Tweens, teens & young adults - Skincare routines & regimens

BREAKING DOWN THE CHARACTERISTICS OF TWEENS/TEENAGE SKINCARE, FROM THE PHYSICAL TO THE PHYSCHOLOGICAL.

Transitioning from a young child into a teenager and then into adulthood can be both an exciting but trying time, with the inclusion of hormones, it impacts tweens in very different and unique ways. Altering them physically, mentally and emotionally, hormones are a certain factor we ought to tune into when it comes to tween development.

HOW DOES SKIN CHANGE?

It’s important to note the physiological changes to the skin during puberty. During puberty the gonadotropin hormone (GnRH) is released from within the brain and as a result it stimulates the pituitary gland to release other hormones that then produce oestrogen and testosterone.

It is testosterone that is then responsible for the skin changes in puberty – it increases sebum (oil) production and the cause for hair growth. For instance, when girls are introduced to their menstrual cycle, it dictates the hormonal fluctuations that are then privy to skin changes that can include and aren’t limited to acne, eczema, psoriasis, seborrheic dermatitis, pityriasis versicolor and hidradenitis.

Whilst the shift in gear as a result of hormones change and affect the skin, it is important to keep an open dialogue around skincare changes. Education and routine is key for tweens and teenagers to be aware of their changing skin and body and we interviewed Black Skin Directory Practitioner Dr Amiee Vyas on treating and looking after skin when it comes to children and young adults.

Nateisha Scott: How is a young black child/teenager’s skin different to other skin tones?

Amiee Vyas: When you are born the skin is very thin which is why it is especially delicate and sensitive. The uppermost layer of the epidermis, the stratum corneum which is often talked about in relation to barrier function in adult skin is especially thin and sweat and oil production are also low, so the skin easily loses moisture. The pigment producing cells (melanocytes) are also less active and this increases with age, so we get darker with time.

 Everyone regardless of skin colour is born with the same number of melanocytes, they are simply larger and more active in darker skin and this increases with age. In childhood melanocyte activity is still very low so it is important to use SPF as early as possible to prevent UV damage. In childhood the oil and sweat glands start to mature slowly, the skin gradually thickens, and the barrier gets stronger. By around 12 years the structure is then similar to adult skin.

NS: You mention characteristics such as melanocyte activity, barrier strength and sweat/oil production, for children aged 8-12 what skincare routines would you then recommend?

AV: Start by introducing a simple routine to control oil but without using harsh ingredients.

A gentle non-comedogenic cleanser like Cetaphil gentle cleanser is a good starting point twice daily. Continue to moisturise with oil free or gel-based moisturisers (Cetaphil gentle lotion is helpful). The word you are looking for on all the products is non-comedogenic.

Black skin is more prone to drying out because it lacks ceramides compared to lighter skin types and this can worsen inflammation. Cerave is another affordable option that also includes small amounts of salicylic acid (a beta hydroxy acid that is excellent at reducing oil and unclogging pores) in some of its formulations. You can introduce these once or twice a week but use sparingly.  Always use an oil free SPF made for acne prone skin daily to minimise pigmentation.

If these measures alone don’t work, consider introducing a gentle antimicrobial. Clinisept/ Clinisoothe are good options. Avoid toners and harsh ingredients that strip the skins oil as it will rebound with even more.  Consider hydrocolloid patches to stop picking and reduce inflammation if you have the odd swollen or raised spot.

NS: For the 12-15-year-old bracket?

AV: Consider over the counter benzoyl peroxide or salicylic acid products from the pharmacy/over the counter, to be used a couple of times weekly but ensure you moisturise regularly. If these basic measures don’t help seek advice from your GP or a doctor experienced in treating young black skin. Seek advice earlier if you see very swollen spots, if the spots are painful and if they are leaving dark marks.

The GP will be able to assess suitability for topical creams like benzoyl peroxide, antibiotic creams, or low strength Vitamin A as well as others they will also guide you to increase the strength as needed.  GPs can also prescribe oral antibiotics, hormonal control and refer to a dermatologist for oral vitamin A if the acne is very severe and/or scarring.

NS: And for teenagers, say around 16-19 years old, what would be a routine you would strongly advise?

