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| Try our spot-on treatments for a healthy complexion |
IF you’re plagued by skin conditions, here are spot-on treatments for a healthy complexion.
Acne
“Acne is characterised by blackheads, whiteheads and cysts and is caused by a combination of overactive grease glands, hormones and bacterial infection,” explains Dr Adam Friedmann, leading dermatologist at The Harley Street Dermatology Clinic. Unlike the T-zone of teenage acne, most adult acne occurs on the cheeks, chin and jawline.
Treatment: “Treatment depends on the severity of the acne,” says Dr Friedmann. The first step is over-the-counter acne treatments containing benzoyl peroxide, a mild bleach that removes the top layer of skin, unblocks pores and has an antiseptic effect on the surface bacteria that cause acne.
Washes and creams containing salicylic acid slow the shedding of cells inside the pores, which cause clogging and pimples. If topical creams don’t work, see your GP about prescription antibiotic gels and creams and discuss taking the Pill – certain types, such as Yasmin, can help with outbreaks.
A low-dose, long course of antibiotics, such as tetracycline, may also be prescribed – and continued for at least eight weeks before improvements can be seen. If acne is severe, ask to be referred to a dermatologist. A drug called isotretinoin can have beneficial effects but because it can also cause side effects, it’s only recommended for severe cases that have not responded to other treatments.
Self-help:
Avoid cleansing cloths, brushes and scrubs as exfoliation will make inflammation worse. Look for the words “non-comedogenic” (non-clogging) on labels when choosing foundation and make-up.
Don’t squeeze pustules. You risk worsening the spot by pushing inflammation deeper into the surrounding tissue and scarring.
Eat healthily: too much sugar, dairy and refined carbohydrates can make acne worse.
Psoriasis
“This is a commonly misunderstood inflammatory skin condition that causes thickening, redness and scaling,” explains Dr Walayat Hussain, consultant dermatologist at Nuffield Health Leeds Hospital.
It can affect the whole body or be localised to areas such as the scalp or fingers and tends to be characterised by remission and flare-ups. A virus or infection such as tonsillitis can trigger the condition in those with a genetic predisposition, as can a stressful event. Alcohol and some heart tablets can aggravate it while, in some cases, it’s associated with arthritis.
Treatment: First-line treatments are topical creams and ointments to moisturise the skin and alleviate dryness, and corticosteroids to reduce inflammation. “Although the older tar-based treatments remain effective, they can be quite smelly and messy,” says Dr Hussain. The newer treatments include vitamin D gels – which slow the over-active build-up of the top layer of skin.
If psoriasis is more severe, ask to be referred to a dermatologist for more treatment options. Many patients benefit from phototherapy, which involves precise doses of ultraviolet light being used on the affected skin to suppress inflammation, explains Dr Friedmann.
It’s available on the NHS (though there’s usually about a 12-week wait) or privately (£100 to £180 for twice-weekly sessions depending on the type of therapy required).
Medication ranges from drugs that reduce the turnover rate of skin cells, through to suppressants of the immune system that vary in strength, says Dr Friedmann. “All have potential side-effects that need to be taken into account.
There are some new biological drugs just being licensed with limited side-effects. A drug called secukinumab has been licensed in the US and is going through trials here in the UK.”
Self-help:
Keeping the skin moisturised is vital.
Being overweight is associated with a higher incidence of psoriasis though it’s unknown why.
Try vitamin D3. Research published in the British Journal Of Dermatology found that vitamin D deficiency is very common in psoriasis sufferers, affecting 80 per cent of patients in winter and 50 per cent in summer. Try Super Strength Vitamin D3, £10.95 for 240 tablets from healthspan.co.uk.
Therapies such as relaxation therapy, mindfulness and Cognitive Behavioural Therapy (CBT) have been shown to improve psoriasis (as well as eczema and acne). This is because stress and anxiety can trigger long-term skin problems and many patients also suffer anxiety or depression because of their condition.
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| Mild rosacea can be effectively treated with an antibiotic gel or cream from your GP |
Eczema
Eczema – or dermatitis – affects up to one in 10 adults, causing patches of dry, red, itchy, scaly skin, explains Dr Hussain. (With chronic, persistent eczema, there may also be thickening or lichenification, scaling and darkening of the skin). “There are three main types of eczema– the most common being atopic eczema,” he explains.
“This has a genetic component and sufferers are generally prone to allergies, such as hay fever and asthma. Irritant eczema is a reaction to something coming into contact with the skin and stripping the natural oils – so it is common in jobs that involve continuous hand-washing, for instance. The third type is allergic contact eczema, such as a reaction to perfume, hair dyes or nickel jewellery.”
Treatment: The principles of treatment are similar for all types of eczema, says Dr Hussain. “Firstly, moisturising the skin is vital. And the greasier and oilier the emollient, the better.
Avoid water-based moisturisers such as aqueous cream – they evaporate off the skin too quickly, drying it further.” Steroid creams are usually prescribed to “calm down” the skin and reduce the inflammation, redness and irritation, he adds. Because of the potential side-effects of prolonged and continuous use of steroid creams, such as thinning of the skin, these should only be used under medical supervision.
(Although you can buy weak steroid creams, such as hydrocortisone over the counter, it’s vital to get a correct diagnosis before self-treating, he stresses). If your eczema can’t be managed by your GP, ask for a referral to a dermatologist for stronger medication or phototherapy (see psoriasis).
Self-help:
Avoid all soap products – they’re too harsh. Check labels on skincare products as paraffin oil and sodium laurel sulphate can also irritate skin.
Keeping a food diary can help you find out if you react to certain foods that could be exacerbating symptoms. For instance, red meat, dairy products, tea and coffee can encourage inflammation.
“Taking therapeutic fish oil supplements supplies the body with a potent source of Omega 3 fats, which means skin is less likely to dry out and be prone to itching and redness,” says nutritionist Dr Sam Christie.
Rosacea
This often misunderstood condition often affects people over 40. Blood vessels in the face expand excessively in response to various triggers, such as sunlight, spicy food, alcohol and stress, causing increased blood flow to the area.
Symptoms range from ruddy-faced flushing to acne-type spots and red, itchy, sore eyes and eyelids. (In rare cases, patients may develop rosacea keratitis – a painful inflammation involving the front part of the eye).
Treatment: Mild rosacea can be effectively treated with an antibiotic gel or cream from your GP. Although there is no infection, topical treatments have an anti-inflammatory effect that works well. Other options include a new gel called brimonidine, which restricts the dilation of blood vessels that causes redness; an anti-inflammatory ointment (azelaic acid) or low doses of an oral antibiotic (tetracycline), which can help reduce inflammation. Laser treatments can be very effective if symptoms persist.
The light energy is converted into heat within the skin, which creates a “pinged by an elastic band” sensation. Some conditions may require several treatments – others get a good result after just one. NHS treatment depends on the severity of your condition and your postcode. (Costs vary dramatically privately – but expect to pay upwards of £300 per session).
Although it’s not known why some people get rosacea, one theory is that sufferers have more bacteria on their skin, including one produced by a mite called Demodex. As a result, some pharmaceutical companies are looking at ways to control the Demodex mite as a way of controlling rosacea.
Self-help:
Use a broad-spectrum sunscreen.
Strenuous exercise can sometimes make symptoms worse. Try low-intensity exercise, such as walking or swimming, rather than running.
Choose products for sensitive skin – usually described as mild, hypoallergenic, fragrance-free and non-comedogenic.
Try camouflage make-up, such as Clinique’s Redness Solutions range.
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