Skincare Questions Answered

I am 15 years old. Can I use serum or vitamin C serum or not?

You can use a serum containing vitamin C and providing it is well formulated, it shouldn’t do you any harm. But as with anyone at any age, I would query why you think it’s necessary and suggest that there may be a simpler, less expensive way to go.

Vitamin C, applied to the skin in a serum or moisturiser, is usually chosen by people wanting to repair damage. This tends to be reduction of pigmentation in marks on the skin as a result of sun-damage, to boost collagen and elastin synthesis and as an antioxidant. It has the most beneficial effect where there is an existing vitamin C deficiency (in the body).

If you have scars, from inflammation or infection in the skin, for instance, acne, then vitamin C could help to fade this. It will work as an anti-oxidant on any skin, it doesn’t differential between mature and young skin! So if you live in a urban environment or somewhere that air pollution is a concern, using vitamin C in a topical treatment could also increase the protection from this. (You need to find a product that is either formulated not to oxidise quickly or in a container that reduces the rate at which it oxidises - preferably both - otherwise it won’t help.

It can irritate, especially if it is in a product at over 5% or if it has oxidised significantly. It can be expensive and there may be cheaper alternatives for the skin problems you are seeking to alleviate. If you believe that your diet may be lacking vitamin C, you can address this by increasing the amount of fruit and vegetables you eat, or if that is difficult, supplements are available - again, you don’t need mega-doses, the recommended daily. A sun cream with broad spectrum protection will help the skin to preserve the plentiful amounts of collagen and elastin you probably still have.

As with anyone of any age, you should know why you are buying a product with a particular ‘active’ ingredient. It is likely to be more expensive than one without and you may not need it. It is commendable to be thinking sensibly about skin condition, protection and health at your age, but try to avoid being lulled by clever marketing to buy something that will make little difference.

After protecting your skin in hot sunshine, a light lotion containing hyaluronic acid or simply vegetable glycerine, aloe vera, and a nice light butter should keep your well skin hydrated. Make sure you keep it clean, so remove any daily dirt or makeup with a hydrosol or light cleanser (not soap unless it is specifically formulated for this and so has a pH lower than 6) and enjoy your wrinkle-free years!
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Q: Is it ok to use two different kinds of daily face wash?

I presume you do this morning and evening and if your skin feels and looks healthy, you have no particular skin issues that might warrant a change, then you can safely use both. It is a good idea to know what you are putting on your skin so often, so a quick look at the ingredients’ list is advisable.
If these items are both marketed as a Face Wash and they are a similar price, the chances are, they will contain pretty similar ingredients. You can check this by comparing them. It is the sort of product that can really vary, as a bar of soap is technically a face-wash, whilst a really good product with a number of skin conditioning ingredients could be too. If these two are relatively inexpensive - under $7, then I would expect to find something like the following on the list: a surfactant, probably two, to do the cleaning; triglycerides, to leave your face feeling hydrated and not too ‘squeaky’ clean, something like citric acid to bring the pH to around 5; disodium EDTA to bind to any nasty metals and minerals in the water that you don’t want on your skin; some aroma chemicals (hundreds can be hidden behind the word ‘Parfum’ on a label) and maybe some essential oils; a polysorbate to allow the perfume to mix with the other ingredients; something to thicken the mixture, this can be salt; colour - these tend to start with a C followed by a few numbers. Often there are ingredients listed, quite low down the ingredients’ list like ‘fruit extracts’ or oils that are there to enable ‘claims’ - eg: ‘contains real fruit oils’(these can be listed as ingredients even when in the formulation at 0.01% , so, probably not doing much). A preservative or two and you may find some salicylic acid, to help the top layer of dead skin cells wash off, and so leave the skin surface smoother.
You don’t say why you prefer to use different washes. If you simply want them to wash away daily grime and you prefer one scent in the morning and the other at night, great! I just wonder if a gentler approach might still get you the desired results. It is most important not to use anything that causes your skin irritation or inflammation - even minor irritation can cause inflammation your skin needs to mend daily. Putting it through a twice-daily wash with surfactants, colours, perfume, preservatives etc is potentially irritating. However, I think you were asking whether it is safe/advisable to mix different brands and I can see no reason why not.

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What determines skin colour? Is it something you are born with or can it change over time?

The short answer is yes, it’s something you are born with, or at least the potential is there at birth.

Several genes dictate skin colour, inherited from both your mother and father - it isn’t a single gene (although the MC1R gene is the one we all learned was the skin colour-maker.)

The MC1R gene does seem to be pivotal in determining how much melanin you have and the various colour pigments within the melanin - much like the: cyan, magenta, yellow, and black inks in a colour printer - we’re all a mix.

You have a gene that maintains the melanin production: how much you get and where it goes. Another controls the enzyme tyrosinase (you may see on serums for fading melasma that they inhibit the tyrosinase production), if this gene functions poorly, the mechanism to get melanin up to the surface of the skin, won’t be as effective.

The particular bundle of genes you get will limit how much sunlight can tan your skin; however much sun you expose your skin to, there will be a limit to the shade it can deepen. When UV light hits your skin it produces melanin to protect itself, but how much it can do this will depend on your genes. Some people have a high melanin baseline and this provides a much better natural protection from UV rays than someone with very little.

One way to categorise skin types is using the “Fitzpatrick scale’ - there are six types that range from type 1 which is very pale, pinkish, white, usually with blonde or red hair and pale blue eyes, these people have very little melanin and will suffer sunburn even in very little sunshine. Type 6, on the other hand, has lots of melanin and their skin shade is dark brown/black, with brown eyes and brown or black hair, these types are very well protected and darken without burning in hot sunshine.

