Skincare by the Decades: From Playground to Prom

In this episode of Skinside Out, Dr. Zain Husain, Heather, and Courtney continue their Dermatology Through the Decades series by tackling one of the most challenging stages of skin health: the teenage years. 

From acne and oily skin to dandruff, excessive sweating, sports-related skin conditions, sunburns, and social media skincare trends, the team explores the physical and emotional changes that impact teenagers during puberty.

The conversation dives into why acne can have such a profound effect on confidence, the importance of early treatment to prevent scarring, and how parents can support teens navigating skin concerns during these formative years. The hosts also discuss tanning beds, hyperhidrosis, hair loss, athlete's skin infections, and why social media isn't always the best source for skincare advice. 

Whether you're a parent, teenager, coach, or simply looking to better understand adolescent skin health, this episode offers practical, evidence-based advice for navigating the teenage years with confidence.

00:00 – Welcome back to Dermatology Through the Decades
01:00 – Puberty, hormones, and teenage skin changes
02:00 – Why acne dominates the teenage years
03:00 – The emotional impact of acne and self-confidence
04:00 – Why acne shouldn't be dismissed as "just a phase"
05:00 – Severe acne, scarring, and Accutane conversations
06:00 – Sports, sweat, and acne mechanica
07:00 – Hygiene habits and teenage skincare challenges
08:00 – Building healthy skincare habits early
09:00 – Simple skincare routines that actually work
10:00 – Social media, influencers, and skincare misinformation
11:00 – Keratosis pilaris (KP) and rough, bumpy skin
12:00 – Sunburns and tanning culture among teens
13:00 – The dangers of tanning beds
14:00 – Melanoma and skin cancer in younger patients
15:00 – Dandruff, scalp health, and oily skin
15:30 – Hair loss in teenagers and early intervention
16:00 – Hyperhidrosis: excessive sweating and treatment options
16:30 – Common teen skin conditions beyond acne
17:00 – Final advice for teens and parents

Creators and Guests

Host

Courtney Carroll, LE

Courtney Carroll, LE is a licensed aesthetician with extensive experience performing non-invasive cosmetic treatments and customized skincare.

Host

Dr. Zain Husain, MD

Dr. Zain Husain, MD FAAD FACMS is a dual board-certified dermatologist and Mohs micrographic surgeon with fellowship training in cosmetic dermatology.

Host

Heather Murray, PA-C

Heather Murray, PA-C is a distinguished board-certified and fellowship-trained dermatology physician assistant specializing in medical and cosmetic dermatology.

What is Skinside Out?

Welcome to Skinside Out, where science meets beauty, the ultimate dermatology podcast! Dive deep into the fascinating world of skin health with expert insights, evidence-based discussions, and myth-busting truths. Each episode explores the medical, cosmetic, and surgical aspects of dermatology, while keeping you informed about trending skincare topics. Whether you’re a skincare enthusiast, medical professional, or just curious about how to achieve your best skin, Skinside Out is your go-to resource for staying informed and inspired.

59 - Skinside Out
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Dr. Zain Husain: [00:00:00] Welcome to Skin Side Out. I'm your host, Dr. Zane, with Heather and Courtney. So today we are continuing our series, Dermatology by the Decades. So we're entering the teenage years, from playground to prom. So a lot of changes happened during this decade.

Let's dive right in. So Courtney, what are we dealing with with these kids?

Courtney: Puberty. Oh, yes. Everyone's gone through it. Puberty sucks. It's basically, like, just, ugh, so many hormones going crazy. Yeah. Um, besides, like the obvious mood changes, yeah, you're dealing with more acne, more oil production, sweating, like, just gremlin things.

Dr. Zain Husain: And, like, the awkward phases, right? Like...

Courtney: The mean phases. Oh my gosh. People are so mean.

Heather: Yeah.

Courtney: Yeah.

Dr. Zain Husain: Oh, you must've been terrifying as an adolescent.

Courtney: Oh, no, I... Actually, I'm more scary now. Oh. Like, I was actually a [00:01:00] pushover. I was, like... I was the kid that got bullied, and that's what-

Dr. Zain Husain: Really? ...

Courtney: hardened me probably.

Heather: Oh.

