Medical Dermatology Services

Dr Rose Mak manages a wide range of medical skin conditions affecting the skin, hair and nails. She will begin with a thorough consultation and organise tests as appropriate. By working closely with you, she will devise a personalised management plan to suit your own needs.

Some of the common conditions we treat in our dermatology clinic include:

Acne

Acne is common in teenagers and adults and is amongst one of the most common conditions we treat in our clinics. It is important to treat acne early and not to neglect the condition because when treatment is delayed, acne can potentially cause permanent scarring.

 

Treatment for Acne
  • Mild acne can be treated with topical antibiotic and topical anti-acne agents such as topical retinoid (vitamin A derived) preparations.
  • More severe acne can be treated with oral medications including oral antibiotics, anti-androgen tablets and oral isotretinoin (vitamin A derivative) tablets. Oral isotretinoin can only be prescribed by dermatologists in Australia and may lead to long term remission in many patients.
Actinic Keratosis & Bowen's Disease

Actinic keratosis are pre-cancerous lesions with a small chance of progressing to skin cancer. Bowen’s disease or squamous cell carcinoma in situ is a superficial form of skin cancer. Both conditions are related to chronic sun exposure.

 

Treatment Offered Include
  • Creams
  • Cryotherapy / Freezing
  • Curettage
  • Daylight photodynamic therapy
Allergies

Allergy occurs when your immune system overacts to a substance (known as an allergen) that is harmless to most people but triggers a reaction in anyone sensitive to it. The allergen can be in the form of medicines, food, chemicals or air borne particles. This may result in a range of symptoms including different skin rashes and swelling. If you are suspicious of an allergy related skin problem, Dr Mak will start by performing a detailed history and examination and arrange specific tests if indicated.

 

Treatment for Allergies
  • Avoidance of allergen
  • Oral medications to control symptoms
Scientific Publications on Allergies
  • Mak, R.K.H., White, J.M.L., McFadden, J.P. and Goon, A.J.T. Lower incidence of sequiterpene lactone sensitivity in a population in Asia Vs a population in Europe: an effect of chrysanthemum tea? Contact Dermatitis 2007; 57(3): 163-4.
  • White, J.M.L., Goon, A.J.T., Jowsey, I.R., Basketter, D.A., Mak, R.K.H., Kimber, I. and McFadden, J.P. Oral tolerance to contact allergens; a common occurrence? A review. Contact Dermatitis 2007; 56: 1-8.
  • Mak, R.K.H., Wakelin, S.H. Shiitake dermatitis: the first case reported from a European country. Br J Dermatol 2006; 154(4): 800-1.
  • Mak, R.K.H., O’Gorman-Lalor, O., Croom, A. and Wakelin, S.H. An unusual case of latex allergy: contact urticaria from natural rubber latex in chocolate bar wrappers – Clin Exp Dermatol 2005; 30: 190-1.
Eczema

Eczema or atopic dermatitis is a very common inflammatory skin condition characterised by red, itchy rashes that are roughened and scaly. It is common in infancy and childhood but may occur in all ages. A combination of genetics and environmental factors are important in the development of eczema. Eczema can be worsened by stress, sweating, weather changes and certain fabrics such as synthetic and wool which may irritate the skin. If left untreated, eczema may impair quality of life and lead to frequent skin infections.

 

Treatment for Eczema
  • Emollients and soap free cleansers
  • Topical steroids and non-steroids anti-inflammatory creams
  • Oral antihistamines to relieve itchy symptoms
  • In severe cases, oral steroids, wet wraps, phototherapy or oral anti-inflammatory medicines may be required.
Genital Skin Conditions

Different skin conditions can affect the genitalia. If you notice a rash or suffers from itching and discomfort in the genital area, do see your dermatologist. Dr Mak will start with a careful history and examination. Apart from examining the affected area, other areas of the skin may be examined to determine if a more widespread skin disorder is the cause. A diagnostic biopsy from an affected area may sometimes need to be performed the determine the exact nature of the skin condition and she will also organise other relevant investigations when indicated. She will work closely with you and formulate a comprehensive management plan.

