Pictures of skin lesions can help you to identify changes in the skin that healthcare providers typically consider, including the color, size, texture, and location. These lesions differ from the surrounding tissue. They may be smooth, look like bumps or patches, or be a different color or texture compared to nearby skin, such as a raised cyst or a mole.
Common causes include acne, cellulitis, and chickenpox. They can occur suddenly with allergy or be a symptom of a chronic condition. Most skin lesions are benign (not cancer) but others may be severe, like melanoma skin cancer. They also can occur with life-threatening conditions like anaphylaxis, a severe allergy.
1. Acne
Acnepresents primarily as papules. It can also cause pustules, nodules, or cysts. Acne is most common on the following places:
- Face
- Neck
- Chest
- Back
Acne can leave scars if nottreated.
Acne occurs when your pores become blocked with dead skin or an oily secretion called sebum. It can also be caused by too much of a certain kind of bacteria on the skin.
2. Actinic Keratosis
Actinic keratosisis caused by exposure to sunlight. It appears as thick, scaly crusts on the skin. It is most common in people over the age of 40. Because it is related to years of sun exposure, it doesn’t usually appear until later in life.
Get It Checked
Left untreated, up to 10% of actinic keratoses will develop into squamous cell skin cancer. About 40% to 60% of squamous cell cancer cases begin as actinic keratosis.
Actinic keratosis has a scaly, raised surface. This makes it easier to feel than see. Over time, it can turn hard and wart-like. It may develop a horn-like texture. If you think you might have actinic keratosis, see your healthcare provider.
Identifying and treating actinic keratosis early can help prevent skin cancer from developing.
3. Blisters
Blistersare fluid-filled areas of the skin. They can be caused by friction, such as a shoe rubbing on your skin when you walk. They can also be due to a burn, skin disorder, or allergic reaction.
When a blister is less than 0.5 cm, it is called a vesicle. When it’s greater than 0.5 cm, it is called a bulla.
At-home treatment works for most blisters. Avoid putting more pressure on the blister area and try not to pop blisters. If a blister does pop, clean the area. Cover it with a sterile bandage until healed.
See a healthcare provider if you have signs of infection which include:
- Pus, a thick yellowish or greenish discharge
- Fever
- Red hot skin around the blister
4. Cellulitis
Cellulitis is a skin infection. It happens when bacteria or fungi enter the skin.Symptoms of cellulitis include:
- Redness
- Swelling
- Pain
- Leaking of fluid
Cellulitis feels hot to the touch. It can also cause a fever and you may feel unwell.
It is important to see a healthcare provider if you have signs of cellulitis. If identified early, most cases can be treated at home with antibiotics. If left untreated, severe and serious complications can occur. Sometimes hospitalization may be needed.
5. Chickenpox
Chickenpox, also called varicella, is a viral skin infection.
Chickenpox causes red, fluid-filled blisters all over the body. They are typically hot and itchy. The blisters can ooze pus and may cause secondary crusting.
Chickenpox is contagious two days before the rash first appears. It remains contagious until all the blisters have crusted over.
It is possible to recognize chickenpox at home. However, you may want to see a healthcare provider to confirm the diagnosis.
6. Comedones
Comedonesare a kind of acne.
There are a few different types:
- Blackheads are open comedones, which means the pore is still open. They have a dark spot in the middle.
- Soft closed comedones are soft, painless, and smooth.
- Hard closed comedones have white heads. They are also called milia. They are not the same as pus-filled whiteheads.
7. Cold Sores
Cold soresare sores on the mouth or lip area. They are caused by the herpes simplex virus (HSV).
HSV-1 vs. HSV-2
There are differences between HSV-1 and HSV-2:
- HSV-1 usually causes oral herpes. Cold sores and fever blisters appear around the lip and mouth area.
- HSV-2 is usually responsible for genital herpes.
However, oral or genital outbreaks may be caused by either virus.
Cold sores can be red, painful, and cause fluid-filled blisters. You may feel tingling before the sore appears. Because they are caused by a virus, you may also have flu-like symptoms.
Very severe cold sores or sores that don’t seem to be healing on their own may require treatment from a healthcare provider.
8. Contact Dermatitis
Contact dermatitisis caused by an allergen or substance that irritates the skin. Symptoms usually appear just in the area that contacts the irritant.
Symptoms may include:
- Redness
- Itching
- Macules
- Papules
- Fissures
- Blisters
- Plaques
- Swelling
- Tenderness to the touch
- Chafing
If contact dermatitis does not get better at home, see a healthcare provider. A dermatologist, or skin specialist, may be able to help.