Courtney: Interesting. Yeah, I did the opposite pipeline- Oh ... for sure. Yeah. I

Dr. Zain Husain: thought, I thought you would've been the bully.

Courtney: No. No, no, no. I was

Dr. Zain Husain: bullied. Just based on your track

Courtney: record. I was bullied har- You know what?

Dr. Zain Husain: Just kidding.

Courtney: I... Um, no, I definitely was bullied. I had really bad acne in high school. Mm-hmm. Um, I got- As did I.

Yeah. Not...

Dr. Zain Husain: Oh.

Courtney: We won't get into that, but...

Heather: I did not have teenage acne. I have adult acne, okay?

Courtney: Um, yeah, I had really bad dandruff in... Which I, I still do. Um, you know, I, Just all that sebum production is just manifesting, and it's just a, a very oily time to be alive.

Heather: Yeah. It sure is. Your hormones are changing.

Yeah. Lots of things are happening.

Dr. Zain Husain: I mean, I really think acne is the star of the show this decade. Yeah.

Courtney: Yeah. What do you

Dr. Zain Husain: think?

Courtney: Yeah. Yeah. So... That and sw- mm, I would say, like, sweating, too. I think people are more- Mm. Yes ... aware- Yeah ... that they're sweating. I think when you're, like, a [00:02:00] kid, like, from 9 to 10, you know- Mm-hmm

you're not really aware of it. But I feel like in this decade you start becoming... Once puberty hits, you're like, "Oh, do I, do I smell?" Yeah. The hygiene is really important-

Heather: Yeah ...

Courtney: now. For sure.

Heather: Yeah.

Dr. Zain Husain: Yeah. Um, so let's talk about, I mean, you know, the acne situation that's going on, um, in this decade. So what is really behind it?

So we talked about hormones, sebum production- Mm-hmm ... um, hygiene issues. Um, so all of these, you know, combine to really sometimes get some really eruptive, um, and inflammatory acne.

Heather: Mm-hmm.

Dr. Zain Husain: But there are, you know... There's different phases, right? There's comedonal acne, which tends- Mm-hmm ... to be more mild. Um, you know, those are those tiny little bumps filled with keratin, um, the first stage of acne.

And then we get more inflammatory, and sometimes, you know, to the severe stage of nodulocystic acne, where we're actually seeing scarring. So it is a very emotional, psychological, [00:03:00] um, you know, disease because of that aspect. And you know, you're also learning about yourself. developing, you know, a sense of your identity in the world.

And, you know, when you don't feel confident or feel good about the way that you look or present yourself to the world, it really has a huge impact. Mm-hmm. So I definitely remember that in high school with, you know, really bad acne. I hated it. Mm-hmm. Mm-hmm. I hated it.

Heather: Mm-hmm.

Dr. Zain Husain: And, you know, I went to dermatologists, but like I mentioned previous episodes, they weren't that helpful.

Um, did not advocate for me. Um, definitely did not recommend, you know, treatments like Accutane, um, which I think would've helped me tremendously.

Courtney: 100%, yeah. Yeah. Mm-hmm.

Dr. Zain Husain: I wish I had done it earlier.

Courtney: I got put on Epiduo Forte, which just- Oh, me too ... went over the counter. Yeah.

Dr. Zain Husain: Yeah. So I think that when kids find this really difficult situation, I don't think it's something that you should dismiss as parents.

Courtney: Mm-hmm. [00:04:00] Mm-hmm.

Dr. Zain Husain: Um, I find that happening a lot. "Oh, you'll just grow out of it. Oh, you know, you're just a teenager. You know, i- it's not a big deal." Yeah. "Everyone goes through it."

Courtney: There is nothing worse or more awkward to me than like being in a room with like a kid who like is probably like a little bit o- you know, on the older side of like the teens, but like who's tried stuff, who really wants to do Accutane.

Mm-hmm. You can tell that they do, and the parent like is just like, "You're not doing that." Oh, yeah. It's just, ugh, heart-wrenching.

Dr. Zain Husain: Oh, I had one patient like who cried in the room- Mm ... um, when her mom just like put the kibosh on that idea, and she really needed it.

Courtney: Yeah, yeah. Yeah. It's... And it... That's... It's usually the patients that like really need it.