Hair Loss

It is normal to lose between 50 – 100 hairs a day. However, if you notice significant hair thinning, a receding hairline or bald patches, seeing your dermatologist early is worthwhile as there are effective treatments. The two main types of excessive hair loss, or alopecia, are androgenetic alopecia (also known as male pattern and female pattern hair loss) and alopecia areata. Androgenetic alopecia is characterised in men by a receding hairline and/or boldness on the top and front of the scalp; whilst in women diffuse hair thinning rather than complete boldness on the mid to frontal areas of the scalp occurs with the condition less severe than that seen in men. Genetic factors, hormonal changes and aging process are all contributory factors in androgenetic alopecia. Alopecia areata is an autoimmune condition characterised by round bald patches which may appear suddenly, most often affecting the scalp although any body sites can by affected. In more severe cases, hair loss is more widespread and may affect the whole scalp or the whole body.

Since many different factors can influence hair loss including other co-existing medical conditions, infections, nutritional problems, hormonal changes, genetic factors, and stress, to name but a few; it is worthwhile to see a dermatologist who will assess you by undertaking a thorough history and examination, appropriate investigations can then be arranged to establish the underlying cause and a personalised management plan is then devised.

Treatments for Hair Loss

This depends on the underlying cause and may include:

  • Topical treatments – steroids and minoxidil lotions
  • Steroids injections – to affected hair loss areas
  • Oral medications – including steroids tablets, oral anti-hormonal treatments and oral immunosuppressive medications
  • Contact sensitization therapy – where a substance is applied onto the scalp to stimulate the immune system thereby increasing hair growth
  • Other options such wigs and hair pieces and hair transplantation may also be discussed with your dermatologist
Hyperhidrosis

Hyperhidrosis or excessive sweating can be generalised or localised to certain body areas (such as underarms).

 

Treatment for Hyperhidrosis
  • Topical treatments
  • Iontophoresis
  • Oral medications
  • Botox injections for axillary hyperhidrosis (underarms excessive sweating). Under Medicare and PBS guidelines, up to 3 treatments are subsidised per year with a minimum of four months between treatments provided patients fulfil eligibility criteria.
Nail Disorders

Abnormal nails may arise due to infections (bacterial or fungal), trauma, co-existing underlying skin conditions (such as psoriasis, eczema or lichen planus), benign nail bed tumours but very rarely the underlying cause may be more serious such as skin cancer.

Treatment for Nail Disorders

These may include:

  • Advice on nail care
  • Topical or oral antibiotics for bacterial infections
  • Topical or oral anti-fungal medicines for fungal infections
  • Treatments for associated underlying skin conditions
  • Surgical treatment
Psoriasis

Psoriasis is a common chronic inflammatory skin condition affecting approximately 2% of the population worldwide. It is most commonly characterised by a red patch with overlying silvery scaling and commonly affected body sites include the elbows, knees, face and scalp. Nails and joints may also be affected. Both genetic and environmental factors play important roles in the development of psoriasis. Psoriasis may be triggered by infection, trauma, smoking, stress and medications; and is associated with other co-morbidities including crohn’s dissease, diabetes, cardiovascular disease and obesity. Psoriasis can be stigmatising and severely impact on an individual’s quality of life.

 

Treatment for Psoriasis
  • Topical treatment – which may be adequate to control mild to moderate psoriasis
  • Phototherapy
  • Oral immunosuppressive medicines – can be considered for moderate to severe psoriasis
  • Biologics injections – reserved for moderate to severe psoriasis and only dermatologists can prescribe PBS (Pharmaceutical Benefits Scheme)-funded biologics for psoriasis.
Experience in Psoriasis Management

Dr Rose Mak holds consultant dermatologist appointment at the biologics clinic at Skin and Cancer Foundation in Melbourne and previously at St. Mary’s Hospital in London prior to working in Melbourne. She is experienced in managing psoriasis with a holistic approach and strives to select the most appropriate treatment to suit individual needs. Apart from her clinical interest in psoriasis, she also has a strong research interest in psoriasis. She was awarded the prestigious Medical Research Council clinical research training fellowship and undertook a PhD in cutaneous immunology with special focus on the immunopathogenesis of psoriasis at St. John’s Institute of Dermatology, an internationally renowned cutaneous research centre. Her strong interest in psoriasis has led to scientific publications and book chapter.

