Do you need a consultation?

Frequently asked questions from patients

How many sessions do I need?

In most cases, one session is sufficient. However, an annual treatment is necessary to maintain the results. 

¿Puedo hacer vida normal después del tratamiento?

Yes, but avoid sun exposure for 48 hours. There may be redness and mild peeling, but you can continue with your daily activities using sunscreen.

Is photodynamic therapy painful?

The LED lamp modality may cause burning or stinging, although we will use techniques to minimize this. The Daylight-PDT technique is less painful due to its gradual activation.

What care should I follow afterwards?

Apply moisturizer and sunscreen SPF 50+, avoid the sun and do not scratch the peeling skin. Recovery usually takes 7 to 10 days.

Cutaneous horn is one of those dermatological curiosities that often surprises people, especially those who have never heard of it. If you’re reading this, you’ve probably been diagnosed with this condition, know someone who has it, or simply found the topic interesting. Whatever the case may be, welcome. Here, I will explain what a cutaneous horn is, why it appears, and how it can be properly treated.

My name is Sebastian Podlipnik, I am a dermatologist at the Hospital Clínic of Barcelona, and I have spent years researching and treating various skin diseases, including those related to sun exposure and skin cancer. I have seen numerous cases of cutaneous horns, and my priority is always to ensure that patients understand what this condition is, why it occurs, and how to treat it effectively. 

In this article, I will share my experience with you in a clear way so that you can better understand what it is and what steps to take if you ever encounter this lesion.

What is a Cutaneous Horn?

A cutaneous horn is a skin lesion that appears as a rigid protrusion or growth primarily made of keratin, the same protein that makes up our nails and hair. Visually, it can resemble a horn emerging from the skin, which is where its name comes from. Although its appearance may alarm some, the cutaneous horn is not a disease in itself, but rather a manifestation of an underlying skin problem.

These lesions vary in size, with some being small while others can reach several centimeters in length. A cutaneous horn can appear anywhere on the body, although it is more common in sun-exposed areas such as the face, scalp, ears, and hands. It affects both men and women, although it is more common in people over 60 years of age. (Copcu et al., 2004).

Why Does a Cutaneous Horn Form?

A cutaneous horn forms due to an accumulation of keratin in the skin, but this buildup is not random. It is related to an underlying skin lesion. This is crucial from a dermatological perspective, because although the horn itself may not be dangerous, it signals that benign, precancerous, or even malignant conditions could exist at the base of the cutaneous horn. (Bondeson, 2015).

Is a Cutaneous Horn Dangerous?

One of the most common questions I hear in consultations is whether a cutaneous horn is dangerous. The short answer is: it depends. Not all cutaneous horns are dangerous, but some can be secondary to a malignant lesion. What really matters is the base of the lesion, as I mentioned earlier. Many cutaneous horns develop over benign lesions, such as seborrheic keratosis, which are not dangerous. However, in other cases, the cutaneous horn may form over an actinic keratosis (a precancerous lesion), or, in more serious cases, over a squamous cell carcinoma, a type of skin cancer. (Reddy et al., 2013).

Cutaneous Horn and Skin Cancer

Cutaneous horns are most commonly associated with malignant lesions in people over the age of 50, especially those with prolonged sun exposure. In fact, recent studies suggest that around 20% of cutaneous horns are related to skin cancers, particularly squamous cell carcinoma. Therefore, although it is not always dangerous, it is essential that any cutaneous horn be evaluated by a dermatologist to rule out serious issues. (Yu et al., 2019).

How is a Cutaneous Horn Diagnosed?

The diagnosis of a cutaneous horn is usually straightforward due to its characteristic appearance. However, it is crucial to perform a biopsy in most cases to evaluate the underlying lesion. Through the biopsy, we can determine whether the base of the lesion is benign, precancerous, or malignant, which allows us to decide on the most appropriate treatment. (Meyerson et al., 2017).

When is a Biopsy Necessary?

I recommend a biopsy in most cases of cutaneous horn, especially if the patient has a history of prolonged sun exposure or skin cancer. The biopsy not only provides an accurate diagnosis but also gives us peace of mind by determining if there is an underlying risk that needs to be addressed. (Morgan et al., 2020). In some cases, a dermatoscopic examination of the lesion can help us make an accurate diagnosis and avoid a biopsy. 

Treatment in Cases of Malignancy

When the biopsy reveals a malignant lesion, the treatment can be more complex. In some cases, a more extensive surgery (widening the margins) is necessary to ensure that all affected tissue is removed. This is particularly important in cases of squamous cell carcinoma. (Mounsey et al., 2018).

Treatment Options:

• Surgical Excision: The horn is removed along with the underlying lesion, and this is the method of choice in most cases.
• Cryotherapy: The lesion is frozen with liquid nitrogen to remove it. This is especially indicated if the cutaneous horn is related to benign lesions or actinic keratosis.
• Curettage and Electrodessication: It involves scraping the lesion and destroying the base with electric current. Like cryotherapy, it is reserved for cases of benign lesions or actinic keratosis.
• Photodynamic Therapy: It uses light and a photosensitizer to destroy precancerous cells and is used for premalignant lesions or squamous cell carcinoma in situ (located in the most superficial layer of the skin – the epidermis). (Simmons et al., 2017).

