Saturday, December 31, 2011

Skin Lumps? Strange Bumps? - Identifing Cysts, Warts and More on Your Body

Discovering a lump anywhere on your body is scary, and it’s difficult not to assume the worst. From bumps on our breasts and feet to our head and eye, could they be serious? To cut the worry, check out our guide to bumps women can get and learn when you should see a doctor...

You’re soaping up in the shower when your hand rubs over a new lump in your breast. That’s strange, you think. Could it be cancer?

Relax. Most bumps and lumps on your body are harmless, says Mary Jane Minkin, M.D., a board-certified obstetrician-gynecologist and clinical professor at Yale University School of Medicine in New Haven, Conn. As long as it’s not causing a lot of pain, watch a bump for several days to see if it vanishes on its own, she advises.

“Cancer doesn't disappear,” she says, “so if it goes away, it was nothing worrisome.”

Still, when women find a bump, they assume the worst. Here’s a guide to when to worry and not.

Breasts
Most women who feel a lump in their breast automatically assume it’s the Big C.

“The vast majority of lumps aren’t breast cancer,” says Debbie Saslow, Ph.D., director of Breast and Gynecologic cancers for the American Cancer Society.

Most are abnormal growths that aren’t life-threatening, Saslow says.
Fibroadenoma: These round, hard noncancerous lumps usually occur near the nipple and feel smooth and solid like a marble – and move like one too. Their cause isn’t known, but they’re common in teenagers and young women, says Saslow.

If you’re young, fibroadenomas are usually left alone. “But in middle-age and older women, they’re often surgically removed just to make sure there's no cancer there,” she says.

Cysts: Among the most common causes of breast lumps, these harmless, fluid-filled sacks typically occur in women 30-50 years old. They can come and go with your period and usually aren’t dangerous.

“When close to the breast’s surface, cysts feel smooth on the outside and liquid on the inside,” Saslow explains. “[Deep] cysts will feel hard.”

They’re often diagnosed by ultrasound and/or by fine needle aspiration. During the outpatient procedure, a thin needle is inserted into the lump to remove fluid for testing.

Intraductal papilloma: These small, difficult-to-feel but harmless growths are found inside milk ducts. They frequently occur near the areola (the darkened skin around the nipple) in women 35-55 years old. In some cases, their only symptom is a watery, pink or bloody discharge from the nipple, which is why you should see a doctor.

“Nipple discharge [is also] a sign of breast cancer,” Saslow says. “The evaluation may be just imaging, but usually includes a biopsy.”

Cancer: Most cancerous lumps occur in women over 40. Although the disease can strike any part of the breast, it often lodges in its upper quarter, including near the armpit.

In rare cases, other symptoms – redness or dimpling of the skin, an inward-turning nipple or discharge – indicate inflammatory breast cancer, a rare but fast-growing cancer, says Saslow.
If you have these symptoms, see a physician quickly.

If you spot a new or old lump that has grown or shrunk, tell a doctor right away. They’ll probably give you a breast exam and may recommend diagnostic tests, such as a mammogram, ultrasound or fine-needle biopsy.

When to worry: See a doctor if you feel a single, dominant lump, unless it’s a cyst that comes and goes with menstrual cycles, says Saslow.

“These are usually the size of a grape and are distinct from the rest of the breast tissue.”

Feet
One of the most stressed parts of a woman’s body is a prime spot for skin lumps.

Bunions: Blame killer shoes for these large, bony growths that are common to women. They develop at the outer base of the big toe, causing it to slant in and the joint to jut out.

You can keep them from getting worse – and painful – by wearing roomy, cushioned shoes and orthotics (inserts that relieve pain). A podiatrist also may prescribe stretching exercises and a bunion splint to be worn at night. In severe cases, a surgeon can shave them down.

Bone spurs (osteophytes): These often develop at a joint, like the ankle, but the bony bump can also appear on heels.

Your body commonly creates them to stabilize a joint, or they can be caused by osteoarthritis, a condition in which the cartilage cushioning your bones wears down.

Bone spurs can trigger corns and calluses, your body’s reaction to reduce friction. They usually don’t require treatment unless they’re painful. Then over-the-counter anti-inflammatory medications or cortisone injections can help.

If it's a severe, painful lump, it can be surgically removed.
Plantar warts: These skin growths typically form beneath the pressure points on your feet – the heels or balls – but they can also appear on the side of your heel or bottom of a toe.

These skin lumps feel like hardened skin and sometimes have small clotted blood vessels that look like dark pinpoints.

They’re caused by certain strains of the human papilloma virus (HPV) – not the kind responsible for cervical cancer – and spread by contact with the virus (for example by walking barefoot in moist, public places like the gym shower room).

An over-the-counter (OTC) wart remover with 40% salicylic acid can remove them.

“To get the best results, apply salicylic acid every day for several weeks,” says Howard Sobel M.D., a clinical attending physician in dermatology and dermatologic surgery at Lenox Hill Hospital and Beth Israel Medical Center in Manhattan. It will vanish in 7-12 days.

OTC wart-freezing remedies are effective for one or two warts, says Sobel. “But if you have multiple warts or those that don’t respond to OTC medicine or you’re not sure it’s a wart, see a dermatologist,” he says.

A doctor can quickly remove them by freezing with liquid nitrogen or by cutting them out.

When to worry: If it’s painful and limits daily activities, head to a podiatrist.

