WRINKLES

As we age wrinkles are largely formed through contraction of muscles. There are two broad types of wrinkles , ones seen at rest and one seen on muscle movement e.g when your frown, when you raise your eyebrows and when your smile. Our facial muscles consist of many muscles which cause movement and are in groups and clever placement of Botulinum toxin can for example, make the eyes look more wider and attractive, raised the eyebrows and give a nice lift.

Prevention of wrinkle formation through small adjustments with Botulinum toxin and Dermal filler will be investment for the future.

 

HYPER-PIGMENTATION

The colour of our skin is dependent on the level of Melanin pigment and the activity of the melanin producing cell, the melanocyte.

Hyper-Pigmentation issues are very common. In Caucasian/White skin this usually takes the form of sun spots/freckles/ sun damage as a result of sun exposure. In Skin of Colour e.g Indian/Hispanic/Afro-Carribean it can take the form of Melasma or patches of dark marks as a result of trauma to the skin e.g by frequent scratching or rubbing against shoes/clothing or having developed inflammation in the skin e.g after a bite or Eczema.

Dr Prasad specialises in this area and will provide comprehensive treatment to correct and treat this as well as maintain that skin afterwards to prevent relapse (it coming back).

The beauty of going to a dermatologist rather than going to a beautician or Aesthetic Practitioner will ensure that highly active and potent ingredients are used to ensure quick, effective, safe and medically researched treatments.

For more details about hyper-pigmentation please click to the leaflet: https://www.dermnetnz.org/topics/pigmentation-disorders/

MELASMA

Melasma is a common facial rash which presents as areas of ill-defined brownish or dark macules or patches, usually in symmetrical pattern, on a sun-exposed areas, especially the face. Hormonal influences such as the pill and pregnancy also have a part to play. It is more common in women and in Indian/Afro-Carribean community.

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At Faciem Dermatology London we can successfully treat with a number of highly effective medical grade products and peels.

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Please refer to the leaflet from the British Association of Dermatologist http://www.bad.org.uk/shared/get-file.ashx?id=169&itemtype=document

BROWN SPOTS AND FRECKLES

Brown spots in the skin are often Freckles or Sun spots. Freckles is due to increased melanin and fade or go away in the winter months. Sun spots may reduce in winter months but do not go away.

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Both are a sign of sun damage and Dr Prasad would perform a full Skin survey and dermoscopy on your skin to check the nature of these skin spots.

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Please read about these further https://www.dermnetnz.org/topics/brown-spots-and-freckles/

We can also treat dark areas around the neck, armpits, knuckles, knees and elbows as well around the eyes and anywhere on the body. These form due to dry and hard skin and we use medical grade ingredients to help to significantly improve these areas. We also offer our bespoke deep but gentle exfoliation of these areas with our Hydra-facial machine

ZO Skin care, Hydra-facial

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LUMPS AND BUMPS

The common lumps and bumps which bother patients are skin tags, benign moles, milia ( multiple milia called milium)

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and sebaceous hyper-plasia.

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These often look unsightly and can catch on things if around the neck, armpits, abdomen or groin. At your appointment Dr Prasad will conduct a full dermatological assessment and offer your removal usually through electro-cautery.

picture 11-min

https://www.dermnetnz.org/topics/skin-tag

https://www.dermnetnz.org/topics/dermatosis-papulosa-nigra/

The picture below show a middle aged man with multiple flesh coloured lesions which are harmless and but can look unsightly, the condition is called Sebaceous hyper-plasia.

If we look back to our diagram of the sebaceous gland over time this has been outputting lots of oil and the skin around the pore has enlarged. This is easily treated by Dr Prasad depending on the size of the lesions with Electro-cautery device, Conmed 2000 under local anaesthetic.

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https://www.dermnetnz.org/topics/milium/

https://www.dermnetnz.org/topics/sebaceous-hyperplasia/

NOSE TO MOUTH LINES

Nose to mouth lines are formed as we loose volume from our face. In particular fat pads underneath the skin start to reduce in size and separate and move downwards creating a fold around the naso-labial fold.

