Confessions of a Teenage Client: How to Hear What Young Skin Is Saying

by Beth Bialko (as seen in Dermascope)

Young skin. It is the paradigm for which we are all striving: skin with lightning-fast metabolic turnover, robust support from abundant collagen, elastin reserves in tissues, and consistent melanin production. Smooth, plump, evenly-pigmented, fresh. Clients dream about it. Skin therapists strive to replicate it.

But guess what? Young skin – especially teenage skin – has its own share of troubles. Like teenagers themselves, adolescent skin may not be easy to understand. There may be seemingly unprovoked angry outbursts (in the form of an acne breakout). There may be sullen brooding (in the form of under-the-surface congestion). And there may be awkward, uncomfortable moments (in the form of excess sebum and plugged follicles). True, teenage skin has its whole life ahead of it – but it needs the skills of a professional skin therapist to look and feel its best.

The key, when dealing with skin concerns, especially in adolescent skin, is perfecting the art of listening. Learn to read between the lines and truly hear what the skin – and the teenager inside it – is saying.

Teenage Skin Needs Further Investigation

To understand our young client’s skin, optimizing tools of the trade – such as consultation cards – can facilitate needed communication and get to the heart of the skin issue. We rely on the teenager’s answers (and sometimes their mother’s), to get all the information; however, teenagers can be self-conscious, shy or uncomfortable about their skin. This is especially true of boys, who are often reluctant to seek help from a professional. And while some may engage or over-share everything, others may be reluctant to disclose the details to a stranger, especially in front of their parent. In order to get the details, you may have to play skin detective.

Start the conversation with things to which the teenager can relate, such as hair and/or make-up. Making these common topics relatable to the skin allows you to dig deeper into potential triggers. First, talk hair. If the teenager is using a lot of hair-styling products and acneic activity is present, mention that hair products contain plastics, perfumes and other ingredients that are not healthy for skin. Breakouts can occur around the hairline, cheeks and jaw, which are often evidence of hair product coming in contact with the skin. Girls will self-consciously hide their breakouts with their hair and play with it all day when at school. When a teenager goes to bed with hair product in place, that product ends up getting pressed into the skin while they sleep. Suggest replacing the pillowcase every few days to minimize contact, and tying long hair back. Clean hair is optimum, but not realistic, so at minimum, suggest brushing out styling products before bed.

Next, talk about make-up. Teenagers often share make-up at school, but you can bring bacteria into the conversation. The transmission and transfer of bacteria from compacts, sponges, pads, lip glosses, eye pencils and mascara wands can trigger acne or worse skin conditions, which are not things they want to share with their best friends.

From there, you can ease into more of the skincare discussion. Encourage the teenager to remove make-up – along with sweat and other surface debris – from their skin before sleep. As you examine the skin, you may see evidence of picking or even piercing (using metal implements) of acne outbreaks. Flaking or redness may signal “abuse” of harsh acne products or the use of rubbing alcohol on the skin. Without making accusations, matter-of-factly discuss the dangers of picking or squeezing breakouts, how easily bacteria are spread, and how long-term scarring can result. Teenagers will, without a doubt, probe and poke at their skin from time to time, so it is better to show them safe extractions. Advise them to properly cleanse the face and hands and to wrap the index fingers in tissue – no dirty fingernails! Using gentle pressure, they should make a mound around the breakout, wiggle the impaction out, and then immediately treat the blemished area with a product containing ingredients like Salicylic Acid or Tea Tree Oil.

Teenage Skin Is Not Adult Skin

Teenagers want to be recognized as different from their siblings and definitely different from their parents! We know that there may be a genetic predisposition to acne, however, teenage skin is different than adult skin, especially when it comes to acne. Hormones accompanying puberty, often as early as age 10, are actually the spark that triggers the development of breakouts, comedones and excess oiliness in the skin. Breakouts associated with adult acne will be primarily along the jawline, chin and neck, evidence of adrenal stress and hormonal fluctuations. With teenage acne, however, it may involve the entire face – particularly around the T-zone, forehead, nose, chin and cheeks, as well as the chest and back.

