What is normal?Suggestions for skin careCommon skin conditions
What is normal?
With the hormonal fluctuations of adolescence beginning to settle, the first few decades of adulthood represent a period of relative stability in a person’s skin. The main exception to this is pregnancy.
Some individuals may experience occupational contact dermatitis as a result of exposure to water and chemicals in their workplace.
Occasionally, acne can persist into the third and fourth decades of life.
Suggestions for skin care
By the age of 40, it is estimated that people will have received 46% of their lifetime sun exposure. As with all age groups, adequate sun protection is important, and daily use of a facial sunscreen is recommended. In addition, do not forget about other commonly exposed skin areas, such as the back of the neck and hands. This will help to avoid premature ageing of the skin, and also reduces the risk of developing skin cancer later in adulthood.
Some people may also find nightly application of a moisturiser helpful for preventing skin from drying out, and products such as glycolic acids and alpha-hydroxy acids also help to reduce sun damage. Understanding that it is safe to be exposed to the sun when the UV index is 1 or 2 is important to maintain Vitamin D stores.
Once again, people need to be reminded to check their own skin every three months. Use of a moisturiser at night for the hands is often helpful, both to prevent and treat contact dermatitis.
Common Skin Conditions
Whether as a continuation of issues experienced during teenaged years, or as a result of new onset, acne is also quite common in this age group. There is increasing evidence that low glycaemic index foods may help acne, so once again, the importance of a healthy diet is emphasised. However, if acne persists after appropriate skin care, there are more sophisticated prescription treatments available.
If it is severe or causing concern for any reason, consider consulting your doctor. Even relatively mild acne can often cause great distress and damage to self-esteem and self-confidence, at this vulnerable time of life.
Of greatest concern is the development of cystic acne, which is characterised by painful lumps or blind pimples under the skin. These lesions may cause permanent scarring, and assessment by a doctor for referral to a dermatologist is strongly recommended. Treatment with Vitamin A derivative isotretinoin (trade names Roaccutane™, Oratane™) is often both curative and life-changing.
The term "alopecia" refers to hair loss. Young adults can experience alopecia areata, an autoimmune disorder and occurs when the immune system attacks the hair follicle causing inflammation around the hair root. The hair root then becomes inactive and the hair falls out. If you experience sudden or significant hair loss or hair thinning, then you should see a dermatologist for a specialist medical diagnosis.
Eczema is a common skin condition among young adults. A discoid (nummular) pattern may be seen, which can either involve “dry” (crusty, cracked) or “wet” (oozing, blistering) oval-shaped patches. These can be various shades of pink, red or brown, and may be very itchy.
Skin cancer becomes common within this age group. Skin cancers will usually present as a spot, freckle or mole that is visibly different to the skin surrounding it. It is often a new spot but skin cancer can also be present in a pre-existing spot that has changed colour, size or shape.
It is important that you see a dermatologist if you have any marks or spots on your skin that are:
- changing shape
- bleeding or itching.
As we start to get older our skin, like the rest of our body, also ages and its features and appearance start to change. The biggest contributor to skin ageing is sun exposure. The ultraviolet radiation of the sun interacts with our skin (particularly the dermis, the underneath layer of the skin) and causes damage. This is known as photoageing.
Prevention is better than cure when it comes to the ageing of our skin. Dermatologists will also be able to advise on which of the thousands of skin care products available will have various effects on your skin.
Occupational Contact Dermatitis
Occupational contact dermatitis may be caused by irritant contact dermatitis or allergic contact dermatitis. While irritant contact dermatitis is most common, there are also many potential causes of allergic contact dermatitis. This is a delayed hypersensitivity reaction, so people do not get itchy rashes straight away after contacting a chemical that causes allergy (allergen) - it can take hours or even a day or two.
Important occupational allergens include chromate in cement and leather, hairdressing allergens such as hair dye and bleach, and rubber chemicals in certain gloves. It is said that 4000 chemicals (of a total of 100,000) can cause allergic contact dermatitis.
The most common cause of non-occupational contact dermatitis is nickel from cheap jewellery. Other important allergens include fragrances and preservatives in skin care products.
Contact urticaria is a form of immediate hypersensitivity, with symptoms such as itching, burning and redness occurring within minutes of skin contact with an allergen. Typical causes include latex, hairdressing bleach and some foods, especially when handled by chefs.
Psoriasis is a commonly occurring condition in this age group. It is characterised by red patches with a white, scaly surface, and can sometimes resemble eczema. These patches are of varying size and often affect the scalp, although people often present with more generalised psoriasis affecting much of the body. It tends to have a symmetrical distribution (i.e. occurs on both sides of the body).
There are many different prescription treatments available, including topical treatments (creams and ointments), tablets and UV light phototherapy. The field of psoriasis has recently been completely reinvigorated by the use of a new class of treatments, the ‘biologics’, which can be extremely effective in severe disease.