Yeah. Like, I don't- Yeah ... I feel like we've not really had a case where it's like so mild and we're like, "Oh, we're gonna put you on Accutane" or like, yeah- Right ... someone's asking. We're like, "Let's just start with topicals." But it's always like the kids that are like cystic, chest and back involvement. Yeah, scarring.

Scarring. Yeah. You know?

Heather: It really takes a toll on self-esteem and confidence. For sure. Especially because- [00:05:00] Your body is changing in so many- Yeah ... different ways as a teenager, and so to, to have one thing under control would be nice.

Courtney: Yeah. Yeah. Yeah. I agree. And- And yeah, you're so self-conscious at that age.

Dr. Zain Husain: And also the permanent sequela, right?

Courtney: Mm-hmm.

Dr. Zain Husain: Like, it's not just- Yeah ... gonna be there, you know, at that particular point in time. The scars stay. The scarring's-

Courtney: Mm-hmm ... forever.

Dr. Zain Husain: And it's so hard to treat, so- Mm-hmm ... expensive to treat. I mean, we treat patients all the time. Every...

Courtney: Yeah.

Heather: Yeah.

Dr. Zain Husain: And, you know, like someone in like their 60s like- Yeah

coming in for treatment. So it is definitely something you want to get under control quickly. Mm-hmm. Mm-hmm. Um, before it has other, you know, consequences.

Heather: I think sweating paired with the acne, like sweating worsening- Mm ... acne, especially like acne mechanica, where you can get like, um, acne from like sports equipment- Mm-hmm ... like helmets and stuff like that. I think that mixed with the sweat. Oh, I used to

Dr. Zain Husain: get that with my lacrosse helmet.

Heather: Yeah.

Dr. Zain Husain: Like on the chin.

Mm-hmm. Yeah. Ooh, and I'd have cysts. Yeah. And they would be like constant- So painful ... like

Heather: [00:06:00] for...

Dr. Zain Husain: And like if you get like hit by someone, and like it

Heather: hits a cyst. Ew. Oh, that sounds- Sorry. Like, like it

Courtney: did with- Like, yeah, the one that I extracted on him that hit me in the face. Yeah, I can just see that.

Dr. Zain Husain: I remember having like this like really bad breakout on my forehead, and I was doing a header in soccer.

I'm like, "Ooh."

Heather: Oh, ouch.

Dr. Zain Husain: Ooh. It did hurt. Yeah. Oh

Heather: my God.

Courtney: And that's the thing about like those years too, a lot of people, a lot of, you know, kids start entering into sports- Yeah. Yeah ... you know, doing different things, football, lacrosse- Mm-hmm ... Volleyball, you know, whatever. And yeah, you start bringing in those things that can be contributing and-

Heather: Yeah.

And you can have things like chafing- Mm-hmm ... and fungal infections, athlete's foot, aside from acne- Mm-hmm ... too, so.

Courtney: Yeah. My ex did wrestling in high school, and he said- Mm-hmm. Mm-hmm ... like everyone had to go see the doctor for like tinea, 'cause they all spread it to each other. They all get

Dr. Zain Husain: tinea. Yeah. They all get HSV.

They all get impetigo. Oh. It's disgusting.

Courtney: Yeah. Like it was nasty, nasty.

Dr. Zain Husain: Oh my God. The locker room for like the wrestlers, it was [00:07:00] disgusting. Yeah. Like absolutely disgusting and filthy.

Courtney: Last episode when you said your nightmare was being in like the forest with no trail out, my nightmare situation, like my personal hell, would be like a boys' locker room.

Mm. A high school locker room. Ugh. I know. Disgusting.

Dr. Zain Husain: I survived it.

But, you know, other things, um, you know, I think a lot of it has to do also with, you know, hygiene.

Courtney: Mm.

Dr. Zain Husain: I find that adolescent boys in general are ridiculously bad at- Mm ... taking care of themselves- Mm-hmm ... and their skin.

Courtney: Yeah.

Dr. Zain Husain: Like- Some

Courtney: of them don't even use soap.

Dr. Zain Husain: No.

Heather: Yes, I was just thinking that. Like- Like, what do you use for body wash?

What? Oh, just my shampoo. What's

Dr. Zain Husain: body

Heather: wash? Yeah. Like, they literally ask, like- What's soap? Like- ... what's

Courtney: soap?

