‘Spots’, ‘zits’, ‘pimples’: however you refer to it, acne is a common and embarrassing problem for many people. It can destroy self-confidence and persist into adulthood. However, really good treatments exist that can control, and often cure, the problem.
“When I walked into Dr Farrant’s office in March I had three cysts on my right cheek. Having suffered with cystic acne since my early twenties, I was at the end of my tether. I had tried antibiotics, creams, and antibacterial washes prescribed by other dermatologists.
He gave each cyst a shot of cortisone, which hurt, but was a good pain, as I knew it would make them recede. Sure enough, within a week all three had totally flattened, which was a great relief. The scars are inevitably there, but barely visible.
In the same appointment, Dr Farrant suggested that given I had tried many other things without long-term success, that isotretinoin would be a good strategy going forward. I was reticent at first, given I had heard scare stories about side effects, but I agreed when he said we could start on a ‘baby dose’ and work our way up, while checking in regularly as to any changes in my mood, or my physicality.
The results have been dramatic, as you can see, in just 2.5 months of treatment. I haven’t had any new blemishes or cysts since starting. Side effects have been minimal – very dry lips, helped notably by Carmex – and the results have been unbelievably worth it. If anything, my mood has improved under the treatment, given my cystic acne was causing me so much anxiety and embarrassment before.
I would encourage anyone having problems to go and see Dr Farrant – and to consider isotretinoin. It remains to be seen if the results for me will be long-term for me, but for now, I’m overjoyed with them.”
Eczema affects the normal barrier action of the top layer of the skin, meaning not only that water is lost through the skin but irritants and allergens can penetrate and inflame it. The skin is typically dry, red and itchy. Moisturisers can help restore the barrier, but it is important that the inflammation is ‘switched off’ with creams, tablets or ultraviolet light therapy.
“I had eczema as a baby but it had improved a lot as I got older, only to get worse again when I was at university. I tried lots of creams but none really helped a great deal. My skin got quite a lot worse until it got to the point where I had to sort it.
Dr Farrant listened as I explained all the treatments I had tried and got me to run through my daily routine. I hadn’t realized that most of the creams I was using were moisturisers and weak steroid creams. I had always been reluctant to use cortisone creams, but I was willing to try something a bit stronger, with the aim of giving it a bit of a ‘blast’ then having a break. Dr Farrant also gave me a special eczema cream for my face that didn’t contain a steroid. My skin has never been clearer. I know this is not a cure, but I now feel confident I can manage my skin and I know there are other options if things get bad again.”
Psoriasis is a condition that often runs in families. It is caused when the body produces skin cells much faster than normal – over days rather than months. This causes a build-up of skin cells, resulting in red, flaky, scaly patches, particularly over the elbows, knees, scalp and lower back. It can also affect the nails, groin and other parts of the body. It is often made worse by ‘triggers’ including stress, injury, certain medications and alcohol.
“I have a stressful job in the City and I know this affects my skin, but it has never been this wild before. My GP had given me a pretty strong ointment, but it only really made the skin less dry looking.
Dr Farrant agreed that my skin needed something beyond creams. He initially suggested a course of ultraviolet therapy, but when we discussed it, we dismissed it as I couldn’t make time for the appointments around my work and taking time out was only going to add to my stress levels! So he prescribed ciclosporin but unfortunately I didn’t respond to it. He then switched to methotrexate and within three months my skin is now back under control. I can take my kids swimming without getting stared at and I don’t have flakes of skin all over my suit!
Dr Farrant was really understanding and professional. I was involved in all the decisions and he has been really flexible with appointments, fitting me in first thing so I can still get to work.”
There are many different types of skin lesions. These might be moles, warts, cysts or other harmless skin lesions that produce a lump in the skin. There are a number of ways to treat them depending on how superficial or deep they are within the skin.
“I had hundreds of horrible black ‘stuck on’ warty lumps all over my back. My GP had told me they were harmless, so this may just be my vanity, but I really didn’t like them. I booked to have the bigger ones removed. Dr Farrant injected the bigger ones and used an anaesthetic cream for the very small ones. The warts were burnt off and scraped carefully away, leaving grazes on the skin that all healed within a week or so.
Dr Farrant was very gentle and the nursing staff at the hospital were really kind and arranged to check the wounds after a week. I felt I was in really good hands.”
The skin is the body’s defence against the environment, including UV light. Unfortunately, many of us have enjoyed spending too much time in the sun and are now paying the price. Sun damage varies from simple brown marks known as lentigines, to rough flaky areas called actinic keratoses which can, on rare occasions, develop into skin cancer.
“I had had lots of dry scaly patches on my forehead for some time. My GP had told me it was rosacea and had given me some antibiotic creams for it, but this treatment didn’t seem to do anything. Dr Farrant diagnosed the condition as actinic keratosis, caused by sun exposure, and described the different treatments available. There were lots of different creams and he explained how they worked and also how they were going to make things worse in the short term before the skin got better.
I decided to try the gentlest cream first, and whilst I felt things did get a bit better, Dr Farrant was less impressed with the progress. We agreed to try one of the stronger creams which did, as predicted, cause more reaction, but it was much more effective. I am sure I am more anxious than most and I had lots of concerns. Dr Farrant was always happy to see me in person or answer questions via email, even when he was on holiday! Without his support, I am sure I would have given up, but now my skin is much better.”
Skin cancers are on the increase and now probably account for 50% of dermatological practice. The commonest type – basal cell or rodent ulcer is more common than all other cancers together and melanoma (a malignant tumour on the skin) is one of the biggest cancer killers of young adults. They can present as a new lump, especially one that bleeds or a changing mole, particularly a mole that goes black. Unfortunately many people ignore changes to the appearance of the skin, particularly where it is not visible, meaning skin cancers can go undiagnosed until they have become serious and treatment options are reduced.
“My wife had been nagging me to get a mole looked at and I had put it off for too long. It was clear that Dr Farrant didn’t like the look of it and I appreciated his honesty. He removed it there and then and arranged to see me a week later to discuss the results. The mole was cancerous but caught at an early stage. It was recommended that I have a second ‘clearance’ operation which was arranged a couple of weeks later by Dr Farrant.
Dr Farrant was open and up-front about the problem, but also broke down the management of my condition into stages which made it easier for me to cope with. The surgery was expertly carried out and I have a very neat scar. I have been very carefully followed up and feel reassured to have my skin checked so thoroughly every three months.”