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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.

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BAFTA Beauty-Ready For Your Close-up?

It’s a fascinating spectacle and one I never tire of watching- the nominees bask in the approbation of their adoring public as they glide down the red carpet and receive recognition for their endeavours. And of course the BAFTAs are so much more important, now that they precede the Oscars and are a strategic prequel to the glamour of London Fashion Week.

This years’ best actress line-up is a curiously diverse one, from an aesthetic perspective. Relative unknown Berenice Bejo is a delicious beauty of Argentinian/French extraction (such a winning combination, genetically speaking)-and is a superb example of how women in their 30’s are peaking professionally, even in the fickle world of film. What does she need to get red-carpet ready? Her complexion best suits hair colour in the more chocolate-y end of the spectrum, rather than the copper tones she sported to the Oscar nominees lunch. So much more chic. She has the delicacy of Marion Cotillard-so needs to keep that complexion crystal-clear with skin brighteners, to avoid pigmentation issues. Her Argentinian heritage may well put her at risk of an uneven skin-tone. Her go-to product: La Roche Posay Pigment Control.

Tilda Swinton is at the opposite end of the spectrum. This cerebral beauty (she went to my college at Cambridge University) has the most elegant, alabaster skin. Inconceivable that she would sully it with fake-tan-no make-under required here, Pod. She is the poster-girl for Pomellato jewellery, makers of exquisite confections that tempt one to sell a kidney to procure. To gild this lily requires precise exfoliation to let the canvas do the talking. Her go-to product: Nubo Diamond Peel and Reveal, a 2-phase exfoliant which has remarkable, lustre-giving properties. And sunblock daily, 365 days per annum-Skinceuticals Sheer Physical UV Defense SPF 50 would work brilliantly.

Michelle Williams has come a long way since Dawsons Creek, that oh-so-earnest teen drama I so dearly loved (were adolescents ever so verbose?). She has an incredibly classic, chic look-Mia Farrow’s haircut has never been so perfectly borrowed. She is just starting to get a few early changes in the skin under the eyes, which is to be expected in one so fair at 32-so she should adopt a peptide cocktail in her eye cream, to stimulate collagen production and support those delicate capillaries which can leak and trigger dark circles. Her go-to product: Kinerase Pro+ Therapy Ultra Rich Eye Repair.

From the editor at Runway to Margaret Thatcher-Meryl Streep has an effortless ability to bring strong women to life on screen, with her regal features and commanding presence. She has tremendous bones-all the better to hang great skin off. She would benefit tremendously from a prescription retinoid for a good 3 months before her big event, to build collagen; and on the night she should apply a a hyaluronic acid-rich sheet mask to intensely hydrate the epidermis and prime her skin for make-up that will stay dewy and crease-free all night. She should use Obagi tretinoin 0.1% at night (in conjuction with sunscreen, on prescription only) and prep with an SK II facial treatment mask.

Finally we come to Viola Davis, nominated for The Help, who is coming into her own in her 40s. She has the kind of lush complexion that doesn’t wrinkle but as with all darker skin-types, she needs to be careful as it can look ashy. To make it pop she should nourish it with antioxidants that maximize radiance-Vitamin C and Niacinamide will feed her skin and make it gleam. Her go-to products: Agera Intensive MagC gel for day and Alpha H Liquid Gold Intensive Night Repair Serum.

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.

What to do when acne and wrinkles co-exist, Part 3!

So our imperfection-free epidermis is glowing so brightly, passers-by don shades to cope with the glare…how do we deal with any irregularities in the deeper layer of the skin, the dermis?

Those little dimples due to a lingering pimple (so often below the corners of the mouth where that pre-menstrual break-out lasts far longer our actual period) or those first fine lines between the brows, around the eyes or from nose to mouth…..

