Medical Dermatology

What is eczema?

Eczema is an inflammatory skin condition that causes itchy, dry and flaky skin. Another term for eczema is “atopic dermatitis.”

What are the symptoms of eczema?

• Severe itching
• Redness
• Small bumps
• Dry scaling skin

Eczema can look different in people of different ages and different skin types:

• In babies, eczema affects the front of the arms and legs, cheeks, or scalp.
• In older children and adults, eczema often affects the sides of the neck, the elbow creases, and the backs of the knees.
• Adults can also get it on their wrists, hands, forearms, and face.
• In older children and adults, the skin can become thick and dark, and can even form scars from too much scratching.
• In darker skin types, eczema may present as multiple small bumps.

How can I treat my symptoms at home?

Use unscented thick moisturising creams and ointments for dry skin.

Avoid triggers that can exacerbate eczema, such as:

• Being too hot or sweating too much
• Being in very dry air
• Harsh soaps or cleaning products
• Perfumes
• Wool or synthetic fabrics (like polyester)

What is the medical treatment for eczema?

Using regular moisturisers and avoiding triggers may not be enough to control your eczema.

The medical treatments for eczema include:

• Moisturizing creams or ointments
• Steroid creams and ointments
• Medicines that change the way the immune system works
• Light therapy
• Prescription systemic therapies

About half of children with eczema grow out of it by the time they become adults.

Can eczema be prevented?

Babies who have a parent, brother or sister with eczema have a higher risk of getting it, too.

In these babies, using moisturizing creams or ointments (starting right after birth) might help prevent eczema during the first year.

Contact dermatitis is a rash caused by your skin reacting to a substance it has come into contact with. You may need patch testing to identify the causative substance. A steroid cream or ointment will usually clear the rash.  However, the long-term treatment is to avoid contact with the agent that’s causing it.

There are two types of contact dermatitis – irritant and allergic.

Irritant contact dermatitis

This is caused by direct contact with a substance which irritates the skin. It most commonly affects the hands.

Irritant substances:

• Water. Hands being in water for long periods of time is one of the most common causes. It is more likely if the water is hard, chalky or contains a lot of chlorine.
• Detergents (washing-up liquid, soaps, bleach, etc.).
• Solvents (such as petrol), oils and other chemicals.
• Acids and alkalis, including cement.
• Powders, dust and soil.
• Certain plants.

Allergic contact dermatitis

This occurs when your immune system reacts against a specific substance (allergic skin reaction).

Many substances can cause an allergic contact dermatitis. Common ones include:

• Nickel – this is the most common cause. Nickel occurs in many types of metal – for example, jewellery, studs in jeans and other clothes, bra straps, etc.
• Cobalt – traces of this metal may be found in some jewellery.
• Chromate – a metal which may be found in cement.
• Cosmetics – particularly perfumes, hair dyes, preservatives and nail varnish resins.
• Additives to leather and rubber.
• Preservatives in creams and ointments.
• Plants – the most common culprits being chrysanthemums, sunflowers, daffodils, tulips and primula.

Read more about plants causing skin reactions. Seasonality also has effects on skin sensitivities, so celebrate Spring with these tips!

What is acne?

Acne / pimples develop when pores get clogged with dead skin and oil, and bacteria build up.

Skin then gets inflamed and can turn red and swollen.

How is acne treated?

Doctors can treat acne using different types of medicines.

Most acne medicines require a prescription.

Your doctor might suggest:

Medicines you put directly on your skin – these can be gels, creams, or lotions.

• Retinoids
• Salicylic acid and glycolic
• Antibiotics

Medicines you take as a pill – these include:

• Antibiotics
• Birth control pills
• Isotretinoin

Will my diet affect my acne?

Some studies have found that acne seems to be more common in people who drink a lot of milk. But more research is needed to understand the link between the types of foods people eat and acne. Read more on adult female acne.

What is psoriasis?

Psoriasis is an inflammatory skin condition that causes parts or all of your skin to become red, thick, and flaky.

The flakes on top of psoriasis are usually silver or white and thick.

 

What are the symptoms of psoriasis?

• Areas of skin becomes dry, red, or dark, and are usually covered with silvery or white flakes
• Rashes on the scalp, genitals, or in skin folds
• Itching
• Nail changes

 

Is there a test for psoriasis?

Your doctor or nurse should be able to tell if you have psoriasis by looking at your skin and by asking you questions. In rare cases, doctors take a small sample of skin to check if psoriasis is the problem.

 

How is psoriasis treated?

• There are treatments that can relieve the symptoms of psoriasis. But the condition cannot be cured.
• Treatments for psoriasis come in creams and ointments, pills, or shots.
• There is also a form of light therapy called “phototherapy” that can help with psoriasis.
• Most people need to try different treatments or combinations of treatments before they figure out what works best.

Excessive sweating (hyperhidrosis) means that you sweat much more than normal. Excessive sweating occurs even when you are not hot, anxious, or exercising. 

Why do I sweat so much?

Excessive sweating in the armpits, hands, feet and creases is treatable and is not necessarily associated with underlying disease.

Other causes include spinal disease, anxiety, heart problems and some cancers. It is worth discussing concerns with your doctor.

What can you do to help reduce excessive sweating?

