Hairdressers are willing to help customers detect skin cancers

(Reuters Health) – Most hair stylists at salons and barber shops may be interested in getting trained to detect skin cancers on the scalp, face and neck, researchers say.

Since hairdressers see a customer’s head and neck skin up close and regularly, they’re able to look for unusual spots or changes that could be melanoma, the study authors write in the Journal of the American Academy of Dermatology.

“Hairdressers are uniquely positioned to be part of screening teams to find skin cancers early. People are more loyal to them than most other professions,” said Dr. Suephy Chen of Emory University in Atlanta, senior author of the study.

10 PHOTOS10 strange skin problems that may signal a diseaseSee Gallery10 strange skin problems that may signal a disease

You’re breaking out like crazy

Adult acne is so common (here’s why—and how best to treat it), but when it’s a fairly new development, pay attention. Skin changes like acne can be a sign of polycystic ovary syndrome (PCOS), a hormonal imbalance that affects 10 million women worldwide. When a woman’s body makes excess “male” hormones called androgens, it’s often accompanied by an increase in acne. Your doctor may suspect PCOS if you have acne along with irregular periods or acne that flares up just before your period, says Dr. Reynolds.

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You notice lots of skin tags popping up

A few of these skin growths here or there is normal, but numerous skin tags that begin popping up could indicate type 2 diabetes. They’re spurred on by insulin-like growth factor 1, a protein involved in diabetes that stimulates skin overgrowth, says Rachel Reynolds, MD, a dermatologist with Beth Israel Deaconess Medical Center. Other signs of type 2 include increased thirst, slow healing wounds, and increased hunger. Here are more silent symptoms of diabetes you might be missing.

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You’ve developed a weird rash

Something benign like new laundry detergent or metal buttons on your pants can be behind a new rash, but so can tick bites. Five different types of tick diseases cause telltale skin rashes, from the bullseye of Lyme and STARI (southern tick-associated rash illness) to small pink spots dotting wrists, forearms, and ankles that are associated with Rocky Mountain spotted fever. Watch out for such skin changes if you’ve been camping, hiking, or spending time outdoors in known tick areas. Find a tick attached to you? Here’s how to safely remove it.

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You have a weird rash, Part II

Starting a new medication always comes with potential reactions. One serious problem: an allergy called “drug reaction with eosinophilia and systemic symptoms” or DRESS syndrome, a potentially life-threatening condition marked by an inflammation of the liver, heart, and lungs, says dermatologist Cindy Owen in a press release from the American Academy of Dermatology. Even more confusing: This rash can appear two to eight weeks after starting the med. Watch out if you have a rash accompanied by fever or swelling of lymph nodes.

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You’re so, so itchy

If you have dry skin—especially in the winter months—you may bet used to feeling itchy. But when a good moisturizer provides no relief, it could be something more serious than dry skin. Itchiness can be caused by some cancers like leukemia and lymphoma, as well as liver disease and kidney failure. If itching is all over your body, is severe, comes out of nowhere, or is so bad you’re losing sleep because you’re so uncomfortable, talk to your doctor, says Dr. Reynolds. Itchiness with night sweats, fevers, and unexplained weight loss are other red flag symptoms, she says. For run of the mill itchy skin, try these home remedies.

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There are tender red bumps under your skin

While the gut and skin may not seem all that connected, they are—check out these 21 secrets your gut is trying to tell you. Inflammatory conditions like irritable bowel disease (IBD) can show up on your skin. Painful red nodules may appear on your legs; they’ll also feel deep in the surface of the skin, explains Dr. Reynolds. The condition is called erythema nodosum and may appear during a flare-up of symptoms, such as persistent diarrhea or bloody stool. Blood in your poop may sound frightening, but it’s one of those scary health symptoms that can turn out to be harmless.