Prevention of Cutaneous Horn

Preventing the appearance of these lesions is closely related to sun protection. Most of the lesions that can produce a cutaneous horn are linked to accumulated sun damage, so protecting the skin is key to reducing the risk of developing cutaneous horns. (D’Orazio et al., 2016).

Prevention Tips:

• Apply sunscreen daily, even on cloudy days.
• Avoid sun exposure during peak hours.
• Wear protective clothing and wide-brimmed hats.
• Have regular dermatological check-ups, especially if you have a history of prolonged sun exposure.

Frequently Asked Questions About Cutaneous Horn

My Experience with Patients with Cutaneous Horn​

Throughout my career as a dermatologist, I have treated many cases of skin cancer and cutaneous horns. What I have learned is that early detection and treatment are key to preventing major complications. I advise my patients to pay attention to any changes in their skin, especially in sun-exposed areas, and to consult a dermatologist if they have any concerns.

Conclusion

A cutaneous horn may seem like a simple curiosity, but its evaluation and treatment are essential to avoid complications. Whether benign or malignant, it should be assessed by a dermatologist to ensure proper treatment. Remember that prevention, especially through sun protection, is your best tool to avoid this type of lesion.

If you have more questions about cutaneous horns or other dermatological conditions, feel free to leave your comment below, and if you have one, don’t hesitate to request a consultation. I’m here to help you take care of your skin.

When we think about caring for our skin, we usually consider sunscreen lotion as the first line of defense against sun damage. However, in recent years, a new strategy has been gaining attention: oral sunscreen. 

In this article, I’d like to delve into this complementary approach and explain how it can help you keep your skin better protected from sun damage. If you’re concerned about premature aging, sun spots, or even skin cancer, keep reading to discover how oral sunscreen can help in your skincare routine.

What is Oral Sunscreen and How Does It Work?

Oral sunscreen involves the use of supplements containing active ingredients that protect the skin from the inside against the harmful effects of solar radiation, especially ultraviolet (UV) radiation, but also visible light and infrared. These supplements include antioxidants, vitamins, and carotenoids, which act directly on our cells to reduce damage caused by sun exposure.

The mechanism of action of these compounds is quite interesting. They work primarily as antioxidants and anti-inflammatories. For example, they reduce the formation of reactive oxygen species (ROS), which are the molecules responsible for cellular damage and skin aging. Additionally, some of these ingredients help repair the DNA of cells and strengthen the skin’s immune response against sun damage. (Parrado et al., 2018).

Should We Call It Oral Sunscreen?

The term “oral sunscreen” may not be the most accurate in this context. When we think of sun protection, we usually picture the classic sunscreen that physically or chemically blocks UV rays. Oral supplements, on the other hand, do not directly block UV radiation. Instead, they protect the skin from within, helping to minimize cellular damage that has already occurred.

For this reason, I prefer to see oral sunscreen as a way to help the skin cope with sun damage rather than as a preventive barrier. The most common ingredients in these supplements, such as Polypodium leucotomos or nicotinamide, do not prevent exposure to UV rays. What they do is reduce inflammation, improve DNA repair, and decrease oxidative stress, all key factors in mitigating the cumulative damage caused by sun exposure.

Main Ingredients Used in Oral Sunscreen

• Polypodium leucotomos: This fern extract is probably one of the most studied and recognized for its antioxidant and anti-inflammatory properties. Additionally, it has been shown to help repair the DNA of damaged cells and may prevent sun-related skin disorders, such as photodermatosis. (Parrado et al., 2020).
• Nicotinamide (Vitamin B3): This compound has been shown to be highly effective in preventing non-melanoma skin cancers by improving DNA repair and protecting the skin from sun-induced immunosuppression. (Chen et al., 2014).
• Carotenoids: These are pigments found in brightly colored fruits and vegetables, such as beta-carotene and lycopene. Studies have shown that these compounds are effective in reducing skin pigmentation caused by UVA rays. (Baswan et al., 2020).
• Omega-3 Fatty Acids: The fatty acids found in fish oil are well known for their anti-inflammatory properties. In the context of photoprotection, they help reduce oxidative damage and inflammation caused by sun exposure. (Fania et al., 2021).

Consequences of Cumulative Sun Exposure

Sun damage is not something that is immediately noticeable, but it accumulates over time.. Every time your skin is exposed to the sun, especially without protection, cellular damage occurs that, although not immediately visible, can lead to serious problems over the years. This cumulative damage not only accelerates skin aging—wrinkles, loss of elasticity, and sunspots—but also significantly increases the risk of developing skin cancer.

