Hormones

The underlying process is the same in teenage and adult acne, but the pattern of involvement may be different.

Melasma is a common, acquired disorder of hyperpigmentation that causes brown patches on the cheeks, forehead, upper lip and jawline.

Do you have a teen in your life who is struggling with oily skin, blackheads or breakouts? Read below to discover my tips.

Research indicates that between one and two thirds of female acne sufferers will have a flare around the time of their period.

“You know the common story: Woman stops taking pill. Woman experiences acne. But, numerous word-of-mouth experiences aside, why does this happen to so many of us?” This question was recently put to me by Lucy Abbersteen of Marie Claire magazine. Here’s an excerpt of her article: “Pill useage declines steeply with age, from two thirds of women aged between 20 and 24, to just 11% of women in their late 40s,” explains consultant Dermatologist Dr Justine Kluk. “It’s not uncommon for women who have been on the pill for several months or years to notice a flare-up of acne after discontinuation – and the reasons for this are well documented.” “Acne affects 80% of teenagers, making it a very common problem. It also affects 10 to 20% of women over 25, a figure that is definitely on the rise. So this may be a recurrence of acne in those previously affected.” But, hang on – what about if you never experienced acne before the pill? Don’t get too excited. “Acne can also start in adulthood for the first time,” Dr Kluk adds. “In any event, the time of life when acne peaks is similar to the stage at which many women decide to start the contraceptive pill.” “The combined pill is in fact a very effective acne treatment and many women will find that their blemishes improve – or even disappear – as long as they are taking it. The oestrogen component appears to inhibit acne by a variety of mechanisms including reducing production of androgens (responsible for oil production and pore-blocking), and reducing the amount of active free testosterone in the blood.” Unfortunately, because of the individual differences at play and lack of research, it’s not known exactly how many women will see a flare-up or experience a first case of acne upon pill cessation. “The natural history of acne means that a proportion of women who take the pill will ‘grow out’ of their acne while taking the combined pill, and therefore won’t experience a flare-up when they stop taking it. Others, however, will find their acne recurs or appears for the first time once treatment is discontinued; which suggests the pill was masking the acne all along.” Long story short: You may have had acne all along but the pill was masking it, or you had it before and your contraception was acting as an acne treatment. If you are concerned about acne returning when coming off the pill, speak to your GP or see a dermatologist to put a plan of action in place. Dr Kluk adds that it’s worth noting some progesterone-only contraception (the mini pill, depot injection, progesterone coil or implant) can actually be acnegenic. “Use must be discussed carefully with your GP or gynaecologist if you have a history of stubborn acne,” she says. Click here for the full article. © 2018 Dr Justine Kluk. Any redistribution or reproduction of part or all of the contents of this post in any form is prohibited. You may not, except with our express written permission, copy, distribute or commercially exploit the content. Nor may you transmit it or store it in any other website or other form of electronic retrieval system.

