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Jefferson Health

Home of Sidney Kimmel Medical College

Eight Skin Symptoms You Should
Never Ignore

A dermatologist and medical oncologist recommend self-skin checks and keeping an eye on these unexpected symptoms that could indicate cancer, infection or other issues.

Our skin is exposed to a lot. As the body’s largest organ, it’s the front-line protector for many harmful elements we encounter daily – things like bacteria, toxins, extreme temperatures and ultraviolet (UV) radiation.

Because the skin takes the brunt of these elements, it’s susceptible to damage. Most dermatological complications are minor and easily treatable, but there are some sneaky symptoms that can indicate a much larger – sometimes cancerous – problem. Read on for symptoms dermatologist Dr. Sarah Beggs and medical oncologist Dr. Rino S. Seedor cautions their patients not to ever ignore.

Unexpected Symptoms You Should Address

  • Severe sunburn/blistering – When sunburn causes blisters – fluid-filled bumps – it indicates a second-degree burn known as sun poisoning. This may be accompanied by systemic symptoms, such as fevers, chills, fatigue and nausea. Sun poisoning can increase the risk for premature aging and skin cancer.
  • Rough patches – Rough, red, patchy skin is often thought to be eczema. However, when it doesn’t improve with typical eczema treatment, it could be an early sign of squamous cell skin cancer.
  • Returning moles – When a benign (noncancerous) mole grows back after removal, it typically means mole cells were left behind. It’s more concerning when moles grow back beyond the scar line.
  • Nail streaks – A brownish or blackish streak on the nail may be caused by certain medications, trauma, infection, a mole in the nail bed or skin cancer. Streaks from trauma will grow out with the nail; if they don’t go away with time, get them checked out.
  • Bleeding lesions/wounds that won’t heal – From a seemingly small cut to an open wound, anything that bleeds, seeps and won’t heal with at-home care needs medical attention. Open wounds make you susceptible to bacterial or fungal infection, and some may indicate aggressive melanoma.
  • Painful pimples or boils – Not all acne is normal. Cystic acne refers to pimples that occur deeper in the skin; they become filled with pus, painful, red, and can cause depressions, grooves and scars. People who are prone to cystic acne may require oral medication.
  • Red, itchy and oozing skin – Often signs of contact dermatitis (an allergic reaction), this can occur immediately or days after coming into contact with an allergen, and symptoms range in severity. Proper cleansing; cold compresses; a topical corticosteroid, such as hydrocortisone; and avoidance of the allergen can relieve symptoms and help heal a mild reaction. When symptoms are severe and untreated, they can lead to other complications, such as open wounds, infections and permanent scarring.
  • Red, swollen and painful skin – When these symptoms appear around an opening in the skin, it may indicate infection, or cellulitis. Early cases are easily treatable with antibiotics; more emergent cases may cause systemic symptoms, such as fever and chills. Cellulitis should never go untreated, as it could be fatal.

How Skin Cancer Behaves

The skin is comprised of three different layers. The top layer has pigment-containing cells called melanocytes, explains Dr. Seedor. “Melanocytes can make up normal moles and freckles on the skin, but when they mutate and become aggressive, they become cancerous and have the potential to spread.”

Skin cancer symptoms commonly present as moles or spots following what’s known as the “ABCDE” rule:

  • Asymmetry – oddly shaped
  • Border – fuzzy, irregular and uneven
  • Color – white, gray, blue or jet-black
  • Diameter – larger than 6 millimeters (roughly the size of a pencil tip eraser)
  • Evolution – grows or changes

Many experts believe evolution is the most important indicator, and it applies to all skin characteristics. Anything that changes rapidly – and continues to worsen – is a concern, explains Dr. Beggs.

The sneakiest signs of skin cancer are the ones that don’t fit this mold; they’re not what we’ve traditionally been told to look for, says Dr. Seedor.

They’re also the ones that grow in places “the sun doesn’t shine,” adds Dr. Beggs. “Areas like the gluteal cleft and soles of the feet are difficult to look at, so they can go easily missed. Whenever something is growing on the body and goes unchecked, it can lead to a more severe outcome.”

Self-Skin Checks

Monthly self-skin checks can help catch cancer early and are recommended for everyone but can be especially beneficial for those with a personal or family history of skin cancer.

“If you’ve had melanoma or another skin cancer before, you will always have a heightened risk of recurrence,” explains Dr. Seedor. “If you have a family history – especially among first-degree relatives, such as your mother, brother or sister – genetic factors increase the likelihood of developing the disease.”

Self-screening can help ensure there are no abnormalities or areas of rapid growth, says Dr. Beggs. “If you see anything new or anything that doubles or triples in size over the course of a few months, it should be evaluated as soon as possible.”

“You know your body best, but for those trickier to reach areas, consider asking your partner or provider,” adds Dr. Seedor. “A mirror is often the most convenient tool, but it’s also wise to take pictures of areas that concern you. This can give you a closer look and to document changes that may occur, which can help a provider greatly, if you need a diagnosis.”

How to Guard Against UV

While sunshine benefits our health by providing key minerals, such as vitamin D, unfortunately, the UV it contains may trigger DNA damage, and thus, skin cancer. It’s a common misconception that a tan is normal, and a burn is what’s dangerous, says Dr. Beggs. “Actually, any change in skin color is a sign of damage.”

Some characteristics beyond our control – such as fair skin, light eyes and light hair – can make us more susceptible to pigment changes, freckling, premature aging and skin cancer.

The good news: you can protect yourself from UV. It’s important to avoid artificial forms of UV, says Dr. Beggs. Indoor tanning beds are said to emit significantly more UV radiation than direct sun exposure and are associated with the rise in melanoma among women in their 20s.

Nail salon lamps have also caused concern in recent years, but many lamps now use LED light, because those that use UV carry a slight risk of skin cancer, notes Dr. Beggs.  If you get your nails done often, don’t hesitate to ask which type of lamp they use. You can also apply sunscreen to your hands or wear fingertip-less gloves to help mitigate those risks, she suggests.

You don’t have to avoid the sun, but you should practice sun-safe habits, says Dr. Seedor.

  • Wear a broad-spectrum sunscreen with SPF30 or greater.
  • Don’t forget tricky areas, like your ears and back.
  • Reapply sunscreen every two hours when you’re outside – especially when swimming.
  • Wear hats, sunglasses and sun protective clothing whenever possible.
  • Avoid spending a significant amount of time in the sun during peak-UV hours, between 10 a.m. to 4 p.m.

[Main photo credit: Stiahailo]

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From the Experts, Healthy You