In this consumer‑focused video, board‑certified dermatologist Dr. Shereene Idriss outlines six dermatologic findings that can signal deeper systemic health issues and explains how to recognize, evaluate, and address each one. She begins with jaw‑line acne accompanied by coarse facial hair, linking it to androgen excess and the newly renamed poly‑endocrine metabolic ovarian syndrome (PMOS, formerly PCOS), and recommends hormone testing, ovarian ultrasound, and treatments such as combined oral contraceptives, spironolactone, metformin or GLP‑1 agents. Next, she describes sudden, smooth, round bald patches as alopecia areata, an autoimmune attack on hair follicles, urging early dermatologic assessment, vitamin D, thyroid, iron/ferritin, and A1C labs, and possible steroid injections or systemic immune therapy. She then differentiates a malar or “butterfly” rash that worsens after sun exposure, noting its potential association with cutaneous or systemic lupus versus rosacea, and advises photographic documentation, sun protection, and specialist evaluation. The fourth sign is yellow plaques on the inner eyelids (xanthelasma), which may reflect dyslipidemia; she stresses lipid panels, triglycerides, and glucose testing, and mentions both medical and cosmetic management. Fifth, she explains transverse nail grooves (Beau’s lines) as a record of past systemic stress or illness occurring 3‑6 months earlier, prompting a review of recent health events. Finally, she warns that dark, velvety hyperpigmentation in neck or axillary folds (acanthosis nigricans) signals insulin resistance and possibly early type 2 diabetes or, if rapid, an underlying malignancy; she recommends A1C testing, lifestyle intervention, and appropriate dermatologic treatments. Throughout, Dr. Idriss emphasizes that these skin, hair, and nail changes are not merely cosmetic concerns but important health signals, urging viewers to seek professional evaluation, obtain targeted labs, and consider both medical and cosmetic therapies while avoiding self‑diagnosis or excessive scrubbing.
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That jawline acne that you keep popping, it has nothing to do with your skincare at all. In fact, every single week in my practice, patients come up to me asking me, why do I have acne and hair on my chin? What are these patches at the base of my neck or my armpits that I just cannot scrub off? And am I going bald? Because there's a bald spot on my scalp that appeared out of nowhere. I'm Dr. Shereene Idriss, a board-certified dermatologist, and today we're going to be covering 6 signs that can affect your hair, your skin and your nails that could be signs of something deeper going on. All right, let's jump in. Why do I keep breaking out along my jawline and started suddenly noticing increased hair growth on my upper lip and my chin despite the fact that I spend hundreds of dollars on skincare and nothing is working? It may be a hormonal source and a hormonal problem known as PMOS, because if you are somebody who keeps breaking out along your jawline and you're now noticing that you're growing coarse hair on your upper lip and your chin, it's not a skincare problem and your cleanser cannot be blamed. Acne that repeatedly shows up on your chin and jawline that doesn't respond to skincare or skincare routine changes, and if you're experiencing increased hair growth, you may have an androgen problem. What the hell are androgens? Androgens are male sex hormones, also known as testosterone, that even women make through our ovaries and our adrenal glands because we were all created in utero from the same source. So if we have elevated testosterone levels, or if you are sensitive to them, we develop jawline acne, coarse chin and upper lip hairs, sometimes scalp hair thinning, and irregular periods all at once. It is a party, let me tell you. And those findings are part of what are called the polyendocrine metabolic ovarian syndrome, PMOS, which used to be called PCOS, but as of May 2026, we switched it because it's about damn time that we listen to women, as this is not just an ovarian issue, it is a multi-hormonal issue with a metabolic component. Component which plays a major part in it. And that is why a lot of women with PMOS are predisposed to type 2 diabetes. So if you notice these changes in your ovulation cycle, like let's say you're missing your periods altogether or they're coming late or they're very irregular, and you have signs of excess androgenism, whether it is thinning of hair on your scalp or excess hair on your face plus acne, it is worth checking your testosterone levels and even checking an ultrasound of your ovaries just to make sure, because although topical treatments can help with the aftermath, like salicylic acid and azelaic acid can help with the blemishes or the oiliness, they're never going to help you treat the root cause of the issue. And you might need a combined birth control pill or even an oral blood pressure medication known as spironolactone, which doesn't work to affect your blood pressure but helps to minimize how you respond to androgens. So you and your doctor need to get together to figure this out because you may even want to go on something like metformin, which is a diabetes medication, or GLP-1. But it's important to remember that the medication alone can maybe slow down new hair growth, but it's not necessarily going to erase the existing ones overnight. And this is not a personal failure on your end. And skincare alone could have never helped correct an underlying systemic hormonal issue. So let us stop blaming the cleansers and let us start seeking out the help