Just As Well, The Women's Health Podcast - How To Get Great Skin Q&A: Two Leading Doctors Tackle Your Dilemmas

Episode Date: November 19, 2020

Given how much you loved our episode all about how best to care for your skin throughout the decades, we thought it was about time we do another show solely dedicated to looking after your body’s largest organ. Because, who doesn’t want their skin to be healthy, resilient and looking its best? Women’s Health’s beauty editor, Perdie Nouril, has been collecting your questions over the past couple of weeks, and they range from perennial concerns - such as treating acne, calming rosacea and what to eat for great skin - to some topics that are, terribly, of the moment. (Think: getting rid of the dreaded maskne, and the impact all that blue light we’re exposed to is having - now that meetings, workouts, book clubs, family catch ups etc are often taking place via a screen.) Answering your questions on today’s show are two of the British beauty industry’s most in-demand doctors: Dr Ifeoma Ejikeme, founder of the award winning Adonia clinic, and renowned cosmetic dermatologist Dr Sam Bunting. Expect clear-eyed, actionable advice about a range of conditions and insider tips on how best to invest in your skin - including what much-hyped products and treatments really aren’t worth your money. Follow Dr Ifeoma Ejikeme on Instagram: @dr_ifeoma_ejikeme Follow Dr Sam Bunting on Instagram: @drsambunting Follow Perdie Nouril on Instagram: @perditanouril Like what you’re hearing? We'd love if you could rate and leave us a review on Apple Podcasts, as it really helps other people find the show. Also, remember to subscribe wherever you get your podcasts, so you’ll never miss an episode.  Got a goal in mind? Shoot us a message on Instagram putting ‘Going for Goal’ at the start of your message and our experts could be helping you achieve your health goal in an upcoming episode. Alternatively, you can email us: [e-mail]. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

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Hey everyone, you are listening to Going for Goal, the weekly Women's Health podcast. My name's Rochene Derbyshei Kane. I'm senior editor on women's health, and this is your weekly chance to plug in and be inspired to work on your health and wellness. Given how much you loved our episode all about how best to care for your skin throughout the decades, we thought it was about time that we do another show solely dedicated to looking after your body's largest organ, getting it healthy, resilient and looking its best. This time, however, it's you, our listeners, putting your questions about your skincare concerns to our experts. Women's Health's Beauty Editor Purdy Norrell has been collecting them over the past couple of weeks

and they range from the sort of perennial questions like how to treat acne and rosacea and how to eat your way to better skin to some topics which are terribly of the moment. Like getting rid of the dreaded mascony and the impact that all that blue light we're exposed to is having now that meetings, workouts, book clubs, family catch-ups, etc. are all taking place via a screen. She's recruited two of the British beauty industry's most in-demand doctors, Dr. Ithioma, Echieme and Dr Sam Bunting, and together they answer your questions,

provide clear-eyed advice about how to best invest in your skin, and of course, don't hold back when it comes to busting some skincare BS. Seriously, hang fire on ordering products in those Black Friday sales until you've given it a listen. Over to Perdy. Hey everyone, I'm Perdy, the beauty editor of women's health, And today we've got a bumper episode. So it's our first ever interactive skincare Q&A and over the past few weeks

you guys have sent in all your burning skincare questions. Here to answer them are two of the best pros in the game. Joining me is Dr. Ifioma Egekeme, who is founder and medical director of the award-winning adonia clinic. And also here is cosmetic dermatologist, Dr Sam Bunting, founder of Dr Sam Bunting associates

and her eponymous brand Dr. Sam's. Ladies welcome. Hi. I know. Dr. Educcemi, if you can start by telling us about your background and your approach to skincare. Sure. So as you said, my name's Dr. If I'm Ejikema. I founded a Doni Medical Clinic in about 2017 and my ethos in the clinic is really to create a safe space that everybody can talk about their skincare concerns irrespective of their skin tone. We do lots of different things such as laser hair removal. We also really focus on skin and we do lots of things in skin, everything from hair loss treatment, acne, rosacea, pigmentation. And my ethos with skin is really scientifically led treatments to lead to effective results. So I'm really ingredients driven, especially when it

comes to skincare products. I just follow the ingredients and follow the science to be able to help people get a lovely result. Lovely. Thank you. And Dr. Bunting, you're renowned in, certainly in the press for helping to demystify the beauty arena. So would you say your approach is, you know, pretty no nonsense. That's nice to hear. Yeah, I mean, gosh, I've been around the houses. I practiced hospital dermatology for eight years, set up my clinic. Ten years ago on Hardy Street. And at that time, I've worked with everyone from Dorche and Gabana to a Venn, launching my own YouTube channel about four or five years ago, and doing a TV show for TLC. So I kind of, I've kind of done it all, really. I launched the brand about two and a half years ago now. So

kind of distilled all those sort of learnings and experience and exposure to different parts of the market into the brand. I suppose the brand really epitomizes what I stand for, which is ingredients, driven again and really wanting to deliver the prospect of great skin to everybody that should be something that is achievable. It shouldn't be an aspiration that's only given to those, you know, who can afford expensive products. So I think we're all on the same page. Yeah, and that's so true, isn't it? I think so many people find it really confusing, which is why this episode kind of aims to debunk those myths. Okay, so I'm going to jump straight into the questions. Just for ease, I've broken them up into topics. And the first section to be kicking off with is ageing. So Dr. Bunting, I'll start with you.

