Dr Kerryn Phelps, Health Editor, Channel Nine 'Today'

GRIMSHAW: How may of us have some sort of skin condition?

PHELPS: I think the majority of Australians have a skin condition of some sort, certainly at some time in their lives. If you just look at skin cancers, two out of every three Australians will develop a skin cancer at some time in their lives. So, it's very common that people will be having to seek some sort of medical treatment for a skin condition.

GRIMSHAW: What percentage of skin conditions are hereditary, as opposed to, say, environment?

PHELPS: A lot of conditions have a hereditary component, if you look at some of the common ones like, for example eczema, or psoriasis. They both can tend to run in families. If you have, for example, a parent with eczema, you have about double the chance of that child having eczema when they are in childhood. So, very common. Also with eczema, if you have a family history of asthma or hay fever it's more common that a child would have eczema as well.

GRIMSHAW: How hard is it to treat eczema, because were you surprised at how many people leapt on this cream that we covered on the program last week?

PHELPS: No. People are looking for answers because it really can be quite a distressing condition, because it keeps on coming back. One thing that you can do, though, to help children is that it is often related to food allergy, particularly in childhood, and there are some quite common food allergens that will be related to eczema and are worth having a child tested for. And those common ones we've got some examples here, would be wheat, peanuts, seafoods, eggs, milk and dairy products, sesame and soy products. And these are the common things to look for in a child's diet. Now, you might look at that and say, well, that just looks like breakfast, and so, they're very common foods in an Australian diet. So, if you can get a child tested so you're not cutting them out of important food groups, for example, and make sure that is in fact what they are allergic to, and then you can keep that out of their diet and, quite often, control the eczema.

GRIMSHAW: Are you saying that allergies to any of these foods potentially could cause a child to become an eczema sufferer or simply trigger an onset?

PHELPS: Well, they will have the predisposition to the eczema. It's just that they will get a flare up. Eczema by its nature comes and goes, so you get a flare-up when they have been exposed to an allergen. I mean, it might be a household pet, it could be some sort of irritant in their environment, it could be a chemical of some sort, it could be something that they're eating. So, it's worth actually going through the motions of finding out what they might be allergic to that is flaring up the eczema. Of course, emotional stress is another thing that can cause flare-up.

GRIMSHAW: How do you do skin tests? How do you find out?

PHELPS: Well, for eczema or for food allergies, and any other type of allergies, we can do a patch test, which is where a grid is placed on the skin and then, in that grid, you will put a little prick in the skin, a needle prick, which contains an extract of that particular allergen, and if the skin flares up then you know that's something they're allergic to.

GRIMSHAW: Alright, what we're looking at here is, of course, is skin cell testing for, not for food allergens, but for skin cancer.

PHELPS: Skin cancer, as I said, two out of every three Australians, which is an enormous number, will get a skin cancer at some stage. Now, being winter time it is a great time to check your skin, or to have somebody close to help you check your skin and if, you look at moles, or birthmarks or spots that change colour, increase in size or thickness, bleed, won't heal, will cause a crack or are painful, these are the sort of things to look for, and to see your doctor about. Skin cancers are almost always curable, particularly the more common ones like basal cell carcinomas, and squamous cell carcinomas. Melanomas also are curable, if you get them early. So, if you get a freckle or a mole that changes, make sure you get it treated early.

GRIMSHAW: I've always meant to ask you this, I've always wondered, you know how skin cancers will very often be small on the surface, but they'll spread underneath. Can you feel anything underneath the surface of the skin, if a cancer, a skin cancer is spreading?

PHELPS: Well, sometimes with a Squamous Cell Carcinoma, the skin will feel thicker than the surrounding skin, and it'll look a bit red and maybe even flaky. It can bleed, for example, it'll feel, quite often it might have a stinging sensation to it, and basal cell carcinomas are usually like a little pearly kind of lesion, deeper consistency to the rest of the skin.

GRIMSHAW: We've covered eczema and skin cancer, psoriasis.

PHELPS: Once again, very common. Psoriasis is actually an overgrowth of skin cells, in a particular area. It's like an immune reaction within the skin and it will continue the cells' build up and you'll get this very thickened area of skin it can be all over the body like that or just on the elbows and knees or just in small areas of the skin. And you can see there, that redness, it's thick. You quite often get a silvery flaking over the skin and psoriasis is worse in winter, better in summer, because sunlight actually helps that one.

GRIMSHAW: Will you have it throughout your life? If you have chronic arthritis, not arthritis, psoriasis as a youngster, will you have it as an old person?

PHELPS: Interesting slip of the tongue there because, with psoriasis, you can get a form of arthritis called psoriatic arthritis in the fingers and it can also affect the finger nails, and people quite often find that they get abnormalities in their finger nails with psoriasis as well. In terms of how you go about treating psoriasis, there are certain triggers to it, avoiding emotional stress is important and, also with psoriasis there are no food allergens that will cause psoriasis at all. Some medications will set it off, sometimes a streptococcal throat will set it off, puberty can set it off. The most important thing is that you do get treatment for it which will include treatment such, as sometimes it will be oral medication, but usually can be managed with topical preparations, good moisturising and occasional sunlight, but no sunburn.

GRIMSHAW: OK. Thanks, Kerryn.

PHELPS: Thanks, Tracey.

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