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ACNE: TIPS FOR MANAGING

6 skin care habits that can clear acne
If you’re treating your acne but still seeing breakouts, it can be frustrating. Acne has many causes, and treatment looks different for everyone. Fortunately, there are some self-care steps you can take at home to help manage your acne during treatment.

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To get the best results from your acne treatment, board-certified dermatologists recommend these tips.

Keep your skin clean. Gently wash your face up to twice daily and after sweating. Choose a gentle, non-abrasive cleanser. Apply it with your fingertips, as scrubbing with washcloths, sponges, and other tools can irritate your skin.
Choose the right skin care. Use gentle skin care products and ones that say “alcohol-free” on the label. Avoid products that can irritate your skin, including astringents, toners, and exfoliants. These products can dry your skin and make acne appear worse.
Shampoo regularly. The oil from your hair can cause acne on your forehead. If you have oily hair, shampoo more often than you do now and keep your hair away from your face.
Stick to your treatment. Trying new acne treatments too often can irritate your skin and cause breakouts. Give your treatment time to work. It may take several weeks to few months before you see a difference.
Keep your hands off. Touching your face throughout the day can cause acne to flare. While it can be tempting to pick, pop, or squeeze your acne, doing so will make the acne take longer to clear and increase your risk for scarring and dark spots called post-inflammatory hyperpigmentation.
Stay out of the sun and tanning beds. Along with increasing your risk for skin cancer, tanning damages your skin and can worsen acne. Some acne medications can also make your skin very sensitive to damaging ultraviolet rays from the sun and tanning beds.

Protect your skin by avoiding tanning — indoors and out — and by seeking shade, wearing sun-protective clothing, and applying a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher to all skin not covered by clothing when outdoors. Look for a sunscreen that says “non-comedogenic” or “won’t clog pores.” For more effective protection, select clothing with an ultraviolet protection factor (or UPF) number on the label.

Acne takes time to clear. If you keep seeing breakouts after following these tips, partner with a board-certified dermatologist. Dermatologists can treat existing acne, prevent new breakouts from forming, and reduce your chance of developing scars.
Related AAD resources

HOW TO REMOVE A TICK AND PREVENT FUTURE BITES

HOW TO REMOVE A TICK

Ticks are small, insect-like creatures that live in heavily-wooded or grassy areas. If you walk through these areas, they can attach to your skin and feed on your blood. Although most ticks do not carry disease, some can cause serious illness. To prevent infection, it’s important to remove a tick from your skin as soon as you notice it.
To remove a tick that is attached to your skin, dermatologists recommend the following tips.

Use tweezers to remove the tick. Sterilize the tip of the tweezers using rubbing alcohol and grasp the tick as close to the skin’s surface as possible.
Pull upward with steady, even pressure. Avoid twisting, squeezing or crushing the tick, as this can cause its head or mouth to break off and remain in your skin. If this happens, use tweezers to remove the remaining parts. If you cannot remove the rest of the tick, see a board-certified dermatologist.
Dispose of the tick. Place it in a sealed bag or container; submerse the tick in alcohol; or wrap it tightly in tape. You may also want to save the tick in a sealed jar. That way, if you develop any symptoms after the bite, the tick can be tested for disease.
Clean the bite area with soap and water.

Ticks can bite at any time, however they’re most active in April through September. Fortunately, there are many things people can do to protect themselves and their families against ticks.
To prevent tick bites, dermatologists recommend the following tips:

Walk in the center of trails. Avoid walking through heavily-wooded and brushy areas with tall grass.
If you must walk through heavily-wooded areas, wear long pants and long sleeves. Pull your socks up over your pants, and tuck your shirt into your pants to prevent ticks from crawling up your body. It’s also a good idea to wear light-colored clothes so that ticks can be spotted easily.
Use insect repellent that contains 20 to 30 percent DEET on exposed skin and clothing. Make sure to follow the product instructions. Parents should apply this product to their children, making sure to avoid the hands, eyes and mouth.
Examine your skin after spending time in heavily-wooded or brushy areas. Conduct a full-body tick check to make sure that no ticks are crawling on you. Since ticks prefer warm, moist areas, be sure to check your armpits, groin and hair. You should also check your children, pets and any gear you used outside.

If you develop any symptoms within a few weeks after a tick bite, such as a rash, fever or body aches, see a board-certified dermatologist. Make sure you tell the doctor about your recent tick bite, when the bite occurred and where you most likely acquired the tick.

BED BUGS: TIPS FOR PREVENTING

You can reduce your chance of bringing bed bugs home by following these dermatologists' tips when traveling and shopping for furniture.

How to prevent picking up bed bugs while travelingMost people get bed bugs while traveling.
Bed bugs are tiny insects that feed on human blood. They can crawl into a suitcase or onto clothing unnoticed.
Here's how you can find bed bugs before they find you and your belongings.
When checking into a hotel, cabin aboard a cruise ship, or elsewhere, you want to check your room before unpacking.
Here's what you want to do:

When you walk into the room or cabin, take a deep breath. Do you notice a sweet or musty odor? If there is a heavy infestation, you may notice this smell. Bed bugs produce chemicals to help them communicate.
Next, check the bed. Look carefully at the blankets, sheets, pillows, and mattress pad. Then, check the mattress and box spring. Do you see:
- Blackish specks, which could be bed bug excrement
- Specks of blood anywhere, especially near seams
- Shell-like remains on the bed, bedding, or furniture? Bed bugs have an outer shell that they shed and leave behind as they grow.
You'll also want to check all upholstered furniture. While checking, you may see bed bugs or their eggs. A bed bug is about the size of an apple seed.

If you find signs of bed bugs, you should immediately request another room or cabin. The other room should not be near the current room.

How to prevent bringing bed bugs into your home after traveling.
If you are concerned that you may have picked up bed bugs, you should inspect everything that you bring home (luggage, purse, and other belongings) for signs of bed bugs. You want to look for blackish specks, drops of blood, and shell-like remains.
If possible, inspect everything before you bring it inside your home.
If you see signs of bed bugs or strongly suspect that you might have brought bed bugs home, you should immediately:

Wash all the clothing that you brought home in a washing machine. Even clothes that you didn't wear must be washed in hot water. If you cannot wash something in a washing machine, you can either place it in a hot dryer or seal the items in a plastic garbage bag. If you seal items in a garbage bag, leave the bag securely closed in an extremely cold or hot place for a few months.
Dry your clothes after washing them in a clothes dryer, using the hot setting.
Use a hand steamer to clean your luggage. According to the National Pest Management Association, a garment steamer will kill bed bugs and their eggs.

How to prevent bed bugs when buying secondhand beds and other furniture
Bed bugs can be hard to find in secondhand beds and other furniture. If the bed bugs have not eaten for some time, you may not see signs of them. Bed bugs can live for about a year without eating.
You can prevent picking up bed bugs from secondhand furniture by not bringing secondhand furniture into your home.

More resources
National Pest Management Association
This association provides information to help you avoid and get rid of bed bugs.

Image
Getty Images
References
National Pest Management Association, “Bed Bug Prevention.” Last accessed June 2012.
Steen CJ, Carbonaro PA, Schwartz RA. “Arthropods in dermatology.” J Am Acad Dermatol 2004; 50:819-42.

ACNE-LIKE BREAKOUTS COULD BE FOLLICULITIS

What exactly is folliculitis?
This is a common skin infection that develops in the hair follicles. Folliculitis can appear anywhere on the skin, except for our palms and soles.
What does folliculitis look like?
It usually looks like a sudden acne breakout. Each spot may have a red ring around it, which is a sign of the infection.

What are the symptoms of folliculitis?
Symptoms can vary. You may not feel anything. Sometimes, the infection causes itchy skin. It’s also possible for your skin to feel painful.
How did I get folliculitis?
You get folliculitis when you damage your hair follicles. Once damaged, it’s easy for germs to get inside the follicles and cause an infection. A common source of infection is Staph aureus, which is found on our skin. Other organisms on our skin can also cause an infection.

You can damage your hair follicles by:

Touching or rubbing your skin frequently
Wearing tight clothing
Having skin rub against skin
Shaving

When your skin is damp and hot, it’s easier to damage your hair follicles and get an infection. This can happen when tight clothing rubs against your skin while you’re bicycling on a hot day.
The damage can also happen while you’re using a hot tub or whirlpool. When this occurs, the acne-like breakouts tend to appear on skin that was covered by your bathing suit. Most people see breakouts about 12 to 48 hours after using the hot tub.

What causes folliculitis?
While many things can damage your hair follicles, the following are common causes of folliculitis:

Hot tub (improperly maintained)
Shaving, plucking, or waxing
Tight clothing or equipment
Medication applied to the skin, such as coal tar
Medication you take
Weight gain

How can I get rid of folliculitis?
The acne-like breakouts tend to go away on their own if you:

Have a healthy immune system
Stop doing what caused the folliculitis

To clear your skin more quickly and get relief, apply warm compresses to the area. When using warm compresses, dermatologists recommend that you:

Apply a warm compress at least 3 to 4 times a day.
Leave the compress on your skin for 15 to 20 minutes each time.

If a warm compress helps you feel more comfortable, you can apply it more than 4 times a day.
When shaving, plucking, or waxing causes the infection, you’ll want to stop doing these things for 30 days.

Do I need to see a dermatologist about folliculitis?
It can be helpful to see a dermatologist to make sure you have folliculitis. The infected hair follicles can look like another skin condition, such as acne. A board-certified dermatologist can tell you whether you have folliculitis and give you tips to help clear it. Some people need medication, such as an antibiotic, to clear the folliculitis.
Seeing a dermatologist can also be helpful if you develop razor bumps from shaving and cannot stop shaving. Some men can continue shaving when they apply a medication to their skin. Your dermatologist can also give you tips that can reduce the irritation that shaving causes.

Can I prevent folliculitis?
Sometimes. Here are a few common causes and things you can do to prevent getting folliculitis:

Wear loose clothing when it’s hot and humid. Tight clothing tends to rub against your skin. When it’s hot and humid, the constant rubbing can injure your hair follicles, causing folliculitis. If you wear tight clothing while working out, you may be able to prevent a flare-up by changing out of your clothes immediately after working out and showering.
Use well-maintained hot tubs. You’re more likely to get folliculitis from a hot tub or whirlpool that’s improperly maintained. If you’re unsure whether the acid and chlorine levels are properly controlled, you may want to skip the hot tub or whirlpool. This will help you avoid getting hot tub folliculitis.
Wash your bathing suit or wetsuit after each use and let it dry. Washing your suit after each use and letting it dry completely before wearing it helps to reduce your exposure to bacteria that can cause folliculitis.
Follow these tips when applying medication to your skin. Some people develop folliculitis when they apply medication, such as coal tar, to their skin. You may reduce the risk of developing folliculitis by:
- Applying the medication in the same direction in which your hair grows.
- Not covering the treated area with a bandage or clothing, when possible.
Shave with care. Shaving is a common cause of folliculitis. You may be able to reduce your risk by following these shaving tips at, How to shave.

While the acne-like breakouts of folliculitis tend to go away on their own, it can feel unsettling to suddenly see these appear on your skin. A board-certified dermatologist can tell you whether you have folliculitis and help you feel more comfortable.

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Images
Images 1 and 2 used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
Other image: Getty Images
References
Habif TP, Campbell JL, et al. “Folliculitis.” In: Dermatology DDxDeck. Mosby Elsevier, China, 2006: Card 48.
McMichael A, Guzman Sanchez D, et al. “Folliculitis and the follicular occlusion tetrad.” In: Bolognia JL, et al. Dermatology. (second edition). Mosby Elsevier, Spain, 2008: 517-9.
Yosipovitch G and Kwatra SG. “Itch associated with infections.” In: Living with itch: A patient’s guide.” The Johns Hopkins University Press. United States, 2013: 71-2.

POISON IVY, OAK, AND SUMAC: WHAT DOES THE RASH LOOK LIKE?

While rare, some people see black spots instead of a red rash on their skin. These spots look like black lacquer spilled onto the skin. Instead of black spots, some people develop black streaks on their skin.
If you develop black spots or streaks, there tends to be little or no redness and swelling. The medical term for this condition is black-spot poison-ivy dermatitis.

How does the rash show up on the skin?It takes time for the rash to appear. A rash can develop in a few hours if you’ve had a rash from one of these plants before. If you’ve never had a rash from poison ivy, oak, or sumac, it can take 2 to 3 weeks before you see a rash.
No matter how long it takes for the rash to appear, most people experience the following when they get a rash:

The skin itches intensely where the rash will appear. The itch can be so intense that it wakes you from a sound sleep.
Shortly after your skin starts to itch, the rash appears. Most people develop an itchy, red, and blistering rash.
If you have blisters, they break open and leak fluid.
The blisters crust over, and the rash clears in 2 to 3 weeks. The rash will clear without treatment, but it can be extremely itchy until it clears completely.

The intensity of the itch and severity of the rash can differ from person to person. Some people develop 1 or 2 small rashes. Others develop rashes all over.
Why does the rash from poison ivy, oak, or sumac spread?While it may look like the rash is spreading, what’s most likely happening is that you’re developing one or more new rashes. This happens because you either:

Got urushiol (the oil from these plants that causes the rash) on more than one area of your skin. Typically, the skin with the most oil on it develops a rash first. Skin with less oil tends to react later.

Touched something that still has urushiol on it, such as the unwashed clothing you were wearing when you brushed up against one of these poisonous plants. Urushiol doesn’t have to be on the plant to cause a rash.

If your new rash appears near the current rash, it can look like the rash is spreading.
Many people also mistakenly believe that when they touch their rash, they can spread the rash from one part of their body to another. You cannot spread the rash.
If you have oil from the plant on your skin, you can spread the oil for a short time. Your skin absorbs the oil quickly, so you can only spread the oil from one part of your skin to another for a short amount of time.
How long does a rash from poison ivy, oak, or sumac last?How long you have a rash depends on whether you’ve had a rash from one of these plants before. Here’s the general rule:

Previous rash from poison ivy, oak, or sumac: The rash tends to last 1 to 14 days before it clears on its own.

Never had a rash from poison ivy, oak, or sumac: You can have a rash for 21 days or longer before it goes away.

If you’re wondering why you develop a rash from these plants, you’ll find the answer at: Poison ivy, oak, and sumac: Who gets a rash, and is it contagious?

Images
Image 1 used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
Images 2,3 used with permission of the Journal of the American Academy of Dermatology.

J Am Acad Dermatol 2001;45:246-9.

References
Kurlan JG, Lucky AW. “Black spot poison ivy: A report of 5 cases and a review of the literature.” J Am Acad Dermatol2001;45:246-9.
McGovern TW. “Dermatoses due to plants.” In: Bolognia JL, et al. Dermatology. (second edition). Mosby Elsevier, Spain, 2008: 255-6.

SKIN TAGS: WHY THEY DEVELOP, AND HOW TO REMOVE THEM

Skin tags are harmless growths that can appear anywhere on your skin, but often develop on the neck, eyelids, or underarms. They may be the same color as your skin or darker. Some are pink. Others turn red when irritated. You may see one dangling from a stalk, while another is firmly fixed to the skin.
With all this variation, there is one thing that acrochordons (medical name for skin tags) seem to have in common. Many people want to remove them.

The following explains how dermatologists remove skin tags. It also answers other questions that patients frequently ask their dermatologist.

Why am I getting skin tags?

These growths can appear anywhere on the skin, but they usually develop where skin has been rubbing against skin, jewelry, or clothing for some time. That’s why they usually occur in one or more of these areas:

Breasts (beneath)
Eyelids
Groin
Neck creases (or where clothing or jewelry rubs against the neck)
Underarms

Skin tags are also commonly found on the sides, abdomen, or back.
Because they develop where skin rubs against skin, people who are overweight, pregnant, or have loose skin are more likely to get skin tags.
You also have a higher risk of developing skin tags if you have diabetes, metabolic syndrome (high blood pressure, unhealthy blood sugar levels, extra fat around your waist, or unhealthy cholesterol levels), or a blood relative has skin tags.
It’s important to keep in mind that these growths are harmless.

Should I remove a skin tag?

Because they’re harmless, a skin tag only needs to be removed if it:

Becomes irritated or bleeds
Develops on your eyelid and affects your eyesight
Feels painful, especially when the pain comes on suddenly

A skin tag can become irritated if it frequently rubs against jewelry, clothing, or a seat belt. Shaving can also irritate it, especially if you nick the skin tag. A dermatologist can remove these skin tags.

If you dislike the way a skin tag looks, your dermatologist can also remove it. However, you’ll likely pay the cost. Insurance providers consider removing a skin growth for looks alone a cosmetic treatment. Insurance rarely covers the cost of cosmetic treatments.

How does a dermatologist remove skin tags?

Your dermatologist can quickly and safely remove one or more skin tags during an office visit, and usually without the need for a follow-up appointment.
The treatment that your dermatologist uses will depend on the size of the skin tag, where it appears on your body, and other considerations.
Your dermatologist may use:

Cryosurgery: During this treatment, your dermatologist applies an extremely cold substance like liquid nitrogen to freeze and destroy the skin tag. Sometimes, freezing causes a blister or scab. When the blister or scab falls off, so will the skin tag.

When using cryosurgery, your dermatologist may freeze only the bottom of the skin tag and then snip it off with a sterile surgical blade or scissors.
Electrodesiccation: Your dermatologistuses a tiny needle to zap the skin tag, which destroys it.You’ll develop a scab on the treated skin that will heal in one to three weeks.
Snip: Your dermatologist will numb the area, use sterile surgical scissors or a blade to remove the skin tag, and then apply a solution to stop the bleeding.

After treatment, your dermatologist may give you aftercare instructions to follow. This may include removing the bandage, washing the area carefully, and covering it with a new bandage.
Follow your aftercare instructions carefully to prevent problems like an infection.

Does wart remover work on skin tags?

Given that some skin tags look like warts, it’s easy to think wart remover would work well. It doesn’t.
Warts are hard and need strong medication. Skin tags are soft, so using a wart remover on them can damage your skin. You may develop scarring or irritated skin where you apply wart remover.

