What Your Skin Says About Your Health

Dr. Siobhan Deshauer explains:

The largest organ of the body has a lot to say!

It’s not too surprising, as everything affects everything else and the skin surrounds all the other organs.

So, with that in mind, here’s your guide to what your skin says about your health:

1. Dermatitis herpetiformis (celiac disease): small, fluid-filled blisters grouped together—often on elbows and knees—caused by an autoimmune reaction to gluten; antibodies attack enzymes in the small intestine and skin, linking gut and skin inflammation. Can be confirmed by biopsy showing fluorescent antibodies, and resolves (as you probably know) with a gluten-free diet.
2. Xanthoma (high cholesterol): fatty plaques under the skin that can indicate dangerously high lipid levels, diabetes, or liver disease. Their placement can reveal the lipid type involved—eruptive xanthomas on shoulders, arms, or buttocks signal high triglycerides, while tendon xanthomas (such as on the Achilles tendon) suggest familial hypercholesterolemia and high LDL cholesterol.
3. Gouty tophi (uric acid buildup): hard, lumpy deposits on your joints, fingers, toes, or ears formed by uric acid crystals. These are associated with gout, a painful arthritis once known as the “disease of kings” due to meaty diets. Untreated, the crystals can damage kidneys and cause stones; now treatable with uric acid–lowering medication, but obviously, prevention is better than cure, so easing up the meat is a good idea.
4. Skin tags (diabetes warning): small, soft growths on areas of friction—neck, eyelids, or armpits—often harmless but potentially linked to insulin resistance or diabetes, especially when numerous. Screening with a hemoglobin A1c blood test is advised.
5. Seborrheic keratosis (age spots): waxy, raised brown growths nicknamed “barnacles of ageing.” Usually benign, but a sudden widespread eruption (the Leser–Trélat sign) can indicate an internal cancer and requires medical evaluation.
6. Jaundice (yellow skin): yellowing of skin or eyes from bilirubin buildup, a sign of liver malfunction, bile duct blockage, or excessive red blood cell breakdown. Requires immediate attention. A harmless exception is Gilbert’s syndrome, a genetic condition where mild jaundice appears during stress or illness, sometimes linked to reduced heart disease and cancer risk due to bilirubin’s antioxidant effects.
7. Itchy skin (pruritus): can result from dryness, allergies, or irritation, but widespread itching without a rash may signal liver disease, kidney failure, or certain cancers. In pregnancy, bile acid buildup can cause severe itching and risk to the baby, often prompting early delivery. Persistent itch beyond a few weeks warrants a medical check.
8. Spider nevi (spider angioma): small, red, web-like blood vessel clusters that blanch when pressed. Having one or two is normal, but multiple lesions may suggest liver cirrhosis or (extremely) high estrogen levels. They also appear commonly in pregnancy and usually fade afterwards.
9. Malar rash vs. rosacea: lupus malar rash forms a butterfly pattern over cheeks and bridge of nose but typically spares the nasolabial folds; rosacea often includes the folds, flares with heat, alcohol, spicy foods, and affects appearance rather than internal organs.
10. Quick “glass test” for vasculitis: press a clear glass on the rash—if it blanches, blood is inside vessels (less concerning); if it doesn’t blanch, blood has leaked outside vessels, raising concern for vasculitis, low platelets, or serious infection (including, famously, meningitis).
11. Eczema vs. psoriasis: eczema favors flexor surfaces (inner elbows, wrists, behind knees), is intensely itchy, and clusters with hay fever and asthma; psoriasis favours extensor surfaces (elbows, knees), has thick silvery scale, and carries higher risks of arthritis and heart disease due to systemic inflammation.
12. Acquired hypertrichosis lanuginosa: sudden growth of fine, downy hair can be a paraneoplastic sign—often linked to internal malignancy—so it warrants urgent cancer screening.
13. Acanthosis nigricans: velvety, darker skin in body folds (neck, armpits) is commonly tied to insulin resistance, type 2 diabetes, or PCOS; improving insulin sensitivity can make it fade.
14. Adult-onset or suddenly worse acne: new, persistent acne in adults may reflect hormonal disorders such as PCOS, Cushing’s syndrome, or androgen-secreting tumours—evaluate if other signs (weight change, hirsutism, purple striae) are present.
15. Livedo reticularis: a purplish, net-like pattern—often benign with cold exposure, especially in infants—but can signal vasculitis or antiphospholipid syndrome in adults if persistent or symptomatic.
16. Dermatomyositis: look for heliotrope rash (eyelids), Gottron’s papules (knuckles), V sign (chest), and Shawl sign (back/shoulders) plus proximal muscle weakness; in older adults, screen for cancer (notably lung or stomach).
17. Hives (urticaria) red flags: typical wheals come and go within hours; lesions lasting >24 hours, leaving bruising, or feeling painful/burning rather than itchy suggest urticarial vasculitis—seek assessment.
18. Tripe palms: thick, ridged, velvety palms/soles strongly associate with internal cancers—most often gastric—so prompt investigation is essential.

For more on each of these plus visual illustrations, enjoy:

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Want to learn more?

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Take care!