Your skin changes every day, depending on the weather, your diet, how much sleep you got last night, the amount of stress in your life, and so on. But it’s still your skin, and it’s with you for life, so take good care of it.
Skin Cancer Guide
Basal cell carcinoma (BCC)
This is the most common form of skin cancer, accounting for about 90 percent of skin cancers diagnosed each year. It has the lowest risk of metastasis and is slow to spread, but it still needs to be treated immediately. Because the tumor grows contiguously, once it is excised, the recurrence risk is very low. BCC is 95 to 100 percent curable when caught early.What to look for: The classic basal cell carcinoma is a pearly pink bump, slightly elevated and smooth, but sometimes BCC can show up as a smooth, flat, white-pink scar (these are more aggressive) or a brown patch that resembles a freckle. BCC can be a dry, crusty spot, or it can be ulcerated and tend to bleed. Most are located on the face and neck — sun-exposed areas.
Squamous cell carcinoma (SCC)
This is the second most common skin cancer, and, like basal cell carcinoma, it is usually located on sun-exposed areas. It also tends to stay localized but may spread, and its metastasis is much faster than that of BCC.
What to look for: Pre-cancerous lesions for squamous cell carcinoma are called “actinic keratoses” (AKs). They look like a red or brown patch of sun damage; a suspicious area tends to be crusty and dry, and it may bleed. Though these lesions may not become cancerous, they could very well be precursors of SCC. If treated early, however, AKs can be eliminated before becoming skin cancer.
Although it accounts for only 4 percent of skin cancer cases, melanoma is the deadliest form of the disease. While there are genetic links to the disease, sun exposure remains the biggest factor we can control; the Skin Cancer Foundation has found that women who rarely use sunscreens have twice the melanoma risk of women who always wear sunscreen.
What to look for: Almost all of the time, melanoma appears as a pigmented lesion, but it can sometimes show up as a pink bump or a vertical brown streak on a fingernail or toenail. It may look like a scar, or it may be a sore that bleeds all the time. The symptoms are very sneaky. As a rule, these are the warning signs that we should be on guard for, the ABCDE of melanoma:
A = Asymmetry: Because melanoma has a radial growth phase first, spreading like an oil slick, early melanomas do not look perfectly round like normal moles.
B = Borders: A melanoma has indistinct edges that are hazy and smudgy.
C = Color: There are multiple colors that can signal malignancy. Red pigment may be a sign of inflammation or of angiogenesis (the growth of blood vessels to feed a tumor). If one pigmented lesion stands out as much darker than the others, that’s a suspicious characteristic (this is known as “the ugly duckling sign”). Dark blue, black, or gray pigment can signify that the nevus (or mole) is dense and growing deeper into the skin. A disappearance of color can also be a sign of regression — a characteristic of aggressive malignant lesions.
D = Diameter: Larger than six millimeters (about the size of a pencil eraser) is considered large — and dangerous.
E = Evolving: Be aware of any existing mole that changes in some way. If something that was flat quickly becomes elevated (becoming a nodular bump), that is a sign of tumor growth. If a mole begins to bleed, it could be a sign of an aggressive malignancy.
Check your skin
Once a month, examine your skin, head to toe, to see if anything unusual has developed. The best time to do a skin self-exam is when you get out of the shower, as you’re drying yourself off in the bathroom.
Seriously Simple Skin Care Plan
Most of the time, the best thing you can do for your complexion is the least amount necessary. There are only three products you need to use on your skin every day: cleanser, moisturizer, and sunscreen.
If your skin tends to be dry: You want less soap and more moisturizer. Look for formulations such as creamy lotion or cleansing milk, or even a cold cream cleanser, a cleansing oil, or a balm; they basically all act on the same gentle cleansing principle. Cleanse at the end of the day to remove grime, sweat, makeup, and oil; then, in the morning, just rinse your skin with water.
If your skin tends to be oily or acne-prone: You can use gels, oil-free washes, soap, or synthetic detergents such as sodium lauryl sulfate or sodium laureth sulfate. Two percent salicylic acid dissolves the dead keratin cells plugging the pores and helps prevent acne, while benzoyl peroxide prevents bacteria from overpopulating in the pores, but note that both of these ingredients are extremely drying and should be used only if you truly have oily skin.
