Skin webchat

Dr Patrick Bowler answered your questions about aging, tanning and skin complaints

Dr Patrick Bowler: Hello everyone.

mehehe: Does natural sunlight cause as much damage as sunbed use?
Dr Patrick Bowler: It depends on the amount of exposure you have. Intensive sunbed use can be more damaging than natural sunlight.

Iwan: Are there filters that can be attached to sunbed tubes to make them less harmful?
Dr Patrick Bowler: No.

dave: Hi Dr. Patrick.I have suffered with rosacea on my nose for years (I'm 36) and have recently read some research that suggests that the new cure all for skin problems is Emu oil. What is your opinion on this please. Many thanks.
Dr Patrick Bowler: There are always new treatments coming onto the market. I'm sure there may be something in emu oil that might be helpful but it sounds quackery!

Anluise: Hello Doctor,  I have psoriasis and have regular UVB treatment. How will this affect my skin long term?
Dr Patrick Bowler: This is a serious problem that you need to discuss with your dermatologist because long term use of UVB treatment can damage the skin. There are new alternative treatments for psoriasis.

sking: I have had acromegaly and this has obviously effected my hormones and the pores of my skin have deteriorated. Can you suggest any way to improve this?
Dr Patrick Bowler: Acromegaly causes more grease production so the pores are going to be larger. Obviously control of your acromegaly is important but there are also skin treatments available to reduce pore size at specialist skin clinics. Acromegaly is a condition caused by a small growth in the centre of the brain that causes too much growth hormone. Which causes enlargement of the bones and some facial features.

Tanya: I have dark pigmented skin on my top lip - could this be caused by sun damage and what can I do to lighten this now ? I do not use sunbeds
Dr Patrick Bowler: This pigmentation may be hormone related. Possibly due to pregnancy or the contraceptive pill. Treatment is obsessive sun protection - i.e daily and using sufficient sun protecting lotion. I suggest you visit a skin clinic where they may recommend a skin lightening agent.

sarah: Do freckles alter your risk of skin cancer?
Dr Patrick Bowler: Fair skinned people who burn easily are more at risk from skin cancer and unfortunately these patients normally have freckles

Becky: Hello Dr Patrick. I am thirteen and My dad has skin cancer. Although he got it from staying out in the sun with no protection can i still get it genetically ?
Dr Patrick Bowler: Dear Becky, there are different types of skin cancer. Malignant melanoma does have some genetic predisposition, but the majority of skin cancers are not genetic and are related to sun exposure.

Nikki: I suffer from acne & am on Oxytetracycline.  It doesn't go away.  How much damage does this do to my skin?
Dr Patrick Bowler:Acne is the commonest skin problem but strangely we know relatively little about it! We do know there are hormonal influences to cause blocking of skin pores and grease glands. This then leads to active acne which we're all familiar with - red spots and zits. Oxytetracycline is one antibiotic which is used for treating acne. If it hasn't been helpful go back to your doctor and ask for an alternative. You also need ot address boring things such as early nights, not too much alcohol, drink more water, stop smoking, less stress etc, and consider visiting a skin clinic for lotions and treatments directly applied to the skin.

helen M: I have got chloasma - I wear spf moisturiser and sun block and wear hats in the sun but I still have the pigmentation.  What can i do to reduce this.  I am on the pill as well.  I saw a doctor last year and he gave me an acid based solution but this only dulled the pigmentation.  Will skin peels help?
Dr Patrick Bowler: It would be helpful to know how long you've had chloasma - otherwise known as melasma or pregnancy mask. What you're doing at present is standard treatment, in addition I would suggest a bleaching agent and superficial skin peels.

harjean: I am 22 years old. I am Indian, but have fair skin, therefore do I still need to protect my skin from the sunlight?
Dr Patrick Bowler: If you have fair, light coloured skin it is essential that you protect your skin from the sun. In the UK you should protect your skin every day, from Spring through to autumn, whether cloudy, rainy, or sunny. Use a minimum spf of 15, making sure the product you use has UVA protection as well. (The spf factor only refers to UVB protection) UVB light is burning light and UVA can be remembered as aging light. During June to August I would advise a 30 spf factor.

sad panda: What are the 'alternative treatments' that you mentioned for psoriasis?
Dr Patrick Bowler: There are new topical treatments with vitamin D analogues plus steroids and photo-dynamic therapy. This is when you take a drug by mouth which gets taken up in the psoriasis cells. This is then activated by a light source so the drug only affects the psoriasis and not the surrounding skin. This is a very interesting development which I'm sure will help many people.

Kathy: I have red blotchy patches on the sides of my neck from sun damage as a small child.Its becoming a real problem and affecting my confidence.  Im very careful in the sun now but what else is available - you mentioned more invasive treatments?
Dr Patrick Bowler: This condition poikiloderma de cevette. Which is a red/brown pigmentation affecting the sides of the neck thought to be due to sun sensitivity due to perfume use. Treatment of this is sun protection using lasers. However a new treatment using intense pulsed light has extremely encouraging results with virtually no down-time. These are only available through doctor-led clinics.

