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Ask Dr Emma: Dermatology Edition
Dr Emma answers all your skincare questions.
Is food causing my acne?
I get asked this question all the time. There is actually little scientific evidence to show that acne is caused by foods. Many people report that their acne flares when they eat oily or sweet foods, but scientific studies haven’t been able to back this conclusively.
There are, however, studies that show that people from rural areas who do not have acne, develop acne when they move to urban areas and change their diet. There’s also a school of thought that sugary foods increase the levels of male sex hormones in the blood, which then encourages your skin to produce more oil, and that worsens acne.
My own personal opinion is acne probably is related to some foods. The scientific research in this area is growing and I wouldn’t be surprised if there’s new, stronger evidence published over the next few years. My advice would be if you’ve noticed that a certain food makes your acne worse, then trust your instincts. You don’t always need scientific experiments to confirm what your body is telling you.
Why does my eczema keep flaring?
Eczema is a chronic skin condition characterised by dry, irritated and itchy skin. Eczema is incredibly common; it’s been reported that up to 1 in 5 children and 1 in 10 adults in the UK suffer from eczema. It’s definitely one of the most common things I see in my clinic practice.
Eczema, also known as atopic dermatitis is characterised by inflammation of the skin, caused by the body’s immune system reacting to certain stimulants too aggressively. Why this inflammation happens is a mixture of genetics and environmental triggers. Many people who suffer from eczema are aware of their triggers. Common triggers include coming into contact with soaps and detergents, dust, infections and stress. These should be avoided as much as possible in people who struggle with eczema.
Eczema is a condition of dryness. So if you can stop your skin from getting dry, the eczema will be much better (anyone with eczema will tell you that this sounds a million times easier than it is, however). It’s really important to focus on frequent moisturising with greasy emollients – if you can moisturise 20 times a day, do so. I also advise all my eczema patients to avoid all soaps, and wash their skin with a moisturiser (often referred to as a soap substitute) as well. Soaps can dry out the skin and make eczema flares more likely.
After a greasy emollient, the next important thing to have in your treatment regime is something to fight against the inflammation, usually in the form of a steroid cream. These need to be used after consulting your doctor to ensure the right strength cream is recommended for your eczema, and you’re shown how to use it appropriately. Steroid creams that are too strong or used for too long periods of time can have damaging side effects on the skin, so always follow the treatment regime recommended by your GP or dermatologist.
Is skin cancer actually dangerous?
In a word, yes. But actually there are three main types of skin cancer, and they each have different risks.
Basal cell carcinomas (BCCs) are the most common types of skin cancer. These usually look like pink or “pearly-white” lumps that can grow into large ulcers. It’s incredibly rare for a BCC spread to cause cancer in other parts of the body, so usually once they are removed (either by surgery, radiotherapy or sometimes anti-cancer creams), nothing else needs to be done.
Squamous cell carcinomas (SCCs) are the next most common. They can look like crusty red or white lumps and sometimes feel tender and can bleed. SCCs can sometimes spread to deeper parts of the skin, and rarely to other parts of the body.
The most worrying form of skin cancer is a melanoma. They’re worrying because the cancerous cells in melanoma can spread to other parts of the body and cause metastatic cancer in other organs such as the lung or brain. Over 16,000 people are diagnosed with a melanoma each year in the UK, and this number has been increasing over the last few decades. Sadly, around 2300 of those people die each year from melanoma.
By far, the most important thing you can do to prevent skin cancer is protect yourself from UV light. This means avoiding the sun at its peak, always wearing high factor sunscreen, and avoiding all artificial tanning sunbeds – even one time is too many.
Should I be worried about that mole?
Each week I do at least 20-30 ‘mole checks’. This can be because someone notices a new mole, or a change in a longstanding mole, or their hairdresser points out a mole on the back of their neck, or a mole suddenly becomes itchy, or their GP notices a weird mole when looking at something else, or… you get my drift.
Moles are very normal parts of the skin and almost everyone will have a couple. They’re usually nothing to worry about at all. They can come in many different shapes and sizes, they can be flat or raised, they can be the same colour as the surrounding skin or a bit darker – they can be all these things and still be normal. However, we need to know about moles because some moles are actually melanomas (see above), or have the potential to become melanomas.
The things to look out for that should prompt you to seek medical attention have very helpfully been summarised into the ABCDE rule:
Asymmetry – moles that have an uneven shape
Border – moles that have irregular or blurred borders
Colour – moles that have different shades of black, brown or pink within them
Diameter – moles that are growing quickly
Evolving – moles that are changing
I recommend that people actively check their skin every 1-2 months, looking for anything new or changing. It’s almost impossible for you to know whether a mole is dangerous unless you have experience in looking at moles, so if there’s any concern about a mole using the criteria above, you should always speak to your GP. If your GP is not sure whether a mole could be dangerous, here in the UK you can usually be referred to a dermatologist and be reviewed within two weeks.