One of our readers, Ellie, wants to know what are some of the best products to reduce signs of aging that don't cost a bomb? Well, that's an easy one. So the most important anti-aging product is actually, daily sunscreen. And I think this is so often missed out that people, you know, want to reach first for an eye cream or a serum when, in fact, it's a daily sunscreen started at the right time that will make the biggest impact long term given at 90% of my VH is due to UV damage with on a UVA raise. So I think that the best money you can spend for anti-age and starts with investing in a sunscreen that you like so much that you actively enjoy wearing it every single day. And it's part of the reason why we put so much effort into formulating flawless daily sunscreen

to make it function like a primer, to make it actively anti-blemish to kind of override those common concerns that people have about sunscreen because, you know, in the past, historically, formulations were kind of gunky, whether they made you look white, whether they made you look shiny or break out. So common reasons people don't wear sunscreen, but I'm passionate about getting people to see sunscreen in the right light because it has so much to offer. And what are some of the best sunscreens out there that you recommend? So I think the French pharmacy brands do this really

well. So I have a lot of time for both the Venn and La Roche-Puse when it comes to sunscreen. So the Anthelios range is excellent, really good UVA and UVB protection and non-clogging. And the same goes for events. I think those are both brands that are also really good for

practical, affordable sunscreen that, you know, is actually pleasant to wear. Thank you. And Dr. Eddie Kemi, is there any SPFs that you highly weight? There are a few that I really love. I think sunscreen is a fundamental part of your skincare routine. And there are a couple. There's the Murad sunscreen that I really like. I think a lot of my patients, the issues that we have with sunscreen is finding a sunscreen that's really wearable and finding a sunscreen that doesn't leave that kind of white, ashy cast. Nobody

loves that. So I think it's finding a sunscreen that you're able to wear every single day that feels good for your skin. Now, if you're oily, I recommend finding a sunscreen that's non-cabedogenic and a very lightweight sunscreen. And a few of the ones that Sam has mentioned are excellent. The Murad City Skin, the Supergoop Unseen, are two that won't leave that cast. The Medicaid, advance, day, total protect. Another one I love, that's a good price point that doesn't leave that cast on the skin, which nobody loves. So always look out for a sunscreen that feels light. but doesn't leave that cast. Thank you.

And I think, yeah, it's definitely all about prevention more so than cure, isn't it? Yes, I agree. What products would you then recommend? This is another question we've had in from Jennifer, who wants to know the best products for fine lines. So say, you know, if you didn't wear the sunscreen in your formative years or you're a bit lax with it, what are the best products to try and cure fine lines? I think my number one there has to be retinoids.

So retinoids have the best evidence behind them. They're actually one of the only. products that have been shown in scientific study to actually reverse lines that are already there as opposed to prevent. But with retinodes, I know there's so many different ones in the market, and it can be a bit of a minefield to know which ones you should use. So my goal to with retinoids is always start as low as possible. So go with a retinol or a retinol. Those get converted in the skin to retinic acid. But retinic acid can be a bit harsh if you've never used it before. Some very affordable brands that I like that I think we work well on most people's skin is the Olay Retinal 24.

That's a really nice light retinal. If you wanted to go a little bit more, then the Medicaid Retinal 3 is beautiful. That's a really, really lovely retinal that you can use all over the face. And finally, another one that I do like that I've been using recently is the Murad. you have retinal renewal, night cream. Now, between those three, you'll really find something that's good for most skin types. But the biggest thing with retinoles is when you start a retinol, you have to start slow. And you need to start from a point of hydration.

I think a lot of people reach for retinal when the skin feels dry or they notice a fine line or wrinkle. But actually, in those situations, you might actually need to hydrate the skin. So I always recommend what I call the sandwich technique, but you have a nice moisturiser. It doesn't have to be expensive, just whatever moisturiser that you have. Place that on the skin first, then use your retinal and then place some more. Start that about three times a week. And as your skin gets used to it, then increase slowly up to every single night as your skin tolerates it. So that's a good way to really bring in retinoles to your routine.

