Notebook

Beauty journalist, Malena Habers, wrote in last weekend’s Sunday Times Style about instant gratification skincare and why we’re so obsessed with rapid results. It was my pleasure to provide a few of my thoughts for the article and I’ll share these here with you too.  There is definitely an increasing demand for instant results. With our culture of taking selfies and documenting our every move on social media, the pressure to look photo-ready at all times is enormous. With pretty much everything these days occurring at the touch of a button, whether it’s a taxi or a takeaway, we are definitely less patient on the whole and having great skin is no different. Having said that, most patients who come to see me in the clinic for acne, scarring or cosmetic treatments understand that improving their skin is a process and that it may take a few weeks to start seeing results. Despite having to be patient in the beginning, the upside is that any prescriptions, procedures and skincare advice used in my clinic are evidence based and have a track record of being effective. This means better and more predictable outcomes and a greater chance of maintaining results in the longer term (and is not to say that certain products can’t make you a little glossier, smoother and plumper in the meantime). Some people bring in images of celebrities, influencers and friends and tell me they’d like to look the same, but will agree that their skin or overall appearance is very different to start with. My advice is always to aim for the best version of yourself, not someone else. Understanding this is key to managing expectations. Those who are unrealistic about timeframes and ultimately what is safe, achievable or desirable may keep chopping and changing products (or doctors!) every time a new “miracle cure” becomes available and are most likely to be disappointed in the longer run. Just my opinion. What do you think? © 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.  

Is wearing makeup on an aeroplane actually that bad for your skin? Journalist Jacqueline Kilikita and the team at Refinery29 asked me this very question recently. To see what I had to say on the matter, click on the link below. To be absolutely clear, I am not recommending that you do wear makeup when you fly. My advice is to always stick to your normal skincare routine whenever and wherever practical. So, it’s not a disaster if you wear makeup on a short-haul flight and I wouldn’t have thought that this should be particularly detrimental to your skin health in the bigger picture. You won’t, however, find any Dermatologist who says it’s okay to sleep with your makeup on and, to my mind, the same applies for removing your makeup before you go to sleep on a long-haul flight. If you can’t face the idea of boarding barefaced, opt for non-comedogenic products if your skin is prone to breakouts. Lightweight, hydrating tinted moisturisers or BB creams are your best bet if your skin gets dry when you fly. Happy reading! http://www.refinery29.uk/2018/01/187478/wearing-makeup-plane-skin © 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.      

  I get asked all the time about why I decided to become a dermatologist. The short answer is this. Acne. I started to get spots when I was about 12 years old. My dad bought me Clearasil and told me that I would grow out of it. He’d grown out of it when he was my age after all, but not before developing scarring on his cheeks which is still there today in his sixties. So, I used my facewash and sometimes a bit of toothpaste (or Sudocrem or whatever happened to be knocking about on the bathroom shelf for that matter) and patiently waited for it to go away. Having grown up in South Africa, my mum was always very concerned about skin cancer. I remember very clearly, later on as a teenager, being taken to a dermatologist to have a mole on my right shoulder checked. When I sat down on the examination couch the first thing the specialist said to us was “Never mind the mole. What are you doing about her acne?” This was just the start of my lifelong battle with breakouts, and harsh as it sounded back then, I was relieved for the validation that this thing that was a source of real unhappiness to me was deserving of proper attention and that now we were really going to do something about it. This is where my fascination with skin health began and how my passion and determination to help others feel good about their skin started. Acne is the medical term used to describe spots or breakouts. It is easily the most common skin concern there is, affecting as many as 85% of teens. Unfortunately, research shows that more and more of us are continuing to suffer with it in our twenties, thirties and beyond meaning that spots are definitely not just a teenage issue. In fact, it is estimated that up to 20% of adult women are still battling blemishes. When you think that acne can lead to scarring, poor self-image and loss of confidence, this amounts to a big problem. If you’ve suffered with persistent acne, you’ll recognise the feeling that your face never feels clean. No matter how much time or money you spend on grooming, you still feel like a spotty mess. You long to be one of those carefree people who wakes up 5 minutes before they need to leave the house in the morning. Instead, you have to put aside a full 30 minutes to try and painstakingly conceal each and every spot and you definitely need to get to the bathroom first if you have a new partner for fear that they might reject you if they knew what you really looked like. Yes, some people can manage the occasional pimple at home with appropriate store-bought products or advice from a GP. Many others are fed up by a lack of improvement and are understandably worried about developing dark marks or permanent scarring if their symptoms are left unchecked. Emotional scarring should not be downplayed either as acne erodes self-esteem, causing sufferers to feel embarrassed and isolated. It doesn’t have to be like this! If you want really effective treatment for persistent acne or scarring, come see me in the clinic to talk about the options because there is plenty we can do. As well as prescriptions and procedures that really work, I’m keen that you have a skincare plan that helps you maintain the results in the longer run so you’ll want to show your skin off, not hide away. © 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.  

