The Bad Skin Clinic: Episode 5

Updated: Oct 18, 2019

I had such fun helping my patients from Episode 5 of the #badskinclinic. From acne, to fantastic shirts, I loved the sweet personalities they all had! We're getting closer and closer to the end of the season, so if you have missed out on any episodes - be sure to watch them using this link!

https://www.questod.co.uk/show/the-bad-skin-clinic

Acne - Mariah

It has been incredibly rewarding being able to help Mariah @acnetain with her skin, not only to see the improvement in her skin, but also in her self esteem as she has blossomed. She has been such an inspiration to many who are just starting their isotretinoin journey through her Instagram page. I also know her story has helped so many people as I have received hundreds of private messages to let me know. She is also a fantastic graphic designer with such great attention to detail I am sure she will have a fantastic future ahead of her. . . 👩🏻‍⚕️Special points to Mariah story All patients when starting on isotretinoin will get dry skin, dry lips and sometimes dry gritty eyes. This is what happened with Mariah. Isotretinoin can have a number of effects on the eye and worth thinking about.

There are Short-term side effects of Roaccutane:

• Dry eyes - almost everyone who uses Roaccutane experiences dry eyes due to its oil-reduction properties. You can help by avoiding contact lenses and using eye drops while you're on the treatment. • More tears - Roaccutane can sometimes cause your eyes to produce more tears due to its effect on oil production - again, avoid contact lenses as they may be difficult to put in and keep in place

• Swollen eyes or conjunctivitis - Roaccutane can make your eyes swollen and uncomfortable around the whites and eyelids. It usually goes away within a fortnight and you can speed it along by gently wiping your eyes and avoiding smoky, dry places.

Longer-term side effects of Roaccutane:

• 'Dry eye syndrome' - it's uncommon, but patients can develop dry eye syndrome, where persistent dryness occurs over a longer period of time.

• Cataracts - there have been a few cases where younger patients developed cataracts after using Roaccutane, which may be related to a decreased ability to adapt to light or darkness.

One of the stranger effects of Roaccutane on your eyes, and possibly one of the easier ones to ignore, is what it can do to your night vision. It can cause a slightly reduced ability to see in the dark.

Acne - Danny

I was due to treat the heroic Danny for his hypertrophic acne scars. I’ll discuss that more in details for another patient we have upcoming.

Essentially I used a combination of Pulsed Dye Laser (Candela V:Beam) / Fractionated CO2 laser (Lumenis Ultrapulse) and steroid injections. 👩🏻‍As you can see, from my face in the episode, what struck me most about Danny with his sun damage 🙀🙀.

⚠️ People with a freckling and pale skin type need to take extra care and protect their skin from the sun.

✅ Read more about this in my 1st blog on my website.

👩🏻‍ I gave Danny La Roche Posay Anti-shine which he is now using. I use the same one. I also highly recommend the altruist as incredibly cost effective and high quality.

Supernumerary Nipple - Holly

It was a pleasure to meet the lovely Holly and be able to help her with skin problems. Not long after her first pregnancy Holly noted a swelling in a mark on her skin and she noticed it getting bigger. This was different to her known skin condition. She was troubled particularly at how it would appear cosmetically, just below her breast. She was really keen to have it removed. 👩🏻‍A simple elliptical excision with a closure along the relaxed skin tension lines was performed.

Diagram for further understanding of supernumerary nipple.

Supernumerary nipple? A supernumerary nipple is a minor malformation of mammary tissue resulting in extra nipple or associated tissue. Supernumerary nipples are congenital, and usually harmless. However, they are influenced by hormones and susceptible to other disease processes.

They are found in up to 6% of the population and are formed early on in the development of the embryo from the “milk lines” that extend from the axilla to the groin. A supernumerary nipple is present at birth. It often appears similar to a congenital organoid or melanocytic naevus. Most supernumerary nipples are much smaller than the normal areola and nipple. They may be solitary or multiple, arising on one or both sides of the nipple line.

Lipomas - Jon

What a pleasure to treat Jon and his multiple lipomas. His lipomas are present all over his body and for the most part are relatively painless but he really finds them cosmetically a big problem. Each of his lipomas has a slightly different “squidge” element to them and Mottie particularly enjoyed testing that out.

Jon has a couple of complicating factors in that he has type 2 diabetes and he has to be very careful not to inject any of his insulting into one of his lipomas.

We tested out removal of one of the more protruding lipomas and to check his healing response. It all went well we have already removed two more and he is set up to remove even more in the future.

Everyone always asks the questions are lipomas related to the diabetes and can that upset the blood sugar levels. Although You would think it would make sense given the metabolic pathway that they are related. We don’t have any evidence to date that show the two are related.