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Your skin is sweaty and ruddy

Unless you’re relaxing in a sauna or living the tropics, this may be a sign of an overactive thyroid. In people who have hyperthyroidism, their metabolism is revved up. This can translate to being hot and flushed (particularly when no one else in the room is). Your doctor should question you about other symptoms that could signal thyroid dysfunction, like weight loss or difficulty sleeping. Here’s how to know when to get your thyroid levels checked.

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Your lower legs are swollen and red

When someone is suffering from congestive heart failure, their weakened heart struggles to keep the blood moving against the pull of gravity. As a result, the blood can pool in your legs, explains Dr. High. Seeing deep lines after taking off your socks is another sign, he says. That said, congestive heart failure is most likely to affect the elderly; if you’re a young person and have sock lines, your socks just might be too small. (Sounds funny, but it’s true!) Catch the early signs of heart failure.

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You have yellow bumps underneath your skin

When seen on joints, hands, feet, and glutes, yellow bumps may be fat buildup under the skin. Called xanthomas, these bumps are a sign that your cholesterol or other blood fats are too high; they can also indicate diabetes, pancreatitis, and even some cancers.

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Think of the obvious first

Though skin problems can be a sign of a more serious illness, when saddled with dry skin or itchiness, don’t jump to a worst-case scenario, says Dr. High. If you’re itchy, first try a moisturizer. If you get hives, take an antihistamine or try a hydrocortisone cream. Then if the problem doesn’t clear up quickly, it may be time to see your doctor.

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“Previous studies have shown that hairdressers are willing and eager to do this,” she told Reuters Health by email. “They want to be taught by dermatologists.”

Chen and colleagues surveyed stylists at 15 salons within a 30-mile radius of Emory in fall 2017 and received 229 completed surveys from 12 salons. Questions included whether the hair professionals ever checked clients for skin lesions, had a client who asked them to check for skin lesions, or had referred a client to a doctor for an abnormal mole.

The survey also asked hairdressers for reasons why they might not check for skin lesions, as well as whether stylists should be trained in skin cancer detection and the best way to offer such training. Among the respondents, 82% were women, 86% were white and 97% estimated that more than half of their customers were white.

The research team found that 93% of hairdressers wanted to learn more about skin cancer detection and 73% believed stylists should receive skin cancer detection training, but only 40% thought it should be required for certification as a hair professional.

11 PHOTOS11 things your itchy skin can reveal about your healthSee Gallery11 things your itchy skin can reveal about your health

Kidney disease

An intense itch all over the body often occurs in people with late stage kidney disease or who suffer from chronic renal failure. In fact, one study showed that 42 percent of dialysis patients suffered from moderate to extreme renal itch. “Some people describe it as a nuisance,” says Anthony M. Rossi, MD, assistant attending at Memorial Sloan Kettering Cancer Center and New York Presbyterian Hospital.  “[The itch] is so intense that people wake up in the middle of the night scratching.” Science has yet to uncover why kidney disease causes itchiness, but doctors suspect it has to do with the build up of toxins in your body when your kidneys are unable to remove the waste from your bloodstream. Aside from treating the disease, a doctor may prescribe medications like gabapentin, an anti-seizure medicine that’s been FDA-approved for off-label use to quell renal itch. Here are 9 more little body changes that could signal much bigger health problems.

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Liver disease

Itching all over could also be a silent sign of liver disease. Where incessant itchiness shows up late-stage in kidney disease, it can be an early symptom of liver disease. “If your liver is not functioning properly to detoxify the body, byproducts like bile acids back up,” says Dr. Kathleen Cook Suozzi, MD, assistant professor in the Department of Dermatology at Yale School of Medicine. “The primary goal is to treat the underlying liver disease and prescribe medications that can eliminate the bile acids.” Doctors will typically prescribe medications that can inhibit your body’s uptake of bile acids or help reduce the amount of bile acid returning to the liver. Don’t miss these  9 signs your liver is in big trouble.

