Skin Conditions Risk Factors

Introduction

Skin conditions can be a burden on our daily lives. According to the International Classification of Diseases, there are more than 1000 skin or skin-related diseases.¹ 

Skin conditions affect socioeconomic, psychological, and physical well-being. They reduce the quality of life as well as self-esteem. Notably, skin diseases occurring on (cutaneous) or under the skin (subcutaneous) were the fourth most prominent cause of disability worldwide. In contrast, skin disorders were placed 18^th in terms of the global disability-adjusted life years (DALYs) disease burden ranking.^1,2

What are the most common skin conditions?

Common skin conditions include but are not limited to:

• Eczema: There are numerous forms of eczema, including atopic eczema, which makes the skin itchy, dry, cracked, and irritated, and discoid eczema, which makes the skin itch and become reddish, dehydrated, and cracked.

• Psoriasis: Skin flakiness and scale formation are symptoms of psoriasis. Although they can be formed anywhere on your body, these patches typically appear on your elbows, knees, scalp, and lower back. Skin cell generation is higher in people with psoriasis. The ensuing accumulation of skin cells is what gives psoriasis its characteristic patches.

• Acne Vulgaris: Anyone can have acne at any time; it's not just a problem for those with oily skin. Acne develops when dead skin cells and oil accumulate in hair follicles. Acne commonly affects the face, chest, and back, and can take the form of cysts, papules, pustules, nodules, whiteheads, or blackheads. One of the signs of acne is pimples.

• Actinic keratoses (solar keratoses): These are scaly, dry patches of skin caused by sun damage. The patches typically develop on the face, hands, arms, ears, scalp, and legs because these body parts are frequently exposed to the sun.

• Skin Tags: Skin tags are small and painless loose growths that can be the same colour as your skin. Typically found on the neck, the breasts, the genital area, or the armpits, skin tags should not be mistaken for warts. They may also develop on the eyelids or beneath the buttock creases. 

• Contact Dermatitis: This is characterised by skin redness, itchy bumps, or blisters, but it can also appear as cracks, a thickening of the outer layer of the skin, swelling, peeling, or discharge.³

What are the risk factors for skin conditions?

Skin conditions can be caused by bacteria or fungi, which can be communicable if sharing space and personal belongings with others. However skin conditions may be brought on by various circumstances.

Genetic predisposition

A history of skin conditions or allergies in your immediate family poses risk factors for skin conditions. Skin conditions are hereditary in the same way skin type, colour, and appearance are passed from parents to children. 

If either of your parents had had or currently have a skin condition, chances are that you would have the same as well.⁴ Some genetic skin conditions may not be cured, but there are many treatments and management options available, while others, like albinism and thick and scaly skin or Ichthyosis, are lifelong conditions.^5,6

Continuous exposure to certain chemicals

Being constantly exposed to chemicals that act as irritants will lead to one or more skin conditions, such as irritant contact dermatitis (ICD).⁷ Some such substances include industrial solvents, parabens, high concentrations of alkalis or acids, and corrosive materials. 

Furthermore, if you have sensitive skin, the skincare products you use may contain some chemicals that you are already allergic to which your skin cannot tolerate and sensitise your skin.

These chemicals include phthalates, sodium lauryl sulphate (SLS) and sodium lauryl ether sulphate (SLES), formaldehyde, lead, mineral oil, and sometimes fragrances.⁸

The most prevalent skin conditions, including psoriasis, atopic dermatitis, hyperpigmentation, and acne, are all linked to air pollution to an increasing extent. According to the WHO, air pollution is the modification of the natural properties of the atmosphere and includes both indoor and outdoor environments. Typical contaminants include soot, smoke, mould, pollen, methane, and carbon monoxide.⁹

In addition to direct buildup on the skin's surface and absorption through hair follicles, inhalation, ingestion, circulation of irritants and pollutants in blood, and absorption of these chemicals into deeper skin tissues are all ways they enter the skin. Using protective gear, such as gloves, masks, boots, and coveralls, while handling these chemicals will reduce adverse reactions. 

Weather conditions

The skin is climate-sensitive because it serves as our body's main environmental interface. Our skin reacts to extreme weather conditions differently. Cold weather can cause a reduction in moisture levels, while hot weather increases moisture and oil production.¹⁰

Extremities of either temperature have different effects on the skin, impacting how the skin regulates temperature. Warmer weather has been said to encourage the onset of cellulitis and other heat-related illnesses such as heat cramps and heat strokes. On the other hand, cold weather facilitates dry, itchy, and flaky skin.¹¹

During scorching temperatures, you will notice the sun becomes more intense. Although beneficial to the skin and our bodies, especially in providing Vitamin D and brain health, the sun is the foremost cause of melasma or sun spots, sunburn, premature ageing, and skin cancer.¹² The CDC recommends using sunscreen with at least SPF 15 for all ages while exposed to sun rays, even on a cloudy day.

Smoking and alcohol

Heavy smoking and alcohol consumption have been linked to premature skin ageing.¹³ The severity of the effect is dependent on how long and how much one indulges in smoking or drinking alcohol.¹⁴

Smoking produces free radicals that harm the body's defence mechanisms and slow the production of collagen and elastin, which causes early skin ageing. At the same time, drinking alcohol might result in peripheral vasodilation, which can enlarge the capillaries in the face. 

Reduced blood flow is another side effect of smoking, and it gets worse with time and exposure. Antioxidants like carotenoids keep the skin healthy and improve its appearance. However, alcohol consumption lowers the skin's carotenoid levels, which weakens the skin's antioxidant defence mechanism.

Alcohol drinkers and smokers appear older than they are due to the development of wrinkles, puffiness under the eyes, uneven skin tone, and volume loss around the lips, midface, and eyes.¹³

Summary

Some skin conditions can be avoided by taking precautions or actively avoiding exposure to irritants and pollutants. The breakdown of the most common skin conditions should give you a better idea about how to recognize and understand the risk factors associated with them to lessen or eliminate any skin conditions you may have.