Below are answers to many commonly asked questions, grouped under the following headings:
I allow 30 minutes for a new appointment. Most dermatologists will only allow 15-20 minutes, which may leave you feeling a bit rushed! I believe there is benefit in a longer appointment as it enables a more relaxed consultation and we are far more likely to get to the bottom of the problem.
We normally schedule 15 minutes for all follow ups, but if we anticipate it will take longer then we will book more time.
I hold clinics on Mondays (mornings) and Wednesdays (evenings).
Yes. My Monday clinic starts at 8am and it is popular with London commuters as it allows them to get to work at a reasonable time. My Wednesday clinic extends into the evening till 8:30pm. I also offer a scheduled telephone follow up for results either on a Tuesday or Thursday evening from 7:30pm.
Most insurance companies expect a GP referral letter to validate the claim. It is best to discuss the consultation with your insurer and make sure they will cover the costs of the consultation and any necessary investigation. If a biopsy is required, I prefer to do this at the first appointment as it is much more time efficient for you and me. Some insurers no longer automatically cover this, although I have never had a company refuse to pay for it retrospectively.
You will often be given an approval number by your insurer. It is helpful if this is passed on directly to my secretary.
Most insurance policies do not cover prescriptions. Private prescriptions require you to pay the actual cost of the medication. Sometimes this will be less than a NHS prescription charge and sometimes it will be more. Pharmacies will often charge a private prescription dispensing charge and the costs will vary from pharmacy to pharmacy.
Yes. The majority of patients I see will have a referral and I believe that involving your GP in your care is beneficial and so I would normally advise that you see your GP before making an appointment to see me. However, there are times when patients prefer to seek my help without involving their GP and that is fine too. Please let me know at the time of the consultation if you do not want your GP to receive any correspondence from me.
Unfortunately the private sector works completely independently of the NHS. I will only have access to information you provide or that is provided by your GP. I am totally dependent on the quality of the referral letter from your GP and the results attached to it. If you have had a number of tests already carried out by your GP, it is worth asking for a print out of these and bringing them with you to your appointment ─ in my experience the GP referral may say that ‘results are attached’, but in practice they often don’t make it to the consultation!
If you have arranged an appointment with me very shortly after seeing your GP, the referral letter may not have been typed, sent or received. It is worth checking that the letter has been written and faxed/emailed if required at short notice.
There is no regulation over who can call himself or herself a ‘trichologist’ or a ‘consultant’. Some may belong to the institute of trichologists and have had some structured training, but unfortunately many others have not and make their living from selling inappropriate and ineffective lotions and potions.
I am a qualified medical doctor and a Fellow of the Royal College of Physicians (FRCP). I specialise in dermatology with a sub-speciality in hair and scalp disorders. I apply the same thorough medical approach to dealing with hair and scalp conditions as I do to the treatment of skin conditions. Scalp conditions are often no different from conditions elsewhere on the body. Having an in-depth understanding of dermatology therefore is important to managing all but the most trivial scalp problems.
Most hair disorders are due to problems affecting the hair growing structure (known as the follicle). Understanding exactly where and what the problem is enables effective treatments to be used.
Having a medical background means I have the scientific knowledge to organise and interpret the appropriate tests, which leads to a more accurate diagnosis, so a more effective treatment and care plan.
I prefer to offer a ‘see and do’ service for simple problems. That means if there is an irritating skin lesion that needs to be removed, I’ll do it at the time of the first appointment whenever time allows. It is usually possible to do this within the initial 30 minute appointment.
Rashes that require a biopsy, lesions that can be shaved or curetted (scraped) can all be treated on the day. Larger lesions that require a formal excision (cutting out) and closure with stitches take longer and are usually booked at a later date. This applies to skin cancer surgery too.
It is really important that you contact my secretary [link to contact page] with as much notice as possible so that we can schedule this time for another patient. Regrettably you will be liable for a £40 cancellation fee if you do not give us at least 48 hours notice of cancellation.
Yes. All patients receive a copy of any letters written to their GP, which contain the treatment instructions. We will email or post this to you within a few days of the consultation and often you will receive this before your GP.
I carry out most of the surgery required. Skin surgery is a large part of both my NHS and private practice for skin cancers at all hospitals. There are times when I will refer on to colleagues for more complex procedures. This applies to skin cancers at specific sites where surgery is very complex or requires a special technique. I have worked with all the people I refer to and you will always be in the best hands.
Yes. All the procedures I carry out are performed under a local anaesthetic, an injection that numbs just the area required. If you require sedation or a general anaesthetic (where you are put to sleep) this will be arranged with my specialist colleagues, either as a day case or as an inpatient.
It really depends on what medication you are taking, why you are taking it, and what operation you are having.
For minor procedures, such as shaves and curettes, blood thinning medication can be continued as usual.
If you have had a stroke, heart attack or have heart stents then it is usual to continue with your medication. If you have decided to take aspirin to help with your general health this can be stopped on the advice of your doctor a couple of weeks before, which will limit bleeding at the time of the operation.
If you take warfarin, we prefer for the blood clotting INR (International Normalised Ratio) test to be less than 2.5 for surgical excisions and I will usually ask for you to arrange for this to be checked a couple of days before the operation. If it is higher than 2.5 then we recommend missing a couple of doses and having it rechecked at your practice on the day of the operation. If for some reason the INR is very high, please contact my secretary as soon as possible as we may need to postpone the surgery.
Most tests are back with me within a week. This includes histology of any biopsies/excisions. The exception is hair biopsies. These are sent to a different laboratory and I like to meet the pathologist in person so we can discuss the case together. I normally allow at least four weeks for this. It is therefore worth checking with my secretary that the results for hair biopsies are back before returning for your follow up appointment.
The majority of patients do come back for results and we normally combine that with a wound review and removal of stitches if necessary. For minor procedures, when we are not anticipating anything nasty, it is possible to have a scheduled telephone follow up. Most insurance companies approve this. My secretary books these in and I will phone you at a pre-arranged time.