How To Treat Acne with Medical Grade Skincare

June is acne awareness month. Acne can be a tricky skin problem to treat, and can not only present in the teenage years but also in adulthood. In this blog I will talk about what medical grade skincare solutions are available to you here at the Medished. Certain products can help if you have mild/moderate acne, however it's important to say that you have to be committed as achieving skin health can take time. Seeking specialist advice from a dermatologist is important if the acne is severe and if more prescriptive products are needed.

WHAT IS ACNE?

Acne is the occurrence of inflamed or infected oil glands. Hormones can act on the oil glands in the skin to make them bigger thus leading to more oil production and blocking your pores. Bacteria can act on the skin surface and cause deeper seated spots. Acne comes in different forms when it comes to the pimples. The most common types are:

-Whiteheads These are pimples that stay under the surface of the skin.

-Blackheads These pimples rise to the skin’s surface and look black.

-Papules These are small pink bumps that can be tender.

-Pustules These pimples are red at the bottom and have pus on top.

-Nodules These are large, painful, solid pimples that are deep in the skin.

-Cysts These deep, painful, pus-filled pimples can cause scars.

Causes of acne are really unknown, but typically hormonal changes, heredity, the start and stop of medications, including birth control, diet, makeup, and use of products that clog pores are known factors. Triggers can vary from one person to the next. Diet can also play a part so possibly reducing your diary and sugar from your diet can be helpful.

For females acne can be more pronounced around the time of your period , first trimester of pregnancy, and also around the time of menopause. When it comes to skincare and acne I would advise certain key ingredients some of which below that can help in the fight against acne, so let's explore this further.

When a patient presents to me initially once we have gone through lifestyle issues, I tend to advice a simple regime to start with. Like all skincare protocols it all starts with cleansing.

Double cleansing is super important as first cleanse will remove makeup and second a cleanse will clean the pores.

Depending on level of acne this kit pictured below by Obagi is great for mild/moderate acne. Its gentle yet effective ingredients make it perfect for teens and adults alike. Unlike other acne treatment regimens, the CLENZIderm M.D. System will never over-dry. Instead, skin is left balanced and hydrated as blemishes heal and fade.

CLENZIDERM M.D. SYSTEM BY OBAGI MEDICAL

So what are the 3 products in this kit?

A) Obagi CLENZIderm M.D. Daily Care Foaming Cleanser

This product contains 2% salicylic acid. This oil soluble compound penetrates deep into your pores, gently washing away and removing dead skin cells, as well as restoring the skin’s natural oils. Targeting blackheads and whiteheads as well as acne, the cleanser also contains soothing menthol that cools and calms any skin irritation. Overall your skin will be left feeling cleaner, clearer and healthier.

B) Obagi CLENZIderm M.D. Pore Therapy

Working with a similar mechanism of action to the Daily Foaming Cleanser, this therapy cleans deep within the pores to clear skin with the aid of salicylic acid. By unclogging the pores and cleaning away dead skin cells, this product not only builds upon the cleansing action of the cleanser. I always advise patients to start with one daily application to ensure your skin does not become too dry.

C) Obagi CLENZIderm M.D. Therapeutic Lotion

This product is specially formulated with 5% benzoyl peroxide, which works its way deep down into the follicles beneath the skin where acne begins targeting the bacteria such as P.acnes.

VITAMIN A (RETINOIDS/RETINOL) PRODUCTS AND ACNE

Retinoids/Retinols are also essential in acne treatment since they treat acne by unclogging pores. They also work to normalise skin cell turnover and act as an anti-inflammatory. The most important side effect of Vitamin A products is an increased sensitivity to UV rays that can lead to sun damage . It's vital when using a retinoid to be vigilant about using sunscreen and my favourite mineral SPF's are pictured below.

The Oxygen Infusion Wash by SkinBetter Science is also an option with mild acne as it contains AHA'S. It great for normal to oily skin. I advise use 3/4 times a week as acids shouldn't be used too often as we need to guard the lipid barrier of the skin. A gentle cleanser can be used on other days.

Many patients will also have occasional breakouts, for which a milder protocol can be advised. One favourite product that I love is the Complexion Renewal Pads shown below by ZO Skin Health. They are moistened facial pads containing salicylic acid that help minimise surface oil while removing pore-clogging dead skin cells and dirt to leave the skin feeling clean and refreshed.

MANDELIC ACID is an antibacterial, it's really helpful in treating existing acne and preventing future breakouts. It's also oil-soluble, so it penetrates the skin's surface and helps to regulate sebum production by keeping pores clear of clogging oils and dead skin cells that lead to breakouts and oily skin.

AZELAIC ACID is a chemical exfoliator. Exfoliating is a way of removing acne blockages that have already formed within your hair follicles, such as whiteheads and blackheads. It is also a way of removing trapped skin cells, oil, cosmetics and other follicle-blocking substances from your skin, reducing your risk of developing acne in the future.

NIACINAMIDE (VITAMIN B3) and ZINC are also must-have for battling breakouts. The Ordinary’s Niacinamide 10% + Zinc 1% (great price tag!) regulates sebum production to minimise pores and reduce blemish-causing bacteria, keeping your complexion clear, calm and collected. Niacinamide boosts the skin’s immunity and improves moisture retention, while a brilliant shot of zinc works to repair damaged skin and promote the creation of collagen.

ESSENTIAL FATTY ACIDS in Omega 3 fish oil benefit skin by soothing your body’s inflammatory response to excess sebum and bacteria, they can also tackle the root of the problem by helping to regulate acne-causing hormones, such as testosterone and androgen.

HYDRATION

A good moisturiser is also essential for when treating acne as the oil levels are not a marker of the hydration levels. It has to be non comedogenic and a personal favourite is the Obagi hydrate pictured below.

I also advise patients use oil-free makeup, and not to use a vitamin C serum if acne is active. Finally acne treatments are also available to help. They can be medical micro-needling with SkinPen, medical grade facials, LED light treatments, and bespoke chemical peels, such as the Blue Peel Radiance by Obagi done in clinic.

Regimes are tailor-made for each patient so its really important to take advise as you may only need two or three products to help you achieve healthier skin! Hope you found this useful,

Lots of love

Dil x

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