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00:00This programme examines dermatological conditions and the procedures involved with treating
00:04them. Due to their graphic nature, viewer discretion is advised.
00:09Nearly done.
00:10OK.
00:11Hi, I'm Dr Emma. Come and have a wee seat.
00:14Can you describe what your hands feel like?
00:17It just feels like burnt skin.
00:20There were like big pustules all over my face and pus would come out of them.
00:25Every day I see people in despair and it's all because of their skin.
00:30It's been 20 years since they are just getting bigger and bigger.
00:34Some of the patients have been suffering in silence for many years.
00:38It's ugly. I don't want it.
00:40And others have tried multiple treatments and nothing has worked.
00:44And that's why they come to see me.
00:47Can't wait to have it gone. It's just going to change everything.
00:51I treat everything from the most extraordinary and extreme.
00:55Well, there's certainly a lot here, isn't there?
00:58I try not to look at it, to be honest.
01:00To the common skin conditions that we see every day.
01:04Woo! That was a good one.
01:06Do you want to see this?
01:07Yeah.
01:09Oh.
01:10It is hard at the moment because resources are stretched
01:13and people aren't able to get the treatment that they need.
01:16That's it out.
01:18Oh, good riddance.
01:19And all I want to do is to help make a difference.
01:22Thank you so much.
01:23Oh, it's my pleasure.
01:25It's gone.
01:25It's gone.
01:26It's gone.
01:27That is amazing.
01:28I am so grateful.
01:30You just don't know what you've done.
01:53Hey, girls.
01:54Morning.
01:55I'm feeling, like, pumped today because I did that extra spin class this morning before
01:59coming here.
01:59But you guys need to come with me the next time.
02:02No.
02:02As I'll give you the 5.30 call, okay?
02:04I'm going to put it in for Wednesday.
02:11In the winter, I would open all the windows.
02:13I would make it extremely cold.
02:14I would have fans on me the entire time.
02:16And in the summer, I'm more or less disabled.
02:18Like, I can't leave the house because it's so hot outside.
02:25I have erythromalacia, which is also known as burning man syndrome.
02:30It's a condition that makes your skin red and inflamed.
02:34And it feels like a permanent, like, burn wound all over your face and hands.
02:42Hi, Sean.
02:43Hi.
02:45How are you feeling?
02:46I'm doing okay today.
02:47Yeah, your hands are looking a bit dry.
02:52It makes me feel really sad because I can't make it go away.
02:56Cream and gloves on tonight.
02:59Probably, yeah.
03:00Probably, yeah.
03:02Sean's condition started about three years ago.
03:05It was his hands that were really, really bad.
03:08They were really, really red.
03:11They were burning and the skin had split.
03:19We're here to see Dr. Emma.
03:21Yeah, lovely.
03:21Would you like to take a seat?
03:22Yeah, sure.
03:24Hi, is it Sean?
03:25Yeah.
03:26Hi, nice to meet you.
03:27I'm Dr. Emma.
03:27Do you want to come with me?
03:28And Mum as well?
03:30With a very organised folder.
03:33So, Sean, tell me about what's been happening with your skin.
03:38I first noticed some weird, like, things happening when I was 16.
03:42I got these weird red lumps on my fingers and then it developed into my fingers swelling.
03:48And then it started burning, like a burning pain on my hands.
03:54And then a little while after I noticed that it was spreading onto my face.
03:58OK.
03:58I was diagnosed with erythra malasia and it just feels like when you get a burn wound.
04:03So, the baseline is it burns all the time.
04:06Yeah, especially in the summer I have to bring a UV umbrella with me everywhere
04:09because it helps me keep cool and I can't really go out with my friends anywhere.
04:13So, this sounds like it's had a real, like, impact on how you're living your life.
04:22Yeah.
04:22Well, I would quite like to get in and have a little look at this, if that's OK?
04:26Sure, yeah.
04:29Your wee hands are so cold, aren't they?
04:32Yeah, actually, I think they've always been really cold.
04:34Yeah.
04:35But it feels hot to you, right?
04:37Yeah.
04:38Yeah.
04:38And because this hand has been down, actually, you can start to see this even more dusky.
04:44And you can see really quite easily where these almost nodules are.
04:49Yeah, that one's very obvious.
04:50This one here, you can see that this is a very obvious little nodule here
04:54and it's that orangey red colour.
04:57And then if I move up your arm, here is something called keratosis pilaris.