Almost every woman in her 30s needs a little something here. Most acne scars will respond beautifully to in-office medical needling, now that we’ve got our fibroblasts functioning uber-efficiently. This also happens to be a fantastic treatment for fine lines and wrinkles-ultimately you want to trigger a healing response, which leads to new collagen being laid down. This can be combined with Restylane Vital, an injectable form of hyaluronic acid which produces superb results when combined with dermaroller treatments-what we refer to in the business as the Gel Needling Lift.

Individual deeper lines in the upper face (forehead, brows and crows lines) melt away with Botox-the soft approach is so much more natural and seeks to smooth creases and discourage excessive movement, rather than to freeze (so 5 years ago). This is a much more natural, harmonious look in a young, animated face and I think lends balance and proportion-nothing is more distracting than an excessively mobile forehead or a deeply furrowed brow in an otherwise feminine visage . Certainly this tends to be the commonest first step for someone coming into a cosmetic dermatologist’s office for the first time and can make a tremendously positive impact on your appearance (it’s also the reason for the gratuitous inclusion of a picture of the delicious Dr Christian Troy from Nip/Tuck-who produced one of my favourite fictional injectable-related plots).

Lower face lines need dermal filler-gradual replacement over a couple of treatments will just re-inforce and support an area of weakness and should never look stuffed. Working with fillers is as much an art as it is a science so be sure the person you choose has the same sense of aesthetics you do. Look at their face for evidence of fillers-do they look natural and youthful or do they look like they’ve had too much of their own product? Choose accordingly….

What to do when acne and wrinkles co-exist, Part 2!

Ok, so we’ve cleaned up the canvas. Now we need to get our glow on (like the effortlessy gorgeous Eva Green, left). Assuming regular use of a Vitamin A-derivative at night, and sunscreen during the day, most people with mild acne will be much better controlled after about 3 months.

Now, at this stage we need to buff and polish, evening out skin-tone and texture, encouraging the hasty exit of post-inflammatory hyperpigmentation. This is essentially an epidermal intervention-it should already be turning over nicely in response to the retinoid-but the great thing is, everything else you now apply will absorb more easily. So we want to improve pigmentation: uneven, dark patches absorb the light and stop our skin from ‘popping’.

There are any number of ways to improve this-my favourite approach is a multi-tasking one. I find that AHAs+pigment suppressors+retinoid=GLOW. The Obagi Nuderm system remains the gold-standard for me-combining prescription-strength hydroquinone, tretinoin, Vitamin C and glycolic acid; but you can equally use azelaic acid, arbutin or kojic acid to tackle pigmentation. Skinceuticals Pigment Regulator is a great alternative, as is La Roche Posay Pigment Control (in stores in January)-both are based on kojic acid and AHAs. Again, improvements occur over the course of weeks. At this stage I will suggest switching to a gentle cleanser (Cetaphil Gentle Cleanser or Avene Extremely Gentle Cleanser….they’re both….quite gentle!), using moisturiser when needed and sticking with the broad-spectrum sunscreen (minimum SPF30).

Once established on this, I might add in a home medical needling device, to significantly enhance product penetration and improve epidermal turnover. Its important to note that all of these steps might cause a bit of irritation in the first instance-so its important to go slow with any new intervention and support your skin’s barrier function with a non-comedogenic emollient along the way.

With a bit of diligence, your skin should now be posh and polished-looking. Next time-addressing deeper, dermal issues….

What to do when acne and wrinkles co-exist? Part 1!

This is the commonest scenario I face on a day-to-day basis: a distressed late 20’s career girl with lower face acne (and maybe an early nose-to-mouth line), upper face fine lines (usually around the eyes and between the brows…..), combined with an -over-all lack of radiance and glow…..and almost invariably, a heavy coating of foundation. In fact, I think you’ll find that this describes most of the female members of the recent cycle of The Apprentice down to a T. What to do???

The approach is simple-we make a plan. What to fix now, and what to do in the medium to long-term. The priority is always getting any disease process under control. And acne is a disease. It amazes me how many people just get used to having break-outs on their chin and jaw-line and think its something they have to live with, because they have done so for so many years. Not to mention the consequences of spots, with their pigment-depositing potential and general co-existence with rough texture, excess oil and big pores. No, no, no! These things are eminently improvable, with a bit of time, patience and persistence.