Many years ago practitioners would go in directly into this area and inject with a dermal filler without address the root of the problem which would lead to over filling and the chipmunk look.

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At Faciem Dermatology London Dr Prasad will perform a careful assessment of your face and anatomy but the general thinking now is that we have to replace and sold ground structure around our cheeks before directly injecting around the nose to mouth lines. Then usually with a cannula device the nose to mouth line is corrected and this leaves you with beautifully refreshed look.

At Faciem Dermatology London we normally use Juvederm Vycross Range for this and follow the MD Codes of revolumisation. Please click below to read further.

JOWLS

Jowls are formed when fat that was once sitting higher within the face and this has fallen as a result of the ageing process and gravity. Fat together with skin tissue changes is now sitting making the jawline heavier and jawline appearance weak.

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Restoration of jawline is done through Dermal fillers e.g Juverderm

Ideal Combination treatments: Dermal Fillers, Profhilo, ZO Controlled depth Peel, PRP, Radiofrequency, Threads

UNDER EYE PIGMENTATION / HOLLOWING

Under eye pigmentation / hollowing is often due to a number of causes interacting with each other. As we age the bone within the orbit starts to absorb and the fat pad around the eyes supporting the skin lessens and falls so we get eye hollowing +/- eye bags. There may be a genetic component.

Changes like this alters the way light falls on the face and causes hollowing.

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Some clients are trouble by dark areas or Hyper-pigmentation around upper and lower eyelid. This may genetic, secondary to Inflammatory skin conditions such as eczema, a contact allergy and a combination of volume loss such as above.

As Faciem Dermatology London Dr Prasad will perform a careful analysis on you and address each and everyone problem. This will include looking at your diet and lifestyle, management of any skin conditions such as eczema, treatment of volume loss such as Tear Trough Filler, the use of Anti Pigment creams such as ZO Hydra-firm, Vitamin C creams such as ZO 10% Self activating Vitamin C, Retinols and Tretinoin creams and PRP.

Treatments: Skin Care, PRP, Juvederm Volbella Tear Trough

AGED EYES

Again through volume loss of fat and collagen and skin laxity and gravity cause the eyelids to heavy/drooped and hooded.

At Faciem dermatology london we treat this with careful assessment of the cause and if appropriate we will offer Eyebrow filler/contouring and lifting with Juvederm Vycrcoss range. We can also use cleave placement of the Botulinum toxin to widen the eyes and lift the eyebrows.

Sometimes CO2 laser Blepharoplasty and Surgical Blepharoplasty is required and we will advise you of this.

Treatments: Fillers , PRP, Skincare

NOSE RESHAPING

Over the last few years Fillers to correct the nose shape has gained popularity as a non surgical option. With careful placement of the right type of filler in the right place can make a dramatic difference.

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As Faciem Dermatology London Dr Prasad is skilled in this area to correct bumps, hooks and curvature of the nose to straighten the nose to give it a more defined and aesthetically pleasing result. This will usually last 6-9 months and perhaps longer after which time the procedure can be repeated.

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Treatments : Fillers

CHIN RESHAPING

The chin area can also be a very rewarding area to correct. Many people have a small chin compared to their face and a chin that is too far back or one that has lost volume and has an overactive muscle (called the mentalist) sitting above bone.

Dr Prasad at Faciem Dermatology London will carefully assess the portions of the face and measure these areas and through careful placement of a suitable dermal filler will address the proportions for a more aesthetic pleasing appearance. The overactive mentalis which is the circular muscle sitting on top of your chin can be corrected by treatment with Botulinum toxin to prevent the cobbling effect. Dr Prasad ia very excited to announce the introduction of Allergan’s new product ‘Vollux’ to the Dermal Filler she uses which is a specific filler designed to be used in areas such as the chin.

