Posts Tagged 'nurse consultant in dermatology'

Spironalactone Treatment for Acne in Essex

What is spironolactone and how does it work in the treatment of acne?

Spironolactone is a drug usually prescribed for patients with heart problems, high blood pressure and fluid retention. It can also have hormonal effects by blocking the action of androgens, “male hormones”, that are normally produced by women in low levels. Some women have raised levels of androgens or increased sensitivity to normal levels of androgens and this can lead to skin disorders. Spironolactone thus can be used in the management of these conditions.

Spironolactone

Spironolactone is often a good treatment for women with PCOS

What skin conditions are treated with spironolactone?

Spironolactone is used ‘off-licence’ to treat women with acne, female pattern hair loss and hirsutism (male pattern hair growth in women). “Off-licence” means that is not specifically indicated for these conditions in the prescribing licence. It is also used in the management of polycystic ovarian syndrome (PCOS). It is not usually given to men to treat skin problems. Will spironolactone cure my condition? Spironolactone is not a cure but taken long-term it can help control and sometimes clear acne. It can help reduce excess facial and body hair and improve the thickness of scalp hair in women with certain types of hair loss. The treatment works slowly over several months.

How long will I need to take spironolactone before I see an effect?

Most women find that their acne starts to improve after about 3 months of treatment. Hair complaints take longer, and treatment usually needs to be continued for up to six months before the benefit can be seen.

What are the common side effects of spironolactone?

Common side-effects in pre-menopausal women include breast tenderness/enlargement and irregular menstrual periods. These symptoms usually settle with continued treatment and may be helped by taking spironolactone with the oral contraceptive pill. Spironolactone can cause a drop in blood pressure when going from sitting to standing (postural hypotension) which causes dizziness, a light-headed feeling or fainting. Uncommon side effects include drowsiness, fatigue, headache, loss of libido (sex drive) and very rarely, confusion and loss of coordination. As this medication is a diuretic it can increase the amount of urine produced by the body.

What are the rare side effects of spironolactone?

Raised blood levels of potassium levels may occur during treatment with spironolactone. This is uncommon in younger patients (< 45 years) and those without heart or kidney problems and in people who do not take other drugs that affect potassium levels. It may very rarely cause abnormal blood counts and allergic rashes. Animal tests with very high doses of spironolactone showed a possible association with cancer, but this has not been observed in normal use of this medication in humans.

Are any other precautions necessary?

Do not take this medication if you are pregnant or planning to become pregnant as it can affect the normal development of your unborn child. Women taking spironolactone should use effective contraception to prevent pregnancy. Taking combined oral contraceptive pills in combination with spironolactone can increase its effectiveness in treating acne as well as providing contraception and reducing hormonal side-effects such as menstrual irregularities.

How will I be monitored for the side effects of spironolactone treatment?

Your doctor may recommend a blood test to check your potassium level before starting treatment and occasionally during treatment. These checks may be needed more frequently if you have heart or kidney problems or if you take other medication that affects potassium levels.

May I drink alcohol while taking spironolactone?

Drinking alcohol may increase some of the side-effects of spironolactone such as dizziness. It would be advisable to moderate your alcohol consumption in accordance with recommended guidelines.

Can I take other medicines at the same time as spironolactone?

If you are taking any of the following medications, please inform your doctor (you can check with your doctor or pharmacist): • Diuretics (“water tablets”) • Potassium supplements • ACE Inhibitors (eg quinapril, captopril) • Tablets for high blood pressure • Aspirin, indomethacin (an anti-inflammatory/analgesic drug) • Digoxin (used to treat heart conditions) • Trimethoprim and trimethoprim-sulfamethoxazole (types of antibiotics)

What happens next?

If you would like to ask our Medical Director & Nurse Consultant, Sue Ibrahim a message, by all means do. We provide a responsive service that aims to set your mind at ease and ensure you are fully informed before booking your consultation. At Elan Medical Skin Clinic in Essex, all new patients receive a thorough consultation and medical assessment prior to treatment.

How do I book an appointment?

You can either call Elan Medical Skin Clinic on 01268 770660 between 9.30am and 5pm Monday to Saturday or you can click here to book online and one of our reception team will contact you by phone or email, whichever you prefer. You will be asked to pay your initial consultation fee by credit or debit card on confirming your appointment.

