Adult Health

Skin, Nail Conditions and Lumps (Adults)

Some links on this page have been colour coded to make it easier to find the information you need:

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In-depth
Clinical level

LOCAL SUPPORT - SELF REFERRAL

YOUR PHARMACY AND SKIN CONDITIONS

Many common skin conditions can be supported with self-care or the support of your local pharmacist. You can see your local pharmacist for advice including support with relevant creams and oral medication such as antihistamines.

From the NHS
Find a pharmacy Find a pharmacy – NHS 

For further information on the range of services offered for common skin conditions by your local pharmacist, see under

WHEN DO YOU NEED AN ASSESSMENT BY A GP OR ATTEND A&E?

Some conditions may need a clinical assessment in a GP practice. Your pharmacist can advise you when this might be the case and this is also well explained in the NHS articles. Much less commonly you may need to attend A&E directly and this is again well explained in the NHS articles.

Podiatry support

Local community podiatrists treat people who have a medical/podiatric problem that puts your foot at risk of deterioration.

Treatment from a community podiatrist

Local community podiatrist treat people who have a medical/podiatric problem that puts your foot at risk of deterioration. Conditions include:

  • painful corns and callus – but not verrucae (warts) or fungal nails
  • ingrowing toe nails
  • foot ulcers

To self-refer to the service see “podiatry” under

NATIONAL SUPPORT - SELF REFERRAL

From the British Dermatology Association
List of Patient Support Groups for many skin conditions often with helplines Patient Support Groups – BAD Patient Hub

From Changing Faces
Support for the potential emotional impact of the appearance of skin conditions including a helpline
Services and support Services For People With Disfigurements | Changing Faces

GENERAL INFORMATION

SYMPTOM CHECKER TOOLS

Remember these tools are purely designed to provide information and potentially help you understand your skin condition. These tools do not provide medical advice, diagnosis or treatment. Professional medical advice provided by a clinician such as a doctor should always be relied on to make decisions, and information provided here should not delay you in any way getting such advice.

From DermNet NZ
This site is backed up with pictures of each condition which is helpful in understanding possible conditions better. In addition, there is very detailed information on each of the skin conditions considered.
DermDiag : A tool to help you identify a skin condition. DermDiag | DermNet NZ

From Skinsight
This tool gives conditions by location which can be very helpful if you have a rash in one place (e.g., hands). It has excellent pictures for each condition which you can compare.
Insight from experts about treating and caring for your skin. skinsight | expert insights about skin care, skin health, and skin disease

From Familydoctor
Skin Rashes & Other Skin Problems Symptom Checker: Skin Rashes & Other Skin Problems

From the Primary Care Dermatology Society (PCDS) a tool intended for GPs
The Cunliffe (TP) General Dermatology Diagnostic Tool The Cunliffe (TP) General Dermatology Diagnostic Tool

From the British Skin Foundation
Explore our A-Z of skin. British Skin Foundation – Know your skin inside out

From the NHS
Thought not strictly a symptom checker explains differences between common causes of itching
Itchy skin Itchy skin – NHS

GENERAL INFORMATION

British Association of Dermatologist
Excellent website with some very good leaflets Home – BAD Patient Hub

From the Primary Care Dermatology Society (PCDS)
“Our primary objective is to educate GPs, nurses, other health professionals, and the general public on skin conditions.” Though some of the information is focused on clinicians it has a good patient and carers page which includes information such as excellent patient leaflets for common conditions which replicate what a GP is likely to say and more. Patients and carers

From DermNet NZ
Excellent website on dermatology  DermNet NZ – All about the skin | DermNet NZ

From Patient info
Skincare and conditions centre Skin Conditions and Diseases | Symptoms, Treatment, Information | Skincare | Patient which includes numerous articles on skin and sections with Information on psoriasis, skin rashes viral rashes, atopic eczema and sunburn.

From NICE
Skin and nail Skin and nail | Specialities | CKS | NICE

EMOTIONAL SUPPORT

From Changing Faces
Great advice and support for the potential emotional impact of the appearance of skin conditions

From the British Association of Dermatologists
Support & Resources Support & Resources – BAD Patient Hub

Long Term Skin Conditions

Some conditions including acne, eczema, psoriasis, and vitiligo which can be more long term are considered under the common long-term conditions section, see under

Skin Cancer

It is worth everyone having some understanding of skin cancer, as an early diagnosis helps.

