Paediatric dermatology · HappyDERM Wrocław and Nysa
Paediatric dermatologist Wrocław
We see children and teenagers, without a referral, at the clinic at ul. Barlickiego 31/1u in Wrocław and in Nysa. Most often they come to us with atopic dermatitis, a rash that will not clear, warts, impetigo, and teenagers with acne. The visit lasts as long as the child needs to settle and the parent needs to leave with a plan that can be followed at home and at nursery.
Why parents come to us most often
A rash in a child rarely looks like the picture found online. The same disease affects the cheeks in a baby, the elbow creases in a pre-schooler and the hands and neck in a teenager. So instead of guessing, we examine the whole skin, ask how long the lesions have been there, whether they itch, what has already been applied and whether anyone else at home has similar symptoms. Below are the problems we deal with every week.
Atopic dermatitis
We check how active the lesions are, whether the child sleeps through the night and whether the skin is not secondarily infected. We set out the treatment of a flare-up and, separately, daily skincare, because these are two different things.
Rashes and urticaria
What matters is how long a single weal lasts, whether there was a fever, a new medicine or an infection. A photo taken at the worst moment is often more valuable than a description.
Impetigo
Honey-coloured crusts around the nose and mouth that spread across the face within days. We treat it and explain how to avoid infecting siblings: a separate towel, short nails, washing pillowcases.
Viral warts and molluscum contagiosum
In children we do not freeze everything straight away. A single wart on the foot and twenty molluscum lesions on the trunk call for different decisions, and sometimes the best one is to wait.
Teenage acne
The earlier we start, the fewer scars. We match the treatment to the severity of the lesions and to how many steps the teenager will really take in the morning before school.
Scaling, cradle cap, hair loss
We examine the scalp, not just the hair. A round patch of thinning in a pre-schooler is often a fungal infection, which must be confirmed before treatment begins.
Nails
A thickened, yellow nail in a child is rarely a fungal infection. More often it is an injury, psoriasis or the result of nail biting. Testing before treatment saves months of unnecessary ointments.
Pigmented lesions
A new, growing or bleeding mole is examined with a dermatoscope. Congenital naevi are described and we agree how often to check them.
What a child’s visit at HappyDERM looks like
The parent tells the story, but it is the child who will be examined, so we speak to the child, not over their head. We show a three-year-old the dermatoscope and let them look inside; we ask a teenager about things they may not want to discuss in front of a parent. We do not promise that “nothing will be done”, because that promise cannot always be kept. We promise that we will not do anything without saying so first.
1. Medical history
How long the lesions have been there, how they have changed, whether they itch, what has been used and with what result, whether there is atopic dermatitis, asthma or hay fever in the family, whether anyone at home has the same.
2. Examination
We examine the whole skin, including under the nappy and on the scalp, because that is where children most often have lesions the parent does not know about. Where needed, a dermatoscope or a sample of scales for testing.
3. Conversation
We say what it most likely is, what to expect and how to recognise that something is going wrong. If an allergist or a paediatrician is needed, we say so plainly.
4. A plan on paper
You receive the recommendations written out: the product, the area, the time of day, for how many days. We agree when the follow-up will be and whether it can be online.
What the parent leaves with
- the name of the most likely diagnosis,
- the order of application when there is more than one product,
- what to do when it improves and what to do when it gets worse,
- the date of the follow-up and the signs that mean not waiting for it.
What helps a small child
Tell the child before the visit that the doctor will look at their skin and may shine a little light on it. Bring a favourite toy or book. Do not plan the visit at nap time. If the child is afraid of a white coat, mention it when booking — we can adapt.
What to bring and how to prepare your child
Before the visit
- photographs of the lesions from different days, especially if the rash comes and goes,
- all the ointments, creams and emollients that have been used, preferably in their original packaging,
- a list of medicines and supplements, including “herbal” ones,
- the results of earlier tests, discharge summaries, opinions of other doctors,
- whether siblings, parents or children in the same group have similar lesions.
On the day of the visit
Do not apply a thick layer of cream to the area in question in the morning, as the lesions will be harder to see. If the problem concerns the nails, remove nail polish. Do not stop medicines prescribed by another doctor on your own. Dress the child in something easy to take off and arrive a few minutes early, so that you do not enter the consulting room in a rush.
Atopic dermatitis: we treat the skin, but we ask about sleep
In atopic dermatitis the area covered by the lesions does not tell the whole story. A child who wakes four times a night and scratches until it bleeds is more ill than the look of their elbows suggests. So we ask how they sleep, whether they scratch at nursery, whether they avoid baths and what applying emollients looks like in practice, because “we use an emollient” means the whole body twice a day in one family and the elbows once every few days in another.
We match the treatment to the severity: from emollients alone, through anti-inflammatory medicines for flare-ups, to systemic treatment in severe forms. With the parent we agree a simple routine, because a complicated one will not be followed. If something in the recommendations causes concern — steroids, for example — we would rather talk about it in the consulting room than find out at the follow-up that the tube was never opened.
Repeating previous treatment without an assessment
Weeping, yellow crusts, pain or fever may mean a bacterial or viral secondary infection. The old ointment is then not enough, and sometimes it does harm.