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Spinal disease

A chronically itchy upper middle of the back (without a rash) can be a hallmark of neuropathic itch, a symptom of nerve malfunction. Before providing treatment, doctors will first rule out spinal cord disease as a cause. Research has shown that spinal disease, whether due to age or injury, can apply pressure on the nerve and pinch it, which results in an itchy sensation on the skin. Neuropathic itches can occur on one side of the body or both, but it’s a big red flag if scratching brings no relief. “People with eczema get a good sensation from scratching,” says Dr. Rossi. “But [nerve itch] doesn’t improve with scratching. The itch intensifies most of the time.” Some people say it feels like insects are crawling on them. Once spinal cord disease or other health conditions have been ruled out, neuropathic itches can be treated with capsaicin cream, which is derived from hot peppers, to burn out the nerves that are firing irregularly on the skin. Make sure you know what muscle spasms can reveal about your health. 

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Celiac disease

Extremely itchy bumps or blisters on knees, elbows, buttocks, and/or hairline are signs of dermatitis herpetiformis (DH), a skin manifestation of celiac disease. “When a person with celiac disease consumes gluten, the mucosal immune system in the intestine responds by producing a type of antibody called immunoglobulin A (IgA),” John Zone, MD, Celiac Disease Foundation medical advisory board member told celiac.org. These IgA antibodies travel to and bind with the skin cells to trigger an itchy response. The prescription Dapsone can provide short-term itch relief for the skin, but the intestinal damage is serious and patients have to adopt a strict gluten-free diet for life. If they continue to eat gluten, celiac patients can develop malnutrition, anemia, bone loss, ulcerative colitis, and even cancer. Here are 11 celiac signs you need to pay attention to.

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Lymphoma

“The other thing that you want to rule out are blood disorders,” says Dr. Suozzi. “Anywhere from five to 30 percent of lymphomas such as Hodgkin’s and non-Hodgkin’s can present with itch.” Itchiness with or without a rash can be the first symptom of Hodgkin’s disease—likely caused by cytokines, cell signal molecules that trigger inflammation in response to infection. If your doctor suspects lymphoma, she may order a chest X-ray to eliminate the possibility. If you’re diagnosed with the disease, the itching will cease soon after starting chemotherapy or radiation therapy. 

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Thyroid disease

“Thyroid disease, whether it’s overactive or underactive can cause weird sensations in the skin,” says Cameron Rokhsar, MD, associate clinical professor of dermatology at Mount Sinai Hospital and dermatologist and cosmetic surgeon at New York Cosmetic, Skin & Laser Surgery Center. “No one knows the association but it may be that the changes in the sweat glands can cause skin dryness.” Itchy, dry skin is more common in people who have hypothyroid, because skin tissue contains thyroid hormone receptors that are seeing diminished cellular activity in the absence of thyroid hormone.

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Allergies

Allergies are one of the most common chronic health conditions in the world. In fact, many skin allergies are classified under the umbrella term contact dermatitis, the itchy rash on your skin that you get when you come into contact with an allergen. Poison ivy, nickel, or compounds found in personal care items like baby wipes and makeup are just a few of the allergens that can cause contact dermatitis. Your dermatologist may stick patches on your skin with different compounds that are correlated to the most common allergens to pinpoint the root cause of your allergies. “It’s like a treasure hunt when we’re trying to look into all the products that people use,” says Dr. Suozzi. A strong topical steroid is prescribed for relief. Don’t miss these 8 signs your skin products are secretly damaging your face.

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Menopause 

If you’ve finally hit menopause, you may have noticed a sudden change in your appearance—including dry skin. The loss of estrogen, an essential building block for collagen production, leads to thinner, itchier skin due to a diminished supply of natural oils that keep your skin’s moisture intact. Maintain your fountain of youth with Aloe Vera gel or calamine lotion, which help hold water in your skin’s outermost layer to alleviate drying and itching.