05:03It's a condition where the follicles themselves get slightly blocked by excess keratin or scale
05:09and that causes a little bump to appear.
05:12Does it, um...
05:13Does it, like, go away with age?
05:15It doesn't go away.
05:16Typically, people who would have this would often have this redness, which flushes very, very easily.
05:23Sean hasn't just come in with this very rare inherited condition called erythromyalgia,
05:29which causes burning in his hands.
05:31He also has a much more common condition called keratosis pilaris.
05:36Both of these conditions are not something that we can cure because they're part of our genetic makeup.
05:41But what we can do is control them.
05:43One of the things that we've used in the past is actually Botox injections,
05:49so botulinum toxin injections.
05:51OK.
05:51And that sounds a bit strange, doesn't it?
05:53Essentially, those small nerve fibres are overworking.
05:57What happens with Botox is it settles down that active nerve.
06:03OK.
06:03So that would be a good thing to try.
06:05I think the changes on your face that you have are actually more in keeping with keratosis pilaris,
06:11which is the little bumps on your arms, and therefore we can approach treatment of that in a slightly different
06:15way.
06:16OK.
06:17That's with us giving you nice stuff to put on the skin, but also with using some things like our
06:21lasers,
06:22that you can see right there behind you, can be very helpful at starting to take some of that redness
06:28away.
06:28I would love to get some of the redness off. That's really annoying to me.
06:32Yeah.
06:33How does all of the whole thing sound to you?
06:36Uh, that sounds...
06:38I mean, that sounds great.
06:39I mean, I don't know, just anything to help would be incredible.
06:42I'm surprised at how many options that Dr. Emma was able to give me.
06:48She also was able to figure out some stuff that I didn't know about,
06:51my hands and face being two different conditions.
06:55It's really important that we try and help Sean manage and live with his erythromyalgia,
07:01because this is a really very serious condition, especially to affect, you know, a 19-year-old man in his
07:07prime.
07:08You know, it's got to the point where he's had ulcers on his fingers,
07:10and this will only get worse unless we intervene now.
07:21Good afternoon, Dr. Creighton's office.
07:29Is that it?
07:31Yeah.
07:32Here we go.
07:35It's hard to strike the balance between being quite outgoing
07:39and wanting to hide this particular part of myself.
07:44Hi, I'm Lauren. I'm here to see Dr. Emma.
07:47I don't want to be known as Lauren with the holes on the side of her head.
07:54I grew up in a really, really small town in Derbyshire.
07:59I think I just really wanted to be different,
08:02and that came out in makeup or dyeing my hair or getting piercings.
08:10I made the decision at 14 years old to start stretching my earlobes,
08:17and it's something that I'm still dealing with the consequences of today.
08:29Day-to-day, this mainly affects my confidence,
08:33and meeting new people for the first time can be quite difficult.
08:39Hi, Lauren.
08:40Hi.
08:40Hi, nice to meet you.
08:41I'm Dr. Emma.
08:42Hey.
08:43Come with me.
08:45We're just down here.
08:47Yep.
08:49Have a wee seat, Lauren.
08:52So what have you come about for your skin today?
08:55So I've come with two stretched earlobes.
08:58Oh, yes.
08:59So are you somebody who did the gouging with the ears?
09:03So you put the little things in and then you make them bigger and bigger and bigger?
09:06Yeah.
09:06And how long did you do that for?
09:08So I had about two and a half, three years.
09:11This has been them since 2012, basically.
09:13Yeah, so like ten and a bit years, really, it's been like that.
09:16Yeah.
09:16And tell me, how does it make you feel?
09:18I don't like it.
09:20I've been asked not to go to certain meetings and not to meet certain clients.
09:25Really?
09:26Because these don't really fit the standard professional individual.
09:31Yeah.
09:32I brought this on myself.
09:33I completely regret the decision.
09:35I think if I met any 13 or 14-year-old now, I would say, please don't even think about
09:40it, you know?
09:41I actually hear that quite a lot.
09:43Yeah.
09:44What size were you actually able to manage to get the whole size to?
09:49Yeah, so I actually went up to 26 millimetres.
09:5226 millimetres, so like an inch as a circle all the way round.
09:57I mean, that's big.
09:58Yeah.
09:59When I'd first taken them out, I'd probably say my low probably went down to like just
10:04above or just below my jawline.
10:06Oh, my gosh.
10:06As a young person, your skin is very stretchy and elastic and can bounce back into place.
10:12So in a way, the fact that you took these out whenever you did 10 years ago is probably
10:17part of the reason why it's been able to go back.
