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Skin care advice from our expert: Tips for healthy skin

Skin specialist Pauline Smith from Dr Lauren Bramley & Partners puts her thinking cap on and tackles some of our readers’ pressing skin issues in an environment of air pollution.


Losing the glow

I’m in my early-40s and am dismayed that my skin is looking dull and lifeless. I spend a lot of time up in the air with my job, constantly travelling. I think that it’s taking a toll. What can I do to feel and look less lacklustre?

Pauline says…

Most people realise that flying can cause skin dryness, psoriasis and acne breakouts, but they may not know why. The re-circulated air in a plane cabin does whatever it can to draw moisture out of the skin. Dry skin tends to get drier on planes, and oily skin gets even oilier, to compensate for rehydration.

When a client comes to me with a skin concern and asks how they can improve it, one of the things I always establish is how they are hydrating in their daily routine; water consumption is vital. I always ascertain what products they’re using too. Many products simply sit on the surface of the skin and hydrate the superficial layer. This this may look good for a couple of hours, but it won’t have lasting effect. There are a few key ingredients that do penetrate and alter the structure of the skin by producing and increasing collagen, and unblocking pores.

Vitamin C, for example, is needed to help produce collagen in general. Retin A (tretinoin – the carboxylic acid form of vitamin A) used topically in the correct manner is also great for skin rejuvenation. Hyaluronic acid  – something you naturally have a lot of when you are a baby (it makes your skin look plump) and then gradually depletes as you get older – is also great when applied topically as a serum. By using this as a base layer to a moisturiser cream, you can treat beneath the surface as well as the top layer of skin.

Vitamin C is also used to block the production of melanin (the process that stops sun damage from appearing) and can help to even the skin’s tone for an overall healthier look. If you were to come in to see me for a medical facial, normally I would precede a Vitamin C infusion with microdermabrasion (an intense exfoliation of the dead skin cells). Most people get this done every four to six weeks on average. It’s addictive though, because it works and it brings on a skin glow!


I’m a woman in my late-30s with a paleish complexion and I’ve started to notice visible sun damage, such as sunspots and broken capillaries on my face, neck and décolletage. I have lots of freckles that have increased over the years and are now beginning to join up. Over-the-counter creams aren’t working. Got any advice?

Pauline says:

I’m curious to know what kind of creams you’re using. With this kind of skin concern, I’d always be inclined to start with a less-invasive treatment before working up to more aggressive one (which would require prior doctor’s approval) if we weren’t achieving the results that you wanted.

A less-evasive treatment consists of topically applied creams that can be used daily at home. I’ve been having some good results in the area of lightening pigmentation with one patient with a cream containing idebenone, a powerful micronutrient related to CoQ10, another defender against cell damage.

If a topical cream didn’t work, I’d advise moving onto treatment using a medical peel. This involves a chemical solution being applied to the skin, which makes it blister and eventually peel off. The new skin is usually smoother and more even than the old skin. Though you could do this at home, having this procedure done with an experienced aesthetician ensures that it’s performed evenly and safely. (Leaving a peel on for too long can burn the skin, for instance; or you could have a reaction and not know what to do.)

Medical peels come in different grades of intensity; the type of peel is selected according to the patient – it might be glycolic acid, lactic acid, AHA (alpha hydroxyl) acid or kojic acid, for example, or a Cosmelan peel and idebenone for depigmentation treatment. It depends on the particular patient.

Teenage outbreak

My teenage son has loads of blackheads and he won’t let me near him. I’m trying not to be one of those overbearing parents in nagging him to take care of his facial hygiene and acne, but it’s hard. Help!

Pauline says…

Send him in to see me, please! It’s much better to not be the parent in the consultation room with a self-conscious — he’ll be much better behaved! Usually when teenage boys see the results from their first session with an aesthetician, this is enough incentive to make them come back.

A blackhead is simply a form of acne – a plug of oil sitting within a skin pore. When the oil meets air, it oxidizes and that’s why it turns black. Blackheads won’t fall out on their own; they have to be removed manually. For a teenage boy, I would usually only recommend one product (as they are tend to be low-maintenance) to try and keep the pores clean in between treatments. A treatment could consist of microdermabrasion (exfoliation of dead skin cells) combined with a mild skin peel.

Taken aback

My southern Italian husband has a really hairy back. Now, I don’t want to turn him into a hair-free Adonis, but I could also do without him stroking his spinal rug. Got any pointers?

Pauline says…

I’m not impartial to a hairy Italian myself! Hair removal is not exactly a set science. There are many variables – including hair colour, skin colour, follicle thickness, and even a person’s metabolism – that will affect the results. For instance, two sisters who have the same kind of hair will sometimes get different results depending on their hormones; it’s weird.

In this case, I’d welcome you to a free consultation to make sure that your husband is a good candidate for laser hair removal. For example, if he’s got dark hair and pale skin, then he’s perfect for this treatment, which can give about an 85 percent reduction in hair growth. He would be required to shave the day before the treatment. I’d likely use the Lumenis Light Sheer Duet that combines vacuum-assisted technology with a diode laser light to heat up the hair shaft and bulb, impeding its ability to re-grow. The hairiest back could be treated in one lunch hour, and the session would be repeated every four to six weeks until the desired results are achieved. IPL (Intense Pulsed Light) treatment is another technology that can achieve great results.