If your skin tends to be sensitive: A less-of-everything routine is your best bet for caring for skin that gets red and irritated easily, burns quickly in the sun, or is susceptible to dark spots. Don’t wash your skin more than once per day, and use gentle formulations (cleansing lotions or milks) with anti-inflammatory ingredients such as soy, allantoin, aloe vera, or chamomile to soothe the skin and calm redness.
For most of us, except those with very oily skin, moisturizer shouldn’t be thought of as an indulgence — it’s crucial to keeping up your skin’s defenses. If the top layer of your epidermis dries out completely, it can’t protect the layers of skin underneath. Moisturizer not only makes the surface look pretty; it also seals and protects what is beneath it.
If your skin tends to be dry: Dry skin is low on natural oils and lipids, so it’s desperate for humectants and emollients. It will drink up a rich, heavy-duty moisturizer, such as a lotion or cream that’s oil-based (a water-based product won’t provide enough long-lasting moisture). Look for one that has waxy occlusive emollients such as shea butter, squalene, lanolin oil, or mineral oil.
If your skin tends to be oily or acne-prone: If your skin feels fine after washing, then skip the moisturizer. But if it feels tight (especially if your cleanser contains salicylic acid or a drying detergent), use a water-based, lightweight lotion or gel formulation that contains humectant ingredients, such as hyaluronic acid or glycerin, and make sure it’s noncomedogenic: a comedone is a blackhead or whitehead, and you certainly don’t want anything that can contribute to those.
If your skin tends to be sensitive: The fewer ingredients, the better. “Fragrance-free” and “hypoallergenic” on a product’s label means it will probably contain fewer irritants, chemicals, and preservatives. Avoid extremes: stay away from heavy emollient creams as well as drying gel formulas, and try a water-based lotion or cream instead, preferably one with an anti-inflammatory ingredient such as soy, aloe vera, cucumber, calendula, oatmeal, or allantoin.
Everyone at every age needs to use sun protection every single day (yes, on cloudy days too). It’s by far the most effective and significant thing you can do to protect your skin and prevent sun damage, skin cancer, and premature aging. If you use only one product, make it a sunblock and use it every day.
Always wear a sunscreen with an SPF of 30 to 50 and that says “broad spectrum” on the label, to ensure you get both UVA and UVB protection. Apply sunscreen every hour during intense sun exposure.
Three extras: Options to have at the ready
Be willing to change your routine as necessary. Your medicine chest should be armed with a small but mighty arsenal of products — the three basics, as well as a few extras that you can pull out when needed.
Sloughing off of dead skin cells smoothes the texture, improves skin tone, and helps unclog pores, all at the same time. Chemical exfoliants are acid-based formulas that interact immediately with the skin and dissolve dead cells. Look for beta-hydroxy acid (or salicylic acid) and alpha-hydroxy acids; if your skin is sensitive, lactic acid is the best and gentlest option. Mechanical exfoliation involves physically scrubbing the dead skin off your face with a washcloth, soft brush, or a product that includes a granular substance such as oatmeal, polyethylene beads, salt, sugar, calcium carbonate, dimethicone polymers, or tiny crystal particles. Keep in mind that over-exfoliating is dangerous; use only one exfoliating option once or twice a week.
Benzoyl peroxide spot treatment
It’s inevitable: we’re all going to wake up with a pimple (or a few) occasionally. It’s smart to be prepared with a one-two acne-fighting punch: a salicylic acid exfoliant (cleanser, liquid, or lotion) and a benzoyl peroxide treatment that can kill the bacteria that are causing the breakout, help unclog the offending pore, and reduce inflammation.
Topical steroid cream
Every medicine cabinet should have 1% hydrocortisone cream just in case. It’s fantastic for treating rashes, itchiness, bug bites, burns (even sunburns), or any kind of irritation on the skin. If this over-the-counter, low-dose product isn’t effective, get a prescription-strength version from your dermatologist.
