layer of uninvolved tissue. Finally, desiccation (electrosurgery) is performed with a small, metal instrument used to widen the margin and cauterize the wound to minimize bleeding. The wound is left to heal without sutures and typically heals over several weeks.

Excision refers to removal of a skin lesion by completely cutting it out.

A common reason why skin lesions are excised, is to fully remove skin cancers such as basal cell carcinoma, squamouscell carcinoma or melanoma. If the cancer is not cut out it may spread to the surrounding skin and to other parts of the body (metastasise).

Other reasons why a lesion may be removed include for diagnosis, cosmetic appearance, if it is symptomatic (eg tender or prone to being knocked), or to remove an inflamed or frequently infected cyst.