Specialist Answers Related to Skin Problems

Flesh-colored bumps around the eyes can be caused by several conditions. The most common growths that appear in this area are syringomas, which are benign collections of sweat glands that accumulate over time. They generally appear in early to middle adulthood and are most common on the lower eyelids, but they can also appear on the upper lids, the cheekbones, and the sides of the nose. While some cases are hereditary, most of the time the cause is unknown. Syringomas tend to grow slowly and multiply over time but are usually asymptomatic. Depending on their size and location, they can be treated with lasers, electric cautery, or chemical peels, all of which help smooth out the bumps. Large syringomas (the size of a grain of rice or larger) might require surgical excision. However, syringomas tend to grow back, so treatments may need to be repeated a few times a year.

Milia are also commonly found around the eyes. These are hard, round cysts that contain oil and keratin (dead skin) and are sometimes associated with the use of heavy eye creams. Pinpoint-sized milia may resolve on their own, or they may respond to gentle scrubs and exfoliation; larger cysts may need to be drained.

Another possibility is xanthelasma, which are localized deposits of fats that collect in the skin of the upper and lower eyelids. They can be skin- colored to yellowish and are associated about half the time with elevated blood lipids (fats), including cholesterol and triglycerides, which may be a sign of diabetes. Removal usually requires electric cautery or surgery.

I suggest a visit to a dermatologist or an oculoplastic surgeon (a plastic surgeon who specializes in the eye area), who can examine your skin to diagnose your condition and recommend the best treatment for you.

Q2. I slammed my finger at work, and it bruised pretty badly. Now I have a big bump on the top left portion of my index finger. My doctor tried to lance it, and it went down for a while but then it grew back. Then he cut it open and started snipping stuff out and said it looked like scar tissue. He said he didn't want to go too far down because he didn't want to cut my tendon. Do you have any idea what this could be? Will it ever go away?

— John, South Dakota

I am concerned by your story and would recommend you see a hand specialist to clarify what the problem is. While it is possible that you have a condition related to scar tissue, the accumulation of fluid, and other cellular debris from the original injury, I would also be concerned that there are other issues that may require different treatment approaches.

One of those possibilities would be injury to the underlying tendon and the formation of a cyst that is actually connected to the tendon. Injuries to the tendon may result in long-term loss of function so early identification and treatment is important. Orthopedic surgeons and plastic surgeons most commonly deal with problems such as yours, and I would recommend you obtain a consultation.

Q3. I get red, dry bumps on the tops of my arms. I think it's dry skin. What can I do?

— Lena, Ohio

Red, rough bumps on the top of the arms are most likely due to a common condition called keratosis pilaris. In certain individuals, the skin overproduces the protein keratin, which makes up your hair and outer layer of skin. Tiny plugs of keratin (bits of dead skin) can clog the hair follicles, producing small bumps resembling "chicken skin." These can range from a few dry bumps to large, rough patches of skin. The most commonly affected areas include the tops of the forearms and thighs, the back of the upper arms, the sides of the hips, and the cheeks.

Although we don't know exactly why keratosis pilaris occurs, it does seem to have a hereditary component. It often runs in families, and it can be associated with atopic dermatitis (eczema), asthma, and seasonal allergies (hay fever). It usually looks and feels worse in the winter, when skin becomes drier and there's less humidity in the air.

The following tips can help minimize the appearance of keratosis pilaris:

  • Because dry skin aggravates the condition, keep your skin well-moisturized. Look for a body lotion that contains lactic acid to help soften and smooth rough bumps. The best time to apply this lotion is right after you get out of the shower or bath. Pat dry with a towel, and apply lotion liberally to lock in moisture. Try AmLactin or Lac-Hydrin Five, available at most drugstores.
  • While you can't scrub off the bumps, it is a good idea to gently exfoliate with a washcloth, loofah, or body scrub once or twice a week — but no more than that — to help loosen the plugs and remove dead skin. Look for scrubs that contain smooth beads that won't irritate your skin. Avoid scrubs made with walnut shells, apricot seeds, or salt, all of which can scratch your skin and make the bumps more angry-looking.
  • Resist the urge to pick, squeeze, or overscrub your skin. Picking the bumps will make them scab, which can leave dark marks and possibly permanent scars.
  • For stubborn cases, see your dermatologist, who might recommend prescription-strength topical medications (such as urea or Retin-A) or a mild chemical peel to help unclog the follicles.

Q4. I'm a 39-year-old woman with a new skin problem. When the weather started getting warm, I began breaking out in little red bumps across my chest, forearms, and hands. I've been on the birth control patch for about five months, and I've heard it can cause a rash. Is there a connection, or could it be some kind of sun allergy?

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