15 Questions You Should Be Asking Your Dermatologist
You probably don't think about it this way, but your skin is the largest organ of your body. Yes, the largest organ—and that organ is your first line of defense against chemicals, UV radiation, viruses, bacteria, and more.
As a result, it's also quite vulnerable.
Seemingly trivial things like water, bug bites, and sweat can have quite an impact on your skin health—like rashes and not-so-fun fungal infections—not to mention things you know are serious issues, like sunburns and skin cancer. To protect your skin, and yourself, make a yearly pilgrimage (at minimum) to your dermatologist to make sure your 'derma' is in tip-top shape.
But what to ask them? We talked to the country's top derms to compile a list of 15 key questions. Do so, and sweat no more!
What types of skin cancer am I most likely to get?
Different ethnicities are at higher risk for different skin cancers. Latinos, Chinese, Japanese, and Caucasians tend to develop basal cell carcinoma—the most common type of skin cancer. The second most common—squamous cell carcinoma—is more common among African Americans and Asians from India. Melanoma—the deadliest form of skin cancer, is uncommon among African Americans, Latinos, and Asians—but have a greater tendency to show advanced disease at the time of diagnosis than Caucasians. Sadly, melanoma, while rarer for these groups, is often more fatal.
Recommendation: Worried you might have something? Pay attention to your ABCDEs. Consider it a warning sign if you have a mole that is: Asymmetric, has an irregular Border, Color that is not uniform, a Diameter larger than a pencil eraser, or has Evolved in terms of size, shape, color. Don't miss our report on 50 Foods That Lower Your Cancer Risk.
Are there any changes in my moles, beauty marks, spots?
You're getting sun exposure even when you don't think you are. Cloudy days? Check. Snowy winter day? Check. Rainy spring day? Yes! UVA and UVB rays never rest, so it's essential that you stay on top of any sun spots or moles that look suspicious. It's important to be checked yearly to monitor any potential abnormalities—particularly because some skin cancers are not as directly related to UV ray exposure. In fact, in darker-skinned people are more susceptible to acral lentiginous melanoma, an especially virulent form of melanoma (the deadliest form of skin cancer) that typically appears on the palms of the hands and the soles of the feet. Bob Marley died from this type of melanoma when he was only 36 years old.
Recommendation: As soon as you notice something strange, be it a spot, dot, mole, or bump, hightail it to the dermatologist to have them check it out. And make yearly visits even if you don't have something odd. Early detection matters.
What is this bump/mark/nodule that won't go away?
Not a perfect rule of thumb, but bug bites and pimples generally go away within a month, whereas more serious conditions like basal cell carcinoma won't. An itchy spot that won't go away could be ringworm (no worm involved!) a common fungal infection, that's easily treated. Other skin disorders, like eczema or rosacea, while not curable, can be very well managed.
Recommendation: If you have a bump/mark/nodule that doesn't go away within a month: make an appointment with your dermatologist and get it checked out. If you have a condition like ringworm, it could be contagious—not a gift you'd want to pass on!
What's the best way for me to keep an eye on moles at home?
People of all ethnicities should do a monthly skin self-exam. Here's what you want to look for:
- Lesions that bleed, ooze or crust, don't heal or last longer than a month may indicate basal cell carcinoma.
- Growths or non-healing sores, and ulcerated sores next to areas of previous physical trauma, inflammation, or scars—especially if on the legs—may indicate squamous cell carcinoma.
Remember your ABCDEs—we can't recommend this enough, it just might save your life or the life of someone you love.
Recommendation: Any of these warning signs warrant a visit to the dermatologist. Skin cancer can be very successfully treated but is most curable when detected early!
How do I get enough Vitamin D while still being sun-safe?
There's a good reason why vitamin D is known as the "sunshine vitamin." This crucial vitamin is made when the cholesterol in your skin is exposed to sunlight, which is why getting enough sunlight is key for keeping optimal vitamin D levels in your body.
Essential for maintaining strong bones, vitamin D instructs the cells in our guts to absorb calcium and phosphorus—two of the most critical minerals for keeping our bones healthy. Mounting evidence indicates that several chronic diseases, including cardiovascular conditions and cancer, are linked to vitamin D deficiency according to the NIH. And it's estimated that at least 40% of American adults are deficient in vitamin D. (And no, you can't eat it. There are only a few types of food that contain any significant amounts of vitamin D—which is why getting sun is so important.) The most natural and efficient way for your body to make vitamin D is via sunshine-on-skin, though taking supplements can help, too. According to the Vitamin Council, Vitamin D3 is the best kind form of vitamin D supplementation to take.
