Acne is one of the most common skin conditions treated in aesthetics.
It can lead to scarring if it is not treated efficiently. There are National Institute of Clinical Excellence (NICE) guidelines regarding treatment for this condition and therefore some people may require a review with a dermatologist. During your consultation therefore, we will go through the treatments you have tried and what is available on the NHS, who should go to a dermatologist and who can be treated with aesthetic treatments. There are certain drugs that can be used to treat the condition when severe, that only a dermatologist can prescribe, and these drugs can be a contraindication to some aesthetic treatments.
For many people living with acne, it can have a devastating effect on self-esteem. One of the first places we look at someone when speaking with them is the face. Bullying at school and workplaces, people commenting in the street, just makes things much worse. The good news is, that there are many different skin care products and treatments available that can help this condition.
One of the key issues with acne the choice of cleanser, too harsh will strip the skin of the oils it needs to lubricate and protect the skin. It is very tempting to clean the skin with various scrub-type cleansers, or to overuse cleanser several times per day, to try to reduce oil production. However, scrubs or harsh cleansers often increase oil production, and actually have a counterproductive effect. The skin needs a certain amount of oil for protection, so there is no need to strip all of it away, however tempting it is!
Retinoids are another key skin care ingredient; however it is important that you are not taking certain medications if you use these. They can be quite harsh on the skin so it is not an expectation to necessarily use these everyday for those with more sensitive skins.
Unfortunately, for those with darker skins, there tends to be more inflammation associated with certain types of acne when compared with lighter skins. This can lead to a greater chance of post inflammatory hyperpigmentation with darker skins. So, for these types of skin, products with more anti-inflammatory ingredients and less irritants will be more helpful.
LED can also help with repairing the skin and maintaining the skin post treatment. Blue light has growing evidence of effect for acne. It works by killing the p. acnes bacteria associated with acne breakouts.
Pigmentation is used to describe the dark spots which can appear on the skin.
This is related to melanin – the amount and type of melanin that we produce in our skin is related to how dark or light our skin is.
There are a range of conditions which cause abnormal pigmentation in the skin. Some are simply related to overexposure to UV rays from the sun, which stimulates the melanin forming cells (melanocytes) to produce more melanin (pigment) resulting in dark spots on the skin. Whilst others are again autoimmune related such as vitiligo.
Melasma is a common condition in adults which causes greyish or brown patches of pigmentation to develop in the face. It is very common during pregnancy and can also be called the ‘pregnancy mask’. This is due to hormonal changes which can alter the rate of melanin production. It an happen in response to taking birth control or hormone replacement as well as during pregnancy. It is more common again in darker skin types or those that tan quickly. Because UV rays from the sun cause it to worsen too, melasma is normally more noticeable in the summer months.
Sensitive skin, dermatitis and rosacea are all very common.
It often affects the cheeks and result in fine vessels also known as telangiectasia and/or redness (erythema). Most of these conditions have a problem with their acid mantle (aka skin barrier) resulting in water loss from the epidermis, inflammation, increased blood vessels and dilated capillaries. The key to management of these conditions is to improve the skin barrier.
The acid mantle or skin barrier is a protective film on the skins surface which is a mix of lipids released from the sebaceous glands, and the amino acids from sweat. Its job is to keep moisture in the skin, and keep bacteria, viruses, pollution and fungus out. The skins ideal pH is around 5.5 (which is acidic). So, anything that alters the pH of the skin can cause issues with the acid mantle. For example, washing with soap causes the skin to become alkaline, as soap is normally a pH of around 9. So, any time your skin is red, dry, sensitive, or having issues with spots or premature aging, it is likely that your acid mantle/skin barrier is damaged.
Stripping the skin by using abrasive scrubs for example, will strip the skin of the normal lipid layer and therefore damage the acid mantle. Skin cleansers with harsh detergents will do the same by making the skin more alkaline. The good bacteria that reside on our skin (called the microbiome) will also be damage and let in other organisms, such as the p.acnes bacteria which can cause spots, or chemicals that may irritate the skin causing eczema.
The simplest way to improve your skin barrier is to use a gentle cleanser that does not have harsh detergents inside, possibly something that has hyaluronic acid, ceramides and probiotics which will hydrate the skin. Some people use glycolic and lactic acids to exfoliate but these may only be used around twice per week for most skins, otherwise they can become too much. It is very important to use a good moisturizer and of course SPF. This combination should have your skin barrier back in good shape within three months unless there is significant damage.
Just with rosacea and sensitive skin, the key with treating psoriasis from an aesthetic perspective is to build the skin barrier.
However, psoriasis is an autoimmune condition, and it is important to have a consultation with a dermatologist if this condition is not improving with GP treatment. There are other options available such as phototherapy and medications which work on your immune system, that can be instigated to help with this. It is especially important to keep and eye on your joints because psoriasis can be linked with psoriatic arthritis. Hands, feet and the lower back are common areas of pain and/or swelling. There is also a greater chance of having cardiovascular and metabolic conditions, so these need to be monitored for with your GP.
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Here at London & Surrey Aesthetics we aim to help you through a journey of discovery about your skin, by discussing what your concerns and expectations are and coming up with a treatment plan designed for you.
We also aim to increase your knowledge about how to look after your skin at home and give you information.