2009 Skinnies Awards

Missing Hollywood landmark - Sara Jessica Parker’s mole
Like any good movie, skin spots can have a beginning, a middle, and an end. So it goes for a recent Hollywood landmark, the protruding mole on the chin of fashion icon Sara Jessica Parker.
Not a wart, not a skin cancer, not an acne lesion, the flesh-toned nodule sported by diva for years acted like many a facial mole. Early on, there was little to see. SJP, started her career early in the teen TV show, "Square Pegs." While possibly present in those simple times, her future cutaneous co-star is hard to discern. The image from later in her teen years shows it starting to surface. Certain moles are never dark discreet beauty marks. Their pigment cells sit deeper in the dermis, hiding the lesion from the limelight.
As Parker’s fame escalated, her mole made itself known. Showing changes that are not a sign of cancer, the mole poked up to the surface, catching the attention of the paparazzi. With little talent of its own, the mole proved itself to be a distraction. A literal “hanger-on,” it attempted to upstage the “Sex in the City” gang. Could this spot become the fifth gal pal of the group?
Tragically, Parker’s mole overstayed its welcome. Was its lumpy look pert of the reason her character Carrie couldn’t sustain healthy relationships? By becoming a topic of conversation, not all of it good, it had used up its Tinseltown shelf life. The “Sex and the City” movie was to be its last starring role. By that summer, SJP was seen bereft of her companion forever more.
While her publicist created controversy by suggesting that Parker had not had facial surgery, this type of mole doesn't leave on it's own. Lasers, fancy as they may be, are usually not the treatment of choice. The defenseless spot may have been shave excised, to limit scarring. Or possibly a deeper, “punch” excision was performed, perhaps with absorbable sutures to limit stitch marks.
One need not cry for her spot. You can bet a mole this memorable wasn't merely discarded, tossed into a cold, red, synthetic biohazard waste bag. No, moles, even those whose cancerous potential is low, are gently embedded in paraffin, carefully stained by skilled technicians and analyzed by trained physicians. The remains of this landmark are then kept, much like an artifact in an “Indiana Jones” movie, for posterity.

Runner-up, Missing Landmark: Michael Chiklis's birthmark in "The Shield"

This anti-hero actor has a discrete port wine stain birthmark on his neck which will not be seen for a while. Did he have it removed by laser? Nah, his show “The Shield” is just off the air… Actor Michael Chiklis looks tough... ...But even a rogue cop... ...can have a cute birthmark.
Least Likely Leading Man - Mickey Rourke in "The Wrestler"
Whatever happened to Eighties hunk Mickey Rourke? The ruggedly handsome actor achieved movie star status in the arty horror movie, “Angel Heart” and the sexy romp “9 1/2 Weeks.” Then he dropped out of the limelight.
Rourke has triumphantly returned to the forefront with his acclaimed role in “The Wrestler.” He woos hottie Marisa Tomei in a critically acclaimed performance as a has-been wrestler attempting a comeback. But is this the same guy? He once showed chiselled good looks. Now it looks like the chiseller slipped. His skin appears puffy and pockmarked. Odd symmetric lumps are noted on his cheeks and chin. Tissue around his eyelids protrudes in an unnatural fashion.
Rourke attributes his changed visage to the boxing career he returned to in the 1990’s. He claims that the pounding he took in the ring led to his current lumpy looks. While injuries may play some role with the state of Rourke’s face, prosthetic implants seem to be in the action these days. His swollen cheeks and chin appear to contain implanted prosthetics.
To create persistent volume in sunken cheeks, or make recessed chins more prominent, plastic surgeons may use prosthetic implants. While "permanent," these can be problematic if they are out of scale with facial features. Rourke may have had implants, as well as eyelid surgery (blepharoplasty) and surgical lip enhancement. If the goal was to restore his looks circa 1990, the results seem more distracting than dashing.
Usually, movie leading men are conventionally handsome. Hats off to Rourke for getting back on the cinematic pedestal. As any student of skinema.com knows, with his current looks Rourke may not consistently play romantic leads, but abnormal skin can keep him busy playing film villains…

