Time for a skin check
Sadly, summer is over - and what a summer it was! But as winter sets in, all too often our skin gets covered up and forgotten. If you want to avoid a nasty surprise when next springtime comes and you uncover again, you need to take some simple steps in winter.
Getting some sunshine while you can is important to keep your levels of vitamin D (for strong bones) topped up. In the UK from about April to September fifteen to twenty minutes a day in full sunshine, with face and arms uncovered and no sunscreen is enough - never let yourself get burnt. In winter, we don't get enough sun on our skins to make vitamin D. Our bodies can store some, but shortage of vitamin D is common in the UK. If you're over 65, are pregnant or breast-feeding, cover up for cultural reasons or don't get out much, consider a 10 microgram a day supplement.
Be good to your skin!
Hot, cold, wet, dry or windy conditions can all dry out your skin. Ignoring your skin because it's covered in winter woollies leaves you prone to cracking and drying out. This can be sore and itchy, but also makes you prone to skin infections. If an area of cracked skin gets hot, red or tender, see your GP - the skin usually provides excellent protection against invasion from bacteria that live on all our skins, but if they get in through cracks they can multiply and cause infection.
Moisturise at least once a day, and ideally three or four times to keep cracked, dry skin at bay. Lotions only last a short time - for intensive treatment ask your pharmacist about emollient creams and slather all over. For inflamed patches, your GP may recommend a course of steroid cream as well, but you still need to moisturise. Soap can make dry skin worse, so consider using a soap substitute such as aqueous cream (available from pharmacists).
Dig out mole-y warning signs
Malignant melanoma can affect adults of all ages, and accounts for 90% of skin cancer deaths despite being about 20 times less common than other skin cancers. The biggest risk factor is skin damage, particularly from burning and especially in childhood. A combination of pale skin and a hot climate is particularly risky - rates of melanoma are high in Australia and much of the USA - but it's more than possible to accumulate enough skin damage to put you at risk in the UK. Most moles are nothing to worry about, but see your doctor immediately if a mole changes or you don't pass the ABCDE test.
A - asymmetry (irregular shape)
B - borders (ragged edges)
C - colour that's not the same all over or has changed
D - diameter (increase in size, especially to over 6 millimetres)
E - evolution (a new mole or a change in size or appearance of an existing one)
Squamous and basal cell cancers
All new skin changes that don't go on their own should be checked out just in case. Your doctor can usually reassure you but may arrange minor surgery to cut out the growth and check it under a microscope. Squamous cell cancers (SCCs) and basal cell cancers (BCCs) don't often kill but can be disfiguring and need surgery. Found mostly on sun-exposed skin, SCCs can have a red or pink base with crusting or bleeding. BCCs often start as pearly or pink lumps which grow slowly but can crust over or bleed, forming a small ulcer that doesn't heal.
Sandpaper skin? Could it be solar keratosis?
You may not have heard of solar (sometimes called actinic) keratosis, but you've probably seen at least one - you may even have a few! One in four over-60s have these scaly patches, mostly on sun-exposed skin like head, neck and hands. They often start in your 20s or 30s. They can be red but are often more easily felt than seen as rough, sandpapery patches. Most are harmless, but some can develop into SCCs. If you have lots, the risk is higher. Your doctor may advise not treating single ones, or freezing them. If you have more, he may recommend treating a wider area of affected skin with creams like 5-FU, imiquimod, diclofenac or Picato®. They can cause scaling, redness and inflammation for a few weeks, but do get rid of most keratoses. This reduces the risk of skin cancer. Complete the course - two to three days for Picato® and up to three months for the others.
Having type 1 or type 2 diabetes makes you more prone to skin damage, as the nerve supply can be affected so you don't feel injuries. Feet are a potential trouble spot. Always wear socks and well-fitting shoes to avoid rubbing, wash your feet daily with warm water and soap and moisturise. Trim your toenails every six to eight weeks but don't cut too short at the edges. Check daily for redness, cuts, skin that's hot to touch or blisters. See your doctor if you notice changes that last more than a couple of days or are getting worse. If you can't reach your feet or cut your own nails, your doctor can arrange someone to help.
With thanks to My Weekly magazine where this article was originally published.