The 10 Most Common Chronic Skin Conditions
My skin is perfect, said no one ever. Real talk: By the time you hit adulthood, your skin has gone through growing pains of its own. Between the ages of 12 and 24, 85% of Americans have at least minor acne, according to the American Academy of Dermatology; another 10.7% will have eczema. Got dry skin? You’re among one in three people who deal with it every day, according to recent research.
In other words, we’ve all got skin issues. And just as no two people are alike, neither are the skin woes we face, meaning there is no one-treatment-fits-all plan. Each chronic skin condition has its own unique set of symptoms, causes and ways of being managed. Take a look at what the experts have to say about these 10 common skin disorders—and how to keep your skin healthy now and in the future.
Most Common Chronic Skin Conditions
Acne
Leave it to the global pandemic to coin a new derm term: “We seen a lot of ‘maskne’ in the last two years, especially at the height of COVID, due to all the mask-wearing and how it affects the skin,” says Dr. George Han, MD, PhD, an associate professor and director of research in the department of dermatology at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and Lenox Hill Hospital in New York City.
Pandemic or not, says Dr. Han, adult acne is on the rise. “We have women who never had acne as kids coming in as new patients at 30 years old,” he says, adding that the reason for this increase is not clear.
The condition occurs when hair follicles become clogged with oil and dead skin cells, leading to pimples, and to a lesser extent blackheads and whiteheads, according to the Mayo Clinic. Acne can occur on your face, chest and back, among other places—in the case of cystic acne, pimple-like bumps form under the skin surface.
“We don’t understand exactly why acne happens, however, we know that it is driven by hormones, diet and stress,” says Dr. Joshua Zeichner, MD, an associate professor of dermatology and the director of cosmetic and clinical research at Mount Sinai Hospital in New York City.
Over-the-counter topical medications are the first line of defense with acne and can be effective in clearing your skin. “Benzoyl peroxide is perhaps the most effective ingredient to treat ‘angry’ pimples,” Dr. Zeichner says. Look for formulations with 2.5% benzoyl peroxide, which studies show to be as effective as higher concentrations but with less skin irritation.
Meanwhile, “topical retinoids act like pipe cleaners to keep the pores clear,” Dr. Zeichner says. “I use them in treating my adult acne patients because they also offer collagen-stimulating benefits to address aging skin.” Products containing salicylic acid may also help, he says: This ingredient is a type of beta hydroxy acid that removes excess oil and dead cells from the surface of the skin to help dry out pimples.
If you’ve given these remedies a try and your acne stubbornly persists, it’s time to call in the reinforcements. “If they are not doing the trick after one to two months, I recommend speaking to a dermatologist for professional recommendations and to consider an oral medication,” says Dr. Zeichner. “In adult women, we use hormonal therapies like birth control pills or spironolactone to address the hormonal impact on oil glands.”
Related: Do Pimple Patches Actually Work?
Dry Skin
If you’re thinking, I didn’t know dry skin was an actual condition, we’re with you. But there’s the dish-soap-dried-out-my-hands dry skin, and then there’s the clinical sort. Known as xerosis cutis, clinically dry skin can cause cracking, bleeding, itching and irritation. The condition frequently affects older people and is made worse by dry heat during winter months.
Dry skin can also be caused by another underlying condition, such as eczema or kidney disease, according to the American Academy of Dermatology (AAD). Certain medications can contribute to dry skin as well.
Treatment for dry skin starts with lifestyle changes. Follow these tips from the AAD:
- Use warm, not hot, water in showers and baths.
- Limit showers to 5-10 minutes.
- Blot your skin gently with a towel to dry off rather than vigorously rubbing.
- Use moisturizer immediately after showering.
- Choose creams and lotions containing jojoba oil, shea butter or mineral oil.
- Use a humidifier in winter months.
- Wear gloves on your hands in the winter.
- Quit smoking.
In severe cases, your dermatologist might also prescribe a steroid for short-term use to calm any inflammation that’s making itching or cracks in your skin worse.
Alopecia
Unless you’ve been living under a rock (pun intended), you know all about alopecia as it pertains to Jada Pinkett Smith, the Oscars and that infamous Chris Rock slap. In a nutshell, alopecia refers to hair loss. There are a few types of alopecia; alopecia areata is the most common—an autoimmune condition in which the immune system attacks hair follicles on the face, head and sometimes other areas of the body, causing hair to fall out.