Acne happens when pores become blocked by a build-up of dead cells, dirt, and bacteria, causing the skin to break out in whiteheads, blackheads, painful cysts beneath the skin, or papules (small, red bumps). It usually appears on the face and shoulders, although it can show up on the buttocks or other parts of the body. Breakouts or flare-ups may be triggered by medications such as steroids or estrogen; hormonal changes during puberty, menstrual cycles, pregnancy, or times of stress; or excessive sweating. A diet high in processed sugar has been linked to acne, although chocolate and greasy food, specifically, have not. (See also acne scars, blackheads, cystic acne, nodular acne, and whiteheads.)
The inflammation caused by acne can sometimes leave scars, even if you don’t pick at the bumps or pimples. They can be shallow (called atrophic scars), or narrow and very deep (known as ice pick scars). People with light skin may have redness in their scars, and people with darker skin may have hyperpigmentation (darkening) around or in the scars. Mild scars may fade on their own, but others may require dermatological treatments such as microdermabrasion, laser procedures, or surgery. (See also acne, blackheads, cystic acne, nodular acne, and whiteheads.)
Actinic keratoses (AKs) are scaly skin growths — typically on the face, scalp, lips, and back of the hands — caused by sun damage. They may look a bit like red warts, but some are tan, pink, or flesh-colored. If left untreated, AKs can turn into squamous cell carcinoma, a common form of skin cancer. The more AKs you have, the more likely it is that one or more will develop into skin cancer. (AKs are a focus of Dr. Marmur’s research on sun damage and skin cancer prevention.)
Alopecia, or hair loss, can happen for two main reasons: an immune system response in which the body mistakenly attacks its own hair follicles, causing hair to fall out (alopecia areata) which is often temporary, and female pattern baldness or male pattern baldness, which is hormonal in nature and usually permanent. (See also alopecia areata, female pattern baldness, hair loss, male pattern baldness, and traction alopecia.)
Alopecia areata is a disorder in which the immune system is thought to mistakenly attack the body’s own hair follicles, causing hair to fall out. Hair usually falls out in round patches on the scalp, although it can happen in the beard, eyebrows, or arms and legs. With mild alopecia, hair is likely to grow back on its own within a few months. For more severe cases, treatments may include injections, topical creams, or UV treatments. Recovery may not be as complete for people who develop alopecia at a young age, who have it for many years, who lose hair in several places on their bodies, or who also have eczema. (See also alopecia, female pattern baldness, hair loss, male pattern baldness, and traction alopecia.)
Atopic dermatitis, better known as eczema, is a skin disorder that causes redness, swelling, and itchy, scaly patches of skin. For adults, it can be a long-term condition with occasional flare-ups. It’s not caused by any specific allergy, although an allergic reaction to pollen, dust, or animals can make it worse. Other factors that can trigger eczema flares are illness, stress, dry skin, fragrances, and contact with rough cloth like wool. In small children, eczema rashes often appear on the face, scalp, hands, and feet. (Children who get it as babies often outgrow it by age five or six.) In older kids and grownups, it’s likely to show up on the neck, hands, feet, and the inside of the knees and elbows. In general, people with eczema should avoid long, hot showers or baths and harsh soaps, and should keep skin moisturized. Over-the-counter oral antihistamines may help with the itching; prescription treatments include creams containing steroids or immune medications. (See also discoid eczema.)
See atopic dermatitis.
An atypical mole, also known as a dysplastic nevus, is a non-cancerous mole that may resemble melanoma. The more atypical moles you have, the higher your risk of ultimately developing melanoma. Any mole that is crusting, bleeding, or itching; is asymmetrical; has uneven borders; has uneven or very dark colors; is larger than six millimeters; is changing in size or appearance; or looks different from most of your other moles and spots should be checked by a dermatologist.
Basal cell carcinoma
Basal cell carcinoma (BCC) is the most common type of skin cancer. It doesn’t often spread to other parts of the body and it is usually not life-threatening, but it can be disfiguring and should not be ignored. BCCs often look like shiny pink bumps, open sores, scars, pink moles, or red patches. BCCs can be removed surgically or with prescription creams. (See also melanoma, skin cancer, and squamous cell carcinoma.)
