Cleansing Your Way To Great Skin

Cleansing Your SkinWhatever your skin type, cleansing is the key to healthy, clear skin. It really is the cornerstone of a skincare routine, but can be rather neglected. Research from the “International Dermal Institute” shows that most people spend less than 20 seconds cleansing their skin, this isn’t thorough enough to remove all the pollutants, oil and make-up that if not properly removed can sit on the surface and cause blackheads and undersurface congestion.

I always recommend to cleanse in the morning – this will remove any overnight sebum production and leave your skin fresh and ready for your moisturiser. It is essential to cleanse at the end of the day as well and for this I recommend a “Double Cleanse” – the reason for this is the first cleanse will remove all the environmental pollutants, grime, oil, make-up and sunscreen. The second cleanse that you perform will actually cleanse your skin and your pores. If you skimp on this and traces of either the above or any cleanser is left on the skin, then you may experience some lumps and bumps underneath the skin and more blackheads than usual with a dull appearance.

A great Product to start your first cleanse is Dermalogica PreCleanse, this is a lightweight oil made from Olive and Apricot Kernal Oil and fortified with Kukui, Borage and Rice Bran Oil. It is a Hydrophillic (water loving) and once it has liquified sebum and oil based debris on your skin, it rinses clean away without residue and the essential oils give it a fresh lemon smell. The reason oil based cleansers work so well is that oil attracts oil, whilst oil repels water – making this an excellent cleansing medium that leaves your skin ready and receptive for its second skin type specific cleanser. Please note, not all oil cleansers are equal and some will not rinse away, PreCleanse has been specially formulated to go milky when in contact with water and rinse clean away, Olive oil on its own will  not do the same!

PH Balanced Cleansers

The PH of your cleanser is very important as our skin is naturally acidic at around 4.5 – 5.5 on the PH scale. This helps keep our skin protected from bacteria. A PH balanced cleanser will not strip the skin and leave it feeling comfortable and calm instead of tight and itchy. Soap is out of the question as it is far too alkaline and will strip the skin’s natural protective barrier and leave it tight and uncomfortable, the skin will often compensate if it can by pumping out more sebum leaving you slick and shiny. All Dermalogica Cleansers are PH balanced as are my other brands.

I have tested the PH of some other well known so called simple cleansing products, and was very surprised to find that some have the same PH as CIF cleaning product – which was very alkaline. You can buy a PH testing kit and try some of your own skincare products, some of the results may shock you!

How To Apply Cleanser

Regardless of the formulation, massage your cleanser onto the face and neck in small circular movements, work around the nooks of your nose and spend at least a few minutes of massaging in/or foaming up, this is a great time to give your skin a circulation boosting massage. Either rinse away with warm water or remove with a damp muslin cloth, I like these as they are have a slightly exfoliating action and feel great against your skin.

Which Cleanser is Right For You?

This obviously depends on your skin type and condition, but it also comes down to personal preference. Some people will not feel clean unless they use something that foams up, although oils and lotions are excellent cleansers it does come down to what you like to use. I always feel that good products whether they foam or not should be rinsable and leave skin feeling comfortable. You may need to tweak your cleanser with the seasons and as you age – I switch to a creamier cleanser in the winter time as my skin is a lot less oilier than summer.

Going to bed with your make-up on is one of the worst things you can do to your skin! (even if it is a mineral make-up) Please try, even if you may have had one glass of wine too many, to manage one cleanse, it is better than none.

If you need some advice on what cleanser will suit you, please ask as I am happy to advise.

The Management of Oily Skin

Oily skin produces excessive amounts of Sebum (the opposite of dry skin), which is produced from your sebaceous glands. Sebum is a lipid rich protective substance that helps form the skin barrier. Sebum is made up of – Squalene, Sterols, Wax Esters, Sterol Esters, Triglycerides – these are the most abundant.

The reason that the sebaceous glands are over active is down to Testosterone. This hormone is secreted by the male sexual organs, and in women it comes from the ovaries and adrenal glands.

In excess the sebum makes skin look shiny and have open pores and tends to be easily congested – make-up doesn’t seem to stay on that well. Oily skin is genetic and you cannot stop the excess oil, but their are many products and lifestyle choices that can control it. Eventually as you get older and go through hormonal changes your oil secretion should calm down.

I have a genetically oily skin type that I have inherited from my mum (thanks mum!) Oily skin tends to age better than a dry skin – as long as you protect against the sun and don’t smoke etc. Although my skin is very oily, I only experience breakouts before my period, but I have to be careful to avoid Pore Clogging Ingredients (Comedogenic) as my skin gets clogged very easily. Don’t forget Oily skin can still get dehydrated, as it can lose water in the upper layers.

Oily Skin And Acne

So even if your skin is oily, it is not the direct cause of Acne, you would have a genetic predisposition to Acne, or hormone imbalance is triggered by stress and can cause a low grade persistent Acne.

Free flowing sebum is not a problem in regards to acne, It is the sebum that is not released, that builds up and gets inflamed, that results in acne breakouts.

