SymptomSkin, hair & nails
Skin Changes: Normal and Abnormal Signs
Skin changes are any new differences in your skin's color, texture, thickness or markings. Many are normal: wrinkles, dryness, age spots, seborrheic keratoses and cherry angiomas with aging, and darkening during pregnancy. Abnormal changes include a new or changing mole, a sore that does not heal, yellowing of the skin, dark velvety patches in skin folds, and widespread itching or bruising. These can signal skin cancer or an internal problem such as liver disease or diabetes and should be checked.
Also called: Changes in skin, skin abnormalities, new skin marks, skin texture changes
At a glance
- What it is
- Any new change in skin color, texture, thickness, or new spots and growths.
- Normal changes
- Wrinkles, dryness, thinning, age spots, seborrheic keratoses, cherry angiomas, pregnancy darkening.
- Abnormal changes
- Changing moles, non-healing sores, jaundice, velvety dark patches, unexplained bruising, sudden thickening.
- Why it matters
- Some changes are early signs of skin cancer or internal disease.
- Check
- Look over your skin monthly and photograph spots you are watching.
When to get help
Call 911 or go to the ER
- A rapidly spreading rash with fever, blisters, peeling skin or sores in the mouth or eyes
- Skin that is red, hot, swollen and rapidly spreading with severe pain or fever
- Purple or dark red spots that do not fade when pressed, with fever or feeling unwell
See a doctor within a day or two
- Yellowing of the skin or whites of the eyes
- Widespread bruising or tiny red spots (petechiae) without injury
- A mole or dark spot that is rapidly growing, bleeding or changing color
Book a routine appointment
- A sore, scab or pearly bump that does not heal within 4 weeks
- A mole that is changing, or a new spot after 40 that looks different from others
- Dark, velvety, thickened skin in the neck folds or armpits
- Skin that is becoming tight, hard or shiny, especially on the fingers or face
- Persistent itching all over without a rash
Usually safe to manage at home
- Gradual dryness, fine lines and small flat brown spots on sun-exposed skin in middle age
- Darkening of the nipples, a dark line on the belly or facial patches during pregnancy
Normal skin changes with age
As you age, the outer layer thins, collagen and elastin decrease, oil glands become less active and the skin heals more slowly. These changes are expected:
| Change | Why it happens |
|---|---|
| Wrinkles and sagging | Loss of collagen and elastin, plus sun damage |
| Dryness and itch, especially in winter | Fewer oil glands, thinner barrier |
| Thin, easily torn skin and bruising | Thinner skin and fragile blood vessels; worse with steroid or blood thinner use |
| Age spots | Flat brown patches from years of sun exposure |
| Seborrheic keratoses | Stuck-on, waxy brown growths after 40 |
| Cherry angiomas | Small bright red dots |
| Skin tags | Soft flaps in skin folds |
Normal changes in pregnancy and other life stages
- Pregnancy: darker nipples, a dark line down the belly (linea nigra), facial patches (melasma), stretch marks, spider veins and skin tags.
- Puberty: acne, more body hair and oilier skin.
- Menopause: drier, thinner skin and adult acne in some.
Abnormal skin changes and what they may mean
Signs of skin cancer
- a new mole after age 40 or one that changes in size, shape or color
- a spot that looks different from all your other moles
- a shiny, pearly bump, often with tiny blood vessels (basal cell carcinoma)
- a firm red lump or scaly patch that bleeds or crusts (squamous cell carcinoma)
- a sore that does not heal within 4 weeks
- rough, scaly patches on sun-damaged skin (actinic keratosis)
Use the ABCDE rule for moles: asymmetry, irregular border, uneven color, diameter over 6 mm, and evolving. See melanoma and skin moles.
Skin changes that point to internal disease
| Skin change | Possible internal cause |
|---|---|
| Yellow skin and eyes | Liver disease, blocked bile duct, hemolysis. See jaundice |
| Dark, velvety patches in folds | Insulin resistance, type 2 diabetes, obesity; rarely cancer. See acanthosis nigricans |
| Generalized darkening | Addison's disease, hemochromatosis |
| Pale skin | Anemia |
| Easy bruising and tiny red spots | Low platelets, clotting disorders, leukemia |
| Thick, tight, shiny skin | Scleroderma |
| Yellow plaques around eyelids | High cholesterol |
| Itch without rash | Liver or kidney disease, thyroid problems, iron deficiency, lymphoma |
| Shin spots or slow-healing sores on the feet | Diabetes |
| Butterfly rash on the face | Lupus |
| Sudden eruption of many seborrheic keratoses | Rarely, an internal cancer |
Inflammatory skin conditions
Red, itchy, scaly or weepy patches are often eczema, psoriasis, contact dermatitis or fungal infection. These are not dangerous but often improve with treatment.
Sudden skin changes
New rashes appearing over hours to days are often caused by infections, medicines or allergies. A rash after starting a new drug, especially antibiotics, anti-seizure medicines or allopurinol, needs prompt review, particularly with fever or mouth sores.
How to check your skin
- Once a month, in good light, check all of your skin with a full-length and a hand mirror, including your scalp, soles, between toes and under nails.
- Photograph any spot you are watching, with a ruler beside it, to compare later.
- Ask a partner to check your back and scalp.
- See a doctor for anything new, changing or unusual.
People with many moles, a history of skin cancer, fair skin that burns, or a weakened immune system should consider regular checks with a dermatologist.
How doctors evaluate skin changes
A doctor will look at the change, often with a dermatoscope, and ask how long it has been present, whether it has changed and about your sun exposure, medicines and general health. Depending on findings, they may take a skin biopsy, order blood tests (liver function, blood sugar, thyroid, blood count) or refer you to a dermatologist.
Protecting your skin
- Use broad-spectrum sunscreen of SPF 30 or more daily on exposed skin.
- Avoid tanning beds and peak sun.
- Moisturize after bathing to reduce age-related dryness.
- Do not smoke, which speeds skin aging.
Frequently asked questions
What skin changes are normal with aging?
Wrinkles, dryness, thinner skin that bruises easily, age spots, seborrheic keratoses, cherry angiomas and skin tags are all normal. They are not dangerous, though a doctor should check any spot you are unsure about or that is changing.
What skin changes should I worry about?
See a doctor for a new or changing mole, a spot that looks different from others, a sore that has not healed in 4 weeks, yellow skin or eyes, unexplained bruising or tiny red spots, dark velvety patches, or skin that is becoming hard and tight.
Can skin changes be a sign of diabetes?
Yes. Dark, velvety skin in the neck or armpits (acanthosis nigricans), frequent skin infections, slow-healing sores on the feet, skin tags and brown spots on the shins can all be associated with insulin resistance or diabetes.
Can liver problems cause skin changes?
Yes. Liver disease can cause yellow skin and eyes, itching, spider-like blood vessels on the chest, red palms and easy bruising. Any yellowing of the skin or eyes needs prompt medical assessment.
How often should I check my skin for changes?
Check once a month. Regular self-checks help you learn what your skin normally looks like, so new or changing spots stand out. People at high risk of skin cancer should also have periodic checks by a dermatologist.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Dermatology: Skin care in your 40s and 50s; Skin cancer: how to check your skin
- MedlinePlus: Aging changes in skin
- NHS: Skin cancer (non-melanoma)
- American Cancer Society: Skin cancer signs and symptoms
- National Institute on Aging: Skin care and aging