Seeing a dermatologist can give you peace of mind

Skin tags come in many shapes and sizes, so you may mistake a wart or even a skin cancer for a skin tag. Board-certified dermatologists know the difference between something small and something major. By seeing a dermatologist, you’ll find out what’s going on and that can bring peace of mind.

Related AAD resources

5 reasons to see a dermatologist for mole, skin tag removal

Images
Image 1: Getty Images
Image 2: Used with permission of the Journal of the American Academy of Dermatology. (J Am Acad Dermatol. 2019;81:1037-57.)
References
Belgam Syed SY, Lipoff JB, et al. “Acrochordon.” In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.
Farshchian M, Kimyai-Asadi A et al. “Cryosnip for skin tag removal.” J Am Acad Dermatol. 2021 May 30:S0190-9622(21)01032-X. doi: 10.1016/j.jaad.2021.05.039. Epub ahead of print.
Hirt PA, Castillo DE, et al. “Skin changes in the obese patient.” J Am Acad Dermatol. 2019 Nov;81(5):1037-57.
Kutzner HH, Kamino H, et al. “Fibrous and fibrohistiocytic proliferations of the skin and tendons.” In: Bolognia JL, et al. Dermatology. (fourth edition). Mosby Elsevier, China, 2018: 2068-9.
Schwartz, RA. “Acrochordon.” In:Medscape(Elston DM., Ed.) Last updated 10/26/2022. Last accessed 3/28/2023.
Tucker, R. “Advice on how to treat skin tags.” The Pharm Jour. Published March 1, 2011. Last accessed March 23, 2023.
U.S. Food and Drug Administration. “Products marketed for removing moles and other skin lesions can cause injuries, scarring.” Last updated 8/10/22. Last visited 3/30/23.

Written by:
Paula Ludmann, MS
Reviewed by:
Elisa Gallo, MD, FAAD
Laurel Geraghty, MD, FAAD
Shri Lipner, MD, PhD, FAAD
Last updated: 5/1/23

Here are some facts and tips about
skin cancer that you should know:

More than 5 million cases of skin cancer are diagnosed each year in the United States

One in five Americans will develop skin cancer by the age of 70

The most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma

The main risk factor for skin cancer is exposure to ultraviolet (UV) radiation from the sun or tanning beds

You can reduce your risk of skin cancer by wearing sunscreen with SPF 30 or higher, avoiding sunburns, seeking shade, wearing protective clothing and sunglasses, and avoiding tanning beds .

You should check your skin regularly for any changes in moles, freckles, or spots, and see a dermatologist if you notice anything suspicious.

• Slip on a shirt- up to 80% of UV radiation can still get through on a cloudy day.

• Slop on at least an ounce of SPF 30 sunscreen thirty minutes before going outdoors. Re-apply every two hours and more frequently if you are sweating.

• Slap on a hat- the hat should have at least a 2-3-inch brim all around

•Wrap on sunglasses- they should have at least 99% UV absorption to protect the eyes and the skin around the eyes.
Non-melanoma skin cancer is the most common and includes basal cell carcinoma and squamous cell carcinoma.
Warning signs of non-melanoma skin cancer include:

•   A new skin growth
•   A spot that is getting larger
•   A sore place that does not heal within three months
•   Any change on the skin, especially the size or color of a mole
•   Scaliness, oozing, bleeding, or change in the appearance of a bump, nodule, or mole
•   The spread of pigmentation beyond the border of a mole
•   A change in sensation, itchiness, tenderness, or pain in the skin

1. The ACS guidelines state that anyone who is age 20 and older should have a skin examination by a physician during his/her health-related check-up.
2. The warning signs of non-melanoma skin cancer and melanoma are different.
3. Warning signs of melanoma have a simple ABCDE rule:
4. Asymmetry: one half of the mole does not match the other half
5. Border irregularity: the edges are ragged, notched or blurred
6. Color: pigmentation is not uniform, with variable degrees of tan, brown, or black
7. Diameter: greater than 6mm- about the size of the eraser end of a pencil.Any sudden increase or progressive increase should be of concern.
8. Evolution: new or changing skin growths or spots

HOW TO PREVENT SKIN PROBLEMS WHILE GARDENING

The grass under Tim’s hedges desperately needed trimming, so one summer day he tackled the job. He never suspected that 36 hours later he’d be in the emergency room with a painful, blistering rash.
The doctor who examined him noticed that the rash appeared only on Tim’s hands, neck, and parts of his arms. Tim said that while he was trimming his grass, he was wearing a short-sleeved shirt.
After a few more questions, Tim’s doctor gave him the diagnosis — phytophotodermatitis. While the name is anything but simple, the cause is straightforward.
Tim got plant sap on his skin. When sunlight hit the sap on Tim’s bare skin, a chemical reaction occurred. This reaction causes a painful, blistering rash. It can take hours — or even a few days — for the rash to appear.
Injuries like this are more common than you may think. By taking a few precautions, you can prevent many injuries due to gardening or yardwork.

9 ways to protect your skin while gardeningDermatologists recommend the following while gardening:

Cover up. When working with plants, everything from the plant’s sap to its thorns or spines can injure your skin. Touching certain plants can cause an allergic skin reaction. The best way to protect yourself is to cover your skin. When working with plants, dermatologists recommend wearing:
- Gloves
- Shirt with long sleeves
- Pants
- Socks
- Shoes that cover your feet, such as running shoes
Dermatologists also recommend wearing a wide-brimmed hat and sunglasses while outdoors. This helps to protect you from the sun.

Use sunscreen. To protect your skin from the sun, you’ll also want to apply sunscreen that offers:
- Broad-spectrum protection
- SPF 30 or higher
- Water-resistance
Be sure to apply the sunscreen to all skin not covered by clothing, including your face, neck, and ears. To protect your lips from the sun, use a lip balm with SPF 30 or higher. You can stay protected by re-applying sunscreen every two hours.

Covering up and using sunscreen can also help to reduce your risk of getting sunburn, skin cancer, and early signs of skin aging, including age spots and wrinkles.
Avoid gardening when the sun is strongest. The sun’s rays are strongest between 10 a.m. and 2 p.m. When possible, dermatologists recommend staying indoors during these hours.

If you must garden during these hours, try to stay in the shade. This will also reduce your risk of heat stroke, heat rash, and skin cancer.
Take precautions to avoid bug bites. You can prevent many injuries and illnesses due to bugs by:
- Spraying insect repellent with DEET on your clothing once you’re outdoors
- Avoiding gardening and yardwork during dawn and dusk, which is when bugs are most active
- Flicking a bug off rather than killing it, which can prevent the bug from biting or stinging
- Checking your skin from head to toe for ticks when you finish gardening, being sure to check the skin between your toes, hairline, and underarms
Read labels on pest control products, plant foods, and fertilizers before using them. Many gardening products that we use from insecticides to weed killers can cause injuries ranging from a mild rash to severe burns. In rare cases, people have developed life-threatening injuries.

Following all precautions on the label can help prevent these injuries. For example, when the label calls for a respirator, use one or don’t use the product.

When using fertilizer, wear gloves. After using a fertilizer, immediately and thoroughly wash your hands.

Avoid touching your face while gardening. You could get plant sap or something else on your face, which might injure you.

If you need to wipe away sweat, keep a clean washcloth handy. Use it to blot your face dry.
Treat wounds right away. If you have a minor injury, such as a puncture wound from a thorn, it can be tempting to ignore it and keep working. Don’t. Even a minor wound can become infected.

To prevent an infection, immediately treat your wound as follows:
- Wash the wound with soap and water
- Apply an antibiotic ointment
- Cover the wound with a bandage
- Keep the wound clean by changing into clean gloves and clothing before you continue
- Clean the wound and change the bandage every day until the wound heals
Skip foods and drinks that contain citrus — or follow this precaution. When citrus juice gets on your skin, it can react with sunlight and can cause a blistering rash or painful swelling. Foods that contain citrus include lemons, limes, grapefruit, and oranges.

Shower when you finish gardening and change into clean clothes. Sap, pollen, and other parts of plants can get on your clothes and skin. To protect your skin, shower and put on clean clothes immediately after gardening.

Make sure you also machine wash the clothes that you wore while gardening before wearing them again.

When to see a board-certified dermatologistWhile many skin problems caused by gardening can be prevented, an injury can still occur. You can treat most skin injuries at home by:

Cleaning and caring for wounds right away
Treating itchy or irritated skin with a cortisone cream
Alleviating allergy symptoms, such as itchy eyes and sneezing, by taking an antihistamine

If an injury doesn’t heal or worsens, a board-certified dermatologist can help.
Related AAD resources

SARCOIDOSIS AND YOUR SKIN: TIPS FOR MANAGING

Dermatologists offer the following advice to their patients who have sarcoidosis on their skin:

Keep all appointments with your dermatologist. Even if you have sarcoidosis on your skin that doesn’t need treatment, check-ups are important. Sarcoidosis can develop inside the body. Finding and treating sarcoidosis in other areas early can prevent a serious problem.
Pay attention to symptoms, so you can discuss them with your dermatologist during your next check-up. When sarcoidosis develops in another part of their body, some people have symptoms like difficulty breathing or an abnormal heartbeat.

If you notice any symptoms, keep track of them. A cell phone can be a great tool for capturing your signs and symptoms. You can use a notebook app to type in signs and symptoms as you experience them or use the phone’s voice recorder.

You’ll want to tell your dermatologist about all symptoms, even if the symptoms seem unrelated.

Signs and symptoms to watch for include:
- Eye problems: Blurry vision, double vision, problem seeing colors, bloodshot eyes, sensitivity to light, or eye pain
- Heart problems: Dizziness, shortness of breath, swelling in your lower legs, chest pains, fluttering or racing heart, or fainting
- Kidney problems: Sharp pain in your side, back, or both; pain or burning when you urinate
- Lung problems: Coughing or difficulty breathing
- Nerve problems: Bell’s palsy (one half of your face droops), pain when moving a certain way, numbness, tingling, or drop foot (difficulty lifting the top part of your foot)
- Other problems: Unexplained weight loss, fever, feeling tired all the time, joint pain, stiffness, or night sweats
See the doctors that your dermatologist recommends. If your dermatologist recommends seeing your primary care doctor or refers you to a specialist, follow up. If sarcoidosis has developed in another organ, treatment can improve your quality of life. Early diagnosis and treatment may prevent it from worsening.
Get your eye exams and lungs tests as recommended. Sarcoidosis can develop in the lungs or eyes. When the sarcoidosis appears in one of these places, you may not have symptoms.

An eye exam can find signs of sarcoidosis before it affects your eyesight. Catching this early and treating it can prevent permanent eye damage and loss of eyesight.

Chest x-rays and testing that measures how well your lungs work can find out whether the disease affects your lungs. Treatment can reduce the effect it has on your lungs.
If your dermatologist prescribes treatment, treat your skin as directed. When treatment is needed, be sure to follow your treatment plan and tell your dermatologist if:
- Treatment doesn't work.
- You keep getting sarcoidosis in the same place. You might have an allergy.
- You think you're experiencing a side effect from treatment.
Avoid anything that can irritate your lungs. It’s common for sarcoidosis to develop in the lungs. Avoid anything that irritates your lungs like dust, chemicals, fumes, gases, secondhand smoke, and smoking. Anything that irritates your lungs could cause sarcoidosis to develop in your lungs.

Live a healthy lifestyle. Eating a healthy diet, exercising, and not smoking can improve your overall health.
Talk with others who have sarcoidosis. Connecting with others who have sarcoidosis can feel like a lifeline. You can meet people who have similar challenges and learn how they cope. You can get support when you’re feeling down.

You’ll find support groups and chat forums online. To get the most benefit from these:
- Stay away from online forums that are filled with negative talk.
- Avoid sharing private health information online, especially with people who don’t log in and share their name.
- Consider who’s giving medical advice. A board-certified dermatologist or other medical doctor is a trusted source.

When sarcoidosis develops on the skin, it can have a serious impact on your health and well-being. Partner with a board-certified dermatologist — an FAAD — for expert care. No one understands your skin better.

Images
Getty Images
References
Haimovic A, Sanchez M, et al. “Sarcoidosis: A comprehensive review and update for the dermatologist:
Part I. Cutaneous disease.” J Am Acad Dermatol. 2012; 66:699.e1-18.
Part II. Extracutaneous disease.” J Am Acad Dermatol 2012; 66:719.e1-10.
Vivehanantha S, Thompson D, et al. “P8673: Contact allergy exacerbating primary cutaneous sarcoidosis.” J Am Acad Dermatol 2014;70(5):AB67. Commercial support: None identified.

Written by:
Paula Ludmann, MS
Reviewed by:
Arturo R. Dominguez, MD, FAAD
Neelam Khan, MD, FAAD
Ivy Lee, MD, FAAD
Last updated: 3/24/23

SO MANY QUESTIONS. SO LITTLE TIME.

Experts offer best practices on efficiently addressing patients’ questions about sunscreen.

By Andrea Niermeier, April 1, 2023

Aisles of products, numerous social media top 10 lists, and abundant information on the internet: Consumers can be quickly overwhelmed with sunscreen questions related to types, usage, and safety — coming to their dermatologist to seek clarity. While most dermatologists could spend hours on the subject, they unfortunately don’t have the time. This month, DermWorld asked dermatologists to share their bite-sized responses to patients’ frequently asked questions about sunscreen.

Q: Who needs sunscreen? Why do I need sunscreen?
A: According to Kanade Shinkai, MD, PhD, FAAD, professor of clinical dermatology at the University of California San Francisco Department of Dermatology, one of the most important things for patients to understand about sunscreen is that it is part of a program of photoprotection from ultraviolet (UV) radiation from the sun that also includes sun-protective clothing, hats, sunglasses, shade. “We know that UV radiation can cause skin cancer and that skin cancer is the most common cancer in the United States, affecting over three million people a year.”
While we know that non-melanoma skin cancers occur more frequently in fair-skinned individuals, darker-skinned individuals are still at risk. Tasneem Mohammad, MD, FAAD, staff physician in the Department of Dermatology at Henry Ford Health Systems, explained that helping patients with skin of color understand that sunscreen can also help with prevention of pigmentary disorders as well as photoaging is crucial. “I help my patients understand that sunscreen can do different things for different populations but that it can do something for all populations.”

Q: What type of sunscreen should I use?
A: The American Academy of Dermatology currently recommends a broad spectrum, water-resistant sunscreen that is SPF 30 or higher. Ultimately, when helping a patient choose a sunscreen, Iltefat Hamzavi, MD, FAAD, senior staff physician in the Department of Dermatology at Henry Ford Hospital, suggests that the most important quality is wearability. “Knowing your skin situation and skin type determine what kind of sunscreen you pick. Not all sunscreens are appropriate for all populations. However, if you are not actually going to wear a sunscreen product because of color or formulation, forget about using that type of sunscreen and go for one you will use.”
Dr. Shinkai likes to start by asking patients about their sunscreen habits and barriers to sunscreen use. “Patients often tell me a lot of things that are quite insightful and offer a lot of opportunities to explore all of the sunscreen options.” Dr. Mohammad added that patients often imagine a beachgoer with a white triangle on the nose or have had negative experiences with thick, greasy, or uncomfortable sunscreens, making them apprehensive. Some patients may complain about the way a sunscreen interacts with their makeup, creates a white cast, or interferes with the hair on their body. For others, cost is a barrier.
Responding to these concerns, Dr. Mohammad reminds patients about the variety of sunscreens available, including lotions, creams, gels, sticks, powders, and sprays. Gels may be recommended to patients with beards or those concerned about body hair, and powders can work well for the scalp. For patients with skin of color, a variety of micronized mineral and chemical sunscreen filters exist. “Really try to explore the barriers to find the opportunities,” Dr. Shinkai suggested.
Dr. Hamzavi echoed this sentiment. “We can customize a sunscreen plan based on patients’ formulation, SPF, and spectrum of photoprotection needs. That requires us to offer something. We can’t just say ‘try whatever you like’. We have to tell patients, ‘This is your skin type, your habits, and your preferences — try this sunscreen.’”

Q: When should I use sunscreen? Do I need to wear it every day or just on sunny days?
A: When speaking to patients about sunscreen use, emphasizing a daily routine is helpful. Dr. Mohammad recommends connecting sunscreen application to another routine such as brushing teeth, getting out of the shower, applying moisturizer, or putting on makeup. Applying sunscreen during these times often provides the recommended 15 minutes before photo exposure, she noted.
Helping patients tailor their sunscreen routine to a variety of situations is also important. Dr. Shinkai commented that wearing moisturizers, makeup, or setting powders with adequate sunscreen components or UV filters for photoprotection may be a reasonable option for a patient heading into the office. When that person later decides to go for a jog during peak hours of the day, that’s when to encourage a water-resistant sports sunscreen. “These are the practical elements that I really try to encourage patients to explore — customizing the type of sunscreen that they should use and when,” Dr. Shinkai added.

Q: How much sunscreen should I use, and how often should I apply it?
A: Realistically, people only apply half to a quarter of the amount of sunscreen that they should, according to Drs. Hamzavi, Mohammad, and Shinkai. Sharing with patients that sunscreen testing in labs is done at a concentration of 2 milligrams per centimeter squared and explaining what that looks like may help patients understand that their actual SPF coverage may not be what they think it is.
While packaging usually recommends reapplication every one-and-a-half to two hours, again Dr. Mohammad urges using a common-sense approach with patients. If the plan for the day is taking a 15-minute walk in the morning or going out to get coffee, applying sunscreen once a day in the morning feels doable to patients. When a person heads to the beach, works outdoors, or sweats a lot, that’s when emphasizing frequent reapplication is necessary.
Dr. Mohammad also suggests that sunscreen type should be considered when speaking to a patient about application. For example, patients can often tell if a cream sunscreen has been applied evenly. However, patients who use spray or powder sunscreen filters may think they have gotten their whole body, but realistically the wind has wafted away 90% of the product, leading to uneven or inadequate coverage. An appropriate recommendation to patients is to spray the product directly into their hands and rub it over the whole body.