Birthmarks are benign skin spots that a person has since birth. They vary in appearance: They can be raised or flat, even wrinkled, and while they’re often darker than the rest of the skin, they can also be lighter. Cafe-au-lait spots are very light brown; Mongolian spots appear bluish or bruised; and hemangiomas, strawberry marks, “stork bites,” and port wine stains are all variations of red birthmarks, which are made up of blood vessels. Birthmarks are generally harmless, although port wine stains on the face may be a sign of a nervous system disorder called Sturge-Weber syndrome, and mole birthmarks larger than the size of a fist are more likely to turn into skin cancer — specifically, melanoma. (See also congenital mole.)
Blackheads, which look like tiny, dark spots, are pores clogged with oil, bacteria, or dead skin cells. They are common in acne and are sometimes called open comedones. (See also acne, acne scars, cystic acne, nodular acne, and whiteheads.)
Blisters are bubbles on the skin filled with watery plasma, often formed because of friction on a sensitive area like the soles of the feet or palms of the hands. Treat blisters by applying antibiotic ointment and covering with a bandage or gauze pad, but don’t peel the top layer of skin away — that skin provides a barrier against bacteria and decreases risk of infection. If a blister is very large and painful, you may puncture it and drain the fluid, but keep the skin intact.
See genital warts.
A congenital mole is a birthmark. A very large congenital mole — larger than about eight inches or the size of a fist — increases one’s risk of developing melanoma later in life. (See also birthmarks.)
Cystic acne is the most severe form of acne, with deep, inflamed cysts, or pockets of pus deep under the skin, that can be painful and leave scars, especially if you squeeze or try to puncture them. Dermatologists can reduce swelling and speed healing of cysts with cortisone shots. (See also acne, acne scars, blackheads, nodular acne, and whiteheads.)
Discoid eczema (also called nummular eczema or nummular dermatitis) often shows up as disc- or oval-shaped sores on the skin and may appear after the skin is injured by a burn, friction burn, or bug bite. The itchy pink, red, or brown sores often start as tiny spots that blister, enlarge, and grow together to form patches. Moisturizing the skin can help, but discoid eczema can be stubborn, and a dermatologist may prescribe ointments or oral medications to help reduce inflammation and itchiness. Patches may persist or recur for a year or more. (See also atopic dermatitis.)
Skin becomes dry when it loses too much moisture, either water or natural oils. Our skin naturally gets drier as we age, and some people have an inherent tendency toward drier skin. But other circumstances can cause dry skin, such as living in a dry climate, washing your hands often, or swimming in a chlorinated pool. Moisturizing often throughout the day can help. A lotion that contains urea or lactic acid may help those with very dry skin.
See atopic dermatitis and discoid eczema.
Female pattern baldness
Female pattern baldness isn’t well understood, but it may be related to hormonal changes (especially after menopause), aging, or genetics. Unfortunately, it is often permanent. Hairs naturally fall out in two- to six-year cycles, but in women with female pattern baldness, new hairs don’t grow to replace them. Remember that not all hair loss is female pattern baldness — nutritional deficiencies, skin diseases, medications, thyroid problems, stress, and other issues can cause hair loss that is reversible with lifestyle changes and/or treatment. (See also alopecia, alopecia areata, hair loss, male pattern baldness, and traction alopecia.)
Folliculitis refers to infections in the pockets around hairs (follicles) that lead to tiny red bumps or whiteheads that may be painful or itchy. Folliculitis is often caused by shaving, sweating, or friction from clothing or bandages, but can also be picked up in dirty surroundings — for instance, in hot tubs that haven’t been cleaned. Mild cases usually clear up on their own. But if the condition persists or recurs, or the bumps turn into deep boils that are large and painful, it may require treatment such as antibiotics or antifungal medication to prevent scarring, hair loss, or thickened skin.
