DERMATOLOGICAL CONSULTATION OF ADULTS (PRICE FOR A VISIT)

DERMATOSURGICAL PROCEDURES

EXAMINATIONS

AESTHETIC MEDICINE TREATMENTS

ESTHETIC MEDICINE (esthetic dermatology) deals with maintaining and improving the attractive appearance of the skin in healthy patients. Wrinkles, color correction, smoothing of the skin, removal of brown discolorations and capillaries are the most popular procedures. You can choose a specific treatment that will provide the desired effect. Patients may choose to participate in the “Skin Rejuvenation Program”, where we choose an individual skin type treatment. We offer a separate program for men interested in improving their appearance.

In any case, the procedure should be preceded by consultation with a dermatologist who will perform the procedure. Such consultation will allow for clarification of any doubts. Consultations also provide an opportunity for the patient to be provided with reliable information regarding the effectiveness of treatment, its durability and possible temporary adverse aesthetic symptoms that may be associated with the surgery. Below are some of the most common methods of aesthetic dermatology.

BOTOX

“Botox” is a well-known brand name of the first botulinum toxin used in medicine. This substance is used to correct wrinkles and excessive sweating.

REMOVING WRINKLES WITH BOTULINUM TOXIN

Botulinum toxin is used to treat wrinkles around the eyes, between the eyebrows, lateral wrinkles of the forehead and some in the lower parts of the face. The treatment consists of subcutaneous or intramuscular administration of a substance that temporarily prevents the contraction of certain muscle groups. For example, reducing the contractility of the forehead muscles means that the furrows characteristic of the crease do not form. The effect of the treatment is reversible. After administration, the effects are visible in about 7-10 days and usually last from 4 to 8 months. After this period, the treatment can be repeated. The method is safe.

Botulinum toxin (“Botox”) is also used to reduce the excessive sweating. The treatment gives the perfect effect of temporarily reducing sweating of the hands, feet, armpits, forehead and skin of the scalp. The effect of the treatment lasts about 8-12 months.

FILLING IN WRINKLES

Wrinkle filling with stabilized hyaluronic acid preparations is used to treat nasolabial folds, fine wrinkles around the lips and eyes and on the forehead. The method consists in the intradermal administration of hyaluronic acid, which is a natural component of the intercellular space (depending on the severity and location of the wrinkles apply different depths of administration). The effect of the treatment is reversible, it lasts about 8-12 months.

MEDICAL PEELING (EXFOLIATION)

Peelings are treatments aimed at removing external layers of the epidermis, including unnecessary cells and substances. There are many types of peels known in dermatology. They differ in the method of how they were manufactured and in their exfoliant ingredients. In any case, the peeling should be individually matched to the type of skin, age and whether there is any underlying skin disease. The application of peeling may be different in patients who expect to improve their appearance or rejuvenation their skin, compared to those who are receiving treatment for hyperpigmentation, excessive seborrhea or comedones. It is worth emphasizing that the face and cleansing peel is the most common, but many people eliminate imperfections of the arms, back or legs with this method.

Medical peels carried out for aesthetic reasons cause:

• refreshing, brightening, smoothing and oxygenation of the skin
• reduction of fine, shallow wrinkles
• improved tension and elasticity of the skin.

Such peelings can also be part of a larger “Skin Rejuvenation Program” offered by our office. Such programs are individually selected for each patient with the guidance of a dermatology specialist.

Medical peelings carried out from medical indications can be used at:

• stains
• excessive seborrhea
• actinic keratosis of the face, shoulders or thighs
• acne – after treatment and as a prophylaxis
• eliminating some traces of inflammatory skin diseases.

In most cases, it is advisable to perform a series of treatments at several week intervals.

After the peeling, the following can be expected as a natural symptom from the procedure:

• skin erythema occurring 1 hour after surgery
• visible exfoliation of the skin
• skin edema.

These symptoms last from several hours to 2-4 days, depending on the type of peeling and the applied method of treatment. Individuals who care about the post-procedure symptom duration should discuss this with their doctor and select a method of treatment accordingly.

