Dermatology services

The following clinics and treatments may be offered after initial consultation with a dermatologist.

Treatment offered will depend on the doctor’s assessment of your condition, needs and appropriateness.

• Skin cancer clinics
• General dermatology clinics
• Dedicated Paediatric Dermatology Clinics
• Female genital dermatosis clinic (location specific)
• Skin surveillance clinic for immunosuppressed/transplant patients (location specific)
• Severe psoriasis clinic
• Mole check clinic for high-risk patients (location specific)
• Combined Dermatology and plastic surgery clinics
• Contact dermatitis/skin allergy clinics
• Minor skin surgery
• Cryotherapy
• Patch testing
• A range of UV phototherapy & photochemotherapy treatments
• Iontophoresis (short taster course) & Botox injections for hyperhidrosis (location specific & funding assessment dependant).

NHS dermatology departments do not treat patients who need cosmetic solutions to benign conditions. Unless there is a clinical need, we do not routinely treat problems such as benign mole or wart removal. We do not perform tattoo removals, treat thread veins, male pattern baldness or excess hair removal.

Whilst we may investigate and treat certain skin disorders exacerbated by a possible allergy, we are not an allergy specialist centre. We do not deal with other suspected allergies, that may cause asthma, hay fever or undesired digestive symptoms.

Non-melanoma skin cancer - NHS (www.nhs.uk)

Skin cancer symptoms | Cancer Research UK

If you have been seen by one of our clinicians and referred for a surgical procedure and require some more information about what to expect, please read the information below:

What is a skin biopsy and why do I need it?

A skin biopsy is a routine investigation that helps us to diagnose skin conditions. It can also be used as a treatment to remove some abnormalities, such as moles. A biopsy is where a small sample of skin is removed under local anaesthetic for it to be looked at under the microscope. Local anaesthetic is a medication that numbs the specific area, so it is pain free, but does not put you to sleep.

There are no alternatives to this procedure. It is the only way to get the information needed to make a correct diagnosis.

Before your biopsy

Please let the staff looking after you know if you are taking any antiplatelet medicines (such as aspirin or clopidogrel) or any anticoagulant medicines (such as warfarin or rivaroxaban). Although taking these medications increase the risks of bleeding and bruising, we do not recommend you stop taking any of these medications.

If you are taking warfarin, please visit your local warfarin clinic two to three days before your surgery date and have your INR checked. If it is below 2 or above 3.5, please contact the dermatology clinic, as your biopsy date may need to be rearranged (Contact details at the end of this leaflet).

Please let us know if you have any allergies to medications including local anaesthetic, or if you are planning to travel within two weeks after your biopsy, as this may affect arrangements for removing your stitches (if you have them).

Some people experience light-headedness after their biopsy. You must not drive to your appointment and should have someone to accompany you home.

You can eat and drink as normal before your appointment.

Consent – asking for your consent

We want to involve you in decisions about your care and treatment. If you decide to go ahead, you will be asked to sign a consent form. This states that you agree to have the treatment and you understand what it involves.

If you would like more information about our consent process, please speak to a member of staff caring for you.

What happens during my skin biopsy?

The biopsy will be performed by a doctor or specialist nurse. We will give an injection of local anaesthetic to the area where the biopsy will be taken. This may sting for a few seconds, but then the area will be numb. You may feel pulling or pressure on the area when we take the biopsy, but it should not be painful. We will take a sample of tissue by cutting or scraping your skin. We may have to take more than one biopsy, depending on your circumstances. If we close your wound(s) with stitches, you will need to have these removed at your GP surgery.

The whole procedure is usually completed within 30 minutes.

What happens after the procedure?

A nurse will dress your wound and explain how to look after it at home.

Make sure you receive a separate aftercare information sheet before you leave hospital. If you have stitches, your nurse will also discuss arrangements for their removal, and will give you a letter to give to the nurse at your GP practice. You will be able to leave hospital as soon as you feel well enough and can eat and drink as soon as you wish.

Will I have any pain or discomfort?

The local anaesthetic will begin to wear off about 30 to 40 minutes after the operation. If you experience any discomfort from your wound, you can take simple painkillers such as paracetamol to help with this. Always follow the instructions on the packet and never take more than the recommended dose. Check that the painkillers will not react with any other medicines you are taking. If you are unsure or if you have allergies to any medicines, speak to your pharmacist.              

What are the risks?  

We will discuss the risks with you in detail before we ask you to sign the consent form. Short-term risks include infection, bleeding and swelling of your wound. Although the biopsies taken are not large, you will have a scar.

Will I have a follow-up appointment?

We will arrange for your results to be communicated to you when they are received from pathology. This may be in the form of a follow-up appointment, a telephone consultation or by letter.

Amended for use with kind permission of Guy’s and St Thomas’ NHS Foundation Trust.

If you have recently had a minor surgical procedure, unless advised otherwise on the day of your procedure, please follow the instructions contained in the procedure aftercare information sheet you were given at the end of your procedure.

Stitch removal

If you have stitches, they will need to be removed on the date instructed by the healthcare professional who you had the treatment with. They are removed by the practice nurse at your local GP surgery.  

You will need to arrange this appointment yourself, as soon as you are able, as GP surgeries can be very busy.

