Neha Pathak, MD, FACP, DipABLM: Welcome to the WebMD Health Discovered podcast. I'm Dr Neha Pathak, WebMD's Chief Physician Editor for Health and Lifestyle Medicine. Today, we're going to be talking about skin care for our children. As more young people start getting interested in skin care routines, we're seeing a flood of products in the market promising clear, glowing, glassy skin for our children.

From trendy serums to masks and cleansers. It seems like our tweens want to buy it all, but are these products really safe for their young skin?

Today, we'll speak with a dermatology PA and explore what the surge in skincare obsession at such a young age really is about. We'll focus on what's necessary versus what's overhyped. It’s also important for us to understand which ingredients can actually benefit youthful skin and which ones to avoid to prevent irritation, breakouts, or long term issues. She's also going to help us understand what ingredients can actually benefit youthful skin, and which ones we should try to avoid to prevent irritation, breakouts, or other long term issues.

This episode is also for the moms and caregivers navigating the skincare craze with their tweens. We'll provide guidance on how to help our kids make smart choices from understanding product labels, coming up with a basic skincare routine that prioritizes protection, and sticking to gentle, age-appropriate products.

We'll also talk a little bit about how to have these important conversations about marketing, social media influence, and the pressures that are really driving these purchases. Whether your child is just getting started with a skincare routine or already has a bathroom shelf full of products, we'll help you sift through the noise and find out what really works for their glowing and growing skin.

First, let me introduce my guest, Randal Antle. Randal is a certified physician assistant and has been a dermatology PA in Atlanta, Georgia for the past 15 years. Randal practices medical and cosmetic dermatology and has a special interest in the treatment of acne in all age groups from pediatrics through adulthood.

She is a member of the American Academy of Physician Assistants, the Georgia Dermatology Physician Assistant, and the Society of Dermatology Physician Assistants. Welcome to the WebMD Health Discovered podcast, Randal.

Randal P. Antle MMSc, PA-C: Thank you for having me.

Pathak: Thanks for being back. We're so excited to jump into our conversation today. I promise not fully selfishly because I have two tweens. But before we dig in, I’d love to ask about your own health discovery or your own aha moment around tween or teen skincare and what you might be changing as a parent or as a health professional to address that aha moment.

Antle: Well, I think we all know this has become a very hot topic, and I also have a teenage daughter, so it's become apparent to me, just as a mother, seeing kind of what friends are doing, what my daughter is doing. But I definitely think in the clinic, in our clinical dermatology practice, there has been quite a bit of buzz about this, mainly from parents probably coming in with their teen or tween children and kind of saying, “Hey, you know, tell me what they should be doing. Tell them what to do.” 

You know the parents are sort of exhausted by giving guidance or saying, don't use this or that. And they definitely seem to want our third-party influence as in our dermatology practice to tell them what to do or what not to do most importantly. And so that is definitely something we've seen going on in clinical practice.

Pathak: That is very, very comforting to know that this is not just a fight that we're having in my home alone, but this is happening everywhere. I'm seeing it in the news. I'm definitely seeing it in my kids, their friends. So, I'm just curious, is this a big shift from what you've seen over your 15 years of practice?

Antle: Absolutely. I mean it's just become such a, a rage and I don't know. I thought at first it was mainly because I had a daughter that was in this age group. But I think, you know, just talking to my colleagues, it's definitely just happening. And yes, it's in the news. We're recording a podcast about it. It is a thing. 

Pathak: So can you take us through some of the ingredients that you're the most concerned about being included in your tween skincare routine? What should we be thinking about as sort of just this is an easy, not going to buy this product because it includes these ingredients? 

Antle: That's really important. I think one thing that I've realized is you can't just tell them not to use anything, certainly with my own child and I think other patients of mine as well. You know, we can't just say, “Oh, use a simple cleanser and moisturizer and call it a day.” They don't want to do that.

They're going to want to get these products. They want a full collection on their vanity, and they want lots of bottles. They want five to 10 steps routine in many cases. And so, I think we need to kind of guide them in that direction. And sort of to what you're saying, what I started thinking about was, OK how can we educate parents, caregivers, and also the kids themselves, on what to look for, what not to look for.

I think the biggest thing is sort of separating out the age groups. When I think of tweens, I'm kind of thinking in that more nine or sometimes eight to 12 year old age range. And then we have teen skincare, which goes into, you know, 13 and up, which is a little more acne prone, those kinds of things. So, when I'm thinking about that tween age group, we really want to focus on products that are not going to disrupt their natural skin barrier or maybe change their skin.

