Archive for the ‘ Acne ’ Category

Oscars 2015 – How to Approach Beauty for THE Event of The Year

rosamund pike BAFTASAttending the Oscars:for a nominee, this may well be the pinnacle of  their career and the world is watching. Its also the perfect opportunity for an emerging talent to showcase themselves so putting their best face forward is vital. At the BAFTAS earlier this month, I got to see the nominees firsthand, where Rosamund Pike was a real standout for me. Her skin looked extraordinary, her presence was both commanding and womanly; she completely owned her beauty. Subtle and deft make-up was of course in evidence, but you could tell the ‘canvas’ was in tip-top form.  Getting skin into impeccable condition is a beauty fundamental for every actress – this is not the time for blemishes. So here’s my 12-week timeline to getting the kind of skin that light loves and you can’t take your eyes off. This is a great approach for brides approaching their big day – their own personal red carpet experience.

  • Take a light-handed approach to injectables. This is not the time to try something new. If you get regular treatments, do them well in advance. Many patients like the results of Botox right at the end of their treatment period because they have all the smoothness without any restriction in facial movement. So plan anything like this with military precision, and communicate your timetable clearly with your doctor! We like to know.

  • Peace of mind comes from planning in advance. Most effective skincare ingredients take 2 skin cycles to really make an impact so start radiance- delivering products containing retinoids and niacinamide (an amazing combination that work in synergy, making retinoids easier to tolerate) a minimum of 2 months beforehand.

  • Get problem skin under control. You will undoubtedly start to feel stressed as you enter the last few weeks when pressing issues like dress fittings start to infiltrate every waking thought so ensure your skin stays calm under pressure with gentle but effective azelaic acid – a fantastic multi-tasker that calms blemishes, but also works on clogged pores, dark marks and redness.

  • As the big night approaches focus on hydration. Skin acts like a mirror, reflecting light, when its water content is optimal; so this is key. One of the best ways to do this is with an occlusive paper face mask, one of my favourite quick fixes for lackluster skin. They feel like a proper treatment but with much less risk than a facial. This is ideal for the last 3 nights, as it makes sense to discontinue any more potent actives at this point to avoid any pesky dry patches from irritation.

  • On the day, keep it simple. The hard work is over. Use a non-foaming cleanser and a hydrating moisturiser and that’s it; no scrubs, brushes or other possible irritants. Your skin likes it calm. Keep make-up textures sheer, glossy and allow the beauty of your skin in its best possible natural state to be displayed – skin looks its best when it looks like skin. Then go forth and shine like the star you are, remembering to actually enjoy your moment in the spotlight.

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4 Sobering Skin-related Reasons To Moderate Your Alcohol Intake

Alcohol consumption in women is a topic that keeps cropping up in the press – especially since NICE approved the drug nalmefene for ‘mild alcoholics’ who failed to cut down on drinking 2 glasses a wine a night after a 2 week trial period. Sober October lends itself to a self-imposed trial of abstinence – but it may be worth considering the negative impact alcohol has on the skin in order to harness the extra motivation that beauty benefits deliver. There’s no doubt in my mind that smokers may often find that extra bit of will-power to say no when the ‘carrot’ is probable improvement in acne and wrinkles. So lets consider the possible fall-out from too much booze:

1) Flaming cheeks

Alcohol vasodilates, meaning that blood vessels on the surface of the skin widen, increasing our natural ‘blush’. In certain individuals, this can lead to a debilitating prolonged ‘flush’, causing embarrassment and self-conciousness. This is a sign of alcohol intolerance, as it represents low levels of an enzyme called acetaldehyde dehydrogenase that breaks down one of the alcohol byproducts. Result? Major hangover the next day.

In terms of appearances, the situation is even worse for those with rosacea – alcohol is a known provocateur, with as little as one drink causing problems in as many as 2 out of 3 sufferers. Redness is a hard thing to conceal cosmetically, as many who have tried (and failed) with green-tinged camouflage make-up will attest.

2)Parched pillow face

Yes, alcohol is a diuretic and the accompanying dehydration and disturbance in sleep quality will take its toll on your complexion the morning after. Dry, dull skin is likely to be accompanied by puffiness, especially around the eyes (not a particularly attractive combination), as a consequence of the added salt in many alcoholic beverages like margaritas, beer and white wine.

And the symptoms of a hangover will be much worse if you drink dark spirits like rum and whisky – they contain congeners, chemicals produced during alcohol fermentation that give the drink its flavor.

3) Blemish booster

The sugar in many alcoholic drinks (take a mojito, for instance) causes insulin levels to spike – this creates a pro-inflammatory milieu that can trigger an acne flare.

4) Flaky follicles

Regular guzzling of alcoholic beverages can also drive a number of common dry skin disorders, namely psoriasis and seborrhoeic dermatitis – one of the commonest manifestations of these 2 disorders is a scaly, dry scalp.  As if that wasn’t enough, increased alcohol intake makes you more likely to develop psoriasis in the first place.

So there you have it – beaucoup booze can make turn you into a spotty, ruddy, flaky, crispy-skinned person. So how to drink safe and preserve your looks at the same time? Aim for moderate drinking, ensure you have 2 nights off a week to give your body time to recover and choose your beverage with care. Skip sugary mixers + dark liquors, try to eat at the same time as drinking and alternate an alcoholic beverage with a glass of water – your skin will say thank-you.

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 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, 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. 

Q:When is acne not acne? A: When it’s perioral dermatitis

I’ve had a cluster of patients presenting with a troublesome facial eruption that’s been mislabelled and thought I’d blog about it because it’s very pleasing to sort and responds rapidly to correct treatment – woo-hoo!

