Understanding different skin types and conditions

Everybody’s skin is different, so it’s important to know about the various skin types, as well as the conditions and diseases that can affect each one.

While skin type is determined by genetics, the condition of our skin can change over time as it’s affected by various internal and external factors. Younger people are more likely to have a normal skin type compared to older people.

There are four basic types of healthy skin: normal, dry, oily and combination skin. Your skin types depend on how much water is in your skin (as this affects elasticity and comfort), how oily it is and how sensitive it is. Each skin type has its own characteristics and required treatments.

If you need help with identifying your skin type the skin test may be a useful tool. If you need further advice on how best to care for it, speak to a dermatologist or pharmacist.

Normal skin
‘Normal’ is a term widely used to refer to well-balanced skin. The scientific term for healthy skin is eudermic.

Characteristics of normal skin include a regular texture, no or few imperfections and a soft appearance. Normal skin does not require special care.

Dry skin
‘Dry’ is used to describe a skin type that produces less sebum than normal skin. As a result of the lack of sebum, dry skin lacks the lipids that it needs to retain moisture and build a protective shield against external influences.

People with dry skin may have a rough complexion, red patches, more visible lines and almost invisible pores. Dry skin is less elastic.

Oily skin
‘Oily’ is used to describe a skin type with heightened sebum production. An over production is known as seborrhea.

This has a bright and porous appearance. Oily skin can vary in severity depending on the time of year. Changes can be caused by stress, heat, puberty or other hormonal changes.

Combination skin
Combination skin is, as the name suggests, skin that consists of a mix of skin types.

Skin can be dry or normal in some areas, but oily in others, like the T-zone (nose, forehead and chin). This is a common skin type and may require different treatment in different areas.

‘Normal’ is a term widely used to refer to well-balanced skin. The scientific term for well-balanced skin is eudermic. The T-zone (forehead, chin and nose) may be a bit oily, but overall sebum and moisture is balanced and the skin is neither too oily nor too dry.

Normal skin has:

• fine, or barely visible pores
• good blood circulation
• a velvety, soft and smooth texture
• no or few imperfections and blemishes
• no severe sensitivity 

As a person with normal skin ages, their skin can become dryer. Read more in age induced dryness.

‘Dry’ is used to describe a skin type that produces less sebum than normal skin. As a result of the lack of sebum, dry skin lacks the lipids that it needs to retain moisture and build a protective shield against external influences. This leads to an impaired barrier function. Dry skin (Xerosis) exists in varying degrees of severity and in different forms that are not always clearly distinguishable.

Significantly more women suffer from dry skin than men and all skin gets drier as it ages. Problems related to dry skin are a common complaint and account for 40% of visits to dermatologists.

For many people, dry skin is caused by external factors like the weather, hot water and low air humidity. It's usually temporary but for some it can become a lifelong condition. Skin moisture depends on supply of water in the deeper skin layers and on perspiration.

Skin is constantly losing water via:

• Perspiration: active water loss from the glands caused by heat, stress and activity.
• Trans-epidermal water loss (TEWL): the natural, passive way in which skin diffuses about half a litre of water a day from the deeper skin layers.

Dry skin is caused by a lack of:

• Natural moisturising factors (NMFs) - especially urea, amino acids and lactic acid – that help to bind in water.
• Epidermal lipids such as ceramides, fatty acids and cholesterol which are needed for a healthy skin barrier function.

As a result, the skin’s barrier function can become compromised.

Find out more in dry skin.

Dry skin ranges from skin that is a little bit drier than normal, through very dry skin to extremely dry skin. The differences can normally be distinguished by:

Dry skin
Mildly dry skin can feel tight, brittle and rough and look dull. Skin elasticity is also low.

Very dry skin
If the dryness is not treated, skin may develop:

• mild scaling or flakiness in patches 
• a rough and blotchy appearance (sometimes it appears to be prematurely aged)
• a feeling of tightness
• possible itchiness

It is also more sensitive to irritation, redness and the risk of infection. Find out more in dry skin.

Extremely dry skin
Certain areas of the body – particularly hands, feet, elbows and knees – are prone to:

• roughness
• chapping with a tendency to form rhagades (cracks)
• calluses
• scaling
• frequent itchiness

Extremely dry skin is most commonly found on the elderly or on severely dehydrated hands.

Learn more about dehydrated skin.

Atopic dermatitis is a common skin disease characterised by dry skin and symptoms such as itching or flaking skin. This typically occurs in childhood but also affects many adults too. The main cause is genetic predisposition, but a number of factors can trigger flare-ups. Learn more on our website.

