Understanding Basic Types of Moles

It is necessary to clarify that not all moles are the same. There are a few classifications. But the most important for you is to be able to
discern the common mole from the moles that are more risky to cause skin cancer.

Moles are overgrowths of the skin’s pigment cells called melanocytes. Usually the moles are round spots on the skin colored in medium to dark brown. The greater part of moles is flat with constant color and regular in shape. A number of moles are raised with lighter colors. The people often had mistaken the new moles with the freckles. Sporadically the moles may develop a white halo around them.

Common Mole

In fact the moles could come into view everywhere on the body. Their color is usually brown, because is caused by the pigment melanin. Usually the common mole appears at the first part of life, when the system is growing but it is not impossible some moles to appear after the age of 20. The sun is one of the direct factors that have a strong influence on the moles. The people who are often exposed at sun light tend to have more moles that the others.

The common moles could change during the adolescence and the pregnancy, because of the big hormonal changes in the system. There is no typical way of change of one common mole. Usually one mole exists about forty to fifty years. Usually at the beginning of its life cycle the mole is flat and thin something like a freckle. Sometimes the color of the new mole is brown to black or even pink.

According to the size and shape the moles become bigger and rise over the surrounding skin with the time. Usually this is attended with the lightening of their color. It is not unusual some moles to rise over the skin and to develop a small stalk. The older moles tend to have some hairs on it that makes it odious sometimes. Some moles do not ever change.

The question which excites a lot of people is: Is it possible the common mole to disappear by its own? In fact the answer is yes. Some moles at the end of their life cycle tend to loose their color and to fade away. The raised moles also could fall of if they are raised vastly over the skin and have a thin stalk, but remember you must not try to wrench it away yourself. Look for a professional medical pracictioner to remove your mole for you.

As you can see there is no typical course of mole development. Because of that it is very important to know well your moles and to keep the history of their growth. According to the risk of skin cancer the early mark of any changes in the mole could be the decisive factor for the success of the melanoma treatment.

In order to make the process of the moles observation easier and at the same time enough efficient and useful for your dermatologist, our organization develops a list of common descriptions and characteristics of the moles that will help you to check your moles regularly and correctly. Be sure that you know the common types of moles.

Types of Moles

Each person has at least a few skin moles. They usually come out by the time an individual is 20 and at the beginning looks like freckles. Of course there are a lot of people who were born with skin moles. Usually every 1 of 20 babies has one or more moles at its birth.  A skin mole’s shade and form don’t usually change. A mole typically lasts about forty or even fifty years before start to become lighter. Some skin moles fade away completely, and some never fade at all. Sometimes a number of moles extend stalks that raise them above the skin’s surface it is possible these moles to drop off.

A skin mole is a spot on the skin with darker color. Generally it is part of skin pigmentation and could appear anywhere at the body. Most often we are talking about benign moles that are just a couple colored cells of the skin. Sometimes the facial moles could be even charming. On the other hand, from time to time moles can cause a serious health risk and can become Cancerous moles.

There are several skin mole types depending on its placement on our body:

Facial moles – or all moles on the face. It could appear all over the face and the head.

Body moles – are the moles at the other parts of the body with no specific location.

Genital Moles – Very often a lot of people feel ashamed of its genital moles. It is not surprising that most often the mole can cause
more psychological than health problems to its owner.

Moles in Children – It is normal the kids to have some moles at their bodies and it is important their parents to know what to check and how to examine the moles of the children

Black Moles
This variant of a benign mole (the common mole) is also referred to as a mole of midlife. It typically is seen in darker-skinned persons

between the ages of sixteen and thirty years. Of course this rule has a lot of exceptions. Usually the black mole is little, up to 5 mm.

Bleeding Moles
In common cases the mole which is bleeding or ooze is a reason to go to dermatologist. But even in this case the bleeding could be caused by irritation of the mole on the underwear or just a cut during shaving.

Body Moles
Moles may come out from the birth of an individual or may appear later during the whole life. It may begin from maturity and could still
grow when the person become forty or fifty years old. There is no specific place where the moles tend to occur more often

Changing Moles
The changes in the mole have to be brought to the attention of your dermatologist. It is normal the mole to grow with us and to change through the years but any unusual change in the color, fast growth, bleeding or oozing, inching or pain could indicate that the mole is turning into a melanoma.

