Skin flare-ups can be miserable. Here’s exactly what you need to know to tackle them

Skin problems solved

There can be numerous reasons for rashes, itches and other annoying skin problems.

‘To get the help you need, start by looking at where your problem’s located, what it feels like, and when it occurs,’ says Dr Anthony Bewley, consultant dermatologist at Whipps Cross and St Barts NHS Trust.

1. Flaky, scaly, reddened skin

‘This is typical of psoriasis – especially if it’s on your elbows or knees,’ says Dr Bewley. ‘The normal turnover of skin cells speeds up, so new cells are produced and shed every few days instead of every few weeks. It’s exacerbated by stress, smoking and alcohol, and can often appear for the first time in your fifties. It’s usually slightly itchy.’

✔Help is at hand

‘Moisturising, barrier, anti-inflammatory, and tar creams from your pharmacist can all help,’ suggests Dr Bewley. For general skin advice, check out the new website at www.PSO-What.com, which is due to launch later this month.

2. Red, cracked & very itchy, weepy skin

‘It’s more likely to be eczema than psoriasis if it’s very itchy and weepy, and on the inner creases of your elbows and behind your knees,’ explains Dr Bewley.

‘It can be exacerbated by stress, but allergies can trigger it, too. Nickel is the most common culprit, causing patches of eczema on your ears if you wear nickel earrings, or your tummy if you have nickel in your jean studs. Hair dye and nail varnish can also contain ingredients that cause an allergic reaction.

Eczema on your face can be caused by touching your skin with painted nails.’

✔Help is at hand

‘Start with creams from your pharmacist, and if these don’t work your GP can prescribe something stronger,’ advises Dr Bewley. ‘Itching is often particularly intense at night, and antihistamine tablets from your pharmacy can help with this – and they’ll also help you sleep.’

3. Freckly patch

A new freckly patch or a freckle that’s grown in size must be checked. ‘It could be a form of skin cancer called lentigo maligna,’ says Dr Joanna Gach, consultant dermatologist at Spire Parkway Hospital in Solihull.

✔Help is at hand  

‘You must have it checked by a dermatologist who may need to arrange for a biopsy,’ adds Dr Gach. ‘If it’s cancer, the patch will need to be surgically removed.’

4. A scaly & circular patch on your groin

Sometimes also displaying yellow pustules, the circular patch screams ringworm. ‘It’s a fungal infection and can also crop up between your toes or under nails (where it causes thickening and crumbliness),’ explains Dr Bewley.

‘You’re more at risk if you use warm, damp gyms, locker rooms and public pools, or if you’re around children a lot. Having lowered immunity – for example if you have diabetes, or you’re taking drugs to treat arthritis – also makes you more susceptible.’

✔Help is at hand  

‘Treat with an anti-fungal cream from your pharmacy, or tablets prescribed by your GP,’ advises Dr Bewley.

5. Itchy white patch on your genitals

‘As you age, this can be a sign of lichen sclerosus, a condition that needs to be checked,’ says Dr Gach. ‘Untreated, it can develop into a problem that makes it painful to have intercourse or go to the loo – and can increase your risk of vulval cancer.’

✔Help is at hand

‘Don’t mistake your itch for thrush,’ warns Dr Gach. ‘This needs to be treated by your GP and dermatologist, usually with steroid and emollient creams.’

6. Intensely itchy rash of small red spots

‘Often mistaken for eczema, an extremely itchy rash is more likely to be scabies (caused by a burrowing mite) – especially if it’s between your fingers,’ says Dr Bewley.

‘It’s contagious, and caught by at least 20 minutes of skin-to-skin contact, so it’s often transmitted through sex (and can affect the genitals and nipples) but you’re also at risk if you’re a care worker looking after patients in a nursing home – or sharing a bed with someone who does this job.

‘The incubation period is six weeks, so, if you get this kind of rash, think about any contact you could have had that far back.’

✔Help is at hand

‘Your pharmacist can sell you an anti-scabies cream without a prescription,’ explains Dr Bewley. ‘But it’s important to be sure that this is what you have – if you mistake eczema for scabies, the anti-scabies cream will irritate your skin more. If in doubt, get your GP to diagnose it first.’

7. Itching without any rash

‘Washing too much – especially with foamy products containing sodium laureth sulphate (SLS) – can cause this itchy problem,’ says Dr Bewley.

✔Help is at hand

If you know SLS isn’t the issue, ask your GP to test your iron levels as itchy skin can be caused by a deficiency, says Dr Bewley. ‘Also, blood pressure medicines can cause itching. Or, you could have a problem with your kidneys, liver or thyroid, so you may need blood tests.’

8. A scab or sore that won’t heal

‘A scab that won’t heal, but keeps flaking over, might be a form of chronic sun damage called actinic keratosis (AK),’ explains dermatologist Dr Stefanie Williams. ‘AKs are often rough skin patches that keep scabbing over and won’t disappear with emollients or steroid creams. Do not ignore an AK as it has the potential to turn into a skin cancer.’

✔Help is at hand  

‘Always see a GP about a non-healing skin lesion,’ says Dr Williams. ‘They may treat it with a cream or send you to a dermatologist. Or, refer yourself to a private dermatologist.’

9. Hard skin on feet

‘Dry, hard skin on your foot could be a callus or a wart,’ says Dr Williams. ‘A callus (or corn if it’s on your toe) is usually caused by friction from wearing ill-fitting shoes and is your body’s attempt to protect your skin from blistering. A wart (or verruca) can look similar but
is distinguished by lots of tiny black dots caused by a virus.’

✔Help is at hand

Your pharmacist can sell over-the-counter treatments – but you need to know whether it’s a callus or verruca before you seek help. ‘If these don’t help, you may need a dermatologist-grade pedicure,’ adds Dr Williams.