Your ability to tan may change over time, but this is still due to your genetics and how much sun you’ve been exposed to over the years (so how much exercise your melanin production has done!). As skin ages, it thins and it functions less effectively. Tanning often become less even, in terms of which bits of skin tan, but also the depth of colour. People with pale skin can have very dark areas of melasma appearing just in a few spots. In general, people with skin types 1 and 2 will have a more noticeable change in skin colour due to sun exposure, than those with types 4 to 6.

 

Q: Why is my scalp so itchy? I have exfoliated it to get rid of the flaking and itchiness but it didnt help. I have a dry scalp. Any tips to get rid of an itchy flakey scalp?

It is difficult to know why exactly, without knowing a bit more, or seeing the area.
It could be caused by a variety of things: you may be reacting to a harsh surfactant in your shampoo or ‘build-up’ from hair styling products, or you may have seborrheic dermatitis (eczema) and psoriasis can cause these problems too. These would require different treatments.

I’m not sure how effective ‘exfoliating’ is until the cause is established. If you have used something with a gritty texture, like sugar or salt, it shouldn’t harm your scalp in the long-term, but could further inflame an already irritated surface. If you used an alpha hydroxy acid (AHA) or salicylic acid, again, it can be irritating, and I wouldn’t recommend this sort of treatment until you have established what is causing the problem.

The easiest first… check your shampoo ingredients, this will contain at least one, and possibly three or four surfactants, and these can be responsible for the symptoms you report.

Surfactants
Surfactants have one end that attracts to water and the other end to oil. When there are enough in a solution, they are drawn together to make a ‘micelle’ (hence micellar water). These then are attracted to dirt suspended in oil and in water, so both are washed away in water when rinsing the shampoo. There are several types: anionic, nonionic, cationic or amphoteric.

Anionics are frequently used in shampoos as they give a nice foam, take away dirt effectively and are relatively cheap…but they can cause irritation. Look at the ingredients’ list on your regular shampoo. If it contains sulphates or sulfonates in the name, they are in this category. These are usually mixed with nonionic surfactants as these are particularly good at removing oil, these are generally not abrasive and include: cocamides and ethoxylates. Cationic surfactant won’t be mixed with anionics but could be in with nonionic and these include: dequalinium and phenamylinium chlorides, cetrimonium and cethexonium bromides. As these are positively charged and damaged hair gives off a negative charge, they can cling to the hair strands and cause build-up and irritation. They also make the scalp more oily (they bind to keratin), which in turn attracts grease more readily. (They are useful for anti-static and as disinfectants, so if you are choosing shampoo that promises either, there may be cationic in there).

Formulators are looking to find the ‘sweet spot’ between cleaning effectively without irritation and it’s not an easy balance. The very gentle surfactants don’t clean very well and people tend to like a foam (I don’t know why, they just do!) and they don’t really do mega-bubbles. They are also much more expensive.

Seborrheic dermatitis.
If you have patches of skin on other parts of your body that are itchy, dry, and scaly, it could still be a reaction to a surfactant (don’t forget that if you are putting something on your hair in the shower, it will also wash over your face and body) -see above. This would be a condition that might easily worsen if you used an AHA to exfoliate - I certainly wouldn’t recommend it. If you have seborrheic dermatitis and you will find this quite uncomfortable. You should get a diagnosis confirmed by a nurse or doctor before attempting to treat it yourself. There are dietary factors, but a number of ways to calm this using topical treatments too - steroid creams are effective, but really a last resort.

Affected skin often has an impaired barrier and surface lipids, especially ceramides, degrade faster. You can treat skin (on your body or head with a simple home-made pack including aloe vera, colloidal oats and vitamin E oil). In the long-term increasing vitamins A and C in your diet can also help strengthen the skin barrier, (when it is damaged skin is more susceptible to irritants). Dimethicone has been demonstrated to help and is often used in both shampoos and conditioners, so look out for this too.

Psoriasis
This is much more difficult to manage as it seems to be caused by an over-enthusiastic immune response. As with eczema, you should get a diagnosis before attempting to treat it. Although aloe vera and colloidal oats are unlikely to worsen either and may well alleviate symptoms. This is where a mask containing salicylic acid would be worth trying (although I wouldn’t rub anything abrasive into your scalp, whatever is causing it, but especially with psoriasis.) It can be worsened by increased yeast in the skin (as can eczema), so reduce anything in your diet containing yeast. You could try using well-diluted geranium or rosemary essential oils topically. I would recommend using a calendula or rosemary hydrosol, as a hair rinse, to improve the scalp condition. These have anti fungal properties and have done well in trials to help psoriasis.

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Q: The skin around my eyes becomes red after I shower. However, this usually goes away on their own. I also have perioral dermatitis, that may affect it?

It is possible that this irritation is being caused by whatever you are using to wash your hair and face whilst showering. It could also be the water itself, if the water in your area contains high levels of algaesides, pH adjusters (or is particularly alkaline), chlorine or other disinfectants. These chemicals and others are added to water before it arrives in your shower. They are there to make water safe to drink, but it is not unusual to have a skin reaction to any of them, especially at higher levels.

A quick way to determine which of these, if either, is the culprit, simply take a quick shower without using any soaps, shampoo/shower gels etc. If your eyes are still comfortable and not reddened, then it may be the contents of the bottles you take into the shower are the problem.( The area around your mouth will probably take longer to heal and there may be some delay in the inflammation after the irritant is encountered, so I would begin by using the eye-reddening as a guide.)

If the redness appears, then it is likely to be the water. You could use swimming goggles to protect your eyes and I would suggest a really thick emollient around your lips before getting into the shower - something very simple like petroleum jelly mixed with 20% coconut oil should stay fast.

If the water doesn’t cause irritation, look at what is running down over your face during the shower; anything you use on your hair with also cover your face and body. The most common and quite likely cause is a harsh surfactant - this does the actual cleaning in the shower gel and shampoo. It could also be the preservative, added colours or perfumes (including essential oils) and other ingredients can do it too. In fact it really could be any, but I would start with those we know cause this kind of reaction first.