Dermal Filler, Vollux

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Treatment: Fillers, Botulinum toxin

JAWLINE CONTOURING

With time the fat travel downs the face causing the jawline to look fuller and as collagen breaks down within the skin the jawline looks weaker.

The Jawline can be strengthened by carefully assessing the parts where volume loss has occurred and where the tissues need to be pulled back

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At Faciem Dermatology a full overall facial assessment is conducted and it may be that Jawline rejuvenation is performed as part of restoration of volume and lifting of the cheek and mid-face. Some individuals , particularly within a younger age group often like a more defined jawline and we can also do this with direct treatment with needle and cannula.

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Treatment : Filler: Juvederm Voluma

MOUTH RESTORATION

As we get older we loose volume in our face and our mouth gradually starts to take a downwards appearance which can look aged and make a person look sad. By using lifting techniques like Dermal Fillers/Revolumisers we can restore this area for a more youthful look.

We can also use small amounts of Botox around the muscles which downturn the mouth again to help create a lifted appearance.

Treatment: Dermal Filler, Liquid face lift

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CREEPINESS NECK/CHEST

Creepiness around the neck and chest occurs again because as we age we loose volume around the tissues here and in particular we looks collagen and elastin fibers. This is further accelarted by sundamage and lifestyle factors such as smoking.

Modern Aesthetic medicine can now transform this area with Botox for neck bands around the neck, Hydrating fillers like Juvederm Volite which consists of multiple injections around the tissues to create a more hydrated look and Micro-needling, chemical peels and skin tightening and collagen inducers such as Profhilo.

Treatment: Dermal Filler, Juvederm Volite, Micro-Needling, Chemical Peels

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HANDS / FEETS

The hands and feet often get overlooked. As we get older then skin has a tendency to become more dehydrated and repeated pressure through walking can cause hard skin to accumulate around pressure areas called Callous/Hard skin.

As Faciem Dermatology London we use our Bespoke Hand and Feet Hydra-facial and ZO Skin care Rejuvenation to help slough off dead skin and apply fruit acids and skincare enzymes that will beautifully melt away at the hard skin leaving the area beautifully soft and nourished.

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https://www.dermnetnz.org/topics/fungal-nail-infections

XANTHELASMA

Xanthelasma is the term for hard yellow patches around both upper and lower eyelids. Sometimes but not always it is representative of raised fats in your blood.

At Faciem Dermatology London, Dr Prasad will confirm diagnosis and will offer your serial TCA chemical peels to the areas, usually every 4-6 apart which slowly but surely chemical peels away the area the area , the area usually scabs and then crusts then reveals normal skin.

https://www.dermnetnz.org/topics/xanthoma

Treatment: TCA

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EXCESSIVE SWEATING

A lot of individuals are troubled by excessive sweating, some are situational around the time of a meeting and event and some clients suffer all the time with it.

At Faciem Dermatology we use a variety of methods to control this including Botulinum toxin. This involves multiple tiny injections around the treatment areas such as Armpits, Palms, Soles of feet to prevent the small sweat glands within your skin from sweating. The procedure takes approximately 45 minutes and will last 3-5 months.

Please click on the following link to read further.

http://www.bad.org.uk/for-the-public/patient-information-leaflets/hyperhidrosis

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ROSACEA

Rosacea is a long term inflammatory problem within the skin affecting the face. Rosacea can presents in many different ways and because of this it can it is often misdiagnosed. It can presents as facial flushing with flat red areas on the face or it can also be associated with spots such a red spots and yellow spots. If rosacea has been present for a long time it can cause to long standing thickened skin particularly around the nose which to improve and reduce needs a type of laser to reduce the thickness of the tissues.

At Faciem Dermatology London, Dr Prasad is passionated about treating skin diseases and is particularly passionate about treating roasacea suffers well as often people have been poorly treated and incorrectly managed.

https://www.bad.org.uk/shared/get-file.ashx?id=229&itemtype=document

https://www.dermnetnz.org/topics/rosacea

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ACNE

Acne is one of the commonest facial skin problems. Essentially it is localized inflammation and blockage around the sebaceous glands of the skin. Often it will start around the time when your oil glands become reactive and stimulated by hormones in your teens. What people often do not know that we have a distinct entity called Adult acne which requires careful management.

