Posts Tagged ‘ non-comedogenic ’

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


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:


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.


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


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.


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


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. 

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.

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

50 Shades Of Grey-Have You Got London Skin?

ImageLondon Skin is a real phenomenon-every time I travel by tube, horrendous overhead lighting notwithstanding, I’m struck by the generally low standard of the average person’s complexion, and I want to climb up on my seat and start preaching. There seems to be a reluctant acceptance of dull, grey, lacklustre skin sprinkled with clogs, bumps and pigmentation from acne-which is frequently badly concealed by heavy, matte-finish (therefore dull) and clog-promoting make-up. I strongly believe that this is symptomatic of a nation who doesn’t know where to get high quality skincare advice, perhaps a consequence of the fact that there are fewer than 500 dermatologists in the UK (which works out at a roughly one tenth of the number found in France).

Many, I suspect, wouldn’t even classify their issues as acne-but most will never have known the joy of ‘clear skin’, and the freedom that comes with not having to approach the mirror of a morning as though creeping up on an enemy. This state of affairs makes me want to weep. Great skin is the one beauty ‘accessory’ that looks great on everyone-and unlike a Birkin, is something that everyone can own.

Where to start if you have London Skin?

1) Prune. It’s extremely important that like a good doctor, you do no harm. Get rid of any products that are not non-comedogenic, and I absolutely include make-up (foundations, concealers etc) in this. Be obsessive. Like you have food allergies. Read all the labels and discard, discard, discard.

2) Activate. Skin, which is not perfect, needs things left on it. It is not enough just to cleanse and moisturize-there needs to be filling in the sandwich. The most important thing is a vitamin A-derivative (like retinaldehyde or prescription-only tretinoin). To regulate the way the top layer of the skin matures. If it clogs, then you need this in some form (unless you’re pregnant, in which case there are alternatives). And then you need anti-inflammatories-to kill the nasty red bumps and whiteheads, which are the consequence of the clogs from 6 weeks ago. Benzoyl Peroxide can irritate but at a 2.5% concentration (you don’t need higher) and in a well-formulated product, which may well contain dimethicone, this is now a much friendlier product than you may recall from your teens. Or use BHAs +/-AHAs in a leave-on format.

Start off applying your actives on alternate days-usually anti-inflammatory in the morning and vitamin A-derivative at night. Treat the whole face, don’t just spot-treat. Otherwise you will never get a handle on it. After 2 weeks, try increasing to daily use morning and night. Stick with it for a minimum of 6 weeks and once its better, don’t stop. Wean down the anti-inflammatories but stay on the vitamin A. Your skin will look better for it in the long run.

3) Rationalise. Cleanser should do just that-and again, should cause no harm. I don’t believe that cleansers alone can fix acne, any more than they can get rid of wrinkles. But they are an essential part of the support system. And don’t over-cleanse with either aggressive foamers, daily physical exfoliants or by double-cleansing. Depleting the skin’s natural barrier will make any ‘actives’ more irritant and you’ll get eczema as well as acne. And then you’ll stop treatment…. and your London Skin will persist and probably look worse.

4) Nourish. Again, the afore-mentioned ‘actives’ need to be given time to work. You don’t acquire problem skin overnight; therefore you can’t expect it to melt away in 72 hours. Give it at least 6 weeks, and probably more like 12…in which time, you will need a moisturiser that allows your treatments to do their thing, and keep you complying. Failing to put your acne treatment on is the single commonest reason it fails. I know this because when I ask my non-responders (who say ‘it didn’t work’) to bring in their treatment bottles, they fidget, avoid eye contact and admit that they gave up after 2 weeks. Usually because they didn’t remember to use this important part of the support system.

After applying your active to clean skin, leave it to penetrate and dry, then moisturize over the top. If you’re very irritable apply a bit before the active (which will lessen its effect, but you can slowly remove this step as tolerance builds).

5) Preserve. Sunscreen, broad-spectrum, SPF30, non-comedogenic, and beyond that, however you like it. But take the time to find one that you are happy to use every day-so important. And one that doesn’t make make-up peel off after it’s applied (a common objection) is out there-you just have to find each other!

6). Enjoy. Remember that once things get better, you must relish your non-London Skin. You will have worked hard, and the rewards should be tangible (if not get thee to a dermatologist). Go the supermarket without make-up, or something similarly risky, just because you can.

And travel by tube safe in the knowledge that I will be silently admiring your non-London Skin.

Milia: Pesky White Bumps Around the Eyes

Today, I made one of my patients very happy by extracting one of these little ‘friends’ (the name I give to innocuous   skin acquisitions as opposed to their more sinister counterparts, the ‘foes’). She had the unsightly bump for more than 2 years and it took precisely 2 seconds to remove it with the help of a teensy yellow needle, a couple of cotton buds and some magnification. So satisfying.

Now, these develop most commonly around the eye and are essentially tiny cysts, formed from the lining of the hair follicle. This basically means its a tiny ball made up of a layer of skin cells folded back in on themselves, under the skin. And dead skin cells accumulate within the ball because they have nowhere to go, giving them their characteristic, pearly white colour. They are often mistaken for whiteheaded spots (called pustules) or closed comedones-but when squeezed, nothing happens.

Why they form isn’t fully understood, but comedogenic (or clogging) skincare formulations and sun damage are likely to be contributory. Using topical steroids can also predispose to them, so they are sometimes seen in eczema sufferers. They are also very common in new-born babies, in whom they tend to resolve spontaneously. Unfortunately, this tends not to be the case in adults. So what to do to prevent them?

In truth, not an awful lot works. I advocate the use of non-comedogenic skincare as a general rule, and I think this is a good beginning if you’re prone to milia.

Topical retinoids are beneficial in some patients and certainly make them easier to extract. Over-the counter products containing retinol or retinaldehyde are good alternatives to prescription products, but always introduce this group of ‘actives’ gradually when using them in the delicate eye area.And of course, this step necessitates the use of a broad-spectrum sunscreen, which again should be non-comedogenic (loving Vichy Mattifying Face Fluid Dry Touch SF 50 right now).

If you have milia,you can choose to a) do nothing-they’re harmless. Or b) have them extracted. The commonest method is with a sterile needle followed by manual extraction. A good way to make your dermatologist’s day.