10:21Yeah.
10:22Is it okay if I come in and have a close-up look?
10:24Is that okay?
10:25Of course.
10:27What you can see here is obviously the hole of the, well, the hole.
10:33And this is nicely still intact.
10:35Because there is nothing holding this up, you've got a wee hangy-down bit.
10:40Okay, and then onto this side.
10:42So this one's a little bit sadder, isn't it?
10:45Definitely.
10:46Because although we've got this bridge intact, I think we need to regard it as not a particularly
10:52viable little bridge of tissue.
10:54Okay, well, it is fairly easy to fix this with a simple operation.
11:00And essentially what I do is I freshen up the whole wound itself and then join the edges
11:07back together.
11:08And I think the difference it will make for you, how you feel about yourself, I think
11:13it's really, really worth doing.
11:15That's incredible.
11:17That's really exciting.
11:18Should we just get on and get it done?
11:19I think so, yeah.
11:21Come with me.
11:25All right?
11:26Yeah.
11:26What should you say?
11:27I'm having it done.
11:28What?
11:29Today.
11:29Oh, yeah.
11:30Are you okay?
11:31Yes.
11:32Good.
11:32I'm not pleased.
11:41Can you wriggle your toes for me?
11:43I can.
11:43We scratched.
11:44Well done.
11:45Very good.
11:49Now, let's pop this little ear lobe in here.
11:53What kind of things are you thinking that you might do whenever you get your New Year lubes?
11:58Just wearing my hair up and not feel self-conscious about it.
12:05How was that?
12:06Did you feel anything sharp?
12:07No.
12:09No.
12:09So what we're doing is that we're just freeing up the edges of this and taking out essentially
12:14what is scar tissue.
12:17Boom.
12:18Done.
12:19We've got the little scar itself.
12:22So we're just going to pop a little couple of sutures in and then we'll move on to the other
12:26side.
12:27Wow.
12:27That's so quick.
12:28Yeah.
12:31So I'm creating a bump here in the skin as I'm closing it so that when it's fully healed there
12:36isn't a dip.
12:37So it will be flat.
12:44One done.
12:47Ear lobes are like operating on little slugs.
12:52Because they're so wiggly and the skin on them is so smooth.
12:58If you don't take this scar tissue out and freshen up the edges off it, you can't stitch it together.
13:04It would be like stitching two of your fingers together and expecting them to take.
13:09You have to open the skin and then it could be stitched together.
13:14So now we're going to bring this up a little bit more like so.
13:24The type of suture that I put in is something called a mattress suture.
13:28And it just helps the eversion of the skin.
13:31How long do they stay in for?
13:33A week.
13:34A week.
13:35Awesome.
13:35OK.
13:36Good.
13:36On the home straight now.
13:38This is the last stitch going in.
13:40Good.
13:40That's it all done.
13:42You want to have a look?
13:43Yeah.
13:43I will get the mirror and show you.
13:46OK.
13:47Here we go.
13:47You can take it and have a little look so you can see.
13:51Oh my goodness.
13:55OK.
13:58OK.
13:59My pleasure.
14:00It went really, really, really well.
14:02Yeah.
14:02And they all stitched back together beautifully.
14:05Yeah, it really is.
14:06OK.
14:07Yeah.
14:08Yeah.
14:09My pleasure.
14:12You know, she's been troubled with these really for such a long time and kind of blamed
14:15herself because of why she has them.
14:17So I was glad to be able to help her and, you know, hopefully she'll feel more comfortable
14:22with everything in the future.
14:25I've seen them.
14:26Yeah.
14:26They look amazing.
14:28They look, like, really good.
14:30I didn't think this was going to be possible.
14:32I feel like there's a whole other Lauren that's just, like, ready and waiting to get out
14:37there.
14:50I look like I've been in a fire.
14:52That's the only way I can describe it.
14:55I look like I've been burnt.
14:58The last four years have been very tough.
15:01To start with, after the few spots in the redness, it's sort of blistered.
15:10And then they would dry up and crack.
15:12And then they would just erupt, which was very painful.
15:18My skin felt like I was being eaten from the inside.
15:22I felt like I could rip my face off.
15:29At first, nobody knew what it was.
15:32They just kept telling me it was rare.
15:34Nobody seemed to be doing anything for me.
15:37And then I stopped going out because people were staring.
15:43My way of coping with it was to basically hide in the house I got to bed.
15:50Past that being beautiful now, I'm just an old hag.
