But don’t worry, there are steps you can take to fight the physical impacts of stress. Here’s what you need to know, and what you can do to slow the process.

Stress ages your skin
Long hours at work, or a constant sense of pressure in your life, can impact your body on the outside as well as the inside. Stress is one of the many factors that have been shown to contribute to extrinsic skin ageing.1 That is, premature ageing brought about by external elements like UV sunlight, pollution, and tobacco.

The other type of ageing — intrinsic — happens simply due to the passage of time. It’s harder to influence intrinsic ageing, which is largely down to genetics —2 but you can impact extrinsic factors.

How does stress age skin?
It may sound strange that your state of mind could directly impact ageing. But there are clear biological pathways to explain the effects of emotional tension on your skin.

Psychological stress increases levels of cortisol, which can trigger oxidative stress in the cells of your body.3 When this happens, the natural balance of free radicals (harmful chemicals) and antioxidants (protective chemicals) is thrown out of kilter. Excess free radicals build up, and these damage cells.

In fact, free radicals are linked to all kinds of serious health problems, from cancer to heart disease.4 When skin cells become damaged, ageing accelerates.

What damage does stress do to skin?
High levels of stress can speed up all the visible signs of ageing. This includes the formation of wrinkles, pigmentation, uneven texture, sagging and dryness.3 It’s also linked with flare-ups of skin conditions such as psoriasis, eczema and acne.5,6

Another reason, if you needed one, to aim for a sense of calm and order in your life.

Does stress affect the skin barrier?
Wondering about your dry skin? Well, stress is also linked with barrier dysfunction.7 This in turn can increase loss of water from the skin, a process called trans epidermal water loss (TEWL). Water loss leads to dry, dull skin — not the healthy glow you’re after.

In one study in 46 women, just one stressful event — a challenging interview — produced noticeable decreases in skin barrier function.7 Similar changes happened after a single sleep-deprived night.7

What can you do?
Thankfully, you can counterbalance the impacts of stress on your skin to help you maintain younger looking skin. Here’s how:

Start topical actives — Tretinoin, a form of vitamin A, is proven to reverse the signs of age, including accelerated ageing due to stress. It’s a great all-rounder, and can bring about changes in the structure of your skin, boosting how it looks and feels. Its proven benefits include a significant improvement in fine lines, pigmentation, texture and elasticity.8
Protect your skin barrier — A strong, supple skin barrier sets you up well to face the stresses of everyday life. This means it’s super important to keep your skin well hydrated with a good quality moisturiser. Look for one containing proven ingredients such as niacinamide, panthenol, glycerin and ceramides. Apply it at least twice a day, in the morning on cleansed skin and again in the evening after your active ingredients, or before as well if you’re struggling with side effects.
Don’t forget daily sunscreen — UV radiation is a well-known and powerful skin ageing factor. But thankfully it’s really easy to remove UV photodamage from your list of risks. Just wear plenty of high SPF (30+, with UVA and UVB protection) sunscreen every day, even when it’s cloudy. This is especially important if you’re using actives in your skin routine.
Reduce stress to look younger — This may be easier said than done. But if you can drop your day-to-day stress levels, your skin will reap the benefits. There are many ways to do this, from practical solutions to address the sources of your stress, to coping mechanisms that help when unavoidable pressures mount. Mindfulness, of course, is a tried and tested option, and is something that almost anyone can find time to practise, even if only for 5 minutes a day. Regular physical activity, deep breathing and yoga can all help too.
Sleep enough — Sleep deprivation is a source of physical and emotional stress. Sometimes, interrupted nights are unavoidable (hello, new parents). But we should all be aiming for 7-9 hours of sleep a night, if we can. There may be steps you can take to get closer to this, like cutting out all caffeine for a full 8 hours before bedtime.9 Or taking some daily exercise, but stopping at least 2 hours before lights out. Reducing stress during the day will improve sleep quality as well.

So, while it may be a shock to hear that stress really can make you look older — it’s comforting to know there are effective ways to slow the process.

Our experts at Dermatica will help you to find an anti-ageing skin regimen to regain supple, healthy and youthful skin. And taking other steps to handle the pressures of life should help to keep you looking and feeling younger.

