Perfect skin is all too often an illusive dream. We inherit some imperfections, and then there’s the issue of problem skin.
Acne, pigmentation and eczema can severely dent our confidence. Here’s a battle plan for those tricky spots:
ACNE
What is it?
Acne is a common inflammatory disorder of the sebaceous glands — and includes blackheads (comedones), whiteheads (milia), pustules and inflammatory cysts. Trapped oil from these glands clogs the pores and creates small infections.
Around five percent of women still have acne between the ages of 25–40; and with today’s fast-paced lifestyle, stress levels, hormonal imbalances and increased intake of medications, adult acne seems to be on the rise. Women who did not have teenage acne can still develop the skin disorder in adulthood.
According to research by Dermalogica, more women than ever before are experiencing oilier complexions and more acneic skin problems. Clinical studies from the New England Journal of Medicine indicate that 40–50 percent of adults aged between 20 and 40 have a low-grade, persistent acne and oily skin problem; and up to 50 percent of all adult women report having mild to moderate acne. However, the most significant difference between adult acne and the teenage version (75 percent of teens have some degree of acne) is that adult acne usually affects the jaw line, chin and neck rather than the entire face; heals more slowly; is more persistent; and leaves a higher degree of pigmentation.
Causes
Acne can be triggered by changing androgen hormone levels, which control how much oil is secreted from the sebaceous glands. This is why menstrual periods and pregnancy bring acne on in some women. Emotional stress can aggravate the problem by triggering the body’s adrenal glands to become over-active, which in turn boosts sebum (oil) production. Certain medications like contraceptives and steroids can also affect hormonal levels. Other factors include abnormal cell turnover and skin bacteria.
Who can help?
The dermatologist
American dermatologist and acne specialist Dr Danna Montague-King says, “Doctors can recommend dermabrasion, laser treatment, or the Mon’s Tissue Transplant method. Teenage acne scars are often removed easily with enzyme treatments. This type of treatment allows the newer, underlying skin cells to rebuild the surface appearance.” Prescription drugs can include antibiotics to reduce inflammation. Roaccutane is prescribed only for very severe acne. About 80 percent of patients suffering from severe cystic acne are cured within four months of treatment; but it can be very expensive. Other medications include hormones such as anti-androgens, oestrogen and anti-inflammatory drugs. All these medications should be very strictly monitored as there can be severe side effects. The same goes for local treatments like benzoyl peroxide, sulphur therapy, vitamin A treatments, topical antibiotic treatments and corticosteroids. Ask your family doctor for a referral to a recommended dermatologist.
The beauty therapist
You should start treating acne as soon as it become visible, advises Colleen Matus-Serebro, who owns the Beauty Professionals Salon in Johannesburg, and has a proven track record of treating problem skin. She warns that when seeking treatment for a chronic skin condition, like acne, you need to take care to find someone highly, and specifically, qualified. “There are certain skin conditions (like rosacea, perioral dermatitis, eczema or boils) that mimic acne, and if these are treated like acne you could have a negative reaction.” You can be irreparably scarred by somebody who doesn’t know what they are doing. Matus-Serebro recommends individually prescribed treatments, and a process of diligent cleansing, professional extraction, cauterisation and disinfection.
What can I do?
Relax. The stress hormone, cortisol, has been implicated in some cases of female adult acne. Balance your blood sugar. People with chronic acne may have some degree of impaired glucose tolerance, so high-fat, high-carbohydrate diets may worsen the condition.
Avoid iodine-rich foods and supplements containing kelp, seafood, fish, mushrooms, garlic, onions, watercress and iodised salt, as these can trigger hormone-related acne.
Diet cannot cause nor cure acne, but it can aggravate or improve it. Choose fresh, wholesome foods.
Avoid cosmetics containing oil and those that clog pores.
On the shelf:
Try Dermalogica MediBac Clearing Adult Acne range; Anesi Soin Acne treatments; Esse Barley Grass & Mint Gel Cleanser; The Victorian Garden Lavender Myrrh Facial Healing; Trevarno Lavender & Jojoba Soap; Trevarno T.L.C. Soothing Cream; Tegoder Purifying Mask (for adult acne); Skin Doctors Gamma Hydroxy.
PIGMENTATION
What is it?