The part of a shampoo that does the cleaning is usually a surfactant and you will likely find two in your shampoo and shower gel. In general terms, the harshest and most common irritants are: Sodium lauryl sulfate,(not the same as the less irritating- sodium laureth sulphate). Sodium coco sulfate, ammonium lauryl and laureth sulfates are better but not by much. There are lots - these are just the ones commonly found. If you find these on the ingredients’ list, I would change what you use to one using gentler surfactants and see if the symptoms improve. Those I choose for shampoo are: cocamidopropyl betaine, sodium cocoyl sarcosinate or sodium lauryl glucose carboxylate. It is a complicated area; the very gentle ones are not very good at cleaning, so most products have one to do the cleaning and one to soften the effects. A balance can be found, so maybe look for a brand that particularly formulates in this way.

Preservatives are a huge topic and it can get quite heated, so I’ll keep this brief… those more likely to cause this, in my opinion are: butylparaben, propylparaben, isobutylparaben and isopropylparaben. You will notice they all end in ‘paraben’! This doesn’t mean that everything that contains the same ending is unsafe or will cause irritation, but those I mention are worth avoiding given your symptoms. I would suggest you look instead for those generally considered less irritating, but safe as preservatives like sodium benzoate and phenoxyethanol (these could still be the cause, just that they tend to be less of a problem). Please do not be tempted to use a shampoo without a broad spectrum preservative. There is a high risk of encountering dangerous moulds and bacteria if a shampoo is preservative-free and this could do long-term damage to eyes and skin.

Then there are colours and perfumes - anything on the ingredients lists that begins C- and a number is probably a colour, these can all irritate and there are large number of producers that do not use them, so try one of these. Similarly with perfume, which in itself is another huge area (!)…. Some people tolerate these without any problems, some people just react to one particular ingredient, but not others. So, again, try a products with no perfume and see if that makes a difference.

Most people with the complaints you describe will probably find that one of these is doing the reddening. But as you have probably gathered, finding the exact culprit can be painstaking - and of course, it could easily be more than one.. so a project, but if you have clear eyes at the end of it, worth doing!

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Q: What non-petroleum-based product do you recommend to treat a burn, scar, scratch, or cut?

For a burn, it is most important that the skin is cooled as soon as possible. A minor burn doesn’t need ice or a special pack, just cold water, but it should be cooled like this for at least a couple of minutes, which can make the site ache a bit, but it is worth it.

Healthy bodies should heal most superficial scratches and burns without a need for special creams or lotions. Having said that, if you have a simple zinc oxide cream, the zinc itself helps promote healing and the cream base will protect the site. If you have aloe vera to hand, again, that should help a burn or a scratch. It is better to use it fresh from the plant, but even aloe vera in glycerine, as it is commonly sold, should help ease discomfort and various studies have suggested the healing time can be decreased. If you keep it in the fridge, that will help too.

If you want something a bit more exotic, then look for a moisturiser with L-glutamine, this is an amino acid that the body utilises for healing, or vitamin E. If you can find it, extract of yarrow is excellent for cuts and scratches, it helps stop bleeding and has anti-inflammatory properties too. Calendula and chamomile can be helpful for fading scars and healing superficial skin wounds.

There are essential oils that are recommended for burns and scratches, but this wouldn’t be my first choice. There is always a risk of worsening the irritation and so slowing the healing, if you introduce a concentrated oil to the site. If you know that you are not sensitive to it, you can use lavender essential oil without experiencing skin irritation, you could mix it into jojoba or vitamin E oils - try a 2% dilution to start, you can increase to 5%. Frankincense carterii can also be helpful and some people recommend peppermint or tea-tree oil. I wouldn’t use lemon or garlic(!)- I’ve seen both recommended. These are very likely to cause irritation, inflammation, increased sun-sensitivity and really not help.
A hydrosol, providing it is from a reputable producer - so just distilled herbs, no extras - then a lavender, yarrow, borage, green tea, honeysuckle or rose can all help sooth scratches, burns and stings - providing you are not allergic to any (test a little on the inside of your arm before using directly on the site).

We do tend to medicalise everyday ailments, partly as it encourages you to buy something! If the wound is minor and not likely to get bashed or contaminated, cleaning the site and leaving it open to the air is a good way to start. Use a crepe bandage if it need’s some protection and start simple: cold water rinse, repeated if a burn is still uncomfortable. A spray of something mildly anti-inflammatory and anti-bacterial (hydrosols or aloe vera) and if you need more protection, a thick zinc ointment spread lightly should be soothing and protective.
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Q: Can I use niacinamide with hyaluronic acid and vitamin C?

In theory, yes, but getting them into the skin, to do some good, can be problematic. Your skin contains all three and they help to keep skin healthy. The difficulty that faces most formulators is how to get these into the layers of the skin that could benefit most from them. If you are particularly interested in how this happens, Fick’s Law of Diffusion is where we start - you may want to look it up - I won’t detail it here…
These all tend to start in watery environments (vitamin C comes in several forms now, but l-ascorbic acid is the most common and has been tested more thoroughly). These makes it reasonably simple to get it into a product and onto your skin. It’s the next bit that proves tricky… in order for it to be absorbed deeper, the ‘active’ needs to get there in as concentrated a form as possible - so if it is in something that will evaporate quickly on the skin, like water or alcohol, the active is delivered in a reasonable concentration.