15:54She tends to make like a joke about her face before anybody else does.
16:00To probably mask how she's really feeling.
16:02I don't really like looking at these.
16:05I used to think my skin was my best feature.
16:09I never look in the mirror because I just don't look like how I used to look.
16:23You all right?
16:24Mm-hmm.
16:25It's very itchy.
16:27Mm-hmm.
16:28I'm trying not to scratch it.
16:30Hello, is it Kate?
16:31Yes.
16:32Hi, nice to meet you, Kate.
16:33I'm Dr Emma.
16:34Do you want to come with me?
16:35Please.
16:36Are you going to come with us as well?
16:37I will.
16:38Yeah.
16:39Yes.
16:39The more the merrier.
16:40Not really.
16:42So tell me a little bit about what's been happening with your skin, Kate.
16:46It started off as blisters.
16:49There were like big puss jewels all over my face.
16:52And puss would come out of them.
16:54When did this all first start?
16:56Five or six years ago now.
16:58And then when I went to the doctors, they hadn't got a clue what it was.
17:03So I had another consultation with another doctor.
17:06And they discovered that it was necrobiotic xanthangrabulona.
17:11Mm-hmm.
17:12And how did they find that out from a biopsy?
17:15From your blood.
17:16Yeah.
17:16Are you getting any of the new blisters coming still?
17:19Or have the blisters essentially stopped?
17:21The blisters have stopped.
17:22Uh-huh.
17:22But the bumps have now, they've come up in lumps.
17:27Mm-hmm.
17:27And my eyebrows have gone missing.
17:30Mm-hmm.
17:30And I've got bumps all over my eyelids.
17:33And are they painful on the face?
17:35Oh, God, yeah.
17:37Yeah.
17:37Really painful and itchy.
17:38I've been on all sorts of medication and nothing's worked.
17:42And it's a bit soul-destroying.
17:45Tell me about that.
17:46We had one little boy on the train yesterday, didn't we?
17:49Mm.
17:49He went all the way down the aisle like that.
17:53Kept looking at me as he was getting off the train.
17:55Mm.
17:55So as well as how this on your face feels in terms of the itchiness and the pain, you also
18:02are really self-conscious about how it looks and appears to other people.
18:07Mm-hmm.
18:07Yeah.
18:07Yeah.
18:08So it's quite sad.
18:11Okay, I really want to get in and have a good close-up look at this now.
18:14I think that's going to be the most important thing to do.
18:15That would be wonderful.
18:16Is that okay?
18:16Yeah.
18:20Okay.
18:21Okey-dokey.
18:22Right, thanks.
18:24You can feel it's much thicker on this plaque.
18:28And then we've got all of this yellow colour.
18:31And you've got this redness associated with it.
18:34And then you've got scars.
18:36That's why it's destroyed those hair follicles.
18:39And unfortunately, that's why it's taken your eyebrows with it.
18:43I'd like some definition back on my face.
18:47Yeah.
18:48Okay, right.
18:48I agree with this diagnosis of Necrobiotic Xanthogranuloma.
18:53How have they explained to you what is going on?
18:57Nothing.
18:58Because it's a very rare condition.
19:00It isn't really a skin disease as such.
19:04It's really more from the blood and how the blood cells work
19:08and how they behave in the body.
19:10And that's what the problem is.
19:11Unless it's slowed down at least,
19:14then what will happen is it might progress on the skin
19:18or it might progress inside, in your bones or your kidneys,
19:22and they can't work properly.
19:24And that's why it's very important that, yes,
19:27if one medicine hasn't worked,
19:28then it's so important to get on to the next
19:30to see if that one will help.
19:32The next thing is then, what can we do to make it feel more comfortable?
19:36And what can we do to make it look better for you?
19:39Well, we know that there's some topical agents that we can use to help with the itch.
19:44And I'll prescribe you those today.
19:47The next thing is to think about where these little bumps are sticking out.
19:52They're actually very easy for me just to remove for you.
19:55This one here, I think I might take that off for you today.
19:59Because I can see that you obviously, when you look up, you can see it dangling over your eye.
20:03And then what would be really helpful is if you see one of my colleagues
20:07who's a specialist in medical tattooing.
20:09And I can treat the redness with a laser.
20:11How does that sound?
20:14Brilliant.
20:16Finally.
20:19Finally, something been clarified.
20:22It gives you some hope as well, doesn't it?
20:24Yeah.
20:25That actually something can be done to make Kate look and feel a bit more normal.