Over time, constant exposure to UV radiation causes a series of mutations in the DNA of skin cells. These alterations can interfere with the normal process of cellular regeneration, facilitating the development of melanomas and other types of cancer, such as basal cell carcinoma or squamous cell carcinoma. For this reason, combining topical sunscreen with the use of oral sunscreen becomes key in reducing these negative effects in the long term. (Krutmann et al., 2020).

Chronic sun damage is clearly visible in the case of two 61-year-old twin sisters, Jeanne and Susan. Although they share the same genetics, their sun exposure habits have made a significant difference in their appearance. Jeanne, who has avoided prolonged sun exposure, has much smoother and less aged skin, while Susan, who has been regularly exposed to the sun in Florida, shows evident signs of premature aging, such as sunspots and deep wrinkles. A study showed that Susan appears more than 10 years older than Jeanne due to accumulated sun damage. This example highlights how ultraviolet (UV) radiation and a lack of sun protection can accelerate skin aging, underscoring the importance of using sunscreen and adopting habits that limit direct sun exposure.

Product Recommendation:

Lumium not only helps reduce inflammation and repair damaged DNA but also strengthens the skin’s immune response to the sun. This supplement is ideal for those looking for additional protection beyond what topical sunscreen offers. Remember, it’s always the combination that will give you the best results.

What Does Science Say About Oral Sunscreen?

There are numerous studies supporting the benefits of oral sunscreen. For example, a study conducted on humans demonstrated that the extract of Polypodium leucotomos is effective in reducing inflammation and skin damage after exposure to UVB radiation. (Kohli et al., 2017). Likewise, supplementation with carotenoids has demonstrated its ability to reduce erythema caused by UV radiation. (Baswan et al., 2020).

Additionally, nicotinamide has shown promising results in reducing the risk of non-melanoma skin cancer by improving DNA repair mechanisms. (Chen et al., 2014)This, along with the antioxidant effects of other ingredients, makes oral sunscreen a powerful tool for preventing long-term sun damage.

Limitations of Oral Sunscreen

It is important to remember that oral sunscreen should not replace traditional sunscreen. Oral supplements are a complementary tool and should not be seen as a standalone solution. Avoiding the sun with physical measures (staying under an umbrella, avoiding direct sun exposure, using hats and sunglasses, etc.) and the topical application of sunscreens remains the most effective way to block UV radiation directly on the skin.

Another limitation is that The effects of oral sunscreen are not immediate. Most studies suggest that consistent intake over several weeks is required to observe benefits for the skin. So, if you decide to incorporate these supplements, keep in mind that it is a long-term commitment.

Conclusion

In summary, oral sunscreen is a strategy that effectively complements traditional sun protection measures. Although it does not replace topical sunscreens, it helps reduce the impact of sun damage on the deeper layers of the skin. As research progresses, it is likely that we will see new combinations of ingredients that further improve results.

If you’re interested in providing more comprehensive protection for your skin, I encourage you to consider incorporating oral sunscreen into your routine, always alongside a good topical sunscreen and proper skincare habits. Remember, the sun is unforgiving, but with the right protection, we can minimize its impact on our skin. And don’t forget to visit a dermatologist if you have any concerns about your skin or signs of photoaging. 

Sebaceous hyperplasia is a skin condition that often goes unnoticed until it becomes a cosmetic concern. Although generally harmless, its presence can be worrisome, especially when it affects your appearance. As a dermatologist, I have seen how these small yellowish papules on the face can impact my patients’ confidence. 

If you've noticed these persistent bumps, you might be dealing with sebaceous hyperplasia. Don’t worry, in this blog, I'll explain what they are, why they occur, and most importantly, how you can effectively treat them to restore the health of your skin.

What is Sebaceous Hyperplasia?

Sebaceous hyperplasia occurs when the sebaceous glands, which are responsible for producing the oil (sebum) that keeps your skin hydrated, become enlarged. This enlargement leads to the formation of small, soft bumps that are often yellowish with a central depression, resembling tiny doughnuts on the skin. These bumps most commonly appear on the face, particularly on the forehead, cheeks, and nose. ^cita

Although these bumps are not harmful, their appearance can be concerning, especially since they can sometimes resemble more serious skin conditions, such as basal cell carcinoma. As a dermatologist, I emphasize the importance of getting a professional diagnosis to ensure that you are dealing with sebaceous hyperplasia and not something more serious.

Sebaceous hyperplasia can easily be mistaken for more serious conditions. A precise diagnosis is essential for successful treatment.

Dr. Sebastian Podlipnik

¿Cómo se ven las hiperplasias sebáceas en dermatoscopia?

La dermatoscopia es una técnica utilizada por los dermatólogos para examinar la piel en detalle, usando un dispositivo especial llamado dermatoscopio. Este aparato permite ver la piel con aumento y luz polarizada, revelando estructuras que no son visibles a simple vista. 