The average person seldom has only “beauty marks”. In fact, in our present society the moles are often seen as a hindrance for their owner. There are a lot of people who feel depressed by their moles, especially if we are talking about the facial moles. If such a mole has strong influence upon the overall appearance and the general condition of the person may be it will be better for him or her to remove it.

Management and Treatment of Pruritus

Pruritus, or itch, is a common sensation that causes a person to want to scratch. It is a complex process that may negatively impact quality of life and commonly occurs with skin disorders such as atopic dermatitis and urticaria. It could also be a symptom related to an underlying disease process such as cholestasis or hyperthyroidism, or simply be caused by dry skin, especially in the cold, winter months. Therapy is often aimed at eliminating the underlying cause first, followed by the management of the itchy sensation. Treatment may include prescription and over-the-counter (OTC) medications, herbal remedies, hydrotherapy, phototherapy, and ultraviolet therapy. This overview provides information regarding the various management and treatment options for pruritus.

Pathophysiology of Pruritus

Pruritus is a complex process that involves the stimulation of free nerve endings found superficially in the skin. The sensation of pruritus is transmitted through the C-fibers in the skin to the dorsal horn of the spinal cord, and then, via the spinothalamic tract to the cerebral cortex for processing. Many chemicals have been found to be pruritogenic, therefore causing the itch sensation, including histamine, serotonin, cytokines, and opioids. There are six categories of pruritus: dermatologic, systemic, neurogenic, psychogenic, mixed, and other. Various treatment and management options exist depending on the category or cause.¹

Treatment

Treatment of pruritus can be categorized in several ways. A common method of grouping the various options is causative vs. symptomatic treatment. Causative treatment involves finding the underlying disorder and then correcting it, thereby eliminating the itch sensation. Symptomatic treatment involves substituting another sensation for the itch, using methods such as cooling, heating, or counter irritation (e.g., scratching). Symptomatic treatment can be used in addition to treating the underlying disease process in order to provide earlier relief. Most of the available treatment options are categorized under symptomatic therapy and management.

Prescription Medications

Prescription medications include topical and systemic antihistamines, corticosteroids, local anesthetics, and topical immunomodulators, among others. Some lower concentration preparations of these medications are available OTC.

Antihistamines

Itching occurs when histamine is released, causing redness, swelling, warmth, and consequently itchiness. Antihistamines, or H1 antagonists, act by blocking the histamines, and are the most widely used medications for this condition. They take approximately 15–30 minutes to be effective and can be short- or long-acting.²

Topical antihistamines are available in prescription as well as nonprescription forms. Camphor (Caladryl^®, Pfizer) is a common diphenhydramine preparation that has both antipruritic and anesthetic properties. This traditional therapy carries with it a small risk of contact dermatitis and allergic sensitization.³

Corticosteroids

Local Anesthetics

Calcineurin Inhibitors

Cholestyramine

Rifampicin

Naltrexone

Ultraviolet (UV) Light Therapy

UV phototherapy is used to treat various pruritic conditions including chronic renal failure; AD; HIV; aquagenic pruritus; solar, chronic, and idiopathic urticaria; urticaria pigmentosa; polycythemia vera; pruritic folliculitis of pregnancy; breast carcinoma skin infiltration; Hodgkin’s lymphoma; chronic liver disease; and acquired perforating dermatoses, among others. It is often undertaken after multiple attempts to treat stubborn itch, and can offer relief without many of the side-effects and risks of systemic medications. UV-based therapy utilizes UVB and UVA in both broadband and narrowband, as well as PUVA (psoralen UVA). Cost and side-effects can be a prohibitive factor for patients. Erythema is common in UVB, as is premature aging and photocarcinogenesis with both UVA and UVB. Side-effects associated with PUVA include redness, burning, headache, and nausea.^16,19

UVA, UVB, and PUVA light therapies have been especially useful in the treatment of pruritus in HIV patients, as well as in those patients with systemic mastocytosis and cutaneous T-cell lymphoma. It localizes the effect on the superficial nerve endings, sparing the remaining helper cells, and relieving the pruritus. Because of its more superficial penetration, UVB is believed to be safer than UVA. UVB also spares the remaining helper cells in HIV patients and may localize the effect on the superficial nerve endings, thus relieving pruritus. Systemic mastocytosis and cutaneous T-cell lymphoma also respond to UV therapy and because destruction of the proliferating CD4 clone is desirable, UVA is usually the preferred modality over UVB, although Millikan suggests that the relief of pruritus is more predictable with UVB than with UVA.3