Roaccutane Treatment for Acne in Essex

What is Roaccutane and how does it work?

Roaccutane is a member of a group of drugs, closely related to vitamin A, called retinoids. Isotretitinoin is the generic name of a drug marketed by a number of companies, but the original brand name was Roaccutane. It works in a variety of ways, targeting several of the factors that cause acne and other skin conditions including the production of sebum (an oily substance produced by the skin) and the production of keratin (outer scales of skin) that block the pores of the hair follicle and cause acne.

What skin conditions are treated with Roaccutane?

Roaccutane is licensed and commonly used to treat moderate and severe acne, often where there is risk of scarring. Your dermatologist may occasionally use Roacutane to treat other skin conditions such as hidradenitis suppurativa and rosacea. In the United Kingdom Roaccutane may only be prescribed if you are under the care of a dermatologist.

Roaccutane

Roaccutane is used to treat both men and women with acne

Will Roaccutane cure my acne?

A large proportion of patients (about 9 out of 10) see a significant improvement in their acne with a single course of Roaccutane, although during the first few weeks of treatment the acne may worsen before it starts to improve.

A small number of patients continue to have milder (although improved) acne following Roaccutane that can be controlled with conventional therapies, such as antibiotics. Others may relapse after stopping treatment with Roaccutane, and occasionally, a prolonged or second course of treatment is required.

Roaccutane is sometimes prescribed for severe rosacea too.

What dose should I take and for how long?

Your dermatologist will calculate the amount of Roaccutane you need according to your body weight and decide on an appropriate starting dose. At future appointments, the dose of Roaccutane may be changed depending on how well you are coping with the side effects and responding to the medication. Most patients take between 20 mg and 80 mg of isotretinoin each day, and a course commonly lasts around 24 weeks. With doses in the lower end of this range, which are often better tolerated, a course may last longer than 24 weeks. Your acne may continue to improve for up to 8 weeks after treatment.

How should I take Roaccutane?

As isotretinoin is best absorbed into the body with food containing some dietary fat, it should ideally be taken after a meal or a snack with milk rather than on an empty stomach. The capsules need to be swallowed whole and should not be crushed or split open. Keep the capsules in a cool (5 to 25°C) dark place away from children.

What are the common side effects of Roaccutane?

In general, dryness of the skin, lips, and eyes is the most common side effect. Using a non-comedogenic moisturiser (one that does not block the skin pores) and a lip balm regularly will help to prevent these symptoms. An increased risk of skin infections accompanies the skin becoming dry and cracked. Nosebleeds may occur if the inside of the nose becomes very dry. Dry eyes may interfere with the wearing of contact lenses and may be helped by using artificial tears. The skin may also peel and become fragile, with wounds taking longer to heal. Whilst taking Roaccutane, and for six months afterwards, your skin will be more delicate than usual; waxing, epilation, dermabrasion and laser treatment should be avoided. Shaving is normally tolerated, but the use of a moisturiser afterwards is advisable.

Roaccutane may increase your skin’s sensitivity to the sun. You should, therefore, avoid direct sun exposure whilst taking this medication. Where necessary a sun-protection product with a high protection factor of at least SPF 30 should be used. You should also avoid the use of sun beds. Muscles and joints may ache especially after exercise. Temporary hair thinning may occasionally occur. Isotretinoin can affect your vision, in particular, the ability to see at night, and caution is required in people whose job requires good night vision, such as drivers and those who operate heavy machinery. If you develop difficulties seeing at night or in dark situations you should avoid driving and/or operating heavy machinery. Airline pilots will not be able to continue their job while on isotretinoin and are advised to discuss this with their employer before starting the medication, and check with current Civil Aviation guidelines. These vision changes may be permanent in extremely rare circumstances.

Increased fat levels in the blood, and mild liver inflammation can occur but are usually not of clinical significance; these will be monitored by blood tests during the course of treatment. If you have had problems with your liver or kidneys, or suffer from high cholesterol or diabetes, you should discuss this with your doctor prior to starting the medication.

