Oxford Dermatologists offer a extensive range of highly professional services for complete skin care
including: allergy testing, skin cancer screening and vulval dermatology.


Allergy testing

A key part in the investigation of allergy is finding out the background of your problem. This means taking a detailed accurate history, which can take time and requires longer appointments. This is very important as it helps determine the likely problem and guides what allergens should be testing for.


Skin prick testing

This test involves placing separate drops of solutions of allergen extract onto the skin of your forearm and then using a very fine lancet to prick through the drop into the skin. A positive test results in a small raised wheal. Results are known within 15 minutes and the test is painless. It is safe but has to be performed in a hospital environment. You should not take any anti-histamines, if possible, for 3-7 days before your appointment. Ideally you should also not apply any creams e.g. moisturisers to your forearms on the day of your appointment. We can test you to a wide variety of allergens based on your history including:

  • • Foods
  • • Spices
  • • Animals
  • • Pollens
  • • Moulds
  • • Dusts
  • • Latex

Specific IgE testing

This is another type of allergy testing that requires a blood test. It can be used alone or in conjunction with skin prick testing. Results take about 1-2 weeks and are expressed as a number between 0.35 and 100.


Patch-testing

Patch-testing is advised if allergic contact dermatitis is suspected. This involves having a series of substances in small containers applied to the skin of your back for 48 hours. It normally involves three visits to hospital in the same week. On the first day (usually Monday) you will have a detailed history taken with questions about your eczema or skin reactions, any possible triggers including work and hobbies. All patients have a baseline series applied but other series will be selected depending on the type of problems and possible allergens. Readings are done at 48 and 72 hours and the final results are given at the end of the week.

Who benefits from patch-testing?

  • • It may be difficult to know when allergy is responsible for skin problems. There are some situations where allergy testing is worthwhile.
  • • When there is a change in distribution of eczema for example it may have just affected the elbow creases and now has spread to the face and neck.
  • • Where there is a history of intolerance or reactions to cosmetics, jewellery, fragrances, sunscreens or hair dyes.
  • • When eczema is unresponsive to conventional treatments with topical steroids and emollients.
  • • In high risk sites for allergy including hand eczema, eczema around the eye area, the genital skin or the ears.
  • • When occupational dermatitis is suspected.

What will I be tested for?

The baseline series contains 41 chemicals most likely to cause allergic contact dermatitis and includes metals, fragrances, preservatives, bases of creams and ointments and rubber chemicals. Other series are chosen depending on the nature of the problem. It may be necessary to test for work chemicals, toiletries or cosmetics if these agents are suspected. Photo-patch testing may be needed if an allergy to a sunscreen is suspected. For more information please see the information about patch testing. Skin prick testing for latex, foods and allergens likely to have an impact on the skin such as the house dust mite, can be tested for during the week of patch testing.

What are the most frequent allergens on patch testing?

  • • Nickel. This metal is present in costume jewellery, belt buckles and jean studs. People who are allergic to metals often have intolerance and rashes when they wear costume jewellery or a patch of eczema under a belt buckle.
  • • Fragrance allergy is suspected in cases of facial and neck eczema or where there is a history of intolerance to after shaves or perfumes. Fragrance is found in many personal care products including shampoos, deodorants, wet wipes, plug in air fresheners and hairsprays.
  • • Hair dye. Paraphenylenediamine or related chemicals are often implicated in hair dye allergy. Reactions can be very severe with facial and neck eczema or under the beard area in men. Developing an allergy to this chemical is quite common in hairdressers who have an occupational exposure.
  • • Preservatives. Almost all creams, ointments and personal care products contain preservatives to prevent deterioration of a product. Several different preservatives are tested in the baseline series.
  • • Steroid allergy. Sometimes allergy to a steroid shows up as poor response to treatment rather than a skin reaction. Allergy to hydrocortisone is the most common allergy but it is important to test for other steroids too.

Vulval & Genital Dermatology Service

  • • Dr Cooper can assess all types of vulval symptoms including pain, discomfort and itch.
  • • The most common problems seen are lichen sclerosus, eczema, vulval pain, recurrent candida and lichen planus.
  • • Vulval biopsies can be arranged if necessary.
  • • To read more about vulval conditions please click here

Desensitisation

Desensitisation or immunotherapy uses allergen extracts to treat certain allergies e.g. hayfever / allergic rhinitis to grass or tree pollen, house dust mite. It is mainly indicated for individuals with symptoms not effectively controlled by optimum standard treatment ie usually regular long-acting non-sedating anti-histamines & intranasal corticosteroid sprays.


Dermoscopy

Dermoscopy is a technique used for mole screening and skin cancer diagnosis. It improves the accuracy of melanoma diagnosis. It allows clearer visualisation of the structure of skin lesions.


Cryotherapy

The term ‘cryotherapy’ literally means ‘treatment using low temperature’, and refers to the removal of skin lesions by freezing them. We use liquid nitrogen cryotherapy. A variety of skin lesions can be treated including:

  • • Viral warts & some molluscum contagiosum.
  • • Solar / actinic keratoses & Bowen’s disease.
  • • Seborrhoeic keratoses.
  • • Skin tags.
  • • Benign lentigos.
  • • Some superficial basal cell carcinomas.

Click here to read more about cryotherapy


Photodynamic therapy

Photodynamic therapy (PDT) is a technique used to treat some basal cell carcinomas and pre-cancerous sun-damaged skin. During PDT a light beam activates a cream which has been applied to the lesion (the affected area of skin). This treatment kills the abnormal cells in the skin. It causes an inflammatory response. It is undertaken at the Churchill Hospital.

Click here to read more about PDT


Phototherapy

Carefully used & controlled ultraviolet light can be used to improve the control of psoriasis and other skin conditions including:

  • • Eczema
  • • Polymorphic light eruption
  • • Prurigo / generalised itching
  • • Pityriasis lichenoides chronica
  • • Pityriasis lichenoides chronica

Narrow-band (TL-01) phototherapy is available at the Churchill & Horton Hospitals

Click here to read more about phototherapy


Skin surgery

Skin surgery for benign & suspicious growths is usually undertaken at the Churchill Hospital.