And they're very, very good for those fine lines. And how will you know once your skin's able to tolerate it? Will you kind of get less tingling? So if you start slowly as I've described, you have. You actually won't even have any tingling. It's actually you build your way up to it. So the first week you start three times a week, the second week, four times a week, and the third week every night. Now, as you become more hardcore with your retinol, you can then take off the moisturisers

and then put the moisturiser the retinol straight on the skin. And then you might start to get a bit of the tingling. Thank you. And Dr. Bunting, Rachel has sent this question in. She said, I have under eye wrinkles. I've had them since my early 30s and nothing seems to be working. So would you recommend retinal for Rachel? I mean, retinoids around the eyes can be trickier and certainly I wouldn't ever suggest

someone starts out using vitamin A for the first time around the eyes. I think it's always good to get an education about how your skin's going to behave by introducing it to thicker points of the face. And actually, I've coined something called a 13 dot technique to help encourage people to focus on those thicker parts and stay away from the sort of thinner, more problematic areas that are prone to dryness. So I think, yes, retinoids around the eyes can be helpful once you're used with the retinoid, you know what to expect. Because I think the alarming part of starting to use a retinoid around the eyes is it can very quickly cause dryness and that

can actually make the fine lines look worse. So when I introduce retinoids with my patients, I do it later on. They already know what to expect. We've taught them techniques like buffering. and oftentimes I will use a much more dilute product around the eye area than I would the rest of the face. But of course, it doesn't mean that you don't want those benefits. You want that thickening of the dermis. You want that smoothing out of the epidermas. So I'll often use niacinamide, which is vitamin B3 first, because that's a really good

active ingredient in its own right for improving the appearance of fine lines, improving hyperpigmentation, but it also boosts seramide production. And that can be a really good way to improve the tolerability. of the eye area to a retinoid. So I think, yes, vitamins A, B, and even vitamin C, these are all active ingredients that are great for anti-Asian generally and can be used around the eye area. But I'm just that bit more cautious when it comes to the eye area. I think, again, sunscreen, people often skip out the eye area. It's incredible how many times I've heard people say, oh, I didn't realize we meant to put it down. And yet, of course, it's the thinnest skin

part of the body and it's an area that's in constant animation because we're always smiling. And you wouldn't want to change that, of course, but it does mean those fine lines are constantly being etched in, you know, as we go about her everyday sort of way of being. So it's just to be conscious of those simple but important daily steps that I think can actually make a big difference to how gracefully we age. Brilliant. Thank you. And moving on to our next question, Nicola has said she has very oily skin, but she's also worried about aging now. She's in her 30s. So what should her approach be? So for Nicola, I'd recommend that she really starts to look at her overall skin skincare routine. She's got oily skin. So I usually recommend five steps in your

basic skincare routine, that you have your wash. And because she says she's oily, I'd recommend that she goes for a salicylic acid acid, at about 2%, salicylic acid-based cleanser. Now, a lot of people when they have oily skin tend to just want to use a lot of that salicylic base cleanser. But instead, what I recommend is that you have a gentle cleanser and then your active salicylic-based cleanser if you have oily skin. Use your gentle cleanser every morning, and then you bring in your salicylic cleanser three times a week at night or even five times a week at night.

And as you're aging, what you'll notice is that sometimes people describe their skin as combination skin where they have oily skin, but it's dehydrated. And doing this kind of method with cleansers can actually reduce that and help you gently exfoliate without overstripping the skin. Then if she's thinking also worried about aging, you have to nourish the skin and repair the barrier function of the skin. So she needs to look out for ingredients like hyalimonic acid in a formulation that's not going to break her out. So hyluronic acid and ceramics can really help boost the skin and improve collagen production as well. Another key ingredient you've talked about already is your retinoles.

So retinoles are excellent to help prevent, regulate the oils in our skin and prevent breakouts. So if you're aging and you have oily skin, it's a great multi-purpose ingredient that you can use. And we talked about a few that I love. That leads us quite nicely onto acne. So we had so many questions regarding this area. Dr. Bunting, Tasha would like to know. How does she figure out whether her breakouts are hormonal or from external factors? I think that's pretty easy because I think that in women, breakouts are almost always hormonal to an extent.

I mean, acne before your period is almost physiological. It's so common, it affects around 70 to 80% of women. So there's something about the way our hormones impact our cycle, and the second part of our cycle that interacts with our skin, makes it more oily and more prone to blocking up and breaking it out. I think that irrespective of what the main driver is, the approach is ultimately the same anyway. I guess in patients with breakouts and clinic,

everyone gets a kind of a skincare plan, the actors are required to use, and it's almost always a retinoid-based system in conjunction with non-chamilogenic basics. And that tends to be the best way to get ahead of breakout. So even if you're just breaking out once a month, it's still better to prevent them than it is to wait to react to them. I also often give people an anti-inflammatory agent, whether it's benzopoxide or salicylic acid to use for the actual blemishes when they actually come about. But generally speaking, if you only get breakouts once a month, it's still worth doing this. It's a retinoid thing on a regular basis and trying to prevent as many of those hormonal breakouts as possible.

Other things that can, of course, play into a contraception diet. Those are all factors that can interplay with your own natural hormonal cycle. But in the end, the approach is still the same. Get rid of things that might be triggering your breakouts and your skin care, whether that's, you know, using a balm cleanser or an oil cleanser or a sunscreen that's not appropriate for your skin type. So sort of really having a bit of a product cull. So often these days I find people using long wear makeup, double cleansing to get it off. And that's actually a big contributor to why they're actually breaking out. So you pair all of that back, put solid practices

in place, get a retinoid going and then, you know, assess and see where you are with that after a few months and I think for the majority of people, they'll see a big improvement, whatever's behind it. Okay. And Dr. Edgy Kemi, Kirstie wants to know she has very painful cystic acne, which her doctor says is hormonal, and obviously this isn't changing. Have you got any tips for her? Yes, I do. I echo exactly what Sambantic was saying earlier, that you need to kind of focus on your skincare routine. So the very first, when I hear things like I've got cystic acne, or it's been going on for a very long time. I look at what's going on in the skin from two angles.

