Know Your Skin: Q&A with UAB Medicine Rapid Access Dermatology Clinic

Q&A with Cosmetic Derm

The skin is the largest organ in the human body, and it nurtures and protects the body in several ways. Taking care of that skin is an important part of staying healthy, so it’s a good idea to know when and why to see a dermatologist. The information below highlights some common skin conditions and how dermatologists provide care.

Risk Factors

If they don’t have an existing condition such as psoriasis or eczema, many people think there’s no reason to see a dermatologist. UAB Medicine dermatologist Lauren Graham, MD, PhD, says annual visits are recommended, but there is no official “start date” for healthy people to begin seeing a dermatologist.

“We don’t look at age demographics to make that determination, we consider risk factors instead,” Dr. Graham says. “One of our main goals is to help patients remain alert to skin cancers, so first and foremost we consider those specific risk factors. Studies have shown that people who have jobs that place them outdoors, such as roofers, lifeguards, farmers, landscapers, and athletic coaches, are at greater risk for exposure to the sun’s ultraviolet (UV) rays that can cause cancer.”

Dr. Graham says the frequency of visits depends on the level of sun damage a patient has.

“If you have been diagnosed with a skin cancer, the recommendation is to be seen every six months for the first two years,” Dr. Graham says. “Melanoma (a type of skin cancer) may call for visits as often as every three months, depending on the type of melanoma diagnosed. If you see a dermatologist and we don’t find anything concerning at that visit, we may recommend an annual visit, depending on your sun damage and risk factors. We always have a caveat in place for that policy, which is when something such as a spot or mole is changing or bleeding on its own, we would want to see you right away.”

Symptoms to Watch For

Severe sunburn: In the interest of long-term health, just getting past the suffering caused by sunburn is not enough. UV radiation from the sun and other sources can cause dangerous, lasting damage, and that can happen even if you don’t get sunburned. A dermatologist can diagnose the severity of any damage, guide you toward appropriate skin care products, and explain ways that you can enjoy future fun in the sun while still avoiding sunburn, skin cancer, early aging, and other skin damage.

“More than five sunburns in your lifetime that cause blistering can increase the risk of skin cancer, as does a history of using tanning beds,” Dr. Graham says. “One of the most important things to note is that people of any ethnic background, even those who always tan or rarely burn, can still get skin cancer. For example, the incidence of melanoma is rising among the Hispanic population. Skin-of-color patients also have a higher risk of ‘acral melanoma’, which is melanoma on the nails, hands, and feet.”

Dry, itchy, and irritated skin: If this condition lasts a week or longer, there may be a chronic condition, such as eczema, to blame. A dermatologist can provide symptom relief and determine if the cause is chronic and/or serious.

Persistent acne: If over-the-counter medications have little or no effect on this condition, your dermatologist first can determine the cause or if some other condition is present, then provide specific treatment tailored to your needs. Treatment may include topical medications, oral antibiotics, or hormonal therapies.

A pimple that won’t go away: “That should be evaluated,” Dr. Graham says. “Sometimes a patient sees us because they think they have a pimple that never goes away. You can get acne at any age, but that type of pimple should come and go. Basal cells and squamous cells are becoming more common, especially among the younger population.”

A squamous cell carcinoma develops in the squamous cells that make up the middle and outer layers of the skin. Left untreated, skin cancer can grow larger or spread to other parts of your body.

Rough, scaly, often painful patches: Psoriasis is a skin disease that causes itchy or sore patches of thick, red skin with whitish scales on lighter skin or darker, scaly spots on skin of color. It usually appears on the elbows, knees, scalp, back, face, palms, and feet. This disorder causes skin cells to grow too fast. A dermatologist will diagnose the condition and design a treatment plan.

Red and flushed skin on the face, accompanied by itchy, watering eyes: Red spots that look like acne often are the result of rosacea, a chronic inflammation condition. It can be managed with medications and special eye care routines, depending on the severity of symptoms.

Loss of hair/bald spots: Hair loss may have several causes. A dermatologist will discuss various treatment options for your specific condition.

A mole that grows or changes shape or color: Dr. Graham urges patients to follow the “ABCDE” warning guide for melanoma when it comes to moles. If any of the following descriptions apply to your mole, you should see a dermatologist:

  • “A” for asymmetrical. Mole has an irregular shape with two parts that don’t match
  • “B” for border. Border of the mole is notched or jagged instead of smooth
  • “C” for color. If the color is uneven, with patches of black, red, or bluish tint instead of solid brown
  • “D” for diameter. A mole or spot larger than a pencil eraser or pea
  • “E” for evolving. Any change in size, shape, color, or height of a spot on your skin, or any bleeding, itching, or crusting

If there is a concerning spot that is growing or changing, we strongly recommend a visit,” Dr. Graham says. “Any spot that’s an ‘ugly duckling’ that looks different than the other ones or grabs your eye right away may be a serious condition.

When In Doubt, Check It Out

Patients with immediate concerns don’t need to wait for a regular appointment with a UAB Medicine dermatologist. UAB Dermatology operates an urgent access clinic to make it easier for patients to receive care for skin-related medical complaints and be scheduled for any needed follow-up care.

The clinic offers same-week appointments, and you don’t have to be a current UAB Medicine patient. Conditions treated include new skin lesions, new rashes, lumps, bumps, and moles that recently changed in appearance. Clinic visits are focused on a primary complaint, and if ongoing care is needed, the staff can refer patients to the appropriate UAB Medicine specialists.

Click here to learn more about UAB Medicine Dermatology and the services offered.


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