Dr Irene McLachlan

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Services includes :

• Skin disease: Either acquired or hereditary, skin diseases can affect your life, having a severe, long-term impact on your self-esteem. Common in teenagers, acne as a result of hair follicles being clogged with dead skin cells and oil causing black or whiteheads appear on the forehead, face, chest and shoulders. Dr Iréne McLachlan diagnoses acne from scarring and pigmentation, prescribing treatment based on the grade of acne typically using oral and topical medication in combination with cosmetic procedures (MagdalensPureSkinCare). Often mistaken for acne, rosacea characterised by red colouring, is a chronic inflammatory condition deriving from genetic, environmental and vascular factors. Dr McLachlan prescribes antibiotics, retinoid and long-term topical treatment avoiding steroids to treat rosacea. Eczema or dermatitis refers to a collective of inflammatory diseases affecting the skin’s outer layer and is managed through several treatment measures depending on the severity of the condition. Dr Iréne McLachlan treats psoriasis, a chronic inflammatory skin disease affecting organs characterised by the skin’s pale marks incorporating systemic therapy, including biologics and phototherapy or vitamin D analogues and topical steroids.
• Hair disease: Alopecia areata, telogen effluvium, male and female pattern hair loss, including frontal fibrosing alopecia, are associated with conditions related to hair loss that occurs at any age. Alopecia areata, an autoimmune disorder triggered by emotional stress factors, infections or hormonal changes causes bald circular patches on the scalp. Menopausal women over the age of fifty are more susceptible to scarring and balding in the front part of the scalp. Because frontal fibrosing alopecia gradually progresses, a biopsy determines systematic treatment in combination with topical medication. In conditions of telogen effluvium, a majority of hair follicles are resting with a few actively growing. If the condition doesn’t clear up on its own, Dr Iréne McLachlan treats self-correcting telogen effluvium prescribing topical medication.
• Nail disease: Your fingernails speak volumes about your health, and a change in colour of white, rosy pink and rippling of bumps are often signs of illness in the body. Yellow nails are often a sign of a fungal infection, and as the infection progresses, the nail bed retracts, thickening and eventually crumbling. Yellow nails may also be an indication of lung or thyroid disease, psoriasis and diabetes. Nails cracking from brittleness with a yellowish tint are often a sign of a fungal infection. Usually cured faster than toenail infections, Dr Iréne McLachlan suggests fingernail infection treatment through clipping, scraping discoloured nail surfaces removing debris from underneath the nail. Nail melanoma usually affects the thumb’s nail or large toenail arising from trauma and early diagnosis that involves biopsy of the nail bed is essential in treating the condition.
• Mucosal disease: Cold sores, ulcers and lip inflammation are associated with oral diseases classified as mucosal disorders that affect oral and genital mucous membranes. Cold sores from viral infections such as herpes simplex (HSV) presents symptoms of oral blisters that can recur over time. Triggered by skin trauma through surgical procedures, sun exposure, emotional stress as well as colds and flu, treating cold sores from HSV involves the prescription of oral antivirals to reduce periodic outbursts. Aphthous ulcers, appear as round sores on the inside of the mouth, inside the lips, cheeks or under the tongue also forming on genital regions. Dr Iréne McLachlan treats this condition by prescribing anti-bacterial mouthwash, topical corticosteroids in combination with systematic oral medication. Cheilitis from inflammation of the lips manifests in painful, scaly, ruby-coloured lips as a result of infection, nutritional deficiency, allergies and sun exposure. Instead of prescribing topical and oral retinoids causing chapped, dry lips, Dr Iréne McLachlan will instead advise on the use of emollient lip balms.
• Skin rejuvenation: Aging, skin disorders and sun exposure contribute to skin textural irregularities that include acne scars, static or dynamic wrinkles, pigment variations from freckles, visible blood vessels or sunspots. In addition to these irregularities, the skin will become loose, feeling less firm, losing its tone and diminishing its healthy, youthful glow. There exist various treatment modalities that include botox, fillers, chemical peels and skin needling. Botox injections have numerous cosmetic benefits, preventing permanent lines, regenerating the upper face, reducing the appearance of fine lines for a natural care-free appearance, treating crow’s feet and nose bridge sides. Although chemical peels cannot do what botox does by treating wrinkles or deep facial lines, it can diminish the appearance of acne scars, uneven skin pigmentation and rough patches.
