Positive Life NSW

Skin. What's in that word? According to the Oxford Dictionary, it is the 'flexible continuous covering' of our body, our outer protection, holding everything else in. And in the early days of the plague, it was on the skin where the dreaded 'identifier', Kaposi's Sarcoma or KS appeared. It was seen as the ultimate indicator that a person had moved beyond HIV on to AIDS; it was the stigmata on the surface of the body. Indeed, it was the existence of KS amongst groups of men for whom it was most unusual - initially gay men in the USA, rather than elderly men on the eastern Mediterranean shores - that first alerted medical investigators that something new was here.

But that was a quarter of a century ago, and our world has moved on significantly. Since the onset of HIV/AIDS, and particularly since the mid-1990s, new treatments have intervened in both the infections process (as with PEP), and to slow the progress of the disease (combination therapies). But such momentous advances should not blind us to the fact that there are health issues we should still be acutely aware of.

And some of these can be best done by paying attention to our skin. I don't mean that we have to follow what rich smart ladies did in ancient times, when they used to bathe in asses' milk, to keep their skin soft and healthy-looking. While it would be difficult today to get enough asses together for their milk to fill a bath, there are far less dramatic alternatives in skin protection these days.

The most sensible thing to do with our skin is to observe its changes, and note anything unusual. Since we are living longer, some of the things we observe are due to 'ageing' - some wrinkling perhaps, and a bit of sag here and there (unfortunately, usually not where we'd like it to be), or the appearance of blotches or moles or lumps. And while some people have sensitive skins and are prone to ailments, skin awareness should be with all of us.

Some things we observe are due to where we live - in cities, where pollution levels are high. Rashes and itching might be common, but your GP can dispel any fears and suggest some remedies if this is the case.

And we live in Oz, with one of the highest rates of skin cancers in the world. So be observant. Early detection (as with most things) is best.

So what should we look out for? If we do have moles, we should watch out for changes in them (get them checked every year). Also check out any strange lumps, or sores that don't heal, no matter how small. Some of these may merely be warning signs of sun damage to your skin – or of potential future skin cancer.Your HIV GP would be well qualified to alert you about any of these that need further attention. And these days, medical technology can provide quick responses. If they are cancers of any form - basal cell, squamous cell, or melanoma - there are treatments. For some, they can simply be burnt or frozen off, but some require a more interventionist approach. And if you do have something that should be removed, don't hesitate - much skin 'repair' (dermatology) is covered by Medicare. The important thing is dealing with them early. At least in Australia, there ARE campaigns and heightened awareness about skin issues.

But prevention is also important, and that means going back to sunscreen, shade, and sensible clothing. I know this raises fashion issues - can any gay man cope with this last aspect? But we are talking about staying alive here.

Of course, you can go all the way in another direction - avoid going out into the sun at all. And if you still have to sport a tan, well, take a chance on getting that lovely orange look with fake tans (they even spray them on these days). Although there are also solariums, they do have the risk of encouraging cancers in light-pigmented or sensitive skin.

At the start of the 21st century, we are living longer with HIV. But we do have to take extra care to look after ourselves, and pay attention to what our skin tells us, since early detection remains important.

It used to be said, 'He died young, and had a good-looking corpse!’ Well, maybe I can die old, and still have a good looking corpse. So where are all those cartons of soy milk? Well, who knows? I may as well try it...

Worth Reading:

'HIV Infection Linked to Higher Skin Cancer Risk', NSW Public Health Bulletin 189, Vol. 16 No. 11–12, July 24, 2007 (by Tim Horn, Senior Writer & Editor).

‘Types of skin cancer’ at www.sunsmart.com.au

Ways to look after your skin:

• Avoid sun burn and cover up
• Regularly check changes to your skin
• Talk to your GP about any suspicious spots
• If you would like a second opinion, ask your GP to refer you to a specialist
• Some skin clinics will bulk bill. If you are concerned ask them about the cost