5 Simple Lifestyle Tricks To Help You Cope With The Stress Of Acne

When women with acne come to the clinic, they invariably ask ‘what changes can I make in my life to improve things?’ There is often a frustration that, despite a pristine diet and exercise programme, that nothing they do makes it any better. And therein lies the problem. Frustration….anxiety…. the downward spiral of acne doom. Which leads to the frenetic skincare hopping behaviour that is so often a key driver to the skin blowing up.

And what this repeated observation has led me to muse, is that adopting sensible, rational skincare approaches (an anxiety-relieving act in itself by virtue of taking the guesswork out of skincare) is probably synergistic with adjusting the female mindset. I’ve heard so many times about the ritualistic way women will get home from work, remove make-up (‘because its bad for my skin’) and then spend the evening playing peekaboo with their magnifying mirror, squeezing everything in sight. Occasionally with tweezers. In fact, the disabling variant of acne known as acne excoriee is sometimes largely a consequence of human behaviour; the acne itself may not be so severe, but the fallout of self-help can be disastrous, leading to pot-hole scars and persistent pigmentation. I see this a lot in women with adult acne and the cycle can be extremely disabling – even though they know its harmful, they can’t help themselves.

So of late, I’ve been recommending the following ‘tricks’ to try to break some of these detrimental habits – I firmly believe that you need short-term strategy to get you through the first 4-6 weeks of any acne treatment programme because there is almost always a timelag to improvement (I don’t see patients until 10-12 weeks in for this reason). These might seem silly, daft or even frivolous – but I think that anything that might give you a bit of skin-control back is worth a try.

1) Put your magnifying mirror in the bin.

Start to view yourself as others do. From 1m away. People are simply not as observant as you think.

2) Adjust the lighting in your bathroom.

If it isn’t kind ie harsh, overhead and megabright, soften it. This is a simple frame-shift that takes the pressure off and helps you stop obsessing about every potential bump in your skin.

3) Keep your make-up on until bed.

Yes, that’s right – in this instance, make-up is not your enemy. Its your shield. This is based on the assumption that you have made smart choices – see here.
Winning brands are labeled non-comedogenic ; good choices include Nars, Vichy Dermablend, Armani and Lancome. Then whip it off last-thing, do your skincare regime and then straight to bed with you. No dilly-dallying at the mirror.

4) Keep the weapons short. 

Fingernails are usually the weapons of choice when it comes to picking or fiddling – so perform damage limitation by embracing a short, chic mani.

5) If the urge to pick is very strong, try meditation.

I think the Headspace app is absolutely brilliant for calmly asserting authority over that swirl of thoughts in your head that can drive certain types of behaviour – anything that gives you ‘headspace’ from acne is of value, in my book.

Is Your Make-up Bag Ruining Your Skin?

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A woman’s make-up bag is the cornerstone of handling the ‘no-time’ trend – whether its about finishing lipstick application ‘dans la tube’ or transitioning from a day-to-nighttime look in the office loos.  However its important to manage this vital toolkit wisely, especially if prone to problem skin. Think about an item like a compact foundation – incredibly convenient for touch-ups, but that applicator is in constant contact with both hands (which may, or may not be clean) and face (oily t-zone, anyone?), so will rapidly become dirty and a breeding ground for bacteria.

 

There are some key steps to avoiding skin issues due to the murky depths of your make-up bag:

1)    Wash brushes once a week in gentle shampoo to avoid the harbouring of acne-promoting bacteria.

2)    If using a compact foundation, be scrupulous about sponge hygiene. There is nothing ickier than a sponge in need of a bath.These are breeding grounds for bugs, so wash regularly, allow to dry thoroughly and replace frequently.

3)    Choose products that are non-comedogenic, especially if looking for longlasting products to survive the full work day. I see a lot of patients with a condition called perioral dermatitis – red bumps around the mouth that look like acne – and their cosmetics almost invariably play a role in this annoying and frequently recurrent disease.

Besides: if your make-up promotes blemishes, you will end up spending more and more time covering up your skin in the morning – a rather futile spiral.

4)    Avoid putting fingers into a jar of cream, however indulgent that might feel. Use a clean spatula to decant product hygienically.

5)    NEVER use saliva to wet make-up brushes or correct make-up mishaps. The mouth is a dirty, dirty cavity.

6)    Don’t borrow or lend make-up, especially eye products. Conjunctivitis is highly contagious and leads to a red, sticky eye (not attractive).