Una hiperplasia sebácea es una lesión común que aparece como un pequeño bulto en la piel, generalmente en la cara. Ocurre cuando las glándulas sebáceas, que producen el aceite de la piel, se agrandan. Bajo la dermatoscopia, esta condición se ve como un bultito amarillento con una pequeña depresión en el centro, a veces acompañado de pequeños vasos sanguíneos en su superficie. 

What Causes Sebaceous Hyperplasia?

The exact causes of sebaceous hyperplasia are not entirely clear, but studies suggest that several factors contribute to its development:​ ^Quote

• Aging and Hormonal Changes: As we age, androgen levels decrease, which stimulates the proliferation of sebaceous glands, particularly on the face, typically beginning around the ages of 30-40.
• Androgen Sensitivity: Sebaceous glands respond to androgens, which increase their activity and size, contributing to the development of sebaceous hyperplasia.
• Sun exposure: Prolonged exposure to UV rays can accelerate the development of sebaceous hyperplasia, particularly on the face.
• Immunosuppressive Treatments: Medications such as cyclosporine A, used in transplant patients, can increase the risk of developing sebaceous hyperplasia.​
• Genetic Factors and Syndromes: Some forms of sebaceous hyperplasia are associated with genetic predispositions and syndromes such as Muir-Torre syndrome, although they are much less common.

How to Treat Sebaceous Hyperplasia: My Recommendations

Although sebaceous hyperplasia is benign, many of my patients seek treatment to improve their appearance. 

Preferred Method

1. CO2 laser: In my opinion, the best treatment for eliminating sebaceous hyperplasia is CO2 laser therapy. This laser effectively removes the lesions, leaving the skin much more even. The results are exceptional.^Quote
2. Topical Retinoids: Once sebaceous hyperplasia has been removed, we recommend the use of topical retinol to prevent the appearance of new lesions. nuevas hiperplasias sebáceas. Este tratamiento no solo ayuda a reducir la producción de sebo y en algunos casos la aparición de nuevas lesiones. Si bien, los dermatólogos lo recomiendan ampliamente no existen tantos estudios de que demuestren su eficacia, es por ello que en casos más graves podemos recomendar un tratamiento oral. 
3. Oral Retinoids:​ In more severe cases or when there is a tendency for recurrence, we may offer the use of oral retinoids, always under the supervision of a dermatologist.

CO2 laser ablation is the fastest and most effective solution for treating sebaceous hyperplasia, with full recovery in less than a week.

Dr. Sebastian Podlipnik

Other Treatments

• Electrocautery and Curettage: In contexts where CO2 laser is not available, techniques such as electrocautery and curettage are excellent options that allow for the precise removal of sebaceous hyperplasia.
• Trichloroacetic Acid Peel: Another effective option isFocused chemical peels with TCA at 35-50%.^Quote
• Cryotherapy It can be effective if done with caution and expertise. It is preferable to use a cotton applicator instead of the conventional spray method, as the latter can leave white spots or even cause scarring. However, in clinical practice, it may not make much sense given the availability of CO2 laser and other much more effective methods. 
• Azelaic Acid and Other Alpha Hydroxy Acids: Known for their anti-inflammatory properties, these acids can help reduce the size and appearance of the lesions. However, retinoids are generally more effective. 

Will They Reappear?

Sebaceous hyperplasia lesions generally tend to reappear over time, usually after a few years, although this can vary; in some cases, they may return sooner or later. Topical retinoids can help reduce the likelihood of recurrence, although in practice, oral retinoids tend to offer more consistent results.

Ready to Say Goodbye to Sebaceous Hyperplasia?

If you’ve noticed those small bumps on your face and they’re causing you concern, it’s completely understandable that you’d want to take action. Although sebaceous hyperplasia doesn’t pose a health risk, I know from experience that they can impact how you feel about yourself. Fortunately, there are effective treatments that can help improve the appearance of your skin.

As a dermatologist with extensive experience in this condition, my goal is to offer you the best treatment options, tailored to your needs. Whether you're considering treatment or simply need guidance, I invite you to schedule a consultation. I’m here to help you find the solution that best suits your skin.​

What will I talk about in this article?

Can dermatofibromas be prevented?

Although dermatofibromas cannot be prevented, it is important to educate patients about the benignity of these tumors and that in most cases they will not require further treatment. We always advise patients to watch for any changes in their skin lesions and that consult a dermatologist if you notice anything unusual, as it could be a malignant lesion..

Conclusion

Dermatofibroma is a common benign lesion that can appear anywhere on the body, especially on the extremities. Although generally harmless, it can cause discomfort and cosmetic concerns in some cases. Diagnosis is usually clinical, supported by biopsy if necessary, and treatment is reserved for symptomatic cases or by patient preference. Patient education is critical to ensure proper understanding and management of these lesions.

References

• Myers, D. J., & Fillman, E. P. (2024). Dermatofibroma. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470538/.
• Dermatofibromas: A Review of the Literature. SAGE Journals. Retrieved from https://journals-sagepub-com.sire.ub.edu/doi/10.1177/106689690401200406.

