Of the skin all over our body, why is the face the most prone to problems?

Have you noticed that in our body, facial skin seems to have problems frequently? From acne to wrinkles, from sensitivity to pigmentation, facial skin always seems to bear the brunt and become the "hardest hit area" of various skin problems.

All this is not accidental, but has profound biological and environmental reasons. We can explain it from many angles, such as differences in skin structure, the influence of the external environment, facial expression activities, the use of skin care products and cosmetics, and lifestyle habits.

Facial skin problems are not just skin problems, but also face and image problems. In order to understand and deal with these problems more clearly, today, let's talk about them.

1. Sun exposure is largely responsible for facial problems

In medicine, there is a concept called "exposed parts", which refers to the skin that is easily exposed to the sun. The facial skin is one of the most exposed parts of the body, and it is easily damaged by the sun.

The damage caused by sunlight to the skin mainly comes from ultraviolet rays, which are divided into medium-wave ultraviolet rays (UVB) and long-wave ultraviolet rays (UVA).

UVB is mainly responsible for sunburn. Occasionally, if you encounter short-term high-intensity exposure to the sun (such as swimming at the beach, hiking in the plateau, and walking under the scorching sun), your skin will be sunburned and feel burning and painful.

UVA can penetrate deep into the skin and cause sunburn. Long-term exposure will lead to skin aging. This type of aging is also called skin photoaging. It and natural aging caused by age are both important causes of aging.

Skin photoaging can have many manifestations, such as spots (pigmentation), sagging skin, fine lines and enlarged pores, which are particularly prone to occur on the face. The more and longer the sun exposure, the more obvious it will be.

Figure 1. Skin aging pattern diagram (Source: https://www.sidneyhealth.org/)

In order to reduce the damage of the sun to the skin, it is recommended to pay attention to sun protection on a daily basis, avoid prolonged exposure to the sun during the hours when ultraviolet rays are strongest (usually 10 am to 4 pm), and choose a variety of sun protection methods according to actual conditions, such as holding an umbrella, wearing a hat, wearing sun-protective clothing, and applying broad-spectrum sunscreen.

So, for skin problems that have already occurred, such as pigmentation, wrinkles, etc., if there is a need for treatment, they can be treated through medical cosmetic methods, such as laser treatment, wrinkle removal treatment, etc.

2. Facial skin sensitivity, getting worse

Nowadays, sensitive skin (commonly known as sensitive skin) is widespread around the world. This problem is particularly prone to occur on the facial skin of women.

Its basic characteristic is that after the skin is slightly stimulated by the outside world, it is easy to have intermittent or recurrent burning, redness, stinging, itching and/or tightness, and there may be persistent redness of the skin.

Figure 2. Sensitive skin (Source: https://www.bedfordlodgehotelspa.co.uk/)

According to academic guidelines in my country, the incidence of sensitive skin among Chinese women is 36.1%. However, the incidence of sensitive skin varies greatly from place to place, with 43.02% in Shanghai, 22.39% in Guangzhou, and 17.12% in Beijing.

One of the basic characteristics of sensitive skin is that the skin barrier is damaged. The manifestation of damage is that external chemicals, antigens, microorganisms, etc. can more easily invade the skin and cause inflammatory reactions.

As for the causes of facial skin barrier damage, there are many aspects, which may be related to environmental factors such as dust, changes in temperature and humidity, air pollution, air conditioning, etc. The face is also affected by many chemical factors, such as frequent changes of cosmetics, using multiple brands of cosmetics at the same time, excessive facial cleansing, repeated use of disinfection products, topical irritating drugs, etc.

In today's era of consumerism, many people use too many products on their faces. Excessive skin care can significantly increase the risk of facial sensitivity.

If you find that you have sensitive skin, it is best to seek medical treatment and receive formal treatment. In principle, doctors will try to reduce inflammation, control or eliminate symptoms, repair the skin barrier and improve skin tolerance. Specific solutions are generally comprehensive, such as avoiding inducing and aggravating factors, paying attention to skin moisturizing, and using specific drugs and photoelectric treatments as needed.

3. Oil-producing sebaceous glands are also the key to facial problems

There are many types of facial skin problems, among which acne is one of the most common facial skin problems.

The so-called acne and menstrual pimples are both acne in medicine. The reason why the face is prone to this kind of acne is that the facial skin has its own unique physiological and anatomical characteristics compared with the skin on other parts of the body.

Figure 3. Acne (Source: http://dermablue.com/)

The skin on the face is thinner and contains more sebaceous glands than the skin on other parts of the body. On the one hand, the oil secreted by these sebaceous glands helps protect the skin from external environmental aggressors. On the other hand, overactive sebaceous glands may make the skin oilier, especially in the T-zone of the face, which may clog the pores, form blackheads (lipid filaments) and other acne problems.