  Blackheads are a mix of oil and dead skin cells sitting in the pores. Exposure to air causes them to oxidise and turn black giving them their characteristic appearance. They start to appear in puberty around the same time that sebum production increases and one of the most common complaints I hear from teenage patients is that they are self conscious about visible pores or blackheads, especially on the nose. Establishing a skincare routine and teaching teens how to look after their skin is important, both for skin health and for self-esteem. I usually suggest the following tips for those who want to try something over the counter before seeing a doctor: 1. Wash your face morning and evening with a mild cleanser, such as Cetaphil Gentle Skin Cleanser. For those with very oily skin, foaming cleansers like Bioderma Sebium Purifying Cleansing Gel or salicylic acid-containing cleansers like Garnier Pure Active Intensive Anti-Blackhead Charcoal Gel Wash and Neutrogena Visibly Clear Spot Clearing Facial Wash can be used in the morning instead. 2. Blackheads and acne are not because you are dirty so scrubbing too hard, or using harsh exfoliators, is not particularly helpful and may actually increase inflammation. 3. Apply a sun protection moisturiser after cleansing in the morning. Acne blemishes can leave dark marks on the skin if not properly protected from the UV rays in sunlight. Choose a broad spectrum product with SPF30 or higher e.g. La Roche-Posay Anthelios or Garnier Ambre Solaire. Always check the label for the words “non-comedogenic” which means the product won’t block the pores. 4. There are some really good products for concealing acne blemishes and improving self-consciousness e.g. Vichy Dermablend Corrector Stick. Mineral make-up containing zinc oxide or titanium dioxide is great for absorbing excess oil and camouflaging redness. I like the range from Bare Minerals. 5. In the evenings, a targeted bacteria-zapping gel like benzoyl peroxide e.g. Acnecide or a pore unblocking agent containing salicylic acid e.g. La Roche-Posay Effaclar Duo can be applied to affected areas after cleansing. 6. Follow with a light moisturiser, such as La Roche-Posay Toleriane Fluide or Effaclar H. Moisturiser makes it easier to tolerate the treatment creams in the previous step which may otherwise cause dryness and peeling. Again, make sure that moisturisers or any other leave-on products are labelled non-comedogenic. 7. Wash your hair regularly and tie it back away from your face. Greasy hair, or application of hair serums and gels, can cause breakouts on the forehead. Wearing a headband or hat should also be avoided if you are prone to spots around your hairline or on your forehead. 8. Remove sweaty clothes as soon as possible after sport or exercise and cleanse your skin thoroughly. If sweat remains on the skin for prolonged periods, acne-causing bacteria will thrive. 9. For boys who are starting to shave, be careful to avoid nicking any existing spots. Clean the blade regularly, make sure it is sharp and shave in the direction of the hair growth. 10. Try to break the habit of touching your face and, whatever you do, do not squeeze or pick your blackheads. This can introduce infection and may also lead to permanent scarring. Instead, try a pore cleansing face mask once or twice per week, such as Garnier Pure Active Intensive 3 in 1 charcoal mask or The Body Shop tea tree skin clearing clay mask. If this doesn’t help, you could have your blackheads professionally extracted by an experienced beauty therapist under strict hygienic conditions every month or two. 11. It might sound obvious, but change your sheets weekly. This is especially important for your pillowcase where grease can build up over time and rub off on your skin as you sleep. 85% of teenagers will experience some form of acne at one time or another and I try to reassure my patients that they are not alone. Nonetheless, it should not be considered a rite of passage that everyone has to go through regardless of the severity. If your teen has lots of red and inflamed bumps, dark marks or signs of scarring, or if their skin is starting to impact their self-esteem, I’d love to be able to help. To book an appointment, call my team on 0203 733 3225. © 2018 Dr Justine Kluk. Any redistribution or reproduction of part or all of the contents of this post in any form is prohibited. You may not, except with our express written permission, copy, distribute or commercially exploit the content. Nor may you transmit it or store it in any other website or other form of electronic retrieval system.  

      Acne is the medical term used to describe breakouts. For many of us, our first experience of the condition is during puberty when our bodies start to produce higher levels of the hormone testosterone. The sebaceous glands in our skin are very sensitive to even small changes in the level of testosterone and begin to step up production of sebum, the natural oil produced by our skin, as a result. This sebum mixes with dead skin cells and gets trapped in our pores creating an ideal environment for bacteria to thrive. These factors combine to cause inflammation in the skin leading to the development of acne. In its mildest form, acne is responsible for causing occasional spots or pimples. Whilst most of us can manage this at home by using appropriate store-bought products, some people develop a more severe form of the condition that doesn’t go away despite following a good skincare routine. Examples of this include breakouts occurring at multiple sites on the face and body or the appearance of deep, tender nodules and cysts that can lead to permanent scarring if not properly controlled (as shown in the photo above). In these situations, it is important to seek advice from a Dermatologist as prescription treatment is likely to be necessary. Expert help should also be sought if acne is causing loss of self-esteem, anxiety or feelings of embarrassment and social isolation. Whether you are designing a skincare routine at home or following a treatment plan from a Dermatologist, it is essential that the products you use are specifically intended for blemish- prone skin. Key ingredients to look out for include salicylic acid which stops the build up of dead skin cells and zinc, tea tree or witch hazel which are great for soothing inflammation so check for these on product labels. Using the wrong products, or indeed using too many products, can actually make the problem worse. Start by cleansing your face both morning and night. Acne can cause the skin to be red, bumpy and inflamed so a cleanser designed for sensitive skin is a good solution for this. Massage it gently into the skin before rinsing well with lukewarm water and use a soft cloth or flannel to pat dry. I’m not generally a big fan of toners, but for those with greasy skin a toner can be applied next. It is important to recognise that many acne treatments work by reducing oil production and will dry the skin themselves. A gentle tonifying lotion may be tolerated better than ordinary toner in these circumstances as there is less risk of drying the skin out too much. An alternative to this if skin remains greasy is to use pre-prepared pads soaked in glycolic and salicylic acid.  The final step in the routine is to use a lightweight moisturiser twice a day to nourish and maintain a healthy skin barrier (unless your skin is exceptionally oily). Looking for the words “non-comedogenic” (meaning non pore-blocking) on the packaging can help guide you to the most appropriate choices. The same goes for sun protection products and makeup which also need to be chosen carefully. I would use a sun protection moisturiser in the morning and a plain moisturiser at night. Finally, grainy scrubs and vigorous rubbing are best avoided in very inflamed acne and squeezing or picking spots is also strongly discouraged as this increases the risk of infection and scarring. Using a clay or charcoal mask once or twice a week is a much better way to draw impurities out of the skin in combination with appropriate acne treatment. If you are following this advice and find that you are not getting the results you need, or if you believe that you are suffering with one of the more severe forms of acne described, please make an appointment to see your GP or Dermatologist for advice. © 2018 Dr Justine Kluk. Any redistribution or reproduction of part or all of the contents of this post in any form is prohibited. You may not, except with our express written permission, copy, distribute or commercially exploit the content. Nor may you transmit it or store it in any other website or other form of electronic retrieval system.    

