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Forest Trees

Common Skin Conditions

Seborrheic keratosis

What is it?  Also known as senile warts, brown warts, wisdom warts or barnacles.  They are common on the back, face and scalp.  By age 60, nine out of ten people will have at least one.  Ranging from pale pink and white to light brown and almost black, they often have a 'stuck on' appearance.  They can also be a bit scabby and bits sometimes come off and re-form.

Should you worry?  They're not serious, but can be unsightly. See your doctor if the appearance of the growth bothers you or if it gets irritated or bleeds when your clothing rubs against it.

Treatment  You may not need treatment but want them removed for cosmetic reasons.  Treatments include cryotherapy, shaving off with a sharp blade (shave excision), curettage and cautery (scrapping off the lesion and applying heat) or a chemical peel.

Will the NHS remove seborrheic keratosis?  As they are harmless they do not require any treatment.

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Actinic keratosis (solar keratosis)

What is it?  Small dry scaly patches of skin that have been damaged by the sun.  They may be white, pink, red, light or dark tan or a combination of colours.  They can be warty or horny and sometime tender, often smaller than seborrheic keratoses.  Find them on sun-exposed areas of the face, lips, ears, scalp, shoulder, neck, back of the hands and forearms.  Men are especially prone to them on the bald scalp and ears.

Should you worry?  They can turn into a type of skin cancer called squamous cell carcinoma (SCC), although this is not an issue if you only have one lesion. 

If you have ten or more, the risk is slightly higher.  If the lesion becomes tender, thickened, ulcerated or gets bigger it needs checking out.  It is important to avoid further damage to your skin.

Treatment  If you only have 1 skin patch, a GP might suggest waiting to see if the patch goes away by itself.

If you have more than 1 patch, or a patch is causing you problems such as pain and itchiness, treatment is usually recommended. A GP may refer you to a skin specialist (dermatologist).  Treatments include: cryotherapy, shave or curettage and electrocautery.  For flat lesions, a topical cream/gel.

See your GP if:

  • this is the first time you have noticed patches on your skin

  • the patches begin to bleed, get bigger, change colour, feel tender or develop into a lump

It's important to get these skin changes checked, in case they could be caused by something more serious, such as skin cancer.  If you have actinic keratoses it's important to avoid any further sun damage. This will stop you getting more skin patches and will lower your chance of getting skin cancer.

Basal cell carcinoma (BCC)/Rodent ulcer

What is it? BCCs can look like open sores, red patches, pink growths, shiny bumps, scars or growths with slightly elevated, rolled edges and/or a central indentation. At times, BCCs may ooze, crust, itch or bleed. The lesions commonly arise in sun-exposed areas of the body. In patients with darker skin, about half of BCCs are pigmented (meaning brown in color).  It’s important to note that BCCs can look quite different from one person to another, varying in size from a few millimetres to several centimetres. Patients often ignore them until they start bleeding or ulcerate.

Should you worry?  BCC is a form of skin cancer but it rarely spreads to other parts of the body.

Treatment  Surgery to cut out the lesion and the skin around it is the most common.  Nonsurgical options include cryotherapy, photodynamic therapy, radiotherapy, electrochemotherapy and topical chemotherapy or immune-stimulating creams.

See a GP if you have any skin abnormality, such as a lump, ulcer, lesion or skin discolouration that has not healed after 4 weeks. While it's unlikely to be skin cancer, it's best to get it checked.

BCCs rarely spread beyond the original tumor site. But these lesions can grow and become disfiguring and dangerous. Untreated BCCs can become locally invasive, grow wide and deep into the skin and destroy skin, tissue and bone. The longer you wait to get treatment, the more likely it is that the BCC will recur, sometimes repeatedly.

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Squamous cell carcinoma (SCC)

What it is?  Sometime similar to BCC but faster growing.  These can be scaly red patches, open sores, rough, thickened or wart-like, and sometime look like a mini volcano, with steep sides and a central crater.  They may crust, itch or bleed.  Most often found in the scalp and ears (men) and lower legs or backs of the hands (women).

Should you worry?  Untreated, it can spread, so prompt treatment is vital.

Treatment  Surgery to remove the SCC under local anaesthetic is the most common; sometimes a skin graft is needed.  Other treatment include curettage and cautery as well as radiotherapy.  When caught promptly, almost all squamous cell carcinomas (SCCs) of the skin can be successfully treated. But when they become more advanced, these skin cancers can become dangerous.  That’s why it’s important to be on the lookout for any SCC warning signs, including new, changing or unusual skin growths.

Malignant melanoma

What is it?  The most serious form of skin cancer caused by uncontrolled proliferation of the skin's pigment-producing cells, melanocytes.  While it is less common than basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), this skin cancer is more dangerous because of its ability to spread to other organs more rapidly if it is not treated at an early stage.  It's most often found on the back in men and legs in women.  Previous sunburn, especially with blistering, is a risk factor, as is having more than 100 moles.  

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Things to look for: changes in the size, shape or colour of an existing or new mole, an irregular shape, itching and/or bleeding, oozing or crusting.  They initially tend to grow outwards rather than downwards, so they do not pose a problem.  But if they grow downwards into the deeper layers of skin, they can spread to other parts of the body.

Should you worry?  Left untreated, melanoma can spread.  See your GP without delay if you notice any of the changes mentioned.  

Treatment  Surgery to remove the cancer and an area around it.  If caught early, the outlook is excellent with 80-90% of people monitored for one to five years then discharged.

Examine yourself head to toe once a month: Keep an eye out for new or changing lesions that grow, bleed, or do not heal.  When in doubt, check it out. Follow your instincts and visit your doctor if you see a spot that just doesn’t seem right.

Watch... a nurse consultant in skin cancer explains how to check your skin for signs of cancer:

Practice sun safety: Making daily sun protection a part of your lifestyle is the single most effective way to reduce your risk of developing skin cancer.

How to protect your skin from the sun

  1. Use a sunscreen every day, even if it’s cloudy.    

  2. Apply at least one ounce of sunscreen (enough to fill a shot glass) at least 15 to 30 minutes before going outside. Also use a lip balm or lipstick that contains sunscreen with a sun protection factor (SPF) of at least 30.

  3. Choose a broad-spectrum sunscreen that protects against both UVA and UVB radiation. Make sure it is water resistant and has a SPF of 30 or higher. Other sunscreens may help keep you from getting sunburned, but they won’t protect against skin cancer.

  4. Reapply sunscreen ever two hours.  Reapply every hour if you are swimming or sweating.   

  5. Be extra careful around water and sand. These surfaces reflect the damaging rays of the sun, which can increase your chance of getting a sunburn.

  6. Keep babies younger than 6 months old completely covered and in the shade.

  7. Limit the amount of time you’re in the sun between 10:00 AM and 4:00 PM. This is when the sun's rays are the most intense. Practice the shadow rule: if your shadow is shorter than you, the sun's rays are at their strongest, and you should find shade.

  8. If possible, wear a long-sleeved shirt and long pants. Dark clothing with tightly woven fabric blocks more sun than white or loosely woven fabrics. For additional protection, look for clothes made with special sun-protective materials.

  9. Accessorise with a hat that shades your face, neck, and ears and a pair of sunglasses.  Sunglasses with lenses that have 99% to 100% UV absorption provide optimal protection for the eyes and the surrounding skin.

  10. Be even more cautious if you are taking medications that may make you more sensitive to the sun.  These include specific types of antibiotics, anti-inflammatories, antifungals, blood pressure medications, and chemotherapies.

information taken from: NHS, Skin Cancer Foundation and The ASCO Foundation

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