So the common scenario is a female (like melasma, only about 10% of sufferers are men) who has spots near the mouth – within the nose-to-mouth creases and around the chin.

This has a very classic appearance – lots of tiny bumps that look the same, often joining up – but they tend to spare the skin directly next to the lip edge. The skin may be dry and flakey. The bumps on the chin are what tend to lead to the misdiagnosis of acne, as it bears similarity to the distribution of adult female-pattern acne. It can also appear around the eyes (and is then termed periorificial dermatitis) and if severe, spread onto the cheeks. Importantly, clogged pores or comedones are not a feature; this is one of the key features that distinguishes it from acne.

No-one really knows what causes this annoying problem – but the ‘wrong’ type of skin care aggravates it and topical steroids, especially the stronger variants are a common trigger.

When someone presents with this, the first thing I do is to suspend the current skincare regime (and frequently impose a make-up cull). A non-comedogenic regime is the order of the day (I know…I sound like a broken record). We have an excellent choice of soothing, non-clogging products to choose from, courtesy of French pharmacy brands like Bioderma and La Roche Posay and sometimes this will be enough to solve the problem. If topical steroids are the cause, occasionally things get worse before they get better, but stopping them is essential so stick at it.

More severe cases will benefit from prescription medication – my preferred approach is topical (azelaic acid 15-20%) and oral tetracyclines. Usually treatment for 6-8 weeks will sort things out. So satisfying.

A good skin care regime to try if you suffer from perioral dermatitis is as follows  :

Cleanse : La Roche Posay Physiological Cleansing Gel (one of my all-time favourites, non-foaming but effective at removing make-up)

Treatment product – if using a prescription product like Finacea (15% azelaic acid) apply it now, to clean skin morning and night.

Moisturise : Bioderma Sebium Hydra ( a lightweight non-clogging moisturiser for oily skin that’s dry or irritated)

Protect : Obagi Nu Derm Sunshield SPF 50 (lightweight matte finish, excellent physical block without the whitish cast)

Image : courtesy of http://www.drumd.com/

In-flight Skincare-or how not to have a Break-out after Long-Haul Travel

ImageWhen I get on a plane these days, I treat it like a military operation-I’ve had too many instances where I’ve arrived at the other end crispy dry, broken-out and red-eyed (aka jet-lag acne….sounds so glam ironically). Not the best thing if you’re travelling for business and expected to ‘perform’ at the other end. So I’ve devised a kit of products, which I know will maintain the status-quo-and mean that I get off the plane looking fresh, hydrated and ready to work.  You will need to go to a store like Muji to get some of those small travel-sized pots to decant the bigger products into, in order to keep the powers that be happy re the 100ml threshold.

Remember what you’re battling against is a) horrendously low humidity, meaning skin WILL get dry and b) stress; air-travel is inherently a stress on our systems, particularly if it’s long-haul, and disrupts sleep. For those who are acne-prone and already teetering on the brink of a fresh break-out because their skin is clogged, this combination is enough to send the process into freefall and trigger a fresh flurry of lovely, bumpy red numbers.

So once you’ve boarded, settled and the seat-belts sign is off, get thee to the bathroom with your kit.

1)   Remove  make-up. I recommend using a micellar lotion with a cotton pad-I like Avene Micellar Lotion as it’s non-comedogenic (I know I sound like a broken record but this is SO important) and take all your make-up off. Wash-off cleansers are not practical on airplanes-I know, I’ve tried (and flooded the bathroom floor, resulting in unpleasant wet socks. Nice.)

2)   Problem-solve. Apply a gentle-but-therapeutic product to bare skin, targeting all trouble-prone areas to suppress any imminent ruptures. I like La Roche Posay Effaclar Duo particularly in this context because the gentle BHA works as an an anti-inflammatory, exfoliant and clog-clearer; whilst niacinamide has anti-acne benefits but will also help fortify your skin’s barrier function, helping to prevent moisture loss and keep skin supple.

3)   Hydrate. This is something all acne-sufferers are terrified of. I see it in their eyes when I tell them they will need moisturiser to manage the side-effects of their acne meds. But have faith-there are products out there which will not make acne flare-and, yes, you guessed it, they’re non-comedogenic. If you let acne-prone skin dry out, not only will it get dry (doh!), it will revert to its ‘stressed state’ response and break-out. So: the products I will happily spoon on to an acne sufferer’s skin are: anything Cetaphil-the Moisturising Lotion is great for most, but if very dry especially in winter, then it’s good to have the Cream too. And they come in really handy 14g samples sized tubes-perfect for air-travel. I also love Effaclar H Compensating Moisturiser from La Roche Posay.

4)   Soothe. Areas like the lips and hands really suffer, so be sure to apply a lip balm regularly and pamper your hands and cuticles. Elizabeth Arden 8-Hour Cream cannot be beaten for lips and cuticles. Cetaphil Moisturising Cream will serve double-duty for hands too.

Depending on the length of the flight, I will repeat steps 2 and 3 every so often (3 especially). Take your own eye-mask, cashmere wrap and socks (even in Economy, this brings a touch of First-Class to the whole experience) and try to relax/sleep.  Minimize alcohol and drink lots of water.

Before landing, I will cleanse and apply a light layer of moisturiser. Then conceal any areas of redness  and dark circles with a little Vichy Dermablend Liquid Foundation. Add a pop of blush to the cheek, a layer of gloss (Nars Pillowtalk is my current fave) and a touch of mascara and I’m ready to get things done.-just add a  well-cut navy blazer for polish a la Elle Macpherson and feel……well, a little bit smug.