Greetings to all lovers of skin health and skin cancer prevention!   I am Dr. Sebastian Podlipnik, a skin cancer specialist working at the Hospital Clínic in Barcelona. In my dermatological career, I have had the opportunity to study and care for a wide variety of cases, and today I want to immerse you in a topic that often goes unnoticed and is the subject of much controversy: moles on the soles of the feet and palms of the hands. 

Have you ever wondered why moles on hands and feet deserve special attention?

Although these small skin "companions" may go unnoticed due to their unusual location, their importance and the care they require are just as crucial as those of any other mole on our body. From their appearance to their possible link to skin cancer, we will explore together the mysteries and concerns surrounding these moles, as well as the steps we can take to keep our skin in optimal health. 

 Keep reading, because I'm going to tell you everything you need to know!

Why are moles on the soles of the feet different from those on the palms of the hands?

The main reason for moles on the soles of the feet and the palms of the hands is because the skin in this area is different and is called acral skin.. In general terms, the stratum corneum of the epidermis is much thicker and folds giving a fingerprint appearance. This makes moles in these areas acquire different characteristics and in the past it was more difficult to characterize them as benign or malignant. 

As you can see in the following images, I have put a magnified photo of these folds and also how they look under the microscope. The skin in this location is very special and that will make the moles on the soles of the skin and the palms of the hands look totally different as well. 

In addition, there are other reasons why moles may be different in these locations.

• Sun exposure: The soles of the feet and the palms of the hands are usually less exposed to the sun and therefore may have fewer changes related to sun exposure.
• Pressure and friction: The soles of the feet are subject to increased pressure and friction due to daily activity, which can influence the shape and texture of moles in this area. The palms of the hands are also subject to some friction, but to a lesser extent than the feet. It is believed that this is one of the reasons why melanoma appears on the soles of the feet.^Quote
• Genetic differences: Genetics plays an important role in mole formation, and individuals may inherit predispositions to develop certain types of moles on different areas of the body.

Are moles on hands and feet really more dangerous?

Actually, moles on the soles of the feet and the palms of the hands They are NOT more dangerous than moles on the body. This is a concept left over from the older generation of specialists, who did not have adequate diagnostic tools to detect melanoma early and therefore preferred to remove all moles in these locations. 

Fortunately, however, things have changed radically over the last few years and we now have a revolutionary tool: the Dermatoscope!

How do we study moles on hands and feet?

Since we introduced the dermatoscope into our routine clinical practice, we are able to make very accurate diagnoses even in areas that were very difficult to evaluate in the past, such as the acral skin. 

What is a dermatoscope?

The scientific study that changed everything

In 2004, this study appeared in the prestigious journal JAMA dermatology. ^Quotewhere dermoscopic criteria for benign pigmented lesions on the hands and feet were defined. Thanks to these criteria, we are now able to differentiate much more precisely the difference between melanomas and moles in acral locations. 

It is interesting to note that this article was written by my current bosses, and great friends, at the Hospital Clínic de Barcelona, who are recognized as leading experts in the field of dermoscopy worldwide. Personally, I have a deep respect and appreciation for them because of their significant contribution to this field of dermatology.

What do moles and melanoma on the skin of hands and feet look like?

To better illustrate these images I will show you below some images of what this type of mole looks like in this characteristic location. It is also important to have some clues to know if this mole has benign or malignant characteristics. 

What do moles on the soles of the feet and palms of the hands look like?

Moles on the soles of the feet tend to appear during childhood and adolescence. They can also appear later in life, however it is less common. It is important to know that Moles are stable lesions that will not change or grow over time.and that should reassure us.

Here are some pictures of moles on the soles of the feet and palms of the hands.

What do melanomas on the soles of the feet and palms of the hands look like?

Melanoma, the most serious type of skin cancer, usually develops in areas of the skin that have been exposed to excessive sunlight, however, It can also do it in places where the sun rarely reaches, like your feet! This type of melanoma is called acral lentiginous melanoma.

The big problem with this skin cancer is that the majority of people with people do not usually check their feet for signs of melanoma, And that's a problem because this cancer sometimes spreads before you know it.

When melanoma develops on the acral skin, it can manifest as a changing mole or spotbut you can also do it in the following ways:

• A pink or red spot or wart that is growing
• A new stain on the site of an injury you had some time ago
• A nonhealing foot ulcer (or an ulcer that heals and comes back) 

Melanoma on the foot can sometimes be painful, bleed or itchy, but this is not always the case. In fact, most of the time it can be totally asymptomatic and only manifest itself as a spot that grows.  

Here are some images with some examples of this type of melanoma:

Are there people who are more predisposed to develop acral melanoma?

Melanoma is a rare form of skin cancer, accounting for 2% to 3% of all melanoma cases. However, it is the most common type of malignant melanoma in people who traditionally have dark skin, especially in African-Americans and people of Asian and Middle Eastern origin.

And are polka dots on the nails different?

