Common Dermatological Conditions We Treat: More Than Just Skin Deep

At Lambert Medical Practice in Surbiton, we understand that skin conditions can affect more than just your physical appearance—they can impact your comfort, confidence, and overall quality of life. Our experienced medical team provides comprehensive care for a wide range of dermatological conditions, combining effective medical treatments with practical lifestyle recommendations. This guide explores the common skin conditions we treat and our approach to managing them.

Eczema (Atopic Dermatitis): Beyond the Itch

Eczema is one of the most common skin conditions we treat at Lambert Medical Practice in Surbiton, affecting approximately 1 in 5 children and up to 1 in 10 adults in the UK. This chronic, inflammatory skin condition is characterized by dry, itchy, and inflamed skin that can significantly impact daily life.

Understanding Eczema

Eczema is more than just a superficial skin problem—it represents a complex interaction between genetic factors, immune system dysfunction, and environmental triggers. Key features include:

• Skin Barrier Dysfunction: People with eczema have a compromised skin barrier, allowing moisture to escape and irritants to penetrate more easily.
• Immune System Overreaction: The immune system responds abnormally to triggers, leading to inflammation and the characteristicImmune System Overreaction: The immune system responds abnormally to triggers, leading to inflammation and the characteristic redness, itching, and rash.
• Chronic-Relapsing Nature: Eczema typically follows a pattern of flare-ups and remissions, with symptoms worsening in response to various triggers.
• Association with Other Conditions: Eczema often occurs alongside other atopic conditions such as asthma, hay fever, and food allergies, suggesting shared underlying mechanisms.

At Lambert Medical Practice in Surbiton, we recognize that each patient's eczema is unique, with different triggers, severity, and impact on quality of life.

Our Comprehensive Approach to Eczema Management

Our treatment strategy for eczema combines medical interventions with practical lifestyle modifications:

Medical Treatments

• Topical Corticosteroids: Prescribed in appropriate strengths to reduce inflammation and itching during flare-ups, with careful consideration of potential side effects with long-term use.
• Topical Calcineurin Inhibitors: Non-steroidal alternatives such as tacrolimus and pimecrolimus, particularly useful for sensitive areas like the face and skin folds.
• Emollients and Moisturizers: A cornerstone of eczema management, these help repair the skin barrier and prevent moisture loss. We help patients select the most appropriate products for their specific needs.
• Antihistamines: Sometimes recommended to help control itching, particularly at night.
• Advanced Therapies: For severe cases, we can facilitate referrals for specialized treatments such as phototherapy or systemic medications.

Lifestyle Recommendations

• Trigger Identification and Avoidance: We help patients identify and minimize exposure to personal triggers, which may include certain fabrics, detergents, soaps, foods, stress, or environmental factors.
• Bathing Practices: Guidance on optimal bathing temperature, duration, and products to avoid exacerbating symptoms.
• Clothing Choices: Recommendations for skin-friendly fabrics and clothing styles that minimize irritation.
• Stress Management: Since stress can trigger or worsen eczema flares, we discuss appropriate stress reduction techniques.
• Environmental Modifications: Advice on maintaining optimal humidity levels, dust mite control, and other environmental adjustments.

Patient Success Story: Managing Lifelong Eczema

Emma, a 34-year-old teacher from Surbiton, had struggled with eczema since childhood. Despite trying numerous over-the-counter treatments, she continued to experience debilitating flare-ups that affected her confidence in the classroom and disrupted her sleep.

After a comprehensive assessment at Lambert Medical Practice, we developed a personalized management plan that included:

• A structured skincare routine with specific emollients for different body areas and times of day
• A moderate-potency topical corticosteroid for flare management, with clear guidance on safe application
• Identification of several previously unrecognized triggers, including a preservative in her favorite skincare products
• Practical strategies for managing eczema while maintaining her professional responsibilities

Six months later, Emma reported an 80% reduction in flare frequency and severity. More importantly, she felt empowered to manage her condition rather than feeling controlled by it. Her sleep quality improved dramatically, and she no longer felt self-conscious about her skin in professional settings.

Psoriasis: Managing a Systemic Condition

Psoriasis affects approximately 2% of the UK population and represents another common condition we treat at Lambert Medical Practice in Surbiton. Unlike eczema, psoriasis is an autoimmune condition that accelerates the skin cell production process, leading to the buildup of thick, scaly patches.

