Home » Health » How to tell if your crusty brown skin patch is something sinister… and when you should call the doctor – by top skin expert AENONE HARPER-MACHIN

How to tell if your crusty brown skin patch is something sinister… and when you should call the doctor – by top skin expert AENONE HARPER-MACHIN

Spotting Skin Issues: When to Worry About Spots, Bumps & Moles

The human body’s largest organ, the skin, can present a variety of issues. Understanding when to be concerned about these changes can be a matter of life and death. The following guide breaks down common skin conditions and when to seek professional help.

Understanding Crusty Brown Patches

Brown patches on the skin typically aren’t cause for alarm. These often arise from excess keratin, a protein that helps form the skin’s outer layer. Too much keratin leads to keratosis, where the excess clogs pores, resulting in dry, scaly patches.

Seborrheic keratoses are benign growths that affect many individuals. Their color can range from pink to black, sometimes appearing waxy and raised. While they don’t require treatment, very dark patches should be examined to rule out melanoma, a dangerous skin cancer.

Seborrheic keratoses, benign growths, are common.

Actinic keratoses, or solar keratoses, are dry, scaly patches that feel rough, like sandpaper. Roughly 10% of these can develop into squamous cell carcinoma (SCC).

How to tell if your crusty brown skin patch is something sinister… and when you should call the doctor – by top skin expert AENONE HARPER-MACHIN
Actinic keratoses, or solar keratoses, are dry, scaly patches.

When to Worry About Moles, Bumps, and Growths

Most moles are harmless, arising from melanocytes, which produce skin pigment. They can appear anywhere on the body and vary in color and shape. These don’t usually require attention unless their appearance is bothersome.

Dr. Harper-Machin, a consultant plastic surgeon, has seen a range of skin cancers. The primary concern is melanoma, a skin cancer affecting thousands each year. Changing moles should be monitored for size, shape, outline changes, or if they scab or bleed.

Viral Lumps and Over-the-Counter Treatments

Warts, a common skin growth, are caused by the human papillomavirus (HPV). They are skin-colored bumps and often appear on hands and feet. Though itchy or embarrassing, they are not dangerous and are treatable with over-the-counter remedies.

Skin tags, often mistaken for warts or moles, are soft growths. See a doctor if they bleed, grow, or become painful, though removal is typically cosmetic.

Scaly Patches and Cancer Risks

Some minor skin conditions may indicate non-melanoma skin cancers. A persistent spot that doesn’t heal or bleeds intermittently should be checked. Basal cell carcinoma (BCC) can be subtle and slow-growing but treatable.

A persistent spot that doesn’t clear within several weeks, and may intermittently bleed or crust, should be checked as it could be a basal cell carcinoma – BCC
A persistent spot that doesn’t clear within several weeks, and may intermittently bleed or crust, should be checked.

Squamous cell carcinomas (SCCs) can begin as red, scaly patches and are increasingly common. Early detection is vital, as treatment may not be life-saving if the cancer is not caught quickly. It is reported that the incidence of SCCs has risen by over 50% in the past decade (American Cancer Society).

Squamous cell carcinomas – SCCs – may begin as red, scaly patches but can ulcerate, become lumpy, painful and weepy. They are increasingly common
Squamous cell carcinomas – SCCs – can become lumpy and painful.

Skin Conditions That Don’t Increase Cancer Risk

Conditions such as eczema and psoriasis, affecting millions, can cause red, itchy, and inflamed skin. Neither condition increases the likelihood of cancer. Treatments range from emollient creams to tablets or injections for severe cases.

Common skin conditions such as eczema (pictured) and psoriasis can be painful and disfiguring but today there are treatments which can offer relief
Eczema and psoriasis.

Skin Changes During Pregnancy

Melasma, harmless brown or greyish patches, can develop on the skin during pregnancy, sometimes linked to hormonal changes. Using high-factor sun cream and treatments such as skin-lightening creams can help.

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SMALL ‘SCAB’ WAS A TUMOUR

When Julie Bowie found a small lump on her right leg last year, just above her ankle, she assumed it was an ingrowing hair.

It hurt, and was about the size of a penny – but the 58-year-old hairdresser, from Kent, recalls how within weeks it had formed a scab and then turned into a ‘volcano’.

‘It developed a hole in the middle with sides that were white and puffy, before forming another scab again,’ recalls Julie.

Julie Bowie, 58, a hairdresser from Kent. She found a lump above her ankle which turned out to be a squamous cell carcinoma

Julie Bowie, 58, a hairdresser from Kent. She found a lump above her ankle which turned out to be a squamous cell carcinoma

It was only when visiting her GP for an unrelated matter in September that she happened to mention the lump.

She was immediately given an urgent referral to a dermatologist, who diagnosed her with a squamous cell carcinoma (SCC) – a type of skin cancer caused by an overproduction of squamous cells, which are found in the top layer of the skin.

Two weeks later it was surgically removed under local anaesthetic.

‘I’m left with a big hole in my leg and I needed a skin graft,’ she says. ‘But I’m lucky and I need no further treatment.

‘I’m on a Facebook group for people with SCCs and they’re not always so fortunate. Some wait for a long time before being diagnosed.

‘As a hairdresser, I’m now always telling people to get various lumps on their heads checked out. Don’t ignore anything that’s unusual.’

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Dr Harper-Machin is a spokeswoman for the British Association of Plastic and Reconstructive Surgeons.

Visit bapras.org.uk for patient information guides on benign skin conditions and skin cancer. The charity Skcin (skcin.org) also has information.

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