So what's the best way to get enough sunlight for optimal vitamin D production while still be sun-safe? Numerous studies show that midday is the best time to get vitamin D. The sun is at its highest point, and your body likely manufactures vitamin D most efficiently at that time. But talk to your doctor about what the smartest sun-safe vitamin D plan is for you–there may be other factors to consider.
Recommendation: It has been suggested by some vitamin D researchers that to maintain healthy vitamin D levels, you should expose a good amount of skin (think shorts and tank top, or less…) to sunlight, without any sunscreen on, for 5-30 minutes at least twice a week if you are lighter-skinned; those with darker skin may need longer.
What are your favorite non-toxic sunscreens?
Ready to hit the beach, you pop into the drugstore to grab a quick bottle of sunscreen, only to confront a daunting wall of sun protection products. We've all been there, standing—for a long time—brow furrowed as you pick up bottle after bottle, trying to suss out which might be best for you.
So, which one to buy? Not all sunscreens are created equal. It's smart to talk to your derm about which one is the best for you. But before you show up for your appointment, do a little research. Conventional chemical sunscreens are chock full of potentially toxic chemicals like oxybenzone, octinoxate (octylmethoxycinnamate), homosalate, octisalate, octocrylene, and avobenzone—many of which are hormone and endocrine disruptors—which mimic the hormones our bodies produce. They can interfere with everything from fertility to our reproductive system to our metabolism—and are particularly bad for little ones whose systems are still developing. Smaller amounts can have a more significant negative impact on kids.
So what's the safest sunscreen? Mineral sunscreens, which use zinc or titanium dioxide, physically block UVA and UVB rays by sitting on top of the skin, whereas more dangerous chemical sunscreens actually absorb the rays.
Recommendation: Finding the right mineral sunscreen can take some trial and error. Some can be thick and leave a chalky white residue behind. And if you have sensitive skin, a smart pro-tip is to look for bottles labeled for kids!
How much sunscreen should I actually be putting on?
More than you think. Think shot glass: in order to really cover your whole body, you want to put on an ounce or so of sunscreen. And for the face? Think fingertip: you want 3 to 5 grams of sunscreen for optimal face coverage. And a word to the wise: don't forget to apply to the chest liberally, the scene of much sun damage (freckles, sun spots, and lines, oh my!) on so many people. Yes, it's more than you're likely used to, which is why it's essential for us to share. Talk to your dermatologist about what's right for you.
Recommendation: While a high SPF number may make you feel more protected, the Environmental Working Group makes the point that it's actually far better to apply a lower SPF sunscreen properly, than a higher SPF one lackadaisically.
Do people with dark skin still need sunscreen?
Think having darker skin means you don't have to worry about sun protection? Think again. People of all skin tones need sunscreen. Darker skinned people naturally produce more melanin, which is the pigment that gives skin, hair, and eyes their color. And it's true that the more melanin you have, the fewer UV rays penetrate your skin… but so is this: skin cancer and photoaging don't discriminate. "People who have dark skin tones often believe they're not at risk for skin cancer, but that is a dangerous misconception," says dermatologist Maritza I. Perez, MD, a senior vice president of The Skin Cancer Foundation. In fact, while the incidence of melanoma is higher among light-skinned people, a July 2016 study showed it is more deadly in people of color.
Recommendation: What type of sunscreen is best for those with darker skin? That's the million dollar question. Creams with physical sun blockers like zinc will look very white and ashy on darker skin tones. Not ideal. But we found one we like—called "Unseen Sunscreen" made by SuperGoop, an SPF 40 unisex product that goes on clear and feels like a skin primer since it smooths and mattifies. Ask your doctor if it might be right for you.
Where do you see signs of sun damage?
You are likely well aware of some of the damage done from not-so-protected days at the beach (hello, sun spots!) but skin cancer can appear in areas that don't often see the light of day. Think buttocks, groin, under fingernails, your scalp, on the bottoms of your feet… So it makes sense to have a dermatologist check you out—quite literally, from head to toe.
Recommendation: Total body scans are just that—be prepared to get into your birthday suit so that your doctor can make sure you don't have anything that's cause for concern. We want you to know what to expect so that you can be as comfortable going in as possible.
