Hotter weather means wearing lighter-weight clothing and exposing more skin to the sun's harmful rays. But putting on a bathing suit, shorts or tank top, might also reveal skin that is discolored or sun-damaged, or that has visible imperfections. Some skin flaws are harmless and purely cosmetic concerns, but others are problems that need to get examined by the trained eyes of a dermatologist, said Dr. Lauren Ploch, a dermatologist in Augusta, Georgia. Here is a look at nine common skin concerns, and how they might be treated by a dermatologist. Age spots These flat, brown spots on the skin, also known as solar lentigines, typically crop up on the areas of skin that get the most sun, such as the face, cheeks, hands, shoulders, upper back and tops of feet, Ploch said. Age spots tend to be more irregular in shape than freckles, she added. People may develop age spots beginning in their 20s if they have had a lot of sun exposure, Ploch said. As people age, these spots become more common, and well over 50 percent of Caucasians in their 50s and 60s have at least one age spot, she explained. The spots are less common among people who have darker skin, she noted. These common skin discolorations are caused by an increase in the activity of melanocytes, the cells that produce pigment in skin after sun exposure. An increase in the brownish-black pigment melanin can also cause age spots, as well as freckles; this pigment also gives skin the darker hue seen in suntans. However, doctors aren't sure why such increases in melanocyte activity and melanin occur. Dermatologists may examine age spots to see if they are getting larger or darker over time, because the spots may transform into a type of skin cancer known as lentigo maligna. Wearing sunscreen may help to prevent age spots from forming or ensure that existing spots don't get darker, Ploch said. Applying topical creams containing ingredients such as retinoids or alpha hydroxy acids may help to lighten the spots a little, Ploch said. Other treatment options include using lasers (light therapy) or freezing temperatures (cryotherapy) to destroy melanin-producing cells, but these methods may cause these areas of skin to discolor, she said. Cellulite The lumpy or dimpled appearance of cellulite happens as a result of pockets of fat bulging out from in between the fibrous bands that pull on the skin's connective tissue. Cellulite is a very common problem that affects 85 to 90 percent of women, Ploch said. It may be caused by hormonal and genetic factors, she explained. The dimpled appearance of skin on the upper thighs, backside and hips is more visible in people who have thinner skin (aging is also to blame for thinner skin). Women typically have thinner skin than men, making cellulite more noticeable. "Cellulite is very difficult to treat, and it's an innate characteristic of being female," Ploch told Live Science. Although losing weight may make the bumpiness less visible, it probably won't remove all of the appearance, she said. Ploch is not a fan of using topical creams that claim to treat cellulite, she said, because these creams may at best temporarily hydrate the skin. This may make the cellulite less visible, but only temporarily. She said the most promising treatments for cellulite involve destroying or reorienting the fibrous bands, through the use of lasers, radio-frequency devices or a minimally invasive procedure, such as Cellfina. This treatment uses tiny needles to release the attachment points of the fibrous bands. Although some of the newer treatments for cellulite appear to have good short-term results, it's still too early to tell their long-term effectiveness, Ploch said. To keep the skin looking smoother, the procedures may need to be repeated, and these treatments can be both expensive and somewhat painful, she said. Freckles Dotting the nose, cheeks, arms and shoulders, freckles are tan or brown spots that are more round or oval in shape than age spots are, Ploch said. Blondes and redheads tend to get more freckles than people with dark hair, and freckles also tend to darken in summer and lighten in winter, she explained. Freckles occur when exposure to the sun increases the amount of the pigment melanin in the skin cells; genetics can also play a role in a person's freckle count. People typically get freckles early in their lives, usually before age 10, Ploch said. You don't need to worry about treating your freckles, because they tend not to turn into skin cancer, Ploch said. Even so, for those with freckles, it's still a good idea to stay out of the sun and wear sunscreen outdoors to avoid getting more of the marks, she said. Moles Moles, also called nevi, are small, flat, brown or tan growths of melanocytes, the cells that produce pigment in the skin, Ploch said. As with freckles and age spots, it's possible to get a mole anywhere on the skin, though the growths often appear in sun-exposed areas, Ploch explained. But unlike age spots, which develop because of an increase in the activity of melanocytes, moles form because of an increase in the melanocytes themselves, as they grow in a cluster or clump. It's unclear why people develop moles, but genetics as well as hormones may play a role, she said. People tend to get the most moles during their first 30 to 40 years of life, Ploch said, and people tend to get fewer moles in their 60s, 70s and 80s. In addition, some moles can get lighter with age. People who have moles should be seen by a dermatologist, who can evaluate the growths and remove any mole that looks