A variety of spots or growths can appear on the surface of your skin—especially as you get older—but most are harmless and do not require treatment. The most common noncancerous skin growths are actinic (or solar) keratoses, cherry angiomas, skin tags, age spots (also called sun spots or liver spots), moles, seborrheic keratoses, and warts.
An actinic keratosis is a skin growth that has a rough surface and can be red, skin-colored, or white. It is also called a solar keratosis because it is caused by excessive exposure to the sun over time. Actinic keratoses usually develop on fair-skinned people during middle age or old age. They most commonly appear on the face, hands, forearms, and upper chest. In a small percentage of cases an actinic keratosis can develop into a form of skin cancer known as squamous cell carcinoma (see page 428), so even though it is a noncancerous skin growth, your doctor may remove it. Actinic keratoses can be permanently removed with surgery, including laser treatment.
A cherry angioma is a bright red spot that may be raised or flat and is composed of a collection of tiny, closely packed blood vessels near the surface of the skin. Cherry angiomas can develop on any part of the body but are most often found on the trunk. They increase in number after age 40. However, they do not become cancerous. Cherry angiomas that appear on the face can easily be removed for cosmetic reasons, but most are left untreated.
Small flesh-colored or light brown flaps of skin that protrude from the surface of the skin are called skin tags. They most often occur on the neck, upper chest, and underarms and around the eyes. Skin tags are harmless but can be irritating if they are persistently rubbed. Doctors can easily remove skin tags that are irritating or unsightly by cauterizing (burning) them with heat, chemicals, or electric current, or by freezing them with liquid nitrogen.
Age spots (known medically as lentigines) are brown spots on the skin that resemble freckles and result from long-term exposure to sunlight. They are a sign that the skin is trying to protect itself from the sun by producing a pigment to help absorb the damaging sunlight. Age spots, also sometimes called sun spots or liver spots, appear in almost everyone as they get older, although they occur most frequently in fair-skinned people. Even people in their 20s or 30s can develop these spots—especially if they have fair complexions and have been exposed to excessive amounts of harmful sunlight. The spots most commonly occur on areas of the skin—such as the face, arms, hands, and tops of the shoulders—that are frequently exposed to the sun.
Treatment is usually not necessary unless you want to improve the appearance of your skin. You can purchase a nonprescription skin-bleaching cream at your local pharmacy to help fade the spots. There are a number of treatments available for age spots, including laser treatment to break up the pigment (color) in the spots, prescription skin creams, freezing with liquid nitrogen, or a chemical skin peel that uses a mild acid to remove the top layer of skin.
Moles are common skin growths that can appear on virtually any part of the body. Moles usually first appear as brown or black spots that enlarge slowly over time, becoming elevated and lighter in color. Moles can become flesh-colored, pink, tan, brown, or bluish black. Some eventually sprout hairs. Moles may darken with exposure to the sun.
Moles that are present from birth are known medically as congenital nevi. Moles that are larger than average or irregularly shaped or that have uneven color are called atypical or dysplastic moles. These types of moles have an increased likelihood of developing into the most serious form of skin cancer, malignant melanoma (see page 428). Any mole that changes, is asymmetrical, has an irregular border, displays an uneven color, or is larger than a pencil eraser should be examined by a dermatologist.
Most moles are harmless and require no treatment. However, some men may want to have a mole removed because of where it is located or because it is
Concerns unsightly. A doctor can remove a mole by shaving or cutting it away and then stitching the nearby skin closed. Repeatedly shaving a mole will not cause it to become cancerous, but you may want to have a mole in the beard area removed because it is constantly irritated. Moles are usually removed in the doctor's office.
As they age, many people develop seborrheic keratoses, which are tan, brown, or black; raised; crusted; or waxy spots that have a "pasted-on" look. They most often appear on the chest, back, scalp, face, and neck and can occur alone or in clusters. Seborrheic keratoses are harmless and do not develop into skin cancer, although black seborrheic keratoses may be difficult to distinguish from skin cancer. A doctor can easily remove a seborrheic keratosis if it occurs in a location that affects your appearance. Doctors treat seborrheic keratoses by one of several methods: freezing them with liquid nitrogen, scraping them from the surface, burning them off using an electric current, or cutting them off with a scalpel or scissors.
Warts are skin growths caused by a viral infection. Warts usually are raised, rough, and flesh-colored but can also be dark, flat, and smooth. There are several different types of warts, including common warts, plantar (on the sole of the foot) warts, flat warts, and genital warts (see page 184). Common warts typically grow on the hands and fingers. They occur in areas where the skin has been broken, such as near bitten fingernails or picked hangnails. Plantar warts can be painful when walking. Flat warts are small and grow in clusters of 20 or more. They can appear anywhere, but in adult men they usually occur in the beard area and are thought to result from skin irritation from shaving. Genital warts are a sexually transmitted disease that occur on the genitals and anus or inside the rectum. They have been linked to the development of cervical cancer in women and other genital cancers.
Warts are contagious, which means that the virus that causes them can be passed from person to person. A doctor usually can diagnose warts based on their appearance. Warts should be treated promptly to prevent spreading them to another person. In some cases, common warts may clear up on their own or may be dissolved with an over-the-counter medication. The preferred method of removal for common warts is freezing with liquid nitrogen. Plantar warts may need treatment with acid plasters, liquid nitrogen, or medicated creams. Flat warts are removed by using a chemical skin peel or medicated creams. Genital warts can be treated with imiquimod cream or podofilox gel or may require freezing, acid treatments, or surgical removal.
Skin and Hair
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