 What is Combination Skin?

Identifying your skin type is made even more difficult by the “term” Combination Skin. Strictly speaking it is not a true skin type, but almost everyone at some time has combination skin. I tend to go with the majority rules theory – if your skin is mostly oily – then you have an oily skin type, If your skin is mostly dry – then you have a dry skin type. It is the formulation of the product that is important, cream or lotion, water or oil based.

Physiologically, the nose, chin, center of forehead, and the center of cheeks all have more oil glands than other parts of the face. Problems occur when you buy products for oily skin that are not appropriate for the areas that are not oily, or vice-versa. You may need separate products to deal with the different skin conditions on your face.


Tips For Oily Skin

  • Avoid Harsh stripping of the skin – products with Alcohol will actually cause your skin to pump out more Sebum, to make up for what has been lost!
  • Avoid baking your face in the sun! while it may seem to temporary dry your skin out – the sebaceous glands will go into overdrive to replace the lost oil! not to mention the Sun Damage!
  • High Humidity will make your skin feel even oilier! you need a scrupulous skin-care routine, and avoid pore clogging ingredients.

Don’t give up, it is a manageable skin type and a blessing in disguise! Here are my skin-care must haves for oily skin.

  • Scrupulous double cleansing that breaks down oils and stubborn make-up, so your second cleanse can actually clean your skin and pores – I like Dermalogica Precleanse  for the first cleanse
  • Use a clay based or a foaming cleanser to thoroughly cleanse your skin, Dermalogica Dermal Clay Cleanser or Dermalogica Special Cleansing gel are very effective.
  • Exfoliation can help control oil production, improve skin texture and help prevent clogged pores that lead to spots. Salicylic Acid is an effective ingredient to look for in exfoliants or other products for oily skin, as it can actually get inside the follicle and break down sebum. I like Dermalogica Gentle Cream Exfoliant or Dermalogica Daily Resurfacer.
  • Once or twice a week, apply a deep cleansing clay based mask to help control sebum and clean pores. Try Dermalogica Sebum Clearing Masque or Dermalogica Skin Refining Masque.
  • Even if you think your skin doesn’t need it, apply a light moisturiser like Dermalogica Oil Control Lotion, Dermalogica Active Moist or Crystal Clear No Shine Serum, even oily skin gets dehydrated.
  • For make up, go for oil free formulations, I love Dermalogica Treatment Foundation and Mineralogie Matte Finishing Powder
  • Sunscreen formulations have improved so much as they used to feel too greasy and clog the skin. I like Dermalogica Oil Free Matte Block SPF25 and Mineralogie Face And Body Block SPF30, a unique mineral powder you just dust over skin.

Skin Treatments for Oily Skin

  • By receiving a regular facial every 4 – 6 weeks, you can keep your skin clear and healthy. Professional extractions and exfoliation will help with the ongoing skin concerns of an oily skin, and also tackle any other concerns you may have with your skin.

The Sun and Smart Protection

The skin is a wonderful record keeper! every time you expose your skin to daylight, your skin adds up all those times like money in the bank! – the trouble is eventually the payoff catches up with you!, in the form of premature ageing, wrinkles and hyper-pigmentation and the risk of skin cancers.

This world wide issue reinforces that the best defence is to limit daylight exposure and protect the skin with sunscreen at all times.

The Electromagnetic Spectrum

Sunlight is comprised of different wavelengths of electromagnetic radiation. About 35% of the spectrum is called visible light, with 60% of infra-red range (felt as heat) and 5% is made up of ultraviolet (UV) rays. It is this whole UV range that we must concern ourselves with.

How UV light is absorbed in your skin

How deep do the UV rays penetrate your skin?
UVC radiation is potentially the most damaging as it is very energetic, fortunately for us UVC is absorbed by oxygen and ozone in the stratosphere and never reaches the earth’s surface, if it did we wouldn’t exist!

UVA rays are the longest rays in the spectrum, and they penetrate deeper into the skin. UVA rays are responsible for causing the damage at a cellular level, making them responsible for most skin cancers and the main cause of the signs of ageing in the form of wrinkles and discolouration. UVA is present all year round, even in wintertime!, 80-90 % of the ageing we see on our skin is down to environmental factors.

UVB rays are shorter than UVA rays, and cause the burn or tan effect in the skin. Both UVA and UVB rays can cause cancer, so wearing a broad spectrum sunscreen with antioxidants is absolutely essential!

Damage to the Epidermis

The skin’s response to the sun can be seen initially as erythema (redness of the skin). This is a result of the inflammatory response and dilation of the blood vessels in the dermis. This is due to the cell damage and the repair process.

Erythema generally appears two to six hours after you’ve exposed your skin. The redder your skin gets the more damage you’ve inflicted on your skin.

UVB rays are the most effective at generating erythema, that is why they are often referred to as the burning rays.