Spots are probably the most common skin concern of all, affecting as many as 85% of teens at one point or another. Unfortunately, research shows that more and more of us are continuing to suffer with breakouts in our twenties, thirties and beyond meaning that spots are definitely not just a teenage issue. In fact, it is estimated that 10 – 20% of adult women are still battling blemishes. When you think that spots can lead to scarring, poor self-image and loss of confidence, this amounts to a big problem. Before working out how to keep spots at bay, it helps to understand what causes them. There are 3 main reasons that spots occur:  Excess sebum production. Sebum is the natural oil produced by our skin. We start making more of it as adolescents which is when spots begin to be a problem for most of us. Build-up of dead skin cells. These dead skin cells mix with the sebum and get trapped in our pores. Bacteria. These bacteria cause inflammation in the skin leading to the angry red bumps and whiteheads that we all dread. In additions to these causes, our genes, diet and lifestyle also play a role in the development of spots. We can’t change our genes, but there are a few lifestyle factors that we can try to address to keep spots at bay. Here are some of my top lifestyle tips for reducing spots: Develop a skincare routine and stick to it every day. It is never too late to start, but it helps to get in the habit from your teenage years onwards. Cleanse your skin well twice daily, follow with a toner to tighten pores and then use a moisturiser designed for spot-prone skin. Using products that aren’t designed for people with breakouts or blemishes can actually make things worse so choose carefully. Consistency is key. Stick to the items in your skincare routine and give them a chance to work. Unless you have a bad reaction to a particular product, I would usually suggest using it regularly for 2 – 3 months before switching if you haven’t noticed an improvement at that point. Don’t fall into the trap of using too many products or chopping and changing every couple of weeks. Similarly, don’t stop using the products when the spots are controlled as you could end up back at square one. Whatever you do, don’t scratch, pick or squeeze. This can introduce bacteria, increased inflammation and may ultimately lead to scarring. Always clean your hands before applying your skincare products and avoid touching your face at other times. Don’t go to bed without removing your makeup. Ideally, you should follow your usual nighttime routine even if it’s late and you’re tired. Keep some cotton pads and a bottle of micellar water next to your bed, however, for those occasions where you may otherwise be tempted to sleep with your makeup on. Greasy hair can contribute to spots on the forehead and around the hairline and neck. If your hair gets greasy easily, keep it tied back off your face and make sure that you wash it regularly. Avoid hats and hair accessories that are likely to trap sweat under your skin and stay away from oily hair serums, gels and waxes that may slide down onto your face blocking your pores. Shower every day. Remove sweaty gym clothes as soon as possible after a workout and don’t delay hopping in the shower. Bacteria thrive in sweaty conditions and can be a particular problem on the back and chest in people who exercise frequently. Change your bedsheets once a week at a minimum. This prevents grease from your pillowcase being rubbed back into your skin. Keep sugary, refined or processed foods to a minimum. This doesn’t mean that you can’t have an occasional chocolate or treat, however. Beyond this, there isn’t a great deal of evidence that cutting particular food groups out of your diet reduces spots. There have, however, been a few small studies suggesting that dairy, especially skimmed milk, may play a role in certain individuals. Always consult with a doctor before cutting anything out of your diet to ensure you are still getting all the nutrients you need.  Look after your general health and wellbeing. Lack of sleep and stress can lower your threshold for breaking out. Try to go to sleep at the same time most nights, don’t scrimp on sleep and find ways to let off steam. This may be through doing a hobby, taking a yoga class or relaxing with friends. © 2017 Dr Justine Kluk. Any redistribution or reproduction of part or all of the contents of this post in any form is prohibited. You may not, except with our express written permission, copy, distribute or commercially exploit the content. Nor may you transmit it or store it in any other website or other form of electronic retrieval system.

Highlights from my talk to St John’s Wood mum’s group Mums in the Wood about skin changes during pregnancy and how to tackle them http://mumsinthewood.com/nurse-them/specialists/skin-changes-pregnancy-tackle-dr-justine-kluk/ © 2017 Dr Justine Kluk. Any redistribution or reproduction of part or all of the contents of this post in any form is prohibited. You may not, except with our express written permission, copy, distribute or commercially exploit the content. Nor may you transmit it or store it in any other website or other form of electronic retrieval system.