Other Skin Problems

What is cellulite?

Cellulite is where you get this dimpling, very irregular surface appearances of the skin as a result of the irregularity of fat under the skin. Sometimes it's thought to be due to little fibrous strands that are pulling the skin down between the fat lobules. It commonly occurs on the thighs, on the buttocks, on the bottom. Cellulite can occur in other parts of the skin, but those are the most common. Cellulite is almost certainly in many patients genetically determined and, sadly, there's not an awful lot we can do long-term for this. One of the best approaches is to exercise and to maintain your weight and maintain your muscle tone. That's probably the best way of, at least, not clearing cellulite, but reducing it and making it look less obvious.

Do cellulite creams work?

They may cause a very temporary plumping of the outer skin layers by moisturization, but the changes are going to be very minimal and the changes are going to be temporary. I'm not at all impressed with anti-cellulite creams and, at the moment, we don't have ingredients that I'm convinced are effective. In the short term, you can also have some of the anti-cellulite treatments by some of the vacuum massaging treatments that you'll see advertised in beauty salons. All these do is very temporarily reduce the appearances by producing pressure over the cellulite, over the dimpled area, and suction over the dimpled area, and by alternating suction and pressure, you temporarily reduce the appearances of cellulite. However, with these treatments you've got to continue them forever if you want to control or reduce your cellulite and it rarely gets rid of it for good. But those people who are that concerned about cellulite, there's no risk to them and if they wish to spend their money on the repeat treatments, that's fine. But cellulite remains one of the most important problems that mostly women have and become very concerned about. There are new treatments that are being looked at. There's a range of new laser-assisted treatments that are being looked at. There's a new range of radio frequency treatments that are being looked at. Don't go and have those treatments yet, because we really don't know that they work and we don't know the long-term side effects. Wait until we're sure.

What is eczema?

Eczema is one of the most common group of diseases that affect the skin. It's a disease. Eczema comes from the greek word "Ezceo", which means "I bubble over", and that refers to the type of ezcema where you get little red blisters and itching, intense itching, that feels as if the skin is bubbling and burning. The most common type of ezcema is the inherited type of ezcema, that can affect a high percentage of the childhood population; probably up to 10 percent of children, have what we call infantile or "atopic ezcema". It can be associated within families with ezcema, with asthma, with hay fever. That group of diseases is genetically known as "atopic diseases". So eczema, the common form of ezcema is one of those. The good news is that 80 to 90 percent of children that start with ezcema when they are in their one, two, three, four, five , six year old range; will find their ezcema clears or goes into remission before they get into their teenage years. So many times as a dermatologist, I find myself treating the parents rather than the child, because the parents start feeling guilty about their child having ezcema, and they mustn't. That's something they mustn't overfocus on, because it can give the child a problem. That type of ezcema is the most common ezcema. The next most common ezcema is contact or irritant ezcema, where it's caused by allergy or irritancy from makeups, ingredients, and some plants. For example, primulus is a classic example where you can get external causes triggering eczema. Many people are allergic to things like nickel. Some people are allergic to antibiotics in creams like neomycin, and these can give allergic reactions. All of these can give allergic types of ezcema. And then there is another range of ezcema that are ezcema that occurs in older people, often related to dry skin, often very itchy, worse in the winter months. If you look carefully, you'll often find a history of eczema earlier on in life. But those are the main types of ezcema. There are rarer types, but those are the main types.

How can I treat eczema?

If you got mild eczema, a good way of treating it is to use a very mild half percent or one percent Hydrocortisone cream. Get a bath oil so that you don't dry the skin out. Use a good moisturizing lotion that you find that you can tolerate, and you may need to try several before you can actually go with one. Anything like that will help, if it's still itching at night you can take a non prescription anti-histamine at night to help stop your itching when you're asleep. Those are things you can do yourself. If it is still troubling you, get an appointment with your doctor, and if your doctor isn't comfortable treating you get him to refer you to your dermatologist. What your dermatologist will do is to diagnose the type of eczema that you have and will prescribe the appropriate type of cream. They usually contain various strengths of cortisone, from weak strengths to high strengths. Generally we keep the weak strengths for children and certain parts of the skin, like the face or the skin folds, and we restrict the strongest strengths to other parts of the body and also for short time periods. There's a new group of prescription non cortisone creams and ointments that are very useful now, and we have better oral anti histamines. Sometimes the other thing that can help is when you feel your eczema getting worse, start yourself on primary seed oil capsules. There is a debate on how effective these are but they are certainly not going to do you any harm, and my impression is that they help some people.

What is rosacea?

Rosacea is a very common skin disease in people with fair skin, that is from Northern Europe. Very common in Celtic origin, Scots, Irish, and Welsh. It is where the face often flushes, it goes red. A person then gets enlarged blood vessels and large red spots. It's sometimes mistaken for acne. In fact, it used to be called adult acne. Rosacea usually has that combination of flushing, redness, spots, all together. Sometimes you just get the spots, sometimes you just get the redness.

What is psoriasis?

Psoriasis is like eczema, one of the most commont skin diseases. It affects up to two percent of the population, which means one in fifty of the population have psoriasis. It's mainly genetically determined. You will generally find a family history if you look back closely enough at the person's family. It gives the person disfiguring red, raised, scaly patches on any part of their skin, but the most common sites are the elbows, the knees, the scalp, sometimes the lower back. It can also affect the nails and it can occasionally give you arthritis, commonly in the hand joint. It can be a particularly disfiguring, depressing, and disabling skin disease.