abnormal. Moles are usually tested once removed, because one-third of melanomas arise in a mole, Ploch said. Moles that are superficial, meaning they lie on the surface of the skin and do not extend too deep, can be shaved off, Ploch said. Deeper moles may need to be cut out, which can cause scarring, she added. "The flatter a mole is, the easier it usually is to remove," she said. Skin tags These soft, usually flesh-colored, slightly raised growths of skin appear more frequently as people get older and tend to show up in creases of the skin on the breasts, neck, armpits or groin. Skin tags may attach to the skin by a narrow stalk called a "peduncle," Ploch said. People tend to get more skin tags, also known as acrochordons, during pregnancy or with extra weight gain, suggesting that hormones and genetics play a role in the growths' development, Ploch said. These growths are harmless and may not need any treatment, but they can become irritated by rubbing or when they snag on clothing or jewelry. If skin tags are uncomfortable or bothersome, a dermatologist can remove them by shaving, snipping, freezing or burning them off, Ploch said. The skin tends not to scar after a skin tag is removed, but the tags may grow back, or people can develop new ones, she said. Ploch does not recommend that people use do-it-yourself chemical products at home to remove skin tags or attempt to cut them with a scissors, because such methods could lead to infection and scarring. Spider veins Spider veins are thin, red, blue or purple lines located just under the surface of the skin, and some of these marks resemble spiderwebs or tree branches. These dilated blood vessels may be seen on the legs and the face, Ploch said. Spider veins (also called telangiectasias) may develop because, over time, the valves within veins that normally help to maintain blood flow in the correct direction no longer work. Gaining weight or working in a job that involves prolonged standing can trigger this condition, Ploch told Live Science. As more blood and fluid fill the veins, these blood vessels dilate from the pressure, making them bigger and more visible, she said. Spider veins are not as difficult to treat as varicose veins, which tend to be larger and occur deeper in the skin, Ploch said. She said she prefers to use laser treatments for patients with spider veins, a method that involves using heat to destroy the thin blood vessels. Ploch said that she less often recommends sclerotherapy — which involves injecting fluid into the vein to destroy it — for spider veins, because this treatment can be both painful and expensive. Stretch marks These red, purple or white lines (also called striae) can appear on skin when it is stretched over the course of a relatively short time frame, resulting in damage to the skin's connective tissue, Ploch said. Any stretching of the skin that causes it to thin can result in stretch marks, she said. This stretching can happen during pregnancy, or from gaining or losing weight, growing quickly or having certain diseases, like Cushing's disease, that increase the hormone cortisol, which affects the pituitary gland. Stretch marks may appear as streaks on the abdomen, breasts, sides, inner thighs and hips, Ploch said. When these marks first show up, they are red or purple in color, and this is the stage when treatment with laser therapy may help to diminish them, she said. But existing treatments for stretch marks — with lasers, retinoid creams or vitamin C — tend to give unsatisfactory results, she added. When stretch marks turn white, they are very hard to get rid of, because the skin has scarred, Ploch said. Sunburn The red-as-a-lobster look of sunburn results from damage to cells in the top layer of skin that are hit with too much ultraviolet light, Ploch said. Besides causing redness, sunburn can also make skin swell, itch and feel hot to the touch, and can cause pain. Any sun-exposed skin is vulnerable to sunburn, especially if the area is not protected by sunscreen. But once the initial UV damage to skin is done, there's little to stop the redness from forming, Ploch said. "Preventing sunburn is key," Ploch said. Once skin has burnt, applying moisturizers may help soothe the condition. Products with aloe vera in them may provide a cooling sensation, but are not necessarily better for soothing burns than other moisturizers, she said. Researchers are looking into whether taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen or aspirin, may help prevent sunburn when used before sun exposure, Ploch said. Tinea versicolor Tinea versicolor is a fungal infection caused by an overgrowth of yeast that normally lives on the skin, Ploch said. When yeast overgrows — in humid climates, on oily skin or in people who work outdoors — it interferes with skin pigmentation, causing patches of skin discoloration. Pink, tan or white spots may develop on skin, and the spots may form patches of lighter or darker skin that may become dry or scaly. This common infection can be easily treated with anti-fungal medicines, Ploch said. Topical creams, lotions or shampoos that contain anti-fungals may be applied to the skin to clear the yeast overgrowth, she said. If tinea versicolor covers a large area of the body or is thick, a doctor might recommend an oral anti-fungal medication instead of a topical one, Ploch said. It might take weeks or months for the skin discoloration to go away, and people may wish to wash with an anti-fungal cleanser once a week to help prevent the infection's return, Ploch said. Source
