probably unreasonably nervous about blotchy skin

April 17, 2012 6:33 AM

YANAD, but do I need to be worried about these skin blotches?

About 3 months ago I noticed that I was developing some slightly darker skin blotches on my face (about the color of my freckles). They look kind of like birthmarks to me, except that I'm a bit too old for that; when I originally noticed them I thought I had some dirt on my face or something. They're not raised in any way, and the largest has about the surface area of a dime. I'm very conscientious about wearing sunblock, at least on my face, so it doesn't seem likely that they're to do with the sun, although I guess it could be older sun damage just showing up now.

I'm between jobs and won't have health insurance for another month and a half, so I can't afford to go see a dermatologist unless it's really urgent. Is this something I need to be worried about? And if it doesn't require medical treatment, bonus question: is there anything I can do to get rid of the blotches?

posted by SymphonyNumberNine to health & fitness (9 answers total)

I see you are female, so it might be hormonal. Are you taking an oral contraceptive? That will do it sometimes. Once you have health insurance, see your doctor, but don't lose sleep over it in the meantime. It could be a million things that are not serious in any way.
posted by ThatCanadianGirl at 6:41 AM on April 17, 2012 [1 favorite]

I have the opposite opinion: It could be a million things that ARE serious. See a doctor as soon as you can; skin stuff is/can be pretty serious.

I think another month and a half will be okay, but don't wait a day longer than you have to. Can you schedule something now so that you can go in the very first day your insurance kicks in, instead of waiting until you have insurance before you schedule something? I am not sure about your area, but in my area dermatologist appointments are usually made a month out or more.
posted by TinWhistle at 6:52 AM on April 17, 2012

Seconding TinWhistle's advice; many dermatologists have a wait list that's weeks to months long and don't really take urgent/emergency appointments. Go ahead and call now so you can ensure an appointment as soon as you do have insurance.

In the meantime, take good clear photos of the blotches, and try to get accurate measurements of them. This will be super helpful for your dermatologist to see, especially if they change size or color between now and then.
posted by Metroid Baby at 7:11 AM on April 17, 2012 [1 favorite]

I am on Nuvaring, and was told that this is a common side effect. I am also very conscientious about wearing sunblock, but it doesn't matter. Can you get rid of them? Not that I'm aware of.
posted by bolognius maximus at 7:17 AM on April 17, 2012

It would be a million things, but the most likely thing it sounds like is melasma. Hormonal changes of all kinds (going on or coming off hormonal BC, pregnancy, etc.) can trigger it. There are OTC treatments that may have some modest, gradual effects if used regularly. I've read that using a sunscreen that contains a physical barrier (zinc oxide or titanium dioxide) is more effective in keeping sun exposure from worsening it. Most facial-specific sunscreens contain only a chemical barrier.
posted by drlith at 7:30 AM on April 17, 2012 [2 favorites]

Could be hormonal, could be sun damage or age spots. Some face creams now a days that have retinol or other chemicals in can actually increase your skins sensitivity to sun damage and spots. I've had blotches form from using sunspot fading cream (which worked great) then heading out to the garden for an hour one of the first sunny days we had this spring and all the spots are back with friends all because I forgot sunblock for an hour and my skin was sensitized.

See a doctor for any mystery skin changes. If it's not changing rapidly you can most likley wait until your insurance kicks in. A good family doctor would probably be able to tell you if you need to see a dermatologist urgently if that's still in your price range.
posted by wwax at 8:44 AM on April 17, 2012

Call the dermatologist now; his or her earliest appointment will almost certainly not be until after your insurance starts. You can wait six weeks for this, but I would try to get in as soon after that as possible.

Agreeing with drlith and bolognius maximus and ThatCanadianGirl that it's probably hormonal. I got something very similar after I started NuvaRing.
posted by Sidhedevil at 11:49 AM on April 17, 2012

I went to the dermatologist when my doctor diagnosed some basal skin cell weirdness on my chest. The derm doctor acknowledged the basal cell stuff, but in the course of the full body exam, noticed a collection of freckles on my forearm, frowned, and said "I don't like that."

I thought it was an age spot/liver spot -- there was no mass or elevation.

She took a biopsy, and called last week to say it was melanoma. However, it is stage 0 (melanoma-in-situ) and is quite curable. I get it surgically treated next week.

So yeah -- get it checked at your very earliest opportunity. Fingers crossed that it's hormonal, but you want to be sure. Don't fuck with melanoma.
posted by book 'em, danno at 1:59 PM on April 17, 2012 [4 favorites]

Agreed with Metroid Baby and book 'em danno, I would check against these warning signs for melanoma (see the link for photos):

A: asymmetry
B: border
C: color
D: diameter
E: evolving

from what you've related, it sounds like at least two of these are present with your spots, they are wider than the concerning diameter, and they are evolving. Yes, it could be melasma as well, but you will not know until you get it checked out, and melanoma is quite deadly. I would make the appointment - especially if you do not have any hormonal reason for melasma, and you have risk factors for melanoma like fair skin/freckles/family history - and I would not feel like I had wasted my money if I were told it was benign. Peace of mind is worth a lot.
posted by treehorn+bunny at 7:15 PM on April 17, 2012