If this is not possible, please enquire with your GP reception for alternative stitch removal services or attend your local walk-in service. 

Pain relief

Following your procedure the local anaesthetic will continue to work for a short time. If you do have any pain or discomfort, you can take paracetamol. Avoid Aspirin based pain relief unless you take Aspirin for other medical reasons

Do not take paracetamol if you regularly take a medicine containing paracetamol or if been advised previously that you cannot take paracetamol.

Cleaning

Please keep the wound site clean and dry, with the dressing intact, for at least 48 hours after surgery, unless instructed otherwise by a doctor. If the dressing does become wet, please remove the wet dressing, and replace with a clean dry dressing. After 48 hours you can remove the dressing and wash the wound.

Exercise

Avoid strenuous exercise, or any action that will put tension on the wound site, for up to four weeks after the procedure. Special instructions may be given to you following your procedure depending on the surgical site. If the wound is put under excessive tension, this can prevent the wound healing and cause post-surgery complications. 

Infection

Regularly observe and monitor your wound for signs of infection, such as:  

• discharge, pus, or bleeding from the wound
• if the wound feels warm and swollen 
• unpleasant smell coming from the wound 
• increasing pain in the area 
• if you have a high temperature, or swollen glands. 

If you have any of the above symptoms, speak to your GP or call NHS 111 for advice. You could also visit an NHS walk-in center or minor injuries unit. 

It is not uncommon for a small amount of blood to come through the dressing. If this happens, please don’t be alarmed.

However, if the bleeding is heavy, you can place a second dressing over the top and apply firm direct pressure to the wound for 15 minutes. If bleeding continues, please seek medical attention from your GP, a walk-in clinic or Accident & Emergency.

Lower limb surgery

If you have had a procedure to the lower legs, for the first 24 hours please elevate the affected area when sitting down as this improves blood circulation and reduces the risk of bleeding.

Surgery to forehead or around the eyes

Surgery in this area can result in bruising (a black eye). This does not require any treatment and will resolve over time

When will I get my results?

You will either be given a clinic appointment to come and talk about your results, or your doctor will write to you and your GP. Please be aware that it may be up to six weeks or more for your results to be received from the lab. It can therefore take eight weeks or more before you receive any communication.

For post-surgical wound assessment and care, please contact your primary care provider (GP), who should review the wound and provide ongoing care if needed.

Whilst we endeavour to have biopsy results processed as soon as possible, there are many factors that could impact or delay the reporting of results.

It can take six weeks or more for the dermatology department to receive results from the histology department and review them. Once this is done, the appropriate contact will be made with you, or a follow-up appointment will be created for you.

Eczema (also known as dermatitis) is a non-contagious, inflammatory dry skin condition that can affect people from early infancy to old age. The most common form, atopic eczema, affects 1 in 5 children and 1 in 10 adults in the UK.

The skin is often unbearably itchy – the urge to scratch can be irresistible – and during a flare-up it can also be red, cracked, sore and raw. Alongside the painful physical symptoms, many children and adults experience related sleeplessness, anxiety, depression, and other mental health problems.” National Eczema Society, 2023 - https://eczema.org/information-and-advice.

Whilst there is no cure for Eczema, we aim to target the symptoms exacerbated by the condition. This includes topical treatments aimed at reducing inflammation and irritation.

Patient information

For more advice about eczema, please visit the:

• Atopic eczema - NHS (www.nhs.uk)
• Eczema (atopic dermatitis): Causes, symptoms, and treatment (nationaleczema.org)
• Eczema – British Skin Foundation
• Atopic dermatitis (Atopic Eczema): Symptoms and Causes — DermNet (dermnetnz.org)
• British Association of Dermatologists (bad.org.uk)

Psoriasis is a common, long term skin condition that comes and goes throughout your lifetime. It happens due to immune system over-activity.

Psoriasis is not infectious; therefore, you cannot catch it from someone else. It does not scar the skin, although sometimes it can cause temporary changes of skin colour. Although psoriasis is a long-term condition there are many effective treatments available to keep it under good control.

Psoriasis affects about 1 in 50 people. It may occur at any age from puberty onwards, but rarely can affect younger children.  Psoriasis affects the skin and may affect the nails.”  British Skin Foundation, 2023 - https://knowyourskin.britishskinfoundation.org.uk/condition/psoriasis/

Patient information

You can find out more about psoriasis by visiting the below:

• Psoriasis - NHS (www.nhs.uk)
• Psoriasis: Symptoms, Treatment, Images and More - DermNet (dermnetnz.org)
• British Association of Dermatologists (bad.org.uk)

During a consultation with a dermatologist, you may be offered phototherapy treatment in one of our day treatment units. The dermatology day treatment units are equipped with specialist UV light cabinets, designed for the treatment of certain skin conditions.  If referred, a tailored treatment plan can be created to meet your specific needs.

The use of private or publicly available sunbeds is however not recommended and can increase the risks of skin cancer.  For further information please see the below link to the NHS’s advice about the use of sunbeds.

Patient information

To find out more about sunbeds and if they are safe to use, please visit:

• Are sunbeds safe? - NHS (www.nhs.uk)
• How do sunbeds cause skin cancer? | Cancer Research UK