Q: Broad-spectrum sunscreens protect against both UVA and UVB rays. What is the difference between the rays?
A: Traditionally, dermatologists know that UVA rays are often thought of as the culprit for aging of the skin and UVB rays as more responsible for sunburn. However, visible light is worth discussing with patients as it also has effects on the skin, including pigmentation on darker-skinned individuals and increased inflammatory markers on lighter-skinned populations, Dr. Mohammad noted.
While most sunscreens sold for sun protection these days are labeled “broad spectrum,” covering both UVA and UVB rays, Dr. Mohammad typically recommends that patients get a tinted sunscreen product to have truly broad-spectrum coverage.

Q: What is the difference between chemical and physical sunscreens?
A: Explaining to patients the different properties of each filter is helpful — summarizing that while mineral sunscreens reflect or refract ultraviolet radiation, chemical filters absorb it. Dr. Mohammad often recommends physical sunscreens containing zinc oxide and titanium dioxide for lighter-skinned individuals or those concerned with skin sensitivities. For darker-skinned patients, she suggests chemical sunscreens because these products have a more preferable finish on the skin. “Even the micronized sunscreens can still leave a whitish cast that can be cosmetically unacceptable for many people with skin of color, deterring them from using sunscreen again.”

Q: What does SPF mean? Is a high-number SPF better than a low-number one?
A: Patients may have misconceptions about the meaning of the Sun Protection Factor (SPF) number listed on their sunscreen packaging.
Dr. Hamzavi uses the analogy of an umbrella to help patients understand: “If you walk outside for 10 seconds and have a tiny hole in your umbrella, your umbrella will protect you from getting too wet. However, if you go outside for an hour with a hole in your umbrella, you could potentially be soaked. The variable is exposure over time. An SPF 30 just has more holes than an SPF 100.”
Dr. Hamzavi also recommends sharing with patients that SPF is only calculated to UVB rays. Patients may not know that SPF does not take into account UVA or visible light, which can cause photoaging and pigmentation. Because of this, using an iron oxide or a formulation with antioxidants with sunscreen may be advisable.

Q: How can I protect my baby or toddler from the sun? Can sunscreen be applied to babies?
A: One thing to emphasize to patients is that sun exposure during childhood is some of the most important in setting up risks later in life for skin cancer and melanoma, according to Dr. Shinkai. However, reassuring caregivers that the American Academy of Pediatrics and the AAD provide good guidance is also helpful. Caregivers should use sun-protective clothing and shade for babies younger than six months and a combination of photoprotective covering and physical sunscreens after six months. Coverings may include hats, stroller covers, and playshades, among other things.
Staying practical for patients is necessary. “As we all know, there are times in life when you can’t sit under an umbrella. Using sunscreen on exposed areas is really required,” Dr. Shinkai noted. Physical sunscreens are less likely to induce allergic reactions and are deemed safe and effective, Dr. Mohammad highlighted.

Q: Can I use the sunscreen I bought last summer, or do I need to purchase a new bottle? Does it lose its strength?
A: Dr. Mohammad advises patients to look at both the packaging and the formulation when deciding whether to purchase new sunscreen products. Typically, an expiration date can be found on the packaging. Additionally, she instructs patients to push out some product to examine its consistency. “If the product comes out as oil and then a thick cream, the ingredients are separating, signaling a loss of efficacy.”
If the patient finds the product past the listed expiration date or an unusual consistency, the sunscreen should be replaced.

Q: Will using sunscreen prevent me from getting enough vitamin D?
A: While this may be a concern of patients, Drs. Mohammad and Hamzavi agree that the data does not suggest that this is likely the case. In fact, a 2019 British Journal of Dermatology meta-analysis found little evidence that sunscreen creates vitamin D deficiency in real-life settings, suggesting that concerns about vitamin D should not negate skin cancer prevention advice (https://doi.org/10.1111/bjd.17980).
Dr. Mohammad highlighted that sunscreen does not block 100% of the sun’s rays. Most patients are able to get enough vitamin D from their diet and sun exposure, even with sunscreen. If patients are still concerned about a deficiency, she suggests recommending patients take a supplement.

Q: Are sunscreens safe?
A: To address concerns about sunscreen safety with patients, Dr. Hamzavi emphasizes that simple formulations with a physical barrier have been proven safe and effective. Dr. Mohammad accentuates that sunscreen filters on the FDA’s Generally Safe and Effective (GRASE) list have gone through stringent testing. However, both are transparent to patients that the FDA still has insufficient data for many of the chemical sunscreens on store shelves in the United States.
Dr. Shinkai explains to patients that the science community has known about UV filters in the body for over a decade — which is likely not just coming from the sunscreens people are putting on their bodies. Studies as recent as 2019 and 2020 have indicated some sunscreen systemic absorption. While we know that some data has shown a correlation between sunscreen and alterations on the body, we do not have proven harmful effects of that absorption, Dr. Mohammad emphasized.
In addition to systemic absorption, many patients have concerns about sunscreen and hair loss. Again, Dr. Mohammad clarifies for patients that while some studies have shown a correlation between sunscreen and lichen planopilaris, additional, well-designed studies are needed to determine the accuracy of the results. “I don’t think at this point I would say stop using your sunscreen because it will give you hair loss,” she commented.
While much still needs to be researched about sunscreen in terms of systemic absorption or hair loss, Drs. Hamzavi, Mohammad, and Shinkai all agree on one point: The patient should focus on what data make clear. “We know that sunscreen protects against skin cancer and is very helpful for people who have skin conditions worsened by the sun. We do need further testing of some of these sunscreen filters to have a better idea of the effects or better control in clinical trials. However, the FDA does not recommend that people stop using these sunscreens,” Dr. Mohammad assured.

Q: What can I use if I’m worried about the environmental impact of sunscreens?
A: Dr. Shinkai pointed out that while many patients who worry about the environmental impact of sunscreen may reach for those labeled “reef safe,” this designation does not currently have a regulated or standardized definition and may vary in composition and character.
A large study done by the National Academies of Sciences, Engineering, and Medicine in 2022 pulled together an extensive amount of environmental research and human health information to get a broader understanding of the issue, ultimately recommending that the EPA pursue an ecological assessment to help define what risk the UV filters pose to the environment. This will be a complex study, Dr. Shinkai emphasized, because the way UV filters get into the environment, persist in the environment, and affect different species varies widely.
However, from a human health perspective and as a dermatologist, Dr. Shinkai continues to educate her patients that what we are sure about is that UV protection is important, and that sunscreen is a key player in photoprotection.
Dr. Mohammad instructs patients who are concerned about the environmental impact to use a physical UV blocker and wear photoprotective clothing to reduce the amount of sunscreen they use.

Q: What products can I avoid or use if I think I’m allergic to sunscreen?
A: If a patient is concerned about an allergic reaction to sunscreen, Dr. Mohammad suggests recommending a mineral sunscreen or a chemical product that uses hypoallergenic ingredients. In addition to these topical sunscreens, Dr. Hamzavi also noted that oral adjuncts may be helpful such as some oral antioxidants containing polypodium leucotomas.
Dr. Shinkai reminds patients who are worried about allergic reactions, “Allergy testing, specifically patch testing, to sunscreens may help to identify which UV filters are safe for patients with concerns about allergic reactions.”
Ultimately, helping patients understand what sunscreen is, why it helps them, and which is most appropriate for their skin type and lifestyle comes down to empowering patients to get informed. While the aforementioned suggested talking points can be helpful during patient encounters, dermatologists can direct patients to the AAD Sun Protection Resource Center for more in-depth information.

HOW TO PREVENT ROSACEA FLARE-UPS

Rosacea is a common skin condition that causes redness to form across the nose and cheeks. In addition to seeing a board-certified dermatologist for proper diagnosis and treatment, patients can help control their condition and prevent it from getting worse by identifying and avoiding the things that cause their rosacea to flare.

Think sun protection
Just a few minutes of sunlight on rosacea-prone skin can lead to uncontrollable flushing and redness. Dermatologists recommend that everyone who has rosacea:

Apply a gentle, broad-spectrum sunscreen with an SPF of 30 or higher every day. A fragrance-free sunscreen that contains zinc oxide, titanium dioxide, or both is least likely to irritate your sensitive skin.
Wear a wide-brimmed hat when outdoors during the day.
Stay out of the midday sun.
Seek shade.

HOW TO PREVENT FLARE-UPSPatients can help control their rosacea and prevent it from getting worse by identifying and avoiding the things that cause their rosacea to flare.

Reduce stress
If stress causes your rosacea to flare, you can learn to manage it so that it doesn’t trigger a rosacea flare-up. Here are a few ideas:

Find an activity that relieves your stress and do it often. Common stress busters include tai chi, meditation, or joining a rosacea support group.
Do something that you enjoy on a daily basis.
In a stressful moment, take a deep breath, hold it, and exhale slowly.

Avoid overheating
To avoid a flare-up from heat, dermatologist recommend planning ahead so that you can prevent overheating.
Here are a few things you can do:

Take warm baths and showers rather than hot ones.
Dress in layers, so that you can remove clothing if you start to feel overheated.
Feeling overheated? Drape a cold, wet cloth around your neck. Sip a cold drink. Keep cool with a fan or air-conditioning.
Sit far enough away from fireplaces, heaters, and other heat sources so that you don’t feel the warmth.

Observe alcohol’s effects
When it comes to flare-ups from alcohol, red wine may be the biggest culprit. You may be able to reduce flares from alcohol if you:

Drink white instead of red wine.
Add soda or lemonade to white wine, beer, and other alcoholic beverages to lessen the amount of alcohol.
Limit yourself to 1 or 2 drinks, and have a large glass of cold water after each drink.

Not drinking alcohol also works.

Dial down spicy foods
If spicy foods leave your face red, you may be able to eat your favorites by:

Trying a mild version. Instead of eating hot wings that makes you sweat, opt for mild wings. Choose a mild rather than a hot salsa.

If your rosacea still flares, it’s best to avoid all spicy foods.

Carefully select skin and hair care products
Does your face burn, sting, or itch when you use certain skin or hair care products? Do any of these products cause your face to become dry and scaly? These are signs that they are irritating your skin, which can cause rosacea to flare.
Here’s what you can do to avoid flare-ups:

See a dermatologist, who can give you a skin care plan for rosacea and recommend products.
Stop using astringents and toners.
Look at the ingredients in each of your skin and hair care products, and stop using ones that contain these common rosacea triggers — menthol, camphor, or sodium lauryl sulfate.

The last ingredient is common in shampoos and toothpaste. If you’ll use a product around your face, it’s best to avoid ones that contain sodium lauryl sulfate.

Use rosacea friendly makeup
If makeup seems to trigger your rosacea, you may still be able to wear some makeup.
Dermatologists recommend:

Applying a mild, fragrance-free emollient to your skin before you apply makeup.
Using a light, liquid-based foundation makeup that spreads easily and can be set with powder.

You want to avoid:

Waterproof makeup
Heavy foundations that don’t spread easily or require makeup remover

Check out your medicines
If you think a medicine could be causing your rosacea to flare, don't stop taking it.
First, ask the doctor who prescribed the medicine if it could be triggering your rosacea.
Medicines that can worsen rosacea, include those used to treat:

High blood pressure
Many types of heart problems
Anxiety
Migraines
Glaucoma

Vitamin B3 can also trigger a rosacea flare-up.
If the medicine (or vitamin) could be turning your face red, ask if you could take a different one.

Protect your face from wind and cold
Windburn is common in rosacea-prone skin. A windburn can trigger a rosacea flare-up, especially in the winter. Cold can also trigger rosacea.
The following can reduce flares from wind and cold:

Cover your face (up to just beneath your eyes) with a scarf. Silk or acrylic works best. Avoid putting wool and other rough-feeling fabrics next to your face, as this can trigger a flare-up.
Protect your skin by wearing rosacea friendly sunscreen (see "Think sun protection") and an emollient every day.
Limit your time outdoors.
Follow your rosacea treatment plan.

Keep cool while exercising
Anything that raises your body’s temperature, including exercise, can trigger rosacea. You can still exercise.
Here are some ways you can work out without a flare-up:

Lower the intensity. You can still benefit from a low- or medium-intensity workout.
Exercise where it’s cool. In the summer, try an air-conditioned gym or a shaded path during the coolest part of the day.
Try exercising in the water. Aqua aerobics or swimming in cool water can limit flares.
Keep supplies with you to help you cool down. A towel that you can dip in cold water and then drape around your neck, a bottle of cold water; or ice cubes can cool you.

Treat your rosacea
By treating your rosacea and avoiding what triggers it, many people successfully prevent rosacea flares.
A dermatologist can create a customized treatment plan that helps you control your signs and symptoms.

DERMATOLOGIST-RECOMMENDED SKIN CARE FOR YOUR 20'S

Your 20s is an ideal time to start a skin care routine and adopt skin healthy habits. “The skin care choices you make now will affect what your skin looks like in your next decade – and beyond,” says board-certified dermatologist Rajani Katta, MD, FAAD.
6 skin care practices to start in your 20sWith an overwhelming array of products and skin care trends, it can be difficult to know what’s good for your skin. That’s why we asked two board-certified dermatologists to share their expertise.
Here’s the skin care advice they recommend for women in their 20s:

Use these two skin care products daily: To keep your skin looking its best, dermatologists recommend using these two skin care products every day:
- A mild cleanser: When selecting a cleanser, choose one for your skin type. Dr. Katta says, “For example, if you have acne-prone skin, use a mild cleanser that removes oil.” Dry skin does better with a hydrating cleanser.
  
  To get the best results from your cleanser, wash your face twice a day – when you get up and before bed. You also want to wash after sweating.
- Sunscreen (SPF 30 or higher, broad spectrum, and water resistant): Any time you plan to be outside during the day, even if it’s to take a walk or drive to work, you expose your skin to the sun’s harmful rays.
  
  If you will be outside during daylight, protect your skin. Apply sunscreen to your face and any skin that clothing won’t cover, putting the sunscreen on 15 minutes before you go outdoors. Always put sunscreen on after other skin care products – and beneath your makeup.
  
  Like your cleanser, you want to use a sunscreen formulated for your skin type. If you have oily skin, look for the words “non-comedogenic” or “won’t clog pores” on the product. Women with darker skin tones may want to use a tinted sunscreen. Most tinted sunscreens won’t leave a white cast on your skin.
Add in a skin care product that addresses your primary skin concern: “In our 20s, women’s skin care concerns can vary greatly,” says Dr. Katta. While some women have acne-prone skin, others are noticing fine lines and other signs of aging. Dark spots can be the biggest concern for some.

The best way to address your concerns is to use a skin care product that contains science-backed ingredients, says board-certified dermatologist Rebecca Baxt, MD, FAAD. She recommends the following ingredients:
- Vitamin C serum or cream: Science shows that this ingredient can reduce skin aging and dark spots.
  
  Like other skin care products, you want to use a product formulated for your concern and skin type.
  
  When to apply vitamin C: Dr. Baxt tells her patients, “Apply it after washing your face in the morning, before you put on your sunscreen.”
- Retinoid: The term "retinoid" is a catch-all for an array of vitamin A-based products used on skin. It can treat mild fine lines and wrinkles, acne, and dark spots. It can also improve skin texture.
  
  If you’re looking to treat uneven skin tone, dark spots, or your skin’s texture, look for the word “retinol.” It’s a type of retinoid that’s used for these purposes.
  
  Retinol can give you younger-looking skin by speeding up new skin cell turnover, which starts to slow in your 20s.
  
  To treat acne, dermatologists prescribe one of these retinoids – adapalene, tazarotene, tretinoin, or trifarotene. You’ll also find adapalene in an acne-fighting product available without a prescription.
  
  When spread on acne-prone skin, a retinoid can unclog pores. This can give you clearer skin and allow other acne gels and creams to work better.
  
  When to apply a retinoid: Dr. Baxt recommends applying a retinoid before bed. After washing your face, wait 20 to 30 minutes and then apply it.
  
  If you find the retinoid too drying, apply a moisturizer immediately after washing your face, using a moisturizer that won’t clog your pores. Then apply the retinoid 20 to 30 minutes later.
Make your skin care routine Adjustable, Consistent, and Tailored (ACT). To help her patients remember this point, Dr. Katta tells them to build ACT into their skin care. Here’s why.

“For a skin care routine to meet your needs, it must be adjustable,” says Dr. Katta. For example, you may need a moisturizer during the winter when the air tends to be dry. You’ll also need to adjust your skin care with the passing years. If a product you chose irritates your skin, you’ll want to stop using it right away.

When it comes to creating a skin care routine, consistency is also key. Unless a skin care product is irritating your skin, you need to keep using it. It takes at least 30 days to know whether it’s working.

With so many skin care trends and products available, following one routine can be difficult. The results you see on social media can tempt you to add in another product or two. That’s understandable.

When temptation to try a new product or routine hits, remember this fact. To get results, you need to use products consistently. It takes time to see results.

If you try new skin care products too often, you may not see any progress. In fact, all you may have to show for it is irritated skin.

You also want to create a skin care routine tailored to your needs, as discussed above.

Keep your skin looking its best with healthy habits. Drs. Baxt and Katta stress that keeping your skin looking its best requires more than a skin care routine. Here’s the are key skin-healthy habits they recommend:
- Stop tanning. “Tanning is 100% awful for your skin and your health,” says Dr. Baxt. Every day dermatologists tell their patients that it can cause wrinkles, brown spots, and skin cancer. Dr. Baxt’s advice: “If you use tanning beds or any other indoor tanning device, stop immediately.”
- Protect your skin from the sun. To protect your skin from the sun, the AAD recommends that you seek shade, cover up with clothing, and wear sunscreen that offers SPF 30 or higher, broad-spectrum protection, and water resistance.”
  
  Protecting your skin from the sun every day that you go outside is one of the best things you can do to keep your skin healthy.
  