Laser IPL (Intense Pulse Light)

The office has IPL equipment, is mainly used for closing blood vessels, eliminating discolorations and photorejuvenation treatments.

Closing blood vessels
Thanks to the appropriately selected wavelength of light, you can close vessels located at different depths under the skin. IPL energy is absorbed by the hemoglobin in the vial, and this causes its closure. Usually, two or more treatments are needed to fully close larger vessels. The treatment is not painless, but almost all our patients come back for the second treatment, which convinces us that the therapeutic effect is greater than the temporary discomfort associated with the surgery itself. After the treatment, the skin is often swollen and red for 12 or more hours.

This method allows effective closing of blood vessels on the face, but we do not use it to close the vessels in the legs.

Discolorations
The effectiveness of IPL in the treatment of hyperpigmentation depends mainly on the depth of the lesions and their cause. Therefore, the decision to use IPL in the treatment of discoloration should always be preceded by a dermatologist consultation. The most superficial discolorations (e.g. on the hands of people over 40 or 50 years old) can subside after a single treatment. Most facial blemishes will require more treatments, and in the case of the deepest changes, it is necessary to combine this method with a proper peeling.

Photorejuvenation
With the right choice of parameters, IPL can give the perfect effect of leveling fine wrinkles on the skin and improving its color. People who want to “stop the time” and rejuvenate the skin are encouraged to establish a “rejuvenation program” with the doctor who, depending on the needs, may also include appropriately selected peels, botox or wrinkle fillers. Such programs depend mainly on skin type and age. They are different for men and women.

Experts in esthetic medicine are:   dr n. med. Olga Warszawik-Hendzel, dr n. med. Marta Sar-Pomian, dr Małgorzata Maj , dr n. med. Leszek Blicharz

MEDICAL PEELING (EXFOLIATION)

Peeling is a treatment aimed at removing external layers of the epidermis, including unnecessary cells and substances. There are many types of peelings known in dermatology. They differ in the method of manufacture and exfoliants. The peeling should be individually matched to the type of patient’s skin, age and any underlying dermatological disease. The application of peeling may be different in patients who expect to improve their appearance or rejuvenation their skin, compared to those who are receiving treatment for hyperpigmentation, excessive seborrhea or comedones. It is worth noting that the face and cleavage are the most common areas subjected to peeling, but many people eliminate imperfections of the arms, back or legs with this method as well.

Medical peelings carried out for aesthetic reasons cause:

• refreshing, brightening, smoothing and oxygenation of the skin
• reduction of fine, shallow wrinkles
• improvement in skin tension and elasticity

Such peelings can also be part of a larger “Skin Rejuvenation Program” offered by our office. These programs are individually selected for each patient by a dermatologist.

Medical peels carried out from medical indications can be used for:

• stains
• excessive seborrhea
• actinic keratosis of the face, shoulders or thighs
• in acne: after treatment and as a prophylaxis
• eliminating some traces of inflammatory skin diseases.

In most cases, it is advisable to perform a series of treatments at several week intervals.

After the surgery, the following can be expected as a natural symptom from the peeling:

• skin erythema one hour after surgery
• visible exfoliation of the skin
• skin edema.

These symptoms last from several hours to 2-4 days, depending on the type of peeling and the applied method of treatment. Patients who care about the maximum short period of persistence of these symptoms after surgery should discuss this problem with their doctor and select the method of treatment accordingly.

In our office, peeling consultations and the procedures associated with them are mainly performed by Dr. Olga Warszawik-Hendzel, Dr. Małgorzata Maj and Dr. Beata Góralska-Załęska.

ALOPECIA (EXCESSIVE HAIR LOSS)

Hair loss and hair diseases are the main focus of clinical and scientific activities of our team. We have the knowledge and dermatological equipment to diagnose every cause of hair loss and the current expertise to guide the patient on the treatment of every type of hair loss. In particular we are experts in treatment of alopecia areata, androgenetic alopecia, lichen planopilaris, frontal fibrosing alopecia, discoid lupus erythematosus and other dermatological causes of hair loss.