An elimination diet only under supervision
Cutting out milk, eggs and gluten “to see what happens” is a burden on the child and rarely improves the skin. If we suspect a food allergy, we say which tests make sense and which advertised panels do not.
The purpose of a follow-up visit
At the follow-up we check whether the routine is working and whether it can be simplified. After two visits many families need us only during flare-ups.
Teenage acne: treatment that can be kept up
Acne usually starts between the ages of 11 and 14 and in some teenagers leaves scars that cannot later be removed completely. So we do not wait for them to “grow out of it”. At the visit we assess the type of lesions, because comedones are treated differently from painful nodules, and we ask the teenager, not the parent, what they find hardest and how many skincare steps they will really take.
The first effects are usually visible after six to eight weeks, and the full result after three to four months. We agree on this at the start, so that nobody abandons the treatment after a fortnight. Squeezing the lesions leaves marks that last longer than the acne itself, so we ask that it is not done. If acne is making the teenager reluctant to leave the house, we want to know: it changes the pace at which we treat.
When lesions may be contagious
Not every rash is contagious and not every one means staying at home. Impetigo usually stops being infectious after two days of antibiotic treatment, molluscum contagiosum does not exclude a child from nursery, and warts are no reason to skip swimming, although they should be covered. We tell you specifically what a given diagnosis means for nursery and for the pool, rather than leaving you to sort it out with the class teacher.
Impetigo
A separate towel, short nails, bedding washed at 60 degrees. We treat the lesions topically, and with widespread lesions with an oral antibiotic.
Warts
Do not cut them out, burn them off or “pull them out” with home remedies. Some warts in children disappear on their own within a year, and observation is then the best decision.
A rash with fever
Chickenpox, scarlet fever, hand, foot and mouth disease. Here the child’s general condition matters, not the look of the spots. If the child is listless or the rash does not fade under pressure, do not wait for a dermatology appointment.
When not to wait for a dermatology appointment
A dermatology clinic does not replace the emergency department. Call 112 or go to the emergency department if a child with a rash has difficulty breathing, swelling of the lips, tongue or throat, is drowsy or confused, has a stiff neck, a severe headache with sensitivity to light, or a rash that does not fade when pressed with a glass. The same applies to a sudden, clear deterioration in general condition, even if the rash looks harmless.
Contact by telephone
We read the form on the website during reception’s working hours. In an emergency that is too late.
The glass test does not settle the diagnosis
A rash that does not fade is a warning sign, but a child can be seriously ill with a rash that does fade. Look at the child, not only at the spots.
The doctors who see children, and our clinics
Małgorzata Micał-Strąk, MD, PhD
Specialist in dermatology and venereology, doctor of medical sciences. Sees patients in Wrocław and Nysa. She combines dermatology with aesthetic medicine, which for teenagers means that acne treatment and later work on the scars are carried out by the same doctor.
Ireneusz Pijanowski, MD
Specialist in dermatology and venereology. He completed his specialist training at the Clinic of Dermatology, Paediatric Dermatology and Oncology in Łódź, so a child’s skin is not an add-on to adult dermatology for him.
Wrocław, ul. Barlickiego 31/1u
The main HappyDERM clinic. When booking, ask about morning appointments if your child tends to be tired and tearful in the afternoon; with a small child it is better not to wait in the waiting room longer than necessary.
Nysa, ul. Mariacka 10
The second clinic, in the Przychodnia Centrum medical centre. For families from the Opole region it is often closer than Wrocław, and the doctor is the same.
Questions parents ask reception
Is a referral needed for a child’s visit?
No. The visits are private and booking is by telephone or through the form. A referral is needed neither for the consultation nor for dermoscopy.
From what age do you see children?
We have no fixed age limit; it depends on the problem. When booking, give the exact age and what you are coming with, and reception will say straight away which doctor and which appointment will be right.
Do both parents have to come?
One parent or legal guardian is enough. A teenager over 16 takes part in decisions about treatment but still comes with a guardian. In an unusual legal situation, foster care for example, please call in advance and we will say which documents to bring.
Are photographs enough to make a diagnosis?
With urticaria that disappears before the visit, photographs are invaluable. But a mole, a wart or the scalp cannot be assessed from a phone. Always bring the photographs; the doctor will decide whether anything else is needed.
With atopic dermatitis, do you do allergy tests straight away?
No. In most children with atopic dermatitis, tests change nothing in the treatment of the skin. We refer for them when the history points to a specific allergen — a reaction after one product, for example — and not “just in case”.
Can a child with a rash go to nursery?
It depends on the diagnosis. After the visit we say plainly: from tomorrow, or after 24 hours of treatment, or once it has cleared. If the nursery requires a certificate, mention it at the visit.
What we base this on
- NICE CG57, guidance on the diagnosis and management of atopic eczema in children up to the age of 12.
- NICE NG198, management of acne vulgaris, including in teenagers.
- NHS, rashes in babies and children and the symptoms that mean calling for help.
This page is meant to help you decide whether and how quickly to take your child to a dermatologist. It does not replace an examination. The diagnosis and treatment are decided by the doctor after seeing the child.
Call and tell us how old your child is and what is happening with their skin
Reception will choose the doctor, the clinic and the length of the visit. If the child is unwell, do not write through the form — use urgent care.