Whatever it is, it will need to get into the natural lipids that surround each skin cell, forming a protective layer and they all tend to be more hydrophilic. There has been a very nice study conducted by Dr Majella Lane recently on the optimal delivery of both niacinamide and an l-ascorbic acid ester. It is worth reading her study, but, in brief, she demonstrated that both work better when in a carefully combined solution of two or three vehicles. It wasn’t an exhaustive trial, but she found the vitamin C ester was absorbed best (deepest), in a combination of propylene glycol, propylene glycol myristate and hexelene glycol with fatty acid esters. This allows the vitamin to be absorbed into the skin lipids successfully. Niacinamide worked best in a solution of propylene glycol and a combination of linoleic and oleic fatty acids (these are found in a variety of fruit and nut oils). Hyaluronic acid tends to be a large molecule and there is research to suggest that it is actually useful sitting on the top of the skin if it is mixed with the smaller molecule sodium hyaluronate, which can penetrate deeper - the moisture is delivered superficially and more deeply. This is an additional stage to optimise delivery to those detailed here for niacinamide and vitamin C.

So - the vitamin must be protected and stable before it gets to your skin and must be formulated with ingredients that evaporate at skin temperature, leaving a maximum amount of the vitamin behind. They should also be in a combination of hydrophilic and lipophilic solutions that allow it to be optimally absorbed into your lipids to get down to a layer where the body can use it effectively.

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Q: How can alternative therapies help treat skin cancer?

A: This is a thorny one...

There are four commonly known cancers that affect the skin and a multitude of ‘alternative therapies’. Presuming this to mean treatment given by someone other than an oncologist, dermatologist or medical specialist.

It is very important to establish which one you are treating.

Melanoma is the one that is usually the most serious; it can grow very quickly and spread to other areas in the body. I am sure there are treatments offered for this other than surgery, immunotherapy, radiotherapy and chemotherapy, typically recommended by medical specialists, but I would be very hesitant to try these. It often metastasises quickly, so spending time investigating possible other treatments could mean the difference between sorting a local skin cancer relatively simply, and dealing with a wide-spread, complicated cancer.

Basal cell, Merkel and squamous cell are not usually as dangerous and often detected in an early stage. If they appear on the face, are very large or the patient doesn’t have good general health or has a poor immune response, then, again, the most sensible option is still one of those offered in a hospital environment (which isn’t necessarily surgery or radiotherapy).

Having said that, there are other treatments than can and do work on early stage pre-cancerous skin lesions - those that may develop into squamous cell carcinomas and basal cell carcinomas if left untreated. I have used a modified recipe, originally developed by Dr Ron Guba with success on solar keratoses and early squamous cell carcinomas (his findings can be found in various places online, including roberttisserand.com). It is a simple formula and easy to use, if there is no significant improvement within six weeks, you can presume this treatment will not help. He recommends a mixture of the following: Sandalwood oil -Santalum spicatum 13.3%, Frankincense - Boswellia carterii 6.7%, Sweet orange oil - Citrus sinensis 6.7%, Geranuim - Pelargonium graveolens 6.7%. These are mixed into jojoba oil and melted beeswax to make an ointment that is easy to apply: Jojoba 46.6% and Beeswax 20%.

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Q: How can I remove the scar I have from using garlic to remove a mole?

A: It is difficult to give you helpful advice without seeing the scar. I’m not sure whether you mean a scar, as in, the area blistered or the surface was damaged, or whether you mean the pigment has become darker there. If the former, you probably ought to ask a nurse or GP to have a look at it. If it has left dark pigmentation, but not actual inflammation, then Kojic acid at 2% should be comfortable and effective, over a few months. Alternatively, liquorice extract can lighten skin areas that contain excessive melanin. I wouldn’t use anything stronger as you seem to be saying that this is a site of a mole, it is very important that you don’t irritate the skin there. Before you treat any cosmetic features on the skin, you should make sure it isn’t inflamed or damaged or you could make the area much worse. Please don’t try to bleach it with anything acidic (like lemon juice!) as this can cause very unpleasant burns. I hope it settles down.

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Q: How can I protect my skin during chemotherapy?

A: Depending of the type of chemotherapy, skin can become more photosensitive, drier and patients sometimes develop dark spots, rashes and inflammation.

It is important not to use any products that could compound irritation, so avoid artificially perfumed and coloured products and anything with ingredients that tend to cause dryness, exfoliation and peeling. This includes: AHAs, BHA’s (salicylic acid and willow bark), retinol and harsh surfactants (Ammonium lauryl sulfate, Sodium lauryl sulfate and sodium laureth sulfate). Check your shampoo ingredients, as whatever you wash your hair with in the shower will affect your skin too, harsh ingredients in shampoos can be the cause of skin irritation and dry patches on the body. Use a good, broad spectrum sun cream to counter the increased likelihood of damage from UV radiation.

I would suggest using a hydrating moisturiser with good emollience and occlusive properties. Look for products with aloe vera, algae, glycerine and colloidal oats. Butters such as shea, avocado and mango and oils that are helpful to dry skin: argan, camellia, rosehip, moringa and pomegranate. If you can, choose one with additions like: hyaluronic acid, panthenol, niacinamide, phytokeratins and peptides. If your skin is ok with plant extracts, then an extract with a high polyphenol content should help strengthen the skin.

It is especially important not to put anything on your skin that irritates, and ingredients that have been fine in the past may not be tolerated as well during this treatment. So keep it simple to begin with and then add the extras gradually. They should increase the strength of the skin and help repair damage, but any active ingredient is potentially an irritant, so it might be an idea to keep a record of what you find soothing and anything that causes even a very slight reaction leave out for now.

I think a rose, calendula, algae, honeysuckle or lavender hydrosol could be a gentle and effective way to keep skin clean and well-hydrated. These should also be well-tolerated, as long as you don’t have an allergy or sensitivity to them. I believe that some essential oils, when used in the right concentration, can also help, but now wouldn’t be the time to experiment. When the treatment is completed, you may find that adding rose, helichrysum, frankincense resin, myrrh, chamomile, vetiver or geranium essential oils can help with skin hydration, but keep well within safe levels (I particularly like Robert Tisserand’s book ‘Essential Oil Safety’ and tend to follow his guide in this). A reputable producer is vital as a number of oils are sold with additional aroma chemicals or cheaper oils added. There is usually a ‘therapeutic window’ with botanicals; too little and they do nothing, too much and they can cause a myriad of problems, so use carefully, but consider addIng them when your skin isn’t coping with this additional chemotherapy load.

