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Of skin lumps and bumps

Stacey Colino

THE WASHINGTON POST – While you’ve been spending more time with yourself during the pandemic, you may have noticed a new lump or bump (or two or three) on your skin.

Meanwhile, you may have seen ads on social media for devices or products that claim to help you get rid of skin tags, warts or moles on your own – and wondered if you should try the DIY approach. The answer is: It depends on what and where the growth is.

“The problem with all this at-home stuff is you have to make a diagnosis to know what you’re treating,” said a dermatologist in private practice and a clinical associate professor of dermatology at Tulane University in New Orleans Patricia Farris. “I’ve seen people put wart remover on a skin cancer because squamous cell carcinoma can look warty.” In addition to the risk of misidentification, there are other concerns about treating skin growths yourself.

Here’s a look at five common skin lumps and bumps, with details about which ones you can treat yourself, which are worrisome and which are better left alone.

CHERRY ANGIOMAS

These small cherry-red bumps can range from the size of a pinhead to a pencil eraser. They are harmless and often run in families, and while they can occur anywhere on the body, they’re most often seen on the torso, upper thighs and upper arms.

Because cherry angiomas are small collections of blood vessels, you shouldn’t try to remove them yourself. They can bleed and “you may not be able to stop the bleeding”, warned a board-certified dermatologist in New York City Diane Berson.

These can be left alone, but if you have a large one that bothers you, a dermatologist can remove it with a laser or surgically, then cauterise it to stop the bleeding.

MILIA

Tiny white bumps that occur mostly on the face, especially around the eyes, milia are basically pores that are clogged with sebum and oil and have a layer of skin that has grown over them. They’re harmless and can be left alone; sometimes they even go away on their own. But because they tend to occur on the face, people often want to get rid of them.

Sometimes, using a topical product that contains retinol or salicylic acid can help enhance cell turnover and allow the skin to shed the milia, an associate professor of dermatology at Mount Sinai Hospital in New York City Joshua Zeichner said in an email.

But the safest way to remove them is to have a dermatologist physically open the bump with a sterile needle, then use an extractor to pop out the contents. “I’m cautious about recommending patients do this at home because of the risk of infections or potential scars,” Zeichner added.

MOLES

A mole is a cluster of pigmented cells that creates a spot (called a nevus) that can range from tan to pink to very dark brown or black. Some moles are raised off the skin’s surface, and some sprout hairs; they can occur anywhere on the body.

“Moles are not superficial – the nevus cells are down in the dermis,” said a tenured professor and chair of the department of dermatology at the University of Mississippi Medical Centre in Jackson Robert Brodell. Moles should be monitored for changes that may signal skin cancer: In particular, those that have asymmetry, border irregularities, colour variations, a diameter larger than a pencil eraser, or that are evolving – or what’s known as the ABCDE rule for spotting warning signs of melanoma – should be evaluated by a dermatologist.

Unfortunately, “some people are using salicylic acid or herbal products that they see online to try to burn off moles”, Farris said. That’s a big mistake, according to dermatologists, for several reasons: Using these products can lead to infections, scarring, sores, and crusting and bleeding of the skin. Also, there’s a risk that a cancerous or precancerous mole will go unrecognised. Whenever dermatologists remove moles from patients, they send them for a biopsy.

SKIN TAGS

These tiny bits of pedunculated flesh that dangle off the skin’s surface may be odd-looking, but they’re harmless. The tendency to develop skin tags (aka acrochordons) can run in families, Berson said, and they often occur where there are folds of skin, such as in the armpits or groin area, under the breasts and on the neck. Some people want to have them removed for cosmetic reasons, but this isn’t necessary.

Various topical solutions (that often contain salicylic acid or plant extracts) and over-the-counter removal devices are available for home use.

But experts don’t recommend the DIY approach to removing skin tags because of the risks of bleeding, infection and scarring, as well as pain. Some of the devices use a ligation method with small rubber bands to cut off a skin tag’s blood supply.

Others use electrical current, such as plasma pens that “convert electrical energy into heat, creating a controlled wound in the skin”, Zeichner explained.

It’s safer to visit a dermatologist who, after sterilising and numbing the area, can usually snip off a skin tag at the base of its stalk, then cauterise it to stop bleeding, Farris said, without leaving a scar.

WARTS

No, you can’t get a wart from touching a toad or frog – that’s a myth. Warts, which are rough overgrowths of skin, are caused by a virus that’s highly contagious (most commonly the human papillomavirus, or HPV).

Warts are most common on the hands, but they can also occur on the feet, face, genitals, face or other places.

There are several effective over-the-counter treatments that contain salicylic acid – “the skin turns white as [the wart] dies, then you can gently file it down with a clean nail file or pumice,” said a New York City dermatologist Doris Day. “You can treat warts on the hands, feet, elbow and knees – but not genital warts or warts on the face, where the skin is more sensitive.”

Be patient, because it can take weeks for these over the counter (OTC) products to work. Don’t be overzealous with them, as that can lead to sores, burns and scars, Farris warned. For quicker results, a dermatologist can burn off a wart with liquid nitrogen or remove it surgically.

Non-cancerous skin growths are incredibly common, and they become more so as people get older, with 42 per cent of people 65 and older seeing a physician for them, compared with six per cent of the under-17 crowd, according to the American Academy of Dermatology.

But “if you’re not sure what a skin spot is, go to a dermatologist one time to find out – if something is growing, that’s a sign you should see a doctor,” said Day, author of Beyond Beautiful: Using the Power of Your Mind and Aesthetic Breakthroughs to Look Naturally Young and Radiant.

The same is true if you’ve had a skin growth removed or treated and it comes back.
“You have to have respect for the skin,” she added. “Sometimes things that look like they should be nothing can be more than what you think it is.”

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