You know, the pH of their skin, their skin is usually pretty self-sustaining. It's not problematic in most cases, unless they have a history of eczema or things like that. We have to be extra cautious. But generally speaking, our goal in choosing products is to somewhat leave their skin alone. And so since they're going to still want to use products, choosing things that might have a more moisturizing content to them.

Products are often labeled with phrases that might say dry to normal skin, normal skin, then normal to oily skin, and then oily skin. So, we think of that as kind of a gradient spectrum of the potential towards drying out the skin. And that tween age group, I'm going to definitely kind of suggest you choose things that are labeled for dry skin or dry to normal skin.

Maybe into that normal skin category with that age group. But certainly, if they have a history of eczema, you want to choose those product labels that say more for dry or sensitive skin. So that's one just kind of marketing phrase. As far as ingredients go, in this tween group, we want to avoid a lot of the acid containing products, things that would chemically exfoliate the skin.

So those might be ingredients such as, glycolic acid being a really strong one, salicylic acid, citric acid, lactic acid, and then there's the AHA, BHA. There are the alpha hydroxy acids, beta hydroxy acids. Those are kind of also in that camp of disrupting that skin surface barrier, which we definitely do not want in that tween age group.

Pathak: So, I think that that is really, really helpful. What are some of the shifts when you're talking about that next age group? So the teen age group. What are some of the things that you're thinking about with regard to the ingredients to be thinking about?

Antle: So that age group can still have a drier skin type or a sensitive skin type, but then we also tend to see a little bit of acne pickup, obviously, in that age group. And so those kids that might be slightly more acne prone, they're going to have a little bit more oil, production, and they might be able to tolerate a little bit of those acid products, or you and I have talked previously about retinol containing products for acne, and we can dive into that as well, but, those kids can tolerate a little bit more of those products, but more so with the intention of focusing on reducing acne.

So that would be when we start seeing blackheads or, you know, clogged pores, especially in that T-zone area. If your child does not have acne, I would not really recommend including those products, those ingredients rather. And so just kind of using those guidelines of saying, OK, let me add in a little bit of an ingredient here or there.

When I recommend products with those ingredients for our acne patients, often it's just, a couple times a week at first, not every single day. And I think that's also really important in terms of educating, parents, caregivers, teens, tweens, when we are adding in those exfoliating products, whether they're chemical or physical exfoliants would be something with kind of a grainy texture to it.

We often are just doing that maybe once a week, even for our adults. I say to most of my patients, hey, I'm only going to do this once or twice a week at most the more we irritate that skin barrier, we end up with all the negatives of that burning, redness, itching, irritation, etc.

Pathak: I'm curious about another thing that I've seen, which I wonder if they really want this kind of skin routine I've seen. So not even a product, it's like almost a silicone type of device, that you can scrub over your skin. What do you think about those types of products that there are no chemicals? It's not a personal care product. It's literally just a scrub.

Antle: So that would go into that camp of physically exfoliating. And, you know, I think of things like that, almost like sandpaper on the skin, and if you think about scrubbing the back of your arm every day with something like sandpaper that sounds ridiculous. So why would we do that on our face?

That's even more sensitive. So again, there is a place for exfoliation, but I think there is a slight misconception that we need to be exfoliating every day. And a lot of our education, I feel that we do in the office is explaining to people that over exfoliating has significant negative consequences, and especially in a younger age group where their skin barrier is a little thinner, it's more delicate, more sensitive.

Pathak: That's really helpful. The other piece of what I see is this obsession with wrinkles. So I look at our children's skin. And I'm like, wow, look at how beautiful and shiny and just moisturized it looks. And I'm just wondering, what are they seeing when they look in the mirror?

Because I'm having so many conversations about, well, look at these wrinkles around my eyes. And so, there's this concern about actively trying to choose products that are anti-aging or for wrinkles, which seems completely bananas. So, can you talk about some of those ingredients and how do you talk to your kids in your community or your patients about the need for these types of ingredients or the avoidance of?

Antle: So, one thing I explain to even adult patients, if someone is coming in and saying, hey, when should I start doing Botox? That's a big question. And I'll kind of explain to them that we use something like Botox or toxin injections. That's just one brand example, but there are other brands as well. And when we use those, we're essentially trying to improve grooves in the skin, wrinkles in the skin that are present when you're at rest.