Understanding Psoriasis as a Systemic Disease

Modern understanding of psoriasis has evolved significantly, and we now recognize it as more than just a skin condition:

• Immune-Mediated Inflammation: Psoriasis involves overactivation of the immune system, with T-cells and inflammatory cytokines driving the accelerated skin cell turnover.
• Systemic Inflammation: The inflammatory processes in psoriasis aren't limited to the skin but can affect multiple body systems.
• Associated Comorbidities: Psoriasis is associated with an increased risk of psoriatic arthritis, cardiovascular disease, metabolic syndrome, and psychological conditions like depression and anxiety.
• Genetic Predisposition: There is a strong genetic component, with about one-third of patients having a family history of the condition.

At Lambert Medical Practice in Surbiton, our approach to psoriasis acknowledges both its visible manifestations and its potential systemic impacts.

Our Holistic Approach to Psoriasis Care

We tailor our treatment strategies to the type, severity, and impact of each patient's psoriasis:

Medical Treatments

• Topical Therapies: First-line treatments including corticosteroids, vitamin D analogues (like calcipotriol), tar preparations, and calcineurin inhibitors.
• Phototherapy: For more extensive psoriasis, we can refer patients for controlled exposure to specific wavelengths of UV light, which can slow skin cell turnover and reduce inflammation.
• Systemic Medications: For moderate to severe cases, we coordinate care with dermatologists for treatments such as methotrexate, cyclosporine, or newer biologic therapies that target specific components of the immune system.
• Monitoring for Comorbidities: Regular screening for associated conditions, particularly psoriatic arthritis, which affects up to 30% of psoriasis patients.

Lifestyle and Holistic Support

• Trigger Management: Identification and avoidance of factors that can trigger flares, such as stress, certain medications, infections, and skin injuries.
• Dietary Considerations: While evidence for specific "anti-psoriasis" diets is limited, we discuss the potential benefits of anti-inflammatory eating patterns and maintaining a healthy weight, which can improve treatment response.
• Stress Reduction: Given the well-established link between stress and psoriasis flares, we emphasize stress management techniques as part of the treatment plan.
• Alcohol and Smoking Cessation: Support for reducing these factors, which can worsen psoriasis and decrease treatment efficacy.
• Psychological Support: Recognition of the psychological impact of a visible chronic condition and appropriate referrals when needed.

Patient Success Story: Comprehensive Psoriasis Management

David, a 45-year-old accountant, had lived with increasingly severe plaque psoriasis for over a decade. Beyond the physical symptoms affecting his scalp, elbows, and knees, he was experiencing joint pain and had become reluctant to participate in social activities due to self-consciousness about his skin.

Our approach at Lambert Medical Practice included:

• Optimizing his topical treatment regimen with a combination of vitamin D analogue and corticosteroid
• Screening for and identifying early psoriatic arthritis, leading to prompt rheumatology referral
• Cardiovascular risk assessment and appropriate interventions
• Discussion of the role of weight management, with referral to our practice nutritionist
• Coordination with dermatology for consideration of systemic therapy

Eighteen months later, David's skin had improved dramatically, his joint symptoms were well-controlled, and he reported feeling "back to my old self" in terms of confidence and social engagement. Importantly, addressing the condition comprehensively likely reduced his long-term risk of cardiovascular complications.

Acne: Beyond Teenage Skin Problems

Acne is one of the most common skin conditions worldwide, affecting up to 95% of people at some point in their lives. At Lambert Medical Practice in Surbiton, we treat acne in patients of all ages, recognizing that it's not just a teenage problem but can persist into or even begin during adulthood.

Understanding the Complexity of Acne

Acne develops through a multifactorial process involving:

• Excess Sebum Production: Often triggered by hormonal factors, including androgens.
• Follicular Hyperkeratinization: Abnormal shedding of skin cells lining the hair follicles, leading to clogged pores.
• Proliferation of Cutibacterium acnes: Bacteria that thrive in the sebum-rich environment of clogged follicles.
• Inflammation: The body's immune response to bacterial overgrowth and irritation.
• Hormonal Influences: Fluctuations in hormone levels can trigger or worsen acne, explaining its prevalence during puberty, menstrual cycles, pregnancy, and certain endocrine disorders.

At Lambert Medical Practice in Surbiton, we recognize that effective acne treatment requires addressing multiple aspects of this complex pathophysiology.