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Breast cancer

Paget’s disease of the nipple is an incredibly rare form of breast cancer where cancer cells collect in or around the nipple. According to the National Cancer Institute, Paget’s disease of the nipple accounts for less than 5 percent of all breast cancer cases in the United States. The first sign is scaly, red, itchy patches around the nipple and areola. “Sometimes it’s misdiagnosed as eczema of the nipple,” says Dr. Suozzi. “But when it’s breast cancer-associated it’s unilateral.” Itchy skin isn’t the only sign of disease; here are the 10 subtle signs of disease that your feet can show. 

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You’re pregnant 

The American Pregnancy Association states that 1 in 150 women will develop pruritic urticarial papules and plaques (PUPP), an outbreak of itchy red rashes commonly seen on the abdomen, though they can also appear on your legs and arms. Most women can’t do much about the itch because the rash typically doesn’t develop until late into the third trimester when most medications are off limits. “It’s not proven but some people say [PUPP] can happen with multiple gestations like twins,” says Dr. Rossi. “And some people think it’s because the skin gets stretched out.” Fortunately, it’s harmless and goes away after pregnancy.

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Dermatographia

If after lightly scratching your skin, your fingernails leave thin, raised red welts on your skin that take 15 to 30 minutes to disappear, you may suspect dermatographia. Although the cause of this condition is unclear, the Mayo Clinic says it could be triggered by stress, infections, allergens, or medications like penicillin. “It’s an extreme skin condition, where your skin is sensitive to touch and releases too much histamine,” says Dr. Rokhsar. Areas of touch and clothing are the most susceptible to dermatographic flare-ups. It’s easy to diagnose but often goes undiagnosed because it’s not severe or bothersome enough for people to make an appointment with their dermatologist. If the itch becomes severe, your doctor can prescribe an antihistamine to relieve the inflammation. If this becomes a regular occurrence, ask your doctor if you might have histamine intolerance or even mast cell activation syndrome—both are conditions where the body fails to process histamine properly.

And should your itch not be due to one of these conditions, check out the 7 bug bites you should never ignore.

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Less than one quarter of stylists had received a request from a customer to check for skin lesions, yet more than half had referred a customer to a doctor to check an abnormal mole. About 40% said they rarely or never checked for skin lesions.

Overall, hairdressers said the top reasons they don’t check for lesions are: they lack training; they don’t have the confidence to recognize lesions; they’re unsure about the appropriate steps to take; and they don’t feel comfortable bringing up skin cancer with their customers. Hairdressers who had discussed skin cancer with clients were twice as likely as those who hadn’t to agree with detection training.

“Several patients have come to me and said their hairdresser or barber pointed out a mole or freckle, so they wanted to make an appointment, and at least half a dozen have been diagnosed with melanoma of the scalp from that experience,” said Dr. Neda Black of the Comprehensive Dermatology Center in Pasadena, California, who wasn’t involved in the study.

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Although scalp melanoma is less common than melanoma in other locations on the body, it’s often more severe and fatal because patients don’t notice dark spots or abnormalities on their heads, she said. Those who are active outdoors should get checked, especially since sun protection products aren’t typically marketed for or used on the scalp.

“My first patient who had this was a 30-year-old man who had just gotten married,” Black said in a phone interview. “We were able to cure him, but he would have died if his hairdresser hadn’t caught it.”

The Skin Cancer Foundation recently launched an education program called “Heads Up!” that promotes salon-held training sessions for skin cancer surveillance. Groups such as EyesonCancer.org have also started initiatives to train beauty professionals about different types of cancer, including massage professionals and nail salon aestheticians.

“Clients shouldn’t be shy about asking their hairdresser to check for anything abnormal,” Black noted. “About 99% of hairdressers feel honored to be asked and are willing to take a look.”

SOURCE: https://bit.ly/2YerIzY Journal of the American Academy of Dermatology, online July 17, 2019.

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