It is also important to note that the function of the sebaceous glands is regulated by androgens, and especially during adolescence and early adulthood, fluctuations in hormone levels may lead to overactive sebaceous glands, making facial skin problems more likely.

Acne is a problem that bothers many people. First, it is easy to recur, affecting appearance, social interaction, and mood. Second, it may leave a variety of side effects, such as red acne marks and black acne marks. Acne marks are okay and can fade away naturally. What is more troublesome is acne pits, which are permanent sequelae, equivalent to local scars, and are more difficult to deal with.

If you have recurring acne, it is best to seek medical treatment to treat existing acne and to consolidate and maintain the condition to reduce recurrence.

4. Some lifestyle habits can also affect your face

In life, there are many habits that can cause facial problems through complex mechanisms.

Smoking

The first thing to talk about is smoking. We know that smoking harms health and increases the risk of cancer, but the harm of smoking goes beyond that. It also affects the skin on your face.

Specifically, the main manifestation is accelerated skin aging, increased risk of wrinkles and skin lesions. Studies have shown that smoking is a risk factor for premature facial aging. For example, compared with non-smokers, the number and thickness of elastic fibers in the facial skin of smokers are significantly increased.

In addition, smoking is associated with a variety of skin diseases, such as psoriasis, folliculitis, polymorphic light eruption, skin cancer, etc., all of which may appear on the face.

Emoticon Activities

We know that there are many facial expression muscles on the face, each of which has its own function and can produce a variety of facial expressions.

From other perspectives, facial expressions are related to culture, sociality, psychology, and emotions. From a dermatological perspective, constant facial expressions may lead to wrinkles and folds on the skin, especially on the forehead, around the eyes, and around the mouth.

The crow's feet and forehead wrinkles we often talk about are often related to excessive facial expressions. Girls who love to laugh are likely to have many wrinkles.

However, we don’t advocate that you don’t make facial expressions, which is unrealistic. In order to reduce the above “expression lines”, we can do less exaggerated facial expressions and reduce subconscious bad habits (such as frowning and grinning frequently).

Sleep

Proper sleep is good for health, this is almost an iron rule. There is a little-known fact: if you sleep in the wrong position, your face will be more prone to wrinkles - sleep lines.

Figure 4. Sleep lines (especially the blue lines) (Source: References)

Many studies have pointed out that the sleeping position that is most likely to develop sleep lines is sleeping on your side or on your stomach, especially when you sleep in the same position all the time.

However, sleep lines are different from wrinkles caused by aging. The former are reversible to a certain extent and are not permanent. However, as time accumulates, they may gradually become fixed and become permanent sleep lines.

There are two details you can do to reduce sleep lines: flexibly adjust your sleeping position, giving priority to sleeping with your head tilted back; choose a comfortable, supportive pillow to evenly distribute the force on your face.

Finally, we use a table to try to answer our original question - of the skin all over the body, why is the face most prone to problems?

Table 1. Common causes of facial problems

reason

analyze

Effects of Sun Exposure

The face is the most exposed part of the body and is easily damaged by ultraviolet rays, leading to sunburn and photoaging of the skin, the latter of which manifests as spots, sagging skin, fine lines and enlarged pores.

Sensitive skin

Damage to the facial skin barrier makes it susceptible to external stimuli, which can manifest as burning, redness, stinging, itching, and tightness. This may be related to environmental factors and improper or excessive facial skin care.

Active sebaceous glands

The face contains many sebaceous glands (and is affected by androgens). Overactivity may lead to excessive oil secretion, clogged pores, and acne.

Lifestyle

Smoking, excessive facial movements and improper sleeping posture may accelerate skin aging or cause wrinkles

References

[1] UpToDate. Photoaging of the skin. https://www.uptodate.com/contents/zh-Hans/photoaging

[2] Photomedicine and Skin Barrier Group, Dermatology and Venereology Committee, Chinese Association of Integrated Traditional Chinese and Western Medicine. Chinese Clinical Diagnosis and Treatment Guidelines for Sensitive Skin (2024 Edition). Chinese Journal of Dermatology and Venereology. 2024; 38(5): 473-481.

[3] Hazarika N. Acne vulgaris: new evidence in pathogenesis and future modalities of treatment. J Dermatolog Treat. 2021; 32(3): 277-285.

[4] Wong QYA, Chew FT. Defining skin aging and its risk factors: a systematic review and meta-analysis. Sci Rep. 2021; 11(1): 22075.

[5] Anson G, Kane MA, Lambros V. Sleep wrinkles: Facial aging and facial distortion during sleep. Aesthet Surg J. 2016; 36(8): 931-940.

Author: Tang Jiaoqing, MD, attending physician of dermatology

Reviewer: Feng Jun, deputy chief physician of the Dermatology Department of Sinopharm Tongmei General Hospital

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