References
Lee CM, Watson RE, Kleyn CE. The impact of perceived stress on skin ageing. Journal of the European Academy of Dermatology and Venereology. 2020 Jan;34(1):54-8.
Farage MA, Miller KW, Elsner P, Maibach HI. Intrinsic and extrinsic factors in skin ageing: a review. International Journal of Cosmetic Science. 2008 Apr;30(2):87-95.
Chen J, Liu Y, Zhao Z, Qiu J. Oxidative stress in the skin: Impact and related protection. International Journal of Cosmetic Science. 2021 Oct;43(5):495-509.
Gey KF. Prospects for the prevention of free radical disease, regarding cancer and cardiovascular disease. British Medical Bulletin. 1993 Jan 1;49(3):679-99.
Chuh A, Wang W, Zawar V. The skin and the mind. Australian family physician. 2006 Sep 1;35(9):723.
Jović A, Marinović B, Kostović K, Čeović R, Basta-Juzbašić A, Bukvić Mokos Z. The impact of psychological stress on acne. Acta dermatovenerologica Croatica. 2017 Jul 20;25(2):133-.
Altemus M, Rao B, Dhabhar FS, Ding W, Granstein RD. Stress-induced changes in skin barrier function in healthy women. Journal of Investigative Dermatology. 2001 Aug 1;117(2):309-17.
Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clinical Interventions in Aging. 2006 Jan 1;1(4):327-48.
The Sleep Charity. Sleep Hygiene. https://thesleepcharity.org.uk/information-support/adults/sleep-hygiene/, accessed 16 February 2023.

The post Stress and Skin Ageing: What You Can Do appeared first on SkinLab.

But lots of things can stress the skin barrier, including some active skincare ingredients, overly harsh exfoliation or certain skin conditions. So how can you be sure your skincare is working hard enough to protect it — and how will you know when your skin barrier is struggling?

Scroll down to learn more.

Your incredible skin
Your skin is a truly incredible organ with vital functions that keep you alive. It keeps out bacteria, chemicals and allergens, and helps stave off the effects of temperature extremes and UV radiation. And perhaps most importantly — it stops you drying out.

This crucial protection against dehydration is largely down to the integrity of the skin barrier. So looking after this layer really matters.

What is the skin barrier?
Generally, when we talk about the skin barrier, we mean the stratum corneum. This is the outermost layer of the epidermis, which is in turn the outer layer of your skin.1

The function of the stratum corneum is to keep out the bad stuff, like bacteria — and keep in the good stuff, like water.

The stratum corneum is mostly made up of specialised cells called corneocytes.2 These are flattened cells, stacked up in overlapping layers. Between the layers and holding everything together is a matrix of fats, including natural ceramides.1

The skin barrier can only work properly when it’s hydrated.1 If it becomes dehydrated, essential chemical processes can’t happen. This means skin cells can’t turn over normally, resulting in changes to how your skin looks and feels.

What can affect the skin barrier?
If the skin barrier becomes disrupted, this increases water loss, a process called trans-epidermal water loss (TEWL). This further weakens the barrier.3

There are many possible causes of skin barrier damage — but knowing what they are can help you avoid them:

Harsh cleansers — Some cleansers contain chemicals that interact with the stratum corneum and remove the natural oils that it needs to stay supple and hydrated.4
Exfoliants — Exfoliation with acids such as AHA is designed to remove the outer layers of corneocytes, but going in too strong with exfoliants can disrupt the skin barrier.5
Physical exfoliation — Rubbing at your skin with face scrubs, abrasive pads or brushes can cause damage to the top layers of your skin, leaving it red, stinging or sensitive.
Hair removal — shaving and other forms of hair removal such as waxing or laser treatment can often be accompanied by skin barrier damage.6
Active skincare ingredients — One of the side effects of retinoids, such as tretinoin or adapalene, can be redness, irritation and barrier disruption.7
Ageing — A key feature of ageing is changes to the skin barrier, which explains why older skin can be drier.8
Stress — Studies have shown that stressful events can directly impact the proper function of the skin barrier.9
Sun exposure — UV radiation, in particular UVB, reduces barrier function, increasing water loss and causing abnormalities in the structure of corneocytes.10
Skin conditions — In any skin condition, such as eczema, psoriasis and dermatitis caused by a chemical or other substance, there is skin barrier disruption.3

Sensitive skin can be a sign that your stratum corneum is thinner, with fewer corneocytes.11 So, you may need to work harder to take care of it, and take things slowly if you’re using active ingredients. But there’s no reason why you can’t keep your skin looking and feeling at its best, whatever your skin type.

