Archive for the ‘ Procedures ’ 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.


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


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. 

Tattoos: a form of self-expression (that you’re 50% likely to regret)

Whilst perusing the Daily Mail on-line over coffee the other morning, I came across this rather arresting image of the heavily tatto’ed Mr Victoria Beckham in his pants and I couldn’t help but wonder how he will feel about them in his 50s? Tattoos are increasingly common-some studies report their prevalence as high as 25% in the 18-50 age group in the US. Perhaps somewhat perplexingly, recent studies cite  that some of the commonest reasons for having one was that the individual “just wanted one” or ‘just for the hell of it”. Equally, “being part of the group” was a common motivating factor. The difficulty lies in that the decision to get one leads to a procedure that takes a matter of minutes-but the undoing can take months….and months….and the better the tattoo, the longer it can take. Assuming that the whole thing is actually amenable to removal. And it can be painful and invariably expensive. So David may need to free up some time down the line, if he ever changes his mind…and according to statistics those who are married are more likely to regret getting a tattoo.

From a dermatologist’s perspective, tattoo removal can be a challenge. Historically the methods for removal involved dermabrasion, destruction with caustic materials and cryosurgery, which all lead to scarring-but the advent of a special type of laser called a q-switch laser has revolutionised tattoo removal.  The laser light enters the skin so that it quickly destroys the ink while minimising destruction of the surrounding tissue. This process is called selective photothermolysis. The laser light destroys the ink, and the body breaks it down. The surrounding skin stays intact with relatively  few unwanted side effects. However its important to note that not all tattoos can be completely removed, no matter how many treatments are performed. Here are some important facts to bear in mind:

1) More treatments are likely to be needed if: the tattoo is on an extremity, you have a dark skin type, the tattoo contains multiple inks and a large quantity of ink or the area was previously scarred. Black/blue tattoos are the easiest to remove-green, purple and yellow are much more difficult and different types of laser will be needed to tackle these colours.

2) Leave at least 8 weeks between treatments.

3) Cosmetic tattoos need to be treated with utmost care-these can contain pigments which are flesh-coloured and may paradoxically darken when treated, due to oxidation of the pigment. Test spots are incredibly important.

4) Its important to take care of the skin at the tattoo removal site between treatments-skin should be kept clean and inflammation should be tackled with elevation (particularly of the extremities) and moist wound healing. Leave blisters alone and use a topical steroid cream as directed by your dermatologist. Sun-screen is a must.

In the future, we are likely to see tattoos that respond better to laser removal; micro-encapsulated inks which are designed to be easily removed by a single laser are  in the pipe-line. Whether the highly-unregulated tattoo industry embraces these innovations remains to be seen. In the meantime, think long and hard before going under the needle.

Big Pores, No More

I don’t think I have a single patient who hasn’t at some time complained of big pores. Now, the dermatological population may not be representative (I know my patients are their own harshest critics) and many examine themselves in high-definition lighting with magnifying mirrors…..but I do feel their pain.

Pores are simply the ‘funnel’ which allows oil to flow from the sebaceous gland deep within the hair follicle to the outside surface of the skin. This structure becomes more obvious in 2 instances:

1)   Traffic through the pore increases and it gets clogged: this is either through too much oil or sticky skin cells at the ‘mouth’ of the funnel.

2)   The scaffolding around the pore gets weak. As we age the dermis (the deeper layer of the skin) gets depleted and there is less collagen to hold the pore upright-so it can flop open more, leading to the impression of bigger pores.

Contrary to popular belief, pores do not open and shut like gates.

Approaches to reducing pore prominence are therefore directed to either keeping the traffic flowing smoothly or strengthening the scaffolding.

Long-term use of prescription retinoids will help on 2 levels. They minimize cells clogging on the suface (therefore preventing comedone formation and reducing acne) and they also stimulate fibroblasts to produce more collagen. Over-the-counter preparations that contain properly stabilized REtinol will work in a similar way.

Beta hydroxy acids (BHAs) also help because they are fat-soluble which means they can get into the oily environment of the pore to keep it clog-free.  Products containing salicylic acid are very helpful to oily big-pored complexions for this reason.

Medical needling works brilliantly to build up collagen and strength the pore’s scaffolding-patients often embark on a course of treatment to deal with acne scarring and are surprised when they see pore shrinkage as well.

Finally, microsponge technology may be a great new way to reduce oil flow by allowing these magical little vessels to mop up excess oil-and they may also help deliver a steady amount of BHAs to the skin through the day-genius on 2 levels.