Simple Tips On Targeting Rosacea Effectively

Hello and welcome! I'm going to talk about the skin condition Rosacea which seems to be a current common complaint with many patients and what can be done to to limit flare ups and achieve skin health. I will cover what medical grade skin products are available via the Medished and how they can be used. I will also touch on light therapy can can be incorporated at home to help ...so lets get started!

WHAT IS ROSACEA?

Let me first address what rosacea actually is... well It’s a chronic inflammatory skin condition that causes the breakdown of collagen. There are different levels of the condition however anyone with moderate/severe levels should seek a dermatologist referral via their GP. It tends to affect women more than men, and is more common in fair skin people, however that’s not to say that it doesn’t affect darker skin types. It makes the skin feel hot, tender, sensitive and irritated, and unfortunately there are lots of factors that contribute.

Actually targeting rosacea is a multifactorial process. The triggers can be sun, temperature extremes, spicy food, alcohol, stress, hot baths, blood pressure medication, oral topical steroids and alongside these triggers patients tend to be using INAPPROPRIATE skincare.

Rosacea is complex and chronic, caused by an impaired barrier function, gut imbalances, dysregulation of the immune system, micro-organisms in the skin and environmental triggers. Let me explore a couple of those. Those ‘micro-organisms’ are demodex mites, which live on many adults’ skin, feeding off oily sebum. When the skin changes due to age, stress or illness, the population of the mites increases. When they die, these mites release bacteria into the skin, which trigger an immune reaction, hence redness and inflammation of the skin. UV light triggers ROS-reactive oxidative species which deplete collagen. In my opinion patient education is key to tackling rosacea..and patients need to be aware of the triggers!

WHAT IS A HEALTHY SKIN BARRIER FUNCTION?

Patients with rosacea tend to have a compromised skin barrier. The role of the skin barrier is to keep water in and irritants out...in other words it prevents the penetration of harmful substances and excessive transepidermal water loss. Its key for skinhealth and its a physical, immunological and chemical barrier.

OBAGI and SKINBETTER SCIENCE SKINCARE

When patients arrive to see me at The Medished they tend to arrive with a bag of products that they have had a poor experience with. Once we've discussed lifestyle factors I generally tend to strip back all their products back and pop them on a simple protocol like the one pictured below by Obagi and then gradually introduce actives into their regime after 2/4 weeks.

Obagi Gentle Cleanser contains glycerin, oat amino acids and aloe gel, Obagi Hydrate contains hydromanil, shea, mango butter, avocado and glycerine. Obagi Sun Shield Matte 50 contains zinc oxide 10.5%, octinoxate 7.5% and homosalate 10%. I always recommend mineral SPF's for anyone with sensitive skins, as they reflect the UV rays like a mirror rather than absorb sunlight and dispense it as heat.

Finding an SPF that patients are happy with can be tricky..My TOP TIP is mineral SPF's only and knowing whats works best for you is my job!

THE RETINOL LADDER

After 2/4weeks I tend to try to introduce a VitaminA product. I'm always there to guide patients and be accessible to them so as to gain compliance. I generally advice a retinol ladder..that means starting on a low percentage and introducing retinol gradually into their skin care routine. Products of choice may be the 0.5% retinol by Obagi or the seriously great AlphaRet by SkinBetter Science.

HOW ABOUT A TOPICAL ANTIOXIDANT?

Patients with rosacea can struggle with vitamin C serum so it’s important to know which products to use.. here at the Medished by initial product of choice is the Alto Defense Serum by SkinBetter Science which an awesome antioxidant that can be used twice a day and is clinically proven to reduce the appearance of redness in the skin.

Once a patients skin is used to this protocol we can even try the 10% Vitamin C serum by Obagi!

BEST PRODUCTS FROM THE ZOSKINHEALTH RANGE

Now these protocols discussed above are not set in stone and depending on the skin type and history of sensitivity or rosacea I may use products from the ZO SkinHealth range. I would generally pop my patients on a redness or sensitised protocol. Its so important to consult a medical grade skincare specialist as only then will you be guided by the huge product choice available.

Key products from this range would a Gentle Cleanser and Calming Toner to help cleanse and normalise the PH of the skin. One of my absolute hero products Daily Power Defense contains time-released retinol, antioxidants and specialised DNA-repairing enzymes which work around the clock to help minimise UV oxidative damage and uneven pigmentation. It also helps to restore skin function and elasticity while stimulating collagen production to help diminish fine lines and wrinkles. Its a fantastic product for treating rosacea!

Another brilliant product is Rozatrol which is a daily treatment serum for rosacea featuring a breakthrough combination of ingredients. Rozatrol is clinically proven to minimize visible skin symptoms including red, sensitized skin, facial flushing, and visible blood vessels.

Finally a mineral SPF is essential and my favourite from this range is the Sunscreen and Primer SPF 30 which doubles up as a makeup primer and SPF in one ! whats not to love!

This is just a snapshot of what products we can use however consulting appropriately is key to success.

Aside from avoiding triggers, traditional medicine has often turned to antibiotics and topical agents, such a mild alpha-hydroxy acid peels. Products with azaelic acid, have also helped some people. So to summarise medical grade skincare is pivotal due to achieving a healthy barrier function in combination with prescriptive products if needed.

