Become a patient

In Australia, most specialists (including dermatologists at The Skin Hospital) require a referral from a General Practitioner (GP). Your GP will assess your skin concern and, if specialist care is needed, write a referral addressed to The Skin Hospital or to a specific dermatologist with us.

If you’re already under the care of another specialist (e.g., oncologist, rheumatologist, plastic surgeon), they can also refer you directly to The Skin Hospital.

Make sure your referral is:

• Current (usually valid for 12 months from a GP, 3 months from another specialist).
• Detailed (including your medical history, test results, previous treatments, and the specific concern).

Your GP or specialist can send it directly to The Skin Hospital (via secure fax, email, or electronic referral system).

Consultation fees may vary – please speak to our team at the time of booking for the fees charged by your dermatologist.

With a valid referral, Medicare may cover a portion of your consultation, however as a specialist medical facility we do not bulk bill for consultations.

If you are required to have surgery at The Skin Hospital, the procedure, fees and expected outcomes will be discussed during your consultation with your doctor. The doctor will also provide the date and time of your surgery.

Prior to the surgery, you may be contacted by the Day Surgery Coordinator Nurse, who will advise you of any pre-operative preparation plans, discharge plans, community services that you may require after discharge and your follow up appointments.

To ensure that your visit with us goes smoothly we would ask that you read through the Day Surgery pages thoroughly as it provides essential information for your surgery.

Mohs Procedures

In regards to Mohs procedure, the removal of each layer of tissue takes approximately 1-2 hours. Only 20-30 minutes of that time is spent in the actual surgical procedure; the remaining time is needed for slide preparation and for the doctor to review the slides.

On average, 2-3 layers of tissue (called stages) will be removed prior to clearance of the cancer. The whole process, including suturing the wound, usually takes between 4-6 hours. Some difficult or larger cases may take even longer. This may result in you needing to stay for the whole day.

All other procedures

Your doctor will indicate the estimated duration of your specific surgery during your consultation.

Day surgery patients may receive two accounts; the day surgery facility fee and doctors account will be generated by The Skin Hospital and is payable on admission when the item numbers have been confirmed by your doctor. Your doctor will have discussed their fees with you during your consultation. You will be entitled to a small rebate from Medicare.

If you belong to a private health fund the day surgery account will be sent directly to your health fund (with a completed claim form) and you will be required to pay any policy excess on admission. A member of the reception staff will advise you how much your policy excess is approximately one week prior to surgery. Some doctors charge a known gap for their fees. Ask at reception to find out if this is applicable to your doctor.

EFTPOS, credit cards (except Diners and American Express) and BPAY  are acceptable forms of payment. Please note that The Skin Hospital does not accept cash payments.

If you are having a procedure other than Mohs procedure and a specimen is sent to pathology, a separate account will be sent from the Pathology Department. Usually there is no pathology account for Mohs procedure.

• Please ensure you have completed all your pre-admission paperwork.
• The best preparation for surgery is a good nights sleep, followed by a substantial breakfast. However, if you are having a general anaesthetic you will be required to have no food or drink from the time specified by The Skin Hospital preadmission nurse.
• To reduce the chances of infection, shower and wash your hair the night before or the morning of your surgery. Sleep in fresh night-wear and clean bed linen. Some patients may be asked to use special solution to wash their body or hair prior to the surgery.
• Do not wear make-up, hair spray, body lotion or perfume on the day of your surgery.
• Do not stop taking any of your prescription medication unless instructed by your surgeon.
• Discontinue vitamin and mineral therapy for at least two weeks prior to the surgery to reduce the risk of heavy bleeding during and post surgery eg. Fish Oil, Krill, Vitamin E, Ginko, Garlic & Ginger tablets.
• Leave anything of value, such as jewellery, at home. We cannot accept responsibility for the loss of valuables or money.
• Wear comfortable, loose-fitting clothes, such as a tracksuit, pants, a cardigan, a short-sleeved shirt or blouse. An old button up shirt is preferable. It is wise to bring a book or magazine to read.
• At home, please have Panadol or Panadeine for pain relief, and an ice-pack or pack of frozen peas to use to reduce bruising / swelling / bleeding. Be aware that Panadeine requires a script from your doctor or GP.
• Please arrange for a relative or friend to accompany you home, either by private transport or taxi. You must not go home on public transport or drive following your surgery. It is most important that you do not go home alone and that you have company / assistance overnight. If you decide to go home alone you will be required to sign a release form before surgery so you are aware you are taking on this responsibility for yourself

Medication

• Please bring with you any medications you need to take during your stay.
• If you are a diabetic requiring regular blood glucose levels recorded please bring in your own monitor to ensure currency of readings throughout the procedure.

Interpreter Service

If the services of an interpreter are required, please contact us prior to your admission, so the necessary arrangements can be made. There may be a cost associated with this service.

You will be asked to arrive 30 minutes before your operation so please arrive ahead of the arranged time. It is important to be punctual to avoid delays. Please note that although very rare, the doctor could be delayed in surgery and there may be some waiting period before your procedure.

After arriving at The Skin Hospital, please proceed to reception and register. The reception staff will then show you to the waiting area.

What to bring:

• A list of your current prescribed medication
• Medicare card and/or DVA card
• Health Fund card
• Credit card, EFTPOS card, bank cheque or cash for payment
• Your eye glasses and case. If you wear contact lenses, you will not be able to wear them during the procedure, please bring your lens case for storage.
• Dentures, hearing aids and the containers to store them.
• Any mobility aids, such as walking sticks, or walking frames.

Our staff will advise you on your estimated discharge time. Please arrange for a relative or friend to accompany you either by private transport or taxi.

You must not go home on public transport or drive following your surgery. It is also important that you do not go home alone and that you have the assistance of a responsible adult overnight.

