Medical Dermatology

Medical Dermatology

Dr Rose Mak’s clinics manage a wide range of medical dermatology conditions affecting the skin, hair and nails.

Dr Mak provides thorough consultation and testing processes. Dr Mak works closely with you to create a personalised management plan to suit your own needs.

Medical Dermatology Services Include:

  • Full body skin examination and skin cancer diagnoses
  • Psoriasis, eczema – Inflammatory dermatoses management
  • Acne and rosacea management
  • Botox injections for axillary hyperhidrosis
  • Hair and nail disorders diagnoses and management
  • Pigmentary skin disorders diagnoses and management
  • Pregnancy related skin conditions diagnoses and management
  • Geriatric related skin conditions diagnoses and management
Actinic Keratosis & Bowen’s Disease

Actinic keratosis are pre-cancerous lesions with a small chance of progressing to skin cancer. Bowen’s disease or squamous cell carcinoma in situ is a superficial form of skin cancer. Both conditions are related to chronic sun exposure.

Treatment offered include

  • Creams
  • Cryotherapy / Freezing
  • Curettage
  • Daylight photodynamic therapy
Allergies

Allergy occurs when your immune system overacts to a substance (known as an allergen) that is harmless to most people but triggers a reaction in anyone sensitive to it. The allergen can be in the form of medicines, food, chemicals or air borne particles. This may result in a range of symptoms including different skin rashes and swelling. If you are suspicious of an allergy related skin problem, Dr Mak will start by performing a detailed history and examination and arrange specific tests if indicated.

Treatment for Allergies

  • Avoidance of allergen
  • Oral medications to control symptoms

Click here to view details of Dr Mak’s Scientific Publications on Allergies

Eczema

Eczema or atopic dermatitis is a very common inflammatory skin condition characterised by red, itchy rashes that are roughened and scaly. It is common in infancy and childhood but may occur in all ages. A combination of genetics and environmental factors are important in the development of eczema. Eczema can be worsened by stress, sweating, weather changes and certain fabrics such as synthetic and wool which may irritate the skin. If left untreated, eczema may impair quality of life and lead to frequent skin infections.

Treatment for Eczema

  • Emollients and soap free cleansers
  • Topical steroids and non-steroids anti-inflammatory creams
  • Oral antihistamines to relieve itchy symptoms
  • In severe cases, oral steroids, wet wraps, phototherapy or oral anti-inflammatory medicines may be required

Click here to download Dr Mak’s published article in Medical Republic on 31/5/2019

Genital Skin Conditions

Different skin conditions can affect the genitalia. If you notice a rash or suffer from itching and discomfort in the genital area, do contact our clinics for advice and support.

Dr Mak will start with a careful history and examination. Apart from examining the affected area, other areas of the skin may be examined to determine if a more widespread skin disorder is the cause.

A diagnostic biopsy from an affected area may sometimes need to be performed to determine the exact nature of your skin condition and we can assist with other relevant investigations where required.

We work closely with you to formulate a comprehensive management plan.

Hair Loss

It is normal to lose hair every day, anywhere up to 100 strands is common. However, if you notice significant hair thinning, a receding hairline or bald patches, seeing your dermatologist early is worthwhile as there are effective treatments available.

Two Main Types of Hair Loss

The two main types of excessive hair loss, or alopecia, are androgenetic alopecia (also known as male pattern and female pattern hair loss) and alopecia areata.

Androgenetic alopecia is characterised in men by a receding hairline and/or boldness on the top and front of the scalp; whilst in women diffuse hair thinning rather than complete boldness on the mid to frontal areas of the scalp occurs with the condition less severe than that seen in men. Genetic factors, hormonal changes and aging process are all contributory factors in androgenetic alopecia.

Alopecia areata is an autoimmune condition characterised by round bald patches which may appear suddenly, most often affecting the scalp although any body sites can by affected.

In more severe cases, hair loss is more widespread and may affect the whole scalp or the whole body.

Since many different factors can influence hair loss including other co-existing medical conditions, infections, nutritional problems, hormonal changes, genetic factors, and stress, to name but a few; it is worthwhile to see a dermatologist who will assess you by undertaking a thorough history and examination, appropriate investigations can then be arranged to establish the underlying cause and a personalised management plan to be devised.