Another very curious place where moles can also appear on the hands and feet, are the nails. In this case, they are different and look like lines of pigment that grow along the nail. I recently wrote a very complete article about moles and melanoma on the nails that you can review here.. 

Conclusions

The moles on the soles of the feet and palms of the hands are NOT more dangerous than on the rest of the body.. However, this area is more difficult to evaluate because we do not normally look at the soles of our feet. In addition, there is a diagnostic delay in the case of melanoma, because these are areas that are not normally examined or that doctors do not usually check during consultations. 

In summary, awareness and vigilance are critical in the early identification of melanoma on the feet and hands. Any suspicious skin changes in this area should be evaluated by a dermatologist to ensure timely diagnosis and treatment. 

What will I talk about in this article?

A few words about warts and skin cancer

It is important to note that in some cases, warts or bumps on the skin can be a manifestation of skin cancer. While most warts are benign and do not pose a health risk, it is essential to pay attention to any changes in their size, shape, color or texture. 

Therefore, before any treatment or wart removal, it is essential to visit a dermatologist for an evaluation to rule out any possible complications.

If you are interested, in this article I leave you a summary of what skin cancer can look like. 

Conclusions on how to remove warts

In this article on how to remove warts by a dermatologist, you have learned fundamental things and we have reviewed different diagnoses. It is crucial to differentiate viral warts (HPV) from other skin growths and to avoid self-medication. or home methods that could worsen the situation.

It is key that you leave this issue in the hands of experts for proper treatment. Do not risk with home remedies, better consult a pro to get rid of those warts without drama and with excellent aesthetic results!

In summary, my article gives you the most important fact: trust a dermatologist to say goodbye to warts simply and without drama. Expert hands are the key!

Some time ago, I gave a talk at a congress to my dermatologist colleagues about moles and melanoma on the nails. I thought it would be important to share this information with my patients and blog readers. During the talk, I shared several clinical cases of patients who had spots on their nails that turned out to be melanomas. Seeing the interest and concern in the eyes of my colleagues, I realized the importance of spreading this knowledge and raising awareness about the importance of taking care of our nails. 

My name is Sebastian Podlipnik and I'm a skin cancer specialist at the Hospital Clinic de Barcelona. During my years of experience I have seen many cases of moles and melanoma on the nail and it is one of the reasons why I decided to write this blog. 

In this entry, We will learn how moles look on the nails, how to detect suspicious changes of skin cancer and when to consult a dermatologist.. In addition, I will share with you many pictures of nails so that we can identify them with good images. 

I accompany you on this journey of dermatological knowledge!

What do moles and melanoma on the nail look like?

Moles are common on our skin and are usually harmless. However, when it comes to moles on the nails, it is important to pay special attention to them. 

Often, the following can be observed nail stains brown or black that adopt a linear shape, technically called ".longitudinal melanonychia". They are usually seen as brown or black lines that affect the length of the nail. 

Depending on their characteristics they may correspond to benign lesions or even in some cases to malignant lesions such as melanoma. In general terms Moles are small, well-defined lines, while the Melanomas are more chaotic, with larger spots and the pigment may extend beyond the nail. 

These small brown marks may seem insignificant, but in some cases they could be signs of melanoma, an aggressive form of skin cancer.  

Why do moles and melanoma look like brown or black lines?

This is because the cells that produce the pigment (melanocytes) are located in the nail matrix, which as you can see in the following image, is the most proximal area of the nail. If there is an increase of melanocytes (proliferation), either by a mole or a melanoma, the pigment will adhere to the nail plate (nail) and will advance as the nail grows. 

What do moles look like on the nails?

Generally speaking, nail moles are very stable lesions and should not change significantly over time. They usually present with a band of pigment that affects only one nail. 

What signs should lead one to suspect melanoma of the nail?

There are several signs that may lead us to suspect a malignant lesion of the nail and we will review them so that you have the diagnostic clues. Possibly one of the most important is that a malignant lesion usually only affects 1 nail. If, on the other hand, you notice the appearance of these spots simultaneously on several nails, possibly the cause of the pigmentation is something else that we will see later in the blog.  

| That there be progressive changes

You will find that moles and benign nail lesions are very stable, so we do not expect them to grow or change over time. One of the first signs that we will see in melanoma of the nails are progressive changes such as those shown in the following image. 

| Triangular shape of the pigment line

Maybe this is a little bit more difficult to explain and understand, but if you remember what I explained previously that melanocytes are located in the nail matrix and then attach to the nail as it grows. 

Therefore, if we have a fast growing lesion it will rapidly increase in size in the proximal part of the nail, however the pigment found in the more distal part will be the pigment that "stuck" several months ago to the nail. 

| Other important signs

There are other important signs to be mentioned that are already present in more advanced lesions. These are:

• Thickness more than ⅓ of the nail: If the band of pigment on the nail measures more than one third of the total width of the nail we should be concerned. 
• Pigmentation beyond the nail: If we observe that the brown pigmentation extends to the skin adjacent to the nail.
• Hutchinson's sign: If the pigmentation also affects the proximal nail fold. 

