The Darlington PCT Dermatology and Minor Surgery Service - An Introduction

This local service was launched in February 2004 and is one of the first of its kind in the country. Although the service is currently based at the Woodlands Hospital in Darlington it will soon be moving to a purpose built Primary Care centre in Kings Street, Darlington.

The service has been set up as a result of long hospital waiting lists and an increasing incidence of skin cancer.

The service includes two full time Primary Care Skin Specialists and support staff that include a nursing team that are developing nurse led clinics.

Although the service is involved in diagnosing certain cases of skin cancer it only treats milder cases of skin cancer and pre-cancerous skin lesions. Treatments offered include surgical removal of the skin cancer and treatment of the mildest forms of skin cancer with a new light treatment known as Photodynamic therapy.

The service also deals with patients whom have eczema and a number of other common inflammatory conditions of the skin, as well as patients whom need lumps and bumps removing.

Patients with the most serious skin conditions are not seen in the clinic and are still referred directly to the Darlington Memorial Hospital.

The development of this service has been greatly supported by the local hospital consultant dermatologist Dr Willson Taylor and as a result of working together with the hospital, waiting lists have fallen and patient care has improved significantly. Links with the hospital have been strengthened further as we have now initiated in a joint teaching programme of medical students and GPs.

As a PCT we continue to strive to improve patient care and as part of this we aim to reduce the incidence of skin cancer locally. We have recently been involved in a 'sun protection' poster and leaflet campaign in our local General Practices.

This website is split into three main sections which will be of use to Primary Care health professionals and the public. The sections are as follows:

Skin Cancer Prevention - Advice on how to reduce your chance of developing skin cancer (skin cancer prevention)

Patient support groups - Links to national websites for common skin complaints such as eczema (support group links)

Clinical Guidelines for Dermatology - Local and downloadable guidelines for GPs and other health (Dermatology Guidelines)

professionals to manage common skin conditions.

Skin Cancer Prevention

We all enjoy being outside on sunny days; it makes us feel good. However episodes of sunburn and excess lifetime sun exposure are responsible for up to 100,000 NEW CASES OF SKIN CANCER IN THE U.K every year. Excess sun exposure is also responsible for wrinkling of the skin - it soon makes young people look old! Most skin damage is due to UVB sun rays but there is now evidence that UVA sun rays can also damage the skin.

It is still possible to enjoy being outside but at the same time to take steps to prevent skin cancer from occurring. These steps are as follows:

1) Stay in the shade -

• Shade acts as a natural protection from the suns rays (UV radiation)
• Staying in the shade is particularly important between the hours of 11am-3pm when the sun is at its strongest
• Babies under the age of 6 months should always be kept in the shade
• Thin cloud cover does not give significant protection from UV radiation.

2) Cover up -

• A wide-brimmed hat and sunglasses can reduce the UV radiation reaching your face by 50%
• Wear loose fitting clothing - The more skin that is covered, the better the protection
• Holding the material up to the light is a good way to see how much light and UV radiation will get through
• Natural fibres such as linen and cotton are cooler, especially if loose fitting
• Remember that when t-shirts get wet their protection from UV radiation halves

3) Use factor 15+ sunscreen -

• There will always be occasions when we are out in the sun without adequate shade or cover-up clothing
• On such occasions sunscreen will help protect you from UV radiation
• It must be remembered that no sunscreen can offer 100% protection. If applied properly:
  • Factor 15 sunscreen offers about 93% protection
  • Factor 30 sunscreen offers about 96% protection
  • Factor 60 offers about 98% protection
• When you purchase sunscreen look out for the following:
  • A cream that is factor 15 or stronger that protects you from UVB radiation
  • The cream must also be broad spectrum and protect against UVA radiation, such information is sometimes shown on the back of a bottle by a star rating. A 4 star rating gives maximum protection.
  • The cream should be water resistant
  • By large bottles of cheaper brands as they are just as effective
• Correct application of sunscreen:
  • Apply generous amounts 15-30 minutes before going out in the sun
  • Re-apply generous amounts every 2 hours or more frequently if washed, rubbed or sweated off
  • Put it on before make-up, moisturiser, insect repellent and so on
  • Never reduce the strength of the sunscreen as the holiday goes on

4) Sunbeds - Sunbeds should be avoided. We now have evidence showing that they can cause skin cancer.

5) Remember

• Never burn
• There is no such thing as a healthy tan
• Never use sunscreen to spend longer in the sun
• Take extra care with children
• Any new mole that is not recognised as normal, or any old mole that changes over a relatively short period of time should be reported to your doctor as soon as possible
• For further information you can visit www.cancerresearchuk.org/sunsmart
  
  Patient support groups

  The following links provide access to national support groups for a number of common skin conditions:

  Acne Support Group	www.stopspots.org
  Allergy UK	www.allergyuk.org
  CancerBACUP	www.cancerbacup.org
  British Association of Camouflage	www.skin-camouflage.net
  British Red Cross (Camouflage service)	www.redcross.org.uk
  Hairline International	www.hairlineinternational.co.uk
  Lupus UK	www.lupusuk.com
  National Eczema Society	www.eczema.org
  The Psoriasis Association	www.psoriasis-association.org.uk
  The Vitiligo Society	www.vitiligosociety.org.uk
  Wessex Cancer Trust Marc's Line	www.k-web.co.uk/charity/wct/wct.html
  Skin care campaign	www.skincarecampaign.org

  
  
  Clinical Guidelines for Dermatology

  Click here