Filter - extract
get as close as you can with the extract tool but don't sweat it.
Then once you've done all you can then zoom in and with a big brush start hitting the edges...and don't worry about all this be careful stuff there is always the undo command.
I've found that it's best to go ahead and lightly brush the area up to the skin, even if it does take the skin as long as you smooth out the edges around it too.
Usually the images are so small it's hard to notice any rough spots.
A good way to hide them when building a banner/tour/header etc...is to just duplicate the image, and on the bottom version of the image do filter-gaussian blur- and adjust the settings until you get something you're happy with.
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