Now we are going to see a picture of a patient presenting some signs of malignancy in a nail affected by melanoma. If you have any of these signs, it is important to consult a dermatologist. 

Are there other causes of brown and black lines on the nails?

Before I continue, I would like to give you some peace of mind as the appearance of brown or black spots on the nail can have different causesThe most of them are not serious. We have already reviewed moles and melanoma which correspond to a growth of melanocytes (melanocytic proliferation). But, there are also other times when melanocytes can be activated and also produce brown or black lines on the nails. 

The causes of melanocyte activation can be very broad, and most often several nails are affected at the same time, unlike moles or melanoma that usually affects only one. 

The most frequent causes of melanocytic activation are

• Pregnancy
• Trauma
• Nail biting
• Nail infection
• Lichen planus
• Psoriasis
• Viral warts
• Addison's disease
• Hyperthyroidism
• Photosensitivity
• Lupus
• HIV
• Phototherapy
• X-ray exposure
• Antimalarial drugs
• Chemotherapy drugs

What do we do in the dermatological office when we see a melanonychia?

To properly evaluate a patient with a melanonychia, we perform a series of procedures to establish a diagnosis. 

1- physical examination

To begin with, I will conduct an examination complete physic of all your nails, both fingernails and toenails. This involves evaluating any deformities, the presence of melanonychia on multiple nails, as well as the color, shape and size of the affected areas. In addition, I will review your medical history to identify any underlying conditions that may be causing your nail staining.

2- Dermatoscopy (onychoscopy)

The next step in the diagnostic process involves a dermatoscopic examination. I will use a specific type of microscope to closely examine the suspicious areas. During this examination, my main focus will be to determine if there are signs that the melanonychia may be malignant.

3- Take a course of action with the injury

After completing the above two steps, we will assess whether the lesion is benign, suspicious or malignant. 

• Benign lesion: If it is very clear to us that the reason for the pigmentation in the nail is benign, we can indicate a treatment to improve or discharge if it does not require further studies. 
• Suspicious lesion, but not clearly malignant: Sometimes we will not have enough information to be able to establish a clinical diagnosis of the spot on the nail. In these cases it will be necessary to perform a digital follow-up of the nail or we may also request a biopsy. 
• Lesion clearly suspicious of malignancy: In this case, we will directly assess the possibility of nail surgery to remove the lesion completely and biopsy it in its entirety. 

Conclusions on moles and melanoma of the nail

When it comes to evaluating nail stains, I recommend that you do it in person. This way, he will be able to examine your spot with dermoscopy and provide you with an accurate diagnosis.

Choosing the best dermatologist in Barcelona can seem like a challenging and overwhelming task, especially when you are faced with numerous options and advertisements on Google. It is understandable that, in the midst of this avalanche of information, you may feel distrustful and doubtful about who is the right dermatologist to solve your skin problems.

But don't worry! In this blog, I want to share with you the most important aspects that I consider as a dermatologist so that you can make an informed and reliable decision. From my professional perspective, I will guide you through the key elements to consider when choosing the specialist that perfectly fits your needs. 

Sound education and training

When you have to trust someone to take care of your skin, there is nothing more important than ensuring the dermatologist's training. Education and academic achievement are the first point to consider when choosing the best dermatologist in Barcelona. 

Look for professionals who: 

• Have a specialization in dermatology recognized by accredited institutions
• Participation in continuing education programs
• Attendance and lectures at conferences and congresses 
• Make a contribution to the medical research

Check the specialty of the dermatologist you will visit in the registry of registered physicians in Barcelona.

Although it may seem crazy it is crucial to verify the credentials of the dermatology specialist.Unfortunately, there is a problem of labor intrusion in Spain and many people without the specialty pose as dermatologists. 

For this reason, the The Barcelona Medical Association has made available the page of the registry of registered physicians of Barcelona where you can check the doctor's specialty. It is very easy to check: 

Step 1: Find your doctor

Step 2: review your specialty

Reputation by peers

I will tell you one of the most important secrets for me: other doctors know who is really good! 

So, if you have the opportunity, ask about the reputation of a dermatologist among our professional peers. Our dermatology colleagues are often familiar with our work, professional ethics and level of experience. By obtaining references and opinions from other medical professionals, you can get a more solid idea of the quality of care we can provide. 

Have a specialist in the problem you are suffering from

Today the trend in medicine is to sub-specialize, and you'll find that dermatologists do too. At by choosing a dermatologist who specializes in your specific problem, you can be confident that you are receiving expert, personalized care. you need to effectively address your dermatological problems.

Updated knowledge

Ensuring that the dermatologist has up-to-date knowledge is critical. Medicine and dermatology are constantly evolving, with new treatments, technologies and approaches emerging on a regular basis. 

It is crucial to stay abreast of the most recent advances in our field and participate in continuing education programs. This ensures that we are using the most current and effective techniques and therapies to address your dermatologic needs. 