Can actives damage skin barrier?
Yes. You may already know that certain active ingredients, in particular retinoids like tretinoin, can cause side effects. These include redness, stinging or dry, flaky skin.12

The stratum corneum is being continually replaced, with new cells coming to the surface from the layers below. Retinoids speed up the rate at which new cells come to the surface. While the skin adjusts to this, there can be a phase when the top layer is disrupted, resulting in skin barrier side effects.13 These usually improve after a few weeks.

You can minimise side effects by making sure your skin barrier is in good shape before you begin, and building up your treatment gradually.

How do I know if my skin barrier is damaged?
You’ll probably know if your skin barrier is damaged — unfortunately, the signs are hard to miss.

When the barrier is damaged, there’s more water loss than the stratum corneum can cope with. The first sign is often dryness or tightness, which may progress to other signs, including:14

Flaky patches
Roughness
Redness
Itching
Irritation, burning or stinging

How do I keep my skin barrier healthy?
To keep your skin barrier healthy, you need to keep it well hydrated. The right skincare will help you do this, and moisturising is a critical step.

But not all moisturisers are equal. In fact, some could even make the skin function worse.15 So it’s important to look for one with ingredients that are proven to support skin barrier function and repair.

The simplest moisturisers work by coating the surface of the skin with a water resistant layer, called an occlusive, that stops water passing in or out. Occlusive ingredients include petrolatum and lanolin.15 These might be enough for you if your skin is young and healthy, with no issues.

The next step is to include humectants, substances which actively draw water into the skin.15 Glycerin and hyaluronic acid are humectants.

Another useful ingredient is an emollient, an oil that can improve the texture of the formula and help prevent moisture loss.15 Squalane, which is similar to your skin’s natural sebum, is an example of an emollient.

How do I repair my skin barrier?
If your skin barrier needs more intensive protection or repair, you’ll need a moisturiser with ingredients that work to keep structure of the stratum corneum healthy. There’s a host of ingredients to look out for, which affect slightly different aspects of the skin barrier structure, but which can all build strength if your barrier is struggling.

One important ingredient is some form of fat-like substance to build up the matrix between the corneocytes.15 Natural ceramides make up a large proportion of this matrix.16 Good barrier repair creams will often contain a synthetic version of ceramides.

There’s evidence that a mix of ceramides will help repair the skin.15 Other proven ingredients include:

Niacinamide
Panthenol
Shea butter

How to balance the side effects of your actives
It’s really important to look after your skin barrier when you’re using actives such as tretinoin — especially if you’re experiencing side effects.5

Using a good barrier repair moisturiser in the right way can really help.

It’s a good idea to make sure your skin barrier is as healthy as possible before you begin your retinoid treatment. One study in a group of 50 women looked at the benefits of pre-treating skin with a barrier-boosting moisturiser before starting on topical tretinoin. They continued with the moisturiser throughout tretinoin use.5

The moisturiser contained niacinamide, panthenol, and tocopheryl acetate (a form of vitamin E, which is an antioxidant). A control group used a moisturiser that didn’t contain these ingredients.

Results showed less skin water loss in the women using the treatment moisturiser. Participants also noticed less dryness, peeling, stinging, itchiness, irritation and breakouts compared to those using the control moisturiser.5

So, choose a good quality moisturiser with effective ingredients, and apply it generously twice a day for two weeks before you begin topical retinoid treatment.

Once you’ve started treatment, continue to use your barrier boosting moisturiser:
Every morning after you cleanse
Every night after your active formula, if you’re using one
Before your active formula as well, if irritation is a problem

And of course, don’t forget daily sunscreen, to give your barrier that extra protection. Here are our tips:
Use sunscreen (over SPF 30 with UVA and UVB protection) every morning — even when it’s cloudy.
Apply it about 10-20 minutes before heading out to give it time to absorb.
Follow the instructions on the bottle — this might mean applying more than you think.

Following these steps should help to keep your skin barrier strong, supple and healthy. And of course, if you sign up to Dermatica, our skin experts are always on hand to answer your questions and offer support when you need it.

