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Your skin is your body’s largest organ and your first defense against injuries, infections, heat, and cold. The health of your skin is vital to the health of your whole body. To keep you safe and healthy, your skin is constantly replenishing itself and growing new cells. Yet your skin can also get sick, just like any other part of your body—perhaps more so, because it’s on the outside, interacting with the world around you.
Skin conditions can range from a mild rash or dryness that goes away quickly to deadly cancers that can spread throughout the body. It would be nearly impossible to make a complete list of all the different skin conditions. But here are some that are worth knowing about:
Dermatitis and eczema are medical terms for a red, itchy rash, which may be caused by a number of different medical problems and triggered by irritants, allergies, infections, or other causes. Eczema may also cause blistering, peeling, or seeping in some cases, depending on the underlying cause. 10% to 20% of infants and about 3% of adults in the USA are affected by eczema. While most infants who develop eczema outgrow it by their tenth birthday, some people continue to have symptoms throughout life. The exact cause of eczema is unknown, but it’s thought to be linked to an overactive response by the body’s immune system to an irritant. It is this response that causes the symptoms of eczema.With proper treatment, the disease can usually be effectively controlled.
Acne is the most common skin health problem—17 out of 20 Americans have acne at some time in their lives, and 40 to 50 million suffer from it at any one time. Acne is a common skin disease that causes pimples. Pimples form when hair follicles under your skin clog up. Most pimples form on the face, neck, back, chest, and shoulders. Anyone can get acne, but it is common in teenagers and young adults. It is not serious, but it can cause scars and may be associated with depression.
Psoriasis is a skin disease caused by an autoimmune condition. If you have psoriasis, your body’s immune system mistakenly attacks your own skin and rushes to build new skin cells to replace it. Psoriasis often looks like a rash with silvery scaling around the edges of a patch of red skin. Psoriasis causes cells to build up rapidly on the surface of the skin. The extra skin cells form thick, itchy, dry, red patches that are sometimes painful.
Skin parasites, like lice or scabies, are tiny insects or other creatures that live in or underneath your skin.
Dermatophytes (fungal infections) such as ringworm or athlete’s foot, can grow on the outer layer of your skin, anywhere from the scalp to the soles of your feet, and cause scaling, dry, and thickened skin.
Infectious skin diseases, such as warts, herpes, or staphylococcus infection, may cause unpleasant bumps, sores, or rashes. Bacterial infections, like staphylococcus, can be treated with antibiotics. While some viral infections go away on their own, others stay in your body long after the symptoms are gone.
Xerosis is characterized by abnormally dry skin, and while usually a minor and temporary problem, it can be painful or unpleasant, and may lead to other problems.
Vitiligo is a disease in which skin loses its pigment cells, which results in discolored patches of skin, often with little or no color. While vitiligo can begin at any age, it most often begins before age 20.
Keloids are hardened or darkened areas that are left behind after a scar has healed.
Alopecia is the medical term for hair loss, including male pattern baldness or any other thinning hair or balding in men or in women.
Moles and actinic keratoses are growths on the skin that are often benign but may be warning signs of cancer.
Skin cancer is a cancer that starts in your skin cells. Skin cancer is very treatable if caught early, but can be deadly if you ignore it until it’s too late. There are various types of skin cancer, including squamous cell carcinoma, basal cell carcinoma, and melanoma—often the deadliest of the skin cancers.
There are many types of skin problems, and they all have different causes. Sometimes skin problems can look the same or similar, even when they occur for different reasons. For instance, common problems like rash or dry skin may be caused by:
Sometimes several things may need to happen at once before they cause a specific problem in your skin. For instance, acne is caused by a combination of several factors that all have to occur together before pimples appear. For acne to erupt, you must have:
Many other issues or conditions may cause problems with your skin. These include:
For some skin conditions, such as vitiligo or lichen planus, the exact cause is still unknown.
Different skin problems have different risk factors. Some general risk factors include:
In addition, many skin problems have their own specific risk factors.
Risk factors for dermatitis and eczema include:
Chronic eczema, also known as atopic dermatitis is more common in children who:
Risk factors for acne include:
Risk factors for psoriasis include:
Parasites and fungus are spread through contact with infected people or their clothes. Risk factors include:
Risk factors for dry skin include:
Risk factors for discoloration include smoking, overexposure to sunlight, or tanning beds. Specific risk factors for vitiligo include pernicious anemia and gland diseases such as hyperthyroidism or Addison’s disease.