The determination of the cause of excessive hair loss usually consists of:

• anamnesis (information about the history of hair loss and coexisting diseases/medications)
• a medical dermatological examination
• trichoscopy (computer hair and scalp examination)
• trichogram (microscopic examination of hair roots)
• blood laboratory tests (after receiving above information
• trichoscopy-guided biopsy with histopathological examination (a 4 mm biopsy under local anesthesia and examining it under the microscope after the application of an appropriate stain).

It should be emphasized that no single examination is sufficient to obtain a full picture of the condition of the hair. This is especially true for the trichogram and trichoscopy, which evaluate different parts of the hair and complement each other.

TRICHOGRAM

A trichogram is a diagnostic method that involves the removal of about 100 hairs from the skin of the scalp, where the roots are then examined for particular conditions under a microscope. This method gives information about the activity (dynamics) of the disease and speed as well as the type of hair loss, and also allows for exclusion of some causes of excessive hair loss. Trichogram is performed not only for diagnostic purposes but also to assess whether there has been any improvement since the previous examination. It is suggested that the interval between subsequent tests should not be shorter than a few months, because frequent examinations usually do not provide additional clinical information. This test should be performed no earlier than 3 days after the last hair wash. In order to make it easier for patients with frequent hair washing to be properly prepared, we offer the possibility to perform tests on Saturdays. In case of testing on Saturday, the hair should not be washed after Wednesday evening.

Trichograms in our office are performed by Dr hab. Adriana Rakowska, Dr. med. Olga Warszawik-Hendzel, Dr n. med. Marta Kurzeja and Dr n med. Anna Waśkiel-Burnat

TRICHOSCOPY

Trichoscopy is a non-invasive examination. It involves a computer examination of the hair and the surface of the scalp. It also provides information about the condition of the hair follicles and hair stems. The study is particularly useful in the diagnosis of certain hair diseases (eg. androgenic alopecia of women, unusual alopecia areata, or congenital diseases). This examination also allows for monitoring of treatment effects and/or the progression of a disease. Trichoscopy can also be used to determine the diagnosis of some causes of abnormal hair growth in children (eg. Netherton syndrome or monilethrix). Trichoscopy is painless so it is well tolerated by most children. The examination does not require any special hair preparation.

Trichoscopy in our office is performed by all doctors of our office when needed during a visit.

Doctors who perform a full trichoscopy examination with detailed results: Dr hab. Adriana Rakowska, Dr. med. Olga Warszawik-Hendzel, Dr n. med. Marta Kurzeja and Dr n med. Anna Waśkiel-Burnat

Pigmented nevi (commonly referred to as moles), which we have on the skin for many years, can sometimes transform into skin cancer. Therefore, it is recommended that every adult have their nevi examined once a year and children once every three years.

The office has the most modern camera (videodermatoscope), which allows you to record the image of birthmarks, while also providing early recognition of skin cancers. In addition, the camera gives you the opportunity to compare the appearance of the pigmented nevi during the next visit.

VIDEODERMOSCOPY

The examination consists in viewing skin lesions at a magnification of 20 to 70 times in light, which allows to visualize the deeper structures of the observed change. It is a completely non-invasive and painless examination.

Rosacea occurs in both women and men, but non-treated rosacea may have a much worse course in men and cause more aesthetic problems than in women. Typically, the disease begins around age 40, but it can start at any age.

Most often, the first symptom of the disease is permanent redness of the face, which may often impede with functioning in everyday life. Redness may increase when the ambient temperature changes (eg. entering a warm room in winter), after alcohol or even hot and spicy foods. The skin may show the so-called telangiectasia, which is visible to the naked eye, and presents as expansion of the small blood vessels close to the surface of the skin. Lumps or pimples attach to these symptoms later. Rosacea can also lead to inflammation of the eyelids or conjunctiva. Sometimes rosacea coexists with seborrheic dermatitis. In these people the skin is also flaky and itches (especially around the nose).