Our Evidence-Based Approach to Acne Treatment

We develop personalized treatment plans based on acne type, severity, and individual patient factors:

Medical Treatments

• Topical Retinoids: Derivatives of vitamin A that normalize skin cell turnover, prevent follicular plugging, and have anti-inflammatory properties.
• Topical Antimicrobials: Including benzoyl peroxide and antibiotics like clindamycin, which reduce C. acnes colonization and inflammation.
• Combination Topical Therapies: Products combining retinoids with antimicrobials for enhanced efficacy.
• Oral Antibiotics: For moderate to severe inflammatory acne, typically prescribed for limited durations to minimize antibiotic resistance.
• Hormonal Therapies: Including combined oral contraceptives and anti-androgen medications for female patients with hormonal acne patterns.
• Isotretinoin: For severe, scarring, or treatment-resistant acne, we can refer patients for consideration of this highly effective but closely monitored oral retinoid.

Skincare and Lifestyle Guidance

• Evidence-Based Skincare: Recommendations for gentle, non-comedogenic cleansers and moisturizers appropriate for acne-prone skin.
• Myth Busting: Addressing common misconceptions about acne causes and treatments.
• Dietary Considerations: Discussion of emerging evidence regarding potential dietary triggers like high-glycemic foods and dairy for some individuals.
• Stress Management: Recognition of the stress-acne connection and appropriate coping strategies.
• Makeup and Cosmetic Advice: Guidance on non-comedogenic products and proper removal techniques.

Patient Success Story: Adult-Onset Acne Resolution

Sophia, a 32-year-old marketing executive, developed persistent acne around her jawline and chin in her late twenties, despite having clear skin as a teenager. The condition was affecting her professional confidence and not responding to over-the-counter treatments.

At Lambert Medical Practice, we identified a hormonal pattern to her acne and developed a comprehensive approach:

• A topical regimen combining adapalene (a retinoid) and benzoyl peroxide
• A three-month course of oral antibiotics to rapidly reduce inflammation
• Hormonal therapy with a combined oral contraceptive specifically approved for acne
• Guidance on appropriate skincare products and makeup
• Discussion of potential dietary triggers, leading to Sophia identifying a correlation between dairy consumption and flares

After four months, Sophia's skin had cleared significantly, with only occasional minor breakouts. By continuing with maintenance therapy and her modified skincare routine, she has maintained these results for over a year and reports feeling "liberated" from the constant worry about her skin.

Rosacea: Managing a Chronic Facial Condition

Rosacea is a chronic inflammatory condition primarily affecting the central face, characterized by flushing, persistent redness, visible blood vessels, and sometimes papules and pustules. At Lambert Medical Practice in Surbiton, we recognize the significant impact rosacea can have on quality of life and self-esteem.

Understanding Rosacea's Subtypes and Triggers

Rosacea is not a single condition but encompasses several subtypes with overlapping features:

• Erythematotelangiectatic Rosacea: Characterized by flushing, persistent central facial redness, and visible blood vessels.
• Papulopustular Rosacea: Presents with persistent central facial redness along with transient papules and pustules (often mistaken for acne).
• Phymatous Rosacea: Involves thickening of the skin and irregular surface nodularities, most commonly affecting the nose (rhinophyma).
• Ocular Rosacea: Affects the eyes, causing irritation, dryness, and sometimes more serious complications.

Common triggers that can exacerbate rosacea include:

• Sun exposure
• Hot or cold temperatures and wind
• Spicy foods and hot drinks
• Alcohol, particularly red wine
• Stress and anxiety
• Certain skincare products and cosmetics
• Exercise and hot baths/showers

At Lambert Medical Practice in Surbiton, we help patients identify their personal triggers as a key component of management.

Our Multifaceted Approach to Rosacea Management

We tailor treatment to the specific subtype and severity of each patient's rosacea:

Medical Treatments

• Topical Agents: Including metronidazole, azelaic acid, and ivermectin, which target inflammation and, in some cases, Demodex mites that may contribute to symptoms.
• Oral Antibiotics: Particularly tetracyclines like doxycycline, which are used primarily for their anti-inflammatory rather than antimicrobial properties.
• Brimonidine and Oxymetazoline: Topical agents that temporarily reduce redness by constricting blood vessels.
• Isotretinoin: For severe, resistant cases, particularly those with phymatous changes.
• Vascular Laser and Intense Pulsed Light: We can refer patients for these procedures to address persistent redness and visible blood vessels.

