Dermatology

Dermatology is the medical speciality which manages skin disease. This is a community based service which can deal with 99.5% of skin problems without the need to go to a major hospital setting. Management can involve treatments which range from simple advice and information to drug treatments and surgery.  If light treatment is recommended then we will arrange onward referral for you.  As GP specialists we have considerable knowledge and years of experience in dermatology. The service is also supported by consultant dermatologists and nurse specialists.

All the medical staff regularly attend dermatology courses to keep abreast of developments in this field. Cumbria Medical Services is committed to medical education and holds regular teaching sessions for local GPs and nurses to improve the breadth of dermatology knowledge in Cumbria.

Please note we do not treat benign lesions (Warts, Skin Tags, Cysts) for cosmetic purposes and these will need to be referred to a private provider on the need for any treatment. On rare occasions benign lesions can be treated and removed if they are causing significant problems and meet our criteria. Our Dermatologists will assess these and have the final decision on if treatment is necessary.

What to expect in the first appointment

NHS patients can only be seen in the community dermatology service if they have been referred by a GP.

We hope to see you promptly and generally on time but nearly always within 15-20 minutes of your appointment time.

We will ask appropriate questions to try to establish a diagnosis. It is important for us to know what medication you take and what creams you have used; so please do bring a list.

If you have a skin lesion which might need surgery please make a note of your availability as we may be able to give you a date for surgery at your appointment.

It is important for us to meet your expectations and concerns so we welcome your questions to ensure you leave the consultation satisfied.

There are often a number of treatment options and we are happy to explore these with you to provide what is most appropriate for you.

Information on your condition

We hope to be able to give you a skin diagnosis, but this is not always possible at the first appointment as some skin conditions take time to develop. We are keen to ensure that you do understand your condition and how to manage it, even if it cannot be completely cured. We will try to explain in plain English and either give you written information or direct you to a useful dermatology website where you can find out more, if you wish.

Follow up arrangements

We will make follow up appointments to ensure your skin condition has improved or that a skin cancer has not recurred. However, if you notice changes and feel you should be seen sooner than your set appointment, please do not hesitate to contact us and we will try to accommodate you into an earlier clinic. In many cases we are happy to review you only if you feel it is necessary. In this case we will see you at your request directly without having to go back to your GP for re-referral

Diagnoses

Acne vulgaris

A common cause of spots from around the ages 12 to 25. The majority of cases can be managed by your GP, but some more severe cases require treatments only available in dermatology clinics.

For more information see:

Actinic Keratosis

See solar keratosis

Alopecia

This is a term which describes hair loss. This can happen for many reasons. Alopecia areata is an autoimmine condition that most commonly affects the scalp. It can be very difficult to treat, but some options are available.

For more information see:

Baldness

Hair loss on the scalp is normal with age – both male and female pattern baldness are common. There is limited therapeutic threatments that can be offered on the NHS.
Also see our information under ALOPECIA

For more information see:

Basal Cell Carcinoma (BCC)

This is the commonest form of skin cancer and is related to sun exposure. This is very rarely life threatening and does not metastasise (spread to other parts of the body).  It does, however, need treating as it will continue to grow. This can be treated with creams, freezing treatment or removal surgically.

For more information see:

Bowen’s Disease

This is a red scaly area with abnormal cells on the surface of the skin. There is a chance that this will progress to a skin cancer, about 5% do. This will be treated with either creams, cryotherapy or surgically.  It is important that people with Bowens disease use good sun protection. See sun and the skin.

For more information see:

Bullous Pemphigoid

This is a rare condition where blisters form on the skin, generally in people over 70. It normally lasts around 1-5 years then settles. Treatment is normally with oral steroids.

For more information see:

Cancer

Skin cancers come in many forms. The most common are Basal cell carcinomas (BCC), Squamous cell carcinomas (SCC) and Melanoma.

Cellulitis

This is a bacterial infection of the skin. Treated with either topical or tablet antibiotics normally.

Contact dermatitis

This is a type of eczema that occurs as a result of direct contact with causative agents. The same treatments would be used for contact dermatitis that would be used for eczema and may require patch testing to identify the cause.

For more information see:

Cysts

Pilar, epidermal, dermoid. Cysts are a harmless sac which grows deep in the skins structure. Their names relate to the structure of origin. These are only removed surgically if causing problems (recurrent infections, discomfort etc).