Cutaneous Field Stimulation (CFS)

CFS, which electrically stimulates thin afferent fibers, including nocireceptive C-fibers, was reported to inhibit histamine-induced itching. The reduction in itching is accompanied by degeneration of the epidermal nerve fibers. In one open trial, localized itching responded to CFS treatment, and pruritus was reduced by 49% at the end of 5 weeks. Itch relapsed gradually after the discontinuation of CFS, which led the researchers to conclude that nerve fibers regenerated into the epidermis.20

Over-the-Counter Treatments

In addition to the nonprescription medications mentioned above, there are other OTC treatments that can be helpful for treating and managing pruritus. Moisturizing after a bath is extremely important, and emollients such as white petrolatum, or petrolatum depositing moisturizing body washes, and in-shower moisturizers (e.g., Olay^® Ribbons^®, Procter & Gamble; emulsifying ointment USP) can be helpful when applied while the skin is still wet.²¹

There is new evidence to show that moisturizers containing niacinamide and glycerin (e.g., Olay^® Quench^®, Procter & Gamble) not only hydrate the skin, but improve the skin’s resistance to external factors and improve the barrier function. Glycerin is required for moisturizers to work quickly and add moisture to the skin, but the niacinamide helps to sustain that benefit over a longer period of time.²¹

Alternative Therapies

Several alternatives to traditional treatment of pruritus have been proposed. Often these therapies can be used in conjunction with prescribed or OTC medications to relieve symptoms quickly. Compounds that have been found to be effective for pruritus by depressing cutaneous sensory receptors include menthol, camphor, and phenol.⁷ Some other alternative therapies that have been suggested include herbal remedies, nutritional therapy, reflex therapy, and hydrotherapy.³

Herbal Remedies

Several herbs have been proposed as corticosteroid-sparing agents and may provide a viable alternative to topical steroids and their side-effects. Oatmeal baths appear to be most useful because of its colloidal protein and high mucilaginous content. Other herbs have been suggested because of their high mucilage content as well, including flax, fenugreek, English plantain, hearts ease, marshmallow, mulberry, mullein, and slippery elm.3 More extensive research needs to be conducted regarding their possible use and effectiveness for the treatment of pruritus.

Tannins, also derived from herbs, may be helpful as well. The exact mechanism of action is unclear, but may perhaps be related to the coagulation of proteins in the skin. The most common tannin-containing herb is witch hazel, but others include oak bar, English walnut leaf, goldenrod, Labrador tea, lady’s mantel, lavender, and St. John’s wort.

Other possible herbs that may be advantageous include chamomile, which has shown to be equivalent to low concentrations of hydrocortisone, aloe vera, and capsaicin.3 Some side-effects may include irritant or allergic contact dermatitis. Some herbals can be toxic if ingested as well. Some of the oldest group of medications used to soothe and cool pruritic skin is menthol and camphor, which are both considered low risk and safe to use topically. ^3,4

Nutritional Therapy

Nutritional therapy, despite not being sufficiently researched as a monotherapy for pruritus, may be helpful in combination with other anti-itch treatments. Vitamins D and E, and linolenic acid have shown some efficacy in the treatment of psoriasis and atopic eczema.³

Reflex Therapy, Acupuncture, and Hydrotherapy

While they are not traditionally used, reflex therapy, acupuncture, and hydrotherapy are three treatments that may be beneficial as adjunctive therapy, however further research is needed. There is little research available regarding the effectiveness of reflex therapy and hydrotherapy. These options may be considered in difficult-to-treat patients where traditional approaches have been unsuccessful. Acupuncture is based on the gate theory of neurotransmission, however it is infrequently used in the Western world, and therefore has insufficient evidence to fully support its use. ³