Runner-up, Least Likely Leading Man: WALL-E

Robotic janitor WALL-E, with his out of date exterior and unhygienic coating of dust and garbage is not your typical Romeo. Yet with charm, humor and tenacity, he wins over the girl-with-the-good-skin, porcelain-toned EVE.
Celeb skin secret revealed - Tina Fey's Scar
Comedienne, writer, producer, and actress Tina Fey has had quite a year. The glam, yet down to earth gal received Emmy awards for her show “30 Rock” and rode a media tsunami with her Sarah Palin impersonation on SNL. Her life seems charmed, but a hard to see skin defect has hinted at a traumatic past.
Usually, deft makeup artists, talented camera operators and sympathetic lighting designers have worked to give Fey’s left cheek a normal appearance. Occasionally, however, a shadow is cast, revealing a significant depressed scar. Since the scar runs against normal facial contours, it was a safe bet that this was not the result of an elective surgery, but rather due to some type of injury.
For years, despite media requests, the typically talkative Fey kept silent about the source of the flaw. Unlike fellow femme Sharon Stone, Fey deigned to discuss the defect. Her reticence simply fueled speculation and now the true story has been revealed. In a Vanity Fair piece, Fey’s husband disclosed that when she was five years old, Fey was randomly slashed by a stranger in her front yard. The comedienne avoided discussing the incident for fear that it would seem like exploitation.
Yet, Fey's career has not suffered. This scar does little to dim her star power. When you have this much talent, why mess with (im) perfection? With the truth finally revealed, is there a fix for Fey’s disfigurement? With such a longstanding defect, it is unlikely that over-the-counter creams would lend much benefit. Similarly, peels and even fractional lasers don’t make a great difference for deep scars. A valid option might be scar revision. A plastic surgeon could excise the scar and re-suture the skin with better alignment to Fey's facial contours.

Runner-up, Celebrity skin secret
Why is Angelina Jolie ("Wanted") getting so many tattoos?

Answer: So the ink will be a permanent sunscreen. Kidding! Kids--use creams with sunblock instead!
Most Skinematic Presidential Race - Obama Vs. McCain '08
Some say that eyes are the windows into a man's soul. Is our skin a measure of our character? In the campaign for the American Presidency, there was a transformational amount of skin issues to be found...

John McCain's melanoma (s):

If John McCain were elected, he would not have been the first American president to have skin cancer. Ronald Reagan had one excised from his nose while in office. Bill Clinton had a similar lesion scraped from his back even as he was running from the Monica Lewinsky scandal. Yet Clinton's and Reagan's skin cancers were basal cell or non-melanoma in nature. Definitely worth treating, but nothing life threatening. Note: The dark lesion seen here is not a melanoma, but probably a benign lesion called a keratosis.
John McCain, either because of his time in a Viet Nam prison camp (hadn't you heard?), or time spent in an Arizona swimming pool, developed for melanoma. Four of them. And, it was revealed in the heat of the race, one of them may have been more aggressive than was previously reported.
...was revealed to use tanning beds.

The 2008 US Presidential campaign had plenty of notable news items, many of them generated by perky Alaskan Gov. turned VP candidate Sarah Palin. Yet among the moose hunting, child rearing, and trooper gating anecdotes, one bit of trivia went relatively unnoticed. It was revealed that last year, Palin had a tanning bed installed in the Alaska Governor's mansion. Supposedly it was bought used and paid for by the Palin's. But unlike Sarah the Governor's wardrobe shopping spree, the cost of the unit and installation is not what worries us. While some use tanning beds attempting to limit the depressive symptoms caused by a sun-free Alaskan winter, is it really worth the risk to the skin? Melanoma, when surgically removed early, can be fully treatable. But when this dark black cancer metastasizes and goes to lymph nodes and other organs, most chemotherapies, radiation, and immune therapies come up short. So it was not unreasonable for the media to request a fuller disclosure of McCain's actual prognosis. Especially when his potential successor...
The 2008 US Presidential campaign had plenty of notable news items, many of them generated by perky Alaskan Gov. turned VP candidate Sarah Palin. Yet among the moose hunting, child rearing, and trooper gating anecdotes, one bit of trivia went relatively unnoticed. It was revealed that last year, Palin had a tanning bed installed in the Alaska Governor's mansion. Supposedly it was bought used and paid for by the Palin's. But unlike Sarah the Governor's wardrobe shopping spree, the cost of the unit and installation is not what worries us. While some use tanning beds attempting to limit the depressive symptoms caused by a sun-free Alaskan winter, is it really worth the risk to the skin?
Before Palin attempts to brown her skin or end up with a red burn (possible in supposedly "safe" devices), we'd suggest she look into the data showing increased melanoma skin cancer rates in women using tanning beds. Perhaps a chat with former running mate John McCain would steer her straight. We recommend dietary sources of vitamin D like fortified milk, soy drinks, fish and egg yolks. And as for tanning, we suggest Sarah keep the "pale" in Palin: Just Say No!