Alopecia can occur in both men and women and people of any race and age, although it typically appears for the first time when people are in their 20s, 30s and 40s, per the National Institutes of Health. About 6.8 million Americans have alopecia areata, with a lifetime occurrence around 2%, according to the National Alopecia Areata Foundation.
Depending on your age, location of hair loss and extent of baldness, your doctor may talk with you about the following options to help stimulate hair growth, per the American Academy of Dermatology:
- Corticosteroids
- Minoxidil
- Topical immunotherapy
- Methotrexate
- Janus kinase (JAK) inhibitors. In June, the Food and Drug Administration (FDA) approved a new drug, Olumiant, to treat severe alopecia areata. Other JAK inhibitors, including CTP-543, have shown promise in clinical trials and may be approved soon.
Other options include wigs, transplants or scalp prosthesis, or going the opposite route and shaving your head.
Related: Best Skincare Routine for Morning and Night
Eczema
Even the word sounds itchy—and with eczema, your skin usually is. “We talk about eczema as the itch that rashes—people feel itchy and before their eyes, a rash starts to appear,” says Dr. Han. That rash typically looks like tiny red bumps clustered together.
While the condition has no single cause, there is often a family history of asthma and allergies associated with the condition. (The condition itself is tied to genetics: If one of your parents has eczema, your risk of developing it jumps two- to three-fold, according to research in the Journal of Pediatrics.) Other triggers for the condition include smoking, stress, dry skin and hormonal fluctuations, among others.
“Eczema is a condition where the skin barrier is not functioning as well as it should be,” says Dr. Zeichner. “In eczema, the microbiome, or collection of microorganisms that live on the skin surface, is disrupted.” This leads to loss of hydration and inflammation in the skin.
Atopic dermatitis is the condition most people mean when they refer to eczema—the terms are used interchangeably. But there are several other types of the condition, according to the Cleveland Clinic, including contact dermatitis (caused by direct skin contact with an irritant); dyshidrotic eczema (blisters on hands and feet); hand eczema (symptoms are limited to your hands); neurodermatitis (patches on skin are thicker); nummular eczema (characterized by larger welts on your skin); and stasis dermatitis (caused by faulty veins that leak fluid).
“The goal of treatment is to repair the skin barrier with moisturizers,” says Dr. Zeichner. “We also want to reduce inflammation in the skin with over-the-counter anti-inflammatories or topical or systemic medication by prescription.” Treatments for eczema range from DIY therapies (warm baths, baking soda and thick moisturizers) to medical intervention. Your doctor may talk with you about calcineurin, Janus kinase and PDE4 inhibitors, or biologics, all of which work by blocking certain proteins in the body that “turn on” skin inflammation.
Psoriasis
So that was eczema. The skin condition it is most commonly confused with is psoriasis. “If you look at old medical textbooks, you’ll see that we used to distinguish between the two by saying that eczema means you have itchy skin and psoriasis doesn’t itch,” says Dr. Han. “But in the past few decades that has been turned on its head and we now know psoriasis also itches.”
In fact, he says, 80% to 90% of psoriasis patients cite itching as a primary symptom. So what makes psoriasis different than eczema? Mainly, how and where the disease appears on the body. “The classic description of a psoriasis lesion is thick scaly skin on top of a plaque,” says Dr. Han. “It tends to be a red area that’s relatively clearly cut off from the surrounding skin. Whereas with eczema, you have small red bumps in red patches on skin.”
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While plaque psoriasis is the most common form of this condition, there are other types of psoriasis, including nail, scalp, guttate, inverse, pustular and erythrodermic psoriasis. In all cases, the psoriasis is caused by skin cell turnover that occurs too quickly. “The process usually takes 30 days, but in people with psoriasis, cell turnover happens in three days,” says Dr. Han. The dead skin cells pile up, leading to the condition’s telltale plaques.
Treatments for psoriasis range from topical creams like retinoids to systemic medications, and which you use depends largely on the severity of your condition. In cases where your symptoms are very mild, you might even try home remedies for psoriasis, including moisturizers that contain salicylic acid to help exfoliate the plaques, essential oils (the benefits of these are questionable), mindfulness techniques and various foods to reduce skin inflammation. (Skip the processed foods, which make inflammation worse, according to research in the Journal of Investigative Dermatology.)
For moderate to severe psoriasis, your doctor will likely talk with you about drugs called biologics, which work by targeting the proteins in your body responsible for causing inflammation in your skin. Biologics are usually given as injections.