Adult acne can be associated with any skin type. Adults may not necessarily have comedones but can have deeply-inflamed, cystic-like breakouts due to stress hormones, whereas teenage skin tends to be oily – the result of sebum overproduction triggered by androgen activity. Androgens are hormones produced by the adrenals, with the most common androgen being testosterone. Adolescents of both sexes produce large quantities of androgens, which surge at puberty and can contribute to acne development. Androgens enlarge the sebaceous glands within the skin, causing these glands to produce more oil, which exacerbates plugged follicles and serves as “food” for bacteria (P. acnes).

Teenage Skin Is About More Than Acne

As a skin care professional, we know that clients present an array of distinct, specific needs when it comes to skin type, skin conditions and overall concerns. When we have a teenage client on our books, often the thought turns immediately to acne and oiliness. And, yes, in the majority of cases this is true – acne is by far the most common skin complaint among teenagers, affecting nearly all of those in the 12 to 17 age bracket at least occasionally, according to the American Academy of Dermatology. Effectively addressing teenage skin begins when we remember that there is more to young skin than just pimples.

Research shows that when it comes to skin, teenagers care most about the following top five skin issues: acne, oiliness, sweating, warts and eczema. All of these bring with them an element of anxiety and social stigma, affecting a young person’s sense of self-esteem. Adolescent skin, like the person inside it, is still developing. There are bursts of energy, sudden and extreme changes; most of all, there is a profoundly self-conscious aspect to being a teenager. Teenagers and their skin can be highly-emotional. While no one likes walking out into the world with a blemish, a teenager may be convinced that the eyes of the entire world are upon them. Handle your youngest clients with special care, since these skin issues may scar the psyche, as well as the epidermis.

It is important to consider other factors beyond genetics, as most conditions arise from multiple causation. Diet is continuously being reviewed as a potential cause of breakouts and blemishes. In a study by the American Journal of Dermatology, researchers discuss a link between milk consumption and acne. The exact process is unclear but researchers suspect that hormones and growth factors in milk may play a role. The study also suggests that consuming a diet rich in high-glycemic index foods (sugars, white flour, and snacks) appear to elevate insulin levels and, in turn, can stimulate sebum production. Encouraging a healthy diet with plenty of fruits and vegetables can definitely be a step in the right direction.

Sensitivity and erythema may be present from circulation naturally or as a true sensitive skin type. These symptoms can also be the result of incorrect product use such as aggressive scrubs, as well as over-drying and over-stimulating products. Harsh exfoliants, alkaline soaps and alcohol-containing astringents can strip the skin, making it sensitized and dehydrated.

Let us talk about stress. Yes, teenagers are stressed. From pressures like making high grades to peer-acceptance and approval, teenage years are often angst-filled and the emotional surges which define adolescence also contribute to skin conditions including acne.

The good news is this: Teenage skin is still maturing and cellular renewal and turnover is at its fastest rate – basically a new epidermis every 21 to 28 days. Young skin has a vast capacity to heal itself, so present your recommendations as a work in progress. While severe cystic acne will require care by a dermatologist, less intense skin care issues often can be addressed by better hygiene, the use of healthier products, and lifestyle considerations.

Teenage Skin Needs a Clear Routine

Skin at any age craves healthy ingredients and a daily routine. Most teenagers are looking for products to help banish breakouts and bacteria, control oiliness and reduce inflammation. Formulas with medicating ingredients like Salicylic Acid and Benzoyl Peroxide, combined with gentle botanicals, are tough on breakouts, but kind to skin. An at-home regimen for day and night can be combined with targeted treatment products for extra clearing. It is also important to educate young clients on what to use and what to avoid to get the clearest and healthiest skin.

For cleansers, the objective is not to get skin squeaky clean; a skin that squeaks is crying out for help! Teenagers often get overly-aggressive with scrubs, pads and invasive products that might be better-suited to disinfecting their rooms than tending to living skin. Help teenagers choose products that deep-clean and purify skin without stripping it of natural oils. Remember that teenage skin requires hydration and moisture protection; the goal is not to remove every drop of sebum. A foaming wash With Salicylic Acid exfoliates skin cells and clears trapped oil to help wipe out existing and future breakouts. Other ingredients like Oleanoic Acid, African Whitewood Bark Extract and Meadowsweet keep the skin calm and help regulate excessive sebum.