Overview with videos

From the Thames Valley Cancer Alliance
Skin Cancer: Early diagnosis saves lives Skin Cancer – thamesvalleycanceralliance.nhs.uk

Melanoma

From the NHS
Comparing a benign (non-cancerous) mole with a melanoma (cancerous mole)
Moles Moles – NHS

Explaining the ABCDEs of melanoma with photographs

From Skin Cancer Foundation
This is good American dermatology website with some helpful pictures (see ABCDEs of melanoma as an example), though the information about dermatologists does not apply in the UK

Different types of skin cancer with photographs

From DermNet NZ

“Most melanomas have characteristics described by the Glasgow 7-point checklist or by the ABCDE+EFG criteria of melanoma. Not all lesions with these characteristics are malignant. Not all melanomas show these characteristics.” Melanoma Skin Cancer: Images, Diagnosis, and Treatment – DermNet 

From Cancer research UK
Skin cancer Skin cancer cancerresearchuk

From The British Skin Foundation
What is skin cancer? What is skin cancer? | British Skin Foundation

More information on types of skin cancer and skin cancer detection

From the NHS

From Patient info

From NICE
Skin cancers – recognition and referral Skin cancers – recognition and referral | Health topics A to Z | CKS | NICE

From the Royal College of General Practitioners
From dermatology toolkit:  Information and support for patients and carers

It is worth everyone, particularly older people, been aware of Actinic Keratoses and Bowen’s  disease as, if necessary, they are easy to treat and prevent any cancer developing.

Actinic keratoses

As Patient info suggests
“Actinic keratoses are common, especially in older people, many of whom have more than one. Usually they are harmless but there is a small risk that they may eventually turn into skin cancer and therefore treatment may be advised.”

From the Primary Care Dermatology Society
Simple explanation from a GP perspective including on treatment

From the NHS and Patient info

From Dermnet
Offers some good pictures of actinic keratoses Actinic keratoses (Solar keratosis): Diagnosis and Treatment — DermNet 

Bowen’s Disease

As the NHS suggests
“Bowen’s disease is a very early form of skin cancer that’s easily treatable. The main sign is a red, scaly patch on the skin. Bowen’s disease itself is not usually serious. It tends to grow very slowly over months or years, and there are several very effective treatments for it. The concern is that Bowen’s disease can eventually develop into a different type of skin cancer called squamous cell skin cancer if it’s left undiagnosed. Bowen’s disease usually affects people in their 60s and 70s.”

From the Primary Care Dermatology Society
Simple explanation from a GP perspective, including on treatment

From the NHS and Patient info

Reducing the risk of skin cancer

Answers to the question: “ How can you reduce your risk of skin cancer?” can be found under

Skin rashes caused by infection

This is not an exhaustive list but provides details on some of the more common infections causing rashes. This list is divided into bacterial, viral and fungal infections which generally have slightly different common features to help identify them. Each infection, is divided up into self-care (with or without a pharmacist support), assessment by a GP practice, and attendance at A&E. There is also a link to “spotting sepsis”, which though not common is important to diagnose early.

BACTERIAL INFECTIONS

Anyone with meningitis should be seen in A&E:

From the NHS
Rash that does not fade when a glass is rolled over it in a very ill patient:
Meningitis Meningitis – NHS

Normally the following can be treated with self-care (with or without pharmacy support) but on occasions may need to be seen by a GP practice as elaborated on in the articles below:

From the NHS

From the NHS and Patient info
Stye

Anyone with the following may need to see their GP practice for antibiotics as is explained further in the articles below.

From the NHS
Rash maybe red, inflamed, tender, sometimes with blisters, sometimes golden-brown crust

Can present like a cellulitis and can develop into an abscess

From NICE
Cellulitis-acute Cellulitis – acute | Health topics A to Z | CKS | NICE

A circular or oval shape rash around a tick bite which should be treated with antibiotics as soon as diagnosed.

From the NHS
Lyme disease Lyme disease – NHS

VIRAL INFECTIONS

Anyone with the following conditions can often self-care with the support of a pharmacist but on occasions may need to be reviewed by a GP practice as explained further in these articles.

Rash with blisters which can be itchy

From the NHS, Patient info and NICE
Cold sore

From the NHS
Chicken pox Chickenpox – NHS

Anyone with the following should contact their GP practice/111 as soon as possible for antibiotics as is explained further in the articles below.

From the NHS and NICE
Shingles

Post-herpetic neuralgia

 FUNGAL INFECTIONS

Normally the following conditions can be treated with self-care (with or without pharmacy support) but on occasions may need to be seen by a GP practice as elaborated on in the articles below:

From the NHS

From Patient info
Fungal Groin Infection (Tinea cruris)  Fungal Groin Infection (Tinea Cruris) | Symptoms and Treatment | Patient

Normally this rash does not require any treatment but you may wish to see a GP for a diagnosis. The herald patch (like ring worm) before the full rash appears makes the diagnosis more obvious.

From the NHS and Patient info
Pityriasis rosea

Balanitis: This rash on the penis will normally need to be treated by your GP sometimes for a fungal infection, sometimes for a bacterial infection or sometimes as a mild allergic reaction.

