Unsure Which Specialist to Consult for Skin Concerns?

I'm not sure which specialty to see?

Hello Dr.
Lin, ten years ago I developed deep red, stretch mark-like scars on the inner thigh.
I went to Chang Gung Memorial Hospital to see an endocrinologist, and after tests on my adrenal glands, urine, and blood, everything came back normal.
The doctor prescribed a topical medication, but my skin became thinner, and I often experience redness on my thighs when walking or wearing thicker pants.
I am very concerned that there may be an underlying condition causing this.
Thank you for taking the time to answer my question, and I sincerely appreciate any advice you can provide.

Tom, 20~29 year old female. Ask Date: 2000/11/14

Dr. Lin Mingxing reply Family Medicine

In regard to your age, ten years ago, at 18-19 years old, you were still in a period of physical changes (rapid growth in height and weight).
If during that time your body was still growing taller or if you experienced rapid weight gain due to physiological or pathological reasons, then the phenomenon you described could be possible.
This condition often involves itching in the affected area or pulling sensations, but it is generally not harmful to the body.

I recommend that if you have experienced excessive weight gain, you should increase your physical activity to burn off excess subcutaneous fat in localized areas, which will enhance the elasticity and tension of the skin and muscles surrounding the affected area, leading to a reduction in the size of that area.
Additionally, it is important to maintain proper hygiene and dryness in the affected area, as thinning skin and the noticeable dilation of subcutaneous microvessels can make it more susceptible to external injuries or infections.

Reply Date: 2000/11/14

More Info

When dealing with skin concerns, especially those that have persisted for a long time, it can be quite challenging to determine which specialist to consult. Based on your description, it seems that you have developed deep red, stretch-mark-like scars on the inner thighs over the past decade, which have become a source of concern for you. You have already consulted an endocrinologist, who conducted various tests on your adrenal glands and found everything to be normal. However, the issue remains unresolved, and you are experiencing discomfort due to the thinning of your skin, which leads to irritation when walking or wearing certain clothing.

Given your symptoms, it would be advisable to consult a dermatologist, as they specialize in skin conditions and can provide a more focused evaluation of your skin's health. Dermatologists are equipped to diagnose and treat a wide range of skin issues, including those related to skin texture, pigmentation, and integrity. They can assess whether your skin changes are due to a specific dermatological condition, such as atrophic scars, which can occur due to various factors, including hormonal changes, skin trauma, or even certain medications.

In addition to a dermatologist, if you have not already done so, you might consider consulting a plastic surgeon or a cosmetic dermatologist. These specialists can offer insights into potential treatments for skin thinning and scarring, such as laser therapy, microneedling, or other dermatological procedures that can help improve the appearance of your skin. They can also discuss options for skin rejuvenation and restoration, which may be beneficial given your concerns about skin thinning and irritation.

It’s also important to consider lifestyle factors that may contribute to your skin condition. For instance, maintaining proper hydration, using gentle skincare products, and protecting your skin from friction and irritation can help improve your skin's overall health. Additionally, if you have any underlying health conditions that may affect your skin, such as hormonal imbalances or nutritional deficiencies, addressing these with your primary care physician or an endocrinologist may also be beneficial.

Lastly, if you are experiencing significant anxiety or distress regarding your skin condition, it may be helpful to speak with a mental health professional. Chronic skin issues can sometimes lead to psychological stress, and addressing these feelings can be an important part of your overall treatment plan.

In summary, I recommend consulting a dermatologist for a thorough evaluation of your skin concerns. They can provide a tailored treatment plan and may refer you to other specialists if necessary. Additionally, consider lifestyle modifications and seek support for any emotional distress related to your skin condition. Your health and well-being are paramount, and taking these steps can help you achieve a better understanding and management of your skin issues.

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