It is hip to hydrate, however, many teenagers do not understand toners. Stripping the skin with alcohol-based astringents can lead to dehydration and cause even more oil production! Let young clients know how purifying mists can help their skin care regimen by controlling excess oil, providing excellent hydration, and eliminating breakouts on the face and body. Botanical blends like Saw Palmetto, Sesame Seed and Moroccan Argan Kernel Extracts normalize sebum secretion while Orange Peel and Lavender soothe and refresh the skin.

Exfoliation is an important step in skin care. Coach teenage clients on gentle exfoliation techniques and products, avoiding over-exfoliation and harsh scrubs that can tear the skin and cause more damage. Mild physical and chemical exfoliants can slough off excessive pore-clogging skin cells. Natural earth clays like Bentonite and Kaolin soak up excess oils.

Educate young clients about using spot treatments on blemishes versus picking at breakouts. Remind teenagers that popping pimples or picking at the skin can lead to further damage such as acne scars. Topical formulas with Benzoyl Peroxide or Salicylic Acid kill breakout-causing bacteria deep within pores. They are designed to clear breakouts fast and help clients resist the temptation to squeeze pimples. Often, teenagers believe the myth that moisturizers will cause them to breakout or leave a greasy feel on the skin. An oil-free moisturizer can keep sebum under control with ingredients like Niacinamide, while Silicones protect skin balance without drying it out. Recommend hydrating formulas that control oily areas like the nose and forehead for an all-over matte finish.

Sunscreens are a must for all skin. In the case of teenage skin, they should be a daily habit, especially for those who are concerned with or prone to acne scarring. Unfortunately, teenagers are still tanning in hopes of clearing their acne. Ultraviolet rays (natural or artificial) actually make acne conditions worse by stimulating more cell production and further blocking follicles. According to the American Academy of Dermatology, nearly 28 million people tan indoors in the United States annually and of these, 2.3 million are teenagers. These tanning teens may not be concerned about skin cancer, hyperpigmentation or photo-aging right now, but they are going to turn into adult clients. It is never too early to educate on the risks of tanning. Encourage products that incorporate a Broad Spectrum SPF into the moisturizer to make sun protection easy, and suggest a skin-healthy self-tanner for teenagers who want a sun-kissed glow.

Teenage Skin Needs a Coach

Professional skin treatments can be the breakthrough difference for teenage skin that presents issues. Teenagers have a notoriously short attention span, so express treatments that last 20 to 30 minutes can quickly get to the root cause and treat key symptoms. Services designed to help deep-cleanse the skin, extract blackheads and expedite healing of inflamed breakouts tend to be good choices for young clients.

While clients are in the treatment room, you have a great opportunity to educate them about their skin and products. Providing ongoing skin lessons are a great way to review the do’s and dont’s of skin care while taking teenagers through the products you have recommended – and how to properly use them.

We can all be appearance-conscious, but a teenager’s appearance during their formative years truly affects their self-esteem in profound and lasting ways. Teenagers actually rank appearance and facial skin in their top three priorities. It is our job as skin care professionals to give them the knowledge they need to take care of their skin, and to coach them on healthy habits that keep skin glowing. As a professional, remember that the skin is always, always telling us something important. Are you listening?

Here are some useful skincare tips to share with teenage clients:

  • Practice a proper homecare routine that includes daily cleansing.
  • Apply sunscreen daily.
  • Never pick pimples (unless you have been taught the proper extraction method).
  • If your hands are dirty, do not touch your face at all.
  • Pillowcases should be changed weekly (at least) to avoid sleeping on bacteria, saliva and excess sebum.
  • If you have acne on your back or chest, sleep in a clean cotton shirt.
  • Keep a clean cloth for your face in your school locker, especially if you are involved with sports or other activities that cause sweating.
  • After cleansing, reapply any sunscreen moisturizer or product for acneic skin.
  • For blemishes on the forehead, avoid using hair products and wearing hats or helmets for long periods of time.
  • Eat a healthy and well-balanced diet.
  • You should not wear too much make-up to cover up blemishes. A quality, mineral makeup can be lightly applied if needed.

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Confessions of a Teenage Client: How to Hear What Young Skin Is Saying