Primary, Secondary, and Vascular Lesions (Marks) on the Skin


A lesion:

  • A lesion is any mark on the skin that is not a normal part of the skin.
  • It does not necessarily mean that the skin is diseased.
  • A freckle is a lesion; and so is a wrinkle.
  • However, lesions can also be symptoms of disease, such as melanoma, shingles, or measles.

Primary lesions

  • Primary lesions of the skin are lesions that are in the early stages of development.

Secondary lesions

  • Secondary lesions refer to any changes in the skin, such as rashes, bumps or sores, that appear after the initial skin lesion has already developed.
  • These are lesions that primary lesions eventually become.
  • Secondary skin lesions are characterized by piles of material on the skin surface, such as a crust or scab, or depressions in the skin surface, such as an ulcer.


  • Macules are flat (non-elevated) marks on the skin where there is only a change in the normal skin colour.
  • Again, a freckle can be an example of a macule, and the flat red mark left after a pimple has healed is also a macule.
  • It is simply a descriptive term meaning that this is a flat area with a change in the normal colour of the skin.
  • The adjective used to describe a lesion is macular.
  • Large macules, larger than 1 centimetre, are called patches.

Papules are raised areas on the skin that are generally smaller than 1 centimetre.

Plaques are papules that are larger than 1 centimetre.


  • Nodules are raised lesions that are larger and deep in the skin.
  • A nodule looks like a lump, but the skin can be moved over the lesion.
  • Very large nodules are called tumors.


  • A pustule is a lesion that is filled with pus, and the Aesthetician.
  • Extremely deep infections with pockets of pus are called abscesses.


  • Vesicle is the medical term for blisters.
  • They contain body fluids.
  • A bulla is a large vesicle.
  • A vesicle or bulla that has ruptured so that the fluid is exposed to the surface of the skin is said to be weeping or oozing.


  • A wheal is a hive.
  • Wheals are caused by a concentration of the fluid in the tissue.
  • They are reabsorbed into the bloodstream via the lymphatic system.


  • Erosion refers to a shallow depression in the skin.
  • Scratches on the skin are called excoriations, Acne, and the Aesthetician.
  • Deep erosions are called ulcers, in which part of the dermis has been lost.
  • Diseased skin often has remnants of body fluids, pus, or dried blood caked to a lesion.
  • This is described as crust.

Scales are patches of dry, dehydrated skin without crust.


  • Erythema refers to any area of redness associated with a lesion.
  • Bruises are known as haematomas.
  • Purpura is a haemorrhage of the blood vessels.


  • Atrophy means “wasting away.”
  • Skin that has thinned from age or chronic sun exposure is said to have atrophied.
  • Hypertrophy is a thickening of a tissue.
  • Hypertrophic scars are raised scars, due to the thickening of tissue.
  • Atrophic scars are depressed scars, such as acne pocks, caused by loss of tissue.

A number of terms are used to describe the shapes of certain lesions.

  • A linear lesion is a line-like lesion.
  • A ring-shaped lesion is described as annular.
  • Lesions that have a snake-like pattern are called serpiginous.
  • Geographic lesions look like a map.
  • Target, or iris, lesions have a center with a round surrounding area, such as a pustule.

Keratosis is a general term meaning a thickening of the stratum corneum, such as seborrheic keratosis and Sun Damage.

Eczematization refers to a combination of symptoms, including erythema, weeping, crusting, and present vesicles.

A nevus is a mole.

More than one mole is described as nevi.

Lentigines are freckles.

Dyschromias are skin colour abnormalities.

Hyperpigmentation refers to any area that has more than the normal amount of melanin.

Hypopigmentation refers to any area with less than the normal amount of pigment.


Vascular lesions are visible conditions that involve the blood or circulatory system.

Probably the most common forms of vascular lesion are telangiectasias, and distended capillaries, commonly incorrectly referred to as broken capillaries.


  • Areas of skin that contain telangiectasias are described as couperose.
  • In fact, the capillaries are not actually broken; they are simply dilated or new extensions of deeper capillaries that have developed near the surface of the skin.
  • Telangiectasias are permanent and are caused by a variety of factors, including sun exposure as well as exposure to extreme temperatures, friction, or injury to the skin.
  • They can be characteristic of rosacea.
  • Telangiectasias can be caused or worsened by vasodilators, which are drugs or substances that cause dilation of the blood vessels.
  • Included in the category of vasodilators are tobacco and alcohol.
  • Alcoholics often have many telangiectasias.
  • Telangiectasias are too deep in the skin to be affected or improved by ordinary aesthetic treatment.
  • Removal of irritants from the skin care regimen, addition of soothing agents, improvement of the barrier function, and treatment with LED light may improve the appearance or severity of the visible telangiectasias.
  • To remove the lesion, however, medical treatment is required.
  • Most telangiectasias are only a beauty nuisance, but clients with multiple telangiectasias should be referred to a dermatologist for treatment and evaluation.
  • Medical treatment of telangiectasias is most often performed with a specialized laser or intense pulsed light (IPL) device.
  • These devices cause a “drying up” of the vessel.
  • When the flow of blood has been cut off to the telangiectasias, the capillary collapses.
  • The results of these treatments are almost immediate and may involve some flaking or drying of the skin area.

Spider angiomas

  • Spider angiomas are similar to telangiectasias but have a central “body” and branches of telangiectasias resembling a spider.
  • They are also usually beauty nuisances and are treated by dermatologists by the same methods used for telangiectasias.
  • Telangiectasias have a strong tendency to reoccur, even after medical treatment, or new telangiectasias can develop.

Port-wine stains

  • Port-wine stains are a form of vascular birthmark.
  • They are large red or purple-toned patches, often involving as much as half the face.
  • They are also treated with vascular lasers. Often many treatments are required over a period of time.
  • Aestheticians trained in camouflage makeup may be of great help to clients with port-wine stains.


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