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When you look into the mirror to wash your face or put on mascara, do you notice anything new -- a funky red patch or a bump that hasn't healed? When you blow-dry your hair, does it seem to be thinning on top? Sometimes monitoring your looks can help you monitor your health. Get the details to determine whether it's time to make an appointment with your doctor.Hair Loss
It's probably just: stress, genetics, or hormonal changes.
Female hair loss is pretty common and can happen at any age, says Pamela Peeke, MD, a professor at the University of Maryland School of Medicine and author of Body-for-Life for Women. In many cases it's genetic, but stress, general anesthesia, a recent illness, or extreme dieting can also cause your hair to shed, sometimes over several months. Hormonal changes also affect hair growth, so you might see more hair loss when you're pregnant or when you go on or off birth control pills. During the perimenopause years, you lose estrogen more quickly than you lose testosterone, and those higher male hormone levels can cause your hair to thin, too. Try to reduce stress and eat a healthy diet, and be sure to talk to your doctor about testing your hormones. If your hair loss is severe, discuss topical treatments such as Rogaine or more aggressive options like transplants.
But it could be: low thyroid.
Your thyroid gland helps regulate your metabolism and can become underactive (hypothyroidism) or overactive (hyperthyroidism). In either case you may have gradual hair loss, says Erik Alexander, MD, an endocrinologist at Brigham and Women's Hospital in Boston. Hashimoto's disease, an autoimmune disorder in which your immune system produces antibodies that attack the thyroid gland, is the most common cause of hypothyroidism in women. Besides losing hair on your head, you may lose the outer portion of your eyebrows, feel cold all the time, have dull hair and skin, unexplained weight gain, constipation, and fatigue. Unfortunately, thyroid symptoms can be vague and it's easy for doctors to overlook them, says Dr. Alexander. But it's essential to get tested and treated with thyroid-replacement meds because hypothyroidism puts you at risk for high cholesterol, hypertension, and even heart failure.
It's probably just: that you sweat more than other people.
It's called hyperhidrosis, which makes you sweat up to four times the amount needed to regulate body temperature. Three percent of people have it and women report it more than men do. You're not more anxious or overheated, you just have a nervous system that's tuned to sweat more, says David J. Leffell, MD, a professor of dermatology and surgery at Yale School of Medicine. If an antiperspirant with aluminum chloride doesn't work, Botox injections might. They paralyze the sweat glands and decrease sweating. The procedure, which may be covered by insurance, usually needs to be repeated every two to three months.
But it could be: an overactive thyroid.
Graves' disease, the number one cause of hyperthyroidism, most often affects women under 40. In addition to sweating and thinning hair, symptoms include losing weight when you're not trying to, bulging eyes, anxiety, rapid heartbeat, and intolerance to heat. Hyperthyroidism can contribute to heart problems and osteoporosis, so if you have symptoms, ask your doctor for a thyroid blood test. Various treatments destroy the overactive cells and decrease the amount of hormone the gland makes. Then you'll probably need to take thyroid-replacement meds for life.
It's probably just: a natural part of aging.
Your oil glands get smaller as you get older, which leads to drier skin, says Dr. Leffell. Sun damage and decreased cell renewal also contribute to it, as does being dehydrated. Medications for high blood pressure, antihistamines, and retinoid therapies for acne and anti-aging can also make it worse, says Dr. Peeke. You can improve your dry skin by tweaking your beauty routine. Try shorter, cooler showers and trade in harsh bar soap for a mild, creamy cleanser. Afterward, apply a skin cream that contains a humectant like glycerin. Drinking more water may help, too.
But it could be: psoriasis.
When skin cells grow too quickly and your body doesn't shed them normally, the cells pile up and form thick, scaly patches, often on your arms and legs, scalp, palms, and soles of your feet, says rheumatologist Scott Zashin, MD, a clinical professor at the University of Texas Southwestern Medical School at Dallas. Psoriasis is most common in women between 30 and 50. Genetics and an overactive immune system may both play a role. It's important to get it diagnosed because research shows that people with severe psoriasis are at higher risk for heart attack, stroke, skin cancer, and lymphoma. Treatments include oral, topical, and injectable medications and phototherapy using a certain wavelength of UVB light.