The sun and daylight also increase:

  • Cell proliferation and thickening of the stratum corneum
  • Dehydration as the lack of moisture in the stratum corneum leads to gaps in the skin’s barrier, leaking moisture and causing skin to flake.
  • Sun exposure decreases the skin’s Hyaluronic acid content which can lead to a lack of volume in the skin.
  • Hyper or Hypo pigmentation can also result.
  • Following the initial erethema or sunburn, the skin responds by producing Melanin, which gives the tan appearance. Your tan is a sign of skin damage.

Collagen Breakdown and changes to Elastin

In the dermis, UV radiation causes Collagen to breakdown at a higher rate than with just chronological ageing. Sunlight damages collagen fibres and causes the accumulation of abnormal elastin. When this sun induced elastin accumulates, enzymes called Matrix Metalloproteinase’s are produced in large quantities.

Changes in the Dermal Blood Vessels

UV radiation causes the walls of blood vessels to become thinner leading to minor trauma in sun-exposed areas. Venous lakes can result on the lips and broken capillaries on the face and chest area.

Free Radicals generated

UV radiation is one of the major creators of Free Radicals. Always make sure the sun protection you have chosen contains Antioxidants in its formulation, they greatly enhance the protection against sun damage.
DNA Repair Inhibited

UV radiation affects the repair of damaged DNA. UVB is thought to cause the damage and UVA inhibits the repair process. So it is a double hit on the repair ability of the DNA in our cells.

Immune System Affected

The body has a defence system to attack developing cancer cells. These immune system factors include white blood cells, the T Lymphocytes and specialised skin cells called Langherhan cells. When the skin is exposed to sunlight, certain chemicals are released that suppress these immune cells and UVB is known to destroy Langerhan cells. An SPF 15 is proven to protect the Langherhan cells, that is why it is always recommended as a minimum.

Cell Death Prevention

The last line of defence of the immune system is a process called Apoptosis. Apoptosis is a process of cell suicide that kills severely damaged cells so they cannot become cancerous. This cell suicide is seen when you peel after a sunburn. There are certain factors, including UV exposure, that prevent this cell death allowing cells to continue to divide and possibly become cancerous.

The Carcinogenic Effects

The carcinogenic effect of ultraviolet exposure may be diagnosed as various forms of skin cancer. Skin cancer begins in cells, the building blocks that make up the skin. Normally, skin cells grow and divide to form new cells. Every day skin cells grow old and die, and new cells take their place.

Sometimes this orderly process goes wrong. New cells form when the skin does not need them and old cells do not die when they should. The DNA is also effected and these extra cells form a mass of tissue called a growth or tumour. Growth or tumours can be benign or malignant. If you notice any suspicious lesion or skin disorder, you should immediately seek a doctors attention for a diagnosis.

Checking Moles

Melanomas start from moles so it’s a good idea to check for any changes in your moles. Any mole that bleeds, changes its size, shape, colour, texture or sensation should be checked out by a doctor.

Smart Sun Sense and Prevention
The best way to prevent skin cancer and sun damage is to protect skin from the daylight and direct sun. UV radiation can penetrate through light clothing, windshields, windows and clouds. Also, protecting children from an early age is so important, as most of the damage is done when we are young. Sunscreens can be used on babies over the age of six months. keep the following in mind:

  • Avoid the midday sun
  • There is as much UVA in the winter as in the summer
  • One burn doubles your risk of melanoma
  • Protect from UV reflection from sand, water, snow and ice – 90% bounces back
  • Give yourself a yearly examination for skin cancer and changes in moles

Tomatoes could be the key to sun care!
Lycopene is being added to the list of antioxidants that could potentially protect skin suffering substantial sun damage. Lycopene is found in tomatoes and other red fruits. Its concentration is particularly high in cooked tomatoes and tomato paste. In a small, controlled study carried out by Newcastle and Manchester Universities, women were given 55g of tomato paste each day (to eat) for 12 weeks. The skin protection against sunburn increased by 30% in the women. So combined with topical UVA and UVB protection it could offer greater benefits for your skin while in the sun.

How SPF’s Work

The SPF represents the ability of a sunscreen to delay sun-induced burning or erythema. It is important to realise that an SPF is only a measure of how much UVB protection provides. Unfortunately, a similar system of denoting sunscreen protection for UVA radiation has not been universally recognised. Always look for broad spectrum sun products.

sunbathing-fi-600x300Sunscreens work by two mechanisms:

Chemical Sunscreens – Absorb UV rays, lowering the energy level and releasing energy as heat. This type needs to be applied to the skin before any other product, and normally 20 minutes before sun exposure.
Physical Sunscreens – Reflect or scatter the energy rays. They are mineral based so therefore less irritating. They need to be applied last as they bounce the rays off the skin. You will also find physical sunscreens in mineral make-up, which is normally SPF 20-26, depending on brand.
It is important to understand that, even though you may be using a sunscreen, some UVB rays will still penetrate through your skin, you cannot filter out 100% of the sun’s rays.

For example – SPF 2 products protects your skin from 50% of the UVB rays, so you can stay in the sun twice as long as you would be able to without protection. So you may burn after 5 minutes without protection, once this SPF is applied you could stay out for 10 minutes without burning. (this is just an example as this SPF is far too low)

SPF 8 blocks 87.5 % of UVB rays.

