Teenage years are perhaps some of the most tumultuous periods in life. Thanks to hormonal changes, it is not just their emotional state that witnesses constant upheaval but their physical state too. And quite often it is their skin and hair that bear the brunt of this change.

Adding to the problem is the fact that teens quite often either neglect their skin and hair or fuss over it too much, in both cases aggravating the problem even further. While it is important that teenagers wash and cleanse their face regularly and apply sunscreen before stepping out, it is important the skin and hair care regime keeps in view their conditions and needs.

That said, broadly speaking skincare guidelines can be divided into two parts: general or routine; and that for sufferers of specific skin conditions or disorders. Let’s explore them separately.

Routine skincare tips for teens

The first step is to determine the individual’s skin type. There are four main types: normal, dry, oily and combination.

Normal skin: It has an even, smooth skin tone; soft texture; and no visible blemishes, red spots or flaky patches. Pores are barely visible, and skin surface is neither greasy nor dry.

If your skin is normal, wash your face 2-3 times a day with a mild cleanser or regular soap and water, to remove dirt and sweat.

Dry skin: It is dull, rough, scaly and sometimes itchy, with almost invisible pores. Dry skin is usually caused by an abnormal shedding of cells from the skin’s outer layer (epidermis). In normal situations, lubrication from the body’s natural oils helps to prevent water loss from the skin. In individuals with excessive dry skin, this natural lubrication phenomenon gets interrupted due to several dermatological irregularities.

If your skin is dry, wash your face daily with a mild cleanser to prevent your skin from getting drier. Also, moisturise with a non-perfumed, alcohol-free cream after washing. It’s important that you limit taking very hot showers, exposure to high temperatures with low humidity which robs your skin of moisture. Using harsh soaps and excessive washing or scrubbing of your skin will increase the dryness.

If your entire body skin is dry, use a suitable emollient preparation soon after bath on your whole body while your skin is still damp. This will help the moisturising effect of the emollient to reach into the deeper layers of the skin.

Oily skin: Oily skin is acne prone, with open pores, shiny complexion and some degree of blackheads and small pimples. Because hormones affect oil production, the hormonal changes taking place at puberty do affect the levels of these hormones, which in turn influence your skin. The most common hormone-influenced skin condition is teenage acne. This affects 70-80 per cent of the teenage boys and girls at any stage in their teens, as such making it the most common skin disorder among teenagers.

To keep oily skin clean, wash face at least three times a day with regular soap and water. A suitable skin cleanser can be used at night, if needed. This helps to dissolve skin oil and remove excess dirt from the skin surface.

If you have pimples, never pop or squeeze them; it can spread the inflammation and worsen acne.

Use cosmetics and other facial products that are non-comedogenic, meaning they do not clog pores. Keep your hair off your face and wash your hair at least once every two days to reduce oil.

Normal/combination skincare: In this case, you might have an oily T-zone (forehead, nose and chin) and dry skin elsewhere. The pores on your face are large and skin has a higher tendency to get blackheads. If you have a normal/combination skin, wash your face two or three times a day with plain soap and water to remove the excess oil. Moisturise dry areas but not oily areas.

Hair care

Do: Wash your hair with a suitable shampoo 2-3 times a week, keeping your hair neat and tidy.

Don’t: Overuse hairstyling gels, creams, lotions and sprays. If you are using these products, make sure you wipe your forehead with wet wipes soaked in plain water 2-3 times a day to remove the spilled over part of these products on your forehead. Their presence on the skin can cause clogging of the pores and lead to eruption of pimples on forehead, a condition distinctively known as pomade acne.

Create a hairstyle by bringing your hair hanging down on your forehead skin. A continuous skin contact with your hair can also lead to lesions of frictional acne.

Sport bands

Do: Use these hair bands for a short period of time or during the active playtime. Select bands preferably made of soft, non-irritant materials. And ensure they are not too tight.