Genital warts (condylomata acuminata) are a sexually transmitted infection caused by a certain strain of the human papillomavirus (HPV). (It’s the same family of viruses that cause most cervical cancers, but a different strain.) These soft warts are often pink or flesh-toned. Warts may go away on their own, or a doctor may need to remove them. Certain types of HPV vaccines given to prevent cervical cancer also protect against warts.
It’s normal to lose up to 100 hairs every day. Those hairs usually grow back, but some diseases and conditions can keep them from doing so, which might lead to hair thinning and even patches of baldness. Hair loss is a symptom of some 30 disorders including thyroid problems, lupus, anemia, and diabetes. Other causes include stress, pregnancy, poor nutrition, major hormonal shifts like menopause, chemotherapy, and some prescription medications (including blood thinners, some drugs for depression, and birth control pills). Treatment for hair loss varies depending on the cause. A dermatologist can help determine the root cause of hair loss and prescribe the lifestyle changes or medications necessary to help hair grow back, if possible. (See also alopecia, alopecia areata, female pattern baldness, male pattern baldness, and traction alopecia.)
Herpes simplex virus (HSV) causes both oral herpes (cold sores or fever blisters around the mouth or on other areas of the face) and the sexually transmitted infection genital herpes (which can also occur on the buttocks or around the anus). Herpes can also break out in the eyes or other areas. It spreads by contact — you can get the virus from direct contact like sex or kissing, or by sharing utensils, cups, and even towels. Herpes sores themselves may tingle as they form; they then blister and become itchy and achy before healing. Outbreaks can be triggered by illness, stress, or sun exposure.
Hives (urticaria) are red, itchy bumps on the skin often caused by an allergic reaction, stress, or infection. They usually fade on their own, and an over-the-counter antihistamine can help with the itching in the meantime. For severe or chronic cases of hives, a doctor may prescribe stronger medication.
Hyperhidrosis is excessive sweating on the palms, underarms, feet, and face because of overactive nerves or sweat glands. For milder cases, prescription antiperspirants may do the trick. But bringing more severe cases under control may require oral medications, Botox injections to paralyze nerves near the sweat glands, a treatment called iontophoresisin which electrical currents work on the nerves, or even surgery. (See also sweating.)
Intertrigo is a red or reddish-brown rash in areas where skin rubs together or traps wetness. It’s caused by yeast, fungus, or bacteria and is often found between toes, in the groin area, underneath belly folds or breasts, in the armpits, in the crease of the neck, or between the buttocks. Keeping the area dry and uncovered can help, but your doctor may also prescribe antibiotic or antifungal creams.
Lichen planus is a condition that can affect the mouth or other areas of the skin such as the inner wrists, legs, torso, or genitals. In the mouth, lichen planus often appears as grayish-white spots or ulcers on the sides of the tongue, the inside of the cheeks, or the gums. On the skin, it is often itchy, shiny, scaly, and reddish-purple. The cause is unknown, but the experts’ best guess is that is related to an immune system reaction or allergy. It usually gets better within 18 months with treatment like antihistamines or prescription creams, but it may come and go for years. It isn’t dangerous but shouldn’t be ignored, since mouth ulcers may develop into oral cancer if left untreated for many years.
Male pattern baldness
Male pattern baldness is hair loss in men that usually starts as a receding hairline and thinning on the top of the head. It’s caused by hormone shifts and genetic disposition. If hair falls out very rapidly or in patches, or is accompanied by pain or skin scaling, it could be due to an illness or skin condition. For normal male pattern baldness, the topical medication Rogaine has been found to stimulate hair growth and slow hair loss. Oral prescription medications like Propecia work by blocking a hormone associated with hair loss. (See also alopecia, alopecia areata, female pattern baldness, hair loss, and traction alopecia.)