Barack Obama's facial bumps

During the campaign, some voiced concerns about the level of experience shown by Senator Barack Obama. Did he have the maturity to handle the role of Commander in Chief? At skinema.com, we don't pretend to be politically savvy. But in dermatology, we know age like the back of our hand (D'Oh! Is that a sun spot?) Note the small dark bumps on Obama's cheeks. These lesions are known as DPN's, short for dermatosis papulosa nigra. These non-cancerous lesions are not due to diet, healthy or otherwise. The sun, even the intense solar radiation that Obama was exposed to growing up in Hawaii, is not the culprit either. Seen more often in people of color, these discrete dots are a marker for maturity, age, or to put it nicely...experience.
Can skin doctors remove these spots, enact this change? Yes, we can. Treatment requires lightly zapping the lesions with a low strength cauterizing device. Lasers can also be used to transform a transformative politician. We presume Obama has other items on his to-do list. So from a skin perspective, we can confirm: Obama has experience to spare.
Finally, did VP Elect Joseph Biden have a hair transplant like last year's Skinnies winner Nicolas Cage? Clearly, the dermatologic focus of the new administration will continue...

Runner-up, Skinematic Presidential Race: George W. Bush Vs. John Kerry 2004: The Battle of the Ginormous Unibrows

Sunscreened Teens - The Cast of "Twilight"
Vampires have come a long way. For decades, the pale undead bloodsuckers have been reasonably considered evil. Certainly not the kind of guy that a high school gal would want as her prom date. But in “Twilight,” Rob Pattinson’s Edward is the go-to guy for Kristin Stewart’s Bella. How have vamps moved from monster to hunk? Our theory: Because fair skin is in.
Unlike other vampire mythologies, the sun in the “Twilight” series doesn’t cause these undead dudes to die. Dracula had a particularly bad skin day the one time he went strolling on a sunny afternoon. The “Twilight” teens don’t blister or burn, but they twinkle and shimmer, making them stand out to their mortal peers. It doesn’t help that the twinkling effect looks particularly cheesy in the film.
Unlike the vicious vampire leader in “Blade,” who used an extremely high SPF sunblock to live to bite another day, Edward and his posse move to Forks, WA. Their motivation: the high latitude and cloudy climate limits their sun exposure. Yet even non-vamp Bella sees the value in staying clear of the sun (and tanning beds). Like many actresses, Kristin Stewart has adopted the fashionably fair look favored by the new generation of ingénues. Why risk wrinkles, sun spots, and skin cancer just to look leathery brown?
Since tan-free skin has become vogue, not just for the goth set, vamps can step out of their coffins and into sports cars. Bela Legosi would be proud.

Runner-up, Sunscreened Teen: Miley Cyrus

Pop pubescent Cyrus caused controversy when she appeared semi-bare for Vanity Fair. We feel she is still a great role model. Is her back sun-burned and blistered? We see no tacky tanning bed exposure here. If her generation stays this fashionably fair, future dermatologists will need to find work other than treating skin cancer and wrinkles.
Rarest syndrome to inspire a Hollywood blockbuster - Progeria in “Benjamin Button”
“The Curious Case of Benjamin Button” is notable not just for having the least likely title of a major Hollywood hit since “Forest Gump.” It also features images you don’t see every day: Using sophisticated makeup, long segments of the tale show superstar Brad Pitt’s face, aged beyond his years. He looks so different that a confused Angelina would kick him out of their kids’ nursery. His wrinkled countenance is then seamlessly computer grafted onto a diminutive body.
The flick follows Pitt’s “Button,” born small, but appearing elderly and arthritic, who then spends the remaining screen time becoming physically younger. While this concept is fantasy, the situation of child who looks geriatric is very rare but very real.
Progeria (also called Hutchinson-Gilford Progeria Syndrome or HGPS) is an extremely rare condition. There are fewer new cases of this disease each year than people who saw “The Love Guru” during its opening weekend. Due to a genetic problem with cells, children afflicted with HGPS show a rapidly accelerated aging pattern. The gene change happens sporadically, so the risk is not inherited. Like Pitt in the film, these kids lose their hair and their skin appears wrinkled. They develop joint stiffness and problems with their blood vessels. By the time they reach their teen years, most will die of a heart attack or stroke.
Unlike Pitt’s character, their premature aging does not reverse. Nor due they travel the world in a tugboat or have a personal dance recital by a cgi enhanced Cate Blanchett. Fortunately, the likely cause of HGPS has been discovered: A genetically defective cell protein called progerin causes instability of the nucleus of the cell. The diagnosis can be made by analyzing the DNA of blood and skin biopsy samples. There is also research focused on a medicine which may help to stabilize the protein. This medicine showed a reversal of the cell damage when tested in animals. Tests in humans have recently begun.
Fixing this condition won’t be as easy as pressing a “Button.” Since this abnormal protein may also play a role in normal aging, someday, the plot of “Benjamin Button” may not be so far fetched.