Don’t: Prolonged use of these hair bands can cause significant frictional/irritant effect to the hair follicles on the forehead, which can lead to formation of unusual type of pimples, known as “acneiform folliculitis”.

Tips for those with specific skin conditions

Acne sufferers: Acne is by far the most common teen skin condition. It occurs when pores on the skin become clogged preventing the skin oil (sebum) from reaching the surface of the skin. As a result, it starts accumulating in the oil glands leading to the first stage of pimple formation. Keeping the skin clean is the easiest way to reduce your risk of developing more widespread acne lesions. This can be achieved by following the routine skincare for oily and acne-prone skin. Also remember, even severe acne is a treatable condition. Consulting a dermatologist at an early stage can help you avoid post-acne conditions such as dark blemishes, ice-pick acne scars or skin texture alterations.

Eczema sufferers: For many teenagers, childhood atopic dermatitis/atopic eczema continues to affect them into their late teens and even longer. Here are some basic eczema skin management tips:

a. Keep eczema-affected areas covered particularly during outdoor activity sessions.

b. Those with active eczema must remember to apply prescribed creams/ointments.

c. Avoid exposure to dusty environments.

d. Avoid contact with any known skin irritants, for example, prolonged contact with chlorinated water in swimming pools, direct contact with playground grass or plants.

e. After physical sports sessions, shower to wash off the dried sweat on the skin surface. Appropriate moisturisers should be applied to the entire body immediately after a shower.

Viral warts sufferers: Viral warts are common among teenagers. Any area of the body can be affected, but a majority of sufferers are seen with multiple warts on their palms and soles, a condition called palmoplantar warts. Many sufferers usually self-treat opting for over-the-counter wart solutions, only visiting a dermatologist when the condition worsens. But this could pose a problem because with time, warts could grow in size and sink deeper into the skin. Treatment in such situations could be more difficult and time-consuming.

Teenagers and their parents/caregivers should carefully check the skin for presence of any warty lesions at regular intervals. Skin warts are caused by human papilloma virus, which is contagious in nature. The spread of these warts usually happen through direct body contacts or through skin contact via contaminated ground surfaces. Swimming pool sidewalk ways and common shower room floors are areas where contamination can happen easily.

Sun protection guidelines

These are important and must be followed primarily during outdoor activity/sports hours. Teens of Caucasian origin must follow these guidelines as they are at higher risk of sufferings from the adverse effects of sun.

Sunburn

This is mainly caused due to prolonged exposure to sun during mid-day hours when the ultraviolet B (UVB) is more intense and it is a concentrated component of the sunlight.

Sunburns can be graded as mild, moderate or severe. Mild sunburn will result in redness of the exposed body areas and tend to spontaneously disappear after a few hours of sun exposure. Moderate degree of sunburn induces more inflamed reactions and can create symptoms ranging from mild itching and discomfort to mild pain in the inflamed areas. Cold skin compresses followed by emollient applications can help in many cases. However, in some instances, topical steroids may have to be applied for 2-3 days to completely resolve the sunburn reaction.

Severe sunburn can manifest itself in various forms – severely inflamed, tender and sometime painful skin patches or plaques on affected areas.

In advanced cases, frank blistering lesions can also appear on top of the severely erythematous inflamed skin surface. In such cases, a specialist dermatologist should be contacted at the earliest. Treatment may include a combination of short course of oral corticosteroids together with potent topical steroids, oral anti-histamines (if the inflamed areas are severely itchy) and oral or topical antibiotics depending on the severity of the condition.

Frequent application of suitable emollients and cold water showers or localised sponging of the affected areas usually provide additional relief to the associated symptoms.

a. Use SPF30+ sunscreens at least 30 minutes before getting exposed to the sun.

b. Complete protective clothing should be worn during the sun expose periods.

c. Avoid sun exposure for extended periods, as longer the exposure, more severe will be the sun-damaging effects on the skin.

d. Remain in shaded areas. However, this can only offer 50 per cent sun protection as you will still remain exposed to reflected rays of the sun.

e. Schools should provide sun protection education to students during the early years of schooling to make it a part of their behavioural pattern.