‘Oily’ is used to describe a skin type with heightened sebum production. An over production is known as seborrhea. Oily skin is common among adolescents and those aged under 30 years old, because it's linked to acne.

Oily skin is caused by excessive fat production by sebaceous glands. This overproduction of sebum can be triggered by:

• genetics
• hormonal changes and imbalances
• medication
• stress
• comedogenic cosmetics (make-up products that cause irritation)

Oily skin is characterised by:

• enlarged, clearly visible pores
• a glossy shine
• thicker, pale skin: blood vessels may not be visible

Oily skin is prone to comedones (blackheads and whiteheads) and to the varying forms of acne.

With mild acne, a significant number of comedones appear on the face and frequently on the neck, shoulders, back and chest too.

In moderate and severe cases, papules (small bumps with no visible white or black head) and pustules (medium sized bumps with a noticeable white or yellow dot at the centre) appear and the skin becomes red and inflamed.

Read more in acne.

Combination skin has characteristics of both dry and oily skin, because the distribution of sebaceous and sweat glands is not homogeneous. In combination skin the skin types vary in the T-zone and the cheeks. The so-called T-zone can differ substantially – from a very slim zone to an extended area.

Characteristics of combination skin include:

• an oily T-zone (forehead, chin and nose) with shiny skin
• enlarged pores in this area, or pores that look larger than normal, perhaps with some impurities
• blackheads
• normal to dry cheeks

The oilier parts of combination skin are caused by an overproduction of sebum. The drier parts of combination skin are caused by a lack of sebum and a corresponding lipid deficiency.

Unlike skin type, skin condition can vary greatly during the course of your life. The many internal and external factors that determine its condition include: climate and pollution, medication, stress, hereditary factors that influence the levels of sebum, sweat and natural moisturising factors that your skin produces as well as the products that you use and the skincare choices that you make.

Skincare products should be selected to match skin type and address skin condition. Dermatologists and other skincare experts determine a person’s skin type and condition by measuring the following factors:

Signs of ageing
Our skin type can evolve during our lifetime. Those with an oily skin type in their teenage years can find their skin becoming drier post-puberty and those with a normal skin type can find their skin getting drier as they age.

As all skin types age, skin loses volume and density, fine lines and wrinkles appear and changes in pigmentation can occur. Understanding and measuring these signs of ageing helps us to determine the condition of our skin. Read more in skin ageing.

Skin colour
Skin colour and ethnicity influences how our skin reacts to external forces such as the sun, pigmentation disorders, irritation and inflammation. Basic skin colour is determined by the density of the epidermis and the distribution of melanin.

The redness of skin is also a useful measure of skin condition; it indicates how successful our circulation is and can be helpful in identifying conditions such as couperose and rosacea.

Sensitive skin is sometimes referred to as a skin type, but it's possible to have oily and sensitive skin, or dry and sensitive skin for example. Sensitive skin is skin that is easily irritated by different factors that are generally tolerated by well-balanced skin, such as skin care products or high and low temperatures.

It occurs when skin’s natural barrier function is compromised, causing water loss and allowing penetration of irritants. For some people, sensitive skin is a permanent condition, for others, sensitivity is triggered by certain internal and external factors. You may be able to determine what triggers skin sensitive and avoid certain ingredients or environmental factors.

Symptoms are exacerbated by factors that facial skin is most exposed to, from the sun to some ingredients in cosmetics and cleansers. Sensitive skin may be itchy, red or feel like it's burning. Read more in sensitive facial skin.

Sebum and sweat production
The amount of sebum produced by the sebaceous glands in skin controls the efficacy of the skin’s barrier function and, as a result, the condition of skin. The overproduction of sebum can lead to oily, acne-prone skin, while low sebum production causes dry skin.

The perspiratory glands in skin produce sweat to help the body to maintain its optimum temperature. Excessive or low sweat production can influence skin condition.

Natural Moisturising Factors (NMF’s)
Naturally produced in healthy skin, NMF’s such as amino acids help to bind water into the skin, maintain its elasticity and suppleness and prevent it from becoming dehydrated. When the skin’s protective barrier is damaged it is often unable to retain these essential NMF’s so skin moisture decreases and condition is affected.

No matter what your skin type is, it's important to follow these skincare tips to keep your skin looking healthy:

• Use a broad spectrum sunscreen every day, even when it's cloudy, to protect your skin from UVA and UVB rays
• Avoid direct sunlight between the hours of 11am-3pm, and wear protective clothing like a hat and sunglasses
• Moisturise daily
• Wash your skin gently and remove make-up before bed
• Stay hydrated by drinking plenty of water
• Don't smoke