What's that thing on my skin?
Linda Stein hasn't been in the sun in the past 15 years; she's trying to turn back the clock on youthful sun worshipping that resulted in freckles and brown spots. "I probably look younger than I would have had I continued my sun worshipping ways," she says. As the director of clinical research at the Department of Dermatology at Henry Ford Hospital in Detroit, Michigan, Stein has seen firsthand the damage that sun exposure can do.
Sun exposure can exacerbate the natural changes that occur as a person ages. The aging process leads to a breakdown of collagen, which is responsible for making the skin thicker and more elastic. As that thickness begins to evaporate, the skin becomes more like a worn-out rubber band, says Ivona Percec, an assistant professor of plastic surgery at the University of Pennsylvania. It's less resilient, and fine lines and wrinkles begin to form. The pigment of the skin also changes due to cumulative UV light exposure, which leads to slightly uneven pigmentation, resulting in blotches and brown spots. While many of these changes begin to occur among those in their fifties, those experiencing extensive sun exposure can start to see them in their thirties and forties, says Chad Prather, surgical director with the Department of Dermatology at Louisiana State University.
Some of the changes are merely cosmetic growths that occur over time. Stein's advice is to get a baseline exam by a dermatologist so you can become educated about the spots you have on your skin. Also, "anything that grows, changes, bleeds, or becomes painful needs to be checked," she says.
-- Julie Halpert, Caring.com author
Benign change: Seborrheic keratosis
These are brown, slightly to very rough spots that often look like moles. They can occur anywhere on the body, says April Armstrong, director of the Dermatology Clinical Research Unit at the University of California at Davis.
Benign change: Lentigo or lentigenes
Also known as freckles or brown spots, these are the result of sun exposure over time.
Benign change: Cherry angiomas
These are bright red, vascular bumps -- a collection of blood vessels -- that emerge in a person's twenties. Surface and smaller angiomas can grow into larger, bright red spots by the time a person is in the fifties or sixties.
Concerning change: Actinic keratoses
These are rough, red patches that are often easier to feel than see. Most are found on the head, neck, and back of the hands. These precancers can turn into squamous cell carcinoma, a form of skin cancer, so they're best treated to prevent progression to skin cancer, says Jeffrey S. Dover, associate clinical professor of dermatology at Yale University School of Medicine.
Concerning change: New moles
Patients over 40 shouldn't be getting new moles, so any that surface should be checked out, says Adelaide Hebert, director of Pediatric Dermatology at the University of Texas Health Science Center at Houston (UTHealth) Medical School.
Concerning change: Basal cell carcinoma
These spots have a shiny, waxy, or pearly look and can begin to bleed, says Prather.
Concerning change: Squamous cell carcinoma
There are rough, scaly, flaky patches.
Both basal and squamous cell carcinoma, frequently found on the face, almost never metastasize to other areas. But it's best to remove them, since they can involve underlying tissues and structures, Armstrong says.
Prather says since it's often hard for patients to determine which types of spots are potentially dangerous, and these cancers are highly curable when detected early enough, it makes sense to see a dermatologist any time you're uncertain.
Concerning change: Melanoma
This is the deadliest form of skin cancer, since it has a high potential to spread to vital organs such as the brain, lungs, and lymph nodes. Symptoms of melanoma include a mole that has irregular borders, a very dark color, a size bigger than six millimeters or the size of a pencil eraser, or growth and change over time.
The best way to prevent skin damage is to use a broad spectrum SPF 30 sunblock that contains both UVA and UVB protection. Apply it every two hours when in the sun. Wearing a hat or sun protective clothing and staying out of the sun between the peak hours of 10 a.m. and 2 p.m. is also key.
Dermatologists strongly discourage tanning parlors, which can significantly increase the risk of melanoma.
Percec recommends using a prescription-strength Retin-A product to prevent aging of the skin. She says this product increases collagen and stimulates cell turnover, allowing the skin to heal itself quickly. Retin-A is applied topically. Since it makes the top layer of the skin thinner, it leads to a greater likelihood of sunburn. Percec says medical-grade chemical peels and laser treatments can also improve the skin's appearance, as can a procedure called pulse light therapy, which gets rid of highly pigmented cells through heat activation.
As people age, their skin becomes thinner, dryer, and itchier. To address this, Stein suggests using a moisturizer directly after showering or bathing. Armstrong recommends a moisturizer with sunscreen built into it, so it can be applied in one step, along with lip balms with SPF. "A lot of surface changes on the skin and skin cancers are the result of the way our skin interacts with the environment," she says, so the bigger the barrier you use, the more you can help preserve your skin.