7)    Finally, pay attention to the physical properties of your make-up. Unfortunately many cosmetics don’t have an expiry date. Liquid foundations and mascara have the shortest shelf-life – they should be replaced after as little as 3 months. If a foundation changes texture or a mascara acquires an unusual odour, it’s time to bin it. Bacteria can colonise products and the preservatives might not be work quite as well as they did when you first opened it – so to reduce this risk by seeking out products in a pump, rather than in a pot or open-necked bottle.

How To Not End Up A Hot Mess + Care For Your Skin After Hot Exercise

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Keeping fit has become a sticky business of late –  it makes sense, as you are bendier and less likely to hurt yourself when everything’s warm’n’limber. But staying beautiful (especially if you’re headed back to the office after a reviving mid-day work-out) becomes a challenge. Especially, if you suffer from acne. This is clearly a recurring phenomenon – in my recent visit to Psycle (THE place to get your groove on whilst having a massive endorphin hit) I overheard exactly 3 women bemoaning blemishes during the time it took me to go to the loo. Girlfriends who do Bikram say the same thing. Here’s my plan for keeping it together:

BEFORE CLASS:

1)   Keep make-up light on work-out days – use a non-comedogenic, light-textured tinted moisturiser (love Nars). Conceal where needed (Vichy Dermablend Foundation Stick won’t block pores and can mask Vesuvius – a must-have in your kit). Skip powder + use blotting papers if 11 o’clock shine is a problem (love MAC ones)– you can work with base that isn’t powdered; you can’t when it is. And of course, keep eye make-up to a minimum – curl lashes and use only waterproof mascara, obv.

DURING CLASS:

2)   Hair up – loose topknot works best. Bobble water for hydration. Forget face.

AFTER CLASS:

3)   Blot face. Inspect the damage. If you’ve kept it light, you should just be able to touch up your base/concealer where needed. Blusher should be unnecessary. A bit of lip-colour and you should be all set. For body, I think wipes are acceptable. If breakouts are an issue, use a medicated one like Murad Clarifying Wipes or get Stridex Acne Pads from the US. For hair, spritz volumising spray on roots (I like PhytoVolume Actif Volumizing Spray) and use dryer and round brush to get a bit of root lift and restyle front sections of hair. Blast it underneath near the nape of the neck.

LATER:

4)   Work on your complexion – don’t acquiesce to breakouts; get a plan. This will save you so much time in the long-run, not to mention free up valuable headspace for much more important things (like what colour to get Lexie workout gear in). Get a kit together consisting of something like: La Roche Posay Physiological Cleansing Gel and Effaclar Duo and Effaclar H (for day). Swap Effaclar Duo for Avene Triacneal at night. And of course a broad-spectrum sunscreen that works like primer (MUST be non-comedogenic). If that isn’t improving things, go see a derm.

How To Stay Away From Your Acne Breakout Threshold

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I’ve had a rash (collective noun for a group of dermatologically-challenged individuals) of female patients presenting in the post-Xmas period with more spots than usual. “Why, why, why?” they ask me. What’s changed? Why has their previously tamed complexion suddenly decided to misbehave and throw its  toys out of the pram?

There’s no single explanation for this that fits all. But the reality is that anyone can breakout; even the most genetically blessed will get the odd acneic blip if they throw the right (wrong?) elements into the mix.

So here’s a list of practices which might influence the status quo; and when combined in a genetically-susceptible individual may just shift the balance towards Breakout City.

1)   Changing contraceptive pill. Alas, they are not all equal, when it comes to the skin. Whilst the general trend with most combined  pills (ones that contain an oestrogen and progestagen ) will be to reduce acne, certain ones have more complexion-clearing progestagens than others. Those which are most skin-friendly are: Yasmin, Cerazette, Femidene and Cilest. Avoid progestagen-only contraceptive methods (including the Mirena coil) like the plague.

2)   Other medications can also push you towards your breakout threshold. Commonly prescribed agents like SSRIs, anticonvulsants and even certain supplements (like Vitamin B6 and B12) may promote acne in some, through poorly-understood mechanisms.

That’s not to say you should ever stop treatment without exploring the pros and cons or indeed alternatives with your prescribing physician. But it’s worth keeping in mind.

3)   Stress. Research and my personal experience tells me that a fast-paced life undoubtedly contributes to higher levels of acne. Stress hormones behave like androgens, which increase sebaceous gland misbehavour. Ask any student approaching exam period – in fact one study from Stanford University did just that and guess what? Breakouts were more common and more severe in students during exam term.