Runner-up, Rarest syndrome to inspire a Hollywood blockbuster: Skin darkening procedure in "Tropic Thunder."

As a method actor playing an African American role, Robert Downey Jr. undergoes a "controversial" skin darkening treatment. Too bad this procedure is fictional. Many genetically light skinned people would be at much less risk of skin cancer with addition of some skin pigmentation. Robert Downey Jr. goes to the dark side in "Tropic Thunder"
Skin-enemy - Staph bacteria featuring Amy Winehouse
In 2008, the internet went mad for R & B chanteuse Amy Winehouse's appearance with a left cheek as swollen as her beehive hairdo. While some surmised trauma, the official word was that she had developed "impetigo," a type of contagious bacterial infection. The most common cause of impetigo is strep bacteria. Dried, yellow, and flaking, the appearance of the disease is often described as "honey crusted."
While it is certainly possible that Winehouse was fending off a routine case of skin strep, certain aspects are not typical. Usually strep impetigo is seen in children, who are still developing a mature immune system. The affected area may be red and tender but not usually swollen. The appearance of Winehouse's markedly bloated cheek raises the possibility of an infection with Strep's sinister cousin, Staph Aureus. This pesky pest tends to cause more swelling and blistering than strep, and commonly affects adults. Certain strains, known as MRSA (Methicillin resistant Staph Aureus) have developed a resistance to certain antibiotics and can be particularly hard to clear.
The MRSA plague is not limited emotionally labile, tattoo-covered British chanteuses. American professional athletes have also been felled by the boisterous bacterium. NFL football players, pro basketballers and baseball have increasingly caught MRSA and had to take extra time on the bench. Actually, some have spent time in the hospital, getting IV antibiotics.
For patients outside of the spotlight, infection sites can be swabbed and the bacterial culprit identified. Along with the appropriate antibiotic pill, surgical drainage of the swollen area may be necessary. Hospitalization is remains rare, a last resort. We assume that Amy has been more open to antibacterial treatments then she has been about rehab.

Runner-up, Skin-Enemy: Disfiguring trauma, turning hot looking actors into creepy comic book bad guys.

Why do good looking actors subject themselves to hours in the prosthetic makeup chair to play morally unravelled meanies? And why does bad skin make characters so malevolent? Why, indeed?

Heath Ledger's comedy-free Joker Aaron Eckharts's indecisive "Two-Face" Domenic West's puzzling "Jigsaw" in "Punisher: War Zone"
Comeback of the year - Jean Claude Van Damme's forehead lump
Actor Jean Claude Van Damme is back in theaters... ...Along with this prominent forehead bump.
In the indie flick "JCVD" aging Belgian action star Jean Claude Van Damme portrays an aging Belgian action star named...Jean Claude Van Damme. This premise raises many questions. Is this a documentary? Is Van Damme finally exercising both his karate and acting chops? And most importantly: What is that lump doing on his forehead? One may initially assume this is a residual bruise from a kick boxing match. Yet since this lesion has been costarring with his forehead for many years, it is most likely a lipoma.
Lipomas are common, deep, soft bumps or masses that can occur anywhere, but usually grow on the arms, legs, and trunk. Often they are symptom-less, but can cause sudden pain or itch. There may be cosmetic concerns. In certain locations, the non-cancerous collections of fat cells are considered deforming.
Which brings us back to Van Damme. Why not remove such a large growth? It may be that the lump is not a lipoma, but is an overgrowth of bone or blood vessel tissue. And removal in any case would result in a scar. Removal of benign lesions are a personal decision. Besides, even if this is a lump of fat on his head, we doubt anyone will call him "fat-head." We would never do that, certainly.

Runner-up, Comeback of the Year: Harrison Ford's chin scar in "Indiana Jones and the Kingdom of the Retirement Account"

Nobody wants a facial scar. But Ford has seen no need to have this one lasered or surgically altered. They even made this scar part of the Indy mythology.

Ford is back as Indy... ...Sporting his constant companion.
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