Primary care_Skin issues_a woman's jaw

7 skin issues to discuss with your primary care provider

From acne to eczema, your primary care provider can address most skin-related health issues
October 21, 2019

Your primary care provider is often the first person you see when you have a health question. Compared to specialists, they are often easier to visit on short notice. Furthermore, they are usually less expensive, with or without health insurance. However, there is another important reason he or she should be your first stop, especially if you have a skin-related question.

“Your primary care provider should be involved in all aspects of your care,” said Grady Hogue, MD, family medicine physician and clinical assistant professor at the Texas A&M College of Medicine. “Whether or not you see a specialist, your primary care provider should have a strong baseline understanding of the care you are receiving and how it intertwines.” He notes this understanding is especially important with regard to skin because certain health conditions can first manifest through a skin-related symptom. Hogue explains that when in doubt, ask your primary care provider about a skin issue, because they can may be able to address it in-house; otherwise, they will know to direct you to the appropriate specialist.

Irregular or abnormal skin spots

Whether sun damage, a non-cancerous spot or an instance of skin cancer, your primary care provider can diagnose and possibly treat any irregular spot on your skin. To diagnose the condition, they may need to perform a skin biopsy, or a small procedure where a health care provider removes a sample of skin for testing. The sample is analyzed in a laboratory to check for the presence of skin cancer, infections or various skin disorders like psoriasis. Depending on the size, location and possibility of scarring, your provider may redirect you to a dermatologist and/or plastic surgeon for a more specialized biopsy and removal procedure.

“If you notice a spot on your skin that is asymmetrical with irregular borders, non-uniform in color, larger than the size of a pencil eraser or changing in shape, then call your provider,” Hogue said. “Those characteristics are suggestive of possible melanoma, an aggressive type of skin cancer, and you need to consult a health care provider.”

Hair loss and abnormal hair growth

“The initial conversations about hair loss can by done with a primary care physician,” Hogue said. “Hair loss can be caused by a multitude of issues. He or she can help you find a cause and either offer treatment in-house or direct you to a specialist.”

The American Academy of Family Physicians notes the following as common reasons for hair loss.

Similarly, your primary care provider can assist if you experience abnormal hair growth. “Much like unexplained hair loss, abnormal hair growth can often suggest a medical condition,” Hogue said. “For example, women may notice facial hair, which may suggest a diagnosis of polycystic ovary syndrome.” If you notice a change in your hair—whether growth or loss—ask your primary care provider.

Nail fungus

“Much like hair, nail health can be an important indicator of overall health,” Hogue said. “If your nail has fungal infection, your provider may prescribe an oral antifungal drug to treat it grows out.”

Nails with a fungal infection may appear discolored—yellow or brown—as well as thick and easily breakable. People with diabetes, a weakened immune system, blood circulation problems and athlete’s foot—ringworm on the foot—may be more likely to get a nail fungal infection.

Eczema

Eczema, or atopic dermatitis, is a common skin condition that makes your skin red and itchy. This long-lasting skin issue does not go away completely. It can periodically flare by appearing and reappearing on various parts of the body. Common symptoms of eczema are dry skin, small and raised bumps and discolored patches. Associated conditions may include hay fever and asthma.

“Many people ask their primary care provider about eczema, or dry skin,” Hogue said. “Your provider can work with you to find ways to prevent flare ups. In some cases, they may also prescribe a topical ointment or moisturizer to help manage symptoms.”

Rashes

“Often people see their primary care provider when they have an unexplained rash,” Hogue said. “Rashes can be caused by a wide variety of issues. Therefore, it is best to have him or her find the root cause and suggest a treatment.”

Rashes can be signs of an illness or viral infection. However, they can also be caused by something as simple as an allergy to something you came in contact with. Unless the rash is life-threatening or covering a significant part of the body, your primary care provider can help you find the best course of treatment.

Mole, wart and other skin lesion removals

Most skin lesions—an area of the skin that is different from the surrounding skin—can be easily removed in your primary care provider’s office. However, depending on the size and location, they may refer you to a specialist for the removal. Two common skin lesions seen in the primary care practice are moles and warts.

“The majority of moles are harmless; however, some types of moles increase the patient’s risk for developing skin cancer,” Hogue said. “If you notice your mole is changing, bleeding or asymmetrically shaped with multiple colors, then ask your provider.”

Similarly, your provider can remove a wart through a variety of techniques like salicylic acid, freezing through cryotherapy and even injections to remove the tissue.

Acne or rosacea

Although acne and rosacea can be treated by over-the-counter medications, some patients may still need help from their health care providers to manage symptoms. “Treatment for both of these skin conditions should involve proactive as well as reactive efforts,” Hogue said. “Your primary care provider can help you identify triggers. He or she can also help you craft a lifestyle that avoids those triggers.”

Similarly, your provider can prescribe medications specific to your skin and severity of the flare up.

The big picture

The skin is the largest and most visible organ in the body, so it is important to involve your primary care provider in your skin care. “If you have a skin condition, you always have to think if it is connected to something else,” Hogue said. “To name a few, Crohn’s disease, celiac disease, diabetes and lupus all have skin symptoms. An issue with your skin may be the first sign you get that you have a bigger health issue.”

— Mary Leigh Meyer

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