that we really need. Why did I suddenly develop a smooth, round bald patch out of nowhere on my scalp? And am I going bald? A sudden smooth round bald patch is not just normal hair loss, and that could be your immune system attacking your actual hair and thinking that your hair is foreign to your body. And this is known as alopecia areata. A sudden smooth round bald patch that shows up out of nowhere is not normal shedding. So if you notice 1 or 2 or 3 of these bald patches appearing on your scalp where the the skin underneath it is smooth. There's no redness, no irritation, no flaking. It is worth looking at other areas of your body like your eyebrows, your eyelashes, and maybe down below to make sure that you don't have other areas that are also affected. Because an autoimmune condition is one where your immune system fights your own body, and in this case, your immune system is fighting off your hair follicles thinking that your hair is foreign. And here is the part that nobody really says But with alopecia areata, the follicles themselves are not fully destroyed, so regrowth is genuinely possible, especially if you are seen early. But not every patch of alopecia is the same. There are fungal infections, there are scarring conditions that can look slightly different, that need to be treated differently, and treating them fast is key because timing is everything. So if you notice a bald patch, go see a dermatologist the moment you notice it, because the faster you can grow your hair back, the better the likelihood you have of your hair coming back to a better normal baseline. It is also worth noting that with my patients who have alopecia areata, I always check a vitamin D level, a thyroid function, as well as a whole iron panel including ferritin, because these three things are often associated with alopecia areata and they can be easily fixed, and they can also easily help to support better, healthier hair overall. And the last thing that I also check is a hemoglobin A1C, because patients with alopecia diabetes, and this is something that I just do not want to miss. So I cross every T and I dot every I. And depending on what type of hair loss you have and what kind, how extensive it is, you may get steroid injections or systemic immune treatments because hair loss is very emotionally heavy. And no, you're not just being vain or silly or dramatic for wanting answers or wanting to seek out treatments. So please don't sleep on a bald patch. Why do I have this rash that appears on my cheeks and the bridge of my nose, and why is it always worse after sun exposure? Well, a rash that crosses both cheeks and that flares after sun exposure is not always rosacea, and sometimes it could be pointing to your immune system that isn't functioning correctly. You see, a rash that crosses both cheeks and goes on the bridge of your nose but that spares your nasal folds right here and that worsens hours to days after sun exposure could be a pattern known as malar or butterfly rash. And this could be accompanied with systemic symptoms like joint pains, fatigue, mouth sores, hair loss, unexplained fevers. And it could be part of a bigger picture. If your skin alone is involved, it could be cutaneous lupus. But if you have the other symptoms, you could be describing systemic lupus, an autoimmune condition where your immune system is causing inflammation in various different tissues. But I do not want you guys to start freaking out if you notice you have red cheeks, okay? Because red cheeks alone doesn't automatically mean that you have lupus, and it could point you in the direction of rosacea and irritation, or even, God forbid, a sunburn, which in 2026 we are wearing the damn sunscreen. But easy clues to look out for whether or not you need to freak out: number 1, are your nasolabial folds affected? Because if they are affected, it's probably rosacea. Number 2, Do we have acne-like blemishes on our cheeks? Because if you do, it's probably rosacea. And number 3, do your eyes feel gritty and are the borders of your eyelid margins red and inflamed? Because if they are, it's probably rosacea. But if your rash suddenly appears on your face and you don't have those things, I would recommend you photograph it when it is active and you really pay attention to whether or not sunlight triggered it, because the rash that appears hours to days after sun exposure could be lupus.. And please, please, please do not hesitate to go see a dermatologist because a recurring issue like this could leave scarring or discoloration on your cheeks. And this one should not be ignored, especially if it's paired with the symptoms like we just talked about. So a rash that crosses your cheeks isn't automatically a diagnosis of lupus, but it is always worth asking about whether it is lupus, rosacea, or an irritation that you have. What are these yellow patches that I have at the inner corners of my eyelids? Those yellow patches near your inner eyelids are not just a skin thing. They could be a cholesterol clue. Soft, flat, slightly raised yellow patches near the inner corner of your eyelids are generally painless, and they become much more noticeable slowly over time. They are called xanthelasma. It's a mouthful, but they are deposits of fat containing cholesterol underneath the surface of your skin. And some people who have these have elevated cholesterol levels in their bodies, but other people, a lot of people, their cholesterol levels are completely normal. But regardless, when you go see a dermatologist, which I do recommend you go see to confirm that this is what you have, make sure that they do blood work as well to check your