What are you adding to your skin that may be triggering it? And what are you not adding to your skin that could help? So with her, the initial thing I'll do is look at her skincare routine to see if there are any ingredients that she's adding in. This could be something in your hair care routine, such as coconut oils in your hair care routine that can be triggering or inflaming the acne. So when we think about acne, I like people to think about it in three main elements.

Number one is the bacteria. Number two is inflammation. And number three is the oil production. So when we think about controlling it, we think about you have to do something to each of these arms to help reduce her inflammatory and cystic acne. So now when she says it's a hormonal element, now the hormonal element tends to drive the oil production.

But we can still, we can't address her hormones necessarily unless she decides to go down a medical route, but the other elements we can address. So when I see cystic acne, I almost always start prescription medication to really get it under control. And that can be for a short period of time. And I use a mixture of sometimes contraceptives,

sometimes antibiotics, and sometimes prescription retinovic acid, just to get it under control. Now, that will help the bacterial element. The inflammatory element, though, As Sam has mentioned, there are some anti-inflammatories that we can add into the routine, like azaleic acid, salicylic acid, and occasionally benzal peroxide. But if you're getting big cysts in the skin, that's when it's important to kind of have a bit more of a medical approach to acne management.

Because cysts can lead to a lot of scarring, so it's important to get on top of that. Thank you. And we've got another question from Bindi, who says, how can I treat stress-related acne that's appeared during lockdown and as well as taking care of the scars that are subsequently appeared? Well, I think lockdown has caused havoc for people's skin for lots of reasons. And I think uncertainty and anxiety, particularly in my female patients, often plays a big driver in causing them to break out. And I think then it all becomes sort of a downward spiral because then the loss of control of the skin feeds into the anxiety loop and things can rapidly do. deteriorate. I mean, I still think it comes back to the same approach. You still need to look at

routines through about the potentially triggering cosmetics and skincare products. Put the retinoid based routine. You've got to get to the bottom of the root lesion, which is always a comadone. And that's why retinoids are first-line therapy to get things under control. And again, the same tools, anti-inflammatory ingredients for things when you're actively breaking out are helpful. And then, of course, you know, we all have to try to manage ourselves as best as we can these days, whether it's through meditation or yoga and reaching out and staying connected with friends. I think, you know, acne is a complex disorder and stress is one of the commonest provocateurs. And it really is, again, a multi-pronged attack. But I think you've got to get the core routine right.

Because once you kind of feel that control coming back, you can start to see things shifting. and the great news is that a well-formulated acne routine will also start to work in those dark marks and get the pigmentation under control as well. So starting with the retinoid using something like benzoporoxid of salicylic acid, then evolving onto the addition of azaleic acid, which is great for prevention as well as treatment of the pigmentation, a bit of niacinamide in there to kind of soothe barrier. And I think oftentimes you find that that's what really breaks this sort of feedback loop and stops the stress from driving the skin into yet further decline. But yeah, tough times and you factor in a mask as well. I mean, you know, that's kind of

the predominant pattern of acne that we've seen in recent months in the clinic. I mean, mask hygiene is obviously a big part of it as well. Yeah, so interesting. You mentioned the whole mask knee as it's being coined. So the acne caused by masks. It's a huge problem at the moment. So mask knee is actually known as acne mechanica. It's actually been around for a long time, even before masks came along. And it's caused by a few things. You know, you have the mask on, you're sweating, you're talking, that creates the perspiration around the mouth, but also friction. And friction is one of the main reasons why we're getting the spots associated with the mask. So in order to treat it, we have to do a few things and kind of address all those

areas that are occurring. So the first is to use a mask that's clean. If you're using a mask that's clean, you're going to reduce the risk of getting bacteria-associated breakouts. The next is where possible, try not to wear any makeup underneath the bar. mask. Nobody was seeing it anyway. A bit of lipstick is fine, but try and keep the skin as clear as possible otherwise. And when you get home, take off your mask and wash your face straight away. That's the first thing you should do, not just wash your hands, wash your face straight away. Now there are also a couple of key ingredients that you can add into your routine to help reduce the risk of breakouts. One is to add an antibacterial into your routine. I like to use

Clinicept in my clinic. If people have Acne Mechanicae, is to use Clinicept, which you would spray on the face. If you're out and about, you can spray on your face, and that will reduce the bacterial load on the face. The other is to maintain the barrier function of your skin.

