Dr Sam on Pigmentation, Melasma and Acne Scarring

I met up again with Dr Sam recently where we discussed pigmentation, melasma and acne scarring. All those fun things. :)

Enjoy! :)

Confused skin: what do you treat first? And with what product?

Only a very select few have what would be termed 'normal skin'. Which is why I find it odd it is called 'normal'. It's far from the norm for most people!

For the rest of us, there are multiple issues to contend with. Pigmentation, dry, oily, combination, sensitive, rosacea, dehydrated - you name it, you probably have at least one of them. 

But what if you have more than one? What if you have 3 of them? FOUR of them?

It would not be uncommon to see a dehydrated, hyper-pigmented, sensitive, ageing skin with hormonal breakouts. Dr Leslie Baumann wrote about her 16 skin types years ago - and she was spot on, although I think there's more than that..

What do you do in that situation? 

You treat by the potential your issue has to cause pain and/or long-lasting damage such as scarring or broken capillaries.

For that reason, the first thing you do is take care of the sensitivity/rosacea. Inflammation will exacerbate the rest of your issues. For example, if you had rosacea and acne, and used a foaming traditional acne 'wash', your cheeks would scream at you. That's not good. That's not what you need or want for your face.

Sensitivity is King. Best product choice: moisturiser for sensitivity.

Followed by Dehydration. A dehydrated skin drinks anything you put on it, but you have to do it repeatedly. Your anti-ageing serums end up just filling a gap in your skin rather than actually doing their job. 

If you are dehydrated, which 95% of us are, you need to treat the dehydration. You can leave the house in the morning with a perfectly hydrated, bouncy face and be dehydrated to the point of it showing on facial machinery by mid-morning. No matter what you do, what you use, how old you are, and your lifestyle, you can be dehydrated just by waking up. 

Dehydration is Queen. Best product choice: the toning phase - both acid and spritz and serum. Acid on cotton pads to gently strip it back and spritzes and hyaluronic acid serums to follow. Neither of these two products should irritate any of the other issues....

Then you can start to be more general. 

As long as you are keeping your redness under control and your skin hydrated you can tackle anything. But the best product choices for these skin types/conditions are, for the most part...

Dry - facial oils and oil in products including balm cleansers - no foam, ever. Dryness frequently crosses issues with dehydration - if you're both, treat both simultaneously and if you are unsure which you are read this: Cheat Sheet - Dry or Dehydrated

Ageing - targeted serums - think *retinoids* and peptides

Pigmented - dedicated serums for pigmentation and retinoids and SPF (not suggesting you don't use SPF normally, it's just the priority if you scar easily, get sun spots etc)

Oily - acid toners and essences are great as are the right moisturiser. Don't over-embrace oil-free and foaming. 

Acne - acid toning phase is key, as is your moisturiser. Please, please think carefully about how you will go about replenishing the oils in your skin if you use an oil-free moisturiser. If you want to try and keep your oil under control by mid-afternoon, use an oil-free moisturiser if you want to - but use a facial oil dedicated for acne/combination underneath it. I promise a drop or two can make all the difference. We're ahead of the game now, the market has plenty. The old 'foam wash, strip tone, oil-free moisturiser' routine is dead and buried. Or should be.

And finally, a special mention to the sufferers of melasma - or chloasma as it may be called by your midwife if you're pregnant. Melasma and pigmentation are different things. Pigmentation, for example, can be caused by sun damage, acne scarring, picking spots or inflammation and can normally be treated with topical products - glycolic, kojic and azaleic acids, retinoids, and licorice for example with some success.

Your best product choices would be peels, targeted serums containing those ingredients and SPF.

And if you still get no joy, go to a dermatologist before you spend any more cash and see if it isn't in fact...

Melasma can be triggered by those things but is also linked to hormones (hence the link to pregnancy, the pill and peri-menopausal women), illnesses, such as Addison's Disease, Lupus and Celiac disease among many others. Female sufferers outnumber male 9 to 1.

It's basically your melanocytes throwing their toys out of the pram by doing this:

Instead of behaving politely like this:

Something that Into the Gloss managed to misinform its readers of last week by recommending $300 serums to treat melasma:

Sali*, a melasma sufferer, tried to get them to talk about it/correct the piece, to no avail.

You best product recommendation for melasma is time, a laser and sun block. I had mild melasma with pregnancy, it eventually cleared up on its own. Some people aren't that lucky.

Yes, peels (clinical) can help, but if you want it gone, it's a laser. And the bad news is that even if you stay out of the sun and wear a complete sunblock, it will probably come back, because your melanocytes hate you that's what it does. Please make sure you know what you have before you part with your hard-earned cash. 

*I obviously asked Sali's permission to post these screen-grabs and mention her melasma and I refer to the ITG article purely because it led to questions from readers for both Sali and I.
www.salihughesbeauty.com

pepta-bright from indeed laboratories - Review

My love affair with Hydraluron (Hironsluron) is well known. Well, Indeed Labs have done it again.

This is one of those products that you don't know you need until you use it and then can't bear to be without it. I wanted to use it for a few weeks to test the claims of fading scarring and pigmentation.