Management

The management of symptoms is paramount in the treatment of pruritus. Patients should be educated regarding the self-care aspects of this condition. Eliminating the use of irritating or tight clothing is recommended, as well as maintaining a cool environment. Patients should avoid the frequent use of soap, topical irritants in clothing, dry environments, and vasodilators such as caffeine, alcohol, and hot water. Patients should be advised to take brief, tepid or lukewarm baths using mild cleansers with a low pH. Soap film should be rinsed off completely and skin should be patted lightly, followed by the generous application of a moisturizing lotion or cream.^4,7,22

Conclusion

Pruritus is a common complaint, but one that can often be a challenge to treat. It can be a major quality of life issue for patients, so it is important that both the underlying disease and associated symptoms are treated as quickly and effectively as possible. Health teaching regarding the prevention and management of pruritus should be included in the overall treatment of the cause and symptoms.

P. Lovell, RN, BScN1; R. B. Vender, MD, FRCPC²
1. Michael DeGroote School of Medicine McMaster University
2. Dermatrials Research, Hamilton, ON, Canada

Identifying Skin Lesions - Warts, Moles and SebKs

By Van Le |  While freckles can add to a person’s beauty and uniqueness, other skin lesions such as large moles, skin tags, warts, and seborrheic keratoses can be unsightly and embarrassing. Most lesions are malignant (non-cancerous), however, it is important to be aware of and track any skin abnormalities on your body as a preventative measure.

Freckles

Freckles are irritating for some and embraced by others. They are pigment cells that retain within the skin to form light brown spots, and individuals with lighter complexions are more susceptible to freckles since their skin contains less melanin. Freckles, also known as ephelides, can appear on the face, arms and other sun-exposed areas. Excessive and continued exposure to harmful UV rays can cause more freckles and cause them to appear darker. While they are harmless, it is important to distinguish between freckles and symptoms of melanoma, a type of skin cancer that can grow from an existing freckle. Consult your doctor if you notice any change in freckle size, shape and color.

Skin tags

Skin tags are pieces of skin that hang from the surface of a surrounding area. Like freckles, they are benign, but can cause irritation if located on an area that is exposed to constant contact, such as the eyelids or areas where they can be snagged by jewelry or clothing. Skin tags can vary from a small pin-point size to a large grape size. While some can fall off on their own, there are several ways to medically remove skin tags, including freezing and burning. There are home remedies as well as creams available on the market to remove unwanted and embarrassing skin tags.

Seborrheic keratoses

Seborrheic keratoses, another benign skin lesion, can form anywhere on the body, but is commonly found on the chest and back. They can be distinguished from other types of lesions due to their waxy, stuck-on-the-skin appearance and often described as brown candle wax stuck on the skin. While the cause is still unknown, scientists have found that they can be hereditary and not affected by sun exposure.

Warts

Most warts are skin infections caused by viruses of the human papillomavirus (HPV) family. Basically, warts are benign tumors of the epidermis (outer layer of skin), and can occur in people of all ages, but are most commonly found on children and teenagers. There are different types, including flat and plantar warts. Flat warts are small in size but can be high in quantity, can spread to other areas of the body by shaving or scratching, and can be transferred person-to-person by physical contact. Plantar warts grow on the heel, ball or sole of the foot, and pressure from standing or walking pushes them into the deeper layers of skin.

Skin lesions like warts, seborrheic keratoses and skin tags are often harmless, but they can be embarrassing. While they can be surgically removed, there are creams and ointments available on the market to remove and reduce their appearance. If you have further questions about a particular skin lesion, consult your doctor or pharmacist for proper diagnosis and treatment.

Van Le is a staff writer for the CSU Daily Titan and writing intern for Vivoderm Laboratories in Los Angeles, California. She is currently pursuing a Journalism degree at California State University, Fullerton.

For the latest findings on skin lesions and treatments, you can also link to http://www.removalofwart.com

Actinic Keratosis and Other Precancers

THE MOST COMMON PRECANCER :  More Than Ten Million

This figure is generally accepted as the best current estimate of the number of Americans with actinic keratosis (AK). People with a fair complexion, blond or red hair, and blue, green or grey eyes (Identify Your Skin Type) have a high likelihood of developing one or more of these common precancers if they spend time in the sun and live long enough. Location makes a difference: The closer to the equator you live, the more likely you are to have actinic keratoses.