It's probably just: rosacea.
Common in fair-skinned women between 30 and 50, rosacea is an inflammatory condition in which blood vessels dilate easily, making skin look red and flushed. Acne-like bumps often appear on the cheeks, chin, and nose. Many women assume it's just a breakout, says Dr. Peeke, but self-treating can backfire, as some acne products can make rosacea worse. A nonprescription moisturizer called PyratineXR can help, says Washington, D.C., dermatologist Tina Alster, MD, a member of the LHJ Medical Advisory Board. It calms inflammation, she says, especially when combined with two or three pulsed dye laser treatments.
But it could be: lupus.
Caused by an overproduction of antibodies, this autoimmune disease affects about 1.3 million U.S. women, who usually get it between 15 and 44. It may cause a distinctive red rash on the face in the shape of a butterfly, says Dr. Zashin. Other symptoms include fever, pain, fatigue, and problems with your heart, kidneys, joints, and other organs. Your doctor may do a skin test and biopsy to diagnose it. While there's no cure, drugs that reduce inflammation and weaken the immune system (including recently approved Benlysta) can help you manage symptoms.
It's probably just: perimenopause.
As you age and your estrogen levels ebb, the relative rise in testosterone that thins your hair may also lead to hair where you don't want it, says New York City cardiologist Nieca Goldberg, MD, author of Dr. Nieca Goldberg's Complete Guide to Women's Health. This hormonal shift is what makes those coarse hairs sprout on your chin or upper lip, just like the ones guys get. Your doctor can do a hormone test to see if you have excess testosterone, but sometimes it's just genetic. Waxing, electrolysis, or laser hair removal will help. Or your doctor may prescribe Vaniqa, a prescription cream that slows down unwanted hair growth.
But it could be: polycystic ovarian syndrome.
PCOS, an imbalance of your sex hormones, can cause excessive facial hair growth, thinning hair, acne, ovarian cysts, and weight gain (particularly around your stomach), as well as infertility, diabetes, and heart disease if left untreated. If you suspect PCOS, have your gynecologist or an endocrinologist check your hormone levels. While there is no known cause, treatment options include losing weight, birth control pills to stabilize hormones, and medications to target symptoms (such as Metformin, which helps to control blood sugar). Daily exercise and a diet high in fiber and low in sweets can help curb weight gain. Some studies suggest that a low glycemic index diet is best for women with PCOS.
It's probably just: adult acne.
Even if you left your teenage problem skin behind years ago, you can develop acne now. When estrogen and your skin's protective oil barrier decrease with age, bacteria can penetrate more easily and cause breakouts. If your pimples recur, it could mean that your hormones are changing, says Florida dermatologist Kenneth Beer, MD. Your doctor might suggest a birth control pill that helps improve your skin or a drug called Aldactone, which can help balance certain hormones.
But it could be: skin cancer.
A pimple that looks waxy, pearly, persists for weeks, doesn't seem to heal completely, or bleeds occasionally could be a basal cell carcinoma, says Dr. Beer, who has seen such cases. Basal cell skin cancers are on the rise in women in their 20s, 30s, and 40s. Your dermatologist will usually biopsy a suspicious spot, and if it is a basal cell, she may scrape or burn it off, prescribe a chemical cream, or surgically remove it.
While it's more rare, such a spot could even be a melanoma, says David Kriegel, MD, director of the Manhattan Center for Dermatology and a member of the LHJ Medical Advisory Board, who says he's seeing a rise in these more serious cancers. For example, he recently saw a 38-year-old woman with a pimple-like spot that looked as if it could be a basal cell because of its shiny surface. "She didn't want to have a biopsy," he says. "But we convinced her, and it turned out to be a melanoma. It's very serious and it shocked us all."
Melanomas may require surgery, chemotherapy, or radiation. Best skin-cancer prevention? Use a 30 SPF broad-spectrum UVA/UVB sunscreen every day and see your dermatologist for annual skin checks.
Originally published in Ladies' Home Journal, July 2011.