Let me say this from the off: if you are young, have bouncy fabulous skin and no pigmentation or uneven skin tone - you won't love it like I love it. Because bitch you may not need it. (You will still see the benefits - but they won't be as WHOA as someone my age.)

If, however, you have a face that shows you're 30+ and have lived a good life (ahem), worship the sun enjoy sunbathing, have suffered with adult acne and the resulting scarring - any of the above really - then you could do a lot worse than to check this out.

Presented as an 'Intense Brightening Treatment' it claims to do the following (with my subtle comments next to them):

1. Even skin tone - YES
2. Reduce and lighten pigmentation - YES
3. Prevent, treat and diminish dark spots - YES
4. Restore luminosity and radiance - OHMYGOD YES
5. Prevent photoaging - WHO KNOWS?
6. Stimulate cell turnover - TOO EARLY TO TELL
7. Maintain skin's hydration - YEP, USE LESS HYDRALURON AS A RESULT

In short, for me - its all about No. 2 - My acne scars are fading - and No.4 - as soon as you put this on your face it looks like someone has used QVC's soft-lighting-reserved-especially-for-you-know-who to make you look awake, alive and glowing.

What's impressive is what is left out of the formulation. 

It does not contain any:

• bismmuth oxychloride - the ingredient most commonly used to give 'radiance' in eyeshadows/eye creams - also one of the most common allergens and the reason I can't use Bare Minerals.
• hydroquinone - banned in the EU but still widely available in a lot of high-end brands - naughty
• kojic acid - like hydroquinone - skin bleach
• mercury - d'uh - its mercury
• parabens - I don't actually mind about parabens - a lot of fuss about nothing that now has a myth attached to it. Parabens don't give you cancer. Chillax.

Now a part of my staple skincare wardrobe - if you look at pictures of yourself when you were 20 and say 'GOD I look so YOUNG' - this is for you.

pepta-bright is available from Boots for £29.99 - and is at the time of posting on 3 for 2. *sits on bank card*

Sidebar: I use it AM and PM religiously. Its a commitment people. Keep it up.

* PR sample

The lovely Dr Tom Mammone from Clinique

Dr Tom Mammone. Executive Director of Skin Physiology and Pharmacology

Clinique Research & Development, Worldwide

So here is the blog post that almost never was. The charming Dr Tom very kindly gave me this interview back in May. Yes, May. He even went as far to give me a telephone interview when I couldn't make it to our planned meeting. Then I put the notes carefully away - so as not to lose them - and well, lost them. The shame. I thought Ava had taken my lovely notebook to school (she's a stationary addict just like her Mother). She swore blind she hadn't, making me feel even worse.

I was then of course, too mortified to say 'Oh HI Kim! Thank you for arranging for me to speak to the Doc personally. Oh yes - I lost my notes. My bad. Ask him again would you?' No. Can't do that. The SHAME.

And then - THEN - I was looking for my passport - checked the 'safe family keepsake spot for all things important', and found my notebook, sitting there, complete with all my notes and questions in the margin. FINALLY.

So, here, without further ado and with my hugest apologies to the lovely Clinique team - especially Kim - who it turns out, has the patience of a Saint, are Dr Tom Mammone's Top Tips for good skin and good ingredients.

I asked the Dr why he thought that cases of adult acne and concerns about pigmentation are on the increase? He mentioned that he had recently had the same conversation with Dr David Orentreich, Clinique's guiding dermatologist. 

'We think they are in relation to the growing cases of adult allergies - such as shellfish, which sensitise the skin. We are also seeing a lot of acne breakouts around the mouth and chin which we are beginning to link to increased usage of oral products. 10/20/30 years ago - this was just not an issue. Its a relatively new concern.' 

I love it when I can relate to what someone is saying and recognise it to be true. Readers of the blog will know that I myself developed both adult acne and a shellfish allergy around my 40th birthday. It's not nice. The increase in adult acne and the readiness of GP's to offer antibiotics out like sweets is one of the reasons, I think, for an increase in pigmentation problems - and I asked Dr Tom for his top pigmentation fighting ingredients.

1. Vitamin C Ester
   (reads Ascorbyl palmitate on inci lists) -
   A stable form of Vitamin C, it works in both the prevention and cure aspects - it recharges Vitamin E within the skin, aiding antioxidant support by helping your body boost glutathione levels in the skin - glutathione is called 'The Mother of all Antioxidants' (and for good reason).
2. Dianella Ensifolia (lilacea) - This forms part of Clinique’s patent-pending CL-302 complex, which features five synergistic brightening ingredients and is a tyronaise inhibitor. It is the most powerful inhibitor of pigment synthesis we have ever seen.
3. Yeast and mushroom extracts -
   These are proven to break down melanin in the skin and are a key part of our Even Better range.

I also took the opportunity to ask Dr Tom for his most annoying beauty myth. What really gets under his skin?

'You know, when I am at dinner parties and people talk about what they do for a living - I am always asked 'Oh come on, those beauty products, do they really work??' - of course they work. You just need to find the right products containing the right ingredients for your skin!'

And finally I asked for his No.1 tip for good skin.

'People need to treat their skin like they do their body. If you want it to be in good shape you have to work at it - its a commitment!'  (<---THIS!)

Thank you to Dr Mammone for taking the time to talk to me! And look out for Clinique Even Better in my 2012 Awards.