Featured, Skin

My Dermatologist Has X-Ray Vision

Or, How My Skin Doctor Found My Thyroid Problem.

My dermatologist isn’t Superwoman (although I think of her that way). No doctor can see through you, to your blood, thyroid, heart, or bones. I’m not sure anyone would want that. But my dermatologist took one look at my skin and knew something was off with my insides.
It was, frankly, fascinating. My doctor (a dermatologist and dermatoPATHOlogist) “saw” my endocrine system in the state of my skin. I’d gone to her for some dark spots on my neck that I thought were a reaction to a new necklace (metals are common allergens). Assessing the size of my pores and the presence of facial hair (the bane of my waxing aesthetician), she asked if I had Polycystic Ovary Syndrome or PCOS. My Ob-Gyn had only recently diagnosed me with the same condition based on other symptoms, so my dermatologist was spot on. From there, she looked some more, paused, and suggested I consult an expert endocrinologist for Insulin Resistance Syndrome (often tied to PCOS) because the hyperpigmentation that started appearing at the back of my neck looked like Acanthosis Nigricans. I went to see her thinking I just needed a chemical peel or stronger prescription medication for the dark spots — and came out concerned about my pancreas! True enough, after some lab work, I found out how urgent the management of my insulin had become. And who suspected it? My dermatologist. From looking at my SKIN.
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Dermatologists help us look good. They also help manage some pretty serious skin diseases like psoriasis and eczema, and some very serious ones like melanoma and pemphigus vulgaris. But a dermatologist can also be the first person to spot signs of internal problems.
The skin is our largest organ and it is also the most immediate, most visible monitoring system we have for the state of our internal systems. Before a blood test, ultrasound, x-ray, or MRI can reveal an issue, dermatologists can recognize signs on your skin that may point to an internal problem. For instance, before blood sugar values are elevated, diabetes can show tiny distinctive scarred patches on the leg or small areas of numbness; a slow thyroid gland can be indicated by a form of skin thickening in various parts of the body; tiny red spots can signal inflammation of blood vessels both in the skin and in the body’s internal organs. In my case, my pore size and facial hair implied Polycystic Ovary Syndrome or PCOS — the addition of my dark spots to the puzzle led to the suspicion of Insulin Resistance Syndrome and an endocrinologist referral.
For other internal health issues that dermatologists can spot just by looking at you, check out What Doctors Can Tell About Your Health Just By Looking At Your Skin, and for more inspiring dermatology-detective stories, search “Ace Skinvestigators” in skintelligencenter.com.
We tend to forget that dermatology isn’t all Botox® and peels and creams and fillers. Dermatologists are so fantastic at helping us look good (wonderful, don’t get me wrong!)…but their talent at this can sometimes make us forget that they are trained to do much, much more. I was so thankful that my dermatologist’s know-how was a cut above most. Her Sherlockian diagnosis sent me to an endocrine specialist before it ever would have occurred to me to see even a GP! Remember, the only symptoms I thought I had were dark spots. And I work in skincare — a photo-allergic reaction to metal was not a stupid guess (we see this quite a bit in our line of work as we cater to some of the most sensitive skin conditions). If lesson number one was don’t think of dermatologists as “just” skin doctors, lesson number two is: don’t think you know it all. No matter how smart you think you are about skin care, nothing beats a proper diagnosis by a specialist.
Lesson three? Be picky. Don’t let the beautification promise trick you into choosing a dermatologist who’s just about beauty. Dermatologists who research, teach and publish, who treat people who are hospitalized, can spot signs in your skin that can alert you to a potential internal problem (and other specialists) before you even think of getting a blood test or other exams. Top dermatologists may seem less glamorous but, in a very real way, the best of the best can save your life.
 
Ask Karen more about her experience or share her globe-trotting, music-stalking, surfer-loving, skin-healthy life by following her on Instagram/Naranwoah.