Listen to Your Skin

Skin has much to say when it or the structures it covers are troubled.

DERMATOLOGY Our largest anatomical organ is the one we actually live within. Skin has remarkable healing properties when breached. It cools us when body temperature rises and, depending upon our complexion, protects us from harmful ultraviolet rays. Skin can also signal potential health problems deep within us.

Clues to Subsurface Issues

Acne, blackheads, moles, enlarged pores, allergic reactions, psoriasis, hyperhidrosis and melanoma are a few potential skin problems. Though acne is characteristic of puberty, diet is also a contributing factor. Enlarged pores and blackheads are primarily the result of oils and debris lodged within them that stretches them out. Healthy eating improves skin health. Washing in the morning and before bedtime can improve appearance. These are just a couple of ways the skin signals an underlying condition. The anatomy poster entitled The Skin and Common Disorders lists 20 skin lesions.

Ultra dry skin can be hereditary, a sign of aging, or signal serious health problems. Experts have a rule of thumb. Try at-home dry skin treatments — like using moisturizers, humidifiers, and milder soap — for two weeks. If they haven't helped, it's time to schedule an appointment. You should also see an expert for dry skin treatment if you have any of the following specific signs and symptoms: [1]

  • Sudden onset of dry skin
  • Sudden onset of itchiness
  • Severe dry skin that's cracking, swollen, red, bleeding, or oozing
  • The development of dry skin when you have other medical conditions like poor blood circulation or diabetes

The Sun Does More Than Burn

The skin is an effective barrier for delicate underlying tissues. Working somewhat like shades we wear on our eyes, melanin, the skin pigment, can shield us from harmful UV rays and resulting sun burn. The problem is that many people have too little melanin. For the purpose of sun protection, dermatologists grade skin on a 6-point Fitzpatrick scale.

Fitzpatrick Classification
Classification Response to Ultraviolet Rays Skin Color
I Never tans, always burns White
II Tans with difficulty, usually burns White
III Average tanning, sometimes burns White
IV Easily tans, rarely burns Moderate Brown
V Very easy to tan, very rarely burns Hispanic, Latin, African, Asian, Indian
VI Never burns Black

Typically sunscreen is strongly recommended for skin types I – IV. Sunscreen is still recommended for the remaining two skin types may wear sunscreen, particularly under unfavorable conditions. For example, certain dermatological treatments and prescriptions like hydroquinone may decrease effectiveness of melanin. Altitude may play a factor, exposing the skin to higher than normal amounts of radiation.

Frequent sun exposure has been linked to basal cell, squamous cell or melanoma skin cancer. The most common indication of melanoma is a mole that changes appearance. Asymmetrically shaped and irregularly colored moles with changing dimensions and irregular borders should be attended to by a dermatologist.

Irregular moles are not the only indication of cancer. Skin might develop sores that are not the result of trauma. This can sometimes suggest internal issues with our digestive system or precancer.

Don't Ignore Precancers

Two examples of precancer are Bowen's disease and actinic keratosis. The former has been previously discussed at length. The latter, also known as solar keratosis, is the most common, affecting an estimated 10 million Americans. [2] It is generally recognized as scaly or crusty bump that arises on the skin surface. The base my be light or dark, tan, pink, red, a combination of these, or natural skin color. The rough texture is often recognized by touch as it presents a texture ranging anywhere from sandpaper to a protruding yellowish horn. Attention may also be drawn to it when it itches. [3]

Sun exposure causes almost all actinic keratoses. Sun damage to the skin accumulates over time, so that even a brief exposure adds to the lifetime total. Fair-skin and immunosuppressed individuals are at risk. African-Amaericans (Fitzpatrick scale V-VI) rarely have these lesions.

The lesions are usually not life threatening, provided they are detected and treated in the early stages. Any persistently active lesion should be evaluated by a dermatologist, especially if it presents itself spontaneously. Sometimes lesions can be identified by appearance but most likely a biopsy is necessary to perform specific tests.

Treatment for actinic keratosis may involve cryotherapy (freezing the lesion with liquid nitrogen), topical chemotherapy (anti-cancer drugs), or other treatments. The cure rate for cryotherapy is 99 out of 100 percent. Risks include scaring, pain and tingling during surgery, infection, and longer recovery time than other procedures that remove skin cancers. [4] Laser surgery may alternatively be recommended. [2]

Take-away tips: Care for your skin through regular cleansing with non-harsh soaps. Exfoliate dry skin and lubricate with moisturizer. Wear sun protection including, brimmed hats, protective eye ware, and sunscreens with minimum SPF 15 that blocks UVA and UVB rays. Most importantly, don't ignore your skin when it's talking to you.

  1. Ultra Dry Skin? When to Call the Doctor.
  2. Actinic Keratosis and Other Precancers. Skin Cancer Foundation,
  3. Actinic Keratosis (A Precancerous Condition). New York-Presbyterian
  4. Cryosurgery for nonmelanoma skin cancer.