Bottie: Are people with olive skin and who do not burn easily at any less risk of getting skin cancer?
Dr Patrick Bowler: Darker skin types have a much lower risk of developing skin cancer. So thank your parents!

shona: Please tell me what I can do with my sons nose as it burns so easily. It blisters now and doctor has warned us about skin cancer. I use factor 60 but is there a total block out?
Dr Patrick Bowler: We need to educate parents to actively protect their children from the sun. The nearest you can get to a complete block is a white sun block that is normally used when skiing. I first saw these when the Australian cricketers first terrified our English team by wearing war paint! It's almost impossible to completely block out the sun using sun protectors and spf 60 is probably the best you can do. Please ensure they wear suitable clothing too.

Lissa: I have a small red mark on my left arm which swells and itches after half an hour in the sun (without creams) then it dries out. Any suggestions?
Dr Patrick Bowler: Is this red mark there all the time or does it just come out in the sun?

Alex: Is it really necessary to buy fresh suncream each year? I've heard that last year's cream is no longer effective. Would last years spf 40 be equivalent to 30 this year?
Dr Patrick Bowler: There should be a  shelf life date on the product, if there is not EU regulations state (when I last looked) that the product should be active for 3 years. The most important issue about sun creams is to apply enough and regularly. Most people try and make their tube last the year... not a good idea.

Lissa:It is there all of the time.
Dr Patrick Bowler:It is possibly this is a naevus which is irritated by sunlight. In which case you should seek your GPs advice.

Eddie: Are there any beneficial factors at all from sunlight? Surely our skin has become accustomed to certain levels of sunlight exposure.
Dr Patrick Bowler:Sunlight is essential for our wellbeing! It's all about getting a balance in life. You need enough sunlight to metabolise certain vitamins in the skin and it's known that the sun stimulates the brain to give a feeling of wellbeing and good health. So by all means enjoy the sun but make sure you protect.

Mary: My 16 year old daughter would like me to pay for her to have a short (6) course of sunbed showers so she looks brown for her prom night - what do you think?
Dr Patrick Bowler: This has recently come to the UK and my understanding is that it's a bit like getting your car re-sprayed! You stand in a booth and a self tanner is sprayed onto your body as you stand around in the booth - it all takes about 30 seconds. Much preferable to getting a natural tan!

fon: We have just come back from a holiday abroad, my son's face has come out in an awful lot of freckles, will they go away or is this a sign of skin damage in the future?
Dr Patrick Bowler:Freckles are an inherited trait and in young children does not indicate sun damage. However, once you've reached your teens there is bound to be additional sun damage. So your son with his fair skin needs to be extra careful.

cat: I have heard that the tan you gain from a sunbed does not protect you against natural sunlight in the same way as a tan gained outside. Is this true?
Dr Patrick Bowler: It is not true that a tan gained either naturally or from a sunbed gives you protection. A tanned skin is a damaged skin.

Jocelyne: My mole on my thigh has grown by about 1.5mm in the past 6 months but the doctor assures me that until the mole is about 5mm it is not necessary to investigate it further and simply recommends 'keeping an eye on it'. She has explained that this mole is a very suspect one in view of its jagged shape, colour and growth but still has not recommended seeing a specialist. I am getting increasing worried about having skin cancer and about wasting time and allowing to spread elsewhere in the body.
Dr Patrick Bowler: I would advise you to return to your doctor asap and ask for a second opinion.

M/19: Is there a certain age group that skin cancer affects more or is it something for all ages ?
Dr Patrick Bowler: All skin cancers are more common as we get older. There are some extremely rare examples of children below 14 years old dying of malignant melanoma.

Lorraine: While on holiday last year in the Dom. Republic my Daughter burnt her lips and had a terribly sore mouth, we went sking at Easter & although she used a sunblock her mouth got burnt again, it swelled up & blistered, will this happen each time she goes in the sun?
Dr Patrick Bowler:She needs to be extremely careful in the future because burning the skin predisposes to skin cancer. If she wears a complete block and reapplies every 2 to 3 hours this should keep the risk to a minimum. This not only applies to when you're on holiday but also in the UK from Spring through to Autumn.

fiona: I've spent five years living and working in hot climates, am 37 with fair skin so damage already done!  What treatments are available to those of us who succumbed to the 80s fashion of a deep tan?
Dr Patrick Bowler: Just by protecting the skin it can to some extent regenerate. Using high-tech skin care, skin peels and lasers (available through clinics) can help reverse some of the damage but you need expert advise.

Alex:I've heard that just 3 minutes use of a sunbed, occasionally, can be good for you, and not harmful. Is this true?
Dr Patrick Bowler: Either way it's not going to do you any harm or any good provided it's 3 minutes a year!

Lisa: Can you give me some advice, I have got numerous broken veins on my face which really upsets me, I am considering laser treatment but would like your help in what kinda of laser I should have and if there is any thing that can go wrong concerning this treatment?
Dr Patrick Bowler:It's possible to use a variety of lasers and intense pulse lights for treating facial and broken veins. There are limitations as to what can be acheived and some side effects. It is essential that you visit a clinic and see a doctor who's experienced in using these machines.

Dr Patrick Bowler: Thank you very much everyone for visiting my webchat. I'm sorry I couldn't answer all of your questions but I hope to see you all again very soon.