Related: Dermatologist-Approved Skincare Routine for Oily Skin
Rosacea
“Rosacea can look a lot like acne but typically affects older patients as opposed to teens,” says Alok Vij, M.D., a dermatologist at the Cleveland Clinic in Ohio. “Rosacea can have a few components: broken blood vessels on the skin surface, pustules like acne but not blackheads and thickening of the sebaceous skin.” (Picture W.C. Fields with thick skin on his nose, he suggests.)
So, how is rosacea treated? “We start by classifying the severity of the disease,” says Dr. Vij. “If it’s mild, we’ll use topical anti-inflammatory creams or antibiotics for pustular rosacea. Laser therapy may help reduce redness from blood vessels and there is some evidence that oral vitamin A therapy is helpful.”
Rosacea treatment may take four weeks to see improvement because that’s the length of a full skin cycle, he adds. In the meantime, many over-the-counter products and cosmetics can lessen the red appearance.
Vitiligo
Unlike most of the common and chronic skin conditions that are marked by increased plaques, bumps or redness, the disorder vitiligo is characterized by what’s missing: Namely, skin color. “Vitiligo is an autoimmune condition in which your own antibodies attack cells called melanocytes in your body,” says Nada Elbuluk, M.D., a clinical associate professor of dermatology at the Keck School of Medicine and director of the USC Skin of Color Center and Pigmentary Disorders Clinic at the University of Southern California in Los Angeles. “These cells create melanin, which is what gives skin its color, so once they are affected, those areas of skin develop white patches.”
Although scientists are still exploring the causes of vitiligo, the current thinking is that some people are genetically predisposed to the condition. “There are two things that need to happen for vitiligo to occur,” says Dr. Elbuluk. “First, you have the genetics for it, and second, there is some sort of event—maybe a sunburn or skin scrape or even stress—that triggers the onset of vitiligo.”
The psychological impact of vitiligo can be severe: In a review of dozens of studies, a report in the American Journal of Clinical Dermatology found that 62% of people with vitiligo also suffer from depression while 68% struggle with anxiety. “People with vitiligo start to self-isolate or feel uncomfortable in social situations,” says Dr. Elbuluk. “The emotional symptoms of the disease are very concerning.”
Treatment for vitiligo varies depending on which parts and how much of the body is affected, and may include phototherapy, laser therapy, topical steroids, oral medication and surgery. Some people, though, may choose not to treat vitiligo at all. Celebrities like model Winnie Harlow have built their career celebrating their unique skin appearance.
Folliculitis
If you’ve ever nicked yourself shaving, only to discover an inflamed red bump in the spot the following day, that’s folliculitis. Sometimes referred to as fungal acne, the condition is marked by infected or inflamed bumps on the skin that can look like acne at first, according to the Cleveland Clinic. There are different types of folliculitis, named either for the type of bacteria that has caused the infection or the severity and location of the skin symptoms. (You can develop folliculitis anywhere and everywhere, including your butt, chest and chin.)
“Folliculitis is a very common and benign condition that refers to little pimples that occur any place where there are hair follicles on your body,” says Dr. Vij. “You can get it on your face, thighs, back of arms—just about anywhere.” Because symptoms (inflamed bumps) are typically mild, “we tend to use fewer aggressive treatments,” says Dr. Vij. These might include benzoyl peroxide washes and topical antibiotics, as well as warm compresses and anti-itch creams.
Related: Best Sunscreens for Sensitive Skin
Hyperhidrosis
Sweat much? If so, you might be among the one in 20 people in the U.S. who have hyperhidrosis, a skin condition characterized by excessive perspiration (the exact number of folks with hyperhidrosis is unknown and estimates range from one in 50 people to closer to one in 10, per the Cleveland Clinic.
We all sweat sometimes—it’s how our body cools itself, after all. But in people with hyperhidrosis, not only is sweating excessive, it can happen at random times, for no apparent reason, when you’re not even stressed. It is disruptive at best and a self-confidence crusher at its worst.
How can you tell the difference between a heavy sweater and one with a clinical disorder? The Cleveland Clinic list these symptoms of hyperhidrosis:
- Sweat that pools under your arms or back
- Soaking your shirt to the point of needing to change clothes when you’re not exercising
- Beads of sweat on cheeks and forehead during normal conversation
- Sweating so much your hands are wet or socks are soaked
There are two types of hyperhidrosis: focal (also called primary) which results from a genetic mutation and generalized (also called secondary) which results from another condition or medication you may be taking.