AV: Consider cleansers with active acids like glycolic, mandelic and salicylic acid. Always start low strength and go for products that have been pre-formulated rather than trying to layer different actives separately. If you do this, you may use to many and cause inflammation.

Consider low strength vitamin A products/ retinoids that you can get from your pharmacy or over the counter and slowly increase as tolerated. Never go for a strong product first it will have the potential to damage the skin barrier causing sensitivity and irritation or even burn the skin creating a dark scar. Vitamin A is great as it can control oil production, aid exfoliation and minimise pigmentation. Just use it in a controlled way for best results.

NS: Generally, is there anything you strongly recommend young adults avoiding when it comes to skincare and habits?

AV: Absolutely,

-       Harsh actives especially if very young – the skin barrier is weak, for 15+ always start low strength.

-       Abrasive exfoliants which strip the skin and can scratch the skin causing micro-tears and inflammation.

-       Toners – they strip the skin and cause rebound oiliness and irritation

-       Avoid over washing – I recommend once in the morning and double cleansing at night. Use a gentle cleanser alongside actives.

-       Avoid traditional remedies or products that have unknown ingredients.

-       Keep it simple, 2-3 steps morning and night are sufficient

-       Continue to moisturise as above.

-       Don’t forget SPF.

NS: One thing that really affects young adults is hormones and puberty, from your expertise what are the effects both physiologically and physiologically?

AV: As we go from childhood to puberty and mature into young adults not only do our hormones kick into action but there are also a number of psychological and social changes that impact our bodies.

The skin becomes sweatier and oilier and as the skin turns over dead skin cells build up leading to blackheads, congestion and breakouts due to the pubertal hormonal surge of oestrogen and progesterone in females and testosterone males. These hormones stimulate the skin’s sebaceous (oil) glands to produce even more sebum, making it oiler and more prone to acne. Everyone will experience this to some extent, some more severely than others and family history also has an impact.

 [Acne is an inflammatory condition that occurs due to an over production of oil combined with clogged pores, inflammation and colonisation with C acnes bacteria.]

Stress is another factor that increases oiliness due to cortisol release making the sebaceous glands swell further. This can happen at any age but is very common in adolescence due to exams and social changes experienced during puberty.

Adolescent diet is often high in sugar and carbs which can is a compounding factor. Sugar and carbs both cause cellular pathways to increase oil production for males and females. In females this results in an insulin surge which stimulates ovarian androgen (testosterone) production and increases acne further. These foods as well as processed foods are also pro-inflammatory, and oil and inflammation together drive acne.

Inflammation in darker skin types stimulates melanin production as a protective mechanism. This means a spot itself can lead to post-inflammatory hyperpigmentation (flat pigmented “scars”) regardless of whether you touch or pick it. Teenagers are likely to be more self-conscious of their skin leading to picking, using a myriad of overly aggressive skincare products and/or wearing heavy makeup. All of this increase inflammation increase acne and worsen post-inflammatory hyperpigmentation.

Girls will also breakout just before their period because the female hormones decrease just before a bleed and the male hormone testosterone (which is present in lower amounts) relatively peaks stimulating sebum release.

NS: In your opinion, are there any concerns or myths that young black children need to be taught about their skin?

AV: Teach them every skin colour is beautiful from a very young age. Educate them about how to take care of their skin so it is healthy, explain the misconception of colourism and the damaging effects of skin bleaching practices so they are strong and confident in their beautiful healthy skin.

Teach them that any form of irritation or discomfort in the skin must be soothed and treated quickly. If basic measures don’t work seek medical advice early. Be it a cut or a spot, all of these cause inflammations and can result in stubborn confidence damaging pigmentation in the future. If it burns or itches but there is no redness it is still necessary to moisturise quickly to prevent this.

Keep the skin well hydrated to keep the skin barrier strong, healthy and resilient.

Don’t overly rub or play with the skin, these repetitive actions can also cause irritation.

SPF is non-negotiable.

NS: Finally, what words of advice/encouragement would you share with teens/tweens in regard to their skin?

AV: Do it with them from a young age and teach them about self-care and personal care. Make it an enjoyable experience and explain why you do each step.