Melanoma is the most dangerous type of skin cancer. More than 8,500 people in the United States die of melanoma annually, but, if caught and treated early, it’s almost always curable. A majority of melanomas are black or brown, but they can be other colors, such as white, pink, or skin-toned. Any mole that is crusting, bleeding, or itching; is asymmetrical; has uneven borders; has uneven or very dark colors; is larger than six millimeters; or is changing in size or appearance should be checked by a dermatologist. (It’s easy to remember these warning signs as ABCDE: Asymmetry, Borders, Color, Diameter, and Evolution.) And always look out for “ugly ducklings” — moles or spots that simply look different than your other ones. (See also basal cell carcinoma, skin cancer, and squamous cell carcinoma.)
Melasma is a skin disorder in which brown splotches appear on the upper lip, nose, forehead, or cheeks. Sun exposure is a risk factor for melasma, but it is also related to female hormones, so it’s especially common among women who are on hormonal birth control, menopausal women on hormone replacement therapy, or women who are pregnant. Avoiding the sun or hormonal medications may help fade the patches, as can topical creams containing terinoin, azelaic acid, or steroids.
Moles (or nevi) are round or oval brown, tan, or pink skin growths that occur when skin cells called melanocytes cluster. They’re common and normal — most people have somewhere between 10 and 40 moles. If a mole is crusting, bleeding, or itching; is asymmetrical; has uneven borders; has uneven or very dark colors; is larger than six millimeters; or is changing in size or appearance, you should be checked by a dermatologist right away, since those are possible signs of skin cancer. It’s easy to remember these warning signs as ABCDE: Asymmetry, Borders, Color, Diameter, and Evolution. (See also skin cancer and spitz nevus.)
Molluscum contagiosum is a skin condition characterized by firm, smooth bumps that are flesh-colored, white, or pink and that often have a dimple in the middle. They can appear anywhere on the body, including the genitals, and are caused by a virus. Molluscum contagiosum can be spread by skin-to-skin contact, sexual contact, or by sharing items like clothing or towels. It usually clears up on its own within a year.
Nodular acne refers to large, hard bumps under the skin that are often quite painful and may last for weeks or even months. The nodules can leave scars, especially if you attempt to squeeze them. Dermatologists can inject them with cortisone to shrink them safely. (See also acne, acne scars, blackheads, cystic acne, and whiteheads.)
Pityriasis rosea is a skin rash characterized by a large, often scaly patch of pink or pale red skin on the chest, back, arms, or legs. After a few days, more patches can appear on other parts of the body. It’s believed to be caused by a virus, but doesn’t appear to be contagious. The rash usually clears up on its own in three to twelve weeks. In the meantime, oral antihistamines can reduce itching, and mild hydrocortisone creams can be used to soothe the skin.
See tinea versicolor.
Poison ivy, poison oak, or sumac may cause itchy red streaks, swelling, hives, large blisters, or crusting on parts of the body that come into contact with the plant oils. You can transfer the oils to other parts of the skin by rubbing or touching, but you can’t give the rash to someone else. Severe cases may require prescription medications like steroid ointments or oral steroids; otherwise, most of these rashes go away without treatment in one to three weeks. Avoid antihistamine or cortisone creams and instead try calamine lotion, cool showers, antihistamine pills, and baking soda baths (one cup of baking soda to a lukewarm bath) to soothe the itch and irritation.
Psoriasis is a skin condition that causes thickened, red skin with flaky, silvery patches often referred to as scales. It’s believed to be an immune system glitch and is often passed down in families. It’s not contagious, but it is usually a lifelong condition. Several outside triggers can precipitate a psoriasis attack, including respiratory infections, dry skin, cuts, burns, bug bites, stress, sunburn, and some medicines. Topical treatments like creams and shampoos can help control symptoms, as can prescription injections or pills, or light therapy, a medical treatment in which your skin is carefully exposed to ultraviolet light. At home, oatmeal baths can soothe skin and loosen scales (grind one cup of oatmeal in a blender or food processor, then add to a tub of warm water). (See also psoriatic arthritis and scalp psoriasis.)
Psoriatic arthritis is a type of joint pain that often comes on along with skin psoriasis. About one in 20 people with psoriasis will also develop arthritis along with it. Non-steroidal anti-inflammatory drugs (NSAIDS) can reduce pain and inflammation. (See also psoriasis and scalp psoriasis.)