  For most people, going about your day exposes you to the sun’s harmful rays. “Without sun protection, you’re constantly damaging your skin with everyday activities like walking around your neighborhood, taking a train, and going to and from an outdoor parking lot.” says Dr. Baxt.
  
  She adds, “I see so many women in their 40s lamenting the damage they did to their skin in their 20s because they didn’t protect their skin from the sun.”
  
  Dr. Baxt sees many women who think that makeup with SPF protects them. To get the SPF benefits, you’d have to use a makeup that has SPF 30 or higher. You’d also have to reapply your makeup every two hours.
- Don’t scrub your skin. Dr. Baxt says, “Scrubbing usually irritates your skin and then makes it hard to tolerate helpful products.”
- Always remove your makeup before going to bed. Leaving makeup on while you sleep can age your skin more quickly and cause breakouts.
- Limit sugar. Dr. Katta tells her patients that sugar is an ingredient you want to limit.
  
  She says, “The World Health Organization (WHO) advises us to consume no more than six teaspoons (about 25 grams) of sugar per day.” That’s not much. “A sweetened, iced coffee drink can have up to 15 teaspoons of sugar and a can of ginger ale more than six,” she says.
Be cautious about skin care trends that you see on social media. Some skin care trends you see on social media can do more harm than good.

One skin problem that dermatologists frequently treat is the damage done by overusing exfoliating products people see on social media. An exfoliator is designed to remove the top layer of skin, leaving you with glowing skin.

When overused, an exfoliator can damage the protective layer called the skin barrier. A damaged skin barrier leaves you with raw and irritated skin. “You may develop allergic reactions to products that previously didn’t cause a problem,” says Dr. Katta.

To get helpful skin care advice, Dr. Katta recommends following board-certified dermatologists on social media.

You’ll find plenty of advice from board-certified dermatologists on the American Academy of Dermatology’s social media platforms. To find us, type #AADskin into your browser’s search box.
See a dermatologist if you have a skin condition. Dr. Baxt says, “Anyone with a skin condition that affects their quality of life like eczema or rosacea should see a board-certified dermatologist.”

Bottom line: Your 20s is an ideal time to start a skin care routine and adopt skin-healthy habits. If you’re unsure about which products to include in your routine, a board-certified dermatologist can recommend products and a routine tailored to your specific needs.
Related AAD resources

Images
Courtesy of Rebecca Baxt, MD, FAAD, and Ranjani Katta, MD, FAAD

Written by:
Paula Ludmann, MS
Reviewed by:
Rebecca Baxt, MD, FAAD
Shani Francis, MD, MBA, FAAD
Rajani Katta, MD, FAAD
Elan Newman, MD, FAAD
William Warren Kwan, MD, FAAD

MELASMA- SELF CARE

3 ways to make melasma less noticeableMelasma is a common skin problem that causes brown, tan, grayish brown, or bluish gray patches on the face, depending on your skin tone. Although the exact causes of melasma are unclear, common triggers include sunlight, pregnancy, and birth control pills.
If you have melasma, dermatologists recommend the following tips for achieving a more even skin tone:

Protect your skin from the sun every day. One of the most common treatments for melasma is sun protection.

Since sunlight triggers melasma, it is important to protect your skin every day, even on cloudy days and after swimming or sweating. Whenever possible, seek shade when outdoors and wear sun-protective clothing, such as a wide-brimmed hat and sunglasses with UV protection. For more effective protection, select a hat that has an ultraviolet protection factor (UPF) number on the label.

Apply sunscreen to all skin not covered by clothing. Choose a sunscreen that offers:
- Broad-spectrum protection
- Water-resistance
- SPF of 30 or more
- Zinc oxide and/or titanium dioxide to physically limit the effects of the sun’s rays on your skin and iron oxide
Apply sunscreen 15 minutes before going outside, and reapply it at least every two hours.

Along with protecting your skin from the sun, you need to stay out of tanning beds and never use sunlampsIndoor tanning devices can worsen melasma and prevent treatment from working.
Choose gentle, fragrance-free skin care products. If a skin care product burns or stings when you use it, the product is irritating your skin. This may darken dark spots.
Avoid waxing. It’s important to avoid waxing areas of the body with melasma. Waxing may cause skin inflammation, which can worsen melasma. Ask a dermatologist about other types of hair removal that may be right for you.

If your melasma does not go away, see a board-certified dermatologist to discuss available treatments for melasma, such as prescription medications or in-office procedures.

Images
Video created by the American Academy of Dermatology.
Getty Images

Reviewed by:
Arturo Dominquez, MD, FAAD
Ivy Lee, MD, FAAD
Last updated: 2/15/22

KIDNEY DISEASE: 11 WAYS IT CAN AFFECT YOUR SKIN

f you have kidney disease, you won’t see early warning signs on your skin. However, as the disease progresses, you may develop one or more of the following:

Extremely dry skin. Skin can become so dry that it:
- Becomes rough and scaly
- Feels tight and cracks easily
- Develops fish-like scales
Extremely dry skin is common in people who have end-stage kidney disease, which requires dialysis or a kidney transplant.
Itchy skin. Extremely itchy skin is a common symptom of advanced kidney disease. The itch can range from irritating to life-disrupting. Your skin may itch all (or most of) the time.
Some people have itch on one area of their skin. The itch can also spread across most of your body.
Scratch marks and other signs of scratching. When you scratch often, it affects your skin. You can develop:
- Raw, bleeding skin or sores
- Thick, leathery skin (lichen simplex chronicus)
- Firm, very itchy bumps (nodularis prurigo)
If nothing seems to relieve the itch, you may want to see a dermatologist. Some people who have end-stage kidney disease get relief from a treatment called UVB phototherapy.
Color changes to your skin. When the kidneys stop working as they should, toxins build up in your body. This build-up can cause color changes to the skin. You may see any of the following:
- An unhealthy pale color
- Gray hue
- Yellowish color
- Areas of darkened skin, as shown here
- Yellowish, thick skin with bumps and deep lines
- Cysts and spots that look like whiteheads
The last two develop when you’ve had itchy skin for a long time and scratch often.
Nail changes. Kidney disease can affect the appearance of your fingernails, toenails, or both. People who have advanced kidney disease can develop:
- A white color on the upper part of one or more nails and a normal to reddish brown color below, as shown here (half-and-half nails)
- Pale nails
- White bands running across one or more nails (Muehrcke’s nails)
Because your nails reveal a lot about your health, see your doctor if you notice any changes to your fingernails or toenails.
Swelling. Your kidneys remove extra fluids and salt from your body. When they can no longer do this, the fluids and salt build up in your body. This build-up causes swelling, which you may notice in your:
- Legs
- Ankles
- Feet
- Hands
- Face
You may see the swelling in one or several areas of your body.
Rash. When kidneys cannot remove waste from your body, a rash can develop. One rash that occurs in people who have end-stage kidney disease causes small, dome-shaped, and extremely itchy bumps. As these bumps clear, new ones can form. Sometimes, the small bumps join together to form rough, raised patches.
Blisters. Some people who have end-stage kidney disease develop blisters, which can form on their:
- Hands (as shown here)
- Face
- Feet
The blisters will open, dry up, and crust over. As they clear, scars appear.
Lump in your belly. This can be a sign of kidney cancer. In its early stages, kidney cancer seldom causes symptoms. When the cancer advances, it can cause a mass or lump on the:
- Side
- Belly
- Lower back
Feeling a mass in one of these areas can also be a sign of something less serious going on inside your body. If you find any spot or lump, make an appointment to see your doctor.
Skin too tight to pinch. This is an extremely rare side effect that can occur when you get an MRI or another test that requires a contrasting agent. A doctor may request a contrast agent to get a better view inside an area of your body, such as a blood vessel. If you need a contrasting agent, it will be injected into a vein before your test.

Gadolinium is a contrasting agent that can affect your kidneys. When this happens, it can cause:
- Areas of hard, shiny skin that become too tight to pinch
- Inability to fully bend a knee, elbow, or other part of your body
- Skin that feels bound down
This is a rare side effect. If you have kidney disease, be sure to tell any doctor who orders a medical test for you.
Calcium deposit under the skin. Your kidneys have several jobs. One is to balance certain minerals in your blood, such as sodium and phosphate. When the kidneys cannot maintain a healthy balance, levels can rise. Some people develop deposits of calcium in their skin, such as the patient in this picture. This patient also has half-and-half nails, which is another sign of kidney disease.

Calcium deposits usually develop around a joint and are not painful. However, when they occur within a fingertip, they can cause a great deal of pain.
If one of these deposits pushes up through the skin, you may see a chalky discharge.

How dermatologists help patients with kidney diseaseKidney doctors, called nephrologists, often care for patients with kidney disease. When a kidney disease affects the skin, a nephrologist may team up with a dermatologist. Some skin conditions that develop due to kidney disease can be difficult to control. For example, if a patient has extremely itchy skin, it may be impossible to sleep through the night. A board-certified dermatologist can help a patient get some relief. This may involve using the right balance of moisturizers and medication that you apply to the skin. Some patients get relief with a treatment called UVB phototherapy.
The right skin care may also help. If the kidney disease is causing extremely dry skin, these tips from dermatologists may help:
Self-care: Dry skin
1 Centers for Disease Control and Prevention. “Chronic kidney disease in the United States, 2019.” Page last reviewed Mar. 11, 2019. Last accessed Feb. 27, 2020.

Images
Image 1: Image used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
Images 2, 3, 6, 9, 10: Getty Images
Images 4, 5, 7, 8, 11: Journal of the American Academy of Dermatology

Image 4: Streams BN, Liu V, et al. “Clinical and pathologic features of nephrogenic fibrosing dermopathy: a report of two cases.” J Am Acad Dermatol. 2003;48(1):42-7.
Image 5: Saray Y, Seçkin D, et al. “Nail disorders in hemodialysis patients and renal transplant recipients: a case-control study.” J Am Acad Dermatol. 2004;50(2):197-202.
Images 7, 8, 11: Robinson-Bostom L, DiGiovanna JJ. “Cutaneous manifestations of end-stage renal disease.” J Am Acad Dermatol. 2000;43(6):975-86.

References
Amin A, Burgess EF. “Skin manifestations associated with kidney cancer.” Semin Oncol. 2016;43(3):408-12.
Centers for Disease Control and Prevention. “Chronic kidney disease in the United States, 2019.” Page last reviewed Mar. 11, 2019. Last accessed Feb. 27, 2020.
Galperin TA, Cronin AJ, et al. “Cutaneous Manifestations of ESRD.” Clin J Am Soc Nephrol. 2014;9(1):201-18.
Girardi M, Kay J, et al. “Nephrogenic systemic fibrosis: Clinicopathological definition and workup recommendations.” J Am Acad Dermatol 2011;65:1095-106.
Kobayashi TT. “Cutaneous manifestations of renal disease.” In: Fitzpatrick JE, et al. Dermatology Secrets Plus (5th edition). Elsevier. China, 2016:340-7.
Robinson-Bostom L, DiGiovanna JJ. “Cutaneous manifestations of end-stage renal disease.” J Am Acad Dermatol. 2000;43(6):975-86.
Saray Y, Seçkin D, et al. “Nail disorders in hemodialysis patients and renal transplant recipients: a case-control study.” J Am Acad Dermatol. 2004;50(2):197-202.
Scheinfeld NS. “Nephrogenic systemic fibrosis.” Medscape. Posted May 22, 2018. Last accessed Feb. 27, 2020.
Streams BN, Liu V, et al. “Clinical and pathologic features of nephrogenic fibrosing dermopathy: a report of two cases.” J Am Acad Dermatol. 2003;48(1):42-7.
Van Amburgh JA. “How Is uremic pruritus treated?” Medscape Dermatology. Posted Feb 12, 2014. Last accessed Feb 27, 2020.
Van de Velde-Kossmann KM, “Skin examination: An important diagnostic tool in renal failure patients.” Blood Purif2018;45:187–93.

ADULT ACNE TREATMENT DERMATOLOGISTS RECOMMEND

Are you 25 or older and seeing pimples, whiteheads, or blackheads when you look in the mirror? You’re not alone. An increasing number of adults, especially women, are battling breakouts.
With so many acne products available online and in stores, it’s hard to know which lotion, wash, or wipe can help clear your skin.
To get the lowdown, we asked two board-certified dermatologists how to treat adult acne at home.
Who can treat acne at home?"Many adults who have mild acne can effectively treat it with over-the-counter (available without a prescription), acne-fighting products available today," says Ramone F. Williams, MD, MPhil, FAAD.
Mild acne means that you may have blackheads and whiteheads along with small pimples, or just small pimples.
If you have large, painful pimples that sit deep in your skin or acne that leaves a scar when it clears, you’ll need to see a dermatologist for treatment. Products that you can buy online or in a store are unlikely to treat these types of acne effectively.

Which non-prescription treatments do dermatologists recommend for adult acne?It’s all about the active ingredient in the product, according to Julie Harper, MD, FAAD.
Tip for using acne products: When shopping for acne-fighting products, you want to find one product that contains an active ingredient which can effectively treat the type of acne you have.
Use that product for 6 to 8 weeks, taking care to use the product as directed on the instructions. During this time, don’t add another product. Don’t stop using the product you started with.
The active ingredients that Drs. Harper and Williams recommend using to help clear mild-to-moderate adult acne are:

Adapalene: A retinoid, this active ingredient helps to clear blackheads, whiteheads, and pimples.
Azelaic acid: It fights acne and can also fade the dark spots that appear when an acne spot clears.
Benzoyl peroxide: This acne-fighter is especially effective at treating mild pimples. While you’ll find products that contain up to 10% benzoyl peroxide, it’s best to start with a product that contains 2.5%. That will help you avoid side effects like dry, irritated skin or a burning sensation.
Salicylic acid: Because it unclogs pores and exfoliates the skin, salicylic acid works best on whiteheads and blackheads.

How to apply your acne medication for best resultsThe results you see depend in part on how you apply your acne medication.
Dr. Harper says, “You want to apply a thin layer of acne medication to the whole area rather than just your acne spots. When you put medication only on the acne you see, you treat what’s there. By applying medication to all your acne-prone skin, you treat the existing acne and prevent the next breakout.”
When to expect results from acne medicationWhen treating acne, you need to be patient. Acne medication doesn’t work overnight. You must also use the medication(s) consistently and as directed. If the medication works for you, Dr. Harper says you can expect to see:

Fewer breakouts: 4 to 8 weeks
Clearing: 16 weeks after starting the medication

It’s important to understand that no one acne treatment works for everyone. Everyone’s skin is unique.
Who should see a board-certified dermatologist?Dr. Harper says, “If you are not achieving the desired results after weeks of using your acne treatment, it is time to see your dermatologist. Our goal is to help you to clear your acne.”
Dr. Williams adds, “If you are seeing dark spots on your skin after acne clears, it’s also time to see a dermatologist.”
Those dark spots, which more commonly develop in people with darker skin tones, are called post-inflammatory hyperpigmentation (PIH). They indicate that acne is causing significant inflammation. When you have lots of inflammation, treatment that you can buy without a prescription usually cannot effectively treat acne. A dermatologist can develop a treatment plan that helps to clear your acne and prevent more dark spots.
Of course, you don’t have to try treating acne on your own before seeing a dermatologist. Dr. Harper points out, “It is never the wrong time to see a dermatologist for adult acne. For example, there is no acne that is too mild to potentially benefit from seeing your dermatologist.”
Dr. Harper leaves us with this final thought, “If you want to try to manage your acne yourself first, that’s fine, but if you are not achieving clear skin within a few months, then please make an appointment. We would love to help!”
To find a dermatologist who can help you with adult acne, go to Find a dermatologist.
Related AAD resources

Images
Image 1: Getty Images
Images 2,3: Courtesy of Drs. Harper and Williams
References
Bagatin E, Rocha MADD, et al. “Treatment challenges in adult female acne and future directions.” Expert Rev Clin Pharmacol. 2021 Jun;14(6):687-701.
Decker A, Graber EM. “Over-the-counter acne treatments: A review.” J Clin Aesthet Dermatol. 2012 May;5(5):32-40.

DRY SKIN REMEDIES FOR DARKER SKIN TONES

Your dry skin can be uncomfortable, frustrating — maybe even embarrassing. In darker skin tones, the flaking, discoloration, and rough texture are more noticeable than in lighter skin tones.

Since dry skin is more noticeable in people with darker skin tones, you’re likely highly motivated to treat the dryness.
The good news is that many people can effectively treat their dry skin at home. Here’s what board-certified dermatologists recommend:
Dermatologists’ top 7 tips for relieving dry skin

Take short (5 or 10 minutes) baths and showers in warm water. Hot water and spending too much time bathing tends to worsen dry skin.
After getting out of a bath or shower, gently pat (don’t scrub) your skin with a towel but leave some water on your skin so that it feels damp. You’ll use moisturizer to seal in this water.
Slather on a mild, fragrance-free moisturizer immediately after toweling off. Creams and ointments tend to be more effective than lotions.
Use gentle, fragrance-free skin care products. Dry skin is easily irritated, so deodorant soaps and products that contain alcohol or fragrance can irritate your dry, sensitive skin.
Apply a fragrance-free hand cream after you wash your hands. Do this every time.
Relieve extremely dry skin by applying a cream or ointment throughout the day. This helps to keep your skin hydrated.
Wear loose-fitting clothes made of a breathable fabric like cotton. Tight-fitting clothes like leggings and rough fabrics like wool can irritate your dry skin.

By following these tips, you should see some improvement within two weeks.

When to see a dermatologist about dry skin If you still have dry skin after giving these top tips time to work, it’s best to see a board-certified dermatologist. Sometimes getting relief requires a prescription-strength ointment or a bit of individualized insight from the skin expert.
If you have persistently dry skin and nothing brings relief, it’s also possible that you have an undiagnosed skin condition like eczema, ichthyosis, or psoriasis. All cause excessively dry skin.
Some people who have darker skin tones live for years with an undiagnosed skin condition. They often mistakenly believe their skin is just too dry for moisturizer to work.
A board-certified dermatologist can tell you what’s going on with your skin and develop a treatment plan that can relieve the driest of skin.
To find a dermatologist who specializes in treating darker skin tones, go to Find a Dermatologist. Then click on “Filters,” and select “Any Practice Focus.” When the drop-down menu appears, select “Skin of Color.”