• If you find that soaps irritate the affected skin, use a bland soap substitute such as a moisturiser (emollient) ointment or cream.
• If possible, avoid triggers which can make things worse such as heat or spicy food.
• If you have armpit sweating:

• • Try using normal antiperspirants regularly.
  • Avoid clothes that more easily show up sweat marks.
  • Wear loose clothing under the armpits.
• If you have excessive feet sweating, it can help to:
  • Change your socks at least twice a day.
  • Use an absorbent foot powder twice daily.
  • Wear a different pair of shoes on alternate days. This allows them to dry fully.

Treatment options include

• Aluminium chloride – a strong antiperspirant
• Iontophoresis
• Botulinum toxin injections (uses and benefits of Botox)
• Medication

Contact us today about how we can assist you with Hyperhidrosis treatment in Stellenbosch.

What is vitiligo?

Vitiligo is a condition that causes patches of skin (and sometimes hair) to turn white or lose its colour. 

What are the symptoms of vitiligo?

The main symptom is skin that turns white or loses its colour.

 Will I need tests?

Possibly. Vitiligo often happens along with other autoimmune problems, so your doctor might order blood tests to check for those other problems. 

How is vitiligo treated?

Treatments help return normal colour to the skin. The options include:

• Steroid medicines
• Calcineurin inhibitors
• Light therapy

 

Do your best to avoid getting a sunburn or suntan.

• Stay out of the sun in the middle of the day
• Stay under a sun umbrella, tree, or other shady spot
• Wear sunscreen
• Wear a wide-brimmed hat, long-sleeved shirt, and long pants
• Do not use tannig beds

If you are bothered by the way your skin looks, you can use special cosmetic products to make the skin changes less obvious.

In 10 to 20 percent of people, vitiligo goes away on its own. But in most people, the condition gets slowly worse, affecting more and more skin.

Read more on whether indoor tanning is healthy for my skin?

What is rosacea?

Rosacea is a skin condition that causes redness and pimples on the cheeks, nose, chin, forehead, or eyelids.

Most common in adults ages 30 to 60.

What are the symptoms of rosacea?

Rosacea affects the cheeks, nose, chin, forehead, or eyelids. Symptoms include:

• Redness
• Blushing easily
• Raised, red bumps with or without pus in them
• Tiny, swollen blood vessels on the skin
• A burning or gritty feeling in the eyes
• A red, swollen, and rounded nose

There are some things that might make redness on the face worse. Examples include:

• Eating hot or spicy foods, or drinking hot drinks
• Drinking alcohol
• Being too hot or cold
• Sunlight
• Stress and other strong emotions

How is rosacea treated?

Treatment for rosacea has 2 parts – to control symptoms and to prevent flare-ups.

Treatment involves both:

• The medicines can come as gels, creams, or lotions that go on your skin, or as pills that you swallow.
• Lifestyle changes. To help control your symptoms and prevent flare-ups, you should:
• Avoid the common triggers listed above and any other triggers that you know worsen your symptoms
• Use mild, unscented face cleansers to wash your face
• Wear sunscreen every day
• Avoid using products on your face with alcohol, acid, or other ingredients that could bother your skin

The skin can be infected with bacteria, viruses, mycobacteria and fungi.

Skin can also be infested by parasites such as scabies, lice and other organisms.

Your dermatologist will be able to distinguish between these different infections by performing a skin scraping to evaluate under the microscope or by sending a sample for a culture.

The treatment of these infections will be dictated by die identified organism and by medication susceptibility studies.

What’s hyperpigmentation?

A term that describes skin that appears darker. It can:

• occur in small patches
• cover large areas
• affect the entire body

While increased pigmentation usually isn’t harmful, it can be a symptom of another medical condition.

Types of hyperpigmentation

There are several types of hyperpigmentation, the common ones being melasma, sunspots, and post-inflammatory hyperpigmentation.

What causes hyperpigmentation?

A common cause of hyperpigmentation is an excess production of melanin. Melanin is a pigment that gives skin its colour. Several different conditions or factors can alter the production of melanin in your body.

Certain medications can cause hyperpigmentation. Also, some chemotherapy drugs can cause hyperpigmentation as a side effect.

Pregnancy changes hormone levels and can affect melanin production in some women.

Excessive sun exposure can also cause an increase in melanin.

There are many other causes for darkening of the skin. It is best to consult you dermatologist for a clear diagnosis.

How is hyperpigmentation diagnosed and treated?

A dermatologist can diagnose the cause of your hyperpigmentation. They will request your medical history and give you a physical examination to determine the cause. In some cases, a skin biopsy can narrow down the cause.

Treatment should be discussed with your dermatologist.

How is hyperpigmentation prevented?

It’s not always possible to prevent hyperpigmentation. However, you can protect yourself by:

• using sunscreen with an SPF of at least 30
• wearing hats or clothing that block sunlight
• avoiding the sun during the time of the day when it’s strongest

Avoid using over the counter products to lighten the skin without consulting your dermatologist as some of these medications may cause irreversible pigmentation on your skin.

Dr. Johann de Wet is a top dermatologist and skin specialist in Stellenbosch who also specializes in the treatment of adult female acne. His dermatology services and skin cancer treatment in the Cape Winelands extends from Stellenbosch to Somerset West and Cape Town.

Conditions such as Hyperpigmentation, Eczema, Contact Dermatitis, Acne, Psoriasis, Hyperhidrosis, Vitiligo, Rosacea and Skin infections are all treated in our Stellenbosch Dermatology practice.