Dr. Zain Husain: Oh. The thing you wash

Courtney: yourself

Heather: with. I don't know. Just whatever's in the shower.

Dr. Zain Husain: I, I mean, I guess I was different because I had bad acne. I was very diligent with my regimen. Mm-hmm. I just wanted to, like, stop the acne.

Yeah. So I was pretty diligent about, you know, [00:08:00] being consistent with my skincare and being clean because that was one of my other thoughts. I'm like maybe I'm dirty and- Mm-hmm. Yeah ... that's why I'm getting acne," and- Yeah ... that's not true.

Heather: Yeah.

Dr. Zain Husain: Um, but, you know- Yeah, boys are pretty gross.

Courtney: Yeah.

Dr. Zain Husain: Yeah. Yeah. but even girls, like I've come across some, you know, girls who don't really take care of their skin either.

Mm-hmm. Mm-hmm. And I think that as dermatologists, we can really do, um, a lot of, you know, justice by providing with a framework to take care of their skin for the rest of their lives. Mm-hmm. Because these habits set in early.

Courtney: Mm-hmm.

Dr. Zain Husain: And that can really set you up for success for the future, especially, you know, sun protection, using a gentle cleanser, a moisturizer, sunscreen at the very least.

Courtney: Mm-hmm.

Dr. Zain Husain: And if you have acne, like there's, options that we have.

Courtney: I think that's so important, like, you know, as, as providers when you're having this discussion with patients, being able to be honest about like what are they actually gonna do, like [00:09:00] what's easier. I mean, sometimes like I know a male teenager is maybe more likely to use like our Pure Perfecting pads, like exfoliating pads.

Mm-hmm. 'Cause you're not really-

Dr. Zain Husain: Mm-hmm ...

Courtney: washing your fa- Like I'd rather- Yeah ... you use that than not do anything. Yeah. You know, just do a quick

Dr. Zain Husain: wipe. And you can put that in your gym bag. Yeah. Mm-hmm. Like, you know, after a practice or a game. Yeah. You know, you can just kind of use that instead of letting that sweat sit.

Heather: Yeah.

Courtney: Yeah. I think trying to figure out what works for a patient- Mm ... in, just in general regardless of age is so important.

Heather: Yeah. Yeah. Or like a hypochlorous acid spray. Yeah. Mm-hmm. Yeah.

Dr. Zain Husain: Yeah. And I think keeping it simple is definitely the way to go- Mm-hmm ... with these kids.

Courtney: Yeah.

Heather: And

Courtney: I think-

Dr. Zain Husain: Um, because if they're consistent and, you know, they really build that routine, I think you're gonna get a much better result than g- overloading them with products to use, and then they end up giving up and not using anything.

Yeah.

Heather: Especially with the rise of like s- it's not really a rise anymore, but social media. We're there. Um, yeah. We're out there. Yeah. But, um, I think people are just wanting to try like-

Dr. Zain Husain: Mm-hmm ...

Heather: this TikTok [00:10:00] product. Yeah. And like, "Oh, this person raved about this, I wanna try this," and all the celebrity things.

Mm-hmm. And so-

Courtney: You're so easily, I won't say manipul- but you're so easily influenced at that age. Yeah. Oh, yeah. So easily. I mean, I remember seeing the commercials of like Proactiv, you know? And-

Dr. Zain Husain: Oh, yeah.

Courtney: Oh, I used to use Proactiv. Yeah. And I'm begging my mom- Years ... to pay three payments of 49.99- Oh, my God ... to get me my Proactiv so I can have clear skin like- Yeah

like Britney Spear- Like I can't remember who they had on there. Yeah. Yeah. Yeah. And it didn't work. Yeah. So like, yeah, you just see things, and your m- your- Yeah ... your frontal lobe is not developed. And you're just like, "Oh, that- that's gonna work for me. It worked for them."

Heather: Yeah.

Dr. Zain Husain: And remember, these skinfluencers, they're often paid by these companies- Yeah

to advertise. Yeah. Like, it may not necessarily be the right product for you.

Heather: Mm-hmm.

