Ultimate guide to the 6 most common skin conditions

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There’s no need to suffer in silence with a skin condition. Our doctor’s guide explains what to look for and the help available.

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Skin complaints are among the most common reasons people see their doctor. And whether it’s itching, flaking or spots, the good news is there are many treatments available, from things you can do yourself, to over-the-counter measures, and medical help. These are the 6 most common skin conditions our doctors see in patients...

1. Eczema

There are different types of this non-contagious, inflammatory, dry skin condition, but the most common is atopic eczema (atopic dermatitis).

What it looks like: The skin will be itchy, dry, cracked and sore. Inflamed skin can become red on lighter skin, and darker brown, purple or grey on darker skin. Atopic eczema can affect any part of the body, but it most commonly affects hands, insides of the elbows, backs of the knees, face and scalp.

Causes: It’s not known exactly what causes eczema. It often occurs in people who are susceptible to allergies. People with eczema tend to have an over-reactive immune system that responds to certain triggers by producing inflammation that causes red, itchy, painful skin. There may also be a genetic component and it often develops alongside other conditions such as asthma and hay fever.

Self-help: Keep a diary to help you become aware of potential triggers such as metals, soaps, fragrances, antibacterial lotions, shampoo or body wash. Include what you eat and how you feel, as food allergies and intolerances, as well as stress, can also trigger outbreaks. Moisturise skin regularly (five to six times a day can be required) with an emollient cream.

If your eczema is particularly inflamed, or not improving with regular emollient use, then you can also try a small amount of an over-the- counter cortisone cream such as hydrocortisone. Only use this for a maximum of two weeks and if there is no improvement see your GP. These creams should not be used in children under 2 years. Adding oatmeal or baking soda to the bath can help to soothe itchy skin.

When to see a doctor: If the eczema is spreading, has become infected and/or isn’t responding to over-the-counter treatment, speak to a doctor. Treatment includes prescription creams as well as medical light treatments, in some cases.

2. Rosacea

A common skin condition that mainly affects the face, rosacea is more common in women and people with fair skin, though symptoms can be worse in men.

What it looks like: Rosacea causes redness (like a blush) across the nose, cheeks, forehead and chin. There may also be tiny, broken blood vessels and small pinkish-red bumps filled with pus. Other symptoms may include swelling around the eyes, sore eyelids and thickened skin on the nose. Many cases are mild and not everyone develops all the symptoms.

Causes: Genetics, the immune system and environmental factors may all play a part, but the exact cause isn’t known. Certain triggers can worsen symptoms, especially alcohol and spicy foods but also cheese, caffeine, hot drinks, vigorous exercise, stress and sunlight.

Self-help: Avoid the triggers that make your symptoms worse and always wear a high SPF sunscreen (30+).

When to see a doctor: There’s no cure for rosacea but your doctor can advise you on the best treatments. These include prescription gels and creams, antibiotics, or light treatments. Sometimes rosacea can affect the eyes (ocular rosacea) so always see your doctor if you develop a red, painful, gritty eye or blurred vision. These may be symptoms of keratitis (inflammation of the cornea) which needs to be treated urgently.

3. Fungal infection

There are many types of fungal infections affecting skin, hair and nails and nearly a billion people are affected worldwide.

What it looks like: An itchy, scaly rash, sometimes with skin discolouration. Common forms include:

  • Athlete’s Foot (tinea pedis): Symptoms include itchy, white patches between the toes. There may also be red, sore, flaky patches on the feet. Skin may crack and bleed. Athlete’s Foot can spread, causing fungal nail infection.
  • Ringworm can appear anywhere on the body, including the scalp and groin. The main symptom is a red or silver rash that is dry, scaly, swollen and itchy. The rash is usually circular.
  • Intertrigo is a fungal infection that appears under the breasts, in the groin or skin folds. Typical symptoms are inflammation, soreness, discomfort, itching, discolouration and a strong, musty smell.

Causes: Common fungal infections are caused by yeasts such as candida or the fungus dermatophytes. Certain conditions cause them to proliferate. Obese people and diabetics are more susceptible.

Self-help: If you suffer from Athlete’s Foot, a cream, spray or powder from the pharmacy can help. Always wash and dry your feet, wear clean tights or socks every day and alternate shoes regularly. For intertrigo, keep the area as dry and clean as possible. Most fungal infections can be helped with an antifungal ointment, gel or cream from the pharmacy. If you’re concerned about ringworm, make sure you get any pets examined by a vet, as they might carry the fungus.