If you've got rubbing, consistent rubbing, rubbing, rubbing, rubbing, rubbing, that the mask rubs on the skin, that breach in the skin barrier is going to be an area of weakness where bacteria can get in and then cause these postules. Because with acne mechanicae, they don't look like regular spots. They look like little white heads, little white postules, and that's because

of the way in which they're formed. So using a very gentle moisturiser and making sure that your skin is moisturised throughout the day will also really help prevent the acne mechanic. Thank you. And on the flip side of that, actually, we've had a lady called Steph who said that her skin is normally oily, but is now drying out when she wears a mask. So what are the best products to help with this? Dr. Banting, if you could answer that one for me, please. So I think the mask wearing disturbs the microbiome, which, you know, you've got more humidity happening and potentially it alters the composition of the bacteria

that's living on the surface of the skin. And that can basically impair barrier function. And I think a lot of the tendencies around oily skin is often to dry the skin out too much. I have to say that in my practice, tend not to use any sort of foaming cleansers at all. And I tend to stay away from active ingredients, which might be the natural thing for some of the oily skin to go for. But I prefer to actually deposit active ingredients with leave on products. I think you've got more control in the way they interact with the skin. So I think sticking to gentle cleansing, pairing back on any foaming cleansers or any

active ingredients in cleansers that they might be using to sort of tackle their traditional oiliness. And then to look at barrier-boasting ingredients in their hydrating steps, so seramides or niacinamides will really help fortify their skin when it comes to sort of the frictional aspect of wearing a mask. And I guess play with fabrics. I mean, I think other people find that the natural fabrics, whether it's silk or cotton, are a bit kinder on the skin. So I think as long as you've got several in rotation, you can really keep clean. That's, I would say, the best way to approach it. Lovely. Thank you. And I'm going to going to move on to diet and skin now just because we've, you know, we've had a lot of questions

around this area. So Kelly wants to know, are there any foods I should avoid now that I have psoriasis? Dr. Edgichome, if you could answer that one for me, please. Yes. So there's been, historically in skincare, there's been a lot of debate as to whether food has a huge impact on skin. And the advice that we used to give was that there is no, there's no evidence that that food has a big impact on skin. But anecdotally, in my practice, I have patients that can document that if they eat certain foods, you know, if they eat certain foods, they have an increase in their psoriasis flare or their rosacea flare or their eczema flare. And I'm a believer that you should listen to your body and you should document it. So I usually advise by

patients that eat a regular diet. There's nothing specific that you should remove from your diet. But if you have an allergy, avoid that. Then as you go through, if you notice that there's a food that you often eat and you get to flare up of whatever skin condition that you have to document that. And then test it. Wait a few weeks, bring it back into your diet and see if there's an effect. And I think the most important thing is to bring that food back into your diet. Because what often happens is somebody thinks that there's a food that may cause an impact in this,

the rice is, for example. And then they exclude that and exclude something else and exclude something else. And very quickly, you're excluding quite a lot of things for your diet. So it's very important if you're concerned about something, remove it for a week or so. If nothing changes, bring it back in. But there's no specific diet that you need to follow. Thank you. And a question for both of you, really, is to get your thoughts on collagen supplements. How do you both feel about those? They're not something I actively recommend. I think the science behind them is weak and in principle. Any sort of protein that's ingested gets broken down into his constituent amino acids

and then, you know, absorbed through the gut wall and then distributed where the body needs it. So there's really no way of fast-tracking anything that you ingest to the skin, much, much better to focus on eating the right things, the so-called anti-inflammatory diet and ensuring that your skin care is optimized. I would entirely agree with that. I don't recommend my patients take collagen supplements, but the science shows that even vitamin C, you know, we have great evidence of vitamin C, even the vitamin C that you take in, on biopsy in the skin, there's almost no change topically on the skin.

So with skin, most of the benefits that you get are from topical ingredients outside having a well-balanced diet. Thank you. It's good to finally clear that one up because I think it's a question that we are always are. And, you know, there is so many products out there that collagen supplements out there that claim to work. So it's good to get your thoughts. There's also quite a big commitment financially as well. You know, if you decide that a supplement is essential to your routine, that's, you know, I think it's, they're often quite punchy price points. So I think, yeah, you can invest your money better. And then that leads us nicely onto a question by Victoria.

He wants to know what are the most nutrient-dense foods you can eat for your skin, hair and nails? I think that's a million dollar question of that one. So the evidence behind your skin, your hair and your nails is that the body is going to prioritize every other organ in the body except your skin hair and nails. So it's important that you have a well-balanced diet and you're eating a little bit of all the different foodstuffs and making sure that your minerals and your vitamins are up to scratch. If they're not, we do know that the body will claw these back from the skin, the hair and the nails. Now on the other end of the spectrum, having a very, very well-balanced diet, eating clean and doing all the right things, doesn't guarantee that you're going to have beautiful skin, beautiful hair or beautiful nails. The body is just going to, again, invest in those larger organs, but it's the best place to start. So sometimes we talk about skin foods, and there are some foods that we know have good benefits. There are some vitamins that we know have benefits throughout the body as well as the skin. But eating those foods in

isolation, such as fish or spinach, eggs, cheese, all great ingredients. But eating just those foods won't directly lead to good skin. It's more about having a healthy overall diet. Lovely. Thank you. And Dr. Bunton. I've got a good list for things I tell my patients to try to incorporate every day just because I think coming back to that idea of eating the rainbow, the anti-inflammatory diet, I think it's helpful because, you know, you very quickly can look back and you would go, hmm, maybe only two fruits and veg today. That's not a great day. So the list I have is carrots because we like beta carotene. Tomatoes, which are rich in vitamin C and lycopene. And lycopene's great for helping protect the skin against kind of the kind of onslaught of

