Dermatology & Cosmetology — Town Hospital

Dermatology at Town Hospital: an overview

Town Hospital's Dermatology department in the Fifth Settlement, New Cairo, diagnoses and treats diseases of the skin, hair and nails, from acne, pigmentation, eczema and psoriasis to fungal and bacterial skin infections, hair loss and skin ulcers in older people. It also looks after sexually transmitted infections, men's health (andrology) and the male side of delayed conception, and offers laser treatments for the skin where they suit the case. The department's specialty is dermatology, venereology and andrology; the list of doctors is below.

Most skin conditions are diagnosed in the consultation itself, by examining the skin and listening to your story. When the doctor needs to confirm a diagnosis, the hospital's laboratory is open 24 hours a day for blood tests and, when needed, for examining a swab or scraping from the skin. The emergency department is open 24 hours a day, and the outpatient clinics every day from 10 am to 10 pm; the dermatology clinic's days and times are in the up-to-date clinic schedule.

Conditions the dermatology department looks after

The dermatologist decides the diagnosis and the treatment after the consultation and any tests the case needs. These are the conditions patients most often come to the department with.

Acne and acne scars

Acne is spots, blackheads and whiteheads on the face, chest and back, caused by blocked pores and extra oil in the skin. It is most common in the teenage years but affects adults too. It is diagnosed on examination, and treatment depends on how severe it is: mild acne is treated with creams and gels, while moderate and severe acne may need tablets whose class the doctor chooses and monitors for side effects; some must not be taken in pregnancy. The dark marks and scars acne leaves behind are assessed once the acne itself is under control, and the doctor may discuss options such as topical treatments or laser treatment for the skin, depending on the type of scar and your skin tone. Avoid squeezing spots: it worsens inflammation and scarring.

Pigmentation and melasma

Melasma is symmetrical brown patches on the cheeks, forehead and upper lip. It is more common in women and is linked to pregnancy, the contraceptive pill and sun exposure. Pigmentation also includes the dark marks left after acne or any skin inflammation, freckles and sun spots. It is diagnosed on examination, and treatment is founded on daily sun protection with a suitable sunscreen and the lightening creams the doctor prescribes; in some cases the doctor may discuss treatment sessions in the clinic. Melasma tends to come back with sun exposure, so treatment needs patience. Vitiligo is the opposite, white patches caused by loss of pigment, and the doctor assesses it to decide what suits each case.

Eczema and allergic skin

Eczema is inflammation of the skin that causes dryness, redness and itching, and it often comes and goes. Atopic eczema is the allergic type, common in children and in families with allergies and asthma; hand eczema is brought on by frequent washing and detergents; and contact eczema is a reaction to a specific substance, such as jewellery or perfume. It is diagnosed from the examination and your story. Treatment rests on regular moisturising and avoiding the triggers, with anti-inflammatory creams whose strength and duration the doctor sets, and tablets to ease itching when needed. Allergic skin also includes urticaria (hives), raised red wheals that look like insect bites and fade within hours; it is usually treated with antihistamines while the trigger is looked for.

Psoriasis

Psoriasis is a long-term immune condition that is not contagious. It causes thick red patches covered in silvery scales, most often on the elbows, knees, scalp and lower back; it can affect the nails and sometimes comes with joint pain. It is usually diagnosed on examination. No treatment removes the disease, but it can usually be controlled: limited psoriasis is treated with creams and ointments, while widespread disease may need systemic medicines the doctor chooses and monitors with regular blood tests. Other immune skin conditions the department follows include vitiligo and alopecia areata, and the doctor explains what suits each case.

Fungal and bacterial skin infections

Fungal infections (tinea, or ringworm) are common. They show as round red itchy patches that spread outwards, cracked skin between the toes, thick discoloured nails, or pale or dark patches on the chest and back (tinea versicolor), and they thrive in heat, sweat and closed shoes. Bacterial infections include boils and abscesses, impetigo (a contagious crusting rash around the mouth and nose in children), and cellulitis, a hot, swollen, spreading redness that needs prompt treatment. They are diagnosed on examination, and the doctor may take a scraping or swab for the laboratory. Treatment relies on antifungal creams or tablets, and on antibiotics for bacterial infections; an abscess is opened and drained in the clinic when needed.

