Ì첩ÌåÓý

Research we're watching

You probably know to have your skin checked frequently for the signs of melanoma. But you should also be looking out for another, more common type of skin cancer � squamous cell carcinoma. This potentially lethal skin cancer can show up on your skin as a white or pink bump, a non-healing sore, or even a scaly patch. According to the American Academy of Dermatology, cases of squamous cell carcinoma are on the rise, with some 700,000 new diagnoses each year.

"While other skin cancers may be more lethal, they're less common," writes Dr. M. Laurin Council, an assistant professor of dermatology at Washington University in St. Louis. "Squamous cell carcinoma is highly treatable when detected early, so it's important for people to know the signs of this disease and keep a close eye on their skin."

Ask the doctor

ÌýImage: © Boarding1Now/Thinkstock

Q. I'm confused about vitamin D. How much should I take?

A. There's considerable controversy as to whether most people should take a vitamin D supplement at all. Most of the vitamin D in our bodies is made by our skin, when it is exposed to sunlight. In contrast to most other vitamins, we don't get much vitamin D in our diet. Authorities recommend, however, that children from age 1, and adults through age 70, take 600 international units (IU) daily, and that adults 71 years and older take 800 IU daily. People with, or at risk for, certain bone diseases need to take more than this amount. There's general agreement that doses above 4,000 IU daily can be toxic to adults, with lower doses toxic to kids.

Soaps that strip away microbes aren't good, but it may be too soon to try products that add bacteria back.

You may have noticed that antimicrobial skin cleansers have disappeared from the shelves. In September 2016, the FDA ruled that over-the-counter antiseptic soaps and wash products containing triclosan, triclocarban, or 17 other antimicrobial agents could no longer be marketed because their manufacturers didn't demonstrate that the ingredients were both safe and effective in preventing the spread of infections. Moreover, the widespread use of antimicrobials is thought to promote the growth of antibiotic-resistant bacteria, like methicillin-resistant Staphylococcus aureus (MRSA), which can cause infections that are difficult to treat and even life-threatening.

You may also have noticed some new sprays, creams, and lotions whose purpose is just the opposite. Rather than eradicating microbes from our skin, these products, called probiotics, are designed to aid the growth of certain beneficial skin bacteria.

On call

ÌýImage: © EunikaSopotnicka/Thinkstock

Q. I've noticed recently that I sweat excessively, regardless of the temperature. Should I be concerned?

A. Your genes can determine whether you sweat a lot, but a sudden change in your regular sweating may suggest an underlying condition. Sweating is regulated by your nervous system and can be triggered by a number of causes. The primary signal for perspiration originates in the brain in response to a temperature-related or emotional cue, and then is carried by the autonomic nervous system to the sweat glands in the skin.

Ask the doctors

Q. I have fairly thick hair in the summer, but it seems to thin out in late fall. Is there anything I can do now to prevent losing hair in a few months?

A. Sadly, no. What you've experienced is common to all of us. On average, about 90% of the hairs on our heads are in the growing phase and about 10% are in the resting phase. After a few months in the resting phase, the hairs are shed. It's normal to shed up to 100 hairs a day.

On call

Q. I have had a dandruff problem for years. I have tried selenium and zinc shampoos, as well as ketoconazole shampoo. Nothing has worked. Are there other options?

A. Dandruff, which is a chronic skin condition known as seborrheic dermatitis of the scalp, can range from a minor irritant to a severe rash of the entire scalp.

Some experts feel there is evidence that probiotics may help prevent or treat several conditions, such as inflammatory bowel diseases, travelers’ diarrhea, irritable bowel syndrome, and some allergies (particularly eczema).

Acne

Questions to Discuss with Your Doctor:

• At what age did your problem with acne begin?
• Do you have blackheads, whiteheads, pustules, or cysts?
• If so, what areas are involved: your face, chest, back?
• What is your skin-care routine?
• What products do you use? Do any of them help?
• What medications have you tried (e.g., benzoyl peroxide, Retin-A, antibiotics, Accutane)?
• If you are female, does your acne get worse around the time of your menstrual period and do you have regular menstrual periods?
• What medicines do you take, including over-the-counter medicines and birth-control pills?
• Have you been developing extra body or facial hair?

Your Doctor Might Examine the Following Body Structures or Functions:

• Skin exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Blood tests (liver function tests, cholesterol, or if you are female, perhaps a pregnancy test if you are taking the medicine Accutane)

Rash

Questions to Discuss with Your Doctor:

• How long have you had the rash?
• Where did it start?
• Has it spread?
• Is the rash only on parts of your skin that have been exposed to the sun?
• Does it itch or hurt?
• Is the rash red, pink, or purple?
• Is the rash smooth or bumpy?
• Have you had sores in your mouth, eyes, or other mucous membranes?
• Have you had blisters on your skin?
• Have you had trouble breathing?
• Have you had a fever?
• Have you symptoms of an upper respiratory tract infection (for example, a cold)?
• Have you had vomiting or diarrhea?
• Are you taking any prescription drugs, over-the-counter drugs, herbs, or supplements? Did you start any of them in the past two months?
• Have you had any new exposures to foods or chemicals?
• Any exposure to insects?
• Have you had any recent sun exposure?

Your Doctor Might Examine the Following Body Structures or Functions:

• Temperature
• Examination of your skin, mouth, eyes, mucous membranes, lymph nodes, liver, and spleen

Your Doctor Might Order the Following Lab Tests or Studies:

• Skin scrapings for microscopic analysis or culture (if the rash looks infectious)
• Complete blood cell count or other blood tests (if you appear sick or have a fever)
• Skin biopsy