Dermatology Patient Education

An actinic keratosis is a pre-cancerous spot on the skin. Most people notice it as a small, rough spot that doesn’t go away. If left untreated, some actinic keratoses may go on to become a type of skin cancer called squamous cell carcinoma.

There are several ways to treat these pre-cancerous spots. Most commonly, they will be frozen with liquid nitrogen in a procedure called cryotherapy. You can also treat actinic keratoses at home with prescription creams that you apply to your skin for a few weeks, or with a procedure done in the dermatology clinic called photodynamic therapy. With any of these treatments, you can expect your skin to become red and irritated before healing.

Sometimes it takes more than one treatment to get rid of an actinic keratosis, so if you still notice a rough spot after a few weeks, please call us at 617-667-3753 to make a follow-up appointment.

Dry skin (the medical term is xerosis) is often just an inconvenience. However, it can become quite itchy and if you break open the skin from scratching, you can develop an infection in the area. Dry skin can also trigger or worsen flares of eczema and other rashes; therefore, it is especially important to treat dry skin if you suffer from other skin conditions.

Dry skin is usually worst in the winter, when humidity is low and you are indoors near the heater, but you may notice it even when the weather is more mild. There are several ways you can fight dry skin:

• Bathe or shower in lukewarm water — hot water dries out your skin.
• Limit shower to 10-15 minutes.
• Use mild soaps such as Dove or unscented body lotion cleansers (e.g., Olay, Dove). Minimize use of soap on areas that tend to get dry.
• Use lotion cleansers such as Cetaphil to wash your face.
• Use a facial moisturizer with sun block on a daily basis. Ultraviolet rays from the sun are still damaging to the skin even in the winter.
• Regular use of a lip balm with sun block is very helpful for chapped lips.
• When choosing a moisturizer, look for products that are fragrance free, especially if you have sensitive skin. Brands that you can find at the local pharmacy/drugstore are just fine. In general, ointments and creams are more effective than lotions.
• Apply moisturizers immediately after a bath or shower while your skin is still damp. Apply any prescription creams or ointments BEFORE you apply your moisturizer.
• Heavy ointments such as petroleum jelly, Aquaphor healing ointment, or hydrolated petrolatum are useful for severely dry areas such as the hands, feet, elbows, and knees. Wearing cotton gloves or socks over an ointment on hands and feet at bedtime can help with severe dryness and cracking.
• Use of a home humidifier is useful in preventing moisture loss from the skin.

We examine your moles during your full skin exam. We also recommend that you self-monitor your moles at home every few months. The mnemonic device to remember concerning features in moles is ABCDE:

A = Asymmetry (half of your mole looks different than the other half — normally, the two halves should look the same)
B = Border (an irregular or jagged outline)
C = Color (more than one color, including brown, black, red, white, blue, tan)
D = Diameter (larger than 6 mm)
E = Evolving (a new or changing mole, including one that develops symptoms such as pain, itching, or bleeding)

If you notice any spots showing these atypical features, please call us at 617-667-3753 to schedule an appointment for a new, unusual, or changing mole.

A seborrheic keratosis is a very common skin growth. Most people get them over time, and most people have more than one. No one knows why these benign skin growths happen, but they are not skin cancer, and they are not contagious. At this time, there is no known way to prevent them from occurring.

A seborrheic keratosis does not need to be treated for medical reasons, but sometimes people wish to have them removed for cosmetic purposes. Insurance companies do not cover that cost. If you are interested in cosmetic removal, this can be done for a fee at our Cosmetic Surgery and Laser Center at 25 Boylston Street in Chestnut Hill. Please call us at 617-754-0350 for more information.

If you have a history of skin cancer, you should monitor your skin at home between visits to the dermatology clinic for new, concerning lesions. Skin cancers can appear as new bumps or spots on your skin that don’t go away after a few weeks, are painful, or bleed. If you notice any new spot on your skin that does not go away after four to eight weeks, please call us at 617-667-3753 to schedule an appointment to have it checked.

Warts are caused by infection with human papilloma virus (HPV) and can be contagious. There are several ways to treat warts. Commonly used methods include freezing them with liquid nitrogen (a procedure called cryotherapy) and applying salicylic acid plasters to them.

Warts can also disappear on their own, and not everyone chooses to have them treated. If you have chosen to try therapy, remember that it may take several treatments and some time for warts to go away, and not all warts respond to therapy. Warts can also occasionally grow back after apparently successful treatment.

Cryotherapy is a procedure in which liquid nitrogen is used to freeze cells; it is often used to treat pre-cancers and non-cancerous changes in your skin. After you have cryotherapy, you can expect to see redness and swelling of the treated skin as well as a scab or blister. No special care is required; you can wash your skin as usual and use makeup and other cosmetics.

The skin usually heals within three weeks, leaving healthy new skin. If the spot for which you had cryotherapy does not go away after treatment, please call us at 617-667-3753 to have it examined again and possibly retreated.

If you had a skin biopsy during your visit, please closely follow the instructions you were given for caring for the biopsy site. If you notice increasing pain, redness, or swelling, or if the biopsy site becomes hot to touch, please call us at 617-667-3753 as these symptoms can sometimes indicate that an infection has developed.

Biopsy results are usually available within two weeks. If you have not heard from our clinic after three weeks, please call us at 617-667-3753 to speak with someone regarding your results.

Learn more about skin biopsies here.

Protecting yourself from the sun is important to decrease your risk of skin cancer. It can also slow down the appearance of aging. There are several things you can do to protect yourself from the sun. If possible, avoid being out in the sun when it is at its strongest (usually between 10 am to 4 pm).

For sunblock, choose a brand you like that says “broad-spectrum” or “UVA/UVB,” and look for a sun protection factor (SPF) of 30 or higher. Follow the instructions for application closely — one application to your entire body will take about 3 ounces (one shot glass), and the most common error in sunscreen use is simply not applying enough. You should apply the sunscreen half an hour before going outside, and you should reapply as directed on the bottle (at least every two hours, and sooner if you have been sweating heavily or have been in the water).

Don’t forget to protect all your exposed skin — people often forget about their neck, ears, feet, and (if your hair is thin) scalp. Sun protective clothing is also a good option to consider — many companies make clothing with sun protection built in, including such brands as Coolibar, Solumbra, and REI. You can also wash sun protection into your own clothing at home using your washing machine and a product called SunGuard. Hats are a good way to protect your head and neck, and broad-brimmed hats are better for this than baseball caps, which leave your ears and the back of your neck exposed.