Hair loss

Losing 50 to 100 hairs a day is normal; hair loss becomes a problem when the shedding clearly increases or bald patches appear. The most common causes are temporary shedding two to three months after childbirth, a serious illness, a fever, an operation or a crash diet, which usually recovers on its own; iron deficiency or a thyroid disorder; hereditary pattern hair loss in men and women; and alopecia areata, round bald patches caused by the immune system. Diagnosis relies on the consultation and examination of the scalp, with blood tests such as iron and thyroid function when needed. Treatment depends on the cause, from correcting a deficiency to topical treatments and medicines the doctor prescribes, and needs patience: hair grows slowly and the effect is not visible for months.

Skin ulcers in older people

Skin ulcers are more common in older people because the skin becomes thinner and slower to heal. The most frequent are pressure sores over the lower back and heels in people confined to bed or a chair; leg ulcers caused by varicose veins and poor venous circulation, or by poor arterial supply; and foot ulcers in people with diabetes. Assessment starts with examining the ulcer and finding its cause; the doctor may need blood tests such as blood sugar, or may involve another specialty, such as vascular surgery, when poor circulation is suspected. Treatment rests on three things: treating the cause, proper wound care with cleaning and suitable dressings, and relieving pressure by changing the patient's position regularly. An ulcer that becomes redder, discharges more or smells, or comes with a fever, needs a prompt review because it may be infected.

Warts and moles

Warts are small rough growths caused by a virus. They appear on the hands, feet and elsewhere, spread by touch, and some clear on their own in time. They are diagnosed on examination and, when needed, may be treated with topical preparations or removed by methods such as freezing or cautery, depending on where and how many they are, as the doctor decides. Most moles are harmless, but show a mole to a dermatologist if it changes in size, colour or shape, becomes irregular at the edges, or starts to bleed or itch: the doctor needs to examine it, and a sample can be taken in the clinic for the laboratory.

The department also sees sexually transmitted infections and men's sexual health problems, in full confidence.

Tests and procedures your case may need

• Clinical examination: examining the skin, hair and nails and taking your history, which is enough to diagnose most conditions.
• Blood tests: such as iron, thyroid function, blood sugar and hormones as the case requires, in a laboratory open 24 hours a day.
• Skin swab or scraping: to look for fungi or to culture bacteria in the laboratory when needed.
• Skin biopsy: a small sample taken in the clinic under local anaesthetic when the doctor needs to examine the skin under the microscope to confirm a diagnosis.
• Clinic procedures: skin abscesses are opened and drained in the clinic when needed, and some cases may need another minor procedure such as wart removal, as the doctor decides. Laser treatments for the skin are offered when the doctor judges them suitable for the case.

You will find laboratory and imaging services on the Diagnostics page.

When you need emergency care straight away

Most skin conditions are not life-threatening, but a few are. Call an ambulance or go to the nearest emergency department straight away for:

• A widespread rash with blisters or peeling skin, or sores in the mouth, eyes or genitals, especially with a fever and after starting a new medicine in recent weeks: this may be a severe drug reaction.
• Hives with swelling of the lips, tongue or throat, difficulty breathing or dizziness: these are signs of a severe allergic reaction.
• Hot, swollen redness of the skin that spreads quickly over hours, or that comes with severe pain out of proportion to how the skin looks, darkening of the skin, or fever and shivering: this may be a rapidly spreading infection.

Town Hospital's emergency department is open 24 hours a day. Bring the names of any medicines you started recently; the doctor will ask about them first.

Your care, step by step

• Consultation: the doctor asks when the problem started, what makes it better or worse, which medicines and products you use, any other illnesses and your family history, and examines all of your skin, not only the area you are worried about. Bring the creams and medicines you use, or photos of a rash that comes and goes.
• Tests: blood tests, a skin swab or a biopsy as your case needs; many cases need no test at all.
• Decision: the doctor explains the diagnosis, whether it is long-term or passing, and the options, from creams and tablets to clinic procedures; the decision is made together with you.
• Treatment: the doctor explains how to use it, for how long, the possible side effects and when to expect improvement; many skin conditions improve slowly over weeks.
• Follow-up: a visit to assess the response and adjust the treatment, with monitoring blood tests for those who need them. Do not stop treatment at the first sign of improvement, because some conditions return when it is stopped early.

The hospital is contracted with more than 40 payers, including insurance companies, professional syndicates and government bodies, and cover depends on the payer and the terms of the contract.