Skincare

There’s been quite an advance in the formulations of so-called active ingredients in our skincare products in recent years, and the marketing suggests that they can produce impressive results at the deeper skin layers, possibly to the point of circumventing the need for skincare that works with (or at) the more superficial layers. Unfortunately, this is leading to confusion: should you ditch old-style products? Which products do you ditch? Or should you just add in new-style products as extra steps? But then, what order do you put them all on in? You can see that the risk easily arises of ever more complicated skincare routines, and all too often we see patients in our clinic whose skin is congested and overloaded with too many products, causing a problem in itself.

So we thought you might like this little blog series, which makes an attempt to sift through some of the science, the pseudo-science and the downright purloining of scientific words in order to simply sell products.

Our aim is to help you to keep your skincare routine simple yet effective, and in each section we’ve included a note about products in our own SW range as well as products from other ranges that we stock. However, this isn’t a sales plug! We know our products aren’t the only effective ones out there and once you understand what is likely to work for you (as well as what is unlikely to work for anyone!), you might prefer to do your own skincare shopping.

So, with all that in mind, we’ll start at the obvious beginning...

Cleanse

A gentle, creamy cleanser that easily removes make-up, dirt, oil and micro-organisms, and and then rinses off may well be all you need. It is ideal for problem-free, well-functioning skin and is also the best option for sore, sensitive conditions because this type of cleanser will produce minimal disruption of the protective skin barrier. However, the inclusion of a mild acid in your cleanser, such as glycolic acid (an alpha hydroxy acid) or salicylic acid (a beta hydroxy acid) or even a combination, might be beneficial. Glycolic is particularly good for exfoliating, whilst salicylic has been shown to refine the skin texture by diminishing pore size, so both acne-prone and dull skin can benefit. Hydroxy acids break the bonds between the surface skin cells, allowing them to be easily rinsed away, exposing younger, fresher skin cells and stimulating cell renewal. Irritation is unlikely because the cleanser is rinsed away almost immediately, but it is still wise to ramp up your initial use slowly to minimise this risk. We’ve found that even well-conditioned, well-functioning skin may benefit from such a cleanser once or twice a week, to keep it in radiant condition. It’s fair to say, though, that exfoliating becomes less important as you get older, and we explain why later.

Our SW range offers two such cleansers (£35): a mild creamy cleanser with calming properties, and a foaming wash for acne-prone or dull skin, containing both glycolic and salicylic acid

Exfoliate

Despite cleansing with an exfoliating cleanser, you may find that you need an additional exfoliation step two or three times a week. Oily skin prone to break-outs in particular benefits from extra exfoliation. We would recommend using a gentle solution of the hydroxy acids described above and we offer exfoliating pads by Skinbetter (£88) that do exactly that. Since you don’t rinse the solution off, start gradually, because the risk of irritation is higher.

<<Insert image: SB Exfoliator>>

Tone

What can we say? Ditch the toner! Toners are at best unnecessary and even possibly damaging: they usually don’t do what they often say they do (such as “tighten pores”), they can be too harsh and astringent, stripping the skin of its natural oils and disrupting the skin barrier in the process, and other products have taken over the job far more effectively (such as glycolic acid in a cleanser, as we’ve described). You can safely remove any toner from your skincare routine without any ill-effect.

Moisturise

Moisturising advice is currently conflicted and likely to become even more confusing in the near future because recent research has shown that, although a moisturiser can improve skin tone in the short term, there is a lack of evidence to show that it provides any long-term anti-ageing benefit. This means that some of the advice out there is to ditch the moisturiser in favour of other products that may penetrate deeper and therefore be more beneficial. But is that the right thing for you to do?

Let’s get back to some skin basics for a minute. As skin ages, the surface cell-to-cell adhesion declines, which allows for greater moisture loss from the upper layers of skin and also contributes to a breakdown in barrier function. Think dry, flaky, itchy skin. This is why older skin has less of a need for exfoliation, and it also means that you are more likely to need help from your skincare routine to do two things as you get older: first, help replenish the lost moisture within the skin; and second, to help restore and support the barrier function of the skin so that you trap that moisture in it. This essentially boils down to two components: an aqueous component to provide the moisture, and a lipid, emollient component to support the barrier in preventing further moisture loss.

Old-style moisturisers traditionally only accomplished the second function, an emollient sitting on the top of the skin as a physical barrier. And it is these that seem to provide no long-term anti-ageing benefit. They can also cause problems clogging pores and congesting the skin. Before you ditch your moisturiser, though, it is worth bearing in mind that some skin, especially older or compromised skin, benefits from having an extra emollient layer after other products have been applied. After all, dry, flaky skin isn’t going to help your skin look its best!

Hydrate

Hydrators, products that increase the moisture content of the skin, have started to gain traction in the skincare market now. These products have been shown to be associated with anti-ageing benefits, so they are most definitely worthy of a place in your skincare routine. First of all, you might already be using a hydrator without realising because there is now a bit of a confusing overlap with moisturisers. Sometimes it is just a naming issue - skincare companies don’t want to lose their old moisturiser market, so refer to these new products as moisturisers. Other companies have added a hydrating element to their moisturisers so that they both hydrate the deeper layers, and support the skin barrier.

So how do hydrators work? Fundamentally they increase the moisture content in the deeper layers of the epidermis by using skincare ingredients that attract water. The most commonly used ingredient in a hydrator is hyaluronic acid (HA). Found naturally in the skin, although in ever-decreasing amounts as we age, HA is a humectant, which means that it attracts and holds on to water, helping to provide a more youthful, dewy complexion as a result. When applied to the surface of the skin, it holds water and cross links into polymers, helping to support the barrier function, preventing moisture loss. It’s what babies’ skin have lots of!

We offer a range of hydrators (some with moisturising properties) from both the SW and Skinbetter ranges, including SW H2O (£45),Skinbetter Trio and Profhilo Haenkium (£60). Our aesthetic nurses have a wealth of skincare expertise and can provide advice on the most appropriate one for your skin.

SPF

SPF strength still tends to be marketed in terms of protection power from UVB rays, which are the rays responsible for burning the skin. However, when it comes to protecting skin, UVA rays also need to be considered, as they are directly responsible for the sun’s ageing effect (think B for burning, A for ageing). UVA exposure results in hyperpigmentation, inflammation and accelerated loss of both collagen and elastin. These give skin its support and elasticity, so the eventual upshot is deep lines and wrinkles. Make sure your SPF is broad-spectrum with an SPF of at least 30, providing protection against both UVA and UVB rays, and find one that suits your skin so that you use it every day.

In terms of texture and appearance, SPF creams have come a long way in recent years; the days when a facial SPF50 looked like paint emulsion have long gone. In fact, many of our patients find that a high-quality SPF cream over their hydrator provides the right amount of emollient, too, but if your skin still feels uncomfortably dry or tight, then you may benefit from a hydrator with additional moisturising properties. Of course, for your evening routine, SPF isn’t required so a hydrator with moisturising properties may be beneficial at this time anyway.