20:35See you in a minute then.
20:36OK, OK.
20:44You did great there.
20:46Well done indeed.
20:47Good job.
20:49Very good.
20:51Can you tell me if anything feels sharp or sore?
20:54You have started, haven't you?
20:56I have indeed.
20:57Yeah.
20:57No, it's fine.
21:16Good.
21:17Already that's better.
21:19You'll be sent a little kind of box with all nice creams in it for your face to help
21:24it start to feel a bit more comfortable for you.
21:26Yeah, fab.
21:27Good.
21:28And then we'll want to try the lasers with them as well.
21:30Fabulous.
21:31It's been really nice to meet you.
21:33And you.
21:33And I look forward to being able to help you get your skin a bit more comfortable for
21:37you.
21:38I'm so pleased I came today.
21:41Anything to make an improvement.
21:55It's seven weeks since Sean came to see me with his very rare condition called erythromyalgia.
22:01I want to use some Botox injections in his hands because we know that this can give a good effect
22:06in some people.
22:07When I examined him I also discovered that he had another much more common condition causing
22:13the redness on his face.
22:15He's already had one laser treatment and he's back today so I can do another.
22:20How are your hands feeling now?
22:22It's a little bit warm in here so it's kind of painful but not too bad.
22:28Last time I saw Dr. Emma I was getting laser treatment on my face.
22:30I think the overall redness definitely is like less.
22:34So I'm overwhelmingly like happy with how it's going.
22:39Okay.
22:39Come on in Sean.
22:40You remember Motti from before?
22:42Yeah.
22:42Hi.
22:43So what we'll do is I'm going to put the goggles on your eyes and then we will put the
22:47gel
22:48on and then we will do the treatment.
22:50Okay.
22:55Okay Sean I'm just going to do this at the very bottom again like we did before.
22:59Okay.
22:59To the bottom of the cheek.
23:00And you'll feel a one, two, three.
23:03One, two, three.
23:04I'm just going to go on the chin.
23:07Well done.
23:08Well done.
23:09I'm just going to go on the tip of that nose for you.
23:12Well done.
23:12Very good.
23:13All done.
23:13Okay nice.
23:16Okay so we put this cream on to make the hand feel a bit numb where we're going to do
23:21a little bit of the Botox treatment.
23:23Botox has got a number of different functions in how it works and in this case we're doing it really
23:28to help out with the pain that you get with this and the second reason we're doing it is to
23:32help with the great redness that occurs.
23:34It's got more needles out if you need it.
23:37You've done 1.25 in here.
23:38Yeah.
23:38Yeah.
23:39So what we're going to do is you're going to feel a tiny wee scratch, wee tiny scratch.
23:43Well done.
23:44Very good.
23:44And a wee tiny push.
23:46Super.
23:46How was that?
23:47Is it ow?
23:48Yeah.
23:49I didn't feel anything.
23:50Yay!
23:52We're just going to do it in the one hand to begin with and then it's a really good test
23:57because you can see whether this has been effective for you.
24:03There we go.
24:03All done.
24:04How long will the effects last?
24:06Well you're not going to notice anything at all really for maybe about the first four or five days.
24:11And then if this is going to make a difference the effect typically lasts for about four months.
24:21Let's see your facial.
24:23That looks great.
24:24Does it?
24:24Yeah it does.
24:25It really does.
24:26I can really tell.
24:26Like two years ago in this environment my face would be bright red.
24:30Yeah.
24:31In the next couple of weeks I'm going to be taking pictures for Dr. Emma with my hand, keeping her
24:36updated on how the Botox affects it.
24:39And depending on how that goes that will decide what is next for my treatment.
24:44Doors closing. Please mind the doors.
24:49The creams have been much appreciated. I'm not scratching my face all the time now.
24:55I apply just two little bits of moisturizer and have it on my face all over.
25:06Ah, that is so, so good. So nice. And makes me feel better.
25:21The blood condition that Kate has has caused a lot of changes and symptoms in her face.
25:26I've used some creams to calm down the itchiness but also she's troubled by how this looks.
25:33So we're using the laser today to calm down the redness in the area and then another laser to get
25:39rid of some of those lumps and bumps.
25:45Well done. Look at that. Not even a flinch.
25:49I thought we might as well do that once. That's been itchy and horrible for you.
26:05They don't look nice at all.
26:08As I've got older and I'm in my sort of mid-50s now, they seem to have grown considerably.
26:16Are you nervous now, cos? No.