LIGHT THERAPY AT HOME

More recently light therapy has become an excellent adjunct treatment for rosacea, and it definitely offers promising results! My favourite is the LightStim which is a handheld device with a combination of red, infrared, and blue LED lights, developed specifically to reduce the appearance of rosacea. LED (light emiting diode) lights works to treat skin conditions by producing energy that is effective at reducing inflammation and targeting bacteria. For example, both red and infrared light lessens inflammation and redness, while blue light helps kill acne causing bacteria. So in my opinion light therapy is an increasingly recommended treatment , not just for rosacea, but for acne and anti-aging as well!

Well I hope all that helps anyone who is currently struggling with their skin in lockdown due to stress, lifestyle issues and too much sun.. you ever need any more advice you know where to find me! or just send me a message:)

Lots of love

Dil x

Skincare Secrets From The Medished!

Not one to sit idle during lockdown, even when I'm not able to see patients face to face, I've been focusing on delivering video consultations for skincare regimes. I've always been an

advocate of medical grade skincare, the sort that you can't just buy online (or, in our former lives, in shops) but which need to be prescribed by a practitioner who will supervise its use.

So I spoke to Alice Hart-Davis, award winning beauty journalist and author of aesthetics bible, the 'The Tweakments Guide' about the brands I recommend (Obagi Medical, ZO Skin Health and SkinBetter Science) and how I choose between them for patients, what percentage of say, Vitamin C you should look for in a product (it all depends....). How starting out with Retinol doesn't have to be a terrifying experience and why sun screen is the essential foundation of any skincare regime.

Check out our instalive! enjoy!

I look forward to seeing you all back in The Medished before too long!

Lots of love, Dil x

Dr Dil's Top Tips about The Skinbetterscience Skincare Range At The Medished!

I've had Skinbetterscience medical grade skin care at the Medished for nearly 2 years now and have been really impressed with the results and feedback from my patients.

I'm only writing about them now as here at the Medished I believe waiting to see REAL results so I can ethically and confidently recommend skincare products to my patients.

Before taking on a new skincare line it's really important to me to make sure that the claims the products make are backed by science and with decades of research this brand certainly has that. Skinbetterscience products are heavily researched, formulated and packaged to deliver remarkable and an uncomplicated approach to skincare!

Skinbetter science products are also fantastic for daily maintenance after an Obagi Nuderm or C-RX skin transformation system. These great products can be prescribed to you after a thorough consultation and analysis of your skin (currently only online). So lets dive in and discuss the fantastic products I available here at the Medished!

Their flagship groundbreaking collection "Rejuvenate" is supported by their Protect,Transform and Refresh collections. I will now discuss some of my favourites with you!

1) ALPHARET OVERNIGHT CREAM

Now this is a new groundbreaking product that does something no other product on the market does.It combines alpha hydroxy acids with a retinoid (vitaminA) to make a new molecule that is an ideal combination for skin rejuvenation with little to no irritation! Hence NO downtime! Alpharet improves your skin tone, texture, lines and wrinkles and is intended for use at night ensuring that daily SPF is being used in the day. This product is perfect for those patients that may have struggled with retinol/retinoid use due to the downtime that can sometimes be associated.

2) ALTO DEFENSE SERUM

This product is a scientifically advanced, award winning antioxidant serum. By combining Vitamin C and 18 additional antioxidant ingredients this product helps to provide daily protection and improvement of uneven tone and texture of the skin.

This product is perfect for those patients that may suffer from redness and may have struggled with other medical grade vitamin-C serums.

Key antioxidants include Acai, Turmeric, Cocoa, Grape Seed Extract, Mediterranean Olive Extract, Superoxide Dismutase, Green Tea, Coffee, Saffron, Ergothioneine, Chlorogenic Acid, Carnosine, Buddleja Officinalis Flower Extract. Whats not to love!

This product can come as a set with the Alpharet and is called the A-Team duo..a multi-award winning combination for skin rejuvenation. The A-team Duo is perfect for patients who want a change to their night time regime but with maximum benefits.

3) EVEN TONE CORRECTING SERUM

This is another ground breaking product by Skinbetterscience which is a non-retinol, non-hydroquinone multi-action skin tone corrector. It's fantastic for patients who don't want to use hydroquinone for hyperpigmentation correction. The serum is designed to be used twice daily. It reduces the appearance of lines and wrinkles achieving a beautiful even looking complexion after regular use.

The serum can come as part of the 'skin rejuvenating kit' which also contains the Oxygen Infusion Wash and Alpharet Overnight Cream. All three products work amazingly well together to give you that glow! It's a particular favourite of mine for those patients who I feel need a break from hydroquinone based products.

4) OXYGEN INFUSION WASH

This is a personal favourite of mine..a multi-tasking cleanser with slow releasing AHAs and an infusion of oxygen to purify and refresh the skin. It's perfect for Normal to oily skin and I always advise patients to ease it into their skincare regime as initially it can cause some irritation. Once established it becomes a permanent fixture in their regime. I use it daily and love it!

5) INTERFUSE TREATMENT CREAM EYE

At the heart of this comprehensive eye cream is the patented InterFuse technology, delivering skincare ingredients faster and deeper. It’s fantastic for Crow’s feet, wrinkles, puffiness and under-eye darkness. A neuro-calming peptide relaxes the appearance of crow’s feet almost immediately and Vitamin C provides antioxidant and skin brightening benefits. I use it am/pm and it's a winner in my eyes!

The skinbetter scientific approach represents a revolutionary change in the skincare market, establishing a new standard in professional skincare. So there you go..just some of my favourite products from the Skinbetterscience range.

Just as a final note its important to remember is that all my patients will need a regular review of their skincare regimes and this can be done over facetime for convenience and social distancing rules. What not to love ..It's time to upgrade your skin!

With love Dr Dil x