Hyperpigmentation is the darkening (dark spots) of the skin, and hypopigmentation is the lightening of skin (white spots.) Discolouration can be caused by wounds (like blemishes and acne); these are different to the brown spots caused by sun damage (melasma) or hormones (chloasma).
Causes
Pigmentation is caused most often by UV (sun) exposure, and also by trauma, medication, hormones, vitamin deficiencies or skin diseases like psoriasis. Chloasma is a common side-effect of pregnancy, birth control pills or hormonal replacement therapy (HRT). Although all skin types are at risk of pigmentation, dark, Asian or olive skins, and people with dark eyes (even if they have fair skin and hair) are generally more prone.
Who can help?
The dermatologist
For laser, a deep peel or dermabrasion, the skin doctor is your first port of call. Both ablative and non-ablative lasers can have a dramatic effect on melasma, but treatment can be expensive, and results are not always consistent.
The beauty therapist
It is imperative to have a thorough consultation to determine the cause of the pigmentation and the most appropriate method of treatment. Most successful salon treatments use a combination of lotions containing melanin-inhibiting ingredients along with a sunscreen, and a prescription retinoid (such as Renova and Retin-A, or generic versions containing tretinoin, a type of retinoid). Exfoliants, topical peels and lasers all deliver great results — but do your homework and be wary of any therapist suggesting quick fixes or high-acid contents in a peel.
What can I do?
The first line of defence is smart sun behaviour. Use a suncreen (SPF15 or higher) daily and liberally – this can generate some repair, as well as protection from further sun damage. Time can sometimes reduce blotches. The daily use of either Retin-A or Renova (both prescription-only topicals) and exfoliating with an alpha hydroxy acid (AHA such as glycolic acid) or beta hydroxy acid (BHA, or salicylic acid) helps to normalise cell production so the skin can start making healthy cells again.
On the shelf:
Clarins Bright plus range for pigmentation; Dermalogica Night Bright, Day Bright; Environ Evenessence Clarifying Range; Elemis Tri-Enzyme Resurfacing Programme; Neutrogena VisiblyEven Range: Night Concentrate; Kanebo Sensai Cellular Performance Quick Radiance; La Mer Radiant Mask; Tegoder Control Pigmentation Whitening Cream; Anesi Luminesence; Crabtree & Evelyn Fade Serum; Magiclear; Guinot Lightening Range; Skin Doctors Gamma Hydroxy; DIBI Hi-White Whitening and Brightening System.
ROSEACEA
What is it?
Roseacea is said to be rising alarmingly, and there currently is no cure. The good news, however, is that -armed with information and diligence – rosacea can be effectively managed to prevent irreversible damage. It’s an eruption, associated with excessive oiliness, which affects people mostly over 30.
Damaged blood vessels of the nose and cheeks cause the characteristic red, flushed appearance. If left untreated, roseacea can be disfiguring. Signs of rosacea may include: butterfly shaped redness on the cheeks, chin, forehead and nose that appear to be like a sunburn or blush that does not go away; small visible blood vessels on the face; bumps or pimples
on the face; dryness; oedema; or watery/irritated eyes.
Causes
Women are three times more likely than men to develop roseacea (menopause is often a trigger). It may be hereditary; other theories include the demodex mite, vascular disorders, gastrointestinal disease (ulcers), drugs and sun damage. The blood vessels become hyper-responsive to a wide range of stimuli, like physical exertion, the sun, hormonal/adrenal shifts, stress, artificial sweeteners, chocolate, tomatoes, citrus, hot soups, hormones, spicy foods, smoking and alcohol.
In response, the blood vessels dilate and engorge with blood more frequently than is normal, and ultimately stay that way. This eventually damages the blood vessels to the point where they no longer function effectively.
Who can help?
The dermatologist
Because it often produces pimples as it advances, rosacea may be misdiagnosed as common acne, or as a form of dermatitis. Correct diagnosis and informed treatment are critical, since treatment for acne – especially the use of salicylic acids, alcohol or benzoyl peroxide – may make matters much worse. A dermatologist can prescribe topical and oral antibiotics to decrease pimples and nodules. Your GP can prescribe anti-hypertensives to minimise the redness, and also reduce the damaging dilation/engorgement action of the blood vessels.