For your comfort:

• We have a designated recovery area for our patients where there are reclining lounge chairs, magazines and television as well as some light refreshments (tea, coffee, biscuits).
• Mobile phones are not permitted in the operating theatre
• As legislated by NSW Health, smoking is prohibited in all areas within the day surgery. This includes all entrances and external areas.

Once you arrive home:

• You should rest for at least 12-24 hours.
• Do not drive a motor vehicle for 24 hours after surgery.
• Avoid operating complex or dangerous machinery, or doing anything that requires you to be alert and coordinated for 24 hours after surgery.
• A nurse will contact you the next day to check on your progress.
• Contact your doctor if you have any concerns.

After surgery you will be left with a surgical wound. This wound will have been repaired in one of the following ways:

• Healing by spontaneous granulation i.e. allowing the wound to heal itself; this takes about 4-8 weeks and requires daily dressing changes.
• Primary closure with stitches that remain in place for approximately 5-14 days.
• Other skin closures, such as a skin graft, skin flaps, or reconstructive procedures.
• Referral and reconstructive surgery by a plastic or oculoplastic surgeon.

All surgery carries risks and complications .These may include bruising, swelling, bleeding, infection, numbness, scarring, and skin tightening or stretching. Most of these problems will resolve with time, however you will always be left with a scar.

Swelling and bruising are very common, especially when surgery is performed around the eyes and nose. Swelling can be alleviated by keeping your head elevated for the first 48 hours and by using ice-packs regularly for the first 24 hours following surgery. If redness and pain don’t subside within two days, or if the wound begins to drain or discharge, you may have an infection and you should contact your doctor or The Skin Hospital.

Nerve damage can occur, however it is usually temporary. It can be permanent if the cancer is extensive and the nerve is involved. Scarring from the surgery usually settles well. Flaps and grafts take time to heal and improve significantly within 3–6 months. Sometimes the extent of skin cancer and the complexity of the wound may require a larger reconstruction that may result in a more obvious scar.

Your post-operative care will be thoroughly explained to you by a nurse and you will also be given written instructions.

Pain

You will feel some discomfort after your surgery. We request that instead of taking aspirin or disprin, use Panadol or Panadeine for pain relief.

Bleeding

This occurs occasionally following surgery. If this should happen, the bleeding can be controlled by the use of pressure. Leave the dressing in place and apply pressure with a gauze or similar pad. You may support yourself against a couple of pillows in a semi-upright position and apply constant pressure over the bleeding site for 20 minutes.

Swelling

This is common around the surgical site. It can be minimised by applying ice packs (or frozen peas) on the area for 10 minutes, every hour for up to 24 hours after surgery.

Wound Care

You will be given instructions on how to care for your wound after your surgery and arrangements will also be made for your sutures to be removed. Some patients will be asked to return to the Skin Hospital the day after surgery to have their wound checked.

Sporting Activities / Travel

Do not make arrangements for sporting activities or travel after your surgery as you will need to rest for at least one week to prevent post-operative complications. We also advise that you do not undertake strenuous exercise for at least one week or more after your sutures have been removed.

Hygiene

By practising good hygiene, you can reduce the risk of getting sick or passing infections on to others in the day surgery.

What can you do to reduce the spread of germs?

• Wash your hands often:
  • when they are dirty
  • after sneezing or coughing
  • before and after handling food
  • after going to the toilet
  • after touching commonly used items
• Wipe down all frequently touched surfaces regularly as some germs can live on surfaces for several days.
• Cover your mouth and nose for coughs and sneezes as infectious droplets can remain in the air for some time.
• Discard used tissues immediately, and then wash your hands.

Preventing falls

After your procedure, you may be more susceptible to falls. To reduce your risk of falling:

• Ask about the likelihood of falling and your risk factors
• Know what assistance you require and follow the instructions of the nurse. If you have been requested to get help, ring the nurse bell before moving about.
• Stand up slowly after lying down or sitting. Sit on the side of the bed for a few minutes before getting up to prevent dizziness. Take care when bending down, bend at knees only and steady yourself before walking.
• Wear comfortable, fitting, flat shoes that grip -don’t walk around in socks or ill-fitting slippers.
• Use handrails, if available
• Do not leave clothes or bags on the floor.
• Bring walking aids with you.

Above all, be sensible and recognise your limitations while in hospital. Do things safely by following the nurses’ instructions.

Preventing Pressure Injuries

Pressure injuries are caused by unrelieved pressure that damages the skin and underlying tissue. People unable to move after surgery may get pressure injuries even after as little as 1-2 hours.

• Inspect your skin at least once a day for a break in the skin
• Pay special attention to reddened areas on the skin that remain after you have changed positions.
• Change positions regularly – every two hours while in a bed and every hour while in a chair.
• Avoid contact with plastic surfaces such as plastic chairs.
• Avoid direct contact between bony prominences, use cushions.
• Avoid overheating your body.
• Use/wear pads or briefs that have a quick drying surface, or creams and ointments to protect the skin from moisture exposure.
• Use warm (not hot) water and mild soap when bathing/showering.
• Treat dry or flaky skin using barrier creams or oils.
• Eat a well-balanced diet – protein and calories are very important.
• Drink plenty of water.

The Skin Hospital follows the guidelines outlined in the National Safety and Quality Health Standards. One of those standards is preventing and controlling healthcare associated infections. The Skin Hospital follows the guidelines to restrict the needless use of antibiotics in all its surgical cases.

Don’t be surprised if you do not receive routine antibiotics before or after your surgery. It is recognised that there is a group of patients who, due to their current illness or health status, may need antibiotics. Patients will be treated accordingly. It is important to know that the Standard is aimed at limiting antimicrobial therapy – not to deny therapy.