9. Eczema
Eczema is also called atopic dermatitis. It appears as an itchy, red rash. Symptoms may include:
- Red, grey, brown, or yellow patches of skin
- Itching
- Dryness
- Blisters
- Fissures
- Plaques
- Sensitive and painful patches
Certain external conditions like hot or cold weather can cause symptoms to flare up. Some skin products may also contribute to irritation. Food allergies, hormonal changes, and pet/dust mites can often worsen symptoms.
The mostcommon treatment typesinclude:
- Keeping skin hydrated with an emollient like a moisturizer
- Topical soaps and creams
- Corticosteroid cream
- Avoiding triggers and irritants
Mild eczema can be managed at home with over-the-counter remedies. If you have more severe eczema, your primary care provider or dermatologist can help you with a treatment plan.
10. Freckles
Freckles are small, flat, light-brown macules on the skin. They are caused by sun exposure.
Two types of lesions commonly called freckles include:
- Ephelides: These are typical freckles that occur from childhood. They are more common in people with fair skin and/or red hair. They tend to be round in shape and just millimeters in size. They appear in various brown shades.
- Solar lentigines: These are macules with clear borders. They vary from light brown to black. They are most often called sun spots, liver spots, age spots, or actinic lentigines. They are caused by chronic sun exposure and are most commonly seen in older individuals.
Most common freckles are harmless and rarely turn into skin cancer. Freckles do not require any treatment unless they change and skin cancer is suspected.
11. Hives
Hives are also called urticaria. They look like red, swollen, raised marks on the skin, usually caused by an allergic reaction to something specific. They can also happen for unknown reasons.
Hives can itch or sting. Typically, the individual marks last less than 24 hours, though more can continue to appear.
Urticaria vs. Angioedema
Urticaria and angioedema are very similar. Urticaria only affects the skin, though, and each mark lasts less than 24 hours. Angioedema may last for days. Other effects include the following:
- Angioedema occurs under the skin rather than just the outer layer, often with deep swelling around the mouth and eye areas.
- Angioedema can affect the mucous membranes, such as the eyelids and lips. It can be painful. It can sometimes affect the genitals, hands, or feet.
- Severe angioedema can cause the throat or tongue to swell. This may create breathing difficulties.
- Angioedema may cause swelling of the intestinal tract lining, which can lead to gastrointestinal cramping.
It is possible to get both urticaria and angioedema at the same time. Treatment for both conditions is similar. If breathing is affected, it is essential to seek emergency medical attention immediately. Call 911 if you experience:
- Difficulty breathing
- Wheezing
- Chest tightness
- Tongue/facial swelling
- Dizziness
12. Impetigo
Impetigois a bacterial skin infection. It is caused by bacteria entering the skin through a hair follicle or a small cut. The condition causes sores, crusts, and blister-like bumps.
Impetigo is very contagious. It most commonly affects young children. Antibiotics are typically used to treat impetigo.
13. Keloids
Keloidsare raised scars that form after an injury. They range in color from flesh-colored to red. Keloids are caused by an overgrowth of scar tissue and are often itchy and uncomfortable.
Some people are more prone to developing keloids. However, certain preventative measures may stop keloids from forming.
Those who have had keloids in the past have a higher risk of developing them again. To prevent this, there are a few things you can do:
- Pay close attention to any thickening skin in injured areas. If you notice this after an ear piercing, for example, immediately remove the earring and wear a pressure earring over the piercing.
- Practice good wound care. Wash with soap and water and bandage with sterile petrolatum gauze. Apply silicone gel or silicone sheets to freshly healed scars.
Keloids are harmless and do not require medical attention. Still, some people may feel distressed by the way they look. If you notice any thickening of the skin around a recently healed wound, consult your dermatologist. Treatment can help reduce their appearance.
14. Moles
A mole is also known as a melanocytic nevus or simply a nevus. They are usually round, brown/pink macules, papules, or nodules. They can be found anywhere on the body and may appear at any age.
Moles are usually harmless. However, see a doctor if a mole changes shape, color, size, or begins to bleed or crust. This could be a sign of melanoma, a type of skin cancer.
When checking your moles, these changes may suggest melanoma:
- Asymmetrical: Look at the shape of the mole. Moles are usually even in shape and look similar on all sides. Melanomas tend to be uneven in shape.
- Border:Normal moles have a smooth edge. Melanomas typically have an irregular, jagged border.
- Color: Moles tend to be even in color throughout.Melanomas might be uneven in color.