Peanut or soya allergy

Roaccutane contains soya oil. Occasionally, patients with soya allergy might react to the trace levels of soya proteins in soya oil. Exceptionally rarely, patients with peanut allergy might have a cross reaction to soya proteins in soya oil. You should inform your doctor and pharmacist if you think you may have an allergy to soya or peanut.

What are the rare side effects of Roaccutane?

A number of more serious side effects may occur although these are fortunately rare. Roaccutane can lead to changes in mood and/or behaviour and less commonly, unusual experiences including thoughts of self-harm and suicide. There have also been reports of patients attempting suicide. If you have ever had low mood, suicidal ideas or any other mental health problem, please discuss this with your doctor before starting treatment. If you have a history of depression your dermatologist may ask a psychiatrist to see you before starting Roaccutane to determine if it is safe for you to take. If you or your friends/relatives feel that your mood or behaviour is changing, or if you start having thoughts of self-harm whilst taking isotretinoin, please inform your doctor and stop taking it immediately. Your doctor will then discuss it with you and advise if it is safe to take in the future.

Rarely, inflammation of the liver or pancreas may occur. Very rarely, increased pressure in the brain may present with morning headaches and disturbance of vision. Sexual side effects, such as erectile dysfunction and decreased libido, may also occur but these are understood to be rare. If you do suffer from a side effect then stopping or reducing the dose of isotretinoin may resolve the problem. Please talk to your doctor or nurse before making any changes to your medication. The list of side effects is not exhaustive, and if you do develop any new problems while taking isotretinoin please inform your doctor or nurse.

May I drink alcohol whilst taking Roaccutane?

Ideally alcohol should be avoided completely, as this can cause inflammation of the liver.

Can I take other medications at the same time as Roaccutane?

Most drugs can be taken safely with Roaccutane but some medications may interact. It is important that you tell your doctor and pharmacist what you are currently taking before taking any new prescription or over-the-counter medications. Medications to avoid while taking Roaccutane include: • Tetracycline antibiotics • Methotrexate This is not a complete list and it is important that you always inform your doctor and pharmacist that you are taking Roaccutane, and read the in-pack leaflet. Vitamin supplements containing vitamin A should be avoided during a course of Roaccutane.

Are there any other precautions whilst taking Roaccutane?

You must never share your tablets, especially with women. Do not donate blood whilst taking isotretinoin and for a month afterwards in case the blood is given to a pregnant woman.

There has been no known adverse effect on the pregnancy if a man taking Roaccutane fathers a child. However, as Roaccutane is present in semen, it may be a sensible precaution to use a condom to avoid transmission of any of the drug to females. Women should not breast-feed while taking Roaccutane.

Why is there concern about women taking Roaccutane and pregnancy?

If a pregnant woman takes Roaccutane there is a high risk that the unborn baby will be harmed. There is an increased risk of miscarriage and babies may have severe and serious defects (such as abnormal appearance or intellectual disability). For this reason: • Roaccutane should not be taken during pregnancy. • You must not become pregnant whilst taking Roaccutane, or for at least one month after stopping Roaccutane. • You should not breast-feed whilst taking Roaccutane, or for one month afterwards. • If you do become pregnant, or suspect that you may be pregnant, you must stop the medication immediately and contact your doctor, so you may be referred to a specialist pregnancy clinic.

What happens next?

If you would like to ask our Medical Director & Nurse Consultant, Sue Ibrahim a message, by all means do. We provide a responsive service that aims to set your mind at ease and ensure you are fully informed before booking your consultation. At Elan Medical Skin Clinic in Essex, all new patients receive a thorough consultation and medical assessment prior to treatment.

How do I book an appointment?

You can either call Elan Medical Skin Clinic on 01268 770660 between 9.30am and 5pm Monday to Saturday or you can click here to book online and one of our reception team will contact you by phone or email, whichever you prefer. You will be asked to pay your initial consultation fee by credit or debit card on confirming your appointment.

Ageing Lips Need a Gentle Touch

As we age, typically in the late 40s, we begin to lose dental and structural support in the lower face and experience volume loss in the soft tissues in general and in the lips specifically. Ageing lips are a concern to many women.