The incidence is slightly higher in men, because they tend to spend more time in the sun and use less sun protection than women do. African-
Americans, Hispanics, Asians and others with darker skin are not as susceptible as Caucasians (Skin Cancer and Skin of Color).

Is There Cause for Concern?

Actinic keratosis can be the first step leading to squamous cell carcinoma and is therefore known as a “precancer.” Although the vast majority of actinic keratoses remain benign, some studies report that up to ten percent may advance to squamous cell carcinoma. This percentage does not sound very large, but it has a large impact. When it comes to squamous cell carcinomas, 40-60 percent begin as untreated actinic keratoses and may advance to invade the surrounding tissues. About 2 to 10 percent of these squamous cell carcinomas spread to the internal organs and are life-threatening.

Another form of actinic keratosis, actinic cheilitis, develops on the lips and may evolve into squamous cell carcinoma.

The more keratoses you have, the greater the chance that one or more may turn into skin cancer. In fact, some scientists interpret actinic keratosis as the earliest form of squamous cell carcinoma.

What Is Actinic Keratosis?

An actinic keratosis, also known as a solar keratosis, is a scaly or crusty growth (lesion). It most often appears on the bald scalp, face, ears, lips,
backs of the hands and forearms, shoulders, neck or any other areas of the body frequently exposed to the sun. You’ll most often see the plural,
“keratoses,” because there is seldom just one.

In the beginning, actinic keratoses are frequently so small that they are recognized by touch rather than sight. It feels as if you were running a finger over sandpaper. There are many times the number of invisible (subclinical) lesions as visible ones on the skin surface.

Most often, actinic keratoses develop slowly and reach a size from an eighth to a quarter of an inch. Early on, they may disappear only to reappear later. Most become red, but some will be light or dark tan, pink, red, a combination of these, or the same color as your skin. Occasionally they itch or produce a pricking or tender sensation. They can also become inflamed and surrounded by redness. In rare instances, actinic keratoses can even bleed.

If you have actinic keratoses, it indicates that you have sustained sun damage and could develop any kind of skin cancer – not just squamous cell carcinoma.

Actinic keratosis on the back of the hand. These precancers commonly occur on the face and the back of the hands.

A closeup shows elevation, roughness, and crusting. Some keratoses, like this one, are quite discrete and difficult to distinguish clinically from squamous cell carcinoma.

How to Recognize Actinic Keratosis

Examples of typical actinic keratoses are shown here, so examine your skin regularly for lesions that look like them. But it’s not always that simple:

Many actinic keratoses have quite a different appearance, so if you find any unusual or changing growth, be suspicious and see your doctor promptly.

Numerous actinic keratoses can reveale chronic sun damage. They are elevated, rough in texture, and resemble warts.

Two typical keratoses on rim of ear. The top lesion is crusted, the lower one rough in appearance.

While most keratoses have a fine sandpapery roughness, others such as this lesion have an obviously scaly, crusty surface.

Chronic sun exposure is the cause of almost all actinic keratoses. Sun damage to the skin is cumulative, so even a brief period in the sun adds to the lifetime total. Cloudy days aren’t safe either, because 70-80 percent of solar ultraviolet (UV) rays can pass through clouds. These harmful rays can also bounce off sand, snow and other reflective surfaces, giving you extra exposure.

The ultraviolet radiation given off by the lamps in a tanning salon can be even more dangerous than the sun, so dermatologists warn against indoor tanning.

Occasionally, actinic keratoses may be caused by extensive exposure to X-rays or a number of industrial chemicals.

What Age Has to Do with It

Because the total amount of time spent in the sun adds up year by year, older people are most likely to develop actinic keratoses. However, nowadays, some individuals in their 20s are affected. Still, actinic keratoses become much more common in people over the age of 50. Some experts believe almost everyone over 80 has actinic keratoses.

Also, individuals whose immune defenses are weakened by cancer chemotherapy, AIDS, organ transplantation or excessive UV exposure are less able to fight off the effects of the radiation and thus more likely to develop actinic keratoses.

