Alert level 2 and Covid toes.

22 May, 2020

Covid, alert level 3, dermatology and beyond

26 Apr, 2020

It goes without saying that the last month has been very strange for us all. With careful guidance and the impressive self-discipline of New Zealanders the curve of Covid has been flattened. The numbers of new cases are diminishing rapidly.

Tomorrow we go from level 4 to level 3. Not a huge change but so encouraging for us all and a great boost for morale. Hopefully level 2 will follow soon.

New Zealand dermatologists are now actively planning to adjust their work as the levels change. The last blog was on virtual consultations and at level 3 this will still be the majority. As we move toward level 2 then clinics will ease their restrictions with more normal activity. There will be considerable planning and preparation for safe consultations carefully following the advice of the New Zealand government.

You can help your dermatologist by considering these 3 questions* prior to making a Face to Face appointment:
1. In the last 14 days have you been overseas?
2. In the last 14 days have you been in contact with a person who has confirmed/probable Covid illness?
3. Are you unwell or are any of the people in your household bubble unwell with fever or new respiratory symptoms?

If the answer is “No” it is very unlikely that that you have Covid. If the answer is “Yes” then you must not attend the clinic appointment but seek advice from your General Practitioner and consider testing for the virus. Remember that it is not only important to think of your own health, but also of the well being of the healthcare providers with whom you will interact.

If you have a skin problem please do not hesitate to seek advice from your dermatologist. As we begin to leave Covid behind don’t allow your own personal health to suffer through delay.

*With grateful acknowledgement to Counties Manukau Health


Teledermatology during Covid 19

3 Apr, 2020

Covid 19 has arrived in New Zealand and this has produced rapid and profound change for us all in our work style. New Zealand dermatologists have adapted to the new environment and are strictly following the advice of the New Zealand government. Check the website of your dermatologist as this will explain the new procedures and give contact details.

Dermatology is well suited for telemedicine. Online virtual consultations are different but allow your care to continue during this period particularly for urgent problems. Ideally these are done in real time using video conferencing so that you can directly consult with your dermatologist. Sometimes it is easier to have the consultation on your smart phone rather than laptop or desktop so that the camera can be moved easily and the dermatologist can look at different areas of skin. It may be helpful to have someone who is with you in your “bubble” to help you move the phone to areas that you cannot easily reach. 

Some areas of New Zealand are very remote and internet access is unstable or poor quality. Another way to seek help is for you to take photographs and e mail them to your dermatologist who can phone you.  If you send photos make sure they are in focus and with a well-lit background so that the detail of the problem can be seen. For a dermatologist it is often helpful to see where the rash is on your body so take a “long shot” as well as “close ups” so that detail can be seen. 

Pharmacies remain open. Your dermatologist can send the prescription to the pharmacy. Remember to be very specific with the exact details of your pharmacy so that the prescription is sent to the right one!  Give the pharmacy a ring from home to make sure the medicine is ready to be picked up.  Do not go if you are immunocompromised or over 70 years old.

Major health insurers in New Zealand have agreed to fund virtual consultations during this period. The insurers who we understand have agreed to virtual consultations include Southern Cross, Accuro, NIB, AIA, AA, Police Plan, Sovereign and Partners Life.  Check with your insurer for details prior to the consultation.

Every New Zealand dermatologist extends their best wishes to you and your family/whānau during this time. Stay well, stay safe and be kind to each other.  


NZDSI Dermatologists: The Authority on Medical Dermatology, Surgical Dermatology and Cosmetic Dermatology. Why is this justified?

9 Feb, 2020

Although dermatologists are expert in all skin disorders, some have specialty interests and focus their work in specific areas. Some specialise in surgical dermatology especially skin cancer, some in medical dermatology (rashes) and some in cosmetic dermatology. If you look at the New Zealand Dermatological Society Inc (NZDSI) web page you will see the statement “The Authority on Medical Dermatology, Surgical Dermatology and Cosmetic Dermatology”. Why is this justified?

Training to become a dermatologist in New Zealand is rigorous. It may take 12-15 years. Initially there is the university course to graduate as a doctor, usually 6 years. Then follows post graduate training. The initial part is to pass the examinations of Royal Australasian College of Physicians which can be sat after 3 years. After passing these exams, the prospective dermatologist can then apply for a dermatology training position. This is a further 4 years whole time with 2 years spent overseas to build international experience. Some dermatologists will undertake specific additional training in their specific field of interest.
This detail is given so that you can understand the depth and length of training required to become a dermatologist in New Zealand and for you to have confidence in the dermatologist you choose to see. For example, if you have a specific cosmetic question, you will have assurance that the dermatologist will have a full understanding of all the medical (non-surgical) and surgical options for you based on deep and broad experience.

Only NZDSI Dermatologists are permitted to use the distinctive logo. Look for it.


Psoriasis-what is in a name?

16 Dec, 2019

Psoriasis, what is in a name?  A disorder that affects 1-2% of all New Zealanders and causes a huge amount of distress for those afflicted. It does not discriminate.

Psoriasis is a red scaly rash commonly on the elbows and knees but actually can affect any part of the skin including the scalp. It can also be found on body folds and on the nails causing them to become thickened and to split.

Many sufferers of psoriasis adapt their life to the disease, covering up and sometimes avoiding social contact. It can be very stigmatising. It may not be possible to swim at the beach or pool. For some, even a small area of psoriasis, depending on the body site, can be very distressing.

Seek treatment for psoriasis if you have it. There are a range of possible treatments including cream, light, tablets and medications called biologic agents. Light treatment called narrow band ultraviolet light can be very effective especially when there is too much psoriasis to treat with cream. There are a range of tablets which need to be suited to the individual. In New Zealand, there are four biologic agents, funded by Pharmac provided the correct criteria are reached.  These biologics are adalimumab, etanercept, infliximab and secukinumab. There are other biologic agents for psoriasis. These are currently not funded by Pharmac.

There is an enormous amount of research in to psoriasis going on around the world, including in New Zealand, and the future for new and effective treatments is very promising.

It is often commented that stress makes psoriasis worse. Here in New Zealand at the University of Auckland, with the Department of Psychological Medicine, the Faculty of Science and Dermatology there is a study for New Zealanders examining this problem and trying to answer the question – why? The study needs participants so if you are interested in taking part and New Zealand based please e mail Mikaela, a PhD candidate, at

Psoriasis, what is in a name? The answer is complex.