Our lips thin with age and demonstrate less fullness and projection when viewed both in front and in profile This process is called soft tissue atrophy and commonly affects the lips and corner of the mouth. As these areas become less plump, they wrinkle more easily and the mouth develops a “mouth frown”, a very ageing sign. Another ageing sign are smoker’s lines or vertical lip wrinkles in the skin on the top lip resulting from the constant use of certain facial expressions such as pursing lips, chewing, sipping from a straw or bottle and even talking. These wrinkles can become evident form an early age especially if one has an overactive muscle around the mouth.

At Elan Medical Skin Clinic, our Nurse Consultant has over 20 years experience in creating natural looking improvements aroud the lips and mouth. ‘ Treatments should always look natural and not over-done”.

“We often combine a combination of treatments to the lip and mouth area, in order to achieve a natural looking lips” says Sue Ibrahim, “and ageing lips require a very gentle touch”.

At Elan Medical Skin Clinic we are dedicated to providing our patients with the highest standards of care.

Click here to read what our patients are currently saying about treatments at Elan Medical Skin Clinic.

Book your free consultation today!

Itchy skin – Is Your Gel Manicure to Blame?

Could your gel manicure be causing you an itchy vagina?

If you have itchy skin, your initial consultation is your first step to resolving the problem.

Gel manicures are extremely popular, even our Dermatology Nurse Consultant has them. However, the British Association of Dermatologist has issued a warning about the growing number of women that are presenting with irritant contact dermatitis in sensitive areas of the skin, such as the eyes and the genital area from a chemical used in Gel nail varnish.

Itchy rahses

Dermatitis can be triggered by gel manicures

Gel nails, acrylic nails and gel polish nails all contain high quantities of an irritant chemical called Meth acrylate. Like most substances that cause irritant contact dermatitis, you may not notice an allergy immediately. The allergy is more likely to become more prevalent with constant use. Following a gel manicure, if you then touch your eyes or other sensitive areas, this can flare up an allergic reaction in that area.

According to Sue Ibrahim, we are seeing a growing number of skin issues of this nature in Essex. ‘The fashion for Gel nails and gel polish in Essex is huge at the moment and we are not surprised that we are seeing a rise in skin allergies caused by the chemicals contained with the products as well as the solvents that are used to remove the polish or the acrylic nails”.

How do I book a Dermatology Consultation?

If you have an itchy rash, you can book a dermatology consultation by calling Elan Medical Skin Clinic on 01268 770600 between the hours of 9.30-5pm Monday to Saturday. Or you click here to fill in a contact form. Elan Medical Skin Clinic is regulated by the Care Quality Commission.

Click here to read what our patients are currently saying about Elan Medical Skin Clinic in Rayleigh, Essex.

Neck Rejuvenation with Profhilo

If you would like are interested in neck rejuvenation, Profhilo may be the answer for you!

When Profhilo is injected into the neck and jowl area of the skin, we can create a durable lift and tightening of the skin over the next few weeks. After just two-three sessions there is a further gradual tightening of the skin with restored firmness.

Profhilo is a revolutionary new concept in injectable skin treatments as it is not a skin filler.

“When is filler not a filler? When it’s Profhilo, one of the new breed of beneath-the-skin moisturising treatments, which has to be one of the quickest and most effective cosmetic fixes I have ever tried” Alice Hart-Davis in  The Telegraph

Neck Rejuvenation at Elan Medical Skin Clinic in Essex

In some cases, we combine Profhilo with Botox in the neck and jowl area to further improve the contours of the jaw and the signs of ageing in the neck.

For some patients skin tightening treatments would be recommended for neck skin laxity in conjunction with, or instead of Profhilo.

At Elan Medical Skin Clinic in Essex, our award-winning nurse consultant, Sue Ibrahim, has almost 20 years’ experience in cosmetic dermatology and aesthetic medicine and was runner-up in the National Safety in Beauty Awards 2016. Sue Ibrahim has also been nominated and is in the finals of the Aesthetic Nurse of The Year category 2018.

All new patients receive a full consultation and medical assessment before their neck rejuvenation treatment. Your cosmetic consultation includes a general assessment of your needs and a discussion about the range of treatment options available, both at Elan Medical Skin Clinic and those available elsewhere.

We will work with you and are here to help you make the right decision.