26:18The doors closing. Please mind the doors.
26:21The skin condition that Mark has has become more prolific over time.
26:25They've just multiplied and multiplied.
26:27Hi, I'm Mark. I'm here to see you, Dr. Emma.
26:29Great, thanks. OK, thank you.
26:31It makes me upset for Mark that he's feeling a bit dejected, really, by these things that he has.
26:42It'd be nice to eventually get these done and out of the way. Hopefully she can sort them out today.
26:48Well, you're here, aren't you? And there's only Dr. Emma that can tell you what she can do, so...
26:52Hopefully. Hopefully I'll get it sorted.
26:55Hello, Mark. Hi. Hi, nice to meet you. I'm Dr. Emma. Do you want to come with me?
26:59Yeah, brilliant. Thank you. Come on down.
27:03Cheers. Come and have a seat. Thanks.
27:07So, tell me what you've come to see me about in the clinic today.
27:11I've had skin tags in various places, mainly under my arms.
27:15I had only had half a dozen, and the doctor got rid of them about 20 years ago,
27:20and then slowly they came back.
27:22But now it's got to the point, like, I've got 40-odd under each arm,
27:25and I'm thinking, do you know what, I need to do something about this, cos I go on holiday,
27:30I can't lay out in the sun with my shirt off, because I'm thinking,
27:33what will other people think when they see these? They must think, oh, my God, they look horrible.
27:37Do you find them painful at all? No.
27:40Generally now, there's no pain there.
27:42The only time I get bothered is when I've caught one, and it's bled for ages.
27:46Yeah. They all have a little artery that goes up and down into them.
27:49Yeah, and I think at one time I caught one of the larger ones, and that was a good ten
27:52minutes before,
27:53and I'm thinking, oh, what am I going to do?
27:55Yeah. And sometimes the development of skin tags tend to occur because of some inside problems that we can have,
28:03and one of them is something called type 2 diabetes. Are you somebody who has type 2 diabetes?
28:08I am type 2 diabetes, yeah.
28:10You've got type 2 diabetes? Yeah, type metformin.
28:13Okay. And how long have you had that for?
28:15About four or five months now.
28:17Okay.
28:18I didn't realise it was related to diabetes.
28:20Yes, it is. And actually, probably you would have been in a pre-diabetic state for those many years beforehand,
28:27whenever these were just all starting to develop.
28:30Can I have a look at them?
28:32Yeah, sure.
28:37Most of them.
28:38Oh, yeah.
28:39They're like little jewels hanging there, aren't they?
28:41I know, I know.
28:42They're particularly big, that one.
28:43Yeah.
28:44And then, actually, also the other thing that you've got is this velvety look to the axilla,
28:50which is this condition called acanthosis nigricans, which is a thickening of the skin,
28:55which is a condition that actually is related to the high insulin levels and the diabetes.
29:00All right.
29:01Let's have a look at this side.
29:03And you've got this skin thickening, and then you've got this little cluster.
29:07This is quite a funny one.
29:08It's like a little finger pointing at me.
29:11Let me have a look at the ones on your neck.
29:13Yeah, because you've got them on your neck, too.
29:16So, undoubtedly, these are skin tags.
29:19And probably, in your case, they're being caused by the kind of growth effect that insulin has on the body,
29:26because your body's making too much insulin, which is why you're then on the metformin.
29:29And that's what's driving this.
29:31But now you're on the metformin.
29:33I would like to think that the rate of developing these and the growth is actually going to settle down.
29:37But it doesn't get rid of the ones that are there.
29:40There's lots of different ways to get rid of the ones that are there.
29:43But really, the most effective way, probably, is to snip them off.
29:47Are you up for doing that?
29:48Yeah.
29:48OK, I'll go get the room set up.
29:51Brilliant. Thanks.
30:00We scratch.
30:05There.
30:06This one here is a big, long one, isn't it?
30:08Oh, the biggest one.
30:09Yeah.
30:10Yeah.
30:12There you go.
30:13All done.
30:15If your arms get tired sitting up like that, just let us know, OK?
30:19That's OK.
30:21So we're doing what's called snip excisions because they're quite dangly, these ones.
30:28And you're really trying to kill off the little vessel that's in here to stop it growing.
30:35Did you feel anything?
30:36No.
30:36Well, that's it gone.
30:37That's one.
30:39So what we're going to do is just work around these on this side and then Rosie is going to
30:47use the hyphricator to seal off any of the ones that are a little bit oozy.
