While popular in the 80’s, Chemical Peels seem like a cosmetic-fashion of yesteryear. For many years though, Chemical Peels formed an important part of dermatologists and cosmetic Doctors first-line armament for effectively treating many skin disorders. But who can blame Doctors' attention shifting with the overwhelming abundance of new cosmetic procedures.
Admittedly I was certainly distracted by the picosecond-power-pulses of revolutionary new laser technology to really take notice of the steady but impressive track record chemical peels have for treating common skin disorders like acne, melasma and solar keratoses.
Sadly, the diversion has meant a generation of GP’s are less commonly exposed to the brilliant benefits of a very trusted skin basic – a Chemical Peel.  
Which is a great pity really because performing a chemical peel is an accessible, easy, safe AND low cost office-based medical skin procedure (which is ideal for GP’s)  and requires no additional marketing (even more ideal for GP’s) because you can offer it to your existing patients!
This is the kind of simple GP upskill which has immediate benefits to a variety patients (and the GP!) and is an example of the type of office based procedures we should be teaching GP's so they can co-manage chronic skin conditions in the Health Care Homes of the future.
 I can see there is a growing space for treatments like this to be offered in primary care.
Exactly why I brought chemical peels  OUT from the back of the cupboard and INTO my general practice and why I have included this training as part of the Skin, Laser, Cosmetics Special Skills rotation currently offered to GP Synergy GP registrars and GP’s at collective.care.
FYI, I didn't bring chemical peels into my practice for cosmetic patients. The fact that peels happen to rejuvenate the skin and make you look younger is just a convenient side effect ? !
The truth is they are an awesome additional “tool” in a GP's Doctors Bag for everyday general practice patients with everyday skin conditions like acne, acne scarring, melasma (bet your seeing a lot of that lately!) and especially the solar-damaged-elderly riddled with solar keratoses whom can't afford the newer expensive field treatments currently marketed to GP's. Patients are always grateful when offered another treatment choice - especially one that's significantly cheaper (AND has good evidence).

You are not alone, over half of Australians over the age of 40 have solar keratosis (SK) aka Sun Spots - scaly pre-cancerous spots found on sun exposed areas particularly the scalp, face and hands and forearms.  

Unsightly, yes! Dangerous? Actually, kind of! 

They carry real potential to transform into nasty cancers - squamous cell cancers  (SCC's) - so these sun spots should be taken seriously! It's a fact, that globally Australia has the highest rate of Solar Keratosis (SK) development. 

Therefore, my MEDICAL ADVICE is always for early identification of Solar Keratosis (SK) and early medical treatment so you can prevent the progression to a nasty invasive skin cancer. 

If you are concerned about your skin at all, I suggest you book a skin check. My BEST ADVICE to ANYONE out there who can see Sun Damaged Skin on their hands, face or décolletage: 

1. If your seeing Sun Damaged Skin, your aim RIGHT NOW is to prevent your Sun Damaged Skin from developing into a Solar Keratosis (SK). 

2.  If you have had a Solar Keratosis (SK)  diagnosed already then your aim is to prevent more from coming up. 

AND see a GP who can monitor you carefully. (I suggest a GP Management Plan for chronic Sun Damaged Skin annually and seeing a Doctor trained in skin like the Doctors at collective.care) 

On a personal note, if you are curious as to why I wrote this (obviously I am a Skin GP and it's what I do), but I also wanted to share what I explain to my skin patients in my skin clinic every day to personally save me from having to personally explain it over and over again ;) 

But mainly it was to let people know younger and younger people are getting them and they need to know about the proven ways to prevent more of these SK’s developing on their skin in the future.  

So for those with SDS (Sun Damaged Skin) you should definitely start considering your treatment, prevention and skin reversing options. 

I also believe Sun Damaged Skin, like every other chronic medical conditions needs to be treated with the same respect with scheduled regular reviews - so try and avoid adhoc presentations as it makes monitoring a chronic medical conditions far from ideal. 

But first, a quick explainer about SK (Solar Keratosis) 

Solar Keratosis (SK) are basically caused by cumulative sun exposure over time. 

Bad news though, once spotted, more can keep following and it marks the sign of the development of Chronic Sun Damaged Skin. 