So if you look at a younger child, person, a younger child, for example, when they raise their eyebrows, you will see those horizontal lines expressed across their forehead. And when they relax, those lines are no longer static. They're not there. Their skin looks, to your point, glassy and smooth and, you know, wonderful.

When we are using things like toxin injections for adults, some of us, when we relax our forehead, we still see those grooves. So those are the wrinkles we're kind of trying to treat with maybe topicals. They do only so much for us older folks that are in our forties and beyond, but I think explaining to kids when they have maybe some crow's feet when they smile, or they have their forehead expression lines when they raise their eyebrows, but when they relax, those lines are no longer there.

So, you know, explaining the difference of, you don't have wrinkles if the lines are not static, they're not there at rest and that can maybe be helpful to educate them. I think, some kids, course, with all the social media, the filters, kind of this unrealistic expectation of what the skin should look like.

We all have that being thrown in front of us on a daily basis, even as adults as well. But we want to really also protect them, explaining to them that this is not real, pores are normal on the skin, that glass looking skin is a lot of times airbrushed or from a filter on a social media platform, etc. 

And we want to really be careful about not pushing them into a body dysmorphic mindset, certainly anyone at any age can go in that direction if we're not careful about that, but especially our younger kids. And I think our girls especially we need to really protect against that mindset.

Pathak: I'd love to also just take a step back and in terms of what should we know about the difference between skin as it ages and tween skin. You said that it's basically pretty well balanced when it comes to pH. What else is different about tween aged skin? 

So can you help us understand a little bit about what is different when it comes to tween skin compared to skin as it ages?

Antle: So their skin literally is a bit thinner. And when we say that we're talking about kind of that outer barrier is the stratum corneum. And what that means is when you have thinner skin, the products are absorbed much quicker as adults. And you know, aging skin, older skin, it actually takes a bit more effort for those products to penetrate down deeper.

And so, when we put something on a tween, or even a teen, like a retinol type product or acids or peptides, that's another kind of common anti-aging ingredient, it's going to penetrate down deeper. And so, we have to keep that in mind. They could potentially get irritation much faster from using those types of products.

We also don't want to disrupt their barrier with our choices, whether it's chemical, physical exfoliating, things like that.

Pathak: That's really helpful. And then another ingredient that one of my children has been asking about recently is hyaluronic acid. So, can you talk a little bit about what that product is meant to be used for and how you think about it in this sort of a tween or teen skincare regimen?

Antle: So that's actually a good ingredient. And if we want to be selective about our products, one thing that you can look for on the labels is those, you know, it'll say active ingredients and either those acids, the negative ones that we talked about, those exfoliating products. Those are the ones I would say be cautious with, but hyaluronic acid would be great to use.

So that would be something that we can educate them on to look for either on the front of the bottle, the back of the bottle. another one is something called niacinamide. That's another more hydrating ingredient. and then lastly, I'll say something called ceramides. That's another ingredient. All of these essentially.

Kind of pull more water to the skin. They kind of hold on to those water molecules a little bit more. So they're going to be in that camp of hydrating moisturizing, and those would be much safer to use in terms of our product ingredients.

Pathak: So can you just do a high level do’s and don'ts for what to look for on the label?

Antle: Absolutely. Looking at the active ingredients is so important and educating our kids about what actually is in a product. There will be lots of marketing phrases on usually the front of the label. And I just wanted to mention a few that I noticed even in my own medicine cabinet. and I would say the labels that are, more hydrating, more gentle.

They are going to literally say hydrating, they will say calming, they will say soothing, sometimes, labeled for dry or sensitive skin. That would be another great thing to look for. And then lastly, I'll say nourishing. Those are going to be those marketing phrases that generally will point towards a more gentle product.

The caveat there is if we do have an acne picture, occasionally those might have some oils in them. So just be careful if there is an acne situation going on, read what's in there and maybe look for that other marketing or phrase they would put on there, say non pore logging or non-comedogenic.

And then I'll just switch gears and mention a few other terms that would be on the front of the label that would maybe point us towards the ingredients having exfoliating properties to them. they would be things that might say rejuvenating, brightening, renewing, or resurfacing, smoothing. Things like that would usually indicate that those active ingredients might have exfoliating properties to them. Or potentially irritating properties to them.

Pathak: And then can you talk a little bit about organic or natural as a marketing tool? How do you think about those words and concerns potentially that might be hidden in those types of marketing strategies? 