cholesterol levels, including your triglycerides, and even your blood sugar levels to make sure that we are not missing anything and nothing is being overlooked. Because treating an abnormal cholesterol matters for your overall health, AKA heart attacks, AKA badness. So you want to make sure that you are going to treat it, but treating your cholesterol levels is not a guarantee that these are going to disappear on their own. As a cosmetic derm, I have treated these in my practice. I just want you guys to know you do have to play a long game. It takes time, multiple treatments, and effort on your end to get rid of them, but it is absolutely worth you asking if it bothers you. However, I would not recommend that you just book a cosmetic removal of these yellow patches without getting the blood work done too, because the blood work ultimately could save your life. Why did I suddenly develop deep horizontal grooves running across multiple nails? Well, deep grooves running across several of your nails all at once are usually a sign that your body went through something big. And these are called Beau's lines. They appear as deep lines that run side to side across your nails, showing up not on one fingernail, but across several of your fingernails, roughly at the same level. And they're very different than, for example, the vertical ridges that come with age. If you had a significant illness, a massive physical stress or surgery or a car accident, all of that can temporarily stop or slow down the production of your nails, and it leaves a groove known as a Beau's line. And a groove on a single nail alone is usually a sign of trauma, like just to that finger and not necessarily a systemic sign. But if you have several grooves on multiple nails, it could be a systemic issue that happened anywhere from 3 to 6 months prior. So your nails are keeping a timeline of what your body has been through, and this is the way you can actually read it. And the last one you definitely do not want to miss, because if you miss the timing of it and you don't know what to look out for, your life could be at risk. Why is the skin on my neck and under my arms getting thicker and almost velvety looking? If the skin at the base of your neck or your underarms has gone dark and velvety, this is not a hygiene problem. Please stop scrubbing. But it is your body potentially putting out a warning signal for insulin resistance, and it's known as acanthosis nigricans. So please stop scrubbing, stop using the glycolic acid. It's not dirt, it is a huge myth that could have terrible consequences, and life-threatening ones too, because acanthosis nigricans can be one of the earliest visible clues into your insulin resistance. When your body stops responding to insulin, your body thinks it needs to produce more insulin, and that excess is going to push your skin into producing more keratin, and that keratin is going to look darker and more velvety in texture, especially the skin at the base of your neck, the folds of your arms, or even the creases underneath your boobs. And it's an important clue to also pay attention to whether or not you have skin tags, because skin tags often accompany this in those same areas. And one of the most interesting things about acanthosis nigricans is that it often appears years before you develop type 2 diabetes. So in other words, your skin is an early warning sign as to how you're responding to insulin, and if you pay attention early enough, you can change the course of your life because an earlier lifestyle intervention can completely avoid you developing type 2 diabetes. But what also is very interesting is the timing of how fast it appears, because if you notice these patches appear over the course of weeks, you may have stomach cancer that should not be overlooked. But if these patches appear over the course of years, it's most likely a warning signal into your blood sugar levels and your insulin resistance, and you should get your hemoglobin A1C checked to make sure that your blood sugar over time is not elevated. From a cosmetic standpoint, we can manage the pigmentation and the texture, but not while ignoring what is happening underneath into your health and without treating that underlying issue, because at the end of the day, this is not a cleanliness issue. It is a signal that your body is putting out, making sure that you are aware so you do not develop diabetes type 2 over time. But if you are finally in the clear and we know that you are not predisposed to type 2 diabetes and this has nothing to do with that, and you definitely do not have stomach cancer, then I will tell you that over-the-counter glycolic acid and a brightening serum like the Major Fade Hyper Serum can help to reduce the overall look and appearance of those areas that get darker over time. So the 6 signs that we are going to quickly recap: number 1, jawline acne with increased hair growth, a sudden smooth bald patch, butterfly rash, yellow eyelid plaques, nail grooves, and number 6, dark velvety patches. But remember, you know your baseline best and you know it better than anybody else. But if something feels different, You deserve to be taken seriously. So do not panic. I do not want you guys to freak out, but I also do not want you guys to ignore your body when it is clearly trying to get your attention and send you a signal because your skin at the end of the day is not just vain. It is not just superficial. It is not just cosmetic. It is a part of your overall health and should be given the love and the respect that every other organ gets too. I hope you guys have a beautiful Saturday. I will see you guys next week.