For more information see:

Dermatitis herpetiformis

This is a very itchy bump, normally on the scalp, shoulders, elbows knees and buttocks.  This is strongly associated with coeliac disease (gluten intolerance).

For more information see:

Dermatofibroma

This is firm skin nodules which are harmless. They normally appear on legs or arms, possibly at the sites of trauma (eg an insect bite).

Eczema or Dermatitis

Inflammation of the skin results in an itchy, dry skin rash. It is common in children but can last into adulthood. It is caused by a combination of genetic predisposing factors and environmental irritants.
Children often ‘grow out ‘ of eczema, but for others it is a condition that needs long term treatments to try and prevent flare-ups.

For more information see:

Erythema Nodosum

Tender red nodules, typically on the lower legs but also occasionally on thighs or arms. Often no cause is found, but some investigations are usually performed to check if treatment is required. 

Folliculitis

Inflammation of a hair follicle. This is most commonly, but not always, due to infection. It can be due to irritation or blockage.

Fungal nail infections

These are common and most will be dealt with by your GP. Occasionally diagnosis can be difficult and stubborn infections can require long courses of treatment (up to a year).

For more information see:

Granuloma Annulare

A condition where skin coloured bumps forma ring, typically over a joint, the cause for which is unknown. Other rarer forms produce nodules or larger patches of little bumps.
The condition tends to settle after a few months without scarring, but can recur at the same site.

Hidradenitis suppurativa

A condition with recurrent boils and abscesses most commonly in armpits and the groin. There are lots of different treatment options, including topical options, tablets and surgical removal of the affected skin.

For more information see:

Hyperhydrosis (excessive sweating)

This can be a very distressing problem, affecting palms, soles and /or underarms typically. Topical treatments can be tried, but all have problems.

For more information see:

Itch

Also known as prurigo. This can be due to many factors. Once medical causes have been excluded topical treatments can normally resolve this very distressing symptom. Occasionally phototherapy (light therapy) is needed.

For more information see:

Keloid scar

Occasionally scars can become overgrown and form hard, smooth growths. It is unknown why this happens. It is most common in the upper chest, shoulders and upper back. Dark skin is more prone to form keloids. There are some topical options that can help with cosmetic appearance. These never become cancerous.

For more information see:

Lichen Planus

A rare skin condition that results in shiny, flat topped areas of the skin that are red or purple coloured. They tend to be very itchy. It often resolves in around 18 months and topical treatments can be used to try and control it whilst it is active. It can also affect the nails, genitalia and inside your mouth.

For more information see:

Lichen Simplex

A type of dermatitis with a patch of dry, scaly itchy skin. It usually occurs due to repeated rubbing or scratching at a site following an original itchy stimulus – for example a bite. It can normally be controlled with strong topical steroids, moisturisers and lots of will power from the patient to stop the scratching.

Lichen Sclerosis

This condition most commonly affects the genitalia and affects women more frequently than men. It can be controlled well with topical treatments in most cases, but not cured. The skin becomes white and thickened and easily cracked. It can be very itchy.

For more information see:

Melasma or chloasma

Patches of increased pigmentation to darker skin colour, on the cheeks. This becomes more obvious with sun exposure, so patients are recommended to avoid the sun. It can appear in pregnancy or whilst taking the oral contraceptive pill and may not disappear when it is stopped.

For more information see:

Molluscum contagiosum

A viral skin infection resulting in clusters of small round bumps, often on a stalk (pedunculated). They are most common in children but can appear in adults. They tend to disappear in about a year, but can persist longer, especially in children with eczema. No treatment is required.

Nodular prurigo

A disorder with firm, very itchy lumps in the skin. It is unknown if the itch and scratching cause the lumps or if the lumps are first. There are lots of different topical and oral treatments that can be tried and phototherapy can also be helpful.

For more information see:

Pemphigus vulgaris

A rare blistering disorder that typically occurs in people in their 50’s and 60’s. It affects both the skin and membranes of the mouth and genitalia. It is normally controlled with oral medications.