Dr. Zain Husain: And I always say go to the experts who have knowledge, experience, and they can show you the evidence of what works- Mm ... and what doesn't work, so you save money, get the results that you're looking for, and just move on [00:11:00] with your life.

Courtney: Yeah.

Dr. Zain Husain: Rather than going through different products like every month and spending so much money

and

.

Dr. Zain Husain: Any other conditions that we see in our teenage patients that-

Courtney: I was gonna say, um, keratosis pilaris. Yeah. I think we see a lot of KP- Mm-hmm

in teenage patients. Um, I don't wanna say girls get it more than boys, but I think girls notice it more than boys. Yeah. Mm-hmm. I think more times than not, it's girls who are like, "Oh, I have this bumpy skin." Yeah. Mm-hmm. And boys might have it and just not even be paying attention- Yeah ... not know it. Yeah. But I think that's what it is.

If I have it, I never

Dr. Zain Husain: really cared about it.

Courtney: Yeah. Yeah.

Heather: Yeah. This isn't a condition, but I think just sunburns in general. Mm-hmm. Um, we typically see a lot in teens, especially, like... I know when I was a teenager, like, it was cool to be tan. Mm-hmm. And, like, I wanted to be tan so bad. Going back to, like, sports events, I think people forget to- Oh,

Courtney: yeah

Heather: protect themselves. I think my worst sunburn ever was at a track meet. Mm. And I, [00:12:00] like, it... I thought it was really bad timing too, because I was, like, blistering on my shoulders. Oh. And then I went to Cabo the next week. Oh, ouch. And then I was like, "Oh, okay. This probably isn't great." And I was, like, purple. Ooh.

I was- Oh

Dr. Zain Husain: my God.

Heather: Yeah.

Courtney: Mm.

Heather: Yeah. I got nicknamed Mater, um- Oh, wow ... at my gym. My gym coach named me Mater- Oh my God. ... because of how red and awful it was, but-

Dr. Zain Husain: Oh.

Heather: Yeah.

Dr. Zain Husain: Oh, painful.

Heather: Yeah.

Dr. Zain Husain: Um, and let's talk about tanning beds, right?

Heather: Yeah.

Courtney: They're making a resurgence- Mm-hmm ... which is, like, cra- that, that is social media, um-

Heather: Yeah

Courtney: for sure. I mean-

Dr. Zain Husain: Well, they also deregulated it governmental legal, right? Yeah. Mm-hmm. So, like, they're not really having limitations.

Courtney: Tell all of my teenage patients, watch Final Destination, what is it, like, 3 or 4. And there's a scene in there with, like, these girls going into the tanning beds, and the beds, like, catch on fire.

Oh. And- Oh my God. Yeah. And that... I'm s- I thank God every day that I watched that movie- Wow ... because I have never been in a tanning bed because of that. I was always afraid that- Yeah ... the bed was [00:13:00] gonna, like, lock and then, like-

Dr. Zain Husain: Oh my God. Newest

Courtney: fear unlocked ... catch on fire.

Dr. Zain Husain: Yeah.

Heather: Well,

Courtney: just don't go in a tanning bed.

Heather: Yeah, yeah.

Courtney: But that, I'm not kidding. Oh my gosh. That literally saved my life, I think, 'cause- Yeah ... yeah, all my friends were tanning, and I was like, "Did you not watch Final Destination?" Yeah.

Heather: I never got in a tanning bed, but-

Dr. Zain Husain: Mm ...

Heather: I would tell my mom I put on sunscreen, and I didn't.

Dr. Zain Husain: Mm.

Heather: Or, like, I put on tanning oil.

Bad

Dr. Zain Husain: Heather.

Heather: And I am not somebody that tans.

Dr. Zain Husain: Yeah. So, I mean, tanning beds are just definitely a bad idea. Leads not only to increased skin cancer risk, but premature aging. And, you know, that's the one that I typically, you know, point to for my teenage patients. Like, you don't wanna look wrinkly. You don't wanna get sunspots, look old and crinkly, and that really motivates them more than, oh, you're gonna, you know, reduce your risk of skin cancer when you're, like, 60 or

Courtney: 70.

Mm-hmm.

Dr. Zain Husain: Um, you know, we're seeing younger and younger patients with skin cancer. Yeah. Um-

Courtney: And specifically [00:14:00] melanoma- Oh, yeah ... which is scary, you know? Oh,

Heather: yeah. Yeah.

