Posts Tagged ‘ retinoids ’

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.


Winter and retinoids – how to survive


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.

The Secret to Bare-Faced Chic or ‘Bien Dans Sa Peau’


Leaving the house without make-up…a challenge that leads many women to suggest they’d rather chop their arm off than contemplate. But the reality of busy lives, whether it’s getting the kids to school on time or squeezing in a quick gym session before work, frequently necessitates being confident enough in our own skin to face the world sans slap. It’s also not such a bad idea to give ourselves a day off every so often, for the sake of skin health, as Jesse J and Kelly Brook demonstrated recently on Twitter.

The keys to looking great bare-faced are:

1) Skin radiance

2) Minimise under-eye problems

3) Banish blemishes

4) Killer brows

5) Well-moisturised lips

If these 5 things are in place, you’ll be able to project a clean, groomed kind of nude beauty that’s highly desirable and actually very youthful.

Steps 1 and 3 are best accomplished with morning application of AHAs and BHAs and night-time use of vitamin-A derivatives. Follow up with daily sunscreen all year-round. I like Obagi Exfoderm Forte, Tretinoin 0.1% and Sunshield SPF 50 on prescription, which I could not function in clinic without. Over-the-counter I love Medik8 Betagel, Retinol 40 Boost and Heliocare SPF 50 gel. Combine with a home-use dermaroller for extra impact and support with a non-comedogenic cleanser and moisturiser.

2) The under-eye area is a hard one to tackle without make-up, I fully admit. Dark circles are tricky. Sleep is critical. January is a good time to catch up on much-needed slumber as lots of people are cutting back on alcohol and hitting the gym. Keep salt to a minimum to reduce under-eye puffiness due to fluid retention. And utilize skin-care products containing high-potency vitamin C for hyperpigmentation  and collagen production. I like Obagi Professional C serum 15% (again, a clinic staple of mine) and over-the-counter Skinceuticals Phloretin CF serum.

4) Brows frame the face. So important. A thicker brow looks right at the moment. So get professional input and have them threaded-Shavata Brow Studio  fantastic.

5) Dry lips in winter are uniquitous-a supple, moisturized lip is crucial for a healthy appearance so keep them juicy and low-maintenance with regular lip balm usage and do not lick! Saliva irritates the delicate lip area, which naturally lacks sebaceous glands and  Vitamin E, hence the lip’s tendency to age; this dries lips out, so break the cycle by being aware of your behaviour. I love Elizabeth Arden 8-hour Cream, which is now available in an unfragranced version. 

So hopefully these simple steps take you a little closer to comfort in your own (glowing) skin….’bien dans sa peau’.

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.

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.

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….

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.