Common troubles

Teenage is also the time when children are under various kinds of stresses – from those related to changes happening to their body to peer group pressures and even those related to academic and extracurricular activities. Many skin and hair conditions are triggered or aggravated by the emotional rollercoaster teenagers experience during this period of their life. Here are some of the most common ones:

Picker’s acne

One in four teenage acne sufferers have the habit of picking and poking their pimples, which can worsen the condition. Sufferers and their caregivers should be made aware of this, so it could be controlled at an early stage.

Lip-Lick dermatitis/angular chelitis

In this condition, the teenage sufferer is seen with persistently inflamed eczema-like skin rashes on and around their lips. Teenagers with newly fit dental braces are seen to be more frequently affected. This could likely be due to a higher degree of self-consciousness due to wearing the braces which make them believe that everybody else is staring at them. This again triggers an OCD behaviour compelling them to sub-consciously lick their lips continuously. This behaviour can result in Irritant skin dermatitis on the affected areas. Acutely inflamed and severely cracked skin on the corners of the mouth are common among sufferers. This in turn can cause secondary bacterial or fungal infection as such making this skin condition more severe and difficult to treat.

Trichitilomania (Patchy hair loss)

This is a type of hair loss which is primarily due to self-inflicted trauma of continuously pulling one’s hair at a few particularly targeted areas. Scalp is the most commonly affected but eyebrows too have been seen to be a target area. This is also a manifestation of OCD. 

Neurodermatitis and psychogenic pruritus

Here, teenage sufferers are primarily seen with complaints of continuous itching and scratching of certain parts of their body. In many cases, no significant skin lesions are seen. These itchy or partially eczema-like skin lesions are seen primarily affecting the reachable areas of the body by the sufferer’s hands. This is believed to occur mainly due to stress-induced sensory nerve hyper-stimulation, but, over a period of time it becomes a habit.

House-bound “Covid” skin syndrome

This has been experienced by some individuals of all ages during last six months of forced stay-at-home situation imposed through the Covid-19 protection medical guidelines. Several pre-existing skin conditions have been seen getting worse due to lack of medical treatment access. A few skin conditions like atopic dermatitis or even acne could worsen due to living 24/7 in an air-conditioned indoor environment making the skin dry.

Similarly, lack of exposure to the sun has caused some degree of vitamin D deficiency. Living indoors and staying away from friends have made many teenagers to be less attentive towards their skin hygiene, causing some degree of general adverse impact on their skin.

Nail biting/nail picking

This is another common condition. Teenagers of both genders suffer equally. Significantly distorted nail plates due to continuously inflicted trauma of nail biting or nail picking can result in among other things, low self-confidence and self-esteem, which can aggravate their OCD behaviour pushing them into a vicious cycle.

Stress-induced sweating

This is quite a distressing problem, which is again quite common. The sufferers have a history of suffering from recurrent attacks of severe but localised excessive sweating mainly affecting the armpits, palms and soles. The onset of these sudden sweating is mostly during stressful/anxiety inducing moments, whether encountered socially or during examination hours. Most of these teenagers are seen to show nervous tendencies with significant low self-confidence, and need psychological counselling together with dermatological treatments.

Seeking psychosocial assistance

Parents and teachers must be aware of the complexity of a few of the skin conditions attributed to the influence of an underlying OCD. In such cases, the sufferer must be offered continuous positive support from everyone around him or her. The negative channels attributing or causing teenager’s state of lower self-esteem must be eliminated. School’s psychological support systems must offer the necessary help through the student counsellors. In more difficult and challenging cases, timely professional help must be arranged by referring the sufferer to an experienced and skilled clinical psychologist.

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