Health, skin deep

skin-deepThe skin is the largest organ – about 20 feet long if laid flat – and a very public venue where you willingly and unwillingly express emotions.

Psychological stress can exacerbate skin disorders, including hives, eczema, psoriasis, urticaria (itching), acne and rosacea. Tens of millions of Americans suffer from chronic skin ailments, and one of the most serious is cancer.

Psychological stress can exacerbate skin disorders, including hives, eczema, psoriasis, urticaria (itching), acne and rosacea. “It is very common for my patients with psoriasis or eczema to have a bad flare of their disease during a stressful life event, such as caring for a sick family member or the death of a loved one,” said Carmen A. Traywick, M.D. of May River Dermatology.

Tens of millions of Americans suffer from skin ailments and two of the most serious and common are basal and squamous cell cancers which usually form on the head, face, neck, hands and arms. Another type of skin cancer, melanoma, is more dangerous but less common.


Childhood sunburns are a big risk factor for skin cancer, according to the U.S. Centers for Disease Control and Prevention (CDC). Enduring one or more blistering sunburns in childhood or adolescence more than doubles a person’s chances of developing potentially-deadly melanoma later in life. Skin cancer knows no boundaries.

“The incidence of all types of skin cancer is increasing due to exposure to the sun and genetic factors. We now know that people who regularly use tanning beds have a 40 fold increase in the incidence of melanoma,” said Dr. Traywick.

Everyone should be checked for skin cancer with regular examinations of the skin for any new or unusual growths or changes in existing moles. If you find anything suspicious, you should discuss it with your primary care physician, a dermatologist (skin doctor) or a health care professional who is qualified to recognize the signs of skin cancer and diagnose the disease at an earlier, less invasive stage. Dermatologists have an extensive knowledge of skin ailments and the healing process. Treatment options include scraping, freezing, burning, radiation, and excision. But once a skin cancer becomes invasive, surgery is the treatment of choice.

Two types of surgical procedures are available for treating skin cancer: the standard incision and Mohs Micrographic Surgery. “If the cancer is in a sensitive area like an eyelid or the tip of a nose, the standard incision is not the best option,” said Oswald L. Mikell, M.D. of Dermatology Associates of the Low Country who performs micrographic surgery right here on Hilton Head.

“Mohs performed by dermatologists treats skin cancers in cosmetically sensitive areas and offers the highest cure rate,” said Dr. Traywick who also performs Mohs.

With almost a 100% cure rate, the most effective surgery for skin cancer in high-risk areas like the head and neck, eyes, ears, lips and nose is Mohs micrographic surgery. “You wouldn’t want to take a big chunk out around your eye and have a sagging eyelid if you can avoid it,” said Dr. Mikell. Mohs is also recommended for recurrent tumors, large or irregular tumors, aggressive and rare tumors. The procedure ensures the removal of all affected tissue while leaving healthy skin intact, resulting in faster healing time, less scarring and a low probability of the cancer returning.

“Once you are sure the cancer is gone, you want to go in and follow-up with the best cosmetic technique to close,” said Dr. Mikell.

Everyday Skin Care

Another skin care concern is dehydration. Too much sun dries out your skin and makes it prone to the signs of dehydration: tightness, irritation, flakiness and dry lines. To protect the skin, sunscreen should be applied each morning.

In addition to reactions to the sun, skin is also sensitive to personal and environmental triggers. Environmental triggers could be a bad smell, pet hair or exposure to an allergen, germ or poison.

Personal triggers could be anything from the stress of giving a speech or finishing a project with a deadline. The interaction between the mind and the skin is powerful.

In fact, the mind may exert a greater influence on the skin than any other organ. Like your body’s other organs, the skin communicates with the brain and immune system.

Under stress, the brain directs blood flow and nutrients to vital areas of the body. “Non-essential” organs, such as the skin, receive less blood flow and nutrients, including oxygen. Chronic environmental or psychological stress may accelerate aging, making skin less supple, less hydrated.

Premature aging skin also may be accelerated by UV light, poor nutrition, and genetics, smoking and drinking alcoholic beverages. The most obvious signs of skin aging are wrinkles and sagging skin.

Every day tens of thousands of dead skin cells shed as tiny flakes to allow cells at the bottom of the skin’s epidermis to grow, move to the surface and differentiate into new skin cells. The constant renewal maintains the skin’s permeability barrier to prevent dehydration and protect against environmental irritants.

Research shows that environmental and psychological stress can delay the rate of waste removal from tissues and slow down skin cell turnover, so the fresh epidermal cells take longer to reach the skin surface, making the skin more vulnerable to environmental pollutants and germs. Dr. Traywick said, “Dermatologists can offer many treatments to help with this and other problems due to aging skin including topical treatments, lasers and other light-based procedures.”

The best prevention for skin ailments and disease is avoiding the sun, managing stress, good nutrition, and seeing your dermatologist on a regular basis to check for suspicious moles in places on your body that you can’t see. He or she can also suggest anti-aging products that you can’t find over-the-counter.

American Society for Mohs Surgery, American Board of Cosmetic Surgery, American Board of Dermatology, Physician of the Year 2008 (Awarded by the S.C. Dermatological Assoc.)

Board Certified Dermatologist, Fellow American Academy of Dermatology, Fellow American Society of Mohs Surgery, Member of the American Society of Dermatologic Surgery