Based on the severity of your sweating, your doctor may treat your hyperhidrosis with anything from clinical-grade antiperspirants to iontophoresis—this at-home device zaps your skin with a mild current to temporarily shut down your sweat glands, according to the American Academy of Dermatology. Other treatments include Botox injections, oral medication and even surgery to remove the sweat glands.
Hidradenitis Suppurativa
“Hidradenitis is a condition where cysts, nodules and scars typically develop in areas like the underarms, groin and under the breasts,” says Dr. Zeichner. “We don’t understand exactly why it happens, but we know that it is caused by blockages within sweat glands.”
Risk factors for developing the condition (which can appear as bumps and blackheads on the skin surface) include family history, smoking and obesity.
Hidradenitis suppurativa is associated with other severe acne-like conditions, which are collectively known as the follicular occlusion tetrad, Dr. Zeichner says. “Hidradenitis suppurativa goes through flares and remissions, but most lesions never completely clear,” he adds. While medications can help keep symptoms under control, currently there is no cure.
Lifestyle modifications can help though. These include regular cleaning of the under-skin pimples with surgical-grade, antimicrobial cleansers; a healthy diet and exercise to maintain a proper body weight; and quitting smoking.
“In mild cases, topical medications offer some help,” says Dr. Zeichner. “Cortisone injections to reduce inflammation are useful. Larger abscesses may be drained. In severe cases, plastic surgeons may remove the glands in the affected areas altogether and replace the skin with a graft.”
As the disease progresses, systemic medications may be needed as well, including a biologic medication (Humira) that is FDA-approved to address the underlying inflammatory response that makes symptoms worse.
And there you have it: The main chronic skin conditions that can mess with your daily mojo. They’re more common than most people realize—especially when you add them all together. So if your skin is itching and you haven’t visited a patch of poison ivy lately, talk with your dermatologist about what’s going on. If you do have one of these chronic skin disorders, treating it early will help you get back to your regularly scheduled life.
Next up: These Top TikTok Skincare Hacks Actually Work
Sources:
- George Han, M.D., Ph.D., associate professor and director of research in the department of dermatology at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and Lenox Hill Hospital in New York City
- Joshua Zeichner, M.D., associate professor of dermatology and director of cosmetic and clinical research at Mount Sinai Hospital in New York City
- Alok Vij, M.D., dermatologist at the Cleveland Clinic in Ohio
- Nada Elbuluk, M.D., clinical associate professor of dermatology at the Keck School of Medicine and director of the USC Skin of Color Center and Pigmentary Disorders Clinic at the University of Southern California in Los Angeles
- American Academy of Dermatology: “Skin Conditions by the Numbers.”
- Dermatitis: “A Population-Based Survey of Eczema Prevalence in the United States.”
- Journal of the European Academy of Dermatology and Venereology: “Prevalence, Predictors, and Comorbidity of Dry Skin in the General Population.”
- Expert Opinion on Pharmacotherapy: “Benzoyl Peroxide: A Review of Its Current Use in the Treatment of Acne Vulgaris.”
- Plos One: “Molecular Characterization of Xerosis Cutis: A Systematic Review.”
- National Institutes of Health: “Alopecia Areata.”
- American Academy of Dermatology: “Hair Loss Type: Alopecia Areata Diagnosis and Treatment.”
- Journal of Pediatrics: “Eczema in Early Life: Genetics, The Skin Barrier and Lesson Learned From Birth Cohort Studies.”
- MarketWatch: “The FDA Approves Eli Lilly’s Olumiant Oral Tablets for Alopecia.”
- Mayo Clinic: “Acne Symptoms and Causes.”
- Journal of Investigative Dermatology: “Short-Term Western Diet Intake Promotes IL-23‒Mediated Skin and Joint Inflammation Accompanied by Changes to the Gut Microbiota in Mice.”
- Current Allergy and Asthma Reports: “Stress and Atopic Dermatitis.”
- Journal of the American Academy of Dermatology: “Association of Atopic Dermatitis with Smoking: A Systematic Review and Meta-Analysis.”
- Cleveland Clinic: “Dermatitis.”
- Cleveland Clinic: “Folliculitis.”
- American Journal of Clinical Dermatology: “Psychosocial Effects of Vitiligo: A Systematic Literature Review.”
- Cleveland Clinic: “Hyperhidrosis.”
- American Academy of Dermatology: “Hyperhidrosis Treatment.”
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