Prescriptive Skin Care

Pigmentation

The colour of our skin is made of three components – melanin, collagen, and vasculature (blood vessels). The yellow in skin tone is imparted by collagen, and the pink shades by the vasculature. Most pigmentary disorders, however, are associated with excess melanin. Melanin is a brown pigment produced in the skin by special cells called melanocytes. Under the influence of sunlight (UV) and hormonal factors, melanin levels can become uneven across the skin, resulting in blotchiness, brown spots, and more seriously, cancer.

Cosmetically, the most common pigmentary presentations are melasma and Diffuse Sun-related Hyperpigmentation (DSH). Melasma is a condition which usually occurs in younger women, and is influenced by both solar radiation and hormones. DSH is seen more in women over the age of 30, and presents as large slightly ash-brown areas that appear obvious in strong light and gives the forehead a dull, lifeless appearance. Melasma and DSH are caused by skin pigment cells (melanocytes) producing excess pigment (melanin).

Treatment of both these conditions involves:

1. Melanin inhibitors (compounds that prevent the melanocytes producing melanin)
2. Sunscreens (used 365 days of the year)
3. Time (treatment usually takes 6-12 months)

The strongest melanin-inhibiting ingredients are prescription-only products. These include lightening agents such as hydroquinone and retinoic acid

At night, regular use of a vitamin A helps to inhibit pigmentation, by blocking pigment-stimulating enzymes.

Sunscreens are vital in the prevention of pigmentation, because solar radiation is essential in initiating pigmentary changes.

Other intensive short-term therapy courses may also be recommended by your doctor or clinician to fast-track the reduction of your pigmentation. Options include Vitamin A peels, prescription-only retinoic acid/hydroquinone creams, chemical peels, IPL (Intense Pulsed Light), and other laser modalities.

Dry Rough Skin

Dry, rough skin is usually caused by a lack of exfoliation and inadequate moisturisation. A buildup of dead skin cells on the surface causes a rough, dry “sandpapery” feel. As we age, the enzyme that causes these cells to shed becomes less active, slowing down the natural rate of exfoliation. The most effective treatment is nightly exfoliation with an alpha + beta hydroxy acid gel to speed up cell turnover rate and a moisturiser enriched with Natural Moisturising Factors and Intercellular Lipids to increase skin hydration. The synergistic effects of using these ingredients to treat dryness include:

1. Activation of enzymes that cause rough, dry surface cells to be shed, revealing smoother, softer skin underneath
2. Binding of moisture in the upper stratum corneum to keep your skin well hydrated
3. More even reflection of light, which makes your skin appear smooth and firm
4. Supplementation of skin surface lipids which helps protect it from irritation

Sometimes, dry rough skin can be a symptom of dermatitis, especially if accompanied by inflammation. Your doctor will be able to identify whether your dry, rough skin is dermatitis or not

Oily Shine

Oily shine is caused by excessive output of sebum (oil) in areas with abundant oil glands. Oily shine usually appears around mid morning and gets worse throughout the day. In hot, humid weather, the sebum “floats” on a layer of perspiration, making oily shine more pronounced.

Topical niacinamide (Vitamin B3) is a key step in regulating excessive oil flow. Niacinamide has been shown to regulate the output of sebum, normalising oil production and diminishing shine. Use of alpha and beta hydroxy acids and retinaldehyde will also help normalise skin function and reduce sebum output.

Myth Buster

It’s a common belief that moisturisers are an essential step in any skincare routine. In fact, moisturisers are not suitable for everyone. People with naturally oily skin should actually avoid moisturisers, as these products are designed to supplement the skin’s lipid (oil) layer, something you don’t need when your skin is already oily!

If you have “combination skin”, apply moisturiser only to the areas where you are genuinely dry, and avoid the areas that are prone to oiliness.



Serving patients in Bournemouth, Poole, Weymouth, Dorchester, Salisbury, Winchester, Southampton and Portsmouth and Harley Street London.

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