For more information see:

Perioral dermatitis

This is a relatively common skin problem seen mainly in adult women. It presents as redness and itchy red bumps around the mouth, and occasionally around the eyes (periorificial dermatitis). The skin often flakes. It can be induced by the use of too many creams, and sometimes using just water to clean the skin is enough to settle it down. It will respond well to oral antibiotics should this not be enough.

For more information see:

Pityriasis rosea

A common widespread scaly rash that starts with a ‘herald patch’. It is thought to follow a viral infection, and normally resolves in about 6 weeks. It can occasionally itch, and this can be treated with a topical steroid cream.

Pityriasis versicolor

A common skin complaint with flaky discoloured areas of skin typically on the chest and back. It is linked to a yeast infection, Malassezia. It normally responds well to topical treatment with antifungal creams or shampoo. Occasionally antifungal tablets are needed.

Polymorphic light eruption

This is a rash that occurs due to photosensitivity – sensitivity to the sun. It can take many forms (hence its name polymorphic), but most commonly it presents as pink or red raised spots on sun exposed sites. It often appears in Spring and may disappear as sun exposure becomes more frequent in the summer. Juvenile spring eruption is a form often seen in young boys where it is present only on the ears.

For more information see:

Pompholyx

A type of eczema that affects the hands and/or feet. The majority of cases can easily be managed with topical treatments, but some cases will require specialist oral treatments, and sometimes light therapy is used.

For more information see:

Psoriasis

This is a common scaly rash that affects at least 2% of the population. There is a spectrum of disease severity and psoriasis has several different forms. Treatments are wide ranging and vary for severity and form of psoriasis. There is no cure, but the condition can be well controlled.

For more information see:

Pyogenic granuloma

This is a bright red skin growth that is fast growing and is said to have the appearance of a raspberry or raw meat. They are not cancerous but can bleed profusely. They need removing for this reason and also to confirm the diagnoses as they can resemble some skin cancers.

Rosacea

A facial skin rash that tends to affect people in middle age. It often has small spots in the skin, but the key feature is the redness. Skin thickening can also be a problem. Topical or oral antibiotics can be used and offer a lot of patients good control for any spots. The redness is more difficult to treat – often avoidance of factors that cause flushing can be helpful. Laser is also sometimes used.

For more information see:

Sebaceous hyperplasia

A term used for enlarged sebaceous glands normally on the nose and forehead. These can sometimes look like a BCC and therefore are sometimes removed for diagnostic reasons.

For more information see:

Seborrhoeic dermatitis

A scaly rash that affects the scalp, eyebrows, side of the nose, around and in the ears. It can also affect the central chest area and under the arms. It is thought to be due to an inflammatory response to the presence of a yeast, Malassezia.  It is a chronic condition, but can usually be controlled with regular use of topical antifungals and occasional topical steroid use.

For more information see:

Seborrhoeic warts

Also known as seborrhoeic keratoses. These are harmless growths that appear in adult life. They never become cancerous, but do change with time. You may have one or many. These are only removed if they are causing problems such as recurrent bleeding or causing significant pain.

Info www.dermnetnz.org/lesions/seborrhoeic-keratosis.html

That’s not a mole! Uncovering the Mystery of Seborrheic Keratosis: https://youtu.be/UXSJyXW1EHo

Solar Keratoses

Also known as actinic keratoses. These are areas of rough skin on sun exposed areas. They are caused by long term sun exposure. They are a precancerous condition with a low risk of turning to a squamous cell cancer.  For this reason they are often treated. They can be treated with creams, freezing therapy or removed surgically.
Patients should also take sun precaution at all times once they have had once solar keratosis.

For more information see:

Urticaria

A disorder that can affect adults or children where itchy, red patches or ‘hives’ appear on the skin. This can be acute or chronic.

For more information see:

Vitilgo

A disorder where the skins pigment cells that colour the skin are destroyed leaving patches of the skin with no colour.
Vitiligo unfortunately does not respond well to treatment.
It is important to protect the skin from sun exposure as the pale skin has no protection in the form of melanocytes.

For more information see:

Warts and veruccas

These are skin growths due to infection with HPV (human papilomma virus). 50% of warts and veruccas disappear with 6 months, and 90% within 2 years. Treatments are not terribly successful, but paints, freezing and duct tape can be used. These can be time consuming and painful, and so most warts are best left to go by themselves.