Excellent communication skills

Effective and empathic communication is essential to establish a good doctor-patient relationship. A A good dermatologist will excel in listening attentively to patients, explaining diagnoses and treatments in an understandable manner, and responding to patients' questions and concerns in a clear and respectful manner. 

For this point you can also look at the doctor's social networks or his YouTube channel and see if you like how he explains the problems. 

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State-of-the-art technologies

Dermatology is in constant evolution, and The use of state-of-the-art equipment and technology can make a difference in diagnosis and treatment results. Look for a dermatologist who keeps up with the latest innovations and invests in cutting-edge technology to offer you the best in skin care. 

From advanced lasers and devices to non-invasive techniques incorporating artificial intelligence, the use of cutting-edge technologies can improve the accuracy, efficacy and comfort of dermatological treatments.

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Sensitivity and empathy

This is possibly one of the most important points as a medical professional. Putting yourself in the patient's shoes and understanding that dermatologic diseases can have a significant emotional impact on patients is critical. Being able to show empathy and sensitivity to patients' concerns and emotions is an essential quality in providing comprehensive care.

Multidisciplinary collaboration with other specialists

Dermatology is interrelated with other medical specialties and collaborating with other medical specialists when necessary is very important to provide comprehensive care to patients. This includes working as a team with other healthcare professionals to ensure the best possible outcome. Therefore, if a specialist also works in a reference hospital in Barcelona, he/she may be in contact with many specialists in other specialties. 

Reputation and references

Reputation and referrals are a reflection of the quality of care a dermatologist provides. The best dermatologist in Barcelona will be noted for having a solid reputation and receiving positive referrals from satisfied patients. This demonstrates their ability to deliver successful results and a high level of patient satisfaction.

In conclusion, how to choose the best dermatologist in Barcelona?

Choosing the best dermatologist in Barcelona requires time, research and consideration. It is important to look for a professional with a solid educational background, verifiable credentials and up-to-date knowledge. 

Also, don't forget to consult the references and opinions of other medical professionalsas well as the experiences of previous patients. Remember that trust and comfort with your dermatologist are critical to establishing a long-term quality care relationship. Your skin is a valuable organ and deserves the best possible care. 

In case of doubt, call the dermatologist's office and ask if the dermatologist has experience in treating the specific areas of concern. 

Do you think I missed a point? Feel free to comment below. 

Sunburn is a reality that affects many people around the world, especially in summer. These burns can be very painful and have serious long-term health consequences.The sunburn may also increase the risk of developing skin cancer. That is why it is important to know how to treat a sunburn properly to avoid complications. 

In this blog you will I will show you some treatments and tips for treating sunburn effectively. We will learn together why these burns occur, how to identify them and how to treat them to ensure a quick recovery and avoid adverse consequences.

Types of sunburn

Sunburns are classified into three types: mild burns, moderate burns and severe burns. 

• Minor burns are those that cause redness and pain on the skin, but do not cause blistering or scarring. 
• Moderate burns are those that cause redness, pain, blistering, swelling and peeling of the skin. 
• Severe burns are those that cause scarring of the skin.

Get started as soon as possible!

Skin can burn if it gets too much sun without proper protection from sunscreen and clothing. To help heal and relieve itchy skin, it is important to start treating a sunburn as soon as you notice it.. The first thing to do is to get out of the sun, preferably indoors.

How to treat a sunburn?

Once you are indoors and out of the sun, dermatologists recommend that you follow the following tips to help you learn how to treat a sunburn :^Quote

1. Take frequent cold baths or showers to relieve pain. As soon as you get out of the bath or shower, gently pat yourself dry, but leave some water on your skin. Next, apply a moisturizer to help retain water in the skin. This can help relieve dryness and tightness of the skin.
2. Use a moisturizer containing aloe vera or soy to help soothe sunburned skin. If a particular area is particularly bothersome, you can apply a hydrocortisone corticosteroid cream that you can buy without a prescription. 
3. Do not treat sunburn with local anesthetic products. "-caine" (such as benzocaine), as they may irritate the skin or cause an allergic reaction.
4. Consider taking aspirin, acetaminophen or ibuprofen to help reduce swelling, redness and discomfort.
5. Drink more water. Sunburn draws fluid to the surface of the skin and away from the rest of the body. Drinking more water when you are sunburned helps prevent dehydration.
6.  If you get blisters on your skin, let them heal. Blistering means you have a second-degree sunburn. You should not pop the blisters, as they form to help the skin heal and protect you from infection.
7. Take extreme precautions to protect sunburned skin while it heals. Wear clothing that covers your child's skin when outdoors. 

Consequences of sunburn

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Although it may appear to be a temporary condition, sunburn - the result of excessive exposure of the skin to the sun's ultraviolet (UV) rays - can be a temporary condition. can cause lasting damage to the skin. This damage increases the risk of getting skin cancer and cause premature aging of the skin, so it is essential to protect the skin from exposure to UV rays.