References
Rawlings AV, Harding CR. Moisturization and skin barrier function. Dermatol Ther. 2004;17 Suppl 1:43-48. doi:10.1111/j.1396-0296.2004.04s1005.x
Proksch E, Brandner JM, Jensen JM. The skin: an indispensable barrier. Exp Dermatol. 2008;17(12):1063-1072. doi:10.1111/j.1600-0625.2008.00786.x
Loden M. Role of Topical Emollients and Moisturizers in the Treatment of Dry Skin Barrier Disorders. Am J Clin Dermatol 2003; 4 (11): 771-788
Ananthapadmanabhan KP, Moore DJ, Subramanyan K, Misra M, Meyer F. Cleansing without compromise: the impact of cleansers on the skin barrier and the technology of mild cleansing. Dermatologic therapy. 2004 Feb;17:16-25.
Draelos ZD. Revisiting the skin health and beauty pyramid: A clinically based guide to selecting topical skincare products. J. Drugs Dermatol. 2021 Jun 1;20:695-9.
Dabboue H, Builles N, Frouin É, Scott D, Ramos J, Marti-Mestres G. Assessing the impact of mechanical damage on full-thickness porcine and human skin using an in vitro approach. BioMed research international. 2015 Jul 13;2015.
Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clinical interventions in aging. 2006 Jan 1;1(4):327-48.
Krysta Binieka, Joseph Kaczvinskyb, Paul Mattsc, Reinhold H. Dauskardta,*Understanding age-induced alterations to the biomechanical function of human stratum corneum. Journal of Dermatological Science
Altemus M, Rao B, Dhabhar FS, Ding W, Granstein RD. Stress-induced changes in skin barrier function in healthy women. Journal of Investigative Dermatology. 2001 Aug 1;117(2):309-17.
Meguro, S., Aral, Y., Masukawa, K., Uie, K. and Tokimitsu, I. (1999), Stratum Corneum Lipid Abnormalities in UVB-lrradiated Skin. Photochemistry and Photobiology, 69: 317-321. https://doi.org/10.1111/j.1751-1097.1999.tb03292.x
E. Berardesca*, M. Farage† and H. Maibach‡. Review Article Sensitive skin: an overview. International Journal of Cosmetic Science, 2013, 35, 2–8
Sorg O, Kuenzli S, Saurat JH. Side effects and pitfalls in retinoid therapy. InRetinoids and carotenoids in dermatology 2007 Jun 20 (pp. 245-268). CRC Press.
Fisher GJ, Voorhees JJ. Molecular mechanisms of retinoid actions in skin. FASEB J. 1996;10(9):1002-1013. doi:10.1096/fasebj.10.9.8801161
Del Rosso JQ, Levin J. The clinical relevance of maintaining the functional integrity of the stratum corneum in both healthy and disease-affected skin. The Journal of clinical and aesthetic dermatology. 2011 Sep;4(9):22.
Elias PM, Wakefield JS, Man MQ. Moisturizers versus current and next-generation barrier repair therapy for the management of atopic dermatitis. Skin Pharmacology and Physiology. 2019;32(1):1-7.
Berkers, T., et al., Topically Applied Ceramides Interact with the Stratum Corneum Lipid Matrix in Compromised Ex Vivo Skin. Pharmaceutical Research, 2018. 35(3).
Mohammed, D., et al., Influence of niacinamide containing formulations on the molecular and biophysical properties of the stratum corneum. International journal of pharmaceutics, 2013. 441(1-2): p. 192-201
Stettler, H., et al., A new topical panthenol-containing emollient: Results from two randomized controlled studies assessing its skin moisturization and barrier restoration potential, and the effect on skin microflora. The Journal of dermatological treatment, 2017. 28(2): p. 173-180.
Ayanlowo, O., et al. Shea butter as skin, scalp, and hair moisturizer in Nigerians. Dermatologic Therapy, 2021. 34(2).

The post Am I Protecting My Skin Barrier Enough? appeared first on SkinLab.

Two retinoids you’ll hear us talk about are tretinoin and adapalene. But what’s the difference, and which one is right for you? Let’s take a look.

First, what’s a retinoid?

Retinoids are a group of chemicals derived from vitamin A. They’ve long been the go-to for treating acne and ageing, because they are so effective. ,

Retinoids come in many forms. Some feature as the active ingredient in over-the-counter skincare products, available in any pharmacy or supermarket. These include retinyl palmitate, retinol, and retinaldehyde (retinal). ​​Retinol is the natural form of vitamin A that you can find in cosmetics, which needs to oxidise twice before it converts to the active form, known as retinoic acid. Retinal needs one step. When we look at retinoids that are on prescription such as tretinoin, this is actually retinoic acid which is the active molecule which can get to work on the skin.

Alternatively, there are more potent, prescription-strength retinoids — which you can get on prescription, or of course, from the dermatology experts at Dermatica.

