Dr. Bernadette Carr answers your questions on moles and acne

I am going on a sun holiday this month but I’m fair-skinned and prone to burning. I have some moles on my back and arms. How should I check my moles?

Pigmented skin lesions and freckles can be normal in adults and children. 

It is common to acquire more freckles or pigmented moles up to the age of 40, after which it is rare to develop a new common mole.

If you have a new lesion which is itching/ bleeding or causing pain this should also prompt review by your doctor.

It is useful to use the ABCDE checklist when examining moles. There are five features which, if present, should prompt examination by a doctor. 

A: Asymmetry (moles which are not regular in shape). 

B: Border irregularity. 

C: Colour irregularity (moles which are not a uniform colour) 

D: Diameter (moles greater than 7mm across). 

E: Evolving (moles which are progressing or changing).

Any or all of these features may indicate a lesion suspicious for cancerous change. 

If your doctor feels it is appropriate for you after examining your mole he may take a skin biopsy or refer you to a specialist service. 

A biopsy involves either removing or taking a sample from the mole and examining it under a microscope to see if there are any suspicious changes.

The most common risk factor for developing malignant skin change is sun exposure and exposure to UVA and UVB rays. It is very important to use a high sun factor (factor 30 would be recommended) with UVA and UVB filtering to afford maximum protection.

Children’s skin may be particularly vulnerable and it’s vital they cover up with a hat and SPF is regularly reapplied throughout the course of the day, especially after swimming/showering.

All of the main types of skin cancer are curable if they are detected early. In most cases surgery to remove the affected area will be sufficient. 

It is a good idea to become familiar with your moles and examine regularly for any change along with use of adequate sun protection.

Q. I am a 24-year-old woman and have very bad skin. 

I have been suffering bad breakouts on my chin and face and have a lot of blackheads since my teens. Should I have grown out of “spotty skin” and what can I do to clear it?

A. Acne is very common especially in young people aged between 12 and 25, however it may affect people of all ages, men and women. 

If left untreated acne may last up to five years before clearing, however some people will experience acne for a longer period. 

Hormonal changes in the teenage years may trigger changes in the oil production in the skin contributing to the development of blocked pores with comedones (whiteheads) and blackheads.

Bacteria in the skin may cause inflammation with the development of infected pustules which, if severe, may form larger cysts in the skin which leads to an increased risk of scarring.

There are a wide range of preparations available over the counter and on prescription to treat acne. 

A topical preparation containing benzol peroxide is a frequently tried as a first step and may be bought in pharmacies. This cream will reduce the amount of bacteria on the skin. A small amount should be used and it may dry the skin.

As a next step, topical antibiotics or retinoid creams may be prescribed by your GP if they are appropriate for you. It is important to use sun protection when using these medications as they may make your skin more sensitive to sunlight and sunburn.

Your GP may also suggest medications in addition to cream such as a three-month course of an oral antibiotic to control skin inflammation and kill bacteria leading to spots.

The contraceptive pill may be helpful in controlling acne due to the effect it has on hormone balance.

For skin that has been badly scarred by acne, laser treatment may be used to improve the appearance of scarring. Most cases will resolve in time, with less than 12% of women aged over 25 suffering with the condition.


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