What are the some of the most common skin care concerns?
Conditions of the skin are as varied as the human beings who have them. Age, ethnicity, environmental factors (including sun exposure), personal habits, and genetics all influence our skin. The information here is intended to serve as an overview of general skin care concerns, and should not replace the advice of a skin care professional, or dermatologist.
Acne – This is the most common skin condition in the United States. While it often affects teenagers who are undergoing hormonal changes, many adults suffer with acne, as well.
Acne lesions start with clogged pores. Buildup of dead skin cells around pores can make the natural oil in our skin (sebum) accumulate, resulting in a comedone (blackhead or whitehead). These comedones can become inflamed by the bacteria that naturally live on our skin, causing red bumps, pustules, or large cysts under the skin.
Acne ranges from mild disease that responds to treatment with topical creams or gels to severe disease that can cause scarring and requires oral medicine for treatment. Early treatment can help to prevent dark spots from inflammation (swelling) in the skin and scarring.
Mild acne can be treated with over-the-counter washes that contain alpha hydroxy acids, salicylic acid, or benzoyl peroxide. More severe acne can be treated with stronger medicines prescribed by a dermatologist. Your personal treatment will depend upon the cause of your acne, which can include bacteria, genetics, hormones, clogged pores, or a combination of those factors.
Common treatments include prescription vitamin A creams (retinoids), oral or topical (applied to the skin) antibiotics, and isotretinoin. Women may benefit from birth control pills and other medicines that work on hormones. Acne usually requires several months of treatment before improvement is seen.
Age spots or freckles – Age spots (lentigines) and freckles (ephelides) are commonly caused by sun exposure. They are flat, brown spots on the skin, otherwise known as "pigmented spots." Age spots can occur in all skin types and usually arise later in life. Freckles usually occur in people with fair skin. There are several ways to lighten the appearance, including hydroquinone and Retin A. Hydroquinone is not a suitable treatment for persons with darker skin; if you have darker skin, a treatment that contains kojic acid can be used.
Aging skin — No matter who you are or what your ethnicity may be, your skin will require different care as the years go by. As we age, we experience changes as part of the natural aging process. These changes include increased dryness, changes in facial contour (shape) and in hair growth, and decreased sweating.
Smoking and sun exposure make our skin age more quickly. The most important change you can make to slow the appearance of expression lines is to avoid indoor tanning and protect yourself by avoiding mid-day sun, covering up, and applying a sunscreen of SPF 30 or greater. Products containing alpha hydroxy acids or retinol also help to reduce fine lines.
Dry skin is a common cause of itching, especially as we age. Dry skin can be prevented by avoiding excessively hot water in the shower or bath, using gentle soaps or cleansers, and moisturizing your skin at least twice daily.
Dark skin – If you are African-American, Native American, Asian, Hispanic or Southern European, certain lightening and anti-aging treatments should be used with caution, especially if you have sensitive skin. Products with alpha hydroxy acids (AHAs), hydroquinone, and tretinoin can cause hyperpigmentation (dark spots) through irritation of the skin, and chemical reactions that deposit pigment. Products containing mandelic acid and copper peptide, which can firm the skin, can be used safely.
Eczema – This itchy, red rash comes in many forms and can appear anywhere on the body. It can affect all ages, but is most common in children with a history of allergies, asthma, or a family history. Gentle skin care and lifestyle changes are as important as medicine to prevent flares. Medicines, including steroid creams, topical immunomodulators (TIMs), antihistamines, and antibiotics, may be used to decrease inflammation, treat infection, and help with itch. Severe eczema may require systemic (affecting the whole body) medicines. As with other skin conditions, it is important to receive a proper diagnosis from a dermatologist for appropriate treatment.
Melasma – Melasma causes brown or tan patches, most often on the face, neck, or upper lip. The condition is triggered by sun exposure or hormonal changes, including pregnancy or taking birth control pills. Melasma is more common in women, but can also affect men. If you think you have melasma, but you haven’t visited a physician or dermatologist, it is important to receive an official diagnosis before beginning any treatment. This condition is commonly treated with hydroquinone, kojic acid, azelaic acid, L-ascorbic acids (Vitamin C), or mandelic acid. To ensure effective treatment, you should use a sunscreen at all times.
Rosacea – This skin disease starts with a tendency to flush or blush, often with triggers like spicy food or alcohol. It can cause redness of the cheeks and nose, visible blood vessels, red bumps, pimples, and even grittiness in the eyes. It’s important to realize that rosacea is a chronic (long-term) condition that can get worse if treatment is delayed. A dermatologist can examine your skin to determine if you have rosacea, and recommend treatment. Depending on the type of rosacea you have, your dermatologist may recommend topical antibiotics, retinoids, or vasoconstrictors. Oral antibiotics may be effective in more severe cases, and laser treatments can improve redness and visible blood vessels.