VEEEEEE. Olive oil is great for vitamin E. Avocados. So you can see we can build a nice salad so far. Yeah, it's making me hungry. Yeah, well, I think, you know, I try and get a good smoothie in a day with, you know, three or four of those ingredients in there. So avocado, blueberries, watermelon and apples. I mean, apples with the skin on is really important as well because all the nutrition is in the skin. And then once you do that, if you can try and, you know, aim to get at least sort of four or five of those seven a day. And then I'll maybe add in a flaxseed supplement. And I always take vitamin D as a supplement. Then a little bit of lean protein. So, or, oily fish is great a couple of times a week. But yeah, that's kind of the way to, I think, to really sort of try and focus as much as you can on fresh veg and fruits and more veg than fruit just in terms of the glycemic index. And I think it's another part of the puzzle in terms of, you know, delivering a whole inside out approach to beauty. And I think people like

direction and they respond well to it. So I think, yeah, that's quite a good mix. It's pretty, you know, available, you know, whatever the season, which is good as well. well. And I think in winter, we do need a bit of encouragement to eat more fruits and vegetables. All too tempting to go for the carbs, isn't it? Yeah, definitely. I think Dr. Bantzambi's of a really good point, actually, of key nutrients that we need. And in terms of deficiencies, we should probably point out that there are a few deficiencies that can really affect the skin and the hair, and that's vitamin D and iron in women especially. So if you're menstruating iron can become low very quickly if you're heavily menstruating

and also vitamin D. So those would be two to look out for vitamin D rich foods and iron rich foods. And Sam mentioned a few of them, you know, iron, spinach being one of them, a really great one for iron, salmon being another one for vitamin D, cheese, for vitamin D. So again, those would be things that you would add in to help boost. but again still maintain that, you know, your wide plates of lean fish, of lean meats, fish, vegetables and fruit. Brilliant.

Thank you. We've got a question from Tina and it's how to treat stubborn hyperpigmentation on darker skin tones. Dr. Edgichemaker, do you answer that one for me, please? Yes. So pigmentation is probably one of the number one things that I treat in the clinic on all skin types, but also on darker skin tones. Now, my approach to treating hyperpigmentation is to first understand the underlying cause. Is it pigmentation around the eyes? Is that due to dehydrated skin, hyperpigmentation, or volume loss?

Or is it in the greater face from things like spots, acne, or melasma? So once I figure out the underlying cause, then I start a strategy to help hydrate the skin and kind of bring the skin back to life. Because a lot of the time, there may have been something done to the skin like acne or a child. treatment that was too aggressive or even a home treatment that was too aggressive to really build the skin, build the skin back up again. Now, the key ingredient that any woman of color has, is the key thing that you need in your skincare routine is a tyrosanase inhibitor. These are a group of products that help to reduce the amount of hyperpigmentation that you get. Now, you only have to think about spots if you're women of color to get a dark mark. And dark marks can hang around

anything from two weeks to six months. So it's really about having a prevention strategy as well as a treatment strategy and your tyrosinase inhibitors do both. So the kinds of ingredients you're going to look out for are arbutin, cogic acid, licorice extracts, things like vitamin C can be helpful and retinoles can be helpful. Other things like oligipatide 68. So these are the types of ingredients we're going to look out for and incorporate them into your routine even when you don't have highoporpeptide. pigmentation to use small amounts three times a week because you know you are going to get a spot or a pressure mark or some allergy or something that's going to trigger the pigment as well. The other strategy with high pigmentation is sunscreen. It's wearing a sunscreen every single day

because if pigmentation is your key concern, you have to prevent hyper or excitability of those pigment producing cells and protect. And you're looking for a UVA and UVB cover, but also your find the newer sunscreens, you'll see PA++. Now, in darker skin types, this is really important to prevent triggering of pigment from lots of different things, especially the sun. And it kind of triggers an overall darkening of the skin. And the PA plus plus plus, the more pluses that you find up to five are great. So look out for those. And Dr. Bunting, we've had in a lot of questions about product recommendations for rosacea. Yes. Well, Rosacea is a tricky one, isn't it? So I think for people not using a physician to guide building a routine, it can be a real mind field because it can feel like,

particularly when the rosacea is active, that everything's stinging and burning and, you know, there's a sort of a genuine fear about introducing new products. So I think rosacea sufferers are the one group where they tend to come in using maybe two or three products as opposed to the sort of 25 that the acne-prone patients I see kind of can often go, you know, because they jump from product to product in desperation. But the resacea sufferers, they know that they are challenged already. in terms of barrier function. So I think in terms of the best way to approach it, so I always break how you approach your problem down

into the kind of the support products, your basics, and then the active products that are kind of the ideal ones to sort of bring things under control. So as you said before, a simple regime on fragrance products, so a non-faming cleanser, ideally something that's quite, you know,

hydrating, very gentle. And I'm a big fan of La Roche-Pouet and a Venn for this again, because they do ranges that actually contain products without any preservatives. So no fragrance, no preservatives. So it just makes them super soothing. And I think cleansing is one of the areas where the simplest kind of, you know, wrong move can actually kind of throw everything off even more.

