Common Skin Problems and How to Treat Them

Our skin is the largest organ in our body and plays an important role as a protective barrier against infections, injuries, and UV radiation. However, many factors can cause issues with skin health leading to problems like acne, rashes, dryness, and more. Here is an overview of some of the most common skin problems and tips for how to treat them effectively at home.

Acne

Acne is one of the most prevalent skin conditions, affecting around 50 million Americans annually. It occurs when dead skin cells, oil, and bacteria clog up hair follicles leading to different types of blemishes like whiteheads, blackheads, pimples, and cysts. Acne most often occurs on the face, back, chest, and shoulders during puberty and adolescence due to hormonal changes but can persist into adulthood as well. 

Causes:

The main causes of acne include:

• Excess sebum production – When oil glands are overactive, excess sebum clogs pores and contributes to acne
• Bacteria – The bacteria Propionibacterium acnes can multiply in clogged follicles and cause inflammation 
• Hormones – Androgen hormones stimulate oil production and alter the development of skin cells lining hair follicles
• Medications – Certain medications like steroids, testosterone, lithium, and anticonvulsants are acne triggers
• Stress – Increased stress hormones like cortisol can exacerbate acne
• Genetics – Family history plays a role in acne susceptibility

Treatments:

• Over-the-counter topical medications like benzoyl peroxide, salicylic acid, and retinoids from Dennis Gross help unclog pores and reduce bacteria
• For more severe acne, see a dermatologist for prescription medications like antibiotics, birth control pills, isotretinoin, etc. 
• Avoid excessive washing and scrubbing which can irritate the skin; gentle cleansing twice daily is sufficient
• Use oil-free makeup and sunscreen products to avoid clogging pores
• Don’t pick at pimples to avoid scarring and infection.

Eczema

Eczema or atopic dermatitis manifests as dry, inflamed, irritated skin that can crack, ooze, and become infected. It often appears on hands, feet, insides of elbows and knees, face, and neck. Eczema results from overactive immune system responses, genetics, environmental triggers like allergens or irritants, stress, and disruptions in the skin barrier.

Symptoms:

Some common symptoms of eczema include:

• Extreme itchiness, especially at night
• Red, cracked, scaly, thickened skin patches
• Raw, sensitive skin from scratching
• Small fluid-filled blisters that can crust and ooze
• Thickened, discolored skin patches from chronic rubbing and scratching

Causes:

Potential causes and triggers for eczema flares include:

• Genetics – family history of eczema or related conditions like asthma
• Overactive immune responses and inflammation
• Irritants like soaps, detergents, perfumes, cigarette smoke
• Allergens from pets, pollen, mold, dandruff, dust mites  
• Microbes like staph bacteria or viral infections on the skin
• Stress and environmental factors
• Dry skin and defects in the skin barrier  

Treatments: 

• Use gentle cleansers and thick moisturizers to improve hydration and skin barrier
• Take lukewarm showers, pat skin dry, and apply moisturizer immediately after
• Use hypoallergenic and fragrance-free skincare and laundry products  
• Wear gloves for wet work and cotton gloves over moisturized hands at night
• Try over-the-counter hydrocortisone creams to reduce inflammation and itching
• Avoid known triggers like harsh soaps, wool, environmental allergens
• Phototherapy and prescription medications may be required for severe cases

Moisturizing Tips:

It’s crucial to keep eczema-prone skin well hydrated. Useful tips include:

• Apply moisturizer within 3 minutes of bathing before water evaporates
• Use thicker ointments or creams rather than lotions or gels
• Choose products with ceramides, hyaluronic acid, colloidal oatmeal  
• Apply moisturizer multiple times per day whenever your skin feels dry
• Use humidifiers at home and work to add moisture to the air

Medications:

Some medications used for eczema include:

• Corticosteroids – Reduce inflammation and itching (topical or oral) 
• Calcineurin inhibitors – Block immune responses (tacrolimus, pimecrolimus)
• Antihistamines – Control itching, especially at night (diphenhydramine, hydroxyzine)
• Immunosuppressants – For severe cases unresponsive to other treatments (cyclosporine)
• Biologics like dupilumab target specific immune pathways
• Phototherapy – UV light treatment to reduce symptoms

Psoriasis

Psoriasis speeds up the growth cycle of skin cells causing a buildup of thick, scaly patches that can be itchy and painful. It often occurs on the scalp, elbows, knees but can appear anywhere. Psoriasis may be triggered by infections, stress, skin injuries, smoking, cold weather, and genetic predisposition.

