For National Healthy Skin Month, we’re spotlighting skin health practices across all stages of life. In this segment, board-certified dermatologist Dr Gabriela Maloney shares evidence-based strategies for managing skin health in adults and middle-aged patients. Highlighting preventative, therapeutic, and cosmetic interventions, Dr Maloney provides practical pearls for dermatologists to enhance outcomes and improve quality of life for their patients. 

Sun protection: the cornerstone of skin health 

Dr Maloney emphasizes that broad-spectrum sunscreen with an SPF of 30 or higher is essential for preventing photoaging and reducing the risk of nonmelanoma skin cancers. Evidence has demonstrated significant benefits, including a 40% reduction in the incidence of invasive squamous cell carcinoma and a 24% decrease in actinic keratoses over 4 years with daily SPF 30 use compared to SPFs of lower formulations. Educating patients on proper application techniques and the importance of reapplying every 2 hours, especially during outdoor activities, is critical. 

The "magic trifecta" for anti-aging 

Counseling this patient group on anti-aging, Dr Maloney recommends a simple yet effective regimen: sunscreen, vitamin C, and retinoids. She advises patients that vitamin C, known for its ability to neutralize free radicals, brighten skin, and boost collagen synthesis, is particularly effective when paired with sunscreen. Retinoids, including prescription tretinoin and over-the-counter retinols, promote epidermal turnover and dermal remodeling, reducing fine lines, hyperpigmentation, and acne. Counseling patients to start with low concentrations and gradually increase use minimizes irritation and ensures a positive experience. 

Expanding the toolbox with additional ingredients 

For patients seeking advanced options, Dr Maloney advises patients that they may benefit from ingredients like azelaic acid and glycolic acid. Azelaic acid offers anti-inflammatory, antimicrobial, and depigmenting properties, making it ideal for rosacea, melasma, and acne. Glycolic acid facilitates exfoliation, improves collagen production, and enhances skin tone and texture, providing versatile benefits. 

Chemoprevention and skin cancer surveillance 

In high-risk populations, Dr Maloney recommends proactive interventions such as nicotinamide supplementation, with evidence suggesting that 500 mg twice daily may help significantly reduce the incidence of new actinic keratoses and cutaneous squamous cell carcinoma. Regular full-body skin examinations and patient education on self-surveillance are essential for early detection of skin cancers, improving outcomes and survival rates. 

Integrating preventative, therapeutic, and aesthetic care 

Dr Maloney highlights the importance of combining evidence-based recommendations with personalized care to optimize patient outcomes. By integrating preventative measures, therapeutic treatments, and cosmetic enhancements, dermatologists can elevate patient satisfaction and quality of life. 

Key takeaways for dermatologists 

• Prioritize sun protection: Educate patients on proper application and the importance of reapplication 
• Simplify anti-aging regimens: Recommend the "magic trifecta" of sunscreen, vitamin C, and retinoids for effective and evidence-based anti-aging benefits 
• Proactive interventions: Utilize nicotinamide supplementation for high-risk populations and ensure regular skin cancer screenings paired with patient education on self-surveillance 
• Integrate care approaches: Combine preventative, therapeutic, and aesthetic strategies to provide personalized, evidence-based care that enhances patient outcomes and quality of life 

Check out Part 1 here for expert insights on caring for the skin of dermatology's youngest patients, Part 2  for tips on managing adolescent and young adult patients, and Part 4 for guidance on caring for the older adult patient population—all for National Healthy Skin Month!