Images
Courtesy of board-certified dermatologists Chesahna Kindred, MD, MBA, FAAD; Shani Francis, MD, MBA, FAAD; and Caroline Robinson, MD, FAAD.

Edited by:
Paula Ludmann, MS
Reviewed by:
Chesahna Kindred, MD, MBA, FAAD
Shani Francis, MD, MBA, FAAD
Sandy Marchese Johnson, MD, FAAD
Bassel Hamdy Mahmoud, MD, PhD, FAAD
Caroline Robinson, MD, FAAD
Sanna Ronkainen, MD, FAAD

HEART DISEASE: 12 WARNING SIGNS THAT APPEAR ON YOUR SKIN

Warning signs can appear on your skin and nails, which is why your dermatologist may be the first doctor to notice that you have heart disease. If you know what to look for, you can also find warning signs of heart disease on your skin and nails. The following pictures show you what to look for.

Swelling in your feet and lower legs
What it may be telling you: Your heart isn’t working properly.

Many diseases of the heart cause fluid to build up in your feet and lower legs. As the fluid builds up, you may see swelling, which can extend as far as the upper legs and groin.

Medical name: Edema (medical term for swelling)

2. Blue or purple color on your skin

What it may be telling you: You have a blockage in a blood vessel.
When you’re extremely cold, your skin can turn blue (or purple). If an area of your skin is blue (or purple) when you’re warm, that’s can be a sign your blood isn’t getting enough oxygen. The patient in this photo has a condition known as blue toe syndrome, which happens when one or more blood vessels are blocked.

Without treatment, the lack of oxygen can cause the skin and underlying tissue to eventually die.

Medical name: Cyanosis (refers to the bluish color on the skin)

3. Blue or purple net-like pattern on your skin

What it may be telling you: You have a blocked artery.
Some people see this pattern on their skin when they feel chilly. When their skin warms up, this pattern disappears. It’s also possible to see this pattern when taking certain medications. If one of these is causing the netlike pattern, it’s usually nothing to worry about.

This netlike pattern can also be a sign of a disease called cholesterol embolization syndrome, which occurs when small arteries become blocked. The blockage can lead to damaged tissues and organs, so it’s important to see a doctor to find out whether you have an undiagnosed disease.

Medical name: Livedo reticularis (medical term for the net-like pattern)

4. Yellowish-orange, waxy growths on your skin

What it may be telling you: You have unhealthy cholesterol levels.
If you see yellowish-orange growths on your skin, you may have deposits of cholesterol under your skin. These painless deposits can appear in many areas, including the corners of your eyes, lines on your palms, or the backs of your lower legs.

If you notice these growths on any area of your skin, see your doctor. You may need cholesterol testing or another medical test. Unhealthy cholesterol levels require treatment, which can prevent life-threatening heart disease. Getting your cholesterol levels under control may also help clear the growths on your skin. If the growths don’t clear, a board-certified dermatologist can treat them.

Medical name: Xanthelasma (cholesterol deposits on the eyelids), Xanthoma (cholesterol deposit found elsewhere on the skin)

5. Clusters of waxy bumps that suddenly appear on your skin

What it may be telling you: You have skyrocketing cholesterol levels or diabetes.
The sudden appearance of these bumps can look like a rash, warts, or a contagious skin condition called molluscum contagiosum. These bumps are actually fatty deposits of cholesterol caused by extremely high levels of triglycerides (type of cholesterol) in the blood.

Treatment is essential to lower the triglycerides and treat any serious medical conditions, such as heart disease caused by the high cholesterol levels.

Medical name: Eruptive xanthoma (refers to the sudden appearance of many fatty deposits of cholesterol)

6. Nails curve downward and the ends of your fingers are swollen
What it may be telling you: You may have a heart infection, heart disease, or lung problem. For many people, these signs are harmless. That said, if your fingers and nails look like this, it’s best to find out if you may have a medical condition, such as lung disease or a heart problem.

Medical name: Clubbing (term describes the downward turned nails and swollen fingers)

7. Red or purple lines under your nails
What it may be telling you: Most people who see these lines under their nails have injured the nail in some way. If you cannot remember injuring your nail, you may want to see your doctor. These lines can be a sign of heart disease or another condition.

When it’s a sign of heart disease, people tend to have symptoms, such as high fever and a weak or irregular heartbeat.

Medical name: Splinter hemorrhage (line often looks like a splinter stuck under the nail)

8. Smooth, waxy lumps on your skin
What it may be telling you: You have protein deposits in your heart or another organ.

These waxy lumps can appear anywhere on the skin. They often indicate that there’s an abnormal buildup of protein in an organ, such as your heart. If protein builds up in the heart, it’s hard for the heart to work properly.

Medical name: Nodules of systemic amyloidosis (“nodule” means lump and amyloidosis refers to the type of protein that has built up)

9. Painful lumps in your fingers, toes, or both
What it may be telling you: You have an infection in your heart or blood vessels.

If you have a heart infection known as infective endocarditis, these painful lumps can develop in your fingers, toes, or both places. The lumps can last for a few hours to several days.

While the lumps go away on their own, patients need treatment for the infection. Because this infection is caused by bacteria, antibiotics can often treat it. Sometimes, surgery is also necessary.

Medical name: Osler nodes. A doctor named Osler discovered the connection between a patient having these lumps, which are now called Osler nodes, and a heart infection.

10. Brownish (or reddish) discoloration, usually on your sole(s) or palm(s)
What it may be telling you: You have an infection in your heart or blood vessel.

The spots that developed on the bottom of this patient’s foot are also a sign of a heart infection called infective endocarditis. Unlike Osler nodules, these spots are painless. These spots will clear without treatment, usually in a few days or weeks. The infection requires treatment.

Medical name: Janeway lesions, which are named after an American doctor, Theodore Caldwell Janeway.

11. Non-itchy rash (flat spots with slightly raised edges) and fever
What it may be telling you: You have rheumatic fever.

If your child develops strep throat, treating it quickly is important. When it’s not treated quickly, other medical problems can develop. One such problem is rheumatic fever. While this seldom happens in the United States today, rheumatic fever is common in developing countries.

When a child has rheumatic fever, it can lead to lifelong heart disease. Rheumatic fever is a leading cause of heart disease in children.

Medical name: Erythema marginatum (name of the rash shown in this picture)

12. Rash and cracked, swollen lips that often bleed
What it may be telling you: A child has Kawasaki disease.

When a child has a rash, fever, and extremely dry lips that may crack and bleed, Kawasaki disease is a likely cause. This disease, which affects the blood vessels, usually develops in children between the ages of 6 months and 5 years of age.

While Kawasaki disease may go away on its own within 12 days without treatment, it can lead to serious side effects, such as heart disease.

Medical name: Mucocutaneous lymph node syndrome (another name for Kawasaki disease)

Other signs that appear on the skin and can be a warning sign of heart disease, include:

A gray ring around the colored part of your eye
Changes to your tongue, such as it swelling and turning red as a strawberry
Discolored skin

If you notice any of these signs, make an appointment to see your primary doctor and try to stay calm. The sign could be harmless, but it’s important to get it checked out. Heart disease is easier to treat when found early.

DRY SKIN REMEDIES FOR DARKER SKIN TONES

Your dry skin can be uncomfortable, frustrating — maybe even embarrassing. In darker skin tones, the flaking, discoloration, and rough texture are more noticeable than in lighter skin tones.

Take short (5 or 10 minutes) baths and showers in warm water. Hot water and spending too much time bathing tends to worsen dry skin.
After getting out of a bath or shower, gently pat (don’t scrub) your skin with a towel but leave some water on your skin so that it feels damp. You’ll use moisturizer to seal in this water.
Slather on a mild, fragrance-free moisturizer immediately after toweling off. Creams and ointments tend to be more effective than lotions.
Use gentle, fragrance-free skin care products. Dry skin is easily irritated, so deodorant soaps and products that contain alcohol or fragrance can irritate your dry, sensitive skin.
Apply a fragrance-free hand cream after you wash your hands. Do this every time.
Relieve extremely dry skin by applying a cream or ointment throughout the day. This helps to keep your skin hydrated.
Wear loose-fitting clothes made of a breathable fabric like cotton. Tight-fitting clothes like leggings and rough fabrics like wool can irritate your dry skin.

By following these tips, you should see some improvement within two weeks.

When to see a dermatologist about dry skin
If you still have dry skin after giving these top tips time to work, it’s best to see a board-certified dermatologist. Sometimes getting relief requires a prescription-strength ointment or a bit of individualized insight from the skin expert.
If you have persistently dry skin and nothing brings relief, it’s also possible that you have an undiagnosed skin condition like eczema, ichthyosis, or psoriasis. All cause excessively dry skin.
Some people who have darker skin tones live for years with an undiagnosed skin condition. They often mistakenly believe their skin is just too dry for moisturizer to work.
A board-certified dermatologist can tell you what’s going on with your skin and develop a treatment plan that can relieve the driest of skin.
To find a dermatologist who specializes in treating darker skin tones, go to Find a Dermatologist. Then click on “Filters,” and select “Any Practice Focus.” When the drop-down menu appears, select “Skin of Color.”

7 DERMATOLOGISTS' TIPS FOR HEALING DRY, CHAPPED LIPS

HOW TO PREVENT AND TREAT DRY, CHAPPED LIPS

Cold, dry weather, sun damage, and frequently licking your lips are just some of the reasons your lips might feel dry and chapped. To prevent and treat dry, chapped lips at home, follow these tips from board-certified dermatologists.

While it may seem that dry, cracked lips are something you must live with until spring comes, you can have soft, supple lips year-round. Here’s what dermatologists recommend.

Use non-irritating lip balm, lipstick, and other products that you apply to your lips. Many people mistake discomfort, such as burning, stinging, or tingling, as a sign that the active ingredients in a product are working. That’s not what’s happening. You’re actually irritating your lips, so you want to stop using any product that irritates your lips.

Ingredients to avoid while your lips are chapped: To help chapped lips heal, stop applying lip products that contain any of the following:
- Camphor
- Eucalyptus
- Flavoring: Cinnamon, citrus, mint, and peppermint flavors can be especially irritating to dry, chapped lips
- Fragrance
- Lanolin
- Menthol
- Octinoxate or oxybenzone
- Phenol (or phenyl)
- Propyl gallate
- Salicylic acid
Ingredients that can help heal chapped lips: While some ingredients can irritate dry, cracked lips, others can help them heal. When looking for products to use on your chapped lips, dermatologists recommend ones that contain one or more of the following:
- Castor seed oil
- Ceramides
- Dimethicone
- Hemp seed oil
- Mineral oil
- Petrolatum
- Shea butter
- Sun-protective ingredients, such as titanium oxide or zinc oxide
- White petroleum jelly
It also helps to use products that are fragrance free and hypoallergenic.

2. Apply a non-irritating lip balm (or lip moisturizer) several times a day and before bed. If your lips are very dry and cracked, try a thick ointment, such as white petroleum jelly. Ointment seals in water longer than waxes or oils.
3. Slather on a non-irritating lip balm with SPF 30 or higher before going outdoors. Even in the winter, it’s important to protect your lips from the sun. The sun can burn dry, chapped lips more easily, which could trigger cold sores.

To protect dry, chapped lips from the sun, use lip balm that contains offers SPF 30 or higher and one (or both) of these sun-protective ingredients:

-Titanium oxide
-Zinc oxide

4. While outdoors, apply the lip balm every 2 hours.
Drink plenty of water. Chapped lips are dry lips, so you want to stay hydrated.
Stop licking, biting, and picking at your lips. When lips feel dry, it may feel natural to wet them by licking them, but this can worsen the problem. As saliva evaporates, your lips become drier.

5. Picking or biting your lips also irritates them, which can prevent healing.

6. Avoid holding items made of metal with your lips. Paperclips, jewelry, and other everyday products made of metal can irritate your already sensitive lips.

7. Plug in a humidifier at home. A humidifier in your bedroom can be especially helpful, especially if you breathe through your mouth at night.
By following these dermatologists’ tips for chapped lips, you should have noticeable improvement in 2 to 3 weeks. To prevent your lips from chapping again, continue applying lip balm whenever it’s dry indoors or outside.

When to see a dermatologist?
Most of the time, the above self-care can heal dry, chapped lips in 2 to 3 weeks. If it doesn’t, see a board-certified dermatologist.

Your chapped lips could be caused by something aside from dry weather. An allergic reaction, yeast infection, or something more serious can make your lips feel dry and uncomfortable. Actinic cheilitis is a precancerous condition that turns one or both lips dry and scaly. A board-certified dermatologist can diagnose the cause.

IN WINTER, WILL MY CHILD NEED DIFFERENT ECZEMA SKIN CARE?

To reduce eczema flares in winter, dermatologists recommend making small changes to your child’s skin care. You can help your child feel more comfortable by doing the following at the first sign of winter:
Continue eczema skin care

Bathe your child (as often as your child’s dermatologist recommends) in warm NOT hot water.
Apply medicine as directed.
Apply moisturizer within 3 minutes of bathing to all skin without eczema medicine.

Moisturize more often, using a thick cream or ointment

Apply moisturizer after every bath, shower, and hand washing. Apply moisturizer ONLY to skin that you have NOT just applied eczema medicine.
Moisturize before bed.
If your child’s skin is dry, consider using an ointment. It holds more water in the skin and reduces the risk of irritating the skin.

SEBORRHEIC DERMATITIS: Self-Care

Dress for success

Dress your child in clothes made from natural, breathable fabrics like 100% cotton. Wool and synthetic fibers like acrylic and polyester can irritate the skin.
Avoid overheating by dressing your child in loose-fitting layers that you can easily remove if your child becomes too hot.

Make your home comfortable

Keep the home thermostat at a temperature that prevents your child from overheating.
Make sure your child is far enough away from radiators, heating vents, and fireplaces so that they don’t warm the skin.
Use a humidifier if the air feels dry.

Enjoy the outdoors in comfort

Dress for the weather, covering as much of your child’s skin as possible.
Make sure your child wears mittens or gloves. Mittens and gloves should be made of cotton or another natural fiber. If you cannot find these, use a cotton glove liner, which can help prevent sweaty hands and irritated skin.
Dress your child in layers.
Avoid overheating by taking a break, unzipping a jacket partially, or removing a layer of clothing.
Remove wet clothes and shoes immediately after coming in from the snow or rain.

1. Be gentle when washing your skin: You want to wash your face twice a day and bathe or shower as needed. When you wash your face, shower, or take a bath, follow these steps, which can also help reduce the scale on your skin:

•Wet your skin thoroughly.
•Gently wash with the medicated soap that your dermatologist recommends, a fragrance-free cleanser, or a cleanser that contains pyrithione zinc. Skip the deodorant soaps and skin care products that contain fragrance, as these can irritate your skin.
•Rinse thoroughly. If you leave cleanser or soap on your skin, it can irritate your skin and lead to a flare-up.
•Apply a fragrance-free moisturizer after washing. Hydrated skin is less likely to flare.

2. Shampoo as often as your dermatologist recommends. Seborrheic dermatitis usually develops on the scalp. Using the medicated shampoo(s) that your dermatologist recommends can prevent the white flakes and dry, itchy scalp.

3. Control seborrheic dermatitis under your mustache or beard by washing these areas with a medicated soap or shaving. Seborrheic dermatitis often develops under a beard or mustache. To reduce flare-ups, wash these areas with a shampoo that contains 1% ketoconazole or a product that your dermatologist recommends.

Another way to reduce flare-ups is to shave off your beard and mustache and continue shaving so that you can keep the skin hair-free.

4. Use alcohol-free skin and hair care products. If a skin or hair care product contains alcohol, it can cause a flare-up. That’s why dermatologists recommend products labeled “alcohol-free.”

This applies to everything you put on your skin or hair, including moisturizer, shaving cream, conditioner, sunscreen, and makeup.

5. Reduce stress. For most people, flare-ups are more common when their stress increases. While we cannot get rid of stress, finding ways to manage it can help. Meditation, exercise, and other techniques for managing stress can be effective.

6. Protect your skin from cold, dry weather. Flare-ups are common when the weather turns cold and dry. The dryness often causes seborrheic dermatitis to flare. To reduce winter flare-ups, dress for the weather. This includes wearing a hat when outdoors.

7. Learn (and avoid) what triggers your flare-ups. A trigger is something that causes a disease to flare. Common triggers for seborrheic dermatitis include:

• Stress
• Cold, dry weather
• Taking hot showers and baths, especially during cold, dry weather. Hot water can dry your skin and your scalp.
• Getting a harsh detergent, strong soap, solvent, or chemical on your skin.
• Becoming sweaty. Sweat cools your body. In doing so, it also dries out your skin. The salt from sweat can trigger a flare-up.
• Being around harsh chemicals. The fumes from drying paint, new carpeting, and cleaning products trigger a flare-up in some people.
• Developing an infection. If the infection irritates your skin, it can trigger a flare-up.What triggers seborrheic dermatitis in one person may not trigger it for someone else. That’s why you need to find out what triggers your flare-ups.

If you’re unsure what triggers your seborrheic dermatitis, try keeping a journal. Note when you get a flare-up and what you were doing before the flare-up started.
A board-certified dermatologist can also help you find your triggers.

8. Wear loose-fitting, soft cotton clothing where you have seborrheic dermatitis. Tight-fitting clothing and fabrics like wool or polyester can irritate your skin.

9. If you use hair spray, hair gel, or pomade, apply it sparingly. Using these products can lead to flare-ups.

10. Protect your skin with sunscreen that contains zinc oxide or titanium dioxide. Heat and sun can also trigger seborrheic dermatitis, so you want to protect your skin from these. These sunscreen ingredients listed above are less likely to irritate your skin.

