What can I do about little red bumps on arms on legs?

About1yr. ago, i began noticing tiny white bumps mostly on my legs, but also on my arms...they have little white "spear-like" things that can be pulled out. they dont hurt or itch at all, i havent changed any soaps or body products...any idea what it is?

• Answer:

  Occasionally a woman will refer to the raised lesion as a "cyst" or a bump. Cysts are a common occurrence, and can arise most any place on the body. they are usually created by a blocked sweat ("apocrine") or skin ("sebaceous gland") gland. For example, if a hair follicle gets blocked it can fill with the debris of exfoliated/shed skin cells which causes the lining of the follicle to get distended. This is similar to what happens when one develops a "white head" pimple on the face. On the genitals, such cysts are called "epithelial inclusion cysts". If the cyst continues to enlarge to a size greater than a half inch, it can incised with a sterile instrument and drained in a sterile fashion. While some women attempt to "squeeze" a cyst to extrude the "cheese-like" skin-cell debris, this is not a good idea. Normal skin bacteria can enter through the break in the skin and set up an infection. There are some specific sites where drainage ducts can get blocked and create cysts. These are named after the area in which they occur: # Skene's duct cysts are located on either side of the urethra. These may be treated with warm moist soaks--or can require incision and drainage. Vaginal cysts of embryonic origin typically are not a recent blocked duct opening. Rather they are a cyst which developed in utero. These are treated with surgical excision if they continue to grow in size over time. Bartholin's duct cysts can develop on either side of the lower portion of the labia majora. These can grow to be the size of walnuts and usually are noticed because of a rapid increase in size and tenderness. Three times per day warm soaks or sitz baths are tried first, followed by incision and drainage if needed. Bartholin's cysts tend to reoccur. If this happens the cyst may be surgically opened and the sides sewn open (like keeping a purse permanently open) to be sure no fluid or skin cells accumulate. This procedure is called "marsupialization." Fox Fordyce is an itchy type of skin lesion which can range in size from small papules to cyst sized bumps. They may also be found on the lower abdomen and thighs. Keratin or skin debris clogs the apocrine/sweat glands, thus it is not a bacterial infection which requires antibiotics. It may be treated with a steroid cream or phototherapy. Hiradenitis suppurativa, by contrast, is a clogged sweat gland which often has a secondary bacterial infection associated with the bumps. This condition does not itch, but can be very painful if deep, infected cysts or nodules form. These areas tend to leave a shiny scar of darkened skin. Somewhat more common in women who have acne, these lesions are often treated with acne-type approaches such as oral or topical antibiotics, or even oral Accutane. Steroids and birth control pills have also been tried. If there are large hardened nodules, or draining fistulas (tracts for pus to travel from one nodule to another), the area can be surgically treated. Sometimes the infection is viral rather than bacterial: * Molluscum contagiosum is caused by a pox virus. The bumps on the vulva or thighs are small, fleshy, and round often with a small indentation in the middle of the round lesion--like a bellybutton. These bumps tend to regress in time even without treatment. For cosmetic purposes they can be removed by freezing/cryo. Human papilloma virus (HPV) subtypes 6 and 11 cause the visible genital warts which look like little cauliflowers. These rough to touch, raised growths can expand in size and number--especially in times of a suppressed immune system (eg pregnancy, illness, etc.). HPV lesions can be treated with applications of bi or trichlorocetic acid, freezing/cryo, or an immune system enhancing cream ("Aldara"). Herpes simplex virus (HSV) is more often linked to an itching, burning area which might be slightly raised. It can look like a bug bite in its early stages, but within several days it becomes an open ulcer or cut in the skin--not a bump. There are a number of medical conditions which can produce bumps which are not related to clogged ducts or infections: * Acanthosis nigricans produces velvety, dark raised areas on the vulva, armpits, and neckline. It is linked with insulin resistance, the metabolic change found in polycystic ovarian syndrome Keratosis Pilaris Keratosis pilaris (commonly called KP) appears as "chicken skin bumps" on the skin. These bumps usually appear on the upper arms and thighs. They also can appear on the cheeks, back and buttocks. Keratosis pilaris, while unattractive, is harmless. What Are the Symptoms of Keratosis Pilaris? This disorder appears as small, rough bumps. The bumps are usually white or red, but do not itch or hurt. Keratosis pilaris is usually worse during the winter months or other times of low humidity when skin becomes dry. It also may worsen during pregnancy or after childbirth.