I hope the treatment is successful and completed minimal side-effects.

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Q: My cologne is causing mild redness and stinging on my neck and inner elbow. How can I manage this?

A: I think you are suffering from irritation rather than an allergy, given that the redness is mild, appears only where you apply it and doesn’t spread. An allergy is more serious and you would need to stop using your cologne.

Presuming that this is an irritation, then it depends on how much you like your cologne and how irritating is the irritant! If you badly want to continue to wear it, you might ask the manufacturer if it comes in a different formulation, perhaps in an oil base or as a balm, as these could be gentler.

The two areas you mention are where the skin tends to be thinner, so irritation is more likely. You could try applying a light oil or moisturiser before spraying the cologne as this would potentially offer your skin a layer of protection and actually may make the scent last for longer.

Cologne is usually formulated at a concentration for unshaved skin, whilst formulations for application to shaved skin must contain a significantly lower concentration of essential oils and aroma chemicals. I don’t expect you shave inside your elbows(!) but you may shave you neck and this would likely make skin much more sensitive.

Check the ingredients list, any citrus oils are quite likely culprits, as are many aroma chemicals, but alcohol can do it too. If the skin reaction worsens, you should probably stop using it and do keep an eye on it; if it looks like contact dermatitis you will probably need to avoid the irritant for good. But if the stinging is worth the smell, then maybe spray on your hair (the skin on your scalp is thicker, and hair will make skin contact minimal). For similar reasons, you could spray it on your forearms, not inside the elbow and the back of your hands will be less sensitive than your neck.

I hope it improves and those around you appreciate your suffering for their olfactory pleasure!

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Q: Are facial wrinkles more pronounced in countries with higher humidity?

A: That is a really interesting question!

I think what makes more difference is the skin they are in, how they treat it, diet, sunshine and the amount of ozone over their heads. Although the humidity may also play a part.

People with Type 1 Skin (on the Fitzpatrick Skin Scale) do tend to wrinkle earlier than people from the other five categories and there is a marked difference between Types 1 and 6, in terms of wrinkles. Type 1 skin tends to be thinner, prone to inflammation and irritation and sun damage. Whereas Types 4 to 6 tend to have a thicker epidermis, make more scar tissue and sebum but are more robust.

Having said that, there are plenty of people with Type 1 skin living in California, Hong Kong and Saudi Arabia and Type 6 in Chile and Peru (very arid places), so we should be able to compare what those conditions do to all skin types.

The ozone layer is thinnest over the Poles, Australia, Argentina and Chile. And the populations apparently ageing more slowly (in general, not just skin) according to the Institute for Health Metrics and Evaluation (IHME) are Japan, Korea and Italy. Some of those ageing more quickly are the Marshall Islands, the Solomon Islands, Papua New Guinea, New Zealand, Australia, and Fiji.

So, someone with a bigger brain than mine can probably collate all that and decide if there is a correlation between wrinkles and watery air… it’s still a very interesting question!

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Q: What is the difference between rosehip and evening primrose oil? Which would be better for very sensitive, dehydrated skin?

A: There are a variety of Evening Primrose species, but the oil is usually from Oenothera biennis seeds. The oil is very high in linoleic acid (about 70%) and γ-linolenic acid (about 10%) with other fatty acids including: palmitic, oleic, stearic, and myristic acids. It also has flavonoids, proteins, vitamins and minerals. These make this oil very good at dampening inflammation in skin and preventing it from spreading. This has been demonstrated in studies on atopic dermatitis and psoriasis.

As with Evening Primrose oil, Rosehip oil can be made from a variety of species, Rosa canina is the best studied and the most likely to be used in Europe, or Rosa rubiginosa. This contains almost equal amounts of linoleic acid (42%) and a-Linolenic acid (38%), Oleic acid 12% , palmitic acid (5%) and a few others. The most abundant vitamins are C, A and E which can all be very beneficial to skin function and healing. The tannins make it feel astringent, but it has been shown to benefit dry skin and maintain softness in the skin. The flavonoids help with antioxidant potential.

However, for extremely sensitive skin, I would approach with caution as both (in fact most botanical extracts) can cause allergic reactions. If your skin is very sensitive, perhaps you could start using shea or mango butter with a little jojoba or almond oil oil mixed in to see how your skin reacts, the butters will also be beneficial for your dry skin. If you don’t react to either, then you may want to try these two oils, one at a time, again mixed with the butters. Their fatty-acids profiles, above, gives you some sense of what they might be expected to help. The Evening Primrose is possibly a more comprehensive anti-inflammatory and Rosehip offers antioxidant properties and a nice high vitamin C content, so should help to restore depleted skin and offer some protection from UV damage and pollutants.

For dehydrated skin you can add hyaluronic acid mixed in glycerine or sorbitol, add to the oils and butters above (you will need to use an emulsifier if you are making this yourself) or you can apply the glycerine and hyaluronic acid to damp skin. I always recommend using a good hydrosol for cleansing and toning in one. This leaves even sensitive skin well hydrated and provides enough oil to improve very dry skin. After this, you can apply the butters with the oil or just the oils.

Both vitamin A and C from Rosehip, should be helpful in the mid to long-term strengthening of the skin. But until the dehydration is rectified, and you have determined what improves and what worsens your sensitive skin, I wouldn’t experiment too wildly. When your skin is well hydrated it will function much better and you will then get far more out of any fatty-acids, vitamins and minerals you put on it.

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Q: Why do overweight people get skin darkening in skin folds?