- Diameter: Moles tend to be small. Melanomas are usually over 6 millimeters wide.
- Evolving: Moles don’t tend to change much. Melanomas often change in size, shape, color, or texture.
Keep an eye out for changes in your moles or new moles with these qualities. If you find anything suspicious, see a healthcare provider right away.
15. Psoriasis
Psoriasistends to look like red, flaky skin, crusty patches of skin, and silvery skin scales in fair-skinned people. Hispanic people are more likely to have salmon-colored psoriasis and silvery-white scales. In African Americans, psoriasis often looks violet and the scales are gray.
Psoriasis happens because the body produces skin cells too quickly, over days rather than weeks. The excess growth of skin cells causes thick, raised, scaly patches.
The most common areas for psoriasis to occur are:
- Knees
- Elbows
- Scalp
- Lower back
Still, it can occur anywhere on the body. There is no cure for psoriasis.
Eczema vs. Psoriasis
Eczema and psoriasis look similar. There are a few differences to look out for:
- Itching tends to be much more intense with eczema and milder in psoriasis.
- Eczema tends to occur in places like the crooks of the knees and the elbows. Psoriasis most commonly occurs on the elbows, knees, scalp, and lower back.
- With eczema, the skin tends to be red, inflamed, cracked, blistered, and may leak pus. With psoriasis, the skin appears scaly, flaky, thickened, raised, and can be silvery.
If you are unsure if you have eczema or psoriasis, consult a doctor or dermatologist. The correct diagnosis will help ensure you get the right treatment.
16. Scabies
Scabiesis caused by a mite. It begins with intense itching. A rash can also develop. The rash appears as small red papules, welts, or scaly lesions. Repeated scratching can damage the skin.
Treatment typically includes medication to kill parasites that's applied to the skin. See a healthcare provider if you suspect scabies because complications can emerge if it's not treated. Some, like kidney and heart damage, can be serious.
17. Sebaceous Cyst
Sebaceous cystsare round and filled with keratin, a protein found in skin, hair, and nails. The nodules are firm and usually skin-colored. They usually appear on the upper body or face. They can range in size and occasionally rupture.
A ruptured cyst may become infected and needs to be treated. Otherwise, sebaceous cysts don’t usually require treatment. They tend to grow slowly and are benign.
18. Shingles
Shinglesis caused by the reactivation of the virus that causes chickenpox. A shingles rash is a very painful red rash comprised of macules, papules, and blisters. The blisters can break and weep fluid. This can lead to secondary crusting.
The rash itches, burns, and can be painful. Other symptoms can include:
- Fever
- Chills
- Headache
- Lethargy
You may hear shingles referred to as a belt or band. This is because it often appears as a belt-like formation around the rib cage or waist.
The risk of shingles can be reduced with vaccines like Shingrix. The Centers for Disease Control and Prevention (CDC) recommends the Shingrix vaccine for people over 50 and for younger adults who have weakened immune systems.
The vaccine also protects against postherpetic neuralgia, a painful condition of the nerves. This is the most common complication of shingles.
19. Skin Tag
Skin tags arealso called acrochordon. They are soft, small, skin-colored growths and occur more often as people age.
Removal is not usually necessary. Skin tags usually don’t require medical attention unless:
- They cause cosmetic concern.
- They’re in a position that causes irritation.
Some studies have shown that skin tags can co-occur more often with obesity and metabolic conditions, like insulin resistance. Ask your healthcare provider if you think skin tags may be a sign that other medical concerns may be at work.
20. Warts
Wartsare caused by the human papillomavirus (HPV). They tend to occur in groups and are contagious.
Warts are raised, flesh-colored papules. They may contain tiny black dots in the center. They are not dangerous but can be painful and are easy to pass to others.
There are several different types of warts, including:
- Common warts
- Plantar warts
- Flat warts
- Filiform warts
- Genital warts
- Periungual warts
Most warts are not dangerous. Rarely, some types of human papillomavirus that cause genital warts can cause cervical or anal cancer.
Primary vs. Secondary Skin Lesions
Skin lesions are either primary or secondary.Primary skin lesions are either present from birth or develop during your lifetime.
Secondary skin lesions arise from primary skin lesions. This can happen when a primary skin lesion is:
- Disturbed
- Irritated
- Changes over time
For example, if eczema is scratched, a crust may form. The crust is a secondary lesion.
Primary skin lesions tend to be divided into three groups:
- Lesions formed by fluid within the skin layers: Examples include vesicles and pustules.