• Acne scars: As part of her cosmetic dermatological services, Dr Iréne McLachlan treats facial scarring that is common in adolescents with severe inflammatory acne that leaves behind scars that have a negative psychological impact. Keloids, or smooth, shiny and hard nodules, vary in colour from pink, brown and red depending on the skin of the person accompanied by pain and intense itchiness spurred on by irritants and friction from clothes. Keloids affect any region of the body but usually appear on the cheeks, earlobes, shoulders and chest. Cryotherapy or freezing is a form of therapy to treat hypertrophic scars, and Dr Iréne McLachlan performs this treatment by using liquid nitrogen to freeze scar tissue. Dr Iréne McLachlan needs to differentiate between keloids and hypertrophic scarring to determine suitable treatment from either the use of silicone gels, steroid injections or skin needling.
• Pigmentation : Pigmentation refers to a skin colour palette with some skin disorders altering the colour of your skin. Hyperpigmentation appears harmless but can be the cause of an autoimmune disease such as Addison’s disease. As a result of inflammatory skin disorders, hypopigmentation from reduced melanin, a pigment responsible for the colour of your skin, is characterised by white patches and is initially diagnosed before the commencement of treatment. To treat hypopigmentation, Dr Iréne McLachlan will first have to diagnose the cause of white spotting conducting investigations that involve a skin biopsy to rule out potential severe systematic conditions. The response to therapy varies. But Dr Iréne McLachlan utilises phototherapy prescribing topical steroids to resolve hypopigmentation.
• Melasma (Chloasma) : Melasma, a common skin disorder, causes brown discoloured patches that are typically darker than usual often appearing on the cheeks, chin, bridge of the nose and forehead. Ordinarily, treatment depends on the grade of melasma ranging from superficial epidermal that responds well to therapy to deep dermal melasma that usually doesn’t respond to treatment therapies. Mixed melasma, a mixture of the two extremes partially responds to treatment in combination with sun protective measures. Dr Iréne McLachlan utilises hydroquinone, micro-needling, deep chemical peels as well as tyrosinase inhibitors and melanocyte sedation together with effective sun-protective practices to treat melasma. Therapies are most functional when the pigmentation is superficial, but for deep pigmentation from dermal melasma, it’s wise to consider alternative combined treatments, switching oral contraceptives for other substitutes.
• Cantharidin: Molluscum contagiosum is an infection from poxvirus characterised by firm, benign lumps, and if scratched, the infection can spread to surrounding regions of the body. Children and those with a compromised immune system or eczema are more susceptible to molluscum contagiosum. Assisted surgical removal should be considered when these bumps, either acquired or sexually transmitted, don’t disappear on their own. A viral wart is a growth of an excessive hard protein, keratin resembling a blister or tiny cauliflower stemming from human papillomavirus (HPV) family strains. If it doesn't disappear with or without treatment, a sample of tissue is extracted for a biopsy. Dr Iréne McLachlan performs cantharidin, applying a blister beetle extract in conjunction with other chemicals to the wart. This process creates an blister which raises the wart from the skin’s surface, finally completing the process by removing dead tissue.
• Skin biopsy: A skin biopsy involves the removal of a selected portion of skin for a definitive diagnosis for skin-related disorders. In conjunction with a skin biopsy, Dr Iréne McLachlan provides clinical details, photographs with a list of possible diagnoses to assist the pathologist’s findings. Dr Iréne McLachlan will inject a local anaesthetic into the skin, numbing the area for biopsy and afterwards, the area is cleaned and dressed using a bandage or suture. Dr McLachlan performs a biopsy through excision, incision or curettage by scraping or removing skin lesions. Results from the biopsy usually take less than a week but depending on second opinions and particular strains, it may take longer.