When to see a doctor: If the rash covers large parts of the body or you’ve been using over-the-counter medication for two weeks and it hasn’t helped, see a doctor as you may need prescription cream.

4. Psoriasis

Common and non-infectious, psoriasis is an autoimmune disease that affects at least 100,000 million people worldwide.

What it looks like: The most common type is plaque psoriasis which causes red, flaky, crusty patches of skin covered in silvery scales, most commonly affecting the elbows, knees, scalp and lower back. Psoriasis causes shedding skin which can be distressing and may also affect the nails. In some sufferers, it can also lead to psoriatic arthritis, an inflammatory disease in which joints may swell and become red and hot.

Causes: Psoriasis is an autoimmune disease, which causes the body to attack its own tissue, leading to an increased production of skin cells. This creates a build-up of patches of dry, scaly skin. It’s not known exactly what causes the immune system to behave in this way, although certain genes and environmental triggers, such as stress, may play a role.

Self-help: If you think you have psoriasis, make sure you keep the area well-lubricated with an over-the-counter emollient. It’s important to see a doctor as quickly as possible (see below).

When to see a doctor: There are many treatments a GP or dermatologist can prescribe, including topical creams and ointments as well as oral and injected medications and phototherapy, where skin is exposed to ultraviolet light. Normally psoriasis can be diagnosed on a clinical examination, but if there’s doubt, sometimes a skin sample (biopsy) is needed to confirm the diagnosis.

5. Shingles

Shingles is an infection that causes a painful rash. Get medical advice as soon as you can if you suspect you have it.

What it looks like: The first sign of shingles is a painful, tingling sensation. You may also have a headache and feel unwell. This is followed a few days later by a red, itchy, blotchy rash on only one side of the body, usually on the chest and stomach, but it can also affect the face, eyes and genitals. The rash then turns to itchy blisters that ooze fluid.

Causes: Most people have chickenpox in childhood but after the illness has gone, the varicella-zoster virus remains inactive in the nervous system. Later in life, this virus can be reactivated and cause shingles.

Self-help: Take paracetamol and keep the rash clean. Do not apply sticky dressings, plaster, or antibiotic creams. Wear loose clothing and keep the area clean. Use a cool compress a few times a day. It can take up to 4 weeks for shingles to heal.

When to see a doctor: Get medical advice as soon as you think you have shingles. Ideally, speak to a doctor within 3 days of your symptoms starting as you may need medicine to speed up your recovery.

6. Acne

Acne is a common skin condition that affects the tiny pores of the skin, particularly on the face, back and chest.

What it looks like: Acne can vary from mild to severe. There are six different types of acne. Non inflammatory acne includes blackheads (small, dark dots) and whiteheads (small, white bumps). Inflammatory acne includes papules (small red bumps that may be tender), pustules (similar to papules, but with a small white tip filled with pus), nodules (large, hard bumps below the surface of the skin) and cysts (large pus-filled lumps).

Causes: Acne is caused when the tiny pores in the skin, known as hair follicles, become blocked with excess sebum (a mixture of oils and waxes) produced by the sebaceous (oil) glands. This creates the ideal environment for the propionibacterium (a bacteria present on human skin) to thrive. Sebaceous glands most commonly produce too much sebum during times of hormonal changes such as puberty. Some women may develop ‘adult acne’ during perimenopause and menopause, when a drop in oestrogen and progesterone hormones creates a temporary imbalance in circulating androgens (male hormones, including testosterone). Androgens are a potent stimulator of the sebaceous glands in the skin, and this can lead to an excess of sebum that causes acne.

Self-help: If you’ve got mild acne, over the counter topical treatments that contain benzoyl peroxide (an antiseptic that helps to reduce bacteria) may help. Do not wash affected areas of skin more than twice a day, as this can irritate the skin and make acne worse. Lifestyle changes may also help, for example, avoiding sugar and processed foods, as these may increase inflammation and exacerbate acne.

When to see a doctor: If your acne is not clearing up, talk to your doctor. Prescription medicines that can be used to treat acne include topical retinoids, topical and oral antibiotics, azelaic acid and the combined oral contraceptive pill (in women). For severe acne, your doctor can refer you to a dermatologist for further treatment.

Find out more about the treatments and causes of acne.

Reviewed by: Rhianna McClymont, Lead GP, Livi

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