For more information see:

Skin camouflage

A skin camouflage appointment offers the opportunity to try out skin camouflage products and see if they might be a helpful option. Skin camouflage products are creams and powders that can be used to reduce the appearance of a mark, scar or skin condition. During appointments, our trained skin camouflage practitioner talks to patients about their concerns and provide practical advice.

Many people with a visible difference can struggle with social anxiety and low confidence, especially as they can experience staring, comments, or unwanted attention. Our specialist skin camouflage service is there for people with marks, scars and skin conditions who may wish to try out the option of skin camouflage and see if it’s a helpful tool for managing life with a visible difference.

What is skin camouflage?

Skin camouflage is the application of specialist, highly-pigmented creams and powders which can be used to reduce the appearance of a mark, scar or skin condition.

Skin camouflage creams and powders come in a vast array of shades and colours so they can be matched to an individual’s skin tone.

Skin camouflage products can be applied to the face and/or body.

Is skin camouflage suitable for my condition?

Because skin camouflage is suitable for a very wide range of conditions, it is easier to start by saying what it’s not suitable for.

Skin camouflage is not suitable for skin that is
– infected
– inflamed or
– broken.

Skin camouflage can be used for a wide range of scars, marks and skin conditions that it is not possible to list them all here.

The following are just a small number of the conditions that people use skin camouflage for:

– vitiligo or loss of skin pigmentation
– scarring, including acne scarring and self-harm scars
– hyperpigmentation i.e. from melasma/chloasma
– birthmarks
– the skin around a prosthesis

Can skin camouflage reduce the appearance of raised or indented scars or conditions?

Skin camouflage cannot level out a raised area, fill in an indented area or alter the skin’s texture.

Skin camouflage is rather a tool for covering an area of skin with a colour that matches the surrounding area.

Can I swim or play sports whilst wearing skin camouflage products?

Skin camouflage creams are made more-long lasting and more waterproof by a specially-formulated powder.

Lots of people play sports, swim and shower whilst wearing skin camouflage products.

Please click on the link below to read the news article which was published in the News & Star in January 2020:

Skin Camouflage News Article

Useful website links for skin problems

https://www.pcds.org.uk    – Primary Care Dermatology Society’s very useful site with a patient/carer section.
This includes: 
How to self examine moles and what to look for if concerned about melanoma. 
Applying moisturisers and steroid creams and ointments.
Links to information on hundreds of skin conditions and drugs used to treat them

https://dermnetnz.org – a very comprehensive New Zealand website. Sections can be translated into any language.

 https://www.youtube.com/watch?v=HoqmVwR68hA   – Using Efudix to treat actinic keratosis 

https://dermnetnz.org/topics/patch-tests  – all about patch testing for contact allergy

https://www.bad.org.uk/ResourceListing.aspx?sitesectionid=159&sitesectiontitle=Patient+Information+Leaflets+(PILs)&originalpath=patient-information-leaflets&q=&range=&l=0 British Association of Dermatologists website – Patient information leaflets

https://nationaleczema.org/eczema/treatment/moisturizing/ – National Eczema Society advice on moisturising and skin care 

02268_Dermol Managing Eczema Pad_AW.indd (dermal.co.uk)

https://www.dermal.co.uk/diseases-conditions/dry-skin-conditions-including-eczema-and-psoriasis/

https://www.youtube.com/watch?v=IH1xsuP4KYsHand Eczema

https://www.enstilar.com/patient-resources – How to apply Enstilar Foam in treating psoriasis

https://www.nhs.uk/medicines/isotretinoin-capsules/ – all about Isotretinoin (Roaccutane) for acne and a few other conditions 

https://www.acnesupport.org.uk/Acne Support

 https://www.skinhealthinfo.org.uk/support-resources/ – Skin conditions resources

https://www.youtube.com/watch?v=ZMrWWfGWdUY – How to apply steroid tape

https://www.youtube.com/watch?v=tpethgKQB3U – How to apply steroids

https://www.youtube.com/watch?v=F7BjsO5scoQ – How to use soaks

https://www.youtube.com/watch?v=AmVamVP00-MHydrocolloid occlusion

https://www.youtube.com/watch?v=oPmlRak5nPsPaste Bandages

https://www.youtube.com/watch?v=LP6jLxqmm2YDaylight PDT

Scroll to Top