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Skin Abnormalities: Separating Harmless From Harmful

By: Jennifer Linder, MD
Posted: January 28, 2011, from the February 2011 issue of Skin Inc. magazine.

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Sebaceous hyperplasias. These result from an abnormal enlargement of the sebaceous gland and are thought to affect nearly 1% of the U.S. population.6 These yellow or orange lesions are most common on the forehead, nose and cheeks because of the abundance of oil glands in these areas of the face. Sebaceous hyperplasias can be mistaken for BCC due to their raised, nodular, bumpy appearance. The term hyperplasia describes the abnormal buildup of cells. They are believed to be caused by the decrease in cell turnover associated with the aging process. Sebocytes, or cells that form the sebaceous glands, mature and then eventually dissolve, releasing oily sebum. Sebaceous hyperplasias form when these sebocytes do not break down and, instead, crowd the oil gland, causing it to expand. Research indicates that sebaceous hyperplasias are not linked to skin carcinogenesis in any way.7 There are several treatment methods available, including cryotherapy, electrocautery, curettage, laser treatments, phytodynamic therapy, and topical treatment using TCA acid and retinoids. Sebaceous hyperplasia may reoccur if not completely removed.

Cherry hemangiomas. These are caused by an abnormal gathering of dilated small blood vessels called venules. This type of lesion is typically small and round and ranges in color from bright red to purple. They can be smooth or raised to the touch. The probability of developing cherry hemangiomas increases with age, and they can appear anywhere on the face or body. There is no link between cherry hemangiomas and skin cancer; however, some more vascular BCC and SCC can have a similar appearance to this common vascular lesion so a physician should always be consulted for proper diagnosis. Cautery and light therapy treatment are the best options. With these types of treatments an electrical hyfrecator, or laser or intense pulsed light (IPL) beam cauterizes the vascular lesion, causing it to disintegrate.

Verrucae planae. These are flat warts. All types of warts are caused by the human papillomavirus and, unlike common warts, flat warts often appear on the face. This particular type of wart tends to be less obvious than other warts but can proliferate in large numbers. Although warts are completely benign and not linked to skin cancer, they are contagious. Compromised skin is more susceptible to contracting the virus and cross-contamination is a risk; therefore, full-face treatments should not be performed on clients with verrucae planae present on the skin. Flat warts can be broken down by acidic preparations, including salicylic, glycolic and retinoic acids and these types of ingredients are often used as a spot treatment. Additional treatment options include: cryotherapy, laser, a chemical called cantharidin and the topical medication imiquimod.

It’s not just esthetics

Trust is the most important aspect of the client-esthetician relationship. Being able to offer more insight into all skin concerns—not just the esthetic—instantly boosts credibility and deepens this trust. Being honest and knowing when treatment is out of your realm of expertise will encourage clients to trust your recommendations. Moreover, estheticians have the ability to save lives. By carefully evaluating each client’s skin and referring to a dermatologist whenever anything appears abnormal, estheticians can help in the early diagnosis of dangerous cancerous lesions.

REFERENCES

1. A Berner, Actinic keratosis and development of cutaneous squamous cell carcinoma, Tidsskr Nor Laegeforen 125 12 1653–1654 (2005)

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