An Ultimate Guide to Medical and Medical Aesthetic Treatments

Medical Indications

Excessive Sweating (Hyperhidrosis)

Hyperhidrosis is sweating well beyond what the body needs to regulate its temperature. It is a recognised medical condition, not a matter of personal hygiene, and it can be disabling. We assess and manage focal hyperhidrosis affecting the underarms, hands, feet, face, head, and sweating that has followed surgery or another medical cause. We take a full history to establish the pattern, duration and triggers of the sweating, and to identify whether it is primary or has an underlying cause. We examine the affected areas, we check for causes that need investigating or treating in their own right — thyroid disorders, infection, medication effects, the menopause and others — and we may ask you to have blood tests.

Headache disorders

Chronic migraine (headache on fifteen or more days each month, of which eight or more are migrainous — one-sided, throbbing, worsened by ordinary activity, and accompanied by nausea, vomiting or sensitivity to light and sound.)

Chronic tension-type headache  (frequent headache felt as pressing or tightening on both sides, without the throbbing quality or the nausea of migraine, often with tenderness of the muscles around the scalp and neck.)

Jaw, face and mouth

Sleep bruxism or night-time grinding: grinding noticed by a partner, jaw stiffness and ache for hours after waking, headache at the temples in the morning, ear pain, and worn, cracked or repeatedly failing teeth and fillings. Common impact includes difficulty eating in the mornings, disturbed sleep for you and your partner, and repeated dental repairs.

Temporomandibular disorder  (myofascial type): persistent pain in front of the ear and over the cheek, worse on chewing and speaking, with restricted mouth opening and sometimes clicking. Common impact includes a soft or liquid diet, weight loss, and difficulty speaking for any length of time.

Trigeminal neuralgia: sudden, severe, electric-shock-like pain on one side of the face lasting seconds to two minutes, triggered by light touch, washing, shaving, chewing or cold air. Common impact can include avoiding eating and washing, disrupted sleep, and withdrawal from work and social contact.

Neck and shoulder

Persistent acute torticollisor wry neck: sudden severe one-sided neck pain with the head held in a fixed abnormal position and movement severely restricted, which has then failed to settle in the usual timeframe. Common impact can include inability to drive or turn the head to check blind spots, inability to work, sleep disturbed by pain, and needing help with everyday tasks.

Myofascial pain of the neck and upper back: persistent aching across the upper trapezius and the muscles beside the spine, with tender knots in the muscle that reproduce a familiar pattern of pain referred into the head or shoulder. Common impact can include inability to sustain screen work or work above shoulder height, disturbed sleep, and difficulty carrying or lifting.

Skin

We assess and manage persistent infection within skin folds where standard treatment has not cleared it: persistent intertrigo. Symptoms can be soreness, burning, itching, moisture and odour within a deep skin fold, with the skin surface breaking down and the problem returning each time it is treated. Common impact can include pain on speaking, smiling or moving the face, disturbed sleep, and avoiding work and social contact because of the odour.

Arrange a clinical assessment

If you recognise your symptoms on this page, book a consultation with one of our doctors or nurses at Rayleigh or Holborn. We will assess you properly and tell you honestly what we think.

What happens at your appointment

Full history — We ask how long you have had the problem, how it affects your work and daily life, what you have already tried, and your general medical, medication and allergy history.

2. Examination — We examine you properly and, where it helps, we measure and photograph what we find so that there is an objective baseline.

3. Investigation where needed — Blood tests, swabs, imaging or a diary to complete at home. Sometimes we ask you to come back once we have those results.

4. Diagnosis — We tell you what we think is wrong, and what we have ruled out. If we do not think you have a condition we can treat, we will say so.

5. Discussion of options — We explain what treatments are appropriate for your diagnosis, what each involves, the risks and side effects, what to expect and when, and what the alternatives are — including doing nothing.

6. Treatment and review — If you decide to go ahead and treatment is clinically appropriate, we treat you and arrange a review to measure whether it has worked. If it has not, we say so and reconsider.

When to seek urgent help instead

Please contact NHS 111, your GP urgently, or attend an emergency department rather than booking with us if you have:

• a sudden, severe headache that reaches maximum intensity within seconds

• a headache with fever, neck stiffness, a rash, confusion, or a first seizure

• new weakness, numbness, difficulty speaking, or loss of vision

• neck pain following a significant injury, or with fever or unexplained weight loss

• spreading skin infection with fever or feeling generally unwell

• any sudden change in a long-standing symptom pattern