SPF 15 blocks 93.33 % of UVB and some UVA rays.

SPF 30 blocks 96.6 % of UVB and some UVA rays.

SPF 60 blocks 97.98 of UVB and some UVA rays.

While it may seem that a product with an SPF 50 or higher would offer a full percentage rate of protection, it is mostly comprised of an increased level of chemicals, which can cause a higher rate of irritation in skin. Also look out for fragrance in sunscreens as these would be photo-toxic and can give you a reaction or pigmentation problems.

If you have a sunscreen sensitivity then look for mineral based products which contain Titanium Dioxide and Zinc Oxide, and can have an anti-inflammatory effect on damaged skin.

Application of Sunscreen
Most importantly, when you use a sunscreen, make sure you apply an adequate amount to ensure you are getting the desired SPF. That’s generally about one teaspoon for the face and about on eighth of a cup for complete body coverage. Unless you are using a waterproof formulation, reapply sunscreen whenever you swim, exercise or sweat profusely. The national cancer society recommends re-application every 2 hours.

Vitamin D Production

Known as the sunshine vitamin, this nutrient is essential for healthy bones and is produced in the body when exposed to sunlight, it is also found in oily fish, fish liver oils, egg yolks and margarine. Most people should be able to get all the vitamin D they need from their diet and by getting a little sun, I know this may seem a bit ironic, but a little sun is good for us, just be careful!

If you are lacking in vitamin D for a long time then your bones may soften. In serious cases this leads to rickets in children and osteomalacia in adults.

By enjoying the sun sensibly, it is possible to make enough vitamin D while not increasing your risk of skin cancer and premature ageing. The amount of time you need in the sun to make enough vitamin D varies from person to person, it depends on things like skin type, time of day and year, and where you are in the world.

The amount of time needed to make enough vitamin D is always less than the high amounts that cause tanning or sunburn. You don’t need to spend hours in the sun to feel the benefits of sunlight. In fact extra time in the sun doesn’t mean you keep on producing more vitamin D. When your body has a healthy level of the vitamin, the excess is broken down. From October to March our skin cannot make vitamin D as there is a low level of UVB in winter sunlight. Fortunately, health benefits of vitamin D do not need to be traded off for skin protection. You can get adequate amounts from your diet/supplements. Cod Liver Oil seems to contain the highest units of vitamin D.

Say NO to Sunbeds!!

While it is true that UV radiation of most sun beds do not cause erythema (redness) – although I have known very fair skinned people to burn – there is still damage being caused at a cellular level, and for some individuals this can lead to melanomas and skin cancer. Sun beds are definitely not safer than the sun! Beware of the coin operated sun beds, they may be quite old and you have no way of knowing if the tubes have been changed.

UVA is the primary wavelength used in sun bed because it causes the tanning reaction without the burning reaction of UVB. The long term effects on your skin will be premature ageing and pigmentation, I like to think of them as “Time Machines” as they definitely accelerate the ageing process – forward in time! making your skin look 10 – 15 years older.

Try some of the excellent Self Tanning products on the market instead, you will thank yourself for it later! I like Fake Bake and Liz Earle’s Face Self Tan Spritz, they don’t clog my pores and look very natural.

Topical Sun Care Products
As consumers we are demanding more from sunscreen products and has fuelled research into new technology in sunscreen ingredients. New types of dispersions of Titanium Dioxide and Zinc Oxide allow the formulation of products that no longer require the use of iron oxides to overcome the intense whiteness of these physical sunscreens. In addition, improvements to chemical sunscreens have enabled formulas that have a more elegant feel and texture to them. Sunscreen products can finally be made more like skin care products, that accommodate different skin types.

Antioxidants in Sun Care are Essential

On the research front, scientists have discovered ways to enhance sun protection for skin without the use of additional sunscreens. These studies indicate that when antioxidants (vitamins C and E) are formulated with sunscreen agents, protection against both UV-induced sunburn and free radicals in the epidermis and dermis is enhanced, but these vitamins need to be in a stable form to actually provide an antioxidant effect.

Dermalogica’s Daylight Defence System with UV Smart Booster Technology

These are very effective sun care products that provide enhanced photo protection by incorporating antioxidants into the product via a unique Smart Booster Technology, a customised micro-capsule technology that safe guards active vitamins, then releases them upon contact with UV rays (anytime the skin is exposed to daylight) for maximum free radical protection. All products in this range are broad spectrum and protect against UVA and UVB rays. You can also choose sun care for specific skin type – oily, dry and sensitive, as they have different formulations.

If you are actually going to sun bathe, then you do need specific sun care products as above, not a tinted moisturiser or your make-up with SPF, these are OK for every day wear if you are out of the sun, but you cannot rely on them for proper sun protection.

Product Recommendations for every day protection:

Skin Sensitivity – A Sore Subject

Dermalogica Soothing Protection SpraySkin Sensitivity: Genetic or Environmental?