Rash is a general term for a change in the color and texture of the skin — rashes are often pink or red and lumpy or bumpy. Rashes can be triggered by a wide variety of causes, including viruses, poison oak, and chemicals in cosmetics, detergents, or rubber products. If you develop a rash, avoid harsh soaps, hot water, and any new products or substances that may have irritated your skin. Calamine lotion is a safe, effective soother for many types of simple rashes, but you should see a doctor or dermatologist to check out a rash that won’t go away.
Rosacea is a common skin condition that has four different subtypes: Erythematotelangiectatic rosacea causes redness, flushing, and spider veins on the face; ocular rosacea results in irritated eyes, possibly with sty-like swelling of the eyelid; papulopustular rosacea causes redness, swelling, and acne; and phymatous rosacea causes bumpy, thickened skin. They all have different treatments, which may include topical creams, antibiotics, or even laser treatments or dermabrasion.
Scalp psoriasis refers to thick, dry scales on the scalp. If you have scalp psoriasis, you may also have psoriasis elsewhere on your body, such as on your elbows, hands, feet, or knees. The treatment is similar to treatments for dandruff (or seborrheic dermatitis of the scalp), including medicated shampoos or antifungal creams. Stubborn cases may require prescription medications. (See also psoriasis and psoriatic arthritis.)
Seborrheic keratosis is a common skin growth marked by wart-like moles that often appear in middle-aged or older people. We call them wisdom spots. The growths are likely to appear on the face, chest, shoulders, or back and may appear waxy. They are benign, so treatment usually isn’t needed, but a dermatologist can remove them with freezing or surgery if they are bothersome or unsightly.
Shingles, or herpes zoster, is a condition that causes blisters, burning pain, and tingling on one side of the body or face. The blisters usually heal within two weeks, but the pain can last for weeks, months, or even years afterward. Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. Once you have chickenpox, the virus continues to live in your body and can be reactivated as shingles when you’re much older, usually when your immune system is in a weakened state. There is a vaccine that can prevent shingles available for people ages 60 and older.
Skin cancer is the most common form of cancer in the world. In the United States, one out of five people will develop some type of skin cancer in their lifetime, most likely either basal cell carcinoma, squamous cell carcinoma, and melanoma — the most dangerous form of skin cancer. Anyone can get skin cancer, but those most at risk are people who spend a lot of time in the sun, have had severe sunburns, have a family history of skin cancer, or have light skin, hair, and eyes. You should have a whole-body skin check once a year to look for abnormal moles and signs of skin cancer. When these cancers are found early they are very treatable and very curable — even melanoma. (See also basal cell carcinoma, melanoma, and squamous cell carcinoma.)
Spider veins are red or blue veins near the skin’s surface, most commonly in the legs and feet, that often resemble spider webs. For most people, spider veins are benign and cause no pain, and are mostly a cosmetic concern. Pregnancy and aging are top causes, but obesity, sitting or standing for long periods of time, and a family history of spider or varicose veins all increase the likelihood of developing spider veins. Compression stockings can help some people, while for others laser therapy may be the right choice. (See also varicose veins.)
A spitz nevus is a mole that looks like melanoma, but isn’t. A dermatologist may not be able to tell by sight whether the mole is cancerous or benign and will likely want to remove it and have it tested. Spitz moles may be pink and dome-shaped or contain different colors like black, red, and brown.
Squamous cell carcinoma
Squamous cell carcinoma (SCC) is one of the most common types of skin cancer. It often appears as scaly red patches, open sores, or warts that may crust or bleed. If detected early, it’s almost always curable, but if left untreated, it can grow deeper into the tissues and become disfiguring. Rarely, late-stage SCC can spread to other tissue and organs in the body and become deadly. SCCs usually appear in areas that have received a lot of sun exposure such as the lips, ears, face, neck, hands, and limbs. The type of treatment depends on the size and depth of the cancer. One treatment with a very high cure rate (about 95 to 99 percent) is Mohs surgery, in which a surgeon removes thin layers of tissue, looks at them under a microscope, and determines whether or not they contain cancer cells. If cancer cells are present, another layer must be cut away, and so on, until the margins are clear. (See also basal cell carcinoma, melanoma, and skin cancer.)