When I am planning acne treatment for new patients to the clinic, we have a discussion about the most effective management options based on the severity of their symptoms, what kinds of spots they are getting (e.g. blackheads, pustules, nodules, cysts) and what treatments they’ve already tried. Sometimes oral treatment is most appropriate, sometimes creams or gels (known as topical therapy) are most appropriate and often both are needed together in combination. Topical therapy of acne includes the use of agents that are available over the counter e.g. benzoyl peroxide and salicylic acid or via specialist prescription e.g. antibiotics, azelaic acid and retinoids. So what are topical retinoids? In short, they are vitamin A derivatives. Examples include adapalene (Differin), isotretinoin (Isotrex) and tretinoin. They are possibly the most critical topical therapy for acne because they reduce blockage of the pores (the opening of the hair follicle onto the surface of the skin) and are also anti-inflammatory. As well as enhancing most acne treatment programmes, they can also help with maintaining control after discontinuation of oral therapy. Retinoids are ideal for blackheads and, when used in combination with other agents, for most types of acne. Although they are a very useful tool in the management of acne, the use of topical retinoids may be limited by side effects such as dryness, peeling, redness and irritation. They have also been associated with photosensitivity i.e. causing the skin to be more sensitive to the sun. These side effects can all be much easier to tolerate if the steps below are followed: 1. Use a gentle skin cleanser morning and evening. Apply to a wet face and rinse off with lukewarm water. Do not scrub vigorously. 2. Apply your retinoid cream at night before you go to bed. Do not apply it in the morning as it can make your skin more sensitive to the sun. Take precautions to avoid sunburn by applying a non-comedogenic, broad spectrum SPF50 sun protection moisturiser in the morning before applying your makeup or leaving the house. 3. Introduce it gradually. Start off by applying it twice per week at night. It is normal to have a bit of redness or peeling after a few days. After a couple of weeks, increase application to alternate nights if tolerated. This can subsequently be increased to every night after a further two to four weeks if you are tolerating treatment with minimal or no irritation. 4. If the skin irritation is severe, stop the prescription for a few days until it has settled before attempting to reintroduce it even more gradually. 5. Most people will eventually be able to apply their prescription cream every night without any ongoing discomfort, however some will only ever manage alternate nights or twice per week at the most. Do what you can – some treatment once or twice a week is usually better than none at all. 6. Apply the cream (or gel) in a very thin layer to cover all of the areas that you tend to get the acne, not just onto individual spots. The quantity really doesn’t have to be particularly large as this will just increase irritation. 7. Avoid the area directly around your eyes as the skin is more sensitive. 8. If your skin is dry or irritated, you can apply a moisturiser at night by layering it on top of your retinoid cream. Ideally you should wait 15 minutes or so between these steps to prevent the the retinoid being diluted by your moisturiser. Look for a moisturiser that is labelled non-comedogenic. © 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.