No other skin is as misunderstood and hard to diagnose as Sensitive skin. In fact, most of us would have had some skin sensitivity at some point in our lives.

A true Sensitive skin is caused by a genetic predisposition , mostly affecting very light/fair skinned individuals and usually of Northern European ancestry. The reason for this could be the lower amount of pigment and a thinner epidermal layer (the top layer of skin). Someone with a truly sensitive skin may experience – blushing, has a very fine complexion and may experience hay fever or asthma and other allergies.

What most people actually suffer from is Sensitized skin, which can affect any person of any racial background or skin colour. Rather than a result of your genetic heritage, sensitized skin is a reflection of your environment and lifestyle. Stress, pollution, hormonal imbalance, harsh cosmetic products, alcohol, a poor diet and over-exfoliation can all make your skin sensitized and feel irritated!. The hormonal imbalance can affect us around our periods or menopause and you may find that products you are normally fine with will cause stinging and irritation.

The symptoms for sensitive and sensitized are both quite similar, itching, burning, redness and stinging, and you need to apply the “Less is more” philosophy to your skin care routine, the less ingredients you apply then the less to irritate! But let’s get one thing straight – anyone can be allergic to anything! so looking for Hypo-allergenic products will be no fail-safe guarantee that you won’t react!

The Epidemic of Over Exfoliation

Over exfoliation triggers the inflammatory response, leading to a compromised lipid barrier that won’t protect your skin or function as it should, this could even lead to premature ageing. There are far too many micro-dermabrasion kits out there, tempting people to scrub and polish the protective barrier away! Don’t get me wrong – exfoliation has its place in skin care, but we must make sure we are using the right exfoliant for our skin’s requirements.

Some of the signs of over exfoliation are: noticeable dryness, patchy areas of dryness, skin tautness, redness and itchiness, stinging, inflammatory acne and irritation.

Maintaining your Skin’s Barrier

Maintaining this is vital, so always remember to apply moisturiser and barrier enhancing products. Sunscreen is critical because sensitized skin is even more vulnerable to UV damage, go for the chemical free sunblocks that contain Zinc Oxide, Antioxidants and Anti-Inflammatories.

A few lifestyle changes can usually solve your skin sensitization, and the right product choices will make a difference, you may find products with fairly active ingredients may sting or tingle as your barrier is letting more into your skin.

Your diet can also help your skin’s barrier, by providing your body with the right nutritional oils to manufacture the lipid barrier, your will definitely strengthen your skin from the inside, I love Viridian Organic Beauty Oil.

Smoking is no good for anyone, but for the sensitive skin it’s going to make matters worse: you will inhibit your body’s ability to provide oxygen and nutrients (vital moisture) to the skin. Excess alcohol and certain medications can also contribute to dry skin, leaving skin feeling more sensitive. Also avoid trigger factors such as spicy foods, hot drinks and caffeine, and help your skin to recover and rebuild itself.

Product Recommendations

Obviously you don’t need all these products, as less is more with a Sensitive skin type, so cherry pick the ones you feel you would use or request some samples!

Acne: The Facts

Acne is triggered by hormones and can occur in virtually anyone at almost any stage of his or her life. Acne not only disfigures the face and body but can also leave profound, permanent scars on your self-esteem and confidence.

What is Acne ?

Acne is often described as a disease involving the sebaceous follicles and hair follicles of the skin. It occurs in people who have a genetic predisposition. If acne runs in families of both parents, three out of four children may suffer from it.

Sebaceous and hair follicles are associated with a sebaceous gland that produces sebum, a complex mixture of lipids. In the hair follicle, the hair acts as a wick, transporting sebum and other cellular debris to the surface of the skin, where it is ultimately removed. Inflammation of infection is rarely associated with this type of follicle, unless the hair becomes ingrown or the opening of the follicle becomes clogged.

The sebaceous follicle, usually lacking a hair or containing only a fine hair, is generally associated with acne. Activity of the sebaceous gland is stimulated by many factors, including the onset of puberty, hormonal fluctuations, pharmaceutical agents, stress, using inappropriate products, heat, friction and humidity.

To understand the physical changes that cause acne, it is important to understand the microscopic processes that produce it. Our skin has pores, referred to as follicles by dermatologists. A follicle is not a hair, it could either contain a hair or be empty, like a tube extending from the surface of the skin (epidermis) down into the dermis.

This deeper layer of skin, the dermis, is made up of collagen and elastin, which gives the skin bounce and support, it also provides a home for blood vessels, other cells and nerves. Underneath the dermis is a layer of fat that cushions and insulates the skin and contributes to a youthful face. The follicle (pore) starts in the dermis as a tube, from this tube branch glands that look like a cluster of grapes. These are your sebaceous glands that produce an oil substance called sebum.