Antle: So very much marketing strategies. Everyone, I think, including myself, likes the idea of more natural things, organic things. They sound great. Keep in mind the term natural is not a regulated term on a product. And in addition to that, the terms that say clean or non-toxic are also not regulated terms.

So meaning the skincare brands might have a little bit of variability in terms of how they interpret that the term organic is actually regulated. And that essentially will mean that they are not adding certain chemicals to it. And again, if they have that label on there, you can know that means a little bit more, organic doesn't always mean better I would say.

So just approach with caution there in terms of natural. One thing that we say a lot in our office, I think across all departments, dermatologists, dermatology providers is we remind people regularly that poison ivy is an all-natural product. So it's a good reminder that natural doesn't always mean not irritating or not a problem.

Pathak: So just help talk us through what you think should be a good skincare routine for a tween morning and evening. What would that look like? 

Antle: So cleansing twice a day and then a moisturizer afterwards is a great morning, evening habit to get into, especially as we start producing more oil in those teenage years. A mild neutral cleanser, again, that's labeled for dry sensitive or normal skin would be my selection. Not a lot of ingredients, not a lot of fragrance, very simple, moisturizing afterwards, maybe choose something that's labeled oil free non pore clogging, non-comedogenic. 

Again, not a lot of fragrance. Simple is best, morning and night is what I would recommend there. And thenone thing to add to the morning is maybe a sunscreen to add in. If we are applying it to the face, ideally something labeled for face can sometimes be, more acne friendly.

So, that's a good thing to look for also on the label. 

Pathak: Thank you so much. This really helped me. And this is going to be some of our listening, or I'll force the children to sit down and listen to this. You came to my tweens Girl Scout troop and did a talk about this. So thank you for that because she came home and was telling everyone that would listen what we were actually supposed to be doing.

Antle: That's great. That's great to hear that. I'm glad.

Pathak: So I think we often think as parents that social media is playing a big part in why our tweens are becoming so interested in all of these pieces of a skincare routine. Well, what else do you think might be going on? 

Antle: I think kids in this age group are collectors of things and if I think back to my childhood years, it was beanie babies and I had a lot of them. And I'm sure many people listening might be able to relate to that or other things, trolls, caboodles, you know, we had lots of things we collected and over time, I don't have those anymore.

So that trend kind of passed the ship sailed. And I think it's interesting to think about this possibly being a trend as well. That might kind of move on as time progresses.

Pathak: That's a great point. For me, it was a garbage pail kids and the trading cards. So, I think that's a really important point and really speaks to the fact that this, hopefully this phase two shall pass in them.

Antle: Yes, correct. Or they'll have wonderful skin as adults.

Pathak: So I'd like to close the episode with some bite sized action items. You've given us so many already. How would you like to close us out? One of the last few things people should be thinking about as they talk to their tweens about skincare. 

Antle: I would say going back to educating them about active ingredients that might be very empowering so that they understand what they're putting on their skin and why, what its purpose is, I think, knowing what those marketing phrases are is really critical for them because especially at an impressionable age, they might not understand what that means and what it delivers to their skin.

Also, I think it's okay to say no to purchasing products. I think as a parent it’s very important they don't have to buy everything that they want unless they're earning their own money and, and able to do that. And then lastly that I'll say is, this is fun for them and I think it's also OK to be encouraging for them to have a little bit of fun with it in a safe way.

I think this is a form of self-care, which is a great thing. And understanding that those five step or 10 step routines might be really enjoyable to them. And so I've really switched gears instead of saying, stop doing everything and just use these two products, maybe allow or, or give some guardrails to having that routine they'd like, but keeping it within the realm of things that wouldn't cause irritation or harm to them. 

Pathak: I want to thank you so much for being here today and having this conversation with me because it does help me process because I totally agree with you. It is something that is a piece of the self-care. What I find also is that they really enjoy when we're sort of doing this as a girly time together. Another piece of it is, along with what you've said, I think there's also this, concern about brands. And that has been a big discussion about, you know, what does that mean? And do you really need to have these brands? And maybe sometimes we will give in and pick one, and we'll play with that for a little bit.

So those are my key takeaways from our discussion. I want to thank you again so much for being with us.

Antle: You're welcome. It was so fun to talk about this.

Pathak: To find out more information about Randal Antle, we'll have more information about her work in our show notes. Thank you so much for listening. Please take a moment to follow rate and review this podcast on your favorite listening platform.

If you'd like to send me an email about topics you're interested in or questions for future guests, please send me a note at [email protected]. This is Dr Neha Pathak for the WebMD Health Discovered podcast.