All retinoids work in a similar way, by increasing cell turnover. This stops the build-up of skin cells, increases skin renewal and unclogs pores. Retinoids also have an anti-inflammatory effect, which can be especially helpful for some types of acne. They also help to stimulate collagen production, reverse fine lines caused by photoageing, and can lighten pigmentation due to their exfoliating effect.

Essentially, these hero ingredients can help deliver a smooth, clear complexion.

Tretinoin

Tretinoin, also known as retinoic acid, is the most widely-researched and potent retinoid. It’s been used to treat acne for at least four decades. It’s prescribed at different strengths, often starting as low as 0.015% and increasing to 0.05% as the skin adjusts.

What are the benefits of tretinoin?

Where do we start with this wonder ingredient? Tretinoin has been widely researched and shown many skin benefits in studies. It’s a great all-round anti-ager, and can bring about significant changes in the structure of your skin, affecting how it looks and feels. The proven benefits include a significant improvement in:
Fine lines
Pigmentation
Texture
Elasticity

All-in-all, tretinoin will help to reverse the signs of ageing, including natural, chronological changes as well as photoageing caused by sunlight.

Tretinoin also offers excellent benefits for acne. Studies have shown it effectively improves:,
Blackheads
Whiteheads
Papules (small bumps)
Pustules (pus-filled spots)

What are the side effects of tretinoin?

It’s effective, yes. But it can be associated with skin irritation when you start using it. Skin may become red or blotchy and flaky, and may burn or sting. This is called retinisation, and it’s really just a sign that the treatment is working, because it shows your skin is starting to exfoliate.

Everyone is different though, and if you don’t get any irritation, that doesn’t mean tretinoin isn’t effective for you.

The irritation will improve as your skin adjusts to the ingredients. And there are a few simple steps you can take to reduce this side-effect:
Prep your skin: Try using a barrier-boosting moisturiser for two weeks before starting treatment. Look for one containing niacinamide, panthenol, and tocopheryl acetate.
Start low and slow: We usually recommend the lowest dose to begin with, and suggest you only apply it twice a week. You can build up in frequency and strength as your skin adjusts.
Make a skincare sandwich: Apply moisturiser before and after your treatment.
Skip a day if you need to: You might need to give your skin a little break, and that’s fine. Wait until your skin has recovered and then re-introduce gradually.

Stick with it — this is strong stuff, but the results are worth it.

Adapalene

Adapalene is a relatively new kid on the retinoid block. It’s a synthetic version of vitamin A with a slightly different structure to tretinoin.

It has similar properties to tretinoin, but it’s a more stable chemical. This means it won’t lose its potency if exposed to sunlight, as tretinoin can. It also means adapalene can more easily be combined with other ingredients to combat acne, such as bacteria-flighting benzoyl peroxide, or clindamycin, an antibiotic.,

What are the benefits of adapalene?

There’s good evidence that adapalene can work wonders for acne. Many studies have compared it with tretinoin, and found that it’s just as effective, and in some studies even more so, for treating both inflammatory and non-inflammatory acne.

There is some evidence for its use as an anti-ageing tool too — it’s been shown to reduce pigmentation and improve wrinkles., But we need more studies in this area to understand its full potential.

What are the side effects of adapalene?

This is where adapalene may have the edge on tretinoin.

Multiple studies have shown that adapalene causes less skin irritation than tretinoin. This has been shown in several different strengths and formulations — even versus tretinoin at 0.025%, which is at the lower end of prescribed concentrations.

Which should I use?

Anti-ageing

If your aim is anti-ageing, tretinoin is your answer. There is currently more evidence for tretinoin than there is for adapalene when it comes to achieving younger-looking skin.

You may need to be prepared for the side effects of the retinisation process. But follow our advice, and you can minimise irritation. You can be fairly confident that you’ll achieve noticeably more youthful skin if you stick with it.

As evidence builds for adapalene, this may become the first choice for anti-ageing. But until then, we’ll suggest you try tretinoin first. You may need to switch to adapalene if your skin just can’t tolerate tretinoin.

Acne

If you’re looking for an effective acne solution, adapalene is the active ingredient for you. There are a few reason why this is the one to go for:
There’s plenty of evidence that it’s effective against acne, and it may work faster than tretinoin
It results in less irritation than tretinoin
It’s more stable, which means it can be combined with other acne-busting ingredients, such as clindamycin or benzoyl peroxide

What should I do next?