A: It may be acanthosis nigricans - this is where the folds of skin, particularly the neck and tummy become significantly darker than other skin. It should improve with weight loss and can be improved by using creams containing retinoids (Vitamin A) and skin lighteners like a-Arbutin, Kojic acid, Liquorice extract or Gluthamine. 

The most common cause is due to a high production of insulin and this then stimulates skin cells to be produced at a much faster rate. It can also be a result of hormonal changes, sometimes seen in pregnancy, abnormal thyroid function and polycystic ovaries. Certain medicines can also cause it.

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Q: What will help me to re-build collagen?

A: I’m afraid you’ve hit the $64,000 question!

It seems to be the era of collagen replacement, or at least it’s what we all think we need - anyone over 35, anyway.

It is possible that you skin is collagen depleted, but it is likely that it would benefit from other things too, which can be addressed quickly and with little cost.

Better hydration is a fast, simple one to rectify and something people often miss. This doesn’t just mean drinking more, although if you think you may be generally dehydrated, then certainly, increase your water intake. It is just as often the lipids in the skin that are a bit lacking. This should respond well to a good quality moisturiser, to boost the fatty acids, ceramides and cholesterol in this layer. The other often over-looked and entirely free and effective collagen-stimulator is facial exercises. There are several good videos on YouTube, and they don’t need to be complicated or take longer than two minutes a day. You are aiming to exercise and massage the muscles in the face that are not used enough and support the areas that tend to sag first. So the chin, under the cheekbones and forehead are easy to do and have been shown to have good results.

Another consideration is to try to rectify those factors that deplete collagen. I use botanical extracts for this with really encouraging results. The polyphenols in the extracts deliver antioxidant properties, some are also anti-inflammatory and inhibit UV-induced connective tissue damage. Another group of flavonoids, anthocyanins, can decrease UVB-induced damage and significantly delay cancer formation and proanthocyanidins inhibit free radicals and inflammatory pathways. All this goes a long way to not just protect, but improve skin texture, stability and, importantly, stop inflammation, which is a major factor in skin looking depleted.

So, collagen… the area I tend to spend most time on is how to increase collagen through topically applied vitamins and minerals - creams and serum mainly. At the other end of the scale, people do have collagen-stimulating fillers injected into the affected areas. I can’t advise about the latter, but I have a detailed piece on my website about collagen boosting ingredients - bottom of first page - scentsofman.com, or below I have listed the vitamins I use most frequently in products designed for this:
Vitamin A
Applying Retinoic acid topically can improve collagen metabolism, but it can also be very irritating. As all vitamin A derivatives are converted into retinoic acid on the skin, the gentler ones can still deliver without the risk of irritation if that is a problem, as low as 1% (I mix retinyl palmitate with palmitoyl tetrapeptide-7 in two of my collagen-boosting products and that works very well).
Vitamin B
I am a big fan of Niacinamide, it doesn’t work overnight, but give it a few weeks and it comes into its own. It tends to improve general elasticity, rather than collagen specifically. DMAE applied at 3% was shown to markedly improve sagging skin.
Vitamin C
Most people have heard of this one and it has been well studied - L-ascorbic acid has been shown to be a cofactor for collagen synthesis. Don’t be tempted to apply large doses, more isn’t always more, in terms of results. You don’t want to irritate or burn your skin whilst attempting to boost collagen. 3% in a cream, applied for 6 months increased elastin and type I and type III collagen. It needs to be kept air-tight and preferably cool. If it turns orange, it has oxidised, so bin it!

Alpha lipoic acid
This is an antioxidant that can repair oxidative damage and used at 0.5%, it can increase collagen synthesis.

Alpha-Hydroxyl Acids - AHAs
AHAs: The most commonly used are glycolic acid and lactic acid. Some people recommend high concentrations (20%), but in my experience, 3- 5% concentrations can still be very good, with less irritation. This will also take a few weeks to deliver a discernible difference on collagen.

Peptides
These vary in their effectiveness, but some have had impressive results on collagen and excellent results on overall skin condition.

Happy hunting - I hope you find some that do the trick!

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Q: Can I add a moisturiser after Adapalene?

A: Yes.
Adapalene (aka Differin) is usually better tolerated than some other retinoids, but it can still make skin quite dry and irritated for a few weeks.

Just ensure that you choose a moisturiser that doesn’t contain AHAs, PHAs, Urea or Vitamin A - anything that might increase the penetration of other ingredients in the moisturiser. Adapalene doesn’t seem to be absorbed into plasma through topical use, or not much anyway, but it will still tend to leave your skin less protected, and you don’t want to exacerbate this.

So I would choose something fairly light and straightforward, with a water content above 75%. Look for some of the following ingredients: aloe vera, seaweed extract, oat protein, calendula extract, chamomile extract, borage, mixed with gentle oils and butters: coconut, hemp seed, cocoa butter, andiroba avocado, argan, rosehip, kukui. Until your skin is feeling hydrated and any redness has gone. (You don’t need to find something with all those ingredients - aloe vera alone can be great - just make sure you’re buying aloe vera and not a jar of glycerine with additives!). Hydrosols would also be a good idea, in terms of moisturising without irritating. They are not oily, but have enough to hydrate skin. I would recommend: rose, seaweed, chamomile, camellia, cornflower, calendula, honeysuckle and possibly lavender.

For now, stay away from moisturisers with active ingredients that could irritate, including Vitamin C - even though this can be healing, I wouldn’t apply it after this sort of treatment if the skin is inflamed or excessively dry.

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Q: How can I cure exfoliative cheilitis (dead skin shedding from lips)?

A: It does depend on what, exactly, has caused it and what exacerbates the symptoms.

It is possible that an anti-fungal cream might help, if the problem originated through a yeast infection. If it seems to be stress-related, that should be addressed, as a topical cream would only sooth the surface of the lips. It could also be caused by low Vitamin B12 and folate, zinc or iron, but you would probably have noticed other symptoms; poor circulation, tiredness, irritability, hair loss. There are auto-immune disorders that might prevent healing in general, so that is also possible. And hormone imbalances can also present with this problem.