Specific laser light treatments have shown excellent results. The laser is used to selectively destroy damaged micro vessels in the dermal capillary bed, reducing redness and stimulating healthy collagen growth. Cosmetic surgery may be recommended for advanced rosacea.
The beauty therapist
Treatment by a professional skin therapist offers relief in many holistic ways, such as: manual lymphatic drainage, aromatherapy, cool marble stones, which give immediate relief to redness and swelling; and reflex-ology or pressure point massage.
What can I do?
Try to avoid extremes of temperature (especially when washing your face) to avoid capillary expansion.
Avoid any abrasive action on the skin. Visit your skin care professional regularly.
For more, go to www.rosacea.org
On the shelf:
Reduce the number of products you use, to save traumatised skin. A good moisturiser, especially during severe weather and when travelling by air, along with a good sun protection product are key staples. Using yellow- or green-tinted make-up will help conceal the redness. Soothing ingredients to use are: aloe, allantoin, arnica, avena sativa, beta glucan, coneflower, chamomile, gingko, green tea, liquorice, red clover, tea tree oil. Try: Skin Doctors Capillary Clear.
ECZEMA/DERMATITIS
What is it
In mild forms the inflamed skin is dry, hot and itchy, while in more severe forms the skin can become broken, raw and bleeding. There are different types of eczema relating to the causes, such as atopic eczema (linked with asthma); contact dermatitis (an allergic reaction to certain metals, chemicals or toiletries); and discoid eczema (triggered by a bite
or sting).
Causes
Eczema is now seen as a worldwide epidemic. It has increased between two and five times over the past 30 years. One reason is the increase in chemicals used in cleaning and skincare products.
Who can help?
The dermatologist
Antibiotics are sometimes given in combination with steroids as therapy for eczema. Although they are intended to prevent the open sores common to eczema from becoming infected, continual use of antibiotics can cause candida overgrowth. Corticosteroids can also be used, but may thin the skin eventually.
The beauty therapist
“Our primary role is to help establish the cause of the eczema, and try to eliminate that and other aggravating factors. Eczema is often caused by allergies, and changing cosmetics is sometimes all that’s needed,” says Matus-Serebro.
What can I do?
Rest and de-stress.
Eliminate or reduce alcohol intake, as it depletes precious nutrients in your body.
Good food is the key, so go organic where possible to avoid harmful pesticides.
A diet high in oily fish is another good way to boost good fats.
A little sunlight each day can be very beneficial for eczema, as it promotes the production of vitamin D.
Drink lots of water.
Avoid acrylic and nylon fabrics that cause irritation. Wash and dry skin carefully.
On the shelf:
Anesi Harmony Cream Eclat is highly effective in the treatment of all forms of dermatitis; Trevarno Calendula Ointment: Olive Workshop Kigelia Gel; Baobab Oil; Hunters Creek Pure Calendula Oil with Vitamin E; The Victorian Garden African Indigenous Sausage Tree Cream; sodium lauryl sulfate (SLS)-free shampoos and skin creams that contain natural oils with anti-fungal properties — such as tea tree, calendula, eucalyptus, myrrh or witch hazel.
PSORIASIS
What is it?
Psoriasis is the recurring growth of too many skin cells which can’t shed properly. Normally cells shed in 28 days; if they are psoriatic, then the turnover is every three to seven days, accompanied by inflammation and redness. The condition appears as thickened scaly areas and small, solid bumps. Areas affected most are the elbows, knees, scalp and chest.
Causes
Both men and women can get psoriasis at any age. However, it generally affects only one to two percent of the population.
Who can help?
The dermatologist A doctor can prescribe topical and oral medications which can clear this persistent condition for periods of time. A combination of both, plus regular doses of sunlight (climato-therapy) can have very good results.
The beauty therapist
A therapist can help with the administration of ultra violet light. Relaxation may alleviate symptoms connected to anxiety.
What can I do?
Enjoy controlled and careful exposure to sunshine. Natural sunlight can significantly improve, or even clear up, psoriasis.
On the shelf:
Coal-tar creams, lotions, cleansers, gels or shampoos are old and effective remedies. These are available both over the counter and by prescription.
Sources:
Annet King, Training and Development Manager, The International Dermal Institute; Colleen Matus-Serebro 011-8886262; Paula Begoun: The Beauty Bible (Beginning Press); Organic products available from: www.faithful-to-nature.co.za
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