The Four Main Factors that contribute to Acne

  • Over active sebaceous glands
  • Cell accumulation (retention hyperkeratosis)
  • Bacteria
  • Inflammation

The reason that the sebaceous glands are over active is down to Testosterone. This hormone is secreted by the male sexual organs, and in women it originates from the ovaries and adrenal glands. In both sexes testosterone is released into the body and enters into the sebaceous gland where an enzyme – 5-alpha reductase, converts the testosterone into di-hydrotestosterone, this stimulates sebum production. 5-alpha reductase is sensitive to hormone levels and goes into overdrive when testosterone levels get high. This is noticeable during puberty and results in teenage acne. The excess oil on the skin acts as a binder and when acne is present an accumulation of cells occurs at the neck of the follicle and sticks to the sebum, creating the perfect breeding ground for bacteria (propionibacterium acnes). At this point the result may be closed comedones (white heads) and open comedones (blackheads).

The Grades Of Acne

Scientists use a grading system to categorize the various stages of acne lesions.

Grade 1– Comprises of open and closed comedones (whiteheads and blackheads), the t-zone may be a little oily.

Grade 2 – Mainly open and some closed comdedones and papules, with some pustules. Comedones and pustules located only in the oilier areas of the face. (easily aggravated by comedogenic substances)

Grade 3 – Papules and Pustules present throughout the t-zone and cheeks, with open comedones. Scarring is likely.

Grade 4– The nodule, a large painful solid lesion extending deep into the skin, accompanied by visible inflammation and redness. Macules (flattened crusted lesion) These are the types of lesions found in hormonal mediated acne and found around the lower face in women, there is a lack of comedones.

Grade 5– The cyst – an inflamed, pus filled lesion extending deep into the skin. This occurs when several nodules merge resulting in a giant lesion, when the grading of acne becomes higher, there are fewer comedones to be found.

Comedogenic Substances

The term “Comedogenic”means to clog pores, and a comedone is a blackhead or whitehead. Comedogenic substances in cosmetics are a major cause of congestion related skin problems. If the application of a cosmetic that contains comedogenic ingredients is applied regularly and left on, e.g. foundation, moisturiser – then problems can occur. These problems appear as closed or open comedones, this can feel like lots of lumps and bumps under the skin and can be known as “Cosmetic Acne”and is purely caused by using products with comedogenic ingredients that are inappropriate for your skin type. Lots of mainstream cosmetic companies (even very expensive brands!) put pore clogging ingredients into their products, they do this because generally they are cheap ingredients or can serve a purpose in the formulation.

Just because an ingredient or product is “Comedogenic”, doesn’t mean that everyone who uses it will automatically develop acne or clogged pores. If your skin gets clogged easily then you are at more risk from using those ingredients. Here are the main ones to look out for:

  • Isopropyl Myristate, Myristyl Myristate
  • Lanolin
  • Cocoa Butter
  • Flax Oil
  • Octyl Palmitate, Octyl Stearate
  • Linseed Oil
  • D & C Red and Orange colours
  • Isostearyl Alcohol
  • Mink Oil
  • Peanut Oil
  • Palmitic Acid
  • Mineral Oil– A Petroleum by product, there are mixed reviews of Mineral oil, in theory cosmetic grade scores a 0 on the comedogenic list, as it doesn’t actually penetrate into the follicle, it just sits on the surface of the skin. This coating the skin may cause problems for some people as the skin cannot excrete and function, so congestion can build up in the skin. (I personally do not like it, and will not use it as it does cause me congestion)

As you can see there are many ingredients that can cause and exacerbate acne, so look closely at your cosmetic formulations for these substances. Be aware that even if you are using products that have no comedogenic ingredients in them, if they are too rich a formula for your skin, then they can ultimately cause some congestion.

Less common but certainly about, is a type of acne called “Acne of Toxic Origin”. This type of acne can occur from both the side effects of medications (antibiotics, cortisone and tranquilisers), occupational causes, and self-infliction. Establishing the cause is the secret and simply removing the cause can improve the skin dramatically.

Other Factors That Will Influence and cause Acne

  • Birth control pills may affect the skin and you may see a change in the amount of breakouts
  • Medicines containing bromides and diodides, as found in cold remedies, can cause breakouts
  • Barbiturates and amphetamines can cause acne type lesions
  • If you have a predisposition to acne it is wise to screen your vitamins for Kelp, seaweed or straight iodine (potassium iodide) and eliminate from your diet (avoid Shellfish)
  • Steroids can be a cause of breakouts
  • Stress influences and aggravates acne breakouts, so often you think this is major stress, when it is in fact simply just “being uptight”
  • Menstruation, pregnancy and menopause, all of these can cause skin problems including acne
  • Harsh drying substances and over exfoliation
  • High humidity can trigger breakouts
  • UV radiation, contrary to what many acne sufferers believe, the sun actually makes matters worse, this is due to the inflammatory effect that happens within the skin
  • Food sensitivities, dairy can often cause skin problems in some people

Antiobiotic Resistant Acne

Antibiotics are commonly prescribed by GP’s to help treat acne by attempting to reduce the levels of P acnes bacteria. The resulting reduction in bacteria will consequently result in the decrease of the inflammation. As this approach only treats the symptoms, and not the true cause of the condition, it can have a limited affect. Unfortunately, the use of antibiotics to treat minor grades of acne can lead to the development of antibiotic resistance.

