15 skin lesions you need to know

Not all skin lesions are the same

Skin lesion blank chart
Some skin changes are dangerous, while others just look bad. Unfortunately, the appearance may not correlate with the danger. For example, the appearance of seborrheic keratosis may bother you a lot, but they aren’t particularly dangerous. On the other hand, a melanoma is very dangerous, but most people are likely to not even notice it. This (not-to-scale) chart charts 15 common skin lesions based on how dangerous they are and how much their appearance tends to bother people. The size of each bubble corresponds approximately to how common the lesion is.

1. Wrinkles

Skin lesion chart with wrinkles
Wrinkles or “rhytids” are formed by a fairly complex series of changes in all layers of the skin. The epidermis thins (or thickens if it is sun-damaged), the dermis and hypodermis thin, and the border between the epidermis and dermis flattens. All of these changes combine to make a depression in the skin, forming a wrinkle.

2. Cellulite

Skin lesion chart with cellulite
Cellulite is the dimpled, lumpy-bumpy skin on the buttocks and thighs, which occurs more often in women. We don’t know for sure what causes cellulite, but there are a few theories. Perhaps blood supply to the fat cells is compromised, causing scarring and dimpling. Or it could be that the tough fibers separating fat cells into groups cause excess fat to push into the skin (like an overfilled quilt).

3. Freckles

Skin lesion chart with freckles
Freckles are small islands of skin containing overactive melanin-producing cells. Each “island” is only a few millimeters in size (a tenth of a centimeter). The cells are present from birth, but the color difference only shows up with sun exposure. Freckles fade away in winter and darken in the summer as you get more sun. They usually appear on the face, arms, and shoulders.

4. Angiomas

Skin lesion chart with angiomas
Angiomas are overgrown blood vessels in the skin. There are two common types. Cherry angiomas are small cherry-colored spots that tend to appear on the trunk in people over age 40. Spider angiomas appear on the face and chest, and have a central spot with spider-like blood vessels entering it. They are common in pregnancy, but can occur in children and adults of both sexes.

5. Telangectasias

Skin lesion chart with telangectasias
Telangectasias are commonly called “spider veins.” They are abnormal blood vessels—tangled and floppy, like a bundle of old stretched out socks. They can form with long-term exposure to UV rays. There are other common reasons why you might get telangectasias—like pregnancy, alcohol use, or rosacea. Rarely, telangectasias can be a marker for a more serious illness, like CREST syndrome or lupus.

6. Varicose veins

Skin lesion chart with varicose veins
Varicose veins are abnormally widened veins, usually found in the legs. Your blood pressure is higher in your legs, which stretches out the thin-walled veins, causing these gnarled, enlarged, and not very pretty varicosities. They are not dangerous per se, but varicose veins are associated with a higher risk of deep vein thrombosis (DVT), which is dangerous.

7. Warts

Skin lesion chart with warts
Warts are caused by a viral infection (Human Papilloma Virus, or HPV) that results in an overgrowth of skin cells, and a bumpy/rough appearance. They are exceedingly common, and not very dangerous. They can be confused with seborrheic keratosis.

8. Common moles

Skin lesion chart with moles
Common moles are areas of skin with clusters of melanocytes. They are usually found on sun-exposed areas of skin. Most moles are smaller than 5mm or a 1/4 inch, with a smooth surface, a sharp border, and an even color. Moles are generally not dangerous, although they can very rarely turn into melanoma. However, having over 50 moles means you are at higher risk for developing melanoma.

9. Seborrheic keratosis

Skin lesion chart with seborrheic keratosis
Seborrheic keratoses are waxy bumpy growths can grow out of solar lentigo, or just show up unannounced. They are dark and have a rough texture, and look a bit like a raisin stuck on to the skin. They’re not dangerous, but they don’t look very nice. SKs tend to appear in your 50s and 60s, and can even show up in areas that don’t get much sun exposure.

10. Solar lentigo

Skin lesion chart with solar lentigo
Solar lentigo or age spots, appear on sun-exposed skin. They contain a high number of melanin cells. Solar lentigo can be the precursor of a benign growth called seborrheic keratosis. Solar lentigo can be difficult to distinguish from pre-cancerous growths or melanoma. So if you develop a new, dark spot on your skin, more than a few millimeters in size, you should see your doctor.

11. Dysplastic nevus

Skin lesion chart with dysplastic nevus
Dysplastic nevus is an abnormal mole – it can be large (over 5mm), with an irregular indistinct margin, and multiple colors and textures. Not all dysplastic nevi are cancerous, but some can become melanoma. You should examine your moles regularly, and see your doctor if you suddenly notice a new mole, or a change in an old mole.

12. Actinic keratosis

Skin lesion chart with actinic keratosis
Actinic keratosis (AK) is an area of abnormal epidermis that has become rough, scaly, and reddish. It is closely associated with exposure to UV rays. There is about a 1 in 50 chance that an AK will become a type of skin cancer called squamous cell carcinoma. Fortunately actinic keratosis is easy to treat by freezing, special skin creams, or surgical removal.

13. Basal cell carcinoma

Skin lesion chart with basal cell carcinoma
Basal cell carcinoma (BCC) is the most common skin cancer, and also the least dangerous. BCCs often show up on sun-exposed areas of the face like the nose, cheeks and ears. They are often pearly shiny dome shaped masses that don’t look particularly alarming. They can sometimes have a telangiectasia on top. If you find and treat them quickly, they are relatively easy to remove.

14. Squamous cell carcinoma

Skin lesion chart with squamous cell carcinoma
Squamous cell carcinoma (SCC) is more uncommon than BCC, and much more dangerous. SCCs are cancers of the cells of the epidermis, and can develop from an actinic keratosis. They occur on sun exposed areas of the face, shoulders, and back. SCCs grow over weeks to months, can be tender, and can even form ulcers, so their appearance tends to be more bothersome than BCCs. They should be treated quickly and aggressively.

15. Melanoma

Skin lesion chart with melanoma
Melanoma is the most dangerous skin cancer, but also the most uncommon. It is a cancer of the pigment cells. Unfortunately it can look like a simple mole while spreading to other parts of the body. UV light can cause melanoma, so wearing sunscreen and avoiding tanning beds is critical. So is regularly examining your moles, and seeing your doctor if you notice any changes.

So what should you do about that funny-looking mole?

Don’t ignore skin changes because you think they’re probably not dangerous. There is no substitute for a pair of trained eyes looking at you. You should always have a skin change checked out by a doctor if:

  • it appears suddenly
  • …changes rapidly
  • …is larger than a pencil eraser
  • …has an irregular shape
  • …has many different colors
  • …and hurts or bleeds
  • you’ve had skin cancer in the past
  • you have very fair skin or red hair
  • you, your family, or friends are worried about it!

Want to find out more about surgical and nonsurgical treatments for a benign skin lesion? Contact us online or by phone to schedule a consultation with Dr. Nagarkar.