The cause of rosacea is unknown. Perhaps microorganisms (including Demodex folliculorum, Helicobacter pylori) are involved in the development of some forms of rosacea, but this has not been clearly demonstrated.

The treatment of rosacea is usually difficult and chronic, but very often effective. The treatment method depends on the severity of lesions and their nature. Sometimes local treatment is sufficient (with creams or medicinal ointments), however, in most cases, it is necessary to treat several months with tablets (antibacterial, anti-inflammatory and / or retinoid). Permanently dilated vessels are closed with a laser (e.g. IPL).

The treatment of rosacea is especially complex in people who used creams and ointments containing steroids. Therefore, the use of such medications on the face is strictly contraindicated (except for short treatments recommended by dermatologists only in some selected cases).

In our clinic all doctors treat patients with rosacea, including Prof. Małgorzata Olszewska and Dr. Beata Góralska-Załęska.

Acne is a chronic disease of sebaceous glands. It usually begins at the age of several years, but the first symptoms may occur after the age of 20 (adult acne). The lesions are located on the face, sometimes also on the upper part of the chest. These can be blackheads, papules, pimples or deep purulent cysts. In most cases, acne is not associated with any other diseases or disorders (e.g. endocrine) and additional tests are not needed. Treatment usually lasts no less than a few months.

The decision regarding treatment depends on the current course of the disease and type and the severity of the lesions.

The most common treatments are: external medicines (gels, creams, ointments), antibiotics or retinoids (derivatives of vitamin A). All doctors in our office have the knowledge and experience necessary for the proper selection of medicines and treatment.

Pemphigus is a chronic autoimmune bullous disease. Its main symptom is the occurrence of erosions and blisters. Lesions can occur in any location. They can also affect the oral or genital mucosa. In some cases, the only manifestation of the disease is the presence of chronically persistent (more than a few weeks) erosions of the oral mucous membranes. Treatment of pemphigus is chronic and is based on immunosuppressive drugs in tablets or biological medicines (rituximab).

The treatment of patients with pemphigus and other autoimmune bullous diseases, such as pemphigoid or dermatitis herpetiformis, is managed especially by Prof. Małgorzata Olszewska and Dr. Marta Sar-Pomian.

It is vital for dermatologists to diagnosis and treat malignant tumors as early on in the course as possible.

In each case, the diagnosis is based on a clinical examination, dermoscopy and the result of the histopathological examination.

The most common cancers of the skin include:

• melanoma
• basal cell carcinoma
• squamous cell carcinoma
• neuroendocrine skin cancer.

In the case of suspected melanoma, the only method of treatment is its surgical removal. Such changes are not removed by laser, cryosurgery or other non-surgical methods.

In the case of other skin cancers, the doctor individually decides on the treatment method depending on the type of cancer, its location and other conditions.

Our clinic has advanced dermatosurgical facilities and specialists with experience in removing cancerous and non-cancerous skin lesions.

Dermatosurgery is mainly done by Dr. Olga Warszawik-Hendzel, Dr. Marta Sar-Pomian and Dr. Justyna Sicińska.

We also specialize in the treatment of actinic keratosis, which is the most pre-cancerous condition preceding the onset of skin cancer.

Before the summer period, we will advise you on how to use sunblock creams to reduce the risk of pre-cancer and skin cancer. After the summer (and throughout the year) we carry out prophylactic dermoscopy to exclude the early forms of skin cancers.

Non-surgical diagnostics (especially dermoscopy) and prophylaxis of skin cancers can be performed by all dermatologists.

Seborrheic dermatitis is a chronic inflammatory disease with an unclear cause. It is thought that part of the cause may be related to a genetic predisposition and response to the fungus Malassezia. Inflammatory changes usually occur on the scalp (often interpreted as “dandruff” or psoriasis). They may appear on the face (especially around the eyebrows or cheeks). Men may have inflammatory changes on the skin of the chest. The treatment is chronic and it is usually preferable to use appropriate preparations prophylactically during the remission period.