11. Treat a flare-up as soon as it starts. Early treatment helps prevent a flare-up from worsening. When you have a treatment plan from a dermatologist, your treatment plan will include information about what to do when seborrheic dermatitis flares.
Treatment for a flare-up tends to differ by patient. Your dermatologist knows how to tailor the treatment to your age, where the seborrheic dermatitis appears on your skin, and other considerations.

12. Partner with a board-certified dermatologist. Getting a treatment plan from a board-certified dermatologist can help you get seborrheic dermatitis under control, take steps to avoid flare-ups, and treat a flare-up as soon as it happens.

To find a dermatologist near you, go to Find A Dermatologist.

If you’re looking for a dermatologist who specializes in treating people who have darker skin tones, click on Filters, then choose "Skin of color" from the "Any Practice Focus" area.

ICHTHYOSIS VULGARIS: DIAGNOSIS AND TREATMENT

How do dermatologists diagnose ichthyosis vulgaris?

A dermatologist can often diagnose ichthyosis vulgaris by looking at a patient’s skin.

To make this diagnosis, your dermatologist will also ask a few questions. Before your appointment, it can be helpful to make sure you have answers to the following questions:

•Do blood relatives in your (your child’s) family have a similar skin condition?
•How old were you (your child) when the skin condition began?
•Do you (your child) have any other skin conditions?
•Do you (your child) have any other medical conditions?
•What medicines and supplements do you (or your child) take?

Sometimes, ichthyosis vulgaris looks like another skin condition. If this happens, your dermatologist can remove a small amount of skin so that it can be looked at under a microscope. This is called a skin biopsy. Your dermatologist can quickly and easily remove the skin during an appointment.

How do dermatologists treat ichthyosis vulgaris?
There is no cure for inherited ichthyosis vulgaris. Treatment focuses on reducing the scale and dry skin. To do this, a treatment plan may require you to:

• Take baths as often as directed. Soaking helps hydrate your skin and soften the scale.
If you have open sores, your dermatologist may recommend placing petroleum jelly or another product on these before getting into the water. This can reduce the burning and stinging caused by the water.
Some patients say that adding sea salt (or table salt) to the water reduces the burning and stinging. Adding salt may also reduce the itch.

• Reduce the scale during your baths. Soaking in water softens the scale. Your dermatologist may recommend that you reduce the scale while it’s softer by gently rubbing the scale with an abrasive sponge, buff puff, or pumice stone.

• Apply moisturizer to damp skin within two minutes of bathing. Moisturizer can seal water from a bath or shower into your skin. Your dermatologist may recommend a moisturizer that contains an active ingredient like urea, alpha hydroxyl acid, or lactic acid. These and other active ingredients can also help reduce scale.

• Apply petroleum jelly to the deep cracks. This can help get rid of the deep cracks.

•Treat a skin infection. If you develop a skin infection, your dermatologist will treat it with medication that you either take or apply to your skin.

If you get frequent skin infections, your dermatologist may recommend adding a small amount of bleach to your bath. Called bleach bath therapy, this can help reduce the bacteria on your skin. You should only use bleach bath therapy if your dermatologist recommends it.
If the ichthyosis is severe and fails to improve with baths, moisturizer, and scale remover, your dermatologist can prescribe medicine.

Some people only need to treat their skin in the winter

If the ichthyosis is mild, you may need to treat it only during the winter. In humid climates, most ichthyosis improves. A mild case can clear completely, returning in the winter when the air is dry.

What is the outlook for someone who has ichthyosis vulgaris?

For people who have the inherited type, the outlook is excellent. Most have a normal lifespan. Ichthyosis vulgaris also can become less serious with age. Most people, however, need to continue treating their skin for life.
To improve acquired ichthyosis vulgaris, you must also treat the disease that triggered the ichthyosis. If the disease can be cured, the ichthyosis may go away. If a medicine triggered the ichthyosis, reducing the dose often gets rid of the ichthyosis.

5 REASONS TO SEE A DERMATOLOGIST FOR MOLE, SKIN TAG REMOVAL

If you have a mole or skin tag that you’d like to remove, the products available online may leave you thinking that this is a DIY project. It’s not.
These online products can cause “potentially harmful side effects and serious risks,” according to the U.S. Food and Drug Administration (FDA). The list of harmful side effects and risks include:

Skin injuries
Infection that requires antibiotics to treat
Scarring
Delaying a skin cancer diagnosis and treatment

Because of the harm these products can cause, the FDA is telling people to avoid using them. None of the products sold for removing moles, skin tags, and other growths at home has received FDA approval.
Dermatologists agree. If you use one of these products, you’re essentially performing at-home surgery, which can go seriously wrong quickly and unexpectedly. Trying to remove a mole or skin tag at home could cause a serious infection. You could have uncontrolled bleeding that requires going to an emergency room (ER) for life-saving care.
If you want to remove a mole, skin tag, or other growth from your skin, here are five benefits of seeing a dermatologist for this treatment:

Find and treat skin cancer. Skin cancer can appear on your skin in many ways. It can look like a changing mole, new growth, or scar. When you see a dermatologist, you receive the care you need to find out whether or not you have skin cancer. If you have skin cancer, you can receive expert medical care.

If the spot you remove at home is a skin cancer, you can leave behind microscopic cancer cells. These cancer cells can multiply and spread deep into the tissue beneath your skin. If you have melanoma, the most serious skin cancer, these skin cancer cells can spread quickly throughout the body.

Caught early and treated, skin cancer is highly treatable.
Control infection risk. When doctors cut into skin, they follow guidelines that dramatically reduce the risk of infection. Without this knowledge, you risk developing a serious infection, which can require a trip to the ER.
Minimize scarring. Any time you wound your skin, you risk developing a scar. Dermatologists have the expertise required to reduce scarring.
Prevent loss of movement due to scarring. If you cause a scar on skin that covers a joint, such as a knuckle or elbow, the scar can limit how far you can move your finger or elbow. Dermatologists understand this risk and use their expertise to help avoid this.
Avoid difficult-to-stop blood loss. Dermatologists have the in-depth medical expertise required to remove skin growths with the least amount of injury. Without this knowledge, it’s easy for you to nick a blood vessel or cut into a vein unexpectedly.

Your dermatologist will also talk with you before treating you, asking you questions about your medical conditions and medications that you take. This information helps your dermatologist know what could cause difficult-to-stop bleeding and take necessary precautions.

When it comes to removing a mole, skin tag, or other growth from your skin, don’t be misled by claims like “safe,” scar free,” or “zero risk.” If you remove a growth or spot from your skin, there is some risk. Your dermatologists know the risks and how to minimize them to give you the best outcome.
Related AAD resources

DERMATOLOGIST-RECOMMENDED SKIN CARE FOR PEOPLE WITH DIABETES

When you have diabetes, finding time for skin care can seem like a luxury. Monitoring your glucose level, sticking to a meal plan, finding time to exercise, and managing stress can definitely take priority.

Dermatologists caution that skin care also plays a key role in helping you manage diabetes. The right skin care can prevent a serious skin condition, such as an infection, open sores, or non-healing wound.

Skin care tips that dermatologists recommend
By taking good care of your skin, you can treat and prevent uncomfortable changes to your skin. Diabetes often causes extremely dry skin, which can itch. Cracks in your skin can develop, grow deep, and bleed. These deep cracks increase your risk of developing a serious infection.
You may also notice that your skin is easily irritated or heals slowly.
To treat and prevent these skin changes, dermatologists recommend the following:

Moisturize every day. Keeping your skin moisturized helps to make it flexible and prevent cracks that often lead to infection.

For best results, dermatologists recommend that you:
- Use a cream or ointment rather than a lotion. Creams and ointments do a better job of healing dry skin than do lotions.
- Choose a fragrance-free cream or ointment that contains ceramides. You want to avoid products labeled “unscented” because these contain fragrance that has been masked so that you cannot smell the fragrance.
- Apply your cream or ointment after bathing, swimming, and when your skin feels dry or itchy.
- Carry your moisturizer with you so that you can apply it to your hands, which often become dry due to the need to wash your hands before checking your glucose level.
Treat dry, cracked heels. This can prevent a serious infection, non-healing sores, and other problems.
Treat dry, cracked heelsIf you have dry, cracked heels, apply a cream containing 10% to 25% urea before getting into bed. Do this every day until your skin heals.
Use a gentle cleanser when bathing. Deodorant soaps and strong body washes can irritate your already sensitive skin. A gentle cleanser or one specially formulated for people who have diabetes helps to soothe your skin and prevent complications.
Bathe and shower using warm (not hot) water. Hot water can strip your skin of moisture, leaving it feeling dry, tight, and uncomfortable.
Dry the folds of your skin carefully. After bathing and swimming, you want to gently dry the skin between your toes, armpits, and other places where skin touches skin. If water stays in these areas, it can lead to a skin infection.
Check your feet dailyCheck your feet every day, making sure to check between your toes and on the bottoms of your feet for rashes, sores, skin wearing away, and other problems.
Get medical care for calluses on your feet. A corn or callus on your foot may seem like nothing to worry about. However, when you have diabetes, the thick skin can break down and open up. Deep cracks can develop. If any of these occur, you can develop a serious infection, such as cellulitis.

A dermatologist or podiatrist can provide the care you need to treat corns or calluses.
Seek immediate medical care for a skin or nail infection. People who have diabetes can develop an infection more easily than people who have a healthy endocrine system. An infection can quickly become serious.

If you notice any of the following on your skin or under a nail, get immediate medical care:
- Skin looks swollen and discolored
- Tenderness or pain
- Wound that is leaking pus or other fluid
- Honey-colored crusts
- Build-up beneath a fingernail or toenail or a nail is starting to lift up
- A thickening or discolored nail
Treat all cuts, scratches, and wounds immediately. To treat wounds, wash the area with soap and water. Apply antibiotic ointment only if your doctor recommends this. Always cover the wound with an adhesive bandage. To help your skin heal, treat the wound every day.

If the wound fails to heal or worsens, seek immediate medical care.
Dermatologists treat diabetic related skin issuesDermatologists treat diabetics who develop slow or non-healing wounds and other complications with their skin.
Check your feet every day for redness, scratches, blisters, sores, and cuts. If you have a minor wound, treat it. Get immediate medical care for all other wounds.
Keep your toenails short. Long, rough toenails can irritate your skin. When toenails grow long, they can lift up. This makes it easier for an infection to develop beneath a toenail. Keeping your toenails properly trimmed can prevent cuts and a possible foot infection.

To trim your toenails, cut them straight across. If you have trouble trimming or reaching your toenails, your foot doctor can keep them properly trimmed.

THINNING HAIR AND HAIR LOSS: COULD IT BE FEMALE PATTERN HAIR LOSS?

Is your part widening? Have you noticed that your ponytail is thinner these days? You may have female pattern hair loss (FPHL), a condition that affects millions of women. FPHL is actually the most-common cause of hair loss in women.
For most women, FPHL begins in midlife, when a woman is in her 40s, 50s, or 60s. It can begin earlier for some women.
FPHL is a progressive condition. This means women tend to continue losing hair. But women do not lose all of their hair, as do some men. Instead, your part often gets wider. Hair near your temples may recede. Without treatment, some women eventually develop widespread thinning.
Treatment can prevent hair loss from worsening and help women regrow their hair. Treatment delivers the best results when started at the first sign of hair loss.
How can I tell if I have female pattern hair loss?
It’s best to make an appointment to see a dermatologist. Dermatologists are the experts in diagnosing and treating hair loss. A dermatologist can tell you whether it’s FPHR or something else that is causing your hair loss. Other causes of hair loss can look like FPHL, so it’s important to rule out these causes.
What causes female pattern hair loss?
It’s hereditary. You inherit the genes from your mother, father, or both. Because FPHL is more common after menopause, hormones may also play a role.
How do dermatologists treat female pattern hair loss?
To give women optimal results, dermatologists may use more than one hair-loss treatment. For FPHL, treatment options include the following.
Minoxidil (meh-nox-eh-dil):
Long used to treat male pattern hair loss, the US Food and Drug Administration (FDA) has approved this non-prescription treatment for women. Today, it is the most-recommended treatment for FPHL. Products containing either 2% or 5% minoxidil have been approved to treat FPHL.
What should I know about using minoxidil?
For the first two to eight weeks, you may notice a temporary increase in hair loss. This stops when your hair begins to regrow.
A common side effect of minoxidil is an irritated scalp, which may cause dryness, scaling, itching, and/or redness on your scalp. If this happens, it’s best to stop using minoxidil and see your dermatologist.
Another possible side effect is to see hair growing in places other than your scalp, such as on your cheeks and forehead. If this happens, you can limit it by:

Trying to apply minoxidil only to your scalp and avoiding other areas
Washing your face after you apply minoxidil to your scalp

When will I see results?
Hair grows slowly, so it takes time to see results. You’ll need to use minoxidil continuously for about one year before you know how well it will work for you. If this medication works for you, you’ll need to use it every day to continue getting results. When you stop, the hairs that grew because of minoxidil will fall out within three to four months, and your hair loss can continue.
Minoxidil, pregnancy, and breastfeeding: Women who are pregnant or plan to become pregnant should avoid minoxidil. Studies of pregnant animals have shown minoxidil can be harmful to a developing fetus.
Women who are breastfeeding should also avoid minoxidil. Traces of minoxidil may pass into breast milk, which can be harmful to a nursing infant.
How is minoxidil used?
You apply it to your dry scalp. Some products you should apply once a day. Others you apply twice a day.

Prescription medications:
Some prescription medications have proven effective in helping women with FPHL grow hair and prevent FPHL from worsening.
To date, these medications have received FDA approval to treat other conditions, but not FPHL. Doctors often prescribe FDA-approved medications to treat medical conditions other than those for which the drug was approved.
A dermatologist may prescribe one of the following medications to treat FPHL. Each of these medications is a pill.
Spironolactone (speh-ren-no-LAK-tone):
This medication is a diuretic, which has been prescribed for decades to treat hair loss. It is a common treatment for FPHL because it can help restore hair growth and prevent hair loss from worsening.
Before taking spironolactone, be sure to tell your dermatologist about your medical conditions, including kidney and adrenal gland problems. Also, be sure that your dermatologist knows all the medications and supplements you take.
Your dermatologist may prescribe another medication to treat FPHL, such as finasteride (fi-NAS-ter-ide), flutamide(flu-TA-mide), or dutasteride (doo-TAS-ter-ide).
With any medication, side effects are possible. Ask your dermatologist about possible side effects that you might experience while taking one of these medications.
When will I see results?
If your dermatologist prescribes one of these medications, you’ll need to take it for 6 to 12 months before you’ll know if it works for you. No hair growth within 12 months means the medication won’t work for you.
Like minoxidil, once you stop taking a prescription medication, you lose the hair that grew. This happens in about three to four months.
Pregnancy and hair-loss medications:
All of these prescription medications may cause birth defects, so none of these is an option for women who are pregnant or plan to become pregnant.
Hair transplant:
Long used to treat hair loss in men, a hair transplant may be an option for some women with FPHL.
The hair transplant has come a long way since the days of hair plugs. Today, most hair transplants look completely natural.
Not everyone is a good candidate for a hair transplant though. If the hair on your scalp is sparse all over, you may not have enough healthy hair to transplant. A hair transplant surgeon, many of whom are dermatologists, can tell you if a hair transplant may help restore your hair.
Are there other treatment options for FPHL? Women want innovative treatments for FPHL. To meet this need, researchers continue to look for new ways to stimulate hair growth and stop hair breakage. Other treatments that you may find for FPHL include the following.
Lasers for at-home use: The FDA has approved laser combs, helmets, and other devices, which are available without a prescription, to treat hair loss at home. These devices emit a low level of laser light that may help stimulate new hair growth. A few studies show that this can be effective for treating FPHL.
As with minoxidil and prescription medicines, you must continue using an at-home laser device to see results. We still do not know whether these devices are safe for long-term use or if they can continue to produce new hair growth.

It is believed the platelets help stimulate your cells to grow hair.
Researchers are just beginning to study this therapy as a treatment for hair loss. The early findings show promise, but more studies are needed to know whether this is a safe and effective treatment for FPHL.
Stem cells: Using stem cells to treat FPHL is still in the experimental stages. Like platelet-rich plasma therapy, more studies are needed to know whether stem cells are a safe and effective treatment for FPHL.
Supplements: Many supplements, including biotin and folic acid, are said to help grow and thicken hair. In studying these different supplements, the findings have been mixed. In most studies, the supplements had no effect on hair growth and thickness.
In one study, however, 120 healthy women had thicker hair and less hair loss after taking specific omega-3 fatty acids, omega-6 fatty acids, and antioxidants. They took this combination for six months. If these results can be repeated in other studies, we’ll have some evidence to recommend taking these supplements.
In the meantime, you’re sure to find supplements that promise to regrow hair. Before taking any of these, it’s best to check with your dermatologist. Some supplements can interact with medications. Your dermatologist can also tell you whether we have any evidence to show that the supplement helps regrow hair.
Hair loss shampoos: These shampoos tend to do one of the following.

Help your hair hold moisture, which makes hair look fuller and thicker
Lessen breakage, which can reduce thinning

While hair loss shampoos may do the above, they cannot regrow hair or prevent hair loss from worsening.
A dermatologist’s diagnosis is best before treating hair lossIf you think you have FPHL, it’s important to see a dermatologist for a diagnosis. Women develop hair loss for many reasons. Other common causes of hair loss in women can look a lot like FPHL. Each of these causes requires different treatment. Without the right treatment, hair loss often continues.
You can find a dermatologist in your area by going to Find a Dermatologist.
Key points

See a dermatologist to make sure that you have FPHL, and to rule out another condition, which may be causing your hair loss
Treatment works best when started at the first sign of hair loss
Minoxidil is the most-recommended treatment for FPHL

Whether the newer treatments for hair loss, such as the lasers for at-home use, are safe for long-term use and can continue to stimulate new hair growth remain to be seen.

IS YOUR WORKOUT CAUSING YOUR ACNE?

