Red rash across face and cheeks
A permanent flushed rash across the bridge of the nose and cheeks may be a sign of lupus, a lifelong autoimmune condition which, among other things, causes joint and muscle pain and extreme fatigue. But not everybody gets the so-called ‘butterfly’ rash.
“The skin is involved in about two-thirds of people with lupus, but only about one-third develop the classic ‘butterfly’ rash,” explains a spokesperson for the charity Lupus UK. “Other skin changes include a widespread measles-like rash, patches of discoid lupus [inflamed sores] or small areas of bleeding into the skin. Thinning of the hair can also be seen at times of a flare of the disease. Lupus can have an impact on your quality of life, especially when multiple symptoms, such as joint pain, fatigue, mouth ulcers, headaches and many others, affect your daily life.”
What should I do?
Lupus often goes undiagnosed for years, due to lack of awareness and because symptoms can be misleading. If you’re concerned, speak to your GP and explain all the things you’re experiencing. Blood tests and a referral to a specialist can determine whether you have the condition. There’s no cure, but treatments and advice on managing lupus can make a real difference to quality of life and help prevent serious complications.
EXCESSIVE HAIR
Every woman has facial hair to some degree, but if this hair is excessive (known as hirsutism), most commonly affecting the upper lip/chin/sideburn area, it could be a sign of polycystic ovary syndrome (PCOS), an endocrine disorder (meaning it concerns hormones) which leads to a variety of symptoms and can affect fertility – irregular or absent periods are a key symptom. It’s characterised by multiple small cysts on the ovaries, though it’s important to note that not everybody with cysts has the syndrome and associated problems.
“One of the most common causes of excess hair on women [not just on the face, but the whole body] is PCOS, which affects one in five UK women,” says Rachel Hawkes, chairwoman of PCOS charity Verity (www.verity-pcos.org.uk). “Some of the other symptoms are acne, male pattern hair loss, irregular period cycles and weight gain [or difficulty losing weight].”
What should I do?
“PCOS is linked to long-term health risks like heart disease and type 2 diabetes, so if a woman has two or more of these symptoms, we’d recommend she talks to her GP,” advises Hawkes. “There’s no cure, however, PCOS can be managed and there is a lot of great information and support available.”
DARK PATCHES
“There are tons of different causes of dark patches,” explains Dr Adam Friedmann, consultant dermatologist at The Harley Street Dermatology Clinic. “Sun exposure can give you freckles, or dark patches called melasma, and this can be made worse by birth control pills and pregnancy, then there are age and liver spots.”
These are common and nothing to worry about, unless they become malignant. “If a freckle starts to get bigger with irregular colours, and looks different from the others, even if it’s still flat, it could mean it’s becoming cancerous,” says Friedmann.
Hyperpigmentation can also occur as a result of scarring, possibly from other skin conditions, like eczema and psoriasis.
It’s rare for hyperpigmentation to be a sign of illness, but in some cases, it could be linked with Addison’s disease, a condition involving the adrenal glands, which also causes fatigue, weight loss, sickness, joint pain and low blood pressure (“You normally notice this sort of hyperpigmentation around the mouth and possibly the tongue,” notes Friedmann), and acanthosis nigricans, dark, thickened patches that usually develop in armpits, groins and necks, can be a sign of underlying illness.
What should I do?
If you are concerned, speak to your GP, and any unusual changes in moles and freckles should always be checked. In most cases, dark patches are not a health concern, but if they’re causing distress or affecting your self-esteem, speaking to a dermatologist for advice could be really helpful.
REDNESS
The beauty industry and lay population often refer to a flushed complexion as rosacea, but for many people, rosacea is a real skin disorder which can have a big impact. “As dermatologists, we talk about acne rosacea,” says Friedmann. Though not every case is the same, symptoms include spots, thickening of the skin, sore, dry eyes and a rash-like flushing/redness. “Over time, if left untreated, the redness can become permanent and disfiguring. You can also get dilation of the blood vessels, and in worse cases, dilated lymphatics which is associated with reddened, facial swelling like rhinophyma, an enlarged, swollen, red nose,” explains Friedmann. “But this is thankfully rare and happens after years of not seeking treatment.”
Facial redness can also occur due to long-term sun exposure, mild eczema, dermatitis and scarring, or spontaneously with no underlying cause/problem.
What should I do?
If you’re suffering from acne rosacea, speak to your GP or see a dermatologist; treatments and advice can make a big difference. If permanent redness with no underlying cause is still causing distress, there may be things, like laser treatment or camouflage products, which could help.
BULGING EYES
Of course, some people’s eyes are naturally more bulbous, but if your eyes have started to protrude more than usual, and are bulging out of your eye sockets, it could be a sign of illness such as Graves’ disease, an autoimmune disorder and the most common form of overactive thyroid. Eyes may also become inflamed and painful, with possible double vision and increased sensitivity to light, too. Other symptoms of Graves include anxiety, weight loss, palpitations, hand tremor, frequent bowel movements and an enlarged thyroid gland (where the front of the throat/neck bulges out).
Other things that may cause eyes to bulge include injuries, infection and tumours.
What should I do?
Get things checked with your doctor so, if necessary, you can be referred for appropriate tests and treatment. If you’re experiencing other symptoms that may indicate thyroid imbalance, writing everything down in a diary might help build up a clearer picture.