For skin cancer, a major risk factor is exposure to too much sunlight. Other factors that increase your risk of skin cancer include:
Problems like rash, itching, redness, or other skin issues can be caused by a number of different medical conditions with different causes. Sometimes you can tell them apart by looking, but there is no substitute for a diagnosis by a trained health care professional.
Your doctor will start by asking about your medical history and your family’s medical history, and examining the rash or affected area. During the physical exam, your doctor will pay attention to:
Some skin problems can be diagnosed at a glance, but others are much harder to tell apart. For hard-to-diagnose skin problems, your doctor may check how it responds to simple tests such as scratching, rubbing, or wetting your skin, or seeing how it responds to heat or cold. Other tests your doctor may use in the office include:
In some cases your doctor may also need to send samples out for a blood test, biopsy, or another lab test that can’t be done in the office, to check for a specific problem such as cancer or a viral or bacterial infection.
Some skin diseases have symptoms that overlap, while others have very specific, recognizable symptoms. Common symptoms that may be caused by a number of different skin diseases include:
Subtle differences between the symptoms can give your doctor clues about the cause, but sometimes further testing is required.
Skin cancer symptoms
Some skin symptoms may be important warning signs of cancer, and should be checked out immediately.
Actinic keratoses are small red or brown spots, usually 1 to 4 mm (1/7 of an inch or less) in areas that have had a lot of sunlight, such as your face, neck, or arms. They may feel rough or gritty, and be easier to feel than to see. It’s hard to tell whether keratoses will develop into squamous cell carcinoma, so you should talk to your doctor if you have them.
Other warning signs of squamous cell carcinoma include:
Warning signs of basal cell carcinoma include:
The main symptom of melanoma is an unusual mole or spot. To tell these spots apart from other moles, doctors use the “ABCDE Criteria”:
If a mole on your skin meets any of these criteria, then your doctor may need to remove it and have it biopsied. Doctors also look for the “ugly duckling sign,” that is, a mole that looks different from all the other moles around it. You should also talk to your doctor about any new moles that appear after age 21.
The outlook for skin problems can vary a great deal. Some go away with treatment, or on their own, while others may need long-term management. A few can be life threatening.
The following skin problems are usually curable or temporary:
Long-term or lifelong skin problems include:
Some skin problems may be short or long-term, depending on the cause. These include:
Keloids can be removed, but may return or worsen after treatment:
Moles and keratoses are often benign, but may be a warning sign of skin cancer.
Some skin problems can be serious or even deadly if left untreated. These include:
MRSA and skin cancer are usually curable if they are found early enough.
Melanoma is the deadliest form of skin cancer, accounting for 3 out of 4 skin cancer deaths, but even for melanoma, 5-year survival is 98% if the cancer is found and treated before it spreads to the lymph nodes. Unfortunately, melanoma survival drops drastically if it spreads–as low as 62% if it spread beyond the immediate area, or 16% if it reaches distant organs such as the lungs or brain.
Good care of your own skin is important for most people, and especially important if you have a skin condition. Proper skin care includes:
Some conditions may have different care needs. For instance, advice for people with dermatitis includes bathing less frequently. Likewise, if you are at high risk for skin cancer, your doctor may tell you to avoid too much sunlight, but if you have psoriasis, extra sunlight can be a big help. Talk to your dermatologist about your own skin care needs.
Some tips that may help for many people include:
One out of five Americans will suffer from skin cancer in their lifetime. Skin cancer can be easily treated if it is spotted early, but unnoticed it can be deadly. To help prevent needless death, the American Academy of Dermatology (AAD) offers free 10-minute screenings where a dermatologist can look over your skin for signs of melanoma and other cancers.
You can also ask your regular doctor for a screening, or find other screening clinics near you. The AAD recommends that you look over your own skin regularly to check for any changes that might need a doctor’s attention.
For most other skin issues, screening is not as urgent. If you notice problems or changes in your skin, the screening tool at FamilyDoctor.org may help, although it’s a good idea to have a doctor look at any unusual or troubling changes in your skin. The self-screening tool can be found at: http://familydoctor.org/familydoctor/en/health-tools/search-by-symptom/skin-rashes.html
Not all skin problems are preventable, but good skin care can go a long way toward protecting the health of your skin.
Hygiene is an essential part of good skin care:
Be aware that some hair and nail products can cause irritation or allergic reactions. Artificial nails should be removed regularly to let your natural nails breathe.
