With adolescence comes an increase in both independence and responsibility. Where their parents were once fully accountable, teens now begin to make many of their own choices regarding lifestyle and health care. Along with a greater sense of self-awareness comes the desire by many young adults to alter their appearance or express themselves through various forms of physical alteration and adornment; many such practices affect the skin. Guidance from trusted adults can help teenagers make the best decisions concerning their skin care and general well-being.
Smoking, alcohol and skin
It is during their late teens that many people are exposed to alcohol and tobacco for the first time. While both cigarette smoking and alcohol consumption impact widely on the body, they are known to have specific effects upon the skin.
Tobacco smoking has two primary effects upon the skin: environmental and systemic.
Environmentally, tobacco smoke dries the skin’s surface upon impact; this can lead to premature ageing and visible wrinkling. Stains from tar and nicotine also appear, particularly on smokers’ hands. While aesthetic in nature, these changes to a smoker’s skin can increase distress and angst as their appearance changes faster than that of non-smokers’.
Systemic effects from tobacco smoke are even more concerning. Smoking reduces blood flow, by restricting blood vessels, and induces the production of reactive oxygen species in the skin. These factors can lead to the destruction of collagen in the skin (again, contributing to premature ageing), impairment of wound healing and discolouration of the skin. Furthermore, smoking has been directly linked to higher rates of squamous cell carcinoma skin cancer and a twofold risk of the skin condition psoriasis.
Various conflicting reports have also linked smoking to higher or lower rates of acne and hand eczema, as well as indicating that smokers may have a higher rate of human papilloma virus infection. In almost all instances, a cessation of smoking has lead to a reduction in disease or disease risk.
Alcohol consumption has a direct effect on skin. Firstly, drinking alcohol leads to dehydration which can dry out skin and make it grey and saggy in appearance. Alcohol can also cause the dilation of blood vessels (capillaries), with repeated consumption causing spider veins due to permanent dilation. To help minimise these risks, reduce your alcohol intake and intersperse alcoholic drinks with plenty of water. Alcohol can also exacerbate specific skin problems including psoriasis, eczema and acne.
Body piercing is widely practiced in modern society, particularly amongst young women. It is a common trend in teenagers, with many seeing it as a way to express themselves or enhance their individuality. A 2004 survey of 500 Americans revealed that, of those pierced, 30 percent had had their first piercing by the age of 18.
Piercings can result in complications, most affect the skin locally:
- Allergic reaction to jewellery: some metals - particularly nickel, cobalt and white gold - can induce hypersensitivity which presents as inflamed or itchy dermatitis. Yellow gold, titanium, platinum and stainless steel are less likely to provoke such allergies.
- Local infection with bacteria (i.e. pseudomonas in cartilage of the ear) or yeasts (i.e. Candida). Left untreated, infection may spread and lead to serious complications such as toxic shock syndrome or sepsis (whole body infection).
- Keloids: excessive scarring which extends beyond the initial site of damage; these are more common in individuals with dark skin tones.
- Pyogenic granuloma: benign, vascular skin growths which are usually small, red and may ooze or bleed.
- Abscess formation
- Inflammation of the cartilage (chondritis)
- Skin growing over jewellery: embedding can occur if piercings are too tight.
- Blood borne infection/disease: improper sanitation and poorly sterilized equipment can lead to the transmission of disease including HIV and hepatitis viruses.
To minimise the risk of complications when receiving a tattoo or piercing consumers should look for signs of good hygiene, such as; fresh equipment, surgical gloves and an autoclave (machine used to sterilize instruments). It is also prudent to check that the piercer or tattoo artist possesses government-issued certification, which verifies their compliance with health guidelines. It is also important to strictly follow the advice of the piercer following a new piercing to minimise the risk of complications.
A tattoo is a permanent mark on the skin, made by puncturing the epidermis and inserting pigment into the dermal layer. According to the same U.S. survey quoted above, 16% of those with a tattoo had obtained their body art before they were 18.
Potential adverse reactions to tattooing include:
- Infection (i.e. impetigo or cellulitis)
- Transmission of infectious disease: such as hepatitis and HIV, through poor sanitation or unsterilized equipment.
- Allergic or toxic reaction to tattoo ink
Another issue to consider when obtaining a tattoo is removal. Dermabrasion and surgery have both been used with varying success, however laser treatment is least likely to leave scarring. The effects of each method vary depending on the type of pigment used, the age of the tattoo, its depth within the skin and individual skin type.
Sunbeds and solariums
The use of solariums is particularly prevalent among young people, with the American Academy of Dermatology reporting that 2.3 million American teenagers use one each year; a large proportion of users are young women under the age of 29. Exposure to UV radiation, such as that emitted by solariums, has been shown to increase the risk of a variety of ailments, including: photoaging, immunosupression, sunburn, scarring, skin cancer and eye damage (such as cataracts). Most serious of these is the increased risk of melanoma, the most lethal form of skin cancer, particularly when exposure occurs at a young age. The International Agency for Research on Cancer (IARC) recently classified UV-emitting tanning devices in the highest risk class for cancer. The agents in this category, including tobacco smoking and asbestos, are defined as "definitely carcinogenic to humans".
Many people, particularly teenagers and young adults, see a tan as being attractive and desirable. This age group may be particularly inclined towards indoor tanning as they are more likely to desire a tan for cosmetic purposes and confidence enhancement. In some cases, visiting a tanning salon may also be a means of socialising and fitting-in; young people often attend tanning sessions with friends. For teenagers who aspire to tanned skin, sunless tanning products (in the form of a spray or cream) can provide a safer and healthier alternatively to solarium use.
Colette Bouchez, Top Teen Skin Problems – and How To Solve Them, WebMD, Last accessed 03 November 2016, http://www.webmd.com/skin-problems-and-treatments/acne/features/top-teen-skin-problems-how-to-solve-them#1 >.
De Hertog, SAE et al. 2001, ‘Relation Between Smoking and Skin Cancer’, Journal of Clinical Oncology, 19(1):231-238.
Drinkaware.co.uk ‘How alcohol affects your appearance’, retrieved 5 May 2011.
Laumann, AE & Derick, AJ 2006, ‘Tattoos and body piercings in the United States: a national data set’, Journal of the American Academy of Dermatology, 55(3):413-421.
Thomsen, SF & SÃ¸rensen, LT 2010, ‘Smoking and skin disease’, Skin Therapy Letter, 15(6):4-7.