4)   Beauty experimentation. Certain trends do not favour the acne-prone. When a new patient comes to see me, I ask them to list what they’re currently using. And that list often encompasses a chaotic collection of more than a dozen products.

Elaborate cleansing rituals are a common culprit; facial oils, double cleansing, muslin cloths, over-used cleansing brushes…..  all can be detrimental, aggravating acne by irritating the skin. Long-wear foundations can also be hazardous, as these can be extremely difficult to remove and are rarely non-comedogenic.

The bottom-line is acne is a fluctuant condition with good days and bad. Correct treatment and good beauty practices can minimize these ups and downs, but every so often the balance is disturbed; this shouldn’t cause despair. Stepping up treatment and banishing any provocateurs in order to regain control for a defined period of time usually re-establishes stability  ….and pulls you back from the brink of your breakout threshold. 

Winter and retinoids – how to survive

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Dry skin and winter go hand in hand – so getting along with our best anti-ageing ally can be harder than usual. Lizard skin doesn’t look so hot. The retinoid family includes over-the-counter products like retinol and retinaldehyde (find these in Medik8, La Roche Posay Retriderm and Avene Ystheal lines); and it also includes prescription products like Differin, Retin-A and Isotrex. These are a godsend for acne-prone and sun-damaged skin, but they can be a challenge to use for the uninitiated and winter makes it even harder to build them into your routine – certainly, retinoid queries are the commonest reason for patients emailing me at the moment. Red eyelids, rashy necks and dry cracked lips are all signs that you may need to modify your routine. Here are some insider tricks to get you through ‘til spring.

1)   Switch up your routine. Make sure you’ve banished all foaming cleansers and that you’re using a richer moisturiser formulation at night. You may also want to ditch your exfoliator – or at the very least, cut back.

2)   Apply retinoids to completely dry skin. Try cleansing, then moisturising generously straight away, to lock in water to your skin. Occlusive moisturisers work best like this. Wait 15 minutes, so skin is completely dry. Then apply a pea-sized amount of your chosen retinoid.

3)   Reduce the retinoid strength. Little and often is better than blitzing your skin once every 5 days, because of common side effects like redness and burning. So dilute it with moisturizer to buffer its effect. This will reduce penetration, making it easier to tolerate.

4)   Start slow. Never attempt to use any retinoid daily from the outset. This is a rookie error. Begin with applying every 3rd day and escalate to alternate day application after 2 weeks. Then try daily use or 2 days on/1 day off after another fortnight. Remember the changes you are trying to effect in your skin occur over the course of months, not weeks. Slow and steady wins the race.

5)   Try short-contact therapy. This approach has worked for many of my thin-skinned sensitive patients who struggle with retinoids. Think of it like a mask – so apply to clean skin for 5 minutes initially and then rinse it off off; build up to leaving on for up to 30 minutes over time.

6)   Protect vulnerable areas. Redness around the eyes and cracked lips are common occurrences if you’re applying your retinoid with too little precision. I suggest using moisturiser as a barrier around the eyes and lip balm on the lips before retinoid application, if these issues are occurring.

7)   Don’t skip on sunscreen. Remember, that sunscreen is the yin to the retinoid’s yang. Even in winter. By all means choose a more moisturing formulation, but don’t skip it. UVA rays age and are the only UV rays of significance in cold climes in winter (unless skiing/at altitude) so use proper sunscreen with at least 5% zinc oxide for a complete anti-ageing effect.

Is Medical Needling The Most Useful Skin–Perfecting Treatment Around?

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The answer – quite probably. And I don’t say this lightly. After Botox, this is the commonest in-office procedure I perform. It involves using a device called a dermaroller on topically anaesthetised skin, and creates multiple tiny punctures through the top layer of the skin, down into the upper part of the dermis, the deeper layer. This creates a multitude of micro-injuries, activating the skin’s healing cascade and prompting the massive release of growth factors from cells called platelets – the things that form a plug to stop bleeding when we cut ourselves.

This procedure is incredibly useful for a number of reasons:

1) Everyone benefits from skin-thickening. Think of folding a piece of card and then think of folding paper –which creases more easily? Exactly.