If you’re looking for effective acne or anti-ageing ingredients, retinoids can help. Adapalene and tretinoin are potent treatments, which need to be prescribed and monitored carefully..

Thankfully, Dermatica makes the process easy. We offer immediate access to an expert dermatology team who offer personalised evidence-based prescription medicines to combat acne and fight ageing. Your treatment is delivered to your door, and you’ll have experts on hand to ask questions whenever you need.

So there’s nothing to slow your journey towards the clear, youthful skin you want.

References
1. Thielitz, A., Abdel-Naser, M.B., Fluhr, J.W., Zouboulis, C.C. and Gollnick, H. (2008), Topical retinoids in acne – an evidence-based overview. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 6: 1023-1031. https://doi.org/10.1111/j.1610-0387.2008.06741.x
2. Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging. 2006;1(4):327-48. doi: 10.2147/ciia.2006.1.4.327. PMID: 18046911; PMCID: PMC2699641.
3. Thielitz, A., Abdel-Naser, M.B., Fluhr, J.W., Zouboulis, C.C. and Gollnick, H. (2008), Topical retinoids in acne – an evidence-based overview. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 6: 1023-1031. https://doi.org/10.1111/j.1610-0387.2008.06741.x
4. Thielitz, A., Abdel-Naser, M.B., Fluhr, J.W., Zouboulis, C.C. and Gollnick, H. (2008), Topical retinoids in acne – an evidence-based overview. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 6: 1023-1031. https://doi.org/10.1111/j.1610-0387.2008.06741.x
5. Piskin S, Uzunali E. A review of the use of adapalene for the treatment of acne vulgaris. Ther Clin Risk Manag. 2007 Aug;3(4):621-4. PMID: 18472984; PMCID: PMC2374937
6. Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging. 2006;1(4):327-48. doi: 10.2147/ciia.2006.1.4.327. PMID: 18046911; PMCID: PMC2699641.
7. Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging. 2006;1(4):327-48. doi: 10.2147/ciia.2006.1.4.327. PMID: 18046911; PMCID: PMC2699641.
8. Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. 2016;74(5):945-73. e33.
9. Krishnan G. Comparison of two concentrations of tretinoin solution in the topical treatment of acne vulgaris. The Practitioner. 1976;216(1291):106-9.
10. Piskin S, Uzunali E. A review of the use of adapalene for the treatment of acne vulgaris. Ther Clin Risk Manag. 2007 Aug;3(4):621-4. PMID: 18472984; PMCID: PMC2374937
11. Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging. 2006;1(4):327-48. doi: 10.2147/ciia.2006.1.4.327. PMID: 18046911; PMCID: PMC2699641.
12. Draelos, Z.D., K.D. Ertel, and C.A. Berge, Facilitating facial retinization through barrier improvement. Cutis, 2006. 78(4): p. 275-281.
13. Piskin S, Uzunali E. A review of the use of adapalene for the treatment of acne vulgaris. Ther Clin Risk Manag. 2007 Aug;3(4):621-4. PMID: 18472984; PMCID: PMC2374937
14. Jain S. Topical tretinoin or adapalene in acne vulgaris: an overview. Journal of Dermatological Treatment (2004) 15, 200–207
15. Jain S. Topical tretinoin or adapalene in acne vulgaris: an overview. Journal of Dermatological Treatment (2004) 15, 200–207
16. Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. 2016;74(5):945-73. e33.
17. Ellis C, Millikan L, Smith E, Chalker D, Swinyer L, Katz I, et al. Comparison of adapalene 0·1% solution and tretinoin 0·025% gel in the topical treatment of acne vulgaris. 1998
18. Bagatin, E., Gonçalves, H.d.S., Sato, M. et al. Comparable efficacy of adapalene 0.3% gel and tretinoin 0.05% cream as treatment for cutaneous photoaging. Eur J Dermatol 28, 343–350 (2018). https://doi.org/10.1684/ejd.2018.3320
19. Kang S, Goldfarb MT, Weiss JS, Metz RD, Hamilton TA, Voorhees JJ, et al. Assessment of adapalene gel for the treatment of actinic keratoses and lentigines: a randomized trial. Journal of the American Academy of Dermatology. 2003;49(1):83-90.
20. Jain S. Topical tretinoin or adapalene in acne vulgaris: an overview. Journal of Dermatological Treatment (2004) 15, 200–207
21. Shalita, A., et al., A comparison of the efficacy and safety of adapalene gel 0.1% and tretinoin gel 0.025% in the treatment of acne vulgaris: a multicenter trial. Journal of the American Academy of Dermatology, 1996. 34(3): p. 482-485.
22. Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging. 2006;1(4):327-48. doi: 10.2147/ciia.2006.1.4.327. PMID: 18046911; PMCID: PMC2699641.
23. Cunliffe W, Poncet M, Loesche C, Verschoore M. A comparison of the efficacy and tolerability of adapalene 0.1% gel versus tretinoin 0.025% gel in patients with acne vulgaris: a meta-analysis of five randomized trials. 1998.
24. Jain S. Topical tretinoin or adapalene in acne vulgaris: an overview. Journal of Dermatological Treatment (2004) 15, 200–207
25. Irby CE, Yentzer BA, Feldman SR. A review of adapalene in the treatment of acne vulgaris. Journal of Adolescent Health. 2008;43(5):421-4.