SK are mainly caused by ultraviolet radiation-induced-skin damage forming a continuum that in some cases result in skin cancer development 

They are diagnosed by simple physical examination. In fact, every time I examine a patient I deliberately run my hands over their skin explaining as I go that SK often can be better-felt-than-seen. They feel like crusty or scaly spots that people describe can itch, burn or sting. 

Studies have shown that it takes about two years for previously confirmed sunspots (SK)  to transform into a nasty squamous cell cancers (SCC). 

Thats not great news - remember SCC skin cancers are the bad ones with the potential to metastasise.  

Therefore, if you have had an SK my advice is that you need a Preventative Skin Check Appointment every 12 months. 

For those with an upcoming collective.care skin consultation, we will talk about Treatment Options, Prevention Options and Reversing Sun Damaged Skin  more at your consultation or you can have a listen here.
About the author:
Dr Bekir MBBS FRACGP believes in advancing the diagnosis and medical, surgical, and cosmetic treatment of the skin and advocates high standards in clinical practice, education, and supporting and enhancing patient care for a lifetime of healthier skin.

#skin #skinclinic #skindoctor #solarkeratosis #health 

​With hay fever affecting 1 in 5 adults and increasing, more people are discovering essential oils are an alternative or complementary treatment for allergy or sinusitis symptoms.
 
Aromatherapy is an ancient healing system that dates back to early Egyptian times. Breathing in the oils’ scents is known as aromatherapy. This practice stimulates your body through your sense of smell and enters the blood stream.  It is a science based on the use of high grade pure essential oils derived from flowers, leaves, roots, seeds and stems of plants.
 
While conventional pharmacotherapy is the preferred method of treating allergic rhinitis and sinusitis, the interest of herbs, roots and plants for healing is gaining grounds fast as more studies gain scientific approval.
 
Although there is generally limited studies on aromatherapy, a 2016 study  (1) showed promising signs that certain aromatherapy oils can  help relieve perennial allergy symptoms, improve quality of life, and reduce fatigue in patients with allergies.
 
Also with bacterial resistance to multiple antibiotics becoming a serious health threat many essential oils such as tea tree and eucalyptus possess antibacterial properties with more and more researchers considering them as potential sources of novel antimicrobial compounds.(2)
 
More over, researches are also finding that essential oils like lemon and eucalyptus improve muco-ciliary function; improving the way the cilia beat in the lining of the respiratory system means phlegm can clear easier.  (3)
 
Popular ways to use essential oils for hay fever and sinusitis include:
 
•    diffusing them into the air particularly with vaporises 
•    using them in the bath 
•    steam inhalations
•    spraying them into the air
•    breathing them in directly from the container
•    applying them inside the nose with a carrier oil 
 
If you’d like to incorporate essential oils into your life to relieve allergy symptoms, here are a few you might want to try.
 
1. Lavender
 
Lavender has a sweet, floral, herbaceous and fresh aroma. Lavender is one of the most popular essential oil’s for its calming, anti-inflammatory and antimicrobial activity. Antimicrobial activity was demonstrated in one study  where several lavender oils, used singly and in combination, inhibited the growth of on methicillin-sensitive and methicillin-resistant Staphylococcus aureus (MSSA and MRSA) with direct contact (4) - promising for those who suffer regular sinusitis infections.
 
2. Blend of sandalwood, frankincense, and ravensara oil
 
This study (1) used a blend of sandalwood, frankincense, and ravensara oils to treat perennial allergic rhinitis. Study participants reported improvement with their blocked nasal passages, runny and itchy noses, and sneezing. This suggests that this blend of essential oils can help with perceived symptoms, quality of life related to allergies, and better sleep.
 
3. Eucalyptus
 
Eucalyptus oil is known as an analgesic and anti-inflammatory (5) and may also whelp with congestion. Its antimicrobial effects are also being studied. Its major component, 1,8-cineole, has antimicrobial effects against many bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), viruses, and fungi (including Candida). Surprisingly for an antimicrobial substance it may also have immune-stimulatory, anti-inflammatory, antioxidant, analgesic, and spasmolytic effects. (6) Its multiple uses are still being investigated.
 
4. Tea tree oil
 
Tea tree oil has a warm, fresh, camphoraceous aroma. There is still significant research to be done on the connection between essential oils and allergy relief, but tea tree oil is very promising with relation to allergy symptoms.  Complementary and alternative medicines such as tea tree (melaleuca) oil have become increasingly popular in recent decades.
 