30:52What's hyphricator then?
30:54So a hyphricator is what we use to seal off any blood vessels.
30:58Now, these are all very, very tiny, these little blood vessels in here.
31:02But as you said, they can still make a right little mess, but it's not bleeding that much here because
31:09there's adrenaline in the anesthetic agent I used.
31:13And adrenaline shrivels up the blood vessels.
31:16And like anything in our body, it's hormones that control the rate at which things grow.
31:23And in diabetes, insulin is a hormone that is responsible for growth.
31:31Is there a reason why they're particularly b-line for my armpits?
31:35It's because the skin is in folds there and it rubs.
31:39Right.
31:39And rubbing as well is actually a stimulant for growth.
31:44Right.
31:51Are you burning them now?
31:54That would be me.
31:55I can smell some burning now.
32:01Now, I'm just going to do this side.
32:04Here we go.
32:10Is that all okay?
32:12Yeah.
32:15Now that you're all smooth as a baby's bottom in here.
32:18Wow.
32:20Okey-dokey, you can put this arm down now and give it a wee rest.
32:22Okay.
32:23So, Mark, if you want, you can hold the mirror with this hand and have a little look.
32:27So you can see all these tiny little dots.
32:30They're slight little grazers.
32:32They'll all be healed up in about seven days' time.
32:35But that's got rid of all of them for you.
32:37Sorry.
32:40Wow.
32:41Essentially, they're all going to just be like that, completely flat.
32:43Here we go.
32:45Thank you very much.
32:46Oh, pleasure.
32:48Removing skin tags is always such a satisfying thing to do.
32:52You know, you start off with this very bumpy, irregular skin with bits and pieces hanging off it.
32:57And, you know, with a few snips and a little bit of clottery, it can end up being very smooth.
33:03And it just makes a big difference then for people going forward.
33:07They don't have this hanging around them.
33:10Did you have it?
33:11Yeah, all sorted.
33:12Oh, really?
33:13Yeah.
33:13They've literally took 80 skin tags off.
33:1680?
33:17Yeah.
33:18Oh, I'm really happy for you.
33:19That's great news.
33:20So, yeah, they're all gone.
33:21Yeah, yeah.
33:21Oh, good, Mark.
33:22It's really good.
33:34Fancy you getting a tattoo?
33:37I'm going to get your name.
33:40Hopefully, the eyebrow tattoos will hide the scarring on my eyes to make me look a little bit more normal.
33:48So, after today, I might look like a different woman.
33:52That would be nice.
33:54So, Dr Emma's referred Kate to me because she's lost her eyebrows through her skin condition that she's got.
34:01I'm really, really looking forward to this.
34:04Right, let's get started.
34:06Let me have a little look, so just relax for me.
34:10Did you have quite thick eyebrows before?
34:12Not really.
34:13No, I would have as thick as yours.
34:14I'm going to use calipers and measure exactly where they should be according to your face.
34:21Just from the corner of the eye.
34:23I'm just going to measure against from the corner of the eye.
34:25Close your eyes with me, please.
34:27That's it.
34:28I'm just going to rest this against your nose.
34:32And this is going to determine where the arch point should be.
34:37Yeah.
34:38Now I'm just going to tailor make them more into the shape of your face.
34:43Now you've got different styles of fronts of eyebrows.
34:47I recommend for yourself going for a sloped eyebrow.
34:51It's actually what I've got.
34:52What, the same?
34:52Exactly.
34:53Exactly.
34:54Because I reckon that my eyes would be about the same pattern.
34:58Yeah, I agree.
34:59OK, let me get you a mirror.
35:04OK, you ready?
35:04OK.
35:05So this is just, this is the shaping.
35:08So inside of that, I'm going to be doing little tiny individual hairs.
35:13The products that we're going to be using are pigments rather than ink.
35:17They will be darker today.
35:18Yeah, right.
35:19That is going to lighten by up to 80% within a week.
35:23Right.
35:24I'm fine.
35:28Right, I'm going to do one tiny little bit going into the skin.
35:32Just coming towards you now.
35:34This is done with a digital machine.
35:37Now the machine has four needles and they're in a straight line so it helps me for doing little individual
35:43hairs.
35:48Nice and still for me.
35:54Almost there.
35:55Just a couple more hairs.
36:00Right, now for the other side.
36:05How's that feeling?
36:06Fine.
36:07Oh, good.
36:08It's not even tickling.
36:10Well, I think you've done incredibly well.
36:12Oh, good.