From the NHS and NICE
Balanitis

Having some basic knowledge of the symptoms and signs of sepsis can allow you to identify when someone is becoming seriously ill and take immediate action. This is explained under

SPECIFIC SKIN CONDITIONS

bites and chronic parasites

Your pharmacist can fully support you for head lice

From the NHS and NICE
Head lice and nits

Normally the following conditions can be treated with self-care with pharmacy support but on a few occasions may need to be seen by a GP practice as elaborated on in the articles below:

From the NHS and Patient info

From the NHS, Patient info and NICE
Insect bites and stings

Pubic lice: If the lice aren’t in your eyelashes, a pharmacist can give you advice about treatments. But going to a sexual health clinic means you can also get tested for other STIs at the same time.

From the NHS
Pubic lice Pubic lice – NHS

A circular or oval shape rash around a tick bite which should be treated with antibiotics as soon as diagnosed

From the NHS
Lyme disease Lyme disease – NHS

HAIR CONDITIONS

Your pharmacist can fully support you for head lice

From the NHS, Patient info and NICE
Head lice and nits

Normally dandruff can be treated with self-care with pharmacy support but on a few occasions may need to be seen by a GP practice as elaborated on in the articles below:

From the NHS and patient info
Dandruff

With a mild hair dye reaction you may be able to self-care with pharmacy support, but you may need GP support and very rarely A&E support (if anaphylaxis) as explained further in the article.

From the NHS
Hair dye reactions Hair dye reactions – NHS

With these conditions you may want to see a GP for a diagnosis as explained in the articles below. Importantly note that the NHS is not able to provide drug treatment for male pattern baldness or provide laser hair removal treatment. 

From the NHS

From Patient info

From NICE

HANDS AND FEET CONDITIONS

Normally the following conditions can be treated with self-care with support of your local pharmacist who can advise if you need to see your GP practice. Painful corns and calluses you can self-refer to an NHS podiatrist (details at the bottom of the page)

From the NHS, Patient info and NICE
Warts and verrucas

From the NHS

You can start with simple self-care as suggested in the article but may need GP support for this condition

NAIL CONDITIONS

From the NHS
Nail problems Nail problems – NHS

Normally the following can be treated with self-care with pharmacy support but on a few occasions may need to be seen by a GP practice as elaborated on in the articles below:

From the NHS and Patient info
Fungal nail infection

If you do decide you want to look at oral antibiotic treatment for a fungal nail infection and meet the criteria (after microbiology lab analysis), then it is worth understanding that the drug treatment is done over a minimum of 1 month and potentially up to 6 months and there are potential side effects with both options. This is explained in more detail below.

From NICE
Fungal nail infection Fungal nail infection | Health topics A to Z | CKS | NICE

Normally for the following conditions you can self-care with support from your local pharmacist who can also advise if you might occasionally need to see your GP practice for antibiotics. You can also self-refer to a podiatrist on the NHS or see a private podiatrist to provide a long-term solution.

From the NHS

SELF-REFERRAL TO NHS PODIATRY

For information on self-referral to NHS podiatry services, including any criteria, see under

SELF-REFERRAL TO PRIVATE PODIATRY

For information on local private podiatrists, see under

accidents and injuries

From the NHS
The following conditions can often be treated with support of your local pharmacist but on occasions will need the support of you GP practice as explained in the articles below

Some burns can be treated with self-care with the support of your local pharmacist, some will need the input of your GP practice nurse, and some you will need to go straight to A&E. This is all expanded on in the article below

Call 999 and ask for urgent help in the case of acid and chemical burns

allergic reaction

An allergic skin reaction normally produces a red itchy rash, sometimes with hives.

With these conditions if mild they only require self-care with pharmacy support, but in some cases GP support may be needed and very rarely A&E support (if anaphylaxis). This is all explained in detail under

If you have a severe allergic response, you should call 999

From the NHS and Patient info
Anaphylaxis

mouth ulcers and other oral conditions

Your pharmacist can treat oral thrush in any adult.

From the NHS

If mouth ulcers are present less than 3 weeks they can be treated by your local pharmacist.

Oral conditions

Further information on “oral conditions” is included in the “frequently asked questions” section, see under

rashses with no cause

For all these rashes you may end up seeing your GP for a diagnosis

From the NHS and Patient info
“Causes itchy white patches on the genitals or other parts of the body”
Lichen sclerosus

“Raised, purple-red blotches on your arms, legs or body, white patches on your gums, tongue or the insides of your cheeks”
Lichen planus

“Swollen fat under the skin causing bumps and patches that look red or darker than surrounding skin”
Erythema nodosum

Lumps and common benign (non-cancerous) raised lesions

From the NHS

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If you think you need medical help right now, 111 online can tell you what to do next.

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