The post Adapalene vs. Tretinoin: Which Is Better For Acne & Anti-Ageing? appeared first on SkinLab.

Experts understand fairly well the role of genetics and hormones in acne, but there are other factors that are less clear. Sadly, diet is one of them.

Here’s what we know so far — and advice on what best to eat for clear skin.

First, why have I got acne?

It feels unfair. Why are you dealing with skin that breaks out, while friends are blemish free?

Unfortunately, there’s no easy answer to this. A host of factors are at play, the most important being genetics. Yes, you can probably blame skin issues on your family history.

Studies in identical twins — who share the same genetic makeup — suggest that genes account for 80% of acne. This means that in most cases either each twin or neither will have the condition.

The other 20% of the risk is down to factors that vary from person to person, and aren’t associated with any genetic tendency. This is why many experts think diet might play a role.

How does acne start?

But the processes that contribute to acne may also be impacted by diet. Acne is characterised by inflammation, excess sebum (oil) production, build-up of skin cells (hyper-keratinisation) and an increase in skin bacteria called C acnes. s.

One example is insulin, which affects levels of another hormone called insulin-like growth factor (IGF-1). This in turn is involved in various cellular processes that impact sebum production and skin cell turnover. Insulin levels are affected by the sugar we eat.

Which foods affect acne?

Sadly, it’s not easy to say. Although there’s plenty of anecdotal evidence for dietary influences on acne — who hasn’t been told to avoid chocolate? It’s unlikely that a single food will change your skin significantly but ask doctors to make specific recommendations.

But there’s a lot of research ongoing, which is starting to build up a picture of what might help.
Glycemic index/load
Glycemic index/load is looking like the most promising area of research when it comes to diet and acne.

The Glycemic index (GI) rates foods according to how fast your body breaks them down into sugar. Foods that your body breaks down quickly cause a rapid spike in blood sugar. These have a high GI. Examples include sweets, chocolate and sugary drinks, white bread and white rice. Foods that break down more slowly — such as whole grains, vegetables and pulses — have a lower GI.

The term glycemic load (GL) simply takes account of the amount of these foods. So a single sweet, which is a high-GI food, has a lower GL than a large handful of sweets.

Several studies have shown that people with acne seem to eat higher-GL diets than those without. And there’s some evidence that switching to a low-GL diet may reduce the number of acne lesions.
Scientists have also noted the complete absence of acne among certain groups of people who live on isolated islands with no access to processed, Western foods. But it’s not clear whether this is due to dietary GL, or other elements of the Western lifestyle.

The evidence suggests that trying to stick to foods that release sugars gradually, avoiding sugar spikes and surges in insulin, might be worth a try. For more information, have a look at the NHS article on the glycemic index.

Dairy

Although it often gets the blame as a spot-causing culprit, there’s mixed evidence for the impact of dairy on acne. Some studies have found a link with milk consumption, and in some cases, this link has only been shown with skimmed milk.

But the same association has not been seen with cheese. This raises the possibility that the acne connection is actually due to the effect of dairy on blood sugar, rather than specific dairy proteins.

There just isn’t enough evidence to advise every acne sufferer to give up dairy. But some people might find it helps. Keep in mind that if you do decide to skip dairy, it’s important to get your calcium from other sources.

Fats

There’s some weak evidence that the types of fats you eat could impact your acne. For example, some studies have shown a link between low fish intake and increased acne. And a diet high in trans-fat and saturated fat may also be a contributing factor.