- Lesions that are solid masses: Examples include nodules and tumors.
- Flat lesions: Examples include patches and macules.
Types of primary lesions include:
- Bulla:A vesicle that is more than 1 centimeter (cm) and filled with fluid
- Macule: A flat, discolored lesion, less than 1 cm in size
- Papule or maculopapular: An elevated solid lesion, up to 1 centimeter in size. It has clear borders, is firm, and can appear in various colors.
- Patch: A flat, discolored lesion, greater than 1 cm in size
- Plaque: A lesion that is raised like a papule, greater than 1 cm in size. It is solid, rough, and flat-topped.
- Vesicle: A fluid-filled blister less than 1 cm in size
- Pustule: Similar to a vesicle but filled with pus instead of fluid
- Nodule: A circular, elevated, solid bump greater than 1 cm in size
Secondary Skin Lesions
Examples of secondary skin lesions include:
- Crust: A rough, elevated area formed from dried fluid. The fluid may be pus, blood, or serum.
- Erosion: The loss of the top layer of skin. It is moist and glistening in appearance.
- Fissure: Straight breaks in the skin that go deeper than the top layer of skin into the second layer of skin. They can be painful and can be caused by excessive dryness.
- Lichenification: A rough thickening of the top layer of skin
- Scale: A build-up of cells that form patches and then flake off the skin
- Ulcer: A wound deeper than the top layer of skin that damages the second layer of skin. It is concave and variable in size. Deeper ulcers are more serious.
Diagnosis
If you notice a lesion on your skin, schedule an appointment with your healthcare provider or dermatologist to have it looked at. During your appointment, they will physically examine the characteristics of the lesion, including its size, shape, color, texture, and location.
Your provider will ask you questions about the lesion, like when you noticed the change in your skin, and whether or not the lesion itches. You can also expect them to inquire about any allergies or health conditions that you have, medications you are taking, and other pieces of your medical history.
Healthcare providers are often able to diagnose skin lesions simply by looking at them. But they may order additional tests to confirm a diagnosis, including:
- An allergy test, such as a skin prick test, to check for hypersensitivity to specific allergens
- A blood test, such as an immunoglobulin E (IgE) blood test, to check for immune system activity that could point to a skin disease or infection
- A microbial swab, to determine which, if any, bacteria or fungus is causing the lesion
- A skin biopsy, to diagnose or rule out malignancy (cancer)
Treatment
Most skin lesions are benign (harmless) and don’t need to be removed unless for cosmetic reasons. Your healthcare provider may recommend having the lesion removed if it is causing you discomfort or if there is any doubt that it could be cancerous.
Skin lesion removal can typically be done in your healthcare provider’s office, although in some cases it may need to be removed by a surgeon. The lesion and surrounding skin will likely be numbed with a local anesthetic before the removal.
Your healthcare provider may use one of the following methods to remove the lesion:
- Shave excision is a technique used for raised lesions or lesions in the upper layer of skin. A provider will remove all or part of the lesion using a small blade. Stitches are usually not necessary.
- Simple scissor excision is another method used for raised lesions or those in the upper skin layer. The provider will use forceps to gently pull the lesion up from the skin, then cut around the lesion with scissors. Stitches are usually not necessary.
- Skin excision (full thickness) is a method used when there is a concern about skin cancer. The entire lesion is removed down to the fatty layers of skin, and some of the surrounding tissues may be removed to ensure the entire area is clear of cancer cells. The area is closed with stitches.
- Laser excision is used to remove benign lesions, such as warts, moles, and even tattoos. The provider will aim a specialized laser beam at the lesion, heating up the skin pigments until they burst and can be carried away by the immune system. Stitches are not needed.
- Cryotherapy is a method used for warts, actinic keratoses, and seborrheic keratosis, in which liquid nitrogen is applied to the lesion to freeze it. Following the procedure, the lesion will blister and peel away.
If diagnostic tests reveal that the skin lesion is malignant, treatment can include surgery to remove as much of the affected skin as possible in order to prevent it from growing back. Depending on the severity of the malignancy, radiation therapy and/or chemotherapy may be necessary to destroy any remaining cancer cells.
Summary
Skin lesions can be present from birth or develop over your lifetime due to sun exposure, bacteria, allergies, or chronic conditions. They can vary in appearance and may or may not be cancerous.
Many lesions can be treated at home with topical ointments and creams. Others require treatment from a healthcare provider. If you are unsure of what type of lesion you have, or if you have a lesion that changes suddenly, it is always best to seek medical care.