So the Roche-Perset-Tolerian domo cleanser or a vent-tolerance-extremiser. They're both excellent. Then you need a good moisturiser because, as I said, barrier dysfunction is part and parcel of the problem. And then you need sunscreen because UVA is undoubtedly a big trigger in rosatia. And again, I find some of the chemical sunscreens can really sort of irritate and sting in those with active rosacea. So you're often best going for an all-mineral sunscreen. They just tend to be gentler and oftentimes contain a bit of a tint, which is also quite helpful from masking any redness. Then if we go over into active products, I think this can be tricky.

It depends on the disease severity. and I will often, you know, if someone's got what they think is active rosacea with, you know, proper spots, papules and postules and background redness, they're often best seeing their doctor or consulting a dermatologist because prescription products will often work best. But if things aren't too bad and it's really just a question of, well, you know, I can see it's happening and I want to get better control, then I think azaleic acid is probably the go-to ingredient over the counter. And I've been a bit of an azaleic acid crusader, I'd say for more than five, five, six years because it wasn't very common to find azaleic acid in skincare products, I'd say, two years ago. Now there's a lot more on offer. And I think brands like the ordinary have brought them into the kind of, you know, consumer's awareness, polished choice. And we've created two azleic acid-based serums as part of the flawless range because I find it's such a helpful active ingredient, not only good in rosacea, it's great in acne, it's great in hyperpigmentation. You can use in pregnancy. I mean, it really is, I think, a bit of an on-sung superhero skin care. So

Azaleic acid is where I go in this instance. And again, it's about being careful and cautious to use sort of the tips of, you know, using things less often, use it over-moisturiser, because it can sting a little bit that the name acid suggests. Not uncommon. But as well-oic acid's a real game changer for those with rosacea, because it can actually help with kind of multiple components of the rosatia and it actually makes the skin look prettier. So that's definitely where I'd go to. So sort out your basics. Remove any aggravants. It's amazing how many people are using things like, you know, toners with, you know, alcohol or physical exfoliants or even something as simple as a flannel, just to remove everything that might be irritating

your skin gently, gently, and then bring a bit of azaleic acid into play and things should get better. Brilliant. Thank you. We've got a bit of a niche one here. from Gillian and she wants to know how can I treat red thread veins around my nose? So thread veins around the nose can be caused by a couple of different things. We've just been talking about rosacea and that can be one of the signs that she may have rosacea, but there are some other signs that we'd look for like flushing or having flushing associated with spicy food or chocolate or going outside. But sometimes people just have red veins or red vessels around the nose and these are broken capillaries. I treat them in a few ways. The first is to repair the barrier function. When I see that, if there hasn't been a big trauma that's happened in that area, then I take that to mean something's happened very slowly over time.

and something blood vessels occur because the body is trying to heal the area. It's actually a protective mechanism that kind of goes a bit of how rye in the body. So the first thing I do is to try and repair the barrier function. And if I see that associated with dry skin, then I'll usually start a serrave product. I do like the serave range. Oh, I love serave. It's so brilliant, yeah, it's such a good range. It's beautiful.

It's so good if you have dry, irritated skin. and the ingredients that I kind of lean on there are the halamonic acids, the seramides, the nisinamide. And the thing I like about it is that MVE technology whereby sometimes you put a moisturiser on and 10 minutes later it's gone. But I like that when I give those to my patients who have dry, irritated skin, and if you're rubbing your nose a lot or something's going on in the area a lot, that may be one of the issues. So I like the technology because it releases the active ingredients.

over a 24-hour period, so it can really soothe for a long time. So that's the first step. The second step is then to do something that directly addresses the vessels. Now, if the vessels are very, very small, very superficial, then something like an azaleic acid can be helpful. Otherwise, there'll be treatments that I do in clinic to help treat each one of those vessels. Now, sometimes they can be five or six, and sometimes they can be 20. Now, if they're five or six, a treatment called advanced electrolysis can be very, very good. and you use a treatment with little needles, almost the size of a hair, to zap each of those. If they're lots and lots, then a vascular laser can be very, very good to treat a larger area to kind of clear them all.

But one thing is important to know that if you have vessels, you tend to get more vessels. So it's important to really restore that barrier function and figure out what's happening in that area. She got allergies that means she's blowing her nose a lot or itching in the nose to try and figure out what the underlying causes and treat that. And final question, before we have to wrap it up, we've had Kamal, she wants to know, should I be worried about blue light now that I'm working from home and constantly on my laptop or phone? I mean, you know, there's a lot of concern for obvious reasons. But I think that the reality is that blue light coming from devices is it's a fraction of the strength of the blue light that's part of, you know, the sun's rays. There's something of the order of 100 to a thousandth of the strength.