Tea Tree oil has been used for almost 100 years in Australia but is now available worldwide. The primary uses of tea tree oil have historically capitalized on the antiseptic and anti-inflammatory actions of the oil but recent developments in our understanding of the antimicrobial and anti-inflammatory activities of the oil and its components suggest it has other clinical uses. Specific mechanisms of antimicrobial and anti-inflammatory action are being studied (7)
 
5. Peppermint
 
Peppermint oil has a strong, fresh and minty aroma. Peppermint essential oil is known to reduce inflammation and popularly used for irritable bowel complaints. Peppermint oil was shown to inhibit histamine release in one study (8) making combining peppermint with lavender and lemon oils a soothing allergy relief combination for nasal congestion and sinusitis.
 
6. Lemon
 
Lemon oil has a fresh citrus aroma reminiscent of the fresh peel. Citrus-scented essential oils are often used in aromatherapy to boost alertness and energy and can also help clear your sinuses and reduce congestion, common symptoms of seasonal allergies by improving much-ciliary function (3)
 
Where to buy:
 
I personally use Perfect Potions aromatherapy essential oils kit with a vaporiser which you can find here and find he oils high grade.
 
But trying essential oils is not without risk.  Risks and potential complications of using essential oils can occur.
 
The purity, quality, and packaging of essential oils are not overseen by the FDA  or TGA. Therefore, it’s important to use essential oils as directed and make sure you are using quality products which are certified organic and pure.
 
Important safety tips when using oils:
 
•    You may experience allergic reactions to oils. Test each new essential oil, especially if you have a lot of allergies. Contact allergy to them is well known and has been described for 80 essential oils. Skin photosensitivites and skin irritations can also occur.
•    Never apply the concentrated oil directly to your skin without diluting it in a carrier oil.
•    Do not ingest essential oils.
•    Use caution when using oils around pregnant and breastfeeding women, children, and especially young children.
 
References:
 
(1) Choi SY, et al. Effect of Inhalation of Aromatherapy Oil on Patients with Perennial Allergic Rhinitis: A Randomized Controlled Trial.  Evid Based Complement Alternat Med. 2016.
 
(2) Solórzano-Santos F1, Miranda-Novales MG. Essential oils from aromatic herbs as antimicrobial agents.
Curr Opin Biotechnol. 2012 Apr;23(2):136-41. doi: 10.1016/j.copbio.2011.08.005. Epub 2011 Sep 6.
 
(3) Lai Y1, Dilidaer D, Chen B, Xu G, Shi J, Lee RJ, Cohen NA.  In vitro studies of a distillate of rectified essential oils on sinonasal components of mucociliary clearance.Am J Rhinol Allergy. 2014 May-Jun;28(3):244-8. doi: 10.2500/ajra.2014.28.4036.
 
(4) Roller S1, Ernest N, Buckle J. The antimicrobial activity of high-necrodane and other lavender oils on methicillin-sensitive and -resistant Staphylococcus aureus (MSSA and MRSA) J Altern Complement Med. 2009 Mar;15(3):275-9. doi: 10.1089/acm.2008.0268.
 
(5) Silva J1, Abebe W, Sousa SM, Duarte VG, Machado MI, Matos FJ.Analgesic and anti-inflammatory effects of essential oils of Eucalyptus.J Ethnopharmacol. 2003 Dec;89(2-3):277-83.
 
(6) Sadlon AE1, Lamson DW. Immune-modifying and antimicrobial effects of Eucalyptus oil and simple inhalation devices. Altern Med Rev. 2010 Apr;15(1):33-47.
 
(7) Carson CF1, Hammer KA, Riley TV. Melaleuca alternifolia (Tea Tree) oil: a review of antimicrobial and other medicinal properties.Clin Microbiol Rev. 2006 Jan;19(1):50-62.
 
(8) Inoue T1, Sugimoto Y, Masuda H, Kamei C. Effects of peppermint (Mentha piperita L.) extracts on experimental allergic rhinitis in rats.Biol Pharm Bull. 2001 Jan;24(1):92-5.
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Tags:
hayfever
sinusitis
allergy clinic
essential oils