Like many bacteria that have been over treated with antibiotics, the P acnes have developed many strains and a resistance to on or more common antibiotics. Also some antibiotics can cause sensitivity to UV light, so sunscreen is vital.

Adult Acne

Post – adolescent acne is on the rise, more people are suffering from the challenges of oily and acneic skin conditions. It is normally in the age group of 20-40 that are diagnosed with a low grade, persistent acne. Acne arising in adulthood is more likely to be inflammatory with fewer comedones that teenage acne, and with lesions located around the mouth, chin and jaw line. It is definitely more challenging to treat, as adults can often have sensitised skin, or a combination of skin conditions in addition to acne and concerns about ageing!

The primary factor leading to adult acne is chronic stress, we all know temporary stress can cause a breakout from time to time, but chronic, continuous stress increases hormone levels, which leads to an increase in oil production. This is frustrating for many people an causes additional emotional stress, which in turn can trigger more breakouts!

The need to “squeeze” and “pick” breakouts opens the skin up to more acne-causing bacteria, and you normally end up with more spots around the area you have picked! You also increase the development of scars and trauma induced pigmentation. I know it’s hard to resist, but they will heal quicker when you leave them alone.

Nutrition For Acne

Antioxidant Fruit and VegetablesDoes what you eat make a difference ? This is a controversial subject and many dermatologists have different opinions. The prevailing wisdom is that the foods we eat have no effect on the systemic disease of acne. What you eat may not be a direct cause of your acne, but plain common sense tells us that you cannot eat lots of sugar and pro-inflammatory foods without effecting your skin, it is after all the largest organ of the body! We must nourish it from within as well as treating it topically (the skin is always last to get its ration of nutrients, the vital organs get them first).

The best advice I can give is to ensure you have an all round healthy diet, which includes plenty of antioxidant rich vegetables, whole grains, proteins (in the form of fish, lean meat, soya and beans and lentils), this is a great anti-inflammatory diet (low G.I) and you will benefit on many levels.

The Sugar Connection

While many people say that giving up chocolate doesn’t cure acne, most people find that we feel better all round when we give up sugary refined foods and drinks. There is a link between people with acne and the way they do not transfer sugar into their cells properly. All sugar is pro-inflammatory and by reducing the amount of inflammation in your body can only have positive benefits on your acne. I know it isn’t easy but try to cut down on sugary foods and drinks, including sweets, chocolate, fizzy drinks and any added sugar. Let food be your medicine!

Recommended reading – The acne prescription by Nicholas Perricone MD.


As well as improving your diet there are certain supplements that are worth considering in the treatment of acne. Given that some of the most drastic medical treatments for acne involve Vitamin A, it makes sense to include some in your diet. You will get adequate amounts in your multivitamin formula, too much is toxic so don’t go over the recommended daily allowance.

Healthy skin also requires a good supply of Zinc, a mineral that is essential to all aspects of our health. Some dermatologists recommend up to 100 milligrams of zinc supplements a day for the treatment of acne. However, these higher doses may result in nausea, vomiting and stomach pain. Pregnant women and nursing mothers should not take zinc in higher doses than 15 milligrams per day to avoid causing harm to the foetus. As always I strongly recommend you seek advice from your doctor before taking any dietary or supplement programme.

Vitmain A and Acne

Vitamin A acne treatment was introduced in the early 1970’s. Also known asRetin-A,Tretinoin or Retinoic Acid, this is the acidic form of Vitamin A – (retinoids), when applied topically it normalizes the skin cells and increases exfoliation at a cellular level. This has a positive effect on the skin but can also be very irritating in some people, the skin can get very red and inflamed from the treatment and is not for everyone. Seek advice from a dermatologist as these products are prescription only.


The breakthroughs achieved by using topical vitamin A acid also led to another oral therapy, this one made from a compound belonging to the same retinoid class as Retin-A. This is known asAccutane and when taken for approximately 4-6 months, has been proven to be an extremely effective treatment for a severe form of acne, know as cystic or nodular acne. Accutane is a prescription medication and has a number of possible side effects that are similar to those resulting from large doses of vitamin A. Among Accutane’s potential side effects are dry, peeling skin, inability to see in the dark and inflamed liver. There is also a link between taking Accutane and mental depression and suicide. If your doctor prescribes Accutane, consider increasing your intake of essential fatty acids, as a common side effect is severe dry skin, lips and nasal passages. Try Udo’s Choice Essential Oil Blend , it has the perfect ration of 3.6.9 fatty acids.

Acne and Ageing Skin

Acne is a chronic inflammatory disease, and spends a significant amount of time being inflamed. Inflammation is a well known accelerator of ageing, and can create free radicals that break down the skins structural components like Collagen and Elastin etc, which can contribute to an aged appearance. Treating your acne, at least to the degree of markedly reducing the number of inflamed lesions, is going to be the best anti-ageing step you could make apart from sun protection.