Courtney: Specifically, so.

Heather: I had one recently. She was what, like, 20, in her 20s? Oh,

Courtney: wow. Mid-20s. Yeah.

Heather: Yeah.

Dr. Zain Husain: That is scary.

Courtney: Dandruff is another, I think, huge thing we see in- Mm-hmm

in teenagers, and-

Dr. Zain Husain: Yeah I think that extra sebum and-

Heather: Mm-hmm.

Dr. Zain Husain: Sweat production, um, in combination with poor hygiene again sometimes.

Courtney: Yeah, 100%. It's always the... I won't say it's always the boys, but a lot of times boys, their moms will come in and they're like, "He never washes his scalp." And I'm like, "Well, you can tell."

Heather: Yeah.

Dr. Zain Husain: Yeah. And then we even see some premature hair loss sometimes, um- Mm-hmm ... at this age, especially with a strong genetic family history- Mm-hmm ... of hair loss. I'm seeing, like, sometimes in their mid-teens-

Courtney: Yeah ...

Dr. Zain Husain: Coming in with hair loss, and that's kind of devastating, especially for these young men. Um, they're not even 20 yet, and they're starting to lose hair in a typical pattern.

So I [00:15:00] like to intervene at that time- Yeah. Yeah ... because it's so hard to treat hair loss, especially at advanced stages. So, you know, I always say, like, you know, we can do a lot but you have to be consistent. And, you know, we can hopefully hold off having to do more radical treatments like, you know, hair transplantation- Yeah

if you are consistent, um, with a good treatment protocol. Mm-hmm.

Courtney: Yeah. Last one I would say is, um, excessive sweating, and I think, you know, there are- Which is

Dr. Zain Husain: called hyperhidrosis.

Courtney: Yep, hyperhidrosis. And I think we definitely see a lot of that into, like, the teenage years. Mm-hmm. Um, I think people are more cognizant with wearing, like, different clothes.

Like, they're- Mm-hmm ... seeing their sweat stains. I think pit stains- Mm-hmm ... become such, like, a, um, a fear for people. Yeah. And, you know, and some people are more prone than others, and you can have different types of hydro- or hyperhidrosis, whether that's the hands, um, you know, sometimes upper lip or even scalp for some people.

Mm-hmm. Feet, um, soles of feet. Mm-hmm. So I think, you know, there are definitely treatments [00:16:00] out there, and I think sometimes teenagers feel like, "Oh, I'm the only one," like, "I'm so sweaty and, like, I smell bad," and whatever. Mm. But there are, yeah, topical treatments. There's a, a pill you can do. So, um, you know,

Dr. Zain Husain: big bone to pick.

Even, like, um- Thank you. Yeah ... like Botox can be used. Um, devices can be used. Mm-hmm. Yeah. Like, you know, MiraDry or, you know, iontophoresis, all these different type of things. Yeah. So it's not something that you have to suffer with. I mean, there are treatment options, and people are embarrassed to talk about it.

Courtney: Oh, no, I had Heather send me in a script today. I was like, I be sweating. It's 100 degrees here, so

Dr. Zain Husain: It is hot. Yeah. 'Tis hot. Yes, it is. All right. Any other skin conditions for our teen patients?

Heather: I mean, like, the typical, like, eczema, psoriasis- Yeah, I mean, they're all there ... rosacea. Yeah. Yeah. We see it in most ages, but, um- Yeah, I think we covered everything pretty well.

Dr. Zain Husain: Yeah. So the teen years are often an awkward time in people's lives, [00:17:00] but, you know, your bodies are changing, your skin is changing, so give yourself grace. And if you, you know, have concerns, don't feel ashamed to seek help. Um, I do think that a lot of teenagers tend to be very, you know, reluctant to seek advice and help.

They're all just probably on using AI now to help them. Yeah. But, um, you know, go to an expert and, you know, we can often help you in more ways than one, and you'll hopefully get the results and the confidence that you're looking for. So I think this wraps up our adolescent decade. Um, and hopefully you guys enjoyed this episode.

Feel free to leave questions, comments. Feel free to like and subscribe, and until next time, Skin Side- Out.

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