Click here to read what our patients are currently saying about Elan Medical Skin Clinic

Give Elan Medical Skin Clinic a call on 01268 770660 today to book your Aesthetic Consultation with our experienced Nurse Practitioner.

Suffering from insect bites? Essex skin expert offers advice

Close up of an insect

Bitten by an insect? Sue Ibrahim from Elan Medical Skin Clinic in Rayleigh, Essex explains what you should do.

There’s no denying that this summer has been glorious so far, says Sue Ibrahim at Elan Medical Skin Clinic in Rayleigh, Essex. But the sunshine has led to more people than usual being bitten by insects and it seems that the horsefly population has exploded.

According to the BBC, calls to the NHS helpline 111 about insect bites are almost double the rate they normally are at this time of year and senior doctors are reporting incidents of patients being treated in hospital for infected horsefly bites.

One explanation for the rise in the number of horseflies is standing water, such as garden paddling pools, where they and other insects thrive. The advice is to drain paddling pools after use.

What should I do if I’ve been bitten by an insect?

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Help – I’m losing my hair!

DermaActive hair repair

DermaActive hair repair

Hair loss can cause embarrassment for men and women – and it can also affect children. Male pattern hair loss is well known but there’s a version that affects women and this can be a very upsetting condition, especially if the bald area cannot be disguised, says Sue Ibrahim from Elan Medical Skin Clinic in Rayleigh Essex.

Patterned hair loss looks different in men and women. In women, there is widely spread thinning of the hair, mainly on the crown. The hairline often remains normal.

What causes female pattern hair loss?

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Suffering from psoriasis? Elan Medical can help

DermaActives DermaCalm Cleanser - Elan Medical Skin Clinic can help with psoriasis - call us now for details

Elan Medical Skin Clinic can help with psoriasis – call us now for details

When it comes to skin conditions, leading skin expert Sue Ibrahim at Elan Medical Skin Clinic in Essex understands the emotional upset they can cause. And psoriasis is no exception.

What is psoriasis?

Psoriasis is a common inflammatory skin disease affecting 2% of the population. It occurs equally in men and women, can appear at any age, and tends to come and go unpredictably. It is not infectious and it does not scar the skin although sometimes it can cause a temporary increase or reduction in skin pigmentation.

Psoriasis can affect the nails and the joints as well as the skin. About half of people with psoriasis have psoriasis affecting the nails. For people with moderate to severe psoriasis about one in three will develop psoriatic arthritis at some time.

Can I treat psoriasis?

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Essex skin expert and new granny offers advice to mums

New mums reminded that dermatologists do not recommend using aqueous cream or Sudafed on babies.

Sue Ibrahim from Elan Medical Skin Clinic in Rayleigh Essex reminds new mums that dermatologists do not recommend using aqueous cream or Sudocrem on babies.

We are delighted to announce that Sue Ibrahim from Elan Medical Skin Clinic in Rayleigh, Essex has recently become a grandmother. Her grandson’s birth at the end of March highlighted the need to remind new mums that dermatologists do not recommend using aqueous cream or Sudocrem on babies.

Aqueous cream contains sodium laureth sulphate (SLS), a detergent that breaks down the skin barrier. SLS functions as a stabiliser and cleansing agent and is a known skin irritant. However, aqueous cream products often contain other ingredients such as chlorocrescol, cetostearyl alcohol and parabens, which may also cause or contribute to adverse skin reactions.

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Rosacea is caused by drinking too much alcohol, right? Wrong, says our Essex skin expert

Rosacea is not caused by consuming too much alcohol, explains Sue Ibrahim from Elan Medical Skin Clinics in Rayleigh Essex, teetotalers are just as susceptible. Nor does it only affect people with very fair skin. Rosacea is now thought to be caused by the Demodex mite – and sadly this little bug isn’t fussy about skin tone, race or gender.

Sue Ibrahim, skin expert at Elan Medical Skin Clinic in Essex

Sue Ibrahim, our skin expert at Elan Medical Skin Clinic in Essex

Sue, our nurse consultant in dermatology says there are newly licensed prescription creams to manage rosacea although they are not widely available on an NHS prescription due to the ongoing expense incurred. But Sue can prescribe them, if required and our rosacea phototherapy comes in handy for flare-ups.

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