Acne requires many different types of attacks but in experienced hands will rapidly become under control.

Dr Prasad has been treating acne throughout all ages for over 15 years and is confident to gain quick and effective control and results.

The diagram below shows you the sebaceous glands within our skin and how it becomes blocked with oil and skin cells and how spots form. People often think that having the odd peel or facial will control their acne and unless acne is very mild this is often incorrect. Acne requires careful assessment and management so Dr Prasad would be delighted to help you in this area.

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ACNE SCARRING

Acne scarring can be very traumatizing to individuals and At Faciem Dermatology we are passionate about treating individuals effectivey and successfully.

The inflammation and blockage of the glands can cause destructions of the collagen and elastin fibers deep with the skin which causes dipped and tethered scars. Any scarring within the skin should alert you to seek a specialist dermatology opinion as it is much easier to prevent than to treat these scars.

Having said that we have a huge number of treatment modalities which we can use to improve the scarring to suit all budgets.

The treatment of acne should always start with skin care and the requirement of oral medication such as Roaccutane, Spironolactone, the pill.

The treatment of scars depends on the type of scar it is and after careful assessment we can offer you chemical peels, micro-needling and laser treatments.

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Acne and scarring can often get people down and depressed so please do not hestitate to seek Dr Prasad’s expert help to stop it taking over your life.

https://www.dermnetnz.org/topics/acne

INGROWING HAIR

Ingrowing hair, otherwise called razor bumps, is often caused by thick coarse hair becoming coiled underneath the skin. This causes blockage and inflammation and redness or dark marks called post inflammatory hyper-pigmentation. It can occur on any hair bearing area. The dermatological term for this is Pseudofolliculitis Barbae and oftem more common in Indian and Afro-carribean skin due to the type of hair.

Ingrowing hair can improved with exfoliating of mild but gold standard ( Ideal treatment) is the use of suitable and safe laser to remove the hair or make it finer.

http://www.bad.org.uk/shared/get-file.ashx?id=122&itemtype=document

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KELOID / RAISED SCARRING

Many people are troubled by raised scarring. Usually a preceeding event has occurred causing inflammation with the skin such as a bite or acne or burn or trauma which has triggered the skin to to increased collagen fibers within that area. The collagen that is made is often thick and stubborn.

Scars such as these require careful management under a skin specialist as you do not want to cause further injury with certain treatments which could potentially make the areas worse.

Please read the link below. At Faciem Dermatology we will assess the lesion and treat it effectively with a variety of treatments which include local injection of an anti-inflammatory product and laser.

http://www.bad.org.uk/shared/get-file.ashx?id=216&itemtype=document

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OILY SKIN

Oily skin can cause local inflammation within the skin cause blockage and acne and congested skin, one that is dull and bumpy and not smooth.

At Faciem dermatology we have multiple treatments that we can reduce and control the oil with multiple treatment options for you.

Certain skin conditions called Sebaceous Hyper-plasia, Seborrboeic Dermatitis
http://www.bad.org.uk/shared/get-file.ashx?id=180&itemtype=document
feed off this oil within the skin and treating the oil will ultimately reduce these conditions from occurring.

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Forhead Sebaceous Hyper-plasia
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ECZEMA/DRY SKIN

Eczema is a very common inflammatory condition with the skin that is immune mediated. Again it can often take over peoples lives and cause scarring. Dr Prasad has again been treating eczema for over 15 years with safe and effective treatments such as topical anti-inflammatories and immunomodulators .

There is a lot of poor and misinformation on the internet. Please click on the trusted sites below to read further.