Can I go in the sun when taking this prescription?
Excited for summer and sunshine? Find out before you hit the beach if one of your medications could make you much more sensitive to sunlight, and cause you to burn more easily, a reaction known as photosensitivity. If you are on a drug that causes photosensitivity, beware: even a little sun exposure could give you a mean burn.
Recommendation: While your dermatologist is likely sun-cautious to begin with—it's essential to share all medications you are on to see if any of them might cause a reaction.
Should I use a water filter for my shower?
As we mentioned before, your skin is the largest organ of your body. Yes, the largest organ—which is why chemicals absorbed through the skin can enter the bloodstream quickly and impact our bodies. Unfiltered shower water can contain myriad chemicals, like chlorine, as well as some less-than-lovely bacteria and fungus from your shower head. And shocker: showering in chlorinated water may lead to more chlorine absorption than from drinking. In fact, a recent NIH study reports that you also have a higher lifetime risk of cancer and other health problems from bathing or showering in chlorinated water than from drinking it.
When selecting a filter, talk to your dermatologist to see what substances have been found in your area's water supply. Pick your shower filter accordingly to remove or reduce those specific contaminants.
Recommendation: Look at the Environmental Working Group's zip code by zip code tap-water database to learn more about the water in your area, and check out this comprehensive shopping guide for filters!
Is my diet affecting my skin?
You know the adage: you are what you eat. And this is as true for our skin as it is for our bodies. Sort of. Not enough research has been done yet to draw a definitive connection between particular foods and skin health, but this much is well known: a diet that keeps you healthy inside helps keep you looking good on the outside, and vice versa: if you eat poorly it will show up on your skin. Another simple rule of thumb: drink lots of water. Dehydrated skin can be dry, itchy, and dull looking—and overall tone and complexion may appear uneven, with fine lines more noticeable.
Recommendation: You can read about myriad food tips for your skin—from not overindulging on greasy foods like fries, to cutting out dairy products, or limiting sugar. These will work for some but not others. If you think your diet is affecting your skin, make an appointment with a derm and a nutritionist to see what's right for you!
What ingredients in skin products do I want to stay away from?
The United States is a country that regulates more or less everything, except for the personal care industry. Many potentially toxic chemicals abound in our beauty products. But there are things you can do to avoid these ingredients and choose products that are not harmful to your health. Look your products up on Skin Deep, a searchable database of 'toxicity' in beauty products, and talk to your doctor about the top ingredients to watch out for in your products.
Recommendation: If we had to pick one ingredient we want you to look out for, it's paraben. BreastCancer.org reports that this common preservative—used in foundations, body moisturizers, anti-aging creams, shaving cream/gels, shampoos, conditioners, and more—help prevent bacterial growth from forming. But parabens can act as endocrine disruptors by mimicking estrogen, which is of particular concern because excess estrogen can are linked to breast cancer. To be safe, be paraben-free. Check out this great guide to paraben-free, non-toxic beauty, and personal product options from Breast Cancer Action, it will help you make the healthiest choices.
Is it OK for me to pop a pimple?
With acne affecting up to 50 million Americans a year, according to the American Dermatology Association, this is a question we all have. And when it comes to zits, Murphy's Law is always in play: the more important the event, it seems, the more likely we are to get a pimple. And there it is, just begging to be popped. But should you do it? No, according to dermatologists. Why? While it may feel good to pop it, a lot can go wrong when we start picking at our face. We may squeeze before it's ready, driving the pus deeper into our skin—which just exacerbates things—causing more inflammation, or we might make a bigger wound that may take longer to heal than the original blemish. Some pimples are more ready to be popped than others. Talk to your doctor to see when you might be able to do some self-intervention, and when you should hold back.
Recommendation: If you just have to pop that pimple—check out the directions from board-certified dermatologist Meghan Feely, MD, FAAD, who practices in private practice in both New York and New Jersey, and is also an attending physician at Mount Sinai's department of dermatology, as shared by the ADA. Better guided than marred!
What treatments would work for my skin?
Everybody's skin is different, so what worked for your best friend, may not be the best option for you. One treatment may be amazing for your brother, mother, or colleague, while another will get you the results you want. It's essential to go into the dermatologist's office and share what your skin care concerns are, as opposed to rattling off a list of things you've heard about.
Recommendation: Find a doctor you feel comfortable with. A good dermatologist will carefully listen to your concerns and will make cautious and mindful recommendations that work for you.