ADULT SKIN PROBLEMS

Do you have skin problems?

Is your skin itching, breaking out, covered in a rash, or playing host to strange spots? Skin inflammation, changes in texture or color, and spots may be the result of infection, a chronic skin condition, or contact with an allergen or irritant. You can learn to recognize common adult skin problems. Yet, while many are minor, they may signal something more serious, so always consult a doctor for proper diagnosis.

Hives (urticaria)

Hives, a common allergic reaction that looks like welts, are often itchy, stinging, or burning. They may appear anywhere and last minutes or days. Severe hives can cause difficult breathing (get immediate medical attention if this occurs). Medications, foods, or food additives, temperature extremes, and infections like strep throat can cause hives. Removing the trigger often resolves the hives in days or weeks. Antihistamines can provide relief.

WHERE AND WHO

Where do skin tags occur?

Skin tags can occur almost anywhere there is skin. However, favorite areas for tags are the eyelids, neck, armpits, upper chest (particularly under the female breasts), and groin folds. Tags are typically thought to occur in characteristic locations where skin rubs against skin or clothing.

Who tends to get skin tags?

Nearly half of the population is reported to have skin tags at some time. Although tags are generally acquired (not present at birth) and may occur in anyone, more often they arise in adulthood. They are much more common in middle age and they tend to increase in prevalence up to age 60. Children and toddlers may also develop skin tags in the underarm and neck areas. Since they are thought to arise more readily in areas of skin friction or rubbing, tags are also more common in overweight people.

SKIN TAG

What is a skin tag?

A skin tag is a common, acquired benign skin growth that looks like a small piece of hanging skin. Skin tags are often described as bits of skin- or flesh-colored tissue that projects from the surrounding skin from a small, narrow stalk. They typically occur in characteristic locations including the neck, underarms, eyelids, and under the breasts (especially where underwire bras rub directly beneath the breasts). Although skin tags may vary somewhat in appearance, they are usually smooth or slightly wrinkled and irregular, flesh-colored or slightly more brown, and hang from the skin by a small stalk. Early or beginning skin tags may be as small as a flattened pinpoint-sized bump around the neck. Some skin tags may be as large as a big grape.

Skin Cancer (Nonmelanoma Skin Cancer)

Introduction

Skin cancer is the most common form of human cancer. It is estimated that over 1 million new cases occur annually. The annual rates of all forms of skin cancer are increasing each year, representing a growing public concern. It has also been estimated that nearly half of all Americans who live to age 65 will develop skin cancer at least once.

The most common warning sign of skin cancer is a change in the appearance of the skin, such as a new growth or a sore that will not heal.

The term "skin cancer" refers to three different conditions. From the least to the most dangerous, they are:

• basal cell carcinoma (or basal cell carcinoma epithelioma)
  squamous cell carcinoma (the first stage of which is called actinic keratosis)
• melanoma

The two most common forms of skin cancer are basal cell carcinoma and squamous cell carcinoma. Together, these two are also referred to as nonmelanoma skin cancer. Melanoma is generally the most serious form of skin cancer because it tends to spread (metastasize) throughout the body quickly. Skin cancer is also known as skin neoplasia.

DOCTOR TO PATIENT

A Painful Rash -- Is It Shingles?

Medical Author: Melissa Conrad Stöppler, MDMedical Editor: William C. Shiel Jr., MD, FACP, FACR
Shingles (Herpes zoster) is an extremely painful skin rash caused by the Varicella zoster virus, the same virus that causes chickenpox. In people who have had chickenpox, the virus is never fully cleared from the body; instead, it remains dormant in the nerve tissues. When physical or emotional stresses to the body weaken the immune system, the virus re-activates and spreads along the nerve fibers to the particular area of skin supplied by the involved nerve (called a dermatome). The virus responsible for chickenpox and shingles is a member of the Herpesviruses, although it is not the same as the Herpes simplex 1 and 2 viruses that cause cold sores and genital herpes, respectively.
Pain, itching, tingling, or burning of the skin are symptoms of shingles that often precede the rash in an outbreak. The blisters that develop resemble the lesions of chickenpox but are concentrated in the area supplied by the involved nerve. Rarely, more than one nerve is involved. Blisters may occur along the entire path of the nerve or only in certain areas supplied by the nerve. As with the blisters of chickenpox, the blisters in shingles eventually burst and begin to crust over and heal. The entire outbreak can last for three to four weeks.

