Specialty MDs can tell a lot about your well-being just by looking at you. Yep, your skin, nails, and hair hold important clues to what's going on inside your body. From anxiety and stress to GI issues and diabetes, doctors who specialize in diabetes, psychiatry, and even ophthalmology share what they can suss out in just one a glance.
The Ophthalmologist
What this doc looks for: Red eyelids or lumps around your lids
The sensitive tissue around your lids could be puffy, red, or even (yikes) droopy because of an allergy to or irritation from a beauty product, like mascara, eye shadow, or even shampoo, says ophthalmologist Robert Abel Jr., MD, of Delaware Ophthalmology Consultants in Wilmington, DE. Food allergies can also cause your upper lid to swell. Despite the bevy of possible suspects, it's worth figuring out. "Redness and discharge from your eyes causes irritation and changes your tear film—the outer liquid layer on your cornea," he says. In other words, you're lining up for burning eyes and blurred vision.
How he can help: You may need antibiotic or steroid eyedrops, or a topical hydrocortisone cream on lids to treat the symptoms. As for the culprit? It can be a new product causing the irritation, but an allergic reaction can pop up after using something many times. To solve the mystery, Abel suggests taking these steps: First, if you typically have touchy skin, choose products designed for sensitive skin and are fragrance-free. Then, try eliminating all products that come in contact with your eye area and reintroduce them one by one to discover what sets off your skin. (If you notice something causes inflammation, wait until the redness subsides again to introduce another product.) Finally, if your sleuthing doesn't turn up anything, your dermatologist may run a patch test to pinpoint the cause once and for all.
The Psychiatrist
What this doc looks for: Bitten-down nails; red, patchy skin
"We can see anxiety on your skin and nails. Nail biting—also called onychophagia—can be a result of stress, boredom, or even perfectionism," says Gregory Thorkelson, MD, a psychiatrist at UPMC Western Psychiatric Institute and Clinic in Pittsburgh. And while anxiety isn't a direct cause of your skin problems, it can make existing ones, like eczemaand psoriasis, worse, he says.
How he can help: You can treat stress-related skin symptoms immediately with the help of your derm, but a therapist can help you work through the root causes of your stress and develop a plan to cope, which will help curb future flare-ups. (Heal your body from the inside out with the 12-day liver detox for total body health!)
The Diabetes Doctor
What this doc looks for: Dark, velvety patches of skin on the back of your neck and under your arms
These dark patches, called acanthosis nigricans, can be one of the earliest signs of prediabetes (it may even show up before prediabetes), says Robert Gabbay, MD, PhD, chief medical officer at Harvard Medical School's Joslin Diabetes Center. Those dark areas are one marker that your body is becoming insulin resistant. "It's thought that insulin overstimulates the skin and causes the dark folds, though it's not fully understood," he says. Because diabetes often runs in families, patients often link dark patches to genetics, rather than the disease. "People don't always make the connection," says Gabbay.
How he can help: If you notice you have dark patches in body folds or creases, are overweight or obese, and have a history of diabetes in your family, your doctor will want to check your blood glucose level. You may not have diabetes yet, despite this early sign, so he'll coach you through steps to take to prevent the disease from actually developing. For example, losing 7% of your body weight will reduce your risk by two-thirds, Gabbay says.
The GI Doctor
What this doc looks for: Shiny, tender red nodules on shins; itchy, blistery rash on elbows, knees, butt, back, or scalp
This type of rash, and skin issues in general, go hand in hand with inflammatory bowel disease (IBD) in about 44% of cases, says Elizabeth Blaney, MD, a gastroenterologist and a clinical assistant professor of medicine at the University of Pittsburgh. Gastroenterologists keep their eyes peeled for two common issues: erythema nodosum (red nodules on shins caused by an immune system reaction) and dermatitis herpetiformis (an itchy, blistery rash triggered by gluten). The latter can point to a case of "silent" celiac disease, meaning it may be one of the only signs something's going on—even if you don't have telltale GI symptoms.
How she can help: Depending on your diagnosis, treating your IBD will make skin symptoms disappear, and a gluten-free diet should do the same if you have celiac disease. In the meantime, NSAIDs may help reduce the pain and swelling of red nodules on your shins, and antibiotic creams like dapsone can stamp out symptoms of a gluten-linked rash.
The Gynecologist
What this doc looks for: A black, brown, white, pink, or red spot on your vulva
You've been told to check your body for moles—and that means your vulva, too, says Lauren Streicher, MD, an associate professor of obstetrics and gynecology at the Feinberg School of Medicine at Northwestern University and author of Sex Rx. It's rare, but you can get melanoma there, even though the spot doesn't see the light of day. Some derms skip the vulva during a skin check—often because the patient doesn't want them to look there. What's more, it's tough to crane your neck to do the scan yourself, even if you think to do so. "That's why it's so important to go for an annual exam at your gynecologist, even if you don't need a pap smear that year," she says. "These are the things we're looking for."
How she can help: If your gyno suspects it's melanoma, she will refer you to a dermatologist for a biopsy.
The Endocrinologist
What this dly or brittle nails
Thyroid conditions, both underactive and overactive, can prompt skin problems, says board-certified endocrinologist Minisha Sood, MD, an endocrinologist at Lenox Hill Hospital. An underactive thyroid can show outwardly as thin hair or brittle fingernails, while an overactive thyroid can leave you with thick, dry skin on your shins.
How she can help: If you're experiencing dry skin along with weight gain or loss, fatigue, and difficulty sleeping, your doc may want to check your thyroid levels with a blood test.
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