So certainly it's been studied extensively in malasma where we know that UV and visible light potentially provoke the problem of worsening hyperpigmentation. But I think that blue light in normal skin types without malasm in the background haven't really got too much to worry about. I think we're much more concerned really with the impact of UV, particularly UVA, when it comes to age. aging. I agree with that completely. I think there's a lot of worry about the blue light. And we get the most of our visible light from the sun, thousands of times more from the sun. And where we'll see it, where I see it from my patience is just it causes general darkening of the skin, which is why we see it in the plasma. But there are some things that you can do. If it really bothers you and you're really worried about it, there are some things that you

can do. And visible light is blocked by zinc oxide or titanium oxide. So wearing a physical sunscreen will protect you. If you're at home, this is the one time that makeup can be helpful for the skin. Iron oxide that's found in makeup actually does block visible light. So those are some things that if it really bothers you, you can do that. You can add that to your routine. Helpful, thank you. And finally, if we could just round off, if each of you could talk about your number one rule for getting your best skin.

Dr. Bunting, should you start with you? Yeah, sure. I think that for me the most important thing is consistency. And I think that's probably, you know, it's the simplest of principles. But I think that if you follow guidance and you, you know, you select the right products and you stick to a routine. I mean, realistically, there's only really room for, I think, for one active product in the morning and one at night. I mean, I personally as a busy girl, don't have time for sort of lots and lots of layers. So I kind of, I want that one product in the morning, that one product at night.

to work with my sunscreen to really deliver the best possible skin. I think if those products are chosen well and you stick with it, then that consistency is what delivers results in the long term. I think it can't be underestimated how big an impact the right skincare can make in your life, both to the way you look, but most importantly to the way you feel. I think it's important to, you know, be patient in terms of results, isn't it? Yeah, we all want things yesterday, don't we? And I think, you know, to some extent, a lot of the brands marketing doesn't really, you know, serve us.

They promise us a lot. And then people get disheartened when things don't happen overnight. But to put it in context, when I'm seeing my patients for review, and we're using pharmaceutical-grade products often because, you know, the severity factor, I don't see them again until three months time. So, you know, I wait for two full skin cycles to have gone by. Because if you think about it, for an active ingredient to change your skin, it has to be exposed for the duration of time. it takes to get from the bottom of the epidermas to the top. And that is a slow process. You can't build new proteins like collagen overnight. It takes time. So I think don't shortchange yourself because I think a lot of people end up discarding products too soon. They've got a bathroom shelf full of bits of things not used up properly. So commit to a plan. Take your selfies at the beginning and good natural light, document your

journey and give it that three month period. I think it's a really sensible length of time to determine and whether something's working for you. And then if those ingredients are working for you, then turn the dial on the percentages rather than getting distracted by new shiny objects that you see on Instagram and adding in another three things just because, you know, your favourite influencer recommended it.

So know your skin, chart your results and act on those, and I think you'll find that you're happy in your skin. Brilliant advice. Thank you. So I was going to say consistency, but I'm sorry. Another one. It's okay. It's the one. It's the one. So I was going to say, check in with your skin. As the seasons change, it's a good time to check in with your skin.

I think not everybody can come to see myself or to see Dr. Bunting, but the products that you have at home, if you're using them and you're seeing results, and all of a sudden, you know, the seasons have changed, six months have passed, look back at those products and see what's going on. So I would say throughout the year, check in with your skin. And this is a really good time to. do that. You know, we're on lockdown, we're all at home. It's a good time to go back to your bathroom cupboard. And what I usually recommend is to look to see what you have that's, first of all, in date. So the first thing to do is to get rid of everything that's out of date. Check your vitamin C. It's probably gone off if it's been there for six weeks or three months. If it looks dark or this kind of brown residue, throw that away. Once you've gotten rid of all the things that are off and you should no longer be using, now have a look at what you've got left and then

check in with your skin. Is it feeling oily? Is it feeling dry? Is it feeling dehydrated? And people will often refer to their skin as combination skin when they've got oily dehydrated skin. And look at the products and see if those products still serve you. And if they're serving you, be consistent with them. But if they're not serving you, then maybe it's time to have a consultation with someone that can help guide you with your skin and help you figure out what products you should be investing in and which products that you should actually that aren't serving you well. Brilliant. Thank you. Ladies, that was incredible. So many brilliant tips and useful nuggets there. Were you taking notes? I have got a healthy list in my iPhone from the first time I listened to that chat. So that was

Purdy Noral, Women's Health Beauty Editor putting your questions to Dr. Ifioma, Echukemi and Dr Sam Bunting. If you enjoyed the episode, absolutely do let us know. You can rate and review on Apple Podcasts. And if you want to comment on anything that's been discussed in the show, you can get in touch with us via the usual channels. All the details are in the show notes. And remember, if you have a health goal in mind that you want our experts help with achieving, let us know and we'll get them on it. We'll be back next week. Until then, take care. Bye.