Skin is the body’s largest organ and without it, as John Lithgow sings in one of my favorite children’s songs, “both your liver and abdomen would keep falling on the floor.” That line used to illicit a giggle from my son in his toddler years, and it’s still a good reminder of how important the outer layer is to our body’s overall well being. Skin not only holds our disparate parts together, it protects us from heat, light, injury, and infection. In return, it’s worth protecting, whether we’re one or 100.
Babies, Toddlers, Preschoolers
For newborns, Lindsay Fitch, a pediatrician with Arundel Pediatrics in Linthicum, recommends doing little for the skin except giving the occasional bath using a very mild cleanser. And don’t worry about skin that looks dry and cracked. “That’s just your baby’s skin getting used to being out of the nice, moist mommy environment,” she says.
After about a month, Fitch still recommends using a “super mild” moisturizing cleanser for bath time and hair. In fact, Fitch stresses the use of mild, unscented products for all children because many traditional baby skincare products are actually harsh. “If it smells perfumey, don’t use it on your kid,” she advises. Look for bath products, lotions, and even laundry detergents that are unscented or only mildly scented with natural oils. Don’t limit yourself to the baby aisle, either. Dove unscented liquid soap is great for babies, she says, as are laundry detergents labeled “free and clear.”
And don’t forget moisturizer. Fitch says parents often bring their toddler to her office thinking the child has a rash, when it’s really dry skin. “Small children can’t necessarily tell you their skin feels tight or dry, and older ones just complain of itchy skin,” she explains. “But in winter, most people really need some lotion, at least after bathing. So if you see your kid itching or scratching, put on moisturizer.”
The most common skin questions parents ask Fitch involve sunscreen. Fitch prefers the physical sunscreens because “they are somewhat more effective, they don’t wear off as fast, and are much gentler on the skin.” Physical sunscreens contain zinc and titanium dioxide that reflect the sun’s rays off the skin. Fitch likes Blue Lizard, California Baby, and ColoreScience. In terms of SPF, Fitch says little ones don’t need anything more than 30; rather, the key is frequent and proper application. And when it comes to sun protection, don’t forget a hat. The hair of young children is thin and they can easily get sunburn on their scalp. Also consider buying UV clothing and swimsuits.
School-Age Kids, Teens
The middle school years can be hard on skin, notes Angela Peterman, a dermatologist with Anne Arundel Medical Center and Anne Arundel Dermatology in Annapolis. Kids in this age group “don’t even realize their bodies are changing and they are confused by it,” she says. It can be hard to get a kid to even wash his face. It’s also the age that skincare starts to become the child’s responsibility. You can expect your child to care for her skin around eighth or ninth grade, Peterman says, adding that girls tend to be more motivated than boys.
Still, most kids – and teens, for that matter – only need to wash their skin in the morning and at night with a mild cleanser, Peterman says. Kids with an eczema problem might want a non-soap cleanser, she adds, while teens with acne problems might consider a stronger cleanser.
Parents should especially zero in on sun protection at this age. Studies show overexposure to ultraviolet light in childhood is a major risk factor for skin cancer. Peterman recommends buying a sunscreen that is broad spectrum with at least SPF 15 for everyday use and SPF 30 for outdoor activities.
Unfortunately, that doesn’t mean they’ll use it. “You can remind kids [to put on sunscreen] but you’re not with them all the time,” Peterman explains. “Kids think they are invincible, and there is still lots of social pressure to have a tan.”
To combat that pressure, make sunscreen easily accessible. Put it in their gym bag or get them to put it on before they leave the house, Peterman suggests.
And insist your teens switch to self-tanners or spray-on tans rather than use a tanning bed. Millions of teens each year fake bake, yet “studies show that indoor tanning increases the risk of melanoma, especially when it begins at an early age,” Peterman says. Melanoma is the rarest but deadliest form of skin cancer. And pediatric melanoma, while still uncommon, is on the rise, especially among young girls. “There is a 75 percent increase in melanoma in women before the age of 35,” Peterman notes, adding researchers think the rise may be linked to tanning booths.
Protecting our kids’ skin is important, but we shouldn’t neglect our own. Coleen M. Barrack, a medical aesthetician with Anne Arundel Dermatology in Annapolis, recommends adults build their skincare routine around a good cleanser, moisturizer, and sunscreen specific for their skin type.
Barrack also suggests avoiding the three Ss: sun, stress, and sugar. Wear sunscreen, eat a balanced diet, exercise, drink plenty of water, take vitamins, and get plenty of rest. “With good skin, it’s 50 percent internal, 50 percent external,” she explains. “If we aren’t feeding the skin the proper nutrients on a daily basis, it’s going to suffer.”
Those in their 20s and 30s should focus on the basics, but begin to think about prevention. In your 30s, add exfoliation to your routine. “After the age of 25, the skin stops naturally wanting to exfoliate itself, so you have to help it along,” Barrack notes. Look for gentle scrubs that contain encapsulated beads of oil, not plastic beads or abrasives such as nutshells.
Those in their 40s, 50s, and 60s need to practice good preventative measures. At the very least, wear sunscreen, a hat or visor, and sunglasses, and evaluate your diet. Barrack says this is the time to start in-office procedures such as microdermabrasion and chemical peels, and definitely use a retinol-type product for fine lines. At home, masks are great to do once or twice a week.
Those over 60 need to be extra careful because skin thins as we age, causing it to easily irritate and dry out. Keep it simple and just hit some of the target issues, Barrack says.
The worst move at any age is extensive sun exposure. It prematurely ages our skin and raises the risk of skin cancer. In the Annapolis area, we love to be out on the water but we don’t protect our skin while we are doing it. “I’m seeing people after the fact, after their skin has gotten to the point where they are totally unhappy with what the sun has done to it,” Barrack says. “We are still a little bit slow about preventive things” in our region.
Skin Gone Bad
What if the sun damage is already done and now, after reading this, you’re worried about skin cancer? Exercising precautions, no matter what age you start, decreases your risk of further skin cancers, says Lisa Renfro, a dermatologist with Anne Arundel Medical Center and Annapolis Dermatology Associates in Annapolis. Use sunscreen, avoid the mid-day sun, and wear protective clothing, she says. She also recommends a skin exam every year after the age of 20. You may need more frequent exams if you are fair skinned, have a history of skin cancer, a family history of skin cancer, or multiple moles.
If you do develop skin cancer, it’s most likely to be basal or squamous cell carcinoma. Renfro says one in five people will develop basal in their lifetimes. Basal and squamous are extremely treatable by several methods. One of the most advanced is Mohs surgery. Mohs is generally used for cancers on the head and neck or hands and feet because these are difficult areas to treat and because Mohs offers the highest cure rate and the smallest possible scar.
But don’t rule out melanoma. Fifteen years ago, the risk of melanoma was 1 in 120; now it’s 1 in 60, Renfro says. “I treat 100-150 melanomas a year. It’s becoming more and more common and in younger people due to increased sun exposure.” The longer it goes undetected, the worse the prognosis. And melanoma can look as innocuous as a little pink dot that’s mistaken for a pimple and ignored, Renfro says. That’s why annual skin exams are so important. When caught in its earliest growth phase, melanoma is 100 percent curable.
Karen Gaspers is a freelance writer in Chestertown, Md., who made an appointment for a full body skin exam after doing research for this article.