36:13Do I get a lollipop?
36:14A darn good set of eyebrows, that's what you get.
36:16Oh, cheers.
36:17That's wonderful.
36:18You're so welcome.
36:23Oh!
36:25Oh, wow!
36:28Can I touch them?
36:31Oh!
36:32They look like eyebrows, don't they?
36:34Yeah.
36:35They look fab.
36:35They look like hairs.
36:36I'm so, so...
36:38Oh, they are, they're great.
36:39Good.
36:40I could crush a grape.
36:41Yeah.
36:42Probably want to go out now tonight, don't you again?
36:44I'm too tired to go on the razz.
36:47LAUGHTER
36:55So, how was little Rory's play then?
36:57He was so disinterested in the entire thing until it got to the bit where they had to, you
37:03know, attack and fight the dragon.
37:05Yeah.
37:05And they all had their swords, were fighting, and Rory's like out with a machine gun.
37:08They were like, brrr!
37:11Don't even want to do.
37:13Such a boy.
37:20So far, the changes have been pretty significant.
37:25The ways that I used to have to manage my condition,
37:28like the fan, like the UV umbrella,
37:31I don't really have to do those as much anymore
37:34because my condition is just so much better.
37:37The base level of pain that I feel the majority of the time,
37:40it's quite low now.
37:41The swelling of the hands have reduced significantly.
37:44It's way less red and also way less dry.
37:47The colour of my face used to be way more red than this,
37:50but now it's a lot more pale a lot of the time.
37:54Sean?
37:55Yep.
37:55Turn one burger, put some cheese on.
37:58OK, that's smart.
38:00It's really fantastic to see Sean's confidence coming back.
38:05Sean went out to the cinema with his friends last week.
38:08In the past, he wouldn't have done that.
38:10Give me the bun.
38:11Aren't you good serving everybody?
38:13I can be more social because I'm not having to worry about the pain.
38:16I'm able to just focus on the actual situation.
38:20I'm definitely happier because of how much the quality of my life
38:24has improved.
38:25I know that I'll always have the reuter millage here,
38:28but I feel more hopeful.
38:31What I really want to do is make a career in art and draw,
38:34and it just feels like I can do it now.
38:38It's a big relief.
38:56I wonder what Dr. Emma will think when she sees her new eyebrows.
39:01I think she'll think they're absolutely smashing.
39:06Hi, Kate.
39:08Hiya.
39:08Hi.
39:09Are you coming through?
39:10You're looking very sea-lined today.
39:13This is the Bette Lynch look.
39:15I love it.
39:16I do too.
39:17That's it.
39:18Sashay on down.
39:20We'll be your backup.
39:25Come and have a seat.
39:26Thank you very much.
39:29Well, Kate, you're looking fabulous.
39:32I know.
39:33I mean, it's not but even just how you're looking.
39:36Your whole attitude is different to the first time that we met each other.
39:40Oh, God, yes.
39:40So what do you think now about whenever you do look in the mirror?
39:44Because you wouldn't have looked in the mirror before.
39:45I look at my eyebrows.
39:47Yeah.
39:48A lot.
39:49Don't I?
39:50And you felt pretty sad that you'd lost yours because of the disease.
39:55I had no...
39:56My features had got lost.
39:58You had these bright yellow plaques here.
40:02Before, it was like sandpaper.
40:04It was really horrible and coarse.
40:06It looks nice and smooth around here.
40:09Yeah.
40:09Also, it was sore.
40:10You didn't even want to touch the skin off your face,
40:12let alone have your sister stroke your cheek.
40:14Yes.
40:15What's happened in the skin is due to what's happening in the blood.
40:19And we can go some way to smooth things,
40:21make it a little bit less red, get the eyebrows back,
40:24give you your joy back.
40:26Yeah.
40:27But the underlying blood also just needs to get the right kind of treatment
40:33to stop it progressing or coming back.
40:36Mm-hmm.
40:36So, in terms so far of the treatment that's happened,
40:40actually understanding a bit more about what's driving it on the inside,
40:43how do you feel where you are now compared to when we just met a couple of months ago, actually?
40:49I feel fantastic.
40:51I'm over the moon with what you've done.
40:54Well, I'm so pleased with where you are.
40:56You're a very different person.
40:58I mean, it's really lovely to see.
41:01This is one journey that's been absolutely amazing.
41:06I'm back to my normal self now, and I'm thrilled.
41:30I'm back to my normal self now, and I'm thrilled.
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