How you treat your acne may have a major impact on the ageing of your skin. As a general rule, any treatment that causes irritation and/or excessive dryness should be used cautiously. The use of Vitamin A at sufficiently low doses to avoid skin irritation will get both anti-acne and anti-ageing benefits. Vitamin A is still the most effective anti-ageing ingredient that you can use on your skin.

Excercise and Acne

Gymnastics pilatesAs you can see eliminating Acne and controlling it is a multi layered task! and we must treat the whole body, not just the symptom. We all know that moderate exercise is a vital part of a healthy lifestyle, this is especially true for the acne patient, but moderation is key. Acne is unique and the exercise that is good for people without acne, can spell disaster for those with acne. For example weight lifting: regardless of gender, this type of exercise makes the body more susceptible to acne breakouts. The reason is simple – weight lifting and weight training increases levels of male hormones, such as testosterone, and male hormones can contribute to acne.

I would definitely recommend some form of Yoga or Pilates, you can achieve a fit, toned and flexible body as well as clear radiant skin at any age.

Yoga and Pilates will:

  • Exercise and tone the body
  • Energizes and soothes the mind
  • Increases blood circulation and lymph flow
  • Helps you achieve a deeply relaxed state – stress reduction

Because acne is aggravated by stress, yoga will help induce relaxation, focus your breathing and ultimately lower stress levels.

Topical Products For Acne

There are many advances in ingredient technology for acne, we need ingredients that ultimately stop the cascade of events leading to acne development. We must regulate the sebaceous glands, promote exfoliation, kill bacteria and calm inflammation.

Fighting Acne

Cleansing – make sure you perform a double cleanse in the evening, this will remove make-up and sunscreens and other debris before you do your second cleanse, which will ultimately cleanse your skin and pores. If not done properly, poor cleansing can result in breakout and clogged pores. ALWAYS take your make-up off before you sleep!!! Use an acid balanced cleanser and avoid soap, it is far too alkaline and will strip your skin’s barrier, making it pump out more oil and letting bacteria in.

Exfoliate– Acneic skin produces five times more dead skin cells than other skin, this means that proper exfoliation can give great results for acne. Hydroxy acids will be effective, as they help cells detach and prevent dead skin cells from clogging the follicle. 1% -2% Salicylic acid is effective in a product formulation, this is a Beta Hydroxy Acid, this is better at exfoliating inside the follicle. (if you are allergic to Aspirin avoid BHA’S, try Alpha Hydroxy Acids instead, like Lactic Acid or Glycolic Acid) Sulphur and Papain are also useful ingredients, avoid physical scrubs with grains in them, they will only aggravate and inflame your skin.

Oil Control– this is one of the trickiest skin care problems, you can’t stop it by applying products, but we can control it and help absorb it. Harsh products will only make you feel oilier, so avoid those at all costs. Once or twice a week use a non irritating caly mask, to help absorb sebum and deep cleanse. Milk of Magnesia is also a great facial mask, it is nothing more that magnesium hydroxide, which does a fine job of absorbing oil.

Bacteria Control – the following are good at controlling bacteria: Benzoyl Peroxide, this is the most effective over the counter choice, as it can penetrate the follicle to reach acne causing bacteria, it can be drying though. Salicylic Acid, Tea Tree Oil, Suphur, Zinc Gluconate, Triclosan – this has had a bit of bad press lately, but it is very effective, it is also in toothpaste – that is why dabbing it on spots can be effective, however the peppermint can be irritating and inflammatory.

The Jan Marini Skincare Management System contains some of these key ingredient and the products actually work!

Key Tips For Acne

  • Avoid comedogenic ingredients in all your products, 75% of skincare products make acne worse.
  • Keep your skin barrier intact, do not over-exfoliate, too much exfoliation is worse than none.
  • Try to eat a low Glycaemic load diet
  • Make sure you are hydrated with enough water
  • Avoid barrier stripping ingredients like – Acetone, SD Alcohol, Isopropyl Alcohol and menthol, irritation will cause inflammation.
  • Use lukewarm water to wash in- not hot or extreme cold.
  • Change your pillowcase regularly
  • Clean the handsets of your phones to reduce bacteria
  • Try NOT to pick and squeeze your spots, they will only get worse. If you do, do not squeeze until they bleed! and apply a good anti-bacterial product afterwards
  • If you have no success with over the counter products, seek advice from a dermatologist about a topical retinoid – like Differin Gel
  • Don’t forget to wear a sunscreen!!, you will be more prone to sun-damage due to the hydroxy acids and some anti-biotics make your skin sun sensitive. There are good oil free choices available from Dermalogica
  • Some anti-androgen contraceptive pills work wonders for acne, however everyone is different and it can be trial and error and your acne may get worse temporarily

Other treatments that have been useful for some people are IPL Laser Therapy, and some Light Therapies with blue and red lights, seek advice from a dermatologist or medical skin clinic.

As you can see acne is a complex skin condition and what works for other people may not work for you, results are not instant and you may never cure your acne but can control it. By following some of these guidelines hopefully you will have a better understanding of Acne and how to treat it, and not let it rule your life!