Hands and Fingers
Like your feet, your hands work hard and can be beset by mysterious protrusions.
Ganglion cysts: These common bumps form near tendons or joints. They can be round, hard or soft, and filled with a thick liquid, a joint lubricator (not pus) that has leaked. The (mostly) painless cyst is a protective swelling that forms around the liquid.

Don’t pop a ganglion cyst – it can trigger an infection – and the body will eventually reabsorb the fluid. Instead, take an OTC anti-inflammatory such as aspirin or ibuprofen.

When to worry: When signs of infection, such as swelling or redness, appear.

Head
Most head bumps are harmless and go away on their own, says Sobel.

Sebaceous cyst: A painless, smooth lump, this is caused when glands producing sebum (an oily substance secreted with sweat to protect skin) get clogged.

Typically, they’re no larger than 5 centimeters and are harmless. These skin lumps are surgically removed or drained only when they interfere with daily activities, such as brushing your hair, or if they become infected, Sobel says.

When to worry: If you have pain, which can signal an infection or cancer.

“Approximately 20% of melanomas originate on the head and neck, so have this often-overlooked area checked if you have any bumps or lumps,” Sobel says.

Neck
“Normally, the nodes under your neck – right near your jaw – are about the size of fingernails,” Sobel says. “With an infection, they can swell to 2-3 times their usual size."

That’s normal – it’s your body’s reaction to the invaders.
But if the nodes change shape, it could mean an inflammatory disease or even cancer, Sobel says.

A lump in the front of the neck is a symptom of an overactive thyroid (called hyperthyroidism), in which the gland produces too much thyroid hormone. It’s usually accompanied by other symptoms, such as sudden weight loss and a rapid or irregular heartbeat. A blood test can diagnose it.

When to worry: If the swollen lymph node grows more than 1 inch or remains larger than a half-inch for more than a month, see a doctor.

Call a doctor immediately if:

It grows more tender

It gets red streaks

You develop a rash or high fever

The node’s size impairs movement, breathing, or swallowing.

These signal a range of diseases, including strep throat and viral mononucleosis, Sobel says.

Your Bottom
Painless lumps in your nether regions are often harmless, says Minkin. They range from annoying to painful to – in the case of herpes – contagious.
Ingrown hairs: They’re caused by strands that break off from shaving with a dull razor or waxing. They can lead to large, red, painful bumps that can turn into boils – infections involving entire hair follicles and nearby skin tissue.

The best way to treat an ingrown hair or boil is to apply heat on the spot with a washcloth soaked in hot water.

“Heat increases circulation to the area, allowing the body to better fight off the infection,” Sobel says.

It also softens the skin around the trapped hair, allowing the hair shaft to break free and stop irritating the skin.

If you have a large boil, a doctor will need to drain or lance it.

Acne: It’s often caused by skin glands that produce too much oil and clog pores. Other culprits include heat and humidity, tight pants and laundry detergent.

If the bottom breakouts are painful or irritated, see a dermatologist, who can prescribe an acne medication or wash.

Hemorrhoids: These are swollen veins in the lower portion of the rectum or anus and they’re often caused by pregnancy, pushing down during bowel movements or excess weight.

Hemorrhoids itch and ache, especially when you’re sitting. And you may notice bleeding when using the bathroom.

If you have blood in your stool, even if it’s caused by hemorrhoids, tell your doctor. Rectal bleeding is a sign of colon cancer.

Hemorrhoids can be treated with OTC corticosteroid cream. If the condition is severely painful, they can be surgically removed.

To prevent them: Drink more water, eat more fibrous foods and avoid straining during bowel movements.
Bartholin’s cysts: These painless lumps are caused when the glands that lie on each side of the vaginal opening to lubricate the vagina become clogged and swollen.

To treat them, soak in a warm bath a couple of times a day for a few days.

“The cysts may spontaneously drain that way,” Minkin says. “If they persist and are painful, you may need to have them drained, which can usually be done in a doctor’s office.”

If the cyst is infected, your doctor may prescribe antibiotics.

Herpes: This serious viral infection requires medical attention. The virus enters your body through small breaks in the skin or the mucous membranes found around the vagina and anus, and it’s usually transmitted from sexual contact.

Look for painful lumps, red, itching blisters or clusters that look like a tiny cauliflower on your genitals.

“The one thing that usually differentiates herpes [from other bumps] is that it really hurts,” Minkin says.

A blood test can confirm herpes. There’s no cure for this recurring infection, but you can control outbreaks through prescription antiviral medication, such as acyclovir.

When to worry: If you suspect a herpes outbreak, see your physician immediately. Herpes is contagious – and dangerous if you’re pregnant.

“Genital herpes can cause potentially fatal infections in infants as well as neonatal complications and premature birth,” Sobel says.

Eye
A lump that develops near the eye is usually a stye or a chalazion.

Stye: An infection, this causes a tender red lump that resembles a pimple around the edges of the eyelid.
Chalazion: This hard lump crops up on the upper or lower eyelid when oil in a gland becomes too thick and clogs, Sobel says.

It may be painful, or you might notice the eyelid is red. In rare cases, the bump can be cancerous.

To treat a stye or chalazion, apply a hot towel compress to the bump 3-6 times a day for 3-4 days to help open up the blockage. Most of the time, they’ll disappear in a few days.

Don’t squeeze or pierce them. If they don’t improve with home treatment, a prescription antibiotic eye ointment or drops may help.

When to worry: See a physician if the lump doesn't respond to care or if your vision changes.

Women’s Health: How Much Do You Know?
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