Treatments For Hair Loss

This depends on the underlying cause and may include:

  • Topical treatments – steroids and minoxidil lotions
  • Steroids injections – to affected hair loss areas
  • Oral medications – including steroids tablets, oral anti-hormonal treatments and oral immunosuppressive medications
  • Contact sensitization therapy
  • where a substance is applied onto the scalp to stimulate the immune system thereby increasing hair growth
  • Other options such wigs and hair pieces and hair transplantation may also be discussed with your dermatologist
Hyperhydrosis

Hyperhidrosis or excessive sweating can be generalised or localised to certain body areas, such as the underarms.

Treatment for Hyperhidrosis

  • Topical treatments
  • Iontophoresis
  • Oral medications
  • Botox injections for axillary hyperhidrosis (underarms excessive sweating). Under Medicare and PBS guidelines, up to 3 treatments are subsidised per year with a minimum of four months between treatments provided patients fulfil eligibility criteria
Nail Disorders

Abnormal nails may arise due to infections (bacterial or fungal), trauma, co-existing underlying skin conditions (such as psoriasis, eczema or lichen planus), benign nail bed tumours but very rarely the underlying cause may be more serious such as skin cancer.

Treatment for Nail Disorders

These may include:

  • Advice on nail care
  • Topical or oral antibiotics for bacterial infections
  • Topical or oral anti-fungal medicines for fungal infections
  • Treatments for associated underlying skin conditions
  • Surgical treatment
Phototherapy

Phototherapy is a treatment prescribed by dermatologists using ultraviolet light to treat different skin conditions. It is well established that natural sunlight is beneficial in certain skin conditions and the ultraviolet part of the radiation produced by the sun is used in phototherapy. Our clinic uses top of the range Waldmann narrowband UVB (NBUVB) phototherapy unit for full body phototherapy treatment.

Click here to read more on our “Phototherapy” page.

Psoriasis

Psoriasis is a common chronic inflammatory skin condition affecting approximately 2% of the population worldwide. It is most commonly characterised by a red patch with overlying silvery scaling and commonly affected body sites include the elbows, knees, face and scalp. Nails and joints may also be affected. Both genetic and environmental factors play important roles in the development of psoriasis. Psoriasis may be triggered by infection, trauma, smoking, stress and medications; and is associated with other co-morbidities including crohn’s dissease, diabetes, cardiovascular disease and obesity. Psoriasis can be stigmatising and severely impact on an individual’s quality of life.

Treatment for Psoriasis

  • Topical treatment – which may be adequate to control mild to moderate psoriasis
  • Phototherapy
  • Oral immunosuppressive medicines – can be considered for moderate to severe psoriasis
  • Biologics injections – reserved for moderate to severe psoriasis and only dermatologists can prescribe PBS (Pharmaceutical Benefits Scheme)-funded biologics for psoriasis

Experience in Psoriasis Management

Dr Rose Mak holds consultant dermatologist appointment at the biologics clinic at Skin and Cancer Foundation in Melbourne and previously at St. Mary’s Hospital in London prior to working in Melbourne. She is experienced in managing psoriasis with a holistic approach and strives to select the most appropriate treatment to suit individual needs. Apart from her clinical interest in psoriasis, Rose also has a strong research interest in psoriasis.

Rose was awarded the prestigious Medical Research Council clinical research training fellowship and undertook a PhD in cutaneous immunology with special focus on the immunopathogenesis of psoriasis at St. John’s Institute of Dermatology, an internationally renowned cutaneous research centre. Dr Mak’s strong interest in psoriasis has led to scientific publications and book chapter.

Click here to download Dr Mak’s Psoriasis Publications

Rosacea

Rosacea is a common chronic skin condition with a ‘red face’ being the most common symptom. Other symptoms associated with rosacea include painful papules and these can be mistaken by some for acne. Rhinophyma, or bulbous enlargement of the nose may occur.

Rosacea may also cause ocular symptoms including irritation, dryness and reddening of the eyelids. It has a predilection for fairer skin types.