You may have already checked all the above and still have symptoms, in which case, make sure you cover your lips with a good quality lip balm during UV exposure, whatever the original cause. Try not to touch the area, or lick your lips as this will dry them more and increase the risks of inflammation and introducing bacteria into the area.

You could try extract of calendula, it is a very good skin healing extract and has had some impressive results in a 10% solution. Chamomile is very soothing ( it contains various bioactive phytochemicals - but don't use it if you are allergic to chrysanthemum), and both yarrow or evening primrose could help too - as extracts or dab on a hydrosol. A physician may suggest a hydrocortisone cream.

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Q: Does eczema get worse with age?

A: Eczema isa term used to describe not just one, but a group of conditions; atopic dermatitis being the most severe form. It usually describes skin that has developed patches of itchy, irritated skin that can become scaly and cracked.

Children who developed it in infancy can often see it go, or markedly improve at around 5, although they may still have episodes throughout life. It can also first appear at around this age (infancy tends to be on the head; in childhood it is usually more widespread). But it can also start later in life. It is not uncommon to see a first episode at 50–60 in plaques of the head, neck, and flexural areas.

Whether or not it deteriorates with age depends on numerous factors, including how well the skin is treated, exposure to the irritant/s and general health. As skin tends to becomes drier as we age, eczema will make it more vulnerable to worsening dryness and this in turn can worsen eczema.

Skin affected by eczema has an impaired sin barrier. When intact, this holds in moisturised and regulates trans epidermal water loss (TEWL), a function that tends to worsens as we age. Importantly, there is a reduction in surface lipids, especially ceramides, which degrade faster in skin with eczema.

Using a cream containing ceramides, that is hydrating and occlusive should help replace both lipids and water whilst keeping them in the skin for as long as possible. The addition of a well-formulated moisturiser with hyaluronic acid, sodium hyaluronate and dimethicone have been demonstrated to help. Niacinamide, glutamine, aloe vera, vitamin A, C and E can also strengthen the stratum corneum. However, this condition can make skin more susceptible to irritants, and pretty much anything that can be described as an ‘active’ ingredient is potentially irritating, so caution is needed when applying any new ingredients to skin, especially in large doses. Moisturisers containing urea and lactic acid should be avoided as these have been shown to irritate eczema.

A secondary problem in this condition, especially in later life, is inflammation and the colonisation of Staphylococcus aureus. This can cause other infections that may require potent antimicrobials to control. If the condition is relatively stable and the skin isn’t ‘weeping’, using a good hydrosol, with no added colours, perfumes or preservatives, can offer excellent antimicrobial and anti-inflammatory properties, whilst soothing any itching, with low risk of irritation. Yarrow, borage, calendula, rose, green tea, honeysuckle and algae should all help.

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Q: Can I use a vitamin E capsule with rice water daily on my face?

A: Yes.
Rice water does make skin feel soft - you only have to rinse sushi rice to discover this! It is reputed to be hydrating, antioxidant and contain amino acids and some B vitamins. There isn’t very much published research on it (probably because it is cheap and readily available!) but anecdotal evidence is good. Store any excess in the fridge and throw it away after 3 days, to avoid water-loving bacterial growth.

I would use the rice water first, let that soak in and just dab off the excess. Then apply the vitamin E.

If the oil works well for your skin, great, maybe think about buying the vitamin E in a larger container as the capsules will work out to be quite expensive if you're doing this each night. There are much lighter oils you could use, if you find your skin feels a bit greasy or sticky with pure vitamin E. Otherwise, it sounds like a good routine.

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Q: How many oils can you mix together for skin?

A: There isn’t really a limit as to how may you can mix.

I think the more important factor is to mix oils that contain the properties you are looking for, depending on you skin type/age/ and skin damage. Some oils are much better for acne-prone skin, some for very dry and depleted skin, some can help lighten dark patches etc.
The price difference between carrier oils is quite surprising, so check these before deciding which to try.
Below are a few I use often in our products:

Acai Berry: Contains good amount of vitamins B1, B2,B3 , C and E. It is a powerful antioxidant with omega 6 and 9. Anti-inflammatory and useful for: arthritis, rashes, muscle pain, wounds, boils, and even herpes ulcers.

Argan: This contains 80% fatty acids, is very nourishing, high in antioxidant vitamin E. Very moisturising and soothing. It is protective and helps repair cell membranes and contains sterols with anti-inflammatory properties.

Avocado: Very nourishing, but it can leave a waxy feel on skin. Rich in essential and trace minerals and vitamin A.

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Q: Does hyaluronic acid need to be applied to damp skin to stop it pulling moisture from skin and leaving it drier?

A: I can see why you ask this as hyaluronic is a humectant so draws moisture to itself; it doesn't much care where that moisture is.

Having said that, it can’t drill down into your own supplies of hyaluronic acid and leach them of moisture. Pretty much anything you put on the skin is only going to make a difference to the top layer (and this is a good thing!). Some constituents can stimulate reactions in the skin that then may affect the function or systems deeper down, but mostly, you are just treating the surface.

Hyaluronic acid in significant amounts, will draw moisture to itself( this is true of most humectants: glycerine, sorbitol etc). How deeply it can penetrate is debated and depends on various factors, including the molecular size - not all hyaluronic acids are made equal(!) -  sodium hyaluronate, the salt, is smaller, so theoretically can be absorbed more efficiently. However the larger HA molecules does a very good job of keeping the top hydrated - so using both together is probably a good idea.

If you are applying it in a cream or serum, it will have been manufactured with a water element in the product, so that provides the dampness, you don’t need to worry about giving it water to work with - although it won’t do any harm. It could possibly dilute the action of other active components in there, but again, the affect would be minimal.