HOW TO PREVENT ACNE CAUSED BY WORKOUTS

Working out can cause excessive sweating, as well as a buildup of oil, dirt, and bacteria on your skin — all of which can lead to acne. However, you don’t have to quit exercising in order to see clearer skin. The key is to maintain proper hygiene before, during, and after your workouts.

Do you suspect that your workout is causing (or worsening) your acne? You could be right.

If your workout is the culprit, you don’t have to stop exercising. You can continue to play sports, take your favorite exercise class, or hit the gym and still see clearer skin. Here’s what dermatologists recommend.

Before your workout

1. Remove your makeup. No need to wash your face. A oil-free makeup remover towelette works fine.

2. Put on clean workout clothes (washed since you last wore them. Dead skin cells, bacteria, and oils on unwashed clothes can clog your pores, leading to acne.

3. Apply oil-free sunscreen before you head outside. If you’re going to exercise outdoors during the day, you can prevent breakouts by protecting your skin from the sun.

Yes, the sun can cause breakouts because it dries your skin. When this happens, your body produces more oil, which can clog pores and cause acne.

To get the protection you need, you’ll want to apply a sunscreen that offers:

• SPF 30 or higher
• Broad spectrum (protects you from UVA and UVB rays)
• Water resistance
• Oil-free formulation (Label may say “non-comedogenic” or “won’t clog pores”)

During your workout

4. Use a clean towel to wipe off sweat. You want a towel that has been washed since you (or someone else) last used it.
When you remove sweat from your skin, gently pat it off. Rubbing your skin can cause acne to flare.

5. Avoid sharing protective equipment like helmets and shoulder pads whenever possible. These can be full of acne-causing bacteria and oil, which may cause you to breakout.

6. Wipe off shared equipment before you use it. Shared equipment can be full of acne-causing bacteria and oil. If you use the equipment and then wipe your forehead or other acne-prone skin, you can spread acne-causing bacteria and oil from the equipment to your skin

To remove sweat during a workout, use a clean towel and gently pat the sweat from your skin.

After your workout

7. Consider showering immediately after your work out. This may rinse away bacteria that can cause acne.

When you wash your face and other skin with acne, you’ll want to use a cleanser that is:

• Mild
• Oil free (label may say “non-comedogenic” or “won’t clog pores” instead)

A mild, oil-free cleanser can remove bacteria that can lead to acne and prevent clogged pores without irritating your skin.

When washing skin with acne, be very gentle. Apply the cleanser with your fingertips and gently rinse it off with warm water. Rubbing, hot water, or anything else that irritates your skin can cause acne to flare.

If you aren’t able to shower, consider changing out of your workout clothes and wiping skin that tends to break out with pads that contain salicylic acid. This can prevent clogged pores.

If you have acne or acne-prone skin, following these recommendations from dermatologists can allow you to work out and see clearer skin. You’ll also want to continue treating your acne.

If you still have breakouts after trying these tips, your sports equipment or clothing might be to blame. Everything from football helmets to synthetic dance clothes can cause acne.

You’ll find out what dermatologists recommend for clearing acne caused by sports equipment or clothing at, Is your sports equipment causing your acne?

Image
Getty Images
Reference
Fulton JE, Acne Rx: What acne really is and how to eliminate its devastating effects! Self-published; 2001.

ARE TRIGGERS CAUSING YOUR PSORIASIS FLARE-UPS?

If your psoriasis seems to flare for no reason, one or more triggers could be to blame. Everyday things like stress, a bug bite, and cold temperatures can trigger psoriasis.

Triggers vary from person to person. By finding your triggers and learning how to manage them, you can gain better control of your psoriasis and have fewer flares.

To find yours, you’ll have to do a bit of detective work. A good place to start is by looking at this chart of the common triggers, which also gives you signs that that it could be a trigger for you.

Common psoriasis triggers that can cause psoriasis flare-ups

Stress

Do you get flare-ups when you're feeling overwhelmed or stressed? Stress is a common trigger.

Reduce risk of flare-ups from stress

Find a way to manage your stress and practice it — even when you’re feeling okay. Common stress busters include yoga, meditation, and support groups.
Before going to sleep, write down 3 things that you’re grateful for. Do this daily.
When you start to feel stressed, take a deep breath, hold it, and exhale slowly.
Check out what board-certified dermatologist Alexa Boer Kimball, MD, MPH, FAAD, tells her patients to help them cope with stress.

Can stress worsen psoriasis?

Skin injury

If this triggers your psoriasis, you’ll get a flare-up near (or in the same spot as) the injury or bite. This happens about 10 to 14 days after you injure your skin.
Flare-ups happen after getting a cut, scrape, sunburn, scratch, outbreak of poison ivy, bruise, or bug bite.
Reduce the risk of flare-ups from a skin injury

If you injure your skin, treat it quickly.
If your skin itches, calm the itch.
Avoid scratching, which can trigger a flare.
Try to avoid getting bug bites by using insect repellent and staying indoors when bugs are most active. Bugs are most active at dusk and dawn.

Drinking frequently or in excess

If you drink daily or have more than 2 drinks in a day frequently, your treatment for psoriasis may have little or no effect. Even treatment that could be effective for you may not work and you’ll continue to have flare-ups.
Reduce the risk of flare-ups from drinking

Quit drinking.
If you continue to drink, limit how much you drink in a day. Women should stop after 1 drink. Men should limit themselves to 2 drinks per day.
Be sure to tell your dermatologist if you drink alcohol. Drinking can make it risky to take some psoriasis medications like methotrexate.

Smoking

Does your psoriasis flare unexpectedly? If you smoke or spend time with people who smoke, this could be the cause.
Reduce the risk of flare-ups from drinking

Stop smoking. Because this can be difficult, ask your dermatologist or primary care doctor for help.
Before trying a nicotine patch, ask your dermatologist whether using it could trigger your psoriasis.
Avoid being around people who are smoking.

Dry, cold weather

If your psoriasis worsens when the humidity or temperature drops, such as in the winter or fall, this is likely a trigger for you.
Reduce the risk of flare-ups from dry, cold weather

Treat your psoriasis.
Limit showers and baths to 10 minutes and use warm rather than hot water.
Immediately after bathing, slather on moisturizer, using a fragrance-free ointment or cream rather than a lotion.
Use a gentle, moisturizing cleanser instead of soap.
Apply moisturizer throughout the day when your skin feels dry.
Plug in a humidifier when the air in your home feels dry.
Stay warm and protect your skin from extreme weather when outside by wearing a hat, gloves, waterproof boots, and a winter jacket.
Sit far enough away from a fireplace, radiator, or other heat source so that you cannot feel the heat on your skin.
Remove wet clothes and footwear when you come in from the cold.
If your psoriasis continues to flare, see your dermatologist. Ask if phototherapy may be a treatment option for you in the winter.

Sunshine, warm weather

During warm weather, psoriasis can flare if you:

Sunburn
Spend time in air conditioning

Reduce the risk of flare-ups during warm weather

If you spend time in air conditioning, apply moisturizer immediately after showering or getting out of a bath.
If your skin still feels dry from spending time in air conditioning, apply moisturizer throughout the day.
Avoid sunburn by wearing sunscreen. You want to apply sunscreen to skin that clothing doesn’t cover and is free of psoriasis. To get the protection you need, use sunscreen that offers broad-spectrum protection, SPF 30 or higher, and water resistance.

Infection

Psoriasis can flare 2 to 6 weeks after strep throat, an earache, bronchitis, or another infection. This is especially common in kids.
Reduce the risk of flare-ups due to infection

Treat the infection. This can lessen or clear the psoriasis.
Tell your dermatologist if you have an HIV (human immunodeficiency virus) infection, which can make some psoriasis treatments risky.

Medication

Some medications can cause a flare-up. If a medication is a trigger for you, you’ll flare 2 to 3 weeks after beginning a medication.
Reduce the risk of flare-ups from medication

If you think a medication is causing your psoriasis to flare, DON’T stop taking it. Ask the doctor who prescribed it whether the medicine could be causing your psoriasis to flare. If it could, ask if you could take another medication.
Before taking a medicine for the first time, ask the doctor prescribing it if the medicine could cause psoriasis to flare. Medicines that commonly trigger psoriasis include lithium, drugs taken to prevent malaria, strong corticosteroids like prednisone (if you quit taking it rapidly instead of stepping down), medicine that treats high blood pressure and problems with your heartbeat, some arthritis medications.

Tattoos and piercings

When you get a tattoo or piercing, you injure your skin. Any time you injure your skin, psoriasis can flare.
Reduce the risk of flare-ups from tattoos and piercings

Avoid tattoos and other types of body art if you have psoriasis.
If you want to get any type of body art, talk with your dermatologist first. Your dermatologist may be able to offer some tips that can reduce flare-ups.

Shaving

If you cut yourself while shaving, you may notice new psoriasis about 10 to 14 days later where you cut yourself.
Reduce your risk of flare-ups from shaving

Take care to avoid cutting yourself while shaving.
Dermatologists’ tip: To reduce cuts and nicks, try applying moisturizer and then shaving gel before you shave.

Images
Getty Images
References
Bergstrom, KG, Kimball AB. (2011) 100 questions & answers about psoriasis. Sudbury, Mass: Jones and Bartlett.
Marks, B. “More than skin deep: Triggers, treatments, and you.” An educational session hosted by the National Psoriasis Foundation. Chicago: Presented June 20, 2015.
Murzaku EC, Bronsnick T, et al. “Diet in dermatology Part II. Melanoma, chronic urticaria, and psoriasis.” J Am Acad Dermatol. 2015 Aug;73(2):353.

Backlink to Original AAD Story- https://www.aad.org/public/diseases/psoriasis/triggers/flares

Enforcing COVID-19

Facemask Policies in the Physician's Office

Recently, some medical practices have reported an increasing number of patients who are resisting or refusing to comply with the practice's COVID-19 facemask policies. As a result, many medical practices are reevaluating their COVID-19 facemask policies and how to enforce them.

What is the current CDC guidance on facemasks for medical practices?

While the CDC continues to generally recommend the implementation of COVID- 19 safety measures (e.g., facemasks, physical distancing and COVJD-19 screening measures), the CDC recommends medical practices and other healthcare settings review community transmission rates to determine which safety measures to implement.
With respect to facemasks, the CDC advises that it is generally safest to implement universal use of source control (i.e., facemasks) for everyone in a healthcare setting, including heqlthcare personnel, patients and visitors. Notwithstanding, certain allowances can be considered for individuals who are up to date with all recommended COVID-19 vaccine doses in healthcare facilities located in counties with low to moderate community transmission. Such allowances may include permitting healthcare personnel who are up to date with all recommended COV/D- 19 vaccine doses to choose not to wear facemasks when they are in well-defined areas that are restricted from patient access, or to allow patients or visitors who are up to date with all recommended COVJD-19 vaccine doses and are not suspected of having COVID-19 (based on symptom and exposure history) to choose not to wear facemasks when in single-person rooms or other designated areas when others are not present.
Currently, the only Michigan county with low or moderate community transmission rates is Presque Isle County. All other Michigan counties have substantial or high COVID-19 community transmission rates. Current CDC COVID-19 guidance for medical practices is available here. Medical practices should continue to monitor for updates to the CDC’s guidance on facemasks and other COVID-19 safety measures.
Should medical practices eliminate facemask requirements for patients, visitors and staff?
No. Even if a medical practice is located in a county with low or moderate COVID-19 community transmission rates, consideration should be given to COVID-19 and other workplace safety standards enforced by OSHA. While OSHA has withdrawn its non-record keeping portions of the COVID-19 healthcare emergency temporary standard (ETS), OSHA continues to strongly encourage all healthcare employers to continue to implement the ETS’s requirements, including requiring facemasks, in order to protect healthcare workers from COVID-19. In addition, while OSHA is currently developing a final COVID-19 standard for the healthcare industry, OSHA retains the ability to enforce the General Duty Clause, which requires employers to keep a workplace free from recognized hazards known to cause death or serious injury.
Why are facemasks required at some medical practices and optional at other medical practices?
At this time, there is no state or federal law, regulation or order that expressly requires the use of facemasks in medical practices. For this reason, while some medical practices have continued to require facemasks as part of their COVID-19 safety measures, other medical practices have implemented policies which require facemasks only in certain circumstances (e.g., if a patient, visitor or staff member is unvaccinated) or which make facemasks optional regardless of vaccination status or community transmission rates.
Notwithstanding, to mitigate and prevent the spread of COVID-19, guidance from the CDC and OSHA continue to recommend and encourage facemasks in healthcare facilities and other healthcare settings. In addition, the Michigan Department of Health and Human Services (MDHHS) continues to recommend wearing facemasks during surge and post-surge recovery phases of the COVID-19 cycle, particularly in high-risk congregate settings, such as healthcare facilities.
While medical practices should implement COVID-19 policies which best meets the needs of their practice, MSMS continues to recommend medical practices implement policies which provide the greatest amount of safety for patients, physicians and other healthcare personnel, as well as the least amount of risk for medical practices consistent with applicable laws, regulations and available guidance.
What if a patient or visitor refuses to wear a facemask?
If a medical practice requires facemasks as part of its COVID-19 safety measures and a patient or visitor objects to or refuses to wear a facemask when required, physicians should ensure its policies include a protocol for explaining the medical practice’s policies, including the CDC’s guidelines for health professionals, which may be different from guidelines for individuals, and that a patient must comply with the practice’s policies while inside the facility. Physicians should avoid using judgmental language against individuals with facemask concerns, which could negatively impact the patient’s trust and the overall physician-patient relationship. In addition, sharing facts about facemasks, as opposed to personal opinions, may be more effective.
Medical practices should also ensure that its policies include a protocol for addressing patients who become hostile or argumentative regarding the practice’s COVID-19 policies. Such protocols may include placing the patient in a room or waiting area away from patients, or if necessary and appropriate, the patient’s appointment may be rescheduled to a telehealth visit. Medical practices should avoid terminating a patient or referring the patient to another physician for treatment due to the patient’s noncompliance with the medical practices’ policies unless the physician-patient relationship has deteriorated, or other exceptional circumstances exist.
What if a patient or visitor requests a medical exemption from any facemask policies?
Medical practices are generally considered places of public accommodation and must comply with the federal Americans with Disabilities Act as well as Michigan’s Persons with Disabilities Civil Rights Act, when enforcing the practice’s own COVID-19 policies. Physicians need to have a process to address requests by patients and visitors for exemptions from the practice’s facemask requirement or similar policies based on medical grounds and to assess whether or not reasonable accommodations are possible. Physicians should not assume that an unmasked patient or visitor cannot medically tolerate a facemask or comply with other COVID-19 policies, but physicians are permitted to accept the patient or visitor’s verbal representation to that effect. Best practices advise to not request medical documentation from the patient or visitor to determine whether the patient or visitor has a disability warranting a reasonable accommodation.
Are medical practices still immune from liability for COVID-19 claims?
Yes. Michigan law still provides immunity to persons, including physicians and medical practices, from tort civil actions arising from exposure or potential exposure to COVID-19 or conduct intended to reduce the transmission of COVID-19. However, in order to be eligible for such immunity, persons must have acted in accordance with all federal, state and local statutes, rules, regulations, executive orders, and agency orders related to COVID-19 that had not been denied legal effect at the time of the conduct or risk that allegedly caused harm. Such immunity applies retroactively to any claim or cause of action that accrues after March 1, 2020.

CAN COVID-19 CAUSE HAIR LOSS?

People develop noticeable hair loss after recovering from COVID-19

Months after recovering from COVID-19, many people find that their hair is falling out in large clumps. If we’ve learned anything from the coronavirus pandemic, it’s to expect the unexpected. The hair loss that many people develop, however, may not be so unexpected. Here’s why.

Temporary hair loss is normal after a fever or illness

Fever is a common symptom of COVID-19. A few months after having a high fever or recovering from an illness, many people see noticeable hair loss.

While many people think of this as hair loss, it’s actually hair shedding. The medical name for this type of hair shedding is telogen effluvium. It happens when more hairs than normal enter the shedding (telogen) phase of the hair growth lifecycle at the same time. A fever or illness can force more hairs into the shedding phase.

Most people see noticeable hair shedding two to three months after having a fever or illness. Handfuls of hair can come out when you shower or brush your hair. This hair shedding can last for six to nine months before it stops. Most people then see their hair start to look normal again and stop shedding.

Telogen effluvium causes noticeable hair shedding

Telogen effluvium causes noticeable hair shedding, but that’s all you should experience. If you have a rash, itchy scalp, or burning, something other than telogen effluvium is likely causing your hair loss, and it’s time to see a dermatologist.

Stress can cause temporary hair shedding

Even if you never developed a fever or COVID-19, you may still see hair shedding. Emotional stress can also force more hairs than normal into the shedding phase. And who isn’t feeling more stressed and anxious during the pandemic?

Again, the hair shedding begins about two to three months after the stress starts.

While seeing your hair fall out in clumps can add to your stress, it’s important to try to de-stress. Only when the stress ends will the excessive hair shedding stop.

Hair tends to return to normal on its own

When the cause of your hair shedding is due to a fever, illness, or stress, hair tends to return to normal on its own. You just have to give it time. As your hair grows back, you’ll notice short hairs that are all the same length by your hairline. Most people see their hair regain its normal fullness within six to nine months.

If you suspect that your hair loss is caused by something more than telogen effluvium from stress or a fever, talk with a hair-loss expert, a dermatologist.

Related AAD resources

AAD Coronavirus Resource Center

Reference

Sperling LC. “Alopeica.” In: Fitzpatrick JE, Morelli JG. Dermatology Secrets Plus (fifth edition). Elsevier, China, 2016:179-84.

5 FACTS YOU SHOULD KNOW ABOUT PRECANCEROUS SKIN GROWTHS

If your dermatologist tells you that you have a precancerous skin growth, it means one thing. Your skin has been badly damaged by the sun, indoor tanning, or both. The good news is that it’s not too late to do something about this damage and protect your health.
To do this, it helps to understand these 5 facts about precancerous skin growths, which your dermatologist may refer to as actinic keratoses (AKs) or solar keratoses.