Psoriasis Publications
  • Di Meglio, P., Villanova, F., Napolitano, L., Tosi, I., Barberio, M., Mak, R., Nutland, S., Smith C.S., Barker, J.N.W.N., Todd, J.A. and Nestle, F.O. The IL-23R A/Gln381 allele promotes IL-23 unresponsiveness in human memory T helper 17 cells and impairs Th17 response in psoriasis patients. J Invest Dermatol 2013; 133(10): 2381-2389.
  • Hundhausen, C., Bertoni, A., Mak R.K.H., Botti, E., Di Meglio, P., Clop, A., Laggner, U., Chimenti, S., Hayday, A.C., Barker, J.N., Trembath, R.C., Capon, F. and Nestle, F.O. Allele-specific cytokine responses at the HLA-C locus: implications for psoriasis. J Invest Dermatol 2012; 132(3): 635-41.
  • Mak, R.K.H., Hundhausen, C. and Nestle, F.O. Invited review: Journey to understanding the immunopathogenesis of psoriasis. Actas dermo-sifiliograficas 2009; 100Suppl: 1-12.
Book Chapter
  • Mak, R. Ustekinumab in psoriasis. In Handbook of Systemic Drug Treatment in Dermatology. Wakelin S.H. and Maibach H.I., editor Manson Publishing, London. 2015.
Rosacea

Rosacea is a common chronic skin condition with a ‘red face’ being the most common symptom. Other symptoms associated with rosacea include painful papules and these can be mistaken by some for acne. Rhinophyma, or bulbous enlargement of the nose may occur. Rosacea may also cause ocular symptoms including irritation, dryness and reddening of the eyelids. It has a predilection for fairer skin types.

 

Treatment for Rosacea
  • In mild cases, rosacea can be treated with topical creams.
  • More severe or persistent cases may require addition of oral medications such as oral antibiotics or oral vitamin A derivative tablets.
  • Vascular lasers to reduce redness and treat broken capillaries can also be discussed.
Skin Cancer Screening & Mole Check

Skin cancer accounts for around 80% of all newly diagnosed cancers every year in Australia. Basal cell carcinomas (BCCs) are the most common skin cancer followed by squamous cell carcinomas (SCCs) as the second most common skin cancer and are known as non-melanoma skin cancers. Malignant melanoma, although rare in the rest of the world, has the highest incidence in Australia; they have the potential to spread to surrounding tissues and other parts of the body and are therefore a more dangerous skin cancer.

Importance of Skin Cancer Screening & Mole Check

Most of these skin cancers are curable with early detection and treatment. However, to the untrained eye, they can be easily missed as their appearance may vary and sometimes rather non specific. Therefore, having skin cancer surveillance by a trained dermatologist is important for early diagnosis and successful treatment of skin cancers.

Experience in Skin Cancer Management

Dr Rose Mak frequently diagnose and manage different skin cancers as consultant dermatologist in tertiary hospitals in London and Melbourne. She has performed numerous full body skin cancer surveillance in diverse ethnic populations and also for specific patient groups (e.g. organ transplant patients on immunosuppressive medications). She appreciates that the same skin cancer can present differently in different ethnic groups. She will start by examination of the skin over the whole body. She can diagnose skin cancer by clinical examination and by taking a skin biopsy from suspicious lesion. Biopsy will be analysed by a skin histopathologist. Further tests including lymph node biopsy, blood tests and radiological imaging may be arranged if indicated.

Treatment for Skin Cancers

  • Excision remains the gold standard of treatment for most skin cancers.
  • Certain forms of early skin cancers can be treated by non surgical methods (such as creams, cryotherapy, gentle curettage/scraping) thereby avoiding the need for surgery when possible.

With her experience in skin cancer management, Dr Mak will work closely with you to select the most suitable skin cancer treatment for you. Dr Mak has a caring and holistic approach and strives to address any concerns or worries that you may have during the diagnosis and treatment process.

Warts

Warts may take on many forms. Treatment include medicated cream, freezing with liquid nitrogen and topical treatments that encourage the immune system to recognise and destroy the skin cells infected with wart virus.

Make an appointment with Dr Rose Mak today.


SJOG Berwick  
03 9769 8206

Epworth Freemasons East Melbourne  03 9769 8206