Skin By Concern

Acne Vulgaris

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What It Is:
Acne is a chronic inflammatory condition of the pilosebaceous unit, characterised by comedones, papules, pustules, nodules, and cysts. It commonly affects the face, chest, and back.

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Causes:

• Hormonal fluctuations: Increased androgen levels stimulate sebum production.

• Sebaceous hyperactivity: Excess oil clogs pores.

• Keratinocyte dysfunction: Causes follicular plugging.

• Bacterial proliferation: Cutibacterium acnes triggers inflammation.

• Triggers: Stress, high glycaemic diets, occlusive skincare products, and certain medications (e.g., corticosteroids).

 

In-Clinic Treatments:

• Chemical Peels: Salicylic acid, glycolic acid, or TCA to reduce comedones and pigmentation.

• Laser Therapy: Blue light (antibacterial) or fractional lasers for scarring.

• Microneedling: Improves scarring and texture.

• Isotretinoin: For severe, resistant cases; requires careful monitoring.

 

Lifestyle Changes:

• Maintain a balanced diet with low glycaemic index foods.

• Avoid over-cleansing; use non-comedogenic skincare.

• Manage stress through mindfulness or relaxation techniques.

• Avoid picking at lesions to prevent scarring.

 

Menopausal Acne

 

What It Is:
A form of adult-onset acne that occurs during menopause due to declining oestrogen and relative androgen dominance.

 

Causes:

• Hormonal changes: Reduced oestrogen leads to increased sebum production.

• Dry skin barrier dysfunction: Exacerbates inflammation.

• Stress: Cortisol can worsen outbreaks.

 

In-Clinic Treatments:

• Hormonal Therapy: Low-dose oral contraceptives or spironolactone to balance androgens.

• Chemical Peels: Improves texture and pigmentation.

• Microneedling with PRP: Promotes healing and collagen production.

• LED Therapy: Reduces inflammation and bacterial growth.

 

Lifestyle Changes:

• Avoid harsh skincare; use gentle, hydrating cleansers.

• Incorporate retinol-based products to regulate cell turnover.

• Consume foods rich in phytoestrogens (e.g., soy).

• Manage stress and prioritise sleep.

 

Rosacea

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What It Is:
A chronic inflammatory condition causing persistent facial redness, flushing, visible blood vessels, and sometimes papules and pustules.

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Causes:

• Vascular hyperreactivity: Leads to persistent erythema.

• Triggers: Sun exposure, alcohol, spicy foods, and stress.

• Immune dysregulation: Can cause inflammation.

• Demodex mites: Overgrowth on the skin may play a role.

 

In-Clinic Treatments:

• Laser/IPL Therapy: Reduces vascular visibility and persistent redness.

• Topical Treatments: Azelaic acid, ivermectin, or metronidazole.

• Oral Medications: Low-dose doxycycline for anti-inflammatory effects.

• Microneedling: Helps with texture in subtype II (papulopustular rosacea).

 

Lifestyle Changes:

• Use broad-spectrum sunscreen daily.

• Avoid triggers (e.g., spicy food, hot beverages, and harsh products).

• Apply gentle skincare with niacinamide or ceramides.

 

Melasma

 

What It Is:
A chronic pigmentary disorder causing symmetrical brown-to-grey patches on sun-

exposed areas like the face.

 

Causes:

• Hormonal changes: Common in pregnancy or with contraceptive use.

• UV Exposure: Triggers melanocyte hyperactivity.

• Genetics: Family history increases susceptibility.

 

In-Clinic Treatments:

• Chemical Peels: Glycolic acid, lactic acid, or TCA peels to exfoliate pigmented layers.

• Laser Therapy: Fractional or low-energy Q-switched lasers.

• Microneedling with Tranexamic Acid: Reduces melanin deposition.

• Topical Prescriptions: Hydroquinone, tretinoin, or triple combination creams (hydroquinone, tretinoin, corticosteroid).

 

Lifestyle Changes:

• Daily application of broad-spectrum sunscreen with SPF 50+.

• Wear protective clothing and hats outdoors.

• Avoid hormonal triggers when possible.

• Use antioxidants (e.g., vitamin C) in your skincare routine.

 

Dark Circles

 

What It Is:
Discolouration or hollowing under the eyes, caused by pigmentation, vascular prominence, or structural changes.

 

Causes:

• Thin skin: Reveals blood vessels (vascular dark circles).

• Pigmentation: Post-inflammatory or genetic hyperpigmentation.

• Volume Loss: Due to ageing and collagen depletion.

• Lifestyle factors: Lack of sleep, dehydration, and stress.

 

In-Clinic Treatments:

• Dermal Fillers: Hyaluronic acid fillers address volume loss.

• Chemical Peels: Mild peels like lactic or glycolic acid reduce pigmentation.

• Laser Therapy: Targets pigmentation and promotes collagen.

• Microneedling: Improves skin texture and appearance.

 

Lifestyle Changes:

• Prioritise 7–9 hours of sleep.

• Hydrate adequately.

• Use caffeine-infused or brightening eye creams.

• Apply cold compresses to reduce puffiness.

 

Fine Lines and Wrinkles

 

What It Is:
Ageing-related creases caused by loss of skin elasticity, collagen degradation, and repetitive facial movements.

 

Causes:

• Intrinsic Ageing: Gradual reduction in collagen and elastin.

• Photoageing: UV radiation accelerates MMPs, breaking down collagen.

• Environmental Damage: Smoking and pollution contribute to oxidative stress.

 

In-Clinic Treatments:

• Botox: Reduces dynamic wrinkles (e.g., crow's feet, frown lines).

• Dermal Fillers: Restore lost volume in static wrinkles.

• Microneedling with PRP: Stimulates collagen production.

• Fractional Lasers: Smoothens wrinkles and improves texture.

 

Lifestyle Changes:

• Use broad-spectrum sunscreen daily.

• Apply retinol or peptides in your skincare routine.

• Avoid smoking and excessive alcohol consumption.

• Consume collagen-boosting foods like berries and leafy greens.