Thick skin is more resistant to wrinkling than thin skin, which is why our eyes and necks give us away when it comes to ageing. Medical dermaroller therapy, when performed in-office (and that’s specifically what I’m talking about here – not at-home treatments using a device with much shorter needles), causes the new deposition of collagen in the dermis, and thickening of the skin’s outer layer by as much as 40%. Anyone and everyone concerned about ageing will benefit.

2) But that’s not all – medical needling also stimulates new elastin formation. What that means is needling helps restore the skin’s elastic recoil, reducing laxity and sagging – something that’s actually incredibly hard to achieve, even when utilising more invasive procedures.

3) It can be safely used on pigmented skin AND it doesn’t make you light-sensitive, so treatments can continue through the summer. This is because the skin’s top layer isn’t removed and the procedure does not activate melanogenesis, the formation of pigment in the skin. Again, this is in stark contrast to chemical peels and ablative laser therapies, which are higher risk in both darker skin types and when performed during periods of intense UV.

4) As if those benefits weren’t enough, it’s a great treatment for acne scarring. In my practice, that means that it’s the perfect therapy for the tidy-up phase, once we’ve corrected the active acne process; so often, we’re not only trying to minimize the aftermath of acne, but also target the first signs of ageing too. Medical needling targets two birds with one stone.

5) The downtime is incredibly short for a treatment with such high yield – I’ve renamed clinics run on Friday ‘Dermaroller Fridays’. Practically this means you can have a treatment at the end of the working week, recover over the weekend, and be ready for work again on Monday. You’ll look sunburnt straight afterwards and for the next 24 hours but over the course of Sunday, normality  gradually resumes. A weekend off is a small social sacrifice to pay for complexion renovation.

And complexion renovation is really what this is all about – stimulating regeneration of the dermis and epidermis in an entirely natural but longlasting way. This is what makes medical needling so popular with my clientele – and ultimately, delivers a very attainable British kind of beauty, which is based on fantastic skin. 

5 Things You Must Know Before Using a Facial Cleansing Brush

Home-use devices are a huge growth area in beauty right now.  And rightly so. They represent a brilliant stepping stone on the path to great skin, providing a little more oomph for women who’ve been disappointed by too many over-the-counter cosmetics but aren’t quite ready yet for the dermatologist’s office.

The cleansing brush is one of thImagee easiest to use and the benefits are immediately obvious – they provide thorough make-up removal without the need for double-cleansing and provide better penetration of serums and moisturiser used afterwards. They also look and feel …. well, fun. A little bit like high-end sex-toys. BUT they can also completely wreck your skin if used wrongly.

So here are some simple tips to help make sure you get the most out of your gismo.

1)   Let it do all the work. Now I’ve listened to many disillusioned women who come into clinic bemoaning the fact that they’ve spent serious cash on one of these devices and then wonder why they’re all red/irritated/broken-out. So I asked one of them to bring it in with her and show me how she used it. Answer: like a Brillo pad. We girls just love a good old scrub. Wrong. It does the heavy lifting so we don’t have to. Literally just hold it in contact with your skin, and let it whirr away as you gently pass it over the various zones of the face.

2)   Now, speaking of red/irritated…. I really don’t think anyone needs to use these devices twice a day. Start off using 3 times a week at night. See how you get on. Thick, oily skin with big pores may well tolerate up to nightly use, but it’s rarely necessary, unless you are wearing industrial-strength make-up every day (in which case we need to talk about make-up!). Sensitive skin needs a brush with a sensitive head, and 3 times a week, like physical exfoliants, is more than enough. Be especially cautious coming into winter.

3)   Which brings me to the cleanser that comes with many of these brushes. It should be gentle and non-foaming. Otherwise the combination of manual cleansing plus surfactants will demolish your skin’s barrier function, leaving you…yes, that’s right. Red/irritated/broken-out. Good ones include Cetaphil Cleanser, La Roche Posay Physiological Cleansing Gel and Avene Extremely Gentle Cleanser. All are non-comedogenic, which is how I like my cleansers.

4)   Avoid if you have active acne or rosacea. These may well be suitable at a later point, when the battlefield is calm and you have the active inflammatory ‘fire’ under control. But do this first with topical actives and keep everything else gentle. Introduce your brush only when stability has kicked in and all your comedones (i.e. spot precursors) have been sorted with a retinoid.

5)   Recognise that the cleansing brush is only one part of a comprehensive skincare regime – alone, it won’t anti-age anyone but what it does do is make useful things you leave on the skin work more effectively and give you the feel-good factor that comes with a senses-pleasing ritual.

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