Sweating is your body’s way of cooling itself by releasing a clear, salty fluid from glands inside your skin. Areas of the body with a lot of sweat glands such as the groin and the underarms sweat the most. Body odor is caused when sweat mixes with bacteria naturally living on your skin. (See also hyperhidrosis.)
Tinea versicolor (also called pityriasis versicolor) is caused by a type of yeast fungus commonly found on the skin and is marked by dark, reddish, scaly patches. It happens most commonly in teenage boys and young men living in hot climates. Treatment is usually a topical antifungal cream; using a dandruff shampoo on the skin in the shower may also help.
Traction alopecia refers to hair loss caused by certain hairstyles like tight ponytails, cornrows, or braids. Years of wearing one of those tightly pulled styles can damage hair follicles, causing the hair to permanently fall out. (See also alopecia, alopecia areata, female pattern baldness, hair loss, and male pattern baldness.)
Varicose veins are swollen, gnarled veins that puff out from the legs and feet when valves malfunction, allowing blood to pool in the veins, and often also causing a heavy of achy feeling in the legs. Pregnancy or standing for long periods of time can cause varicose veins. Treatment ranges from wearing elastic compression stockings and elevating the legs while sleeping, to laser or radiofrequency ablation procedures in which veins are destroyed so the blood can be released. (See also spider veins.)
A venous lake is a dark blue to purple, soft, asymptomatic papule, or lesion, that occurs on sun-exposed sites such as the face, lips, and ears of patients greater than 50 years old due to a collection of dilated blood vessels. Venous lakes are benign but can often mimic a melanoma or pigmented basal cell carcinoma and so should always be examined by a dermatologist. They can be removed for cosmetic reasons by electrosurgery, laser therapy, or sometimes surgical excision.
Vitiligo is a condition in which patches of skin lose their color. It is not contagious or life-threatening, and people of all ethnicities can get it. Vitiligo is often a life-long condition and may be related to an autoimmune disease of the thyroid, which your doctor should check for. Vitiligo isn’t curable, but some topical medicines or light therapy can re-pigment the skin, making the light patches much less visible, especially on the face.
Warts, or verruca, are small, firm, benign growths on the skin caused by certain strains of the human papillomavirus (HPV). Sometimes they itch or hurt, but mostly they are just unsightly. Never try to cut or pick away a wart, since scarring is common. Your doctor or dermatologist can recommend over-the-counter wart removers, prescribe a stronger cream, or remove the wart by freezing or burning it. Wash your hands after touching warts, since you can spread them to other areas of your body.
Whiteheads are raised, light-colored acne bumps. They’re also known as closed comedones, or regular old pimples. (See also acne, acne scars, blackheads, cystic acne, and nodular acne.)
Wrinkles are lines or creases in the skin that are natural results of aging. Overexposure to UV rays or cigarette smoke can increase or hasten the onset of wrinkles. To minimize wrinkling, reduce sun exposure, wear sunscreen, and avoid cigarette smoke. Treatment for wrinkles ranges from over-the-counter creams to stronger prescription creams like tretinoin (Retin-A) or those containing alpha-hydroxy acids. Chemical peels or laser treatments can reduce the depth and appearance of wrinkles, and botulinum toxin injections (Botox) can be used to smooth out certain wrinkles in the forehead and other parts of the face.
See dry skin.
Dr. Ellen Marmur is the author of Simple Skin Beauty: Every Woman’s Guide to a Lifetime of Healthy, Gorgeous Skin (Simon & Schuster), a comprehensive guide to skin care that covers everything from skin cancer and sun protection to cosmetic procedures and anti-aging products.
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Journal of Cutaneous Medicine and Surgery, November-December 2012
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Journal of the American Academy of Dermatology,October 2011
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Journal of Cosmetic and Laser Therapy, 2005
Journal of Cosmetic and Laser Therapy, 2005
Journal of Cosmetic and Laser Therapy, 2004