Eczema in Asian skin can lead to dark marks and should be treated early and quickly.

http://www.bad.org.uk/shared/get-file.ashx?id=69&itemtype=document
https://www.dermnetnz.org/topics/atopic-dermatitis

SCALP / HAIR PROBLEMS

There are many types of hair problems. This can range from Hair loss such as

1. Male Pattern Hair loss
2. Female Pattern Hair loss
3. Alopecia areata
4. Telogen Effifulvium
5. Inflammation conditions of the scalp and beard
6. Scarring hair conditions

There are many more rare hair disorders of the scalp so again it is best to see a dermatology specialist for this.

The picture below shows alopecia areata of the scalp and beard area. Please click on the link below for further information

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Alopecia areata is often triggered by stress and it occurs as a result of auto-immune problem of the hair follicle which can be treated and control through multiple injections of an anti-inflammatory to dampen and reduce the immune issue.

https://www.dermnetnz.org/topics/alopecia-areata
http://www.bad.org.uk/shared/get-file.ashx?id=68&itemtype=document

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Female Pattern Hair Loss can be experienced at different levels and the chart above is a scale we use in dermatology to classify the severity. It is also called androgenetic alopecia. As women we have both male and femal type hormones and when this balance is upset it can affect the hair follicles and hair cycle leading to hair loss.

The other condition that women see a lot is hair loss just after having a baby and after Iron deficiency or Thyroid abnormalities.

The above diagram show the progression of male pattern hair loss. Again there are many claims and promises on the internet often without any medical evidence.

Medically speaking there is only proven and accepted evidence for the Minoxidl, PRP, Low level laser combs and of course hair transplantation.

PRP of the scalp.

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ENLARGED PORES

Many things can be done in cosmetic dermatology for enlarged pores. Please click in the link below

https://www.dermnetnz.org/topics/enlarged-pores/
Treatment: ZO Skin care, Hydra-facial, ZO Stimulator Peel

HARD SKIN ELBOWS/KNEES

All skin types can be affected by hard skin on the elbows and knees. In particular patients with skin of colour often suffer with this because the skin around these areas are dry, have been hardened and thickened and darker over time. Dr Prasad is skilled at treated such area with highly effective creams and other treatments.

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DARK AND THICKENED/VELVETY SKIN

This is a very common issue which affects many people. It is more common in skin of colour and people who are overweight and having difficulty with insulin resistance.

Dr Prasad has been treating this successfully for many years and uses many effective topical ingredients to improve these stubborn areas.

Please click on below
https://www.dermnetnz.org/topics/acanthosis-nigricans/

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ROUGH / BOBBLY SKIN

This is called Keratoses Pilaris and is due to plugging of the glands with dead skin cells. A variety of treatments can help keep this skin issue under control.

https://www.dermnetnz.org/topics/keratosis-pilaris/

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LOSS OF PIGMENT IN SKIN

Loss of pigment of the skin can occur during trauma when the pigmenderm ne producing cells are disrupted, after inflammation such as eczema or as a result of Vitiligo.

To read about Vitiligo please click on https://www.dermnetnz.org/topics/vitiligo/

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MOLE CHECKS

At faciem dermatology London we offer a full dermatology service which include General Dermatology Consultation and mole checks. As a general rule of thumb any lesion that is new even if not pigmented and is growing in size and causing symptoms such as itching or is bleeding should be reported urgently and checked.

I work closely with my colleagues in Skin Cancer surgery and Moh’s micro-graphic tissue preserving surgery and would offer a seamless transfer of care to them.

During the consultation your skin lesions would be examined, measured, photographed with your consent and examined using the dermatoscope. Dr Prasad believes that is much for sensitive than using computer tools to determine high risk lesions.

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A BCC or Basal cell carcinoma, called a Rodent ulcer
This is slow growing and may ulcerate but does not invade into the body.

https://www.dermnetnz.org/topics/basal-cell-carcinoma

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A Malignant Melanoma displaying all the classical features, the ABCD rule. Asymmetrical, Border is irregular, Colour is varied and is is a large lesion. This requires urgent surgery and determination of depth of lesion as this skin cancer is highly invasive.

https://www.dermnetnz.org/topics/melanoma