Is shingles contagious?

Yes, shingles is contagious. Shingles can be spread from an affected person to children or adults who have not had chickenpox. But instead of developing shingles, these people develop chickenpox. Once they have had chickenpox, people cannot catch shingles (or contract the virus) from someone else. Once infected, however, people have the potential to develop shingles later in life.
Shingles is contagious to people that have not previously had chickenpox, as long as there are new blisters forming and old blisters healing. Similar to chickenpox, the time prior to healing or crusting of the blisters is the contagious stage of shingles. Once all of the blisters are crusted over, the virus can no longer be spread.

What are symptoms of shingles? How long does shingles last?

Before a rash is visible, the patient may notice several days to a week of burning pain and sensitive skin. When the characteristic rash is not yet apparent, it may be difficult to determine the cause of the often severe pain. Shingles rash starts as small blisters on a red base, with new blisters continuing to form for three to five days. The blisters follow the path of individual nerves that come out of the spinal cord (called a dermatomal pattern) and appear as a band- or belt-like pattern on an area of skin. The entire path of the affected nerve may be involved, or there may be areas with blisters and areas without blisters. Generally, only one nerve level is involved. In a rare case, more than one nerve will be involved. Eventually, the blisters pop, and the area starts to ooze. The affected areas will then crust over and heal. The duration of the outbreak may take three to four weeks from start to finish. On occasion, the pain will be present but the blisters may never appear. This can be a very confusing cause of local pain.

SHINGLES

What is shingles? What causes shingles?

Shingles is a skin rash caused by the same virus that causes chickenpox. This virus is called the Varicella zoster virus (VZV) and is in the Herpes family of viruses. After an individual has chickenpox, this virus lives in the nervous system and is never fully cleared from the body. Under certain circumstances, such as emotional stress, immune deficiency (from AIDS or chemotherapy), or with cancer, the virus reactivates and causes shingles. In most cases of shingles, however, a cause for the reactivation of the virus is never found. Anyone who has ever had chickenpox is at risk for the development of shingles, although it occurs most commonly in people over the age of 60. It has been estimated that up to 1,000,000 cases of shingles occur each year in the U.S.

The herpes virus that causes shingles and chickenpox is not the same as the herpes viruses that causes genital herpes (which can be sexually transmitted) or herpes mouth sores. Shingles is medically termed Herpes zoster.

DOCTOR TO PATIENT

Can Soaps & Detergents Cause a Rash?

For years, patients have been coming to my office with eczema, complaining that they had changed their soaps and detergents but their rashes had not gone away.

The first thing I always tell them is: "Contrary to what you've heard, eczema is rarely, if ever, caused by soaps and detergents."

I say this because it fits with my experience. People get rashes when they haven't used anything different, and they don't become consistently better if they keep shifting products in a futile effort to locate the culprit in the laundry.

And now -- at last! -- there is published scientific evidence to back up my experience.
Is soap to blame for allergic contact dermatitis? »

SKIN RASHES

What are the different types of common skin rashes?

Whether it is used by patients or doctors, the word "rash" does not have an exact meaning or refer to a specific disease or kind of disorder. It's a general term that means an outbreak of bumps on the body that changes the way the skin looks and feels. Rashes can be localized to one area or else be widespread. The way people use this term, a rash can refer to many different skin conditions. Common categories of rash are

scaly patches of skin not caused by infection

• 
  
  scaly patches of skin produced by fungal or bacterial infection, and
  red, itchy bumps or patches all over the body.

Although rashes are seldom dangerous, self-diagnosis is not usually a good idea. Proper evaluation of a skin rash requires a visit to a doctor or other healthcare professional. The following guidelines may help you decide what category your rash falls into.