• Cryotherapy: A rough patch of skin as a result of sunburn (UVB) leads to actinic keratosis, a precancerous condition progressing to squamous cell carcinoma (SCC). Dr Iréne McLachlan uses cryotherapy to treat actinic keratosis as well as viral warts applying liquid nitrogen to skin lesions. Although you'll experience a slight sting, it doesn't last long with the area forming a blister within hours. A few days after cryotherapy, a scab develops, and the lesion dries up. Dr Iréne McLachlan will assist on applying Vaseline, gently washing the area and dressing the region, protecting it against friction or trauma. Generally, cryotherapy is effective in freezing and drying up cancerous cells or warts and usually gets better after each treatment.
• Skin cancers: Melanoma, a malignant form of skin cancer arises from melanocytes. Although melanomas are common in the skin, it rarely occurs in the eye referred to as uveal melanoma as well as in the intestines and mouth. Melanomas vary in colour, have no pigment, initially appearing flat and developing during the vertical growth phase, becoming raised. Sunburn contributes to basal cell carcinoma, the most common type of skin cancer that usually resembles raised pearly spots, ulcerating over time. Being a locally invasive skin cancer, it rarely spreads to surrounding organs, but patients can develop numerous basal cell carcinomas that require surgical treatment. Overexposure to ultraviolet radiation (UVB) can result in invasive squamous cell carcinoma (SCC) appearing as thick, scaly lesions that bleed easily and requires diagnosis through a skin biopsy. Bowen’s disease, a non-invasive type of skin cancer primarily from UV radiation doesn’t usually spread to other regions but can progress to squamous cell carcinoma if left untreated. Dr Iréne McLachlan works collaboratively with the oncologist surgeon and oncologist to determine whether the SCC has spread to lymph nodes treating the carcinoma through surgical excision utilising curettage and cautery for mild tumours.
• Sun protection: Skin cancer is a health concern for most South Africans and can be avoided and treated through early diagnosis and sufficient sun-protective measures using sunscreen graded SPF. It’s vital to find a sunscreen you like, applying it every thirty-minutes before going outside. Modern sunscreens protect against infrared light, acting as reliable anti-ageing agents stimulating collagen, repairing cellular damage filtering against UVB and UVA. Overexposure to the sun causes severe damage, leading to premature ageing, breaking down collagen and elastin with once healthy-looking skin losing its moisture. The Cancer Association of South Africa (CANSA) recommends avoiding tanning beds, using sunscreen with an SPF of 20 or higher and wearing sunglasses to deflect harmful UV rays effectively.
• Surgical excision : Dr Iréne McLachlan performs surgical excision to remove non-cancerous growths such as moles for cosmetic reasons as well as skin cancers and abnormal lesions. Dr Iréne McLachlan will perform a shave excision, a conventional surgery performed at her practice to remove a mole to reduce the chances of developing malignant melanomas. Generally, shave excisions have better cosmetic outcomes and is sometimes applied for the removal of lesions. Dr McLachlan conducts a surgical excision by administering a local anaesthetic, using a scalpel blade to remove the lesion inhibiting bleeding through electrocautery. Once Dr Iréne McLachlan completes the procedure, she will apply stitches, thoroughly explaining how to care for the wound and safely remove sutures.
• Wart treatment : Rather than through a single modality, Dr Iréne McLachlan utilises collective therapies for effective wart treatment. Warts resemble tiny cauliflower structures occurring in both children and adults as a result of the human papilloma (HPV) virus. Through curettage and cautery, Dr McLachlan scrapes off the wart, applying heat to the skin surface, reducing bleeding and destroying vestiges of skin cancer cells. Salicylic acid is available as an over-the-counter drug used to treat warts and any surrounding callus through thinning but should not be applied to the genitals, neck and face. Dr Iréne McLachlan may also apply cryotherapy using liquid nitrogen to freeze the growth, waiting for the formation of a blister before removing the wart.
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