Good skin care also means having a healthy respect for the sun. Sunlight is an important source of vitamin D, and for most people avoiding the sun altogether can result in worse health problems. But too much exposure to the sun’s ultraviolet rays can lead to skin cancer or other serious skin problems. The right amount of sunlight depends on a number of factors, including:
A small, light-skinned person in Arizona may need less than 10 minutes of sunlight per day to get enough vitamin D, while a darker person in Seattle might need to spend a couple hours out of doors just to get enough sunlight. A good guideline is to aim for enough sun to give you a slight flush without burning or heavy tanning. For the average person, this may be about 5 to 30 minutes of direct sunlight between 10 a.m. and 3 p.m.–more in the winter and on cloudy days, and less in the summer sun.
Another thing you can do to protect the health of your skin is to eat properly and to drink enough water. A balanced diet with a range of fruits, vegetables, and whole grains can help you get the vitamins and other nutrients your skin needs to stay healthy. These include:
Treatment for skin problems starts with good skin care, as we’ve discussed before. But for many people, skin care alone is not enough, and medical treatment may be necessary.
Medical treatments for eczema, rash, or dermatitis include:
Your doctor may also recommend additional treatments, such as:
Treatments for acne include topical treatments you put on your skin, oral treatments you take by mouth, and other therapies.
Topical acne treatments include:
Oral medicines to treat acne include:
For some people, medical treatments may be combined with or replaced by other treatments such as:
Sometimes acne leaves scars behind after the pimples are gone. These may be treated with peels or light therapy, or with other treatments, including:
Psoriasis treatments include many of the same medicines used for rash or acne, as well as:
In addition, sunlight is very helpful against psoriasis, and doctors use a wide range of light-based treatments. If your psoriasis doesn’t respond to light or topical treatments, your doctor may also prescribe pills or injectable medications such as:
OTHER SKIN CONDITIONS
Parasites and fungal infections are treated with medicines that kill the insect or fungus. You may need to thoroughly wash or disinfect all clothes and surfaces that may have come into contact with the parasite.
Warts and bumps caused by molluscum may be removed with surgery or freezing. The underlying virus cannot be treated. Warts can be a lifelong problem, but molluscum eventually goes away on its own.
Herpes is incurable, although you can treat cold sores or herpes lesions with creams to reduce symptoms. Antiviral medicines such as acyclovir (Zorivax) or valacyclovir (Valtrex) can reduce symptoms and may make the disease less contagious.
Bacterial skin infections can be cured with antibiotics. If you have a drug-resistant bacterial infection such as MRSA, your doctor will switch you to a different antibiotic that works in a different way.
Dry skin is usually treated with moisturizers and with lifestyle changes such as drinking more water, using a humidifier, or changing skin care products.
Vitiligo is usually harmless, but if it bothers you it may respond to many of the treatments for other conditions, including:
Severe vitiligo may be treated with skin grafts, or with skin-lightening treatments if it covers more than half of your body.
Keloids can be removed surgically, but they sometimes return after treatment.
Hair loss can be treated with:
Skin cancer treatments are often aggressive, with the goal of wiping the cancer out completely before it can cause worse problems. Treatments for skin cancer include:
Often more than one treatment will be used at a time, or your doctor may prescribe another treatment after the cancer has been removed, to keep it from returning.
About 30% to 60% of those with skin diseases have tried some form of alternative medicine at some point in their lifetimes. In general, alternative treatments are not as well studied or as well understood, and alternative medicine cannot take the place of modern medicine if you have a dangerous condition such as skin cancer or a serious skin infection. However, some alternative and complementary treatments may be useful for mild conditions or alongside medical treatment for more serious problems.
Some of the alternative and complementary treatments that have been used for skin problems include:
Follow your doctor’s instructions, and take good care of your skin. Bathe regularly, using warm water and a mild cleanser. Use moisturizer after bathing or washing your hands, and as often as you need to in between. It’s a good idea to stay away from harsh hair or nail care products, which may dry out or damage your skin. Other things you should avoid for your skin’s health include:
Contact a doctor if you have a rash or other skin symptoms that bother you or don’t go away.
Contact a doctor immediately if you notice a mole or growth that changes or looks very different from other moles on your body.
If you need a dermatologist, your primary doctor can refer you, or you can use the online Find a Dermatologist tool from the American Academy of Dermatology
When you go to see your doctor, it’s good to have a list of the questions you’d like to have answered. Take a moment to write down some of the things you want to know. Your questions for your doctor might include some of these:
Is there anything else I should know about my skin condition?
Other useful resources to help you learn about your skin and take charge of your skin health can be found at:
American Academy of Dermatology
SPOT Skin Cancer
Dermatology A to Z
American Skin Association
FamilyDoctor.org Search by Symptoms: Skin Rashes and Other Changes
National Eczema Association
National Psoriasis Foundation
National Council on Skin Cancer Prevention
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