Treatment For Rosacea

  • In mild cases, rosacea can be treated with topical creams
  • More severe or persistent cases may require addition of oral medications such as oral antibiotics or oral vitamin A derivative tablets
  • Vascular lasers to reduce redness and treat broken capillaries can also be discussed
Skin Cancer Screening & Mole Check

Skin cancer accounts for around 80% of all newly diagnosed cancers every year in Australia. Basal cell carcinomas (BCCs) are the most common skin cancer followed by squamous cell carcinomas (SCCs) as the second most common skin cancer and are known as non-melanoma skin cancers. Malignant melanoma, although rare in the rest of the world, has the highest incidence in Australia; they have the potential to spread to surrounding tissues and other parts of the body and are therefore a more dangerous skin cancer.

Importance of Skin Cancer Screening & Mole Check

Most of these skin cancers are curable with early detection and treatment. However, to the untrained eye, they can be easily missed as their appearance may vary and sometimes rather non specific. Therefore, having skin cancer surveillance by a trained dermatologist is important for early diagnosis and successful treatment of skin cancers.

Experience in Skin Cancer Management

As a Consultant Dermatologist in tertiary hospitals in London (UK) and Melbourne (Australia), Dr Rose Mak has extensive experience with the diagnosis and management of various skin cancers.

Rose has performed numerous full body skin cancer surveillances in diverse ethnic populations and also for specific patient groups, for example organ transplant patients on immunosuppressive medications.

Dr Mak appreciates that one skin cancer can present differently in different ethnic groups and will commence the process with a whole-body examination of the patient’s skin. Rose can diagnose skin cancer by clinical examination and also by taking skin biopsies from suspicious lesions. A biopsy is then analysed by a skin histopathologist. Further tests including lymph node biopsy, blood tests and radiological imaging may be arranged, if indicated.

Treatment for Skin Cancers

Excision remains the gold standard of treatment for most skin cancers. Certain forms of early skin cancers can be treated by non surgical methods, such as creams, cryotherapy, gentle curettage / scraping, thereby avoiding the need for surgery when possible.

With her experience in skin cancer management, Dr Mak works closely with patients to select the most suitable skin cancer treatment for each person individually. Dr Mak has a caring and holistic approach and strives to address any concerns or worries that patients may have during the diagnosis and treatment process.

Vitiligo

Vitiligo is common and affects about 1% of the world’s population. It is a chronic condition in which areas of skin lose their normal pigment and appears very pale. It may develop at any age but most commonly appears before 20 years of age. The condition varies from small single lesions to total loss of skin colour. Skin pigment may return, but is not guaranteed, and often does not return completely.

Main Causes of Vitiligo

Vitiligo is considered an autoimmune condition in which the body’s own immune system rejects some of its pigment producing cells (known as melanocytes), resulting in loss of skin pigments (melanin) in the affected areas. Vitiligo affects men and women of all ethnicities equally, but is more noticeable in people with skin of colour. Recurrent trauma including repeated scratching and rubbing may trigger vitiligo. Vitiligo may be associated with other autoimmune conditions such as thyroid disease, diabetes and alopecia areata.

Most Common Signs of Vitiligo

In vitiligo, the affected skin lacks the normal melanin pigmentation, and appear very pale, pink and white. It is usually symmetrical, affecting both sides of the body, but it may also be localized to one part of the body only. The skin usually feels normal otherwise. The most commonly affected sites include the face and hands, around body openings and within body folds. When hair-bearing skin is affected, the hair may lose its pigment and become white.

Treatments for Vitiligo

Sun protection
Affected skin will burn easily in the sun. Sun protection with sunscreen with a high sun protection factor (SPF) of 30 or higher is important. Sun protection also helps to reduce the contrast between areas affected by vitiligo and the surrounding normal skin. Appropriate protective clothing and sun avoidance are also important.

Skin camouflage
Our dermatologist can advise you on good quality camouflage products with good skin coverage and are water resistant.

Topical treatment
Topical treatment with topical corticosteroid and other types of anti-inflammatory (such as calcineurin inhibitor) may help to restore pigmentation in some patients.

Phototherapy
Phototherapy may be helpful in restoring repigmentation and can be used in combination with topical treatment.

Laser treatment
Excimer laser treatment can be used in combination with topical treatments and may be effective in vitiligo affecting small areas of skin.

Warts

Warts may take on many forms. Treatment include medicated cream, freezing with liquid nitrogen and topical treatments that encourage the immune system to recognise and destroy the skin cells infected with wart virus.

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