In one study, adding an omega-3 fatty acid supplement reduced acne.

But again the number of studies is low, and there isn’t yet enough evidence to make definite recommendations. For good health, everyone should include omega-3 fats from fish, and try to limit trans-fats and saturated fats. These are generally found in animal products including meat and dairy.

What about chocolate?

The jury is still out on this one. In one study, men with acne were given capsules with either unsweetened 100% cocoa, or a control capsule. There was a statistically significant increase in acne in the cocoa group.

Other studies have also shown a link between acne and daily snacking on chocolate and sweets. But we don’t know if, again, this could just be due to all the sugar and the surges in insulin that follow.

And there’s another issue — acne can have a significant emotional impact. So could some of the acne-chocolate links be explained by comfort eating?

In short, more studies are needed before we can give definite no-chocolate advice. But if it triggers flare-ups, you might prefer to go without.

Acne advice

The best advice is to listen to your own body. If you’ve noticed that chocolate milkshakes bring on a break-out, it makes sense to avoid them.

It may not be what you want to hear, but the medical recommendation for people with acne is simply to eat a healthy, balanced diet. This should include:

Plenty of sources of high-quality protein such as lean meat, fish and pulses
Wholegrain foods rather than processed white versions.
At least 5 a day, including a colourful, varied mix of fruit and vegetables
Very little — if any — sugary, processed food and drink

This way, your diet should be naturally nutrient-rich, have a low GL, be low in trans fats and supply enough omega-3 oils.

It’s important to remember that we’re still learning what causes acne itself before we can fully understand what part of the diet has to play. You can have a perfectly balanced diet, but still have severe acne, so it’s important to take any comments or advice that you see on foods exacerbating acne with a large pinch of salt.

It’s not recommended to exclude any types of food or food groups without the guidance of an expert. If you want to get any more personalised information, we recommend speaking to your Dermatologist, GP or registered dietitian as they are the best-qualified people to help.

References
1. Bataille et al. https://www.sciencedirect.com/science/article/pii/S0022202X15301019
2. Baldwin, H., Tan, J. Effects of Diet on Acne and Its Response to Treatment. Am J Clin Dermatol 22, 55–65 (2021). https://doi.org/10.1007/s40257-020-00542-y
3. Baldwin, H., Tan, J. Effects of Diet on Acne and Its Response to Treatment. Am J Clin Dermatol 22, 55–65 (2021). https://doi.org/10.1007/s40257-020-00542-y
4. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
5. Cordain, L. (2005, June). Implications for the role of diet in acne. In Seminars in cutaneous medicine and surgery (Vol. 24, No. 2, pp. 84-91). WB Saunders.
6. NHS. What is the glycaemic index? www.nhs.uk/common-health-questions/food-and-diet/what-is-the-glycaemic-index-gi/, reviewed June 2022
7. Baldwin, H., Tan, J. Effects of Diet on Acne and Its Response to Treatment. Am J Clin Dermatol 22, 55–65 (2021). https://doi.org/10.1007/s40257-020-00542-y
8. Baldwin, H., Tan, J. Effects of Diet on Acne and Its Response to Treatment. Am J Clin Dermatol 22, 55–65 (2021). https://doi.org/10.1007/s40257-020-00542-y
9. Baldwin, H., Tan, J. Effects of Diet on Acne and Its Response to Treatment. Am J Clin Dermatol 22, 55–65 (2021). https://doi.org/10.1007/s40257-020-00542-y
10. Cordain, L. (2005, June). Implications for the role of diet in acne. In Seminars in cutaneous medicine and surgery (Vol. 24, No. 2, pp. 84-91). WB Saunders.
11. Adebamowo C, Spiegelman D, Berkey C, Danby F, Rockett H, Colditz G, et al. Milk consumption and acne in teenaged boys. J Am Acad Dermatol. 2008;58(5):787–93.
12. Baldwin, H., Tan, J. Effects of Diet on Acne and Its Response to Treatment. Am J Clin Dermatol 22, 55–65 (2021). https://doi.org/10.1007/s40257-020-00542-y
13. NHS Eat Well. Dairy and alternatives in your diet. www.nhs.uk/live-well/eat-well/food-types/milk-and-dairy-nutrition/, reviewed January 2021
14. Baldwin, H., Tan, J. Effects of Diet on Acne and Its Response to Treatment. Am J Clin Dermatol 22, 55–65 (2021). https://doi.org/10.1007/s40257-020-00542-y
15