Treatment can prevent a precancerous skin growth from progressing to skin cancer. Some precancerous skin growths go on to become a type of skin cancer called squamous cell carcinoma. There’s no way for your dermatologist to know which ones will progress to skin cancer.

When you get rid of an AK, it cannot go on to become skin cancer.
Treatment can relieve symptoms, such as itching or tenderness. Some AKs feel tender. An AK can also itch or bleed. When you get rid of the AKs, you get rid of the symptoms.
Some people need multiple and repeat treatments. When you think of treating a precancerous spot on your skin, you probably envision going to your dermatologist’s office for a one-time treatment; however, some people need more involved treatment.

If you have severely sun-damaged skin, you may have many AKs. Some of these AKs, you may be able to feel on your skin but not see. These hidden AKs can feel gritty. Some people say they feel like spots of sandpaper on the skin.

To treat both the visible and hidden AKs, your dermatologist may recommend that you have more than one type of treatment.

Your treatment plan many involve going to your dermatologist’s office for a treatment, such as cryotherapy or a specialized light treatment called photodynamic therapy (PDT). You may also need to apply medication at home.

By using more than one treatment, you can treat both the visible and hidden AKs. This reduces the amount of time that you need to treat the AKs and reduces your risk of developing skin cancer.
Sun protection delivers big benefits. Many people who have precancerous skin growths are surprised to learn that they need to protect their skin from the sun. They often think that the damage is done, so what’s the point.

If you have a precancerous skin growth, protecting your skin from the sun offers two big benefits: 1) It helps to prevent the sun from causing further damage to your skin, which could lead to more precancerous growths or skin cancer, and 2) It gives your body a chance to repair some of the damage to your skin.

If you’re unsure about how to protect your skin, you can learn what to do at Prevent skin cancer.
Lifelong skin cancer exams can be life-saving. Having just one precancerous skin growth means that the sun, indoor tanning, or both have badly damaged your skin. As such, you have an increased risk of developing skin cancer.

Getting your skin examined by a board-certified dermatologist helps to find precancerous skin growths and skin cancer early when they’re highly treatable.

Your dermatologist can tell you tell you often you should come in for a skin exam and how often you should examine your skin at home.

Looks can be deceptive

Precancerous skin growths may look harmless. As you now know, their looks can be deceptive. Following your dermatologist’s recommendations can help protect your skin and your health.

Precancerous skin growths may look harmless

These arrows point to precancerous skin growths that are barely noticeable.

Related AAD resources

•Actinic Keratoses: Overview

•Actinic Keratoses: Causes

HOW TO REMOVE A TICK AND PREVENT FUTURE BITES

HOW TO REMOVE A TICK

Ticks are small, insect-like creatures that live in heavily-wooded or grassy areas. If you walk through these areas, they can attach to your skin and feed on your blood. Although most ticks do not carry disease, some can cause serious illness. To prevent infection, it’s important to remove a tick from your skin as soon as you notice it.
To remove a tick that is attached to your skin, dermatologists recommend the following tips.

Ticks are small, insect-like creatures that live in heavily-wooded or grassy areas. If you walk through these areas, they can attach to your skin and feed on your blood. Although most ticks do not carry disease, some can cause serious illness, such as Lyme disease, Powassan virus, or Rocky Mountain spotted fever. To prevent infection, it’s important to remove a tick from your skin as soon as you notice it.

To remove a tick that is attached to your skin, dermatologists recommend the following tips:

Use tweezers to remove the tick. Sterilize the tip of the tweezers using rubbing alcohol and grasp the tick as close to the skin’s surface as possible.
Pull upward with steady, even pressure. Avoid twisting, squeezing or crushing the tick, as this can cause its head or mouth to break off and remain in your skin. If this happens, use tweezers to remove the remaining parts. If you cannot remove the rest of the tick, see a board-certified dermatologist.
Dispose of the tick. Place it in a sealed bag or container; submerse the tick in alcohol; or wrap it tightly in tape. You may also want to save the tick in a sealed jar. That way, if you develop any symptoms after the bite, the tick can be tested for disease.
Clean the bite area with soap and water.
Ticks can bite at any time, however they’re most active in April through September. Fortunately, there are many things people can do to protect themselves and their families against ticks.

To prevent tick bites, dermatologists recommend the following tips:

Walk in the center of trails. Avoid walking through heavily-wooded and brushy areas with tall grass.
If you must walk through heavily-wooded areas, wear long pants and long sleeves. Pull your socks up over your pants, and tuck your shirt into your pants to prevent ticks from crawling up your body. It’s also a good idea to wear light-colored clothes so that ticks can be spotted easily.
Use insect repellent that contains 20 to 30 percent DEET on exposed skin and clothing. Make sure to follow the product instructions. Parents should apply this product to their children, making sure to avoid the hands, eyes and mouth.
Examine your skin after spending time in heavily-wooded or brushy areas. Conduct a full-body tick check to make sure that no ticks are crawling on you. Since ticks prefer warm, moist areas, be sure to check your armpits, groin and hair. You should also check your children, pets and any gear you used outside.
If you develop any symptoms within a few weeks after a tick bite, such as a rash, fever or body aches, see a board-certified dermatologist. Make sure you tell the doctor about your recent tick bite, when the bite occurred and where you most likely acquired the tick.

HOW TO PREVENT SKIN PROBLEMS WHILE GARDENING

Although gardening can be an enjoyable activity for many, it can take a turn for the worse if you injure yourself, come into contact with a poisonous plant, or have an allergic reaction. To prevent skin problems from gardening or yardwork, follow these tips from board-certified dermatologists.

Prevent a rash while gardening

Tim could have prevented his rash by wearing gloves, a long-sleeved shirt, and sunscreen while trimming the grass

9 ways to protect your skin while gardening

Dermatologists recommend the following while gardening:

1. Cover Up When working with plants, everything from the plant’s sap to its thorns or spines can injure your skin. Touching certain plants can cause an allergic skin reaction. The best way to protect yourself is to cover your skin. When working with plants, dermatologists recommend wearing:

Gloves
Shirt with long sleeves
Pants
Socks
Shoes that cover your feet, such as running shoes

Dermatologists also recommend wearing a wide-brimmed hat and sunglasses while outdoors. This helps to protect you from the sun.

Prevent injuries while gardening

Wearing gloves and long sleeves help to prevent many injuries caused by gardening.

Use sunscreen. To protect your skin from the sun, you’ll also want to apply sunscreen that offers:
- Broad-spectrum protection
- SPF 30 or higher
- Water-resistance
Be sure to apply the sunscreen to all skin not covered by clothing, including your face, neck, and ears. To protect your lips from the sun, use a lip balm with SPF 30 or higher. You can stay protected by re-applying sunscreen every two hours.
Covering up and using sunscreen can also help to reduce your risk of getting sunburn, skin cancer, and early signs of skin aging, including age spots and wrinkles.
Avoid gardening when the sun is strongest. The sun’s rays are strongest between 10 a.m. and 2 p.m. When possible, dermatologists recommend staying indoors during these hours.
If you must garden during these hours, try to stay in the shade. This will also reduce your risk of heat stroke, heat rash, and skin cancer.
Take precautions to avoid bug bites. You can prevent many injuries and illnesses due to bugs by:
- Spraying insect repellent with DEET on your clothing once you’re outdoors
- Avoiding gardening and yardwork during dawn and dusk, which is when bugs are most active
- Flicking a bug off rather than killing it, which can prevent the bug from biting or stinging
- Checking your skin from head to toe for ticks when you finish gardening, being sure to check the skin between your toes, hairline, and underarms
Read labels on pest control products, plant foods, and fertilizers before using them. Many gardening products that we use from insecticides to weed killers can cause injuries ranging from a mild rash to severe burns. In rare cases, people have developed life-threatening injuries.
Following all precautions on the label can help prevent these injuries. For example, when the label calls for a respirator, use one or don’t use the product.
When using fertilizer, wear gloves. After using a fertilizer, immediately and thoroughly wash your hands.

Protect your skin while gardening

Gloves help prevent dirt from settling in the lines of your hands, dry skin, and peeling nails.

Avoid touching your face while gardening. You could get plant sap or something else on your face, which might injure you.
If you need to wipe away sweat, keep a clean washcloth handy. Use it to blot your face dry.
Treat wounds right away. If you have a minor injury, such as a puncture wound from a thorn, it can be tempting to ignore it and keep working. Don’t. Even a minor wound can become infected.
To prevent an infection, immediately treat your wound as follows:
- Wash the wound with soap and water
- Apply an antibiotic ointment
- Cover the wound with a bandage
- Keep the wound clean by changing into clean gloves and clothing before you continue
- Clean the wound and change the bandage every day until the wound heals
Skip foods and drinks that contain citrus — or follow this precaution. When citrus juice gets on your skin, it can react with sunlight and can cause a blistering rash or painful swelling. Foods that contain citrus include lemons, limes, grapefruit, and oranges.

Use caution around foods and drinks that contain citrus

You can prevent the swelling and pain due to citrus juice mixing with sunlight by doing one of the following:

Avoid citrus while outdoors
Rinse your skin with lots of water immediately after touching anything with citrus and then apply sunscreen

Shower when you finish gardening and change into clean clothes. Sap, pollen, and other parts of plants can get on your clothes and skin. To protect your skin, shower and put on clean clothes immediately after gardening.
Make sure you also machine wash the clothes that you wore while gardening before wearing them again.

When to see a board-certified dermatologist

While many skin problems caused by gardening can be prevented, an injury can still occur. You can treat most skin injuries at home by:

Cleaning and caring for wounds right away
Treating itchy or irritated skin with a cortisone cream
Alleviating allergy symptoms, such as itchy eyes and sneezing, by taking an antihistamine

If an injury doesn’t heal or worsens, a board-certified dermatologist can help.

10 Surprising Facts About Indoor Tanning

10 Surprising Facts About Indoor Tanning
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Skin Cancer Information

Skin Cancer Information
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Sunscreen Frequently asked Questions

Sunscreen FAQ
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Poison Ivy, Oak, and Sumac:
What Does The Rash Look Like?

Poison Ivy, Oak, Sumac Look
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Poison Ivy, Oak, and Sumac:
How To Treat the Rash

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How to Care for Dry, Cracked Heels

It’s easy for the skin on your feet to become dry and cracked, especially in the winter. Fortunately, there are steps you can take to treat dry, cracked heels at home and prevent them from coming back.
To care for dry, cracked heels, follow these tips from board-certified dermatologists.

Limit baths and showers to 5-10 minutes. Bathing for too long can dry out the skin, making dry, cracked heels worse. Be gentle when blotting your skin dry with a towel.
Use a gentle, fragrance-free cleanser. This will help your feet retain their natural oils.
Moisturize within 5 minutes of bathing. Look for a moisturizing cream that contains 10-25% urea, alpha hydroxy acid, or salicylic acid, and apply it to your heels immediately after bathing while your skin is still damp and whenever your heels feel dry to lock in moisture.
Before bed, apply plain petroleum jelly. Consider wearing socks at night to avoid getting grease on your bedding.
Protect your heels. During the day, apply a liquid bandage over the cracks in your heels to create a protective barrier, which can help reduce pain, speed up healing, and stop germs from entering your skin.
Wear the proper shoes. If you have dry, cracked heels, avoid open-heeled shoes, such as flip flops or slingbacks, shoes that are worn down, or shoes that don’t fit properly.
Sometimes, cracked heels are caused by a medical condition, such as diabetes. If your dry, cracked heels are severe or do not improve after following these tips, talk to a board-certified dermatologist.
Related AAD resources
Dry skin relief
Dry skin relief for those with diabetes
Dermatologists' top tips for relieving dry skin

Academy video shares how to care for facial hair

Healthy-looking facial hair starts with healthy skin. With the right skin care, it’s possible for patients to prevent problems like dandruff, ingrown hair, acne, and itch. Help your patients keep their skin and facial hair healthy

See Full Story

Play Video

Is Your Workout Causing Your Acne?

How to prevent acne caused by workouts.

Working out can cause excessive sweating, as well as a buildup of oil, dirt, and bacteria on your skin -all of which can lead to acne. However, you don't have to quit exercising in order to see clearer skin. The key is to maintain proper hygiene before, during, and after your workouts.
Do you suspect that your workout is causing (or worsening) your acne? You could be right.
ff your workout is the culprit, you don't have to stop exercising. You can continue to play sports, take your favorite exercise class, or hit the gym and still see clearer skin. Here's what dermatologists recommend.

CLICK TO WEBSITE

Your Winter Skin Survival Kit

As temperatures dip, check your products for these skin-saving ingredients :
Cold air outside, hot air inside, and dry air everywhere can disrupt the skin's barrier in the winter. And that can mean dry, itchy skin for everyone, but especially for those who deal with conditions like eczema and psoriasis.
Here are some products that can help your skin look and feel its best throughout the colder months. Some of the ingredients are tried-and-true skin superstars, while others are relatively new additions to the winter skin care arsenal.

Click to Website

ACNE: TIPS FOR MANAGING

Meet Our New Esthetician!

HOW TO REMOVE A TICK AND PREVENT FUTURE BITES

​HOW TO REMOVE A TICK

BED BUGS: TIPS FOR PREVENTING

ACNE-LIKE BREAKOUTS COULD BE FOLLICULITIS

POISON IVY, OAK, AND SUMAC: WHAT DOES THE RASH LOOK LIKE?

SKIN TAGS: WHY THEY DEVELOP, AND HOW TO REMOVE THEM

Why am I getting skin tags?

Should I remove a skin tag?

How does a dermatologist remove skin tags?

Does wart remover work on skin tags?

Seeing a dermatologist can give you peace of mind

Related AAD resources

Here are some facts and tips about skin cancer that you should know:

HOW TO PREVENT SKIN PROBLEMS WHILE GARDENING

SARCOIDOSIS AND YOUR SKIN: TIPS FOR MANAGING

SO MANY QUESTIONS. SO LITTLE TIME.

HOW TO PREVENT ROSACEA FLARE-UPS

DERMATOLOGIST-RECOMMENDED SKIN CARE FOR YOUR 20'S

MELASMA- SELF CARE

KIDNEY DISEASE: 11 WAYS IT CAN AFFECT YOUR SKIN

ADULT ACNE TREATMENT DERMATOLOGISTS RECOMMEND

DRY SKIN REMEDIES FOR DARKER SKIN TONES

HEART DISEASE: 12 WARNING SIGNS THAT APPEAR ON YOUR SKIN

DRY SKIN REMEDIES FOR DARKER SKIN TONES

7 DERMATOLOGISTS' TIPS FOR HEALING DRY, CHAPPED LIPS

HOW TO PREVENT AND TREAT DRY, CHAPPED LIPS

IN WINTER, WILL MY CHILD NEED DIFFERENT ECZEMA SKIN CARE?

SEBORRHEIC DERMATITIS: Self-Care

​ICHTHYOSIS VULGARIS: DIAGNOSIS AND TREATMENT

How do dermatologists diagnose ichthyosis vulgaris?

​Some people only need to treat their skin in the winter

What is the outlook for someone who has ichthyosis vulgaris?

5 REASONS TO SEE A DERMATOLOGIST FOR MOLE, SKIN TAG REMOVAL

DERMATOLOGIST-RECOMMENDED SKIN CARE FOR PEOPLE WITH DIABETES

THIN​NING HAIR AND HAIR LOSS: COULD IT BE FEMALE PATTERN HAIR LOSS?

​IS YOUR WORKOUT CAUSING YOUR ACNE?

​HOW TO PREVENT ACNE CAUSED BY WORKOUTS

​Before your workout

​During your workout

After your workout

ARE TRIGGERS CAUSING YOUR PSORIASIS FLARE-UPS?

Common psoriasis triggers that can cause psoriasis flare-ups

Stress

Skin injury

​Drinking frequently or in excess

​Smoking

​Dry, cold weather

​Sunshine, warm weather

​Infection

Medication

Tattoos and piercings

​Shaving

Enforcing COVID-19 ​Facemask Policies in the Physician's Office

​What is the current CDC guidance on facemasks for medical practices?

​CAN COVID-19 CAUSE HAIR LOSS?

​People develop noticeable hair loss after recovering from COVID-19

​Temporary hair loss is normal after a fever or illness

Telogen effluvium causes noticeable hair shedding

Stress can cause temporary hair shedding

​Hair tends to return to normal on its own

​Related AAD resources

Reference

5 FACTS YOU SHOULD KNOW ABOUT PRECANCEROUS SKIN GROWTHS

Looks can be deceptive

Precancerous skin growths may look harmless

​Related AAD resources

HOW TO REMOVE A TICK AND PREVENT FUTURE BITES

HOW TO REMOVE A TICK ​

HOW TO PREVENT SKIN PROBLEMS WHILE GARDENING

HOW TO PREVENT SKIN PROBLEMS WHILE GARDENING

Prevent a rash while gardening

9 ways to protect your skin while gardening

Prevent injuries while gardening

​Protect your skin while gardening

​Use caution around foods and drinks that contain citrus

When to see a board-certified dermatologist

10 Surprising Facts About Indoor Tanning

HOW TO REMOVE A TICK

Here are some facts and tips about
skin cancer that you should know:

ICHTHYOSIS VULGARIS: DIAGNOSIS AND TREATMENT

Some people only need to treat their skin in the winter

THINNING HAIR AND HAIR LOSS: COULD IT BE FEMALE PATTERN HAIR LOSS?

IS YOUR WORKOUT CAUSING YOUR ACNE?

HOW TO PREVENT ACNE CAUSED BY WORKOUTS

Before your workout

During your workout

Drinking frequently or in excess

Smoking

Dry, cold weather

Sunshine, warm weather

Infection

Shaving

Enforcing COVID-19

Facemask Policies in the Physician's Office

What is the current CDC guidance on facemasks for medical practices?

CAN COVID-19 CAUSE HAIR LOSS?

People develop noticeable hair loss after recovering from COVID-19

Temporary hair loss is normal after a fever or illness

Hair tends to return to normal on its own

Related AAD resources

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