Appearance:

The characteristic signs of psoriasis include:

• Thick, red, inflamed patches with a covering of silvery white scales
• Commonly affects scalp, elbows, knees, lower back, nails, hands, feet
• Lesions can be painful, itchy, crack and bleed
• Nail pitting, discoloration, and crumbling are common nail signs
• Variations include guttate, inverse, erythrodermic, pustular psoriasis   

Causes:

Underlying causes include:   

• Rapid skin cell turnover (every 3-4 days versus 28-30 days normally)
• Faulty immune system triggering inflammation
• Genetic links – family history and certain genes implicated
• Environmental factors like infections (strep), stress, skin trauma, medications
• Related conditions like obesity, diabetes, and depression are associated

Treatments:

• Use a salicylic acid shampoo daily to ease scalp psoriasis and gently exfoliate skin lesions
• Try topical treatments like calcipotriene, tazarotene, and corticosteroids to reduce inflammation and cell turnover
• For moderate/severe cases, phototherapy or oral/injectable medications may be prescribed   
• Avoid picking or scratching lesions and keep skin moisturized to prevent cracks and infections
• Reduce alcohol intake, quit smoking, manage stress levels

Topicals:

Helpful topical treatments include:

• Emollients – Relieve dryness and remove scales
• Coal tar – Slows cell growth and reduces inflammation, itchiness
• Salicylic acid – Sheds excess skin cells 
• Calcipotriene – Vitamin D analog that slows cell growth
• Corticosteroids – Reduce inflammation and immune responses
• Tazarotene – Vitamin A derivative that normalizes cell growth

Systemic Treatments:

For more severe psoriasis, systemic medications include:

• Oral retinoids like acitretin that regulate cell growth 
• Immunosuppressants like methotrexate and cyclosporine
• Biologics that target specific immune mediators (TNF-alpha, IL-17, IL-23)
• Small molecule inhibitors like apremilast regulate immune cell signaling 

Rosacea

Rosacea is characterized by facial redness, dilated blood vessels, and often small red pimples and bumps. It primarily affects the central face including the cheeks, nose, chin, and forehead. Rosacea tends to occur more often in women and people with fair skin but can affect anyone. It usually begins between ages 30-60. There is no cure, but treatments can control symptoms.

Causes:

• Genetics – Family history of rosacea increases risk. Certain gene variants may predispose people.
• Blood vessel abnormalities – Facial blood vessels may dilate too easily and remain dilated.
• Immune system dysfunction – Abnormal immune responses cause inflammation.
• Skin mites – Microscopic mites like Demodex folliculorum may trigger reactions. 
• Stomach bacteria – Helicobacter pylori bacteria have been associated with rosacea. 
• Sun exposure – UV radiation damages skin and causes flares.
• Hot temperatures – Heat causes dilation of facial blood vessels.
• Spicy foods – Capsaicin can trigger flushing and stinging.
• Alcohol – Alcohol expands blood vessels and causes flushing.
• Emotional stress – Stress hormones may affect vascular function.
• Skin care products – Ingredients like alcohol, witch hazel, fragrance, and acids can irritate sensitive skin.
• Certain medications – Blood pressure medications, topical steroids, and more are linked to rosacea.
• Menopause – Hormonal changes may contribute to rosacea development.
• Fair skin – Those with fair skin seem to be more susceptible.

Symptoms:

• Flushing/redness – Frequent episodes of facial reddening are an early sign. Flushing is usually triggered by factors like sun, stress, spicy foods, alcohol, hot drinks, exercise, and temperature changes.
• Visible blood vessels – Over time, persistent redness and flushing lead to permanent dilation of facial blood vessels. Small spider-like veins may appear.
• Bumps and pimples – Small red bumps, pus-filled pimples, or hard nodules may develop in some cases. These are similar to acne lesions.
• Burning/stinging – A burning or stinging discomfort is common, especially during flushing episodes.
• Eye symptoms – Some people experience dry, irritated eyes or inflamed eyelids and styes.
• Thickening skin – The nose may become bumpy and enlarged from excess tissue growth (phymatous rosacea). Skin can also thicken on the cheeks and chin.

Triggers:

Common triggers that can make rosacea worse include:

• Sun exposure
• Hot or cold temperatures
• Wind
• Spicy foods
• Alcohol
• Stress and emotions
• Hot beverages
• Exercise
• Certain skin care products

Treatments:

While not curable, rosacea treatments can effectively control symptoms. Options include:

• Avoiding triggers
• Gentle skin care and sun protection 
• Laser therapy to improve redness and shrink blood vessels
• Oral and topical medications like antibiotics, azelaic acid, etc.
• Brimonidine gel to quickly reduce facial redness

With proper management, most people can keep these skin problems under control and prevent progression or complications. See a dermatologist if you are struggling to treat conditions like acne and dermatitis, as they have specialist treatments available.