Skin problems, moles and lumps – Do you really need a dermatologist?

A GP with additional experience in dermatology can diagnose and manage a large proportion of the skin problems we see every day – from eczema, acne and rashes to cysts, skin tags, warts, seborrhoeic keratoses and, importantly, the assessment of moles and other changing skin lesions.

At Edinburgh GP, we think the ideal skin service should be straightforward:

See an experienced doctor. Examine the skin properly. Use dermoscopy when appropriate. Treat or remove straightforward lesions when necessary – and refer promptly when specialist care is required.

Moles: sometimes less technology is more

Mole mapping and increasingly sophisticated imaging technology can be extremely useful for selected people, particularly those at higher risk or with large numbers of atypical moles.

But not everybody needs to have every mole photographed, mapped and repeatedly analysed.

For many people, what they actually need is a careful examination by an experienced clinician who knows what they are looking at, combined with dermoscopy where appropriate.

A dermatoscope allows the doctor to examine structures and patterns within a skin lesion that cannot be properly assessed with the naked eye. Used by an appropriately trained and experienced clinician, it can improve the assessment of suspicious lesions and help distinguish those that need action from the enormous number of harmless marks we all accumulate.

The aim isn’t to find an excuse to remove every slightly unusual-looking mole.  It is to identify the ones that actually matter.

Know your own skin

One of the most useful pieces of skin-cancer screening equipment is something you already own:

Your eyes – Get to know what is normal for you.

Pay particular attention to a new lesion, a mole that is changing in size, shape or colour, or something that simply looks different from the rest. Bleeding, persistent itching or a skin lesion that won’t heal also deserves assessment.

As we get older, vigilance becomes increasingly important. In particular, a new or changing mole after the age of 40 deserves attention rather than simply being assumed to be another harmless mark of getting older.

And remember that melanoma doesn’t always develop from a mole you’ve had for years – many melanomas arise as new lesions.

So rather than becoming obsessed with every freckle, the useful habit is much simpler:

Know your skin. Notice change. Get something checked if it is new, changing or just doesn’t look right.

And what if something needs removed?

This is where we think a good community dermatology service should join the dots.

If a doctor examines a benign but troublesome lesion and it can safely be removed, it is frustrating to then start an entirely new journey – another referral, another appointment and potentially weeks or months waiting for a relatively minor procedure.

At Edinburgh GP, many skin lesions can be assessed and, where appropriate, removed within the same service by an experienced GP surgeon accustomed to carrying out minor skin surgery.

And it doesn’t have to feel like a trip to hospital.

Our clinic offers comfortable, discreet and reassuring surroundings in central Edinburgh, with the personal approach of a small medical practice rather than a large hospital or surgical department.

We also believe private minor surgery should remain accessible and sensibly priced. A small, straightforward skin lesion shouldn’t necessarily require hospital-level fees or weeks of waiting.

And if we’re worried?

This is equally important.

We don’t believe that every skin lesion belongs in hospital – but we also don’t believe that everything should be treated in a GP clinic.

If a lesion is suspicious for melanoma or another skin cancer requiring specialist management, the correct course is appropriate specialist referral rather than simply removing it privately in primary care.

Good dermatology isn’t about removing the most lesions.

It’s about knowing which lesions can be safely reassured, which can be treated simply, and which need specialist investigation.

Dermatology at Edinburgh GP

Whether it’s a persistent rash, acne, a troublesome cyst, an annoying skin tag or that mole you’ve been meaning to get checked for the last six months, you don’t necessarily need to begin with a hospital consultant.

Start with an experienced GP with an interest in dermatology.

Careful assessment. Dermoscopy when appropriate. Minor surgery when needed. Specialist referral when it matters.

All in comfortable, discreet surroundings in central Edinburgh – and hopefully with a little less time spent Googling photographs of moles at 11 o’clock at night.