A combination of the following will make a big difference in any acne-sufferer’s skin:

1) A BHA wash (containing 1-2% salicylic acid)

2) A topical anti-inflammatory-2.5% benzoyl peroxide (despite historical associations with the nasty, bleaching products of ones’ teens) works well, and there’s no need to use a higher percentage. Seek out those with a moisturising base, like dimethicone, which will help minimise irritancy.

3) A non-comedogenic moisturiser-to preserve barrier function and to help improve tolerability of the acne ‘actives’ in the early stages of treatment.

4) A non-comedogenic sun protection product (minimum SPF 30)-with broad-spectrum cover, which you’ll need as you must use a retinoid (unless getting pregnant).

5) A retinoid-like Differin or Retin-A. In very mild cases, a more gentle Vitamin A-derivative might be sufficient, like retinaldehyde. But you probably need a prescription product if your spot and comedone count is greater than 10-15 lesions. If pregnancy is an issue, azelaic acid is a safe alternative (and will incidentally help tackle your pigmentation). The acne may well get worse before it gets better-do not stop! Retinoids do tend to push out micro-comedones which weren’t previously visible, a process of cutaneous catharsis, if you ask me. It had to come out at some point, so best to get it over and done with. Always use at night, as the molecule is not stable when UV-exposed.

Give it time, be kind to your self in this challenging part of the process…and if your acne is significant, see a doctor to get oral treatment as a holding measure whilst the topicals kick in-but remember, everyone needs an anti-comedonal agent, so a topical retinoid (or azelaic acid) is essential. You must give it at least 8 weeks….so there’s no rush, go slow and build up frequency of application and amount of product used slowly. Your skin is a remarkably adaptable organ, and if you give it time and support it, it will accomodate to the new order of things.

Next instalment…..what  to do once the acne is under control…

Rhamnose-the new cat’s pyjamas of anti-ageing???

Youth lies in the dermis-this, we know. Firm, smooth bright skin owes much to the hardworking cells called fibroblasts which produce those all-important molecules collagen (of which there are no less than 18 types), elastin and hyaluronic acid. Fascinating research done by those clever people at Loreal has shed even more light on what we already know. They have demonstrated through laboratory studies on reconstructed skin that there is a specific type of fibroblast that lies in the upper part of the dermis (know as the papillary dermis) which is critical, both in terms of keeping the dermis perky and stimulated but also the epidermis, the skin’s outer layer. These cells appear particularly sensitive to UVA, the more deeply penetrating rays of the sun and their numbers decline as we get older. Those that remain also have to work harder to get the same information out to other cells in the tissue, which means that the epidermis doesn’t have the same drive to regenerate and repair. So the key message from this work was to find a way to keep these cells ‘on’ and functioning like young healthy fibroblasts.

This led to a search for a new ‘key” anti-ageing molecule which would ‘unlock’ the papillary fibroblasts’ potential…and the exciting finding was the  discovery of a plant sugar called rhamnose, which is found in the Brazilian (I know…..all good things of late are Latin-American in origin!) plant called Cat’s Claw. This plant has long been know for its medicinal properties and was recently  shown to be helpful in  combatting dengue fever.

Rhamnose  was found to improve both epidermis thickness and production of the most important dermal collagen precursor (procollagen 1) in vivo ie in real-life ageing humans in a placebo-controlled double blind study. This means 2 things 1) the preparation is able to penetrate the outer layer of the skin to get to the important bit underneath and 2) it seems to actually stimulate fibroblast cells to function more effectively. Both the laboratory findings and the clinical studies will be presented in Seoul this year at the World Congress of Dermatology in May 2011-all very promising.

So finally…..the cosmetic industry is paying attention to the demands of consumers by backing up claims with hard science. Miaow to that, I say.