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Q: How long does olive oil take to be absorbed into the skin?

A: The best time to apply it is after a shower, or bath whilst your skin is still warm and damp and the absorption will be deeper and quicker.

It has antioxidant properties and in one study was shown to be effective against Staphylococcus, although coconut oils seemed to perform better. (It is hard to know whether antibacterial activity in a petri dish will be replicated on living skin, generally not.)

It contains vitamins A, C and E, which may be beneficial (if absorbed) and it seems to be a good skin softener. Some people find that it can lighten skin.

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Q: What are your best skincare tips?

A: What you use and how you use it will depend on your age, skin condition and whether you have particular skin concerns (hyper-pigmentation/ dry patches/etc).

If you are under 25 with no visible UV damage, no acne or other specific problems, you should be able to keep your skin that way on a fairy simple routine. I would suggest all that is needed is a good hydrosol to cleanse and hydrate skin (the oils are already naturally in the water, so this will remove oil deposits and oil-based makeup). There is probably no need for a specific balm or serum, just a good moisturiser, and by good, I mean everything in the jar is actually there for your benefit; some nice plant oils, good antioxidants, a humectant and nothing too occlusive, but enough to keep the water from the humectants actually in your skin, not evaporating back into the air. Sun protection is always wise, if your skin is going to be seeing any sunshine. I know the jury is out, but personally, I don’t see the need for it unless you live at high altitude or where sunshine is strong enough to tan your skin, even a little. I think it’s a good idea to get a top-up of Vitamin D when sun protection isn’t required.

If you are over 25, genes and skin type will start to become more apparent. So, I would either add a specific serum, after the hydrosol, before the moisturiser, or just ensure the moisturiser contains what it is you now need. If your skin is starting to get dry, make sure there are good quality oils and butters, the nut oils are good and avocado, mango and shea butters will help. This might be the time to also look for Vitamin A ( even under 1% can work very well.

pH
If you want hyaluronic acid, for it’s excellent humectant properties, it generally likes a pH higher than 5 and Vitamin A is happy with that in most of it’s forms. There are some forms of Vitamin C that will work with it, but not L-ascorbic acid, it’s most common, and best researched, form, this needs a pH closer to 3 to be effective. If you think you need both, it is probably better to use a Vitamin C serum and then apply a moisturiser containing Vitamin A (give the serum 10 minutes before adding the moisturiser - your skin’s pH will normalise over that time). If you don’t think you need both, don't waste the money, if your skin healthy, stick with what you’re doing.

Between 35 and 50 is the time you may need to start adding more specific ingredients like AHAs, ceramides and peptides. Providing you know what you want (to repair sun damage, lessen lines, even-out colour/texture) you should get by on just one extra product. Possibly alternate a good Vitamin C at night (Vitamin C can react with sunlight) with a Vitamin A serum in the morning. But by taking time to choose a really good moisturiser, you should be able to get a lot of what you need from that. I use Niacinamide (Vitamin B3) in most of my moisturisers and this would be a good time to use it, if you haven’t already started. It will help strengthen the skin. By now, skin is starting to lose the plumped appearance it once had; it doesn't have the collagen and elastin it had 20 years ago.

Between 50 and 70 you are likely looking for as much moisture as possible, you may have sun damage, you certainly want antioxidants doing what they do best and you should become familiar with AHAs, PHAs, botanical extracts and make sure your moisturiser has plenty of humectant and occlusive properties. Dehydrated skin needs both oil and water, not just water. Make sure there are ceramides in the moisturiser, to keep the skin strong; these help restore the fatty layers between skin cells hold them together. There are ways to ensure you are getting these, and the peptides for elastin and collagen restoration, check the ingredients’ list carefully…

The 1% Line
When looking through the ingredients’ list you will find there is a ‘1% line”: anything in the product in amounts over 1% will be listed in order of largest amount first. So the first five ingredients are usually the bulk of the product. That is not to say that finding peptides down at the bottom is necessarily a bad thing, often .5% is working harder than something at 5%. just know what percentage is useful to you. Colours usually have a prefix of D and C, then a colour name, then a number. Find these on the label, anything below that is likely to be used at less than 1%. Preservatives and fragrance are not usually higher than 1%, so they are listed near the colours. Any ingredient used below 1% can be listed in any order, it doesn’t need to be largest first. Whist I would recommend choosing a product without added colours, the preservatives are necessary to make the product safe. But… there are those that do a good job and are safe and those that are there to keep the product stable enough to endure a year under a bright light in an airport duty free - I’d avoid the latter.

So, decide what your skin needs, find out what will supply this and don’t spend money on ingredients that are making the product a pretty pink or smell like a mango smoothie, they are not helping anyone’s laughter lines!

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Q: Can salicylic acid be used safely direct on skin?

You can use it directly on skin if it is in a medium formulated with under 5% Salicylic acid, although I would recommend 2%. It can be applied to an area and rinsed off at up to 6% and it is used in some face peels at higher doses, but this is quite likely to cause irritation. High percentages can burn the skin and make it more vulnerable to UV radiation.

It is a beta hydroxy acid, so it is good at loosening the top layer of dead skin and smoothing the complexion/fading pigmentation. It is also an effective acne treatment. 10% to 18% concentration is used to remove warts.

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Q: Why would people use lotion and not moisturizser?

Some people may choose a lotion for very light moisturising.

The difference between a lotion and a moisturiser isn’t clearly defined; a lotion tends to have a higher water content, a lower percentage of butter and oil and is rarely very occlusive.It is often a cheaper, simpler product, without the added peptides, ceramides, vitamins and other cosmeceuticals found in moisturisers and serums. But there is no reason, other than cost, not to add them and a well made emulsion with a high water content is a still a lotion and can be very effective (lotions tend to be 70–85% water; moisturisers 45–70% water).