Skin spots to look out for

Dr. Scott's Skin Spot Screening Spiel

Many people look at their skin and wonder "what the heck is that"?

Skin spots are normal for most people, some part of normal aging and some as a reaction to sun exposure.

The most common and harmless ones to see pop up are benign moles a.k.a. Nevi, little red dots called cherry angiomas and seborrheic keratoses which are lovingly called "senile barnacles" by some. These don't need anything done to them if they don't bother you.

The next step up are actinic keratoses which are pre-cancerous skin spots. They feel like rough, mostly flat areas usually on the head and arms/hands. These are easily gotten rid of with liquid nitrogen cryotherapy in clinic if there are just a few or a topical chemotherapy cream if there are a bunch.

Past that, the big things to look for are called the ABCDE's.

Asymmetry (good moles are generally nice and symmetric)
Borders (good moles you can usually tell right where they start and stop)
Color (multicolored usually isn't good)
Dimensions (try to keep them smaller than a pencil eraser)
Evolving (changing in size, shape, color, bleeding or itching)

Multivitamins

If you can get the lid off, you probably don't need them When I ask people if they are taking any vitamins, herbs or supplements, many people will say they are taking a multivitamin. When I ask them why they take it, I get a quizzical look most of the time. I think this is something that resonates from childhood and parental advice of the idea that we need vitamins to help our body develop. I'm not pediatrician so I can't speak to the effects on the developing child, but I will say that most non-pregnant adults without major medical conditions do not need extra vitamins. You'll be impressed by these labels promising 120%, 300%, 1200% of your daily dose of vitamin whatever it is, but the truth is that for most of these vitamins, if you take more than your daily dose your body needs, the rest just ends up in your urine. You are literally peeing money away in this case. There's been a new trendy vitamin every decade or so for the last 40-50 years; First it...

NSAIDs

Advil and Motrin are ibuprofen, then you have Aleve (naproxen). Those are the over-the-counter ones. Prescriptions are Mobic (meloxicam), nabumetone, indomethacin, Toradol (ketorolac), diclofenac, Lodine, and the list goes on. All of these medications are in a class called non-steroidal anti-inflammatory drugs (NSAIDs). I'm giving you this list because there is mounting evidence that these medications a) don't work as well as we'd thought and b) have some very serious long term side effects we're finding out more about. NSAID's act by reducing the amount of prostaglandins you make in order to reduce inflammation. However, prostaglandins have a ton of other effects and are involved in the maintenance of just about AIDs and also stronger if they are taken every day and/or around-the-clock. every other organ system that you have. The effect is stronger with higher doses of NS NSAID's work best and are best indicated for times when something is r...

Pain

Sorry to be a pain I would say about 90% of the comments I hear from people about their pain threshold is that they think they have a high pain tolerance. Which is statistically impossible unless I just attract people who have a high pain tolerance. We traditionally ask people to rate their pain on a 1-10/10 scale and while we hear a lot of 9's and 10's, I would say that, having been present for a number of them, a 10/10 would be giving birth to a first child. For those who haven't experienced that, my old psychiatry resident described it as "so if I lit you on fire and ran you over with my truck, you would not be in any more pain than you are now" (he was also a former Marine sniper which might explain that). But this is pretty pervasive throughout the medical system and got me wondering as to how people's understanding of what their pain threshold was matched up to what it really was. Fortunately, there were researchers who had a yen to poke peopl...

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