Skincare and Lifestyle Guidance

• Gentle Skincare Routine: Recommendations for mild, non-irritating cleansers and moisturizers specifically formulated for sensitive, rosacea-prone skin.
• Sun Protection: Guidance on daily, year-round sun protection with broad-spectrum, mineral-based sunscreens that minimize irritation.
• Trigger Avoidance: Support in identifying and managing personal triggers through symptom diaries and gradual elimination strategies.
• Camouflage Techniques: For patients concerned about the cosmetic impact, advice on appropriate makeup products and application techniques to neutralize redness.
• Stress Management: Given the strong stress-rosacea connection, discussion of appropriate stress reduction techniques.

Patient Success Story: Regaining Confidence with Rosacea

Richard, a 48-year-old sales manager, had struggled with increasingly severe rosacea for several years. The persistent redness, frequent flushing episodes during presentations, and recent development of papules and pustules were affecting his professional confidence and social life.

Our comprehensive management plan at Lambert Medical Practice included:

• Initial treatment with oral doxycycline at an anti-inflammatory dose, alongside topical ivermectin
• A carefully selected skincare regimen with products specifically formulated for rosacea
• Detailed trigger identification, which revealed significant flares with red wine, spicy food, and hot environments
• Strategies for managing unavoidable triggers in professional settings
• Referral for vascular laser treatment to address persistent background redness and visible blood vessels

Six months later, Richard reported an 85% improvement in his symptoms. He had developed effective strategies for managing his condition during work events and was no longer avoiding social situations. Perhaps most importantly, he no longer felt that his face was the first thing people noticed about him.

The Psychological Impact of Skin Conditions

At Lambert Medical Practice in Surbiton, we recognize that skin conditions can have profound psychological effects that extend far beyond physical symptoms. The visible nature of dermatological problems can impact self-esteem, social interactions, and overall mental wellbeing.

Understanding the Skin-Mind Connection

Research consistently demonstrates the psychological burden of skin conditions:

• Higher Rates of Depression and Anxiety: People with visible skin conditions experience depression and anxiety at rates 2-3 times higher than the general population.
• Social Avoidance: Many patients report avoiding social situations, limiting recreational activities, or experiencing difficulties in intimate relationships due to their skin condition.
• Workplace Impact: Skin conditions can affect career choices, job performance, and workplace interactions.
• Bidirectional Relationship: Psychological stress can trigger or worsen many skin conditions, creating a potential cycle of physical symptoms and emotional distress.
• Body Image Issues: Chronic skin conditions can significantly alter body image and self-perception.

Our approach at Lambert Medical Practice acknowledges these psychological dimensions as integral to effective dermatological care.

Our Holistic Approach to Psychological Support

We integrate psychological support into our dermatological care through several approaches:

• Validation and Empathy: Acknowledging the emotional impact of skin conditions and creating a non-judgmental space for patients to discuss these concerns.
• Quality of Life Assessment: Incorporating questions about the condition's impact on daily activities, sleep, work, and relationships.
• Stress Management Strategies: Providing guidance on stress reduction techniques that can both improve psychological wellbeing and potentially reduce physical symptoms.
• Referrals When Appropriate: Recognizing when patients might benefit from additional psychological support and facilitating referrals to counseling services or psychodermatology specialists.
• Support Group Information: Connecting patients with condition-specific support groups and reliable online resources.

By addressing both the physical and psychological aspects of skin conditions, we aim to provide truly comprehensive care at Lambert Medical Practice in Surbiton.

When to Seek Dermatological Care at Lambert Medical Practice

While many minor skin issues resolve on their own or with over-the-counter treatments, certain situations warrant professional medical attention. At Lambert Medical Practice in Surbiton, we encourage patients to consult with us for:

• Persistent or Worsening Symptoms: Skin conditions that don't improve with standard self-care measures or over-the-counter treatments after 2-4 weeks.
• Severe Symptoms: Intense itching, pain, or widespread rashes that affect daily activities or sleep.
• Signs of Infection: Increasing redness, warmth, swelling, yellow or green discharge, or fever accompanying a skin condition.
• Sudden or Unusual Rashes: Particularly those accompanied by other symptoms like fever, joint pain, or feeling unwell.
• Changing Moles or Growths: Any skin growth that changes in size, shape, color, or texture, or that bleeds, itches, or doesn't heal.
• Significant Psychological Impact: When a skin condition is causing substantial distress, affecting self-esteem, or leading to social withdrawal.
• Uncertainty About Diagnosis: When you're unsure what's causing your skin symptoms and need professional evaluation.

Early intervention often leads to more effective treatment and can prevent complications or chronic issues.