A PUBLICATION OF THE SKIN CANCER FOUNDATION
For more information or to order this article as a brochure, please contact:
The Skin Cancer Foundation
149 Madison Ave., Suite 901,
New York, NY 10016
© 2008

Photos courtesy of:
Pearon G. Lang, Jr., MD, and
MSKCC Dept. of Dermatology
Photos courtesy of:
Pearon G. Lang, Jr., MD, and
Memorial Sloan Kettering Cancer Center
Deptartment of Dermatology

Oil Production in the skin

The skin has many oil (sebaceous) glands, which secrete oil that contains wax esters, triglycerides, and squalene - a hydrocarbon that is an intermediate in the formation of cholesterol. These fats (or lipids) form a film that helps keep moisture in the skin. While increased sebum production results in oily skin, the opposite is not always the case, as dry skin can also arise from an impaired skin barrier. Oil production can be affected by diet, stress, and hormones-as well as genetics. In a study of twenty pairs each of identical and nonidentical same-sex twins, identical twins had virtually identical amounts of oil production, while the nonidentical twins had significantly different amounts.

No amount of blotting and scrubbing will “remove” the skin’s oil production, and many of us unknowingly destroy the natural beauty of the skin in pursuit of clarity. The skin’s own sebum mechanism is there to regulate own moisture. Drying your skin profusely with oil-stripping, foaming cleansers, detergents and de-greasers like soap and sulfates, or alcohol-based toners that leave the skin feeling tight (always a sign it’s been stripped), will only cause the skin to “rebound” with excess oiliness and destroy its protective and anti-bacterial “matrix,” leaving it sensitized. By stripping the natural acid mantle of the skin, these deep cleaning products actually make skin more vulnerable to bacteria and inflammation. Dabbing benzoyl peroxide often destroys the beauty of the skin by causing flaking, while more aggressive treatments, such as antibiotics or Accutane can cause a cascade of side-effects.

Eliminating Allergens and Chemicals for Sensitive Skin

If you suffer from sensitive or dry, delicate skin, you already know how difficult it can be to find a skin care product that does not cause a negative reaction. However, have you considered many other kinds of chemicals you are exposed to every day? Many unsuspecting products, like household cleaners, air pollution and even industrial chemicals in your furniture can induce inflammation in susceptible individuals. If you suffer from dry or sensitive skin, you are more at risk for reactions, especially if you are already experiencing extreme dryness or eczema symptoms.

To repair your natural skin barrier, you must first take active steps to build it up by eating healthy fats – like olives, avocados and raw nuts or butters and engaging in a natural healthy diet to start. To further help your condition, review the dermatological list below to identify, and where possible, eliminate allergy-causing ingredients. Whether what you experience is merely a sensitivity or full-blown allergic reaction, try to eliminate anything that causes inflammation and can degrade your skin barrier – and its ability to protect you from harmful irritants. Give your skin a chance to heal by protecting it from things that may cause a reaction.

1. Eliminate chemical ingredients in skin care and perfumes – including parabens and all manner of chemical substances until you have narrowed down your reactions.

2. Eliminate problem ingredients in soaps, shampoo, bath, body care, dental, shaving, and conditioning products and medications. Avoid products that foam or contain detergents. Always rinse thoroughly after cleansing and shampooing. Protect your skin with moisturizer afterwards.

3. Avoid direct contact with dish and laundry detergents, household cleansing products, paints, strippers, furniture polishes, and other ingredients containing harsh chemicals. Wear gloves, moisturize, or avo: altogether. Studies show that residual detergent remaining in launderei clothing may be a prime contributor to eczema. Rinse your clothing twice if your washing machine allows.

4. Notice whether fabrics in clothing, furniture, or bedding are irritating your skin due to their rough texture or chemicals treating them. Use hypoallergenic protectors on mattresses and large furniture if this is the case.

5. Pay attention to contact allergies from jewelry, flatware, and coins or metals containing nickel, a common allergen. Some are allergic to gold, so always be aware of unsuspecting culprits.

6.  Only use quality filtered water and avoid hard water when possible. Chlorinated water, excessively hot water, or long soaks in baths, showers, or hot tubs, can strip precious oils from your skin.

If you consider all these factors and use them diligently, your skin barrier can be restored and you may be able to withstand common irritants and practices. But for now, notice what chemicals irritate you and avoid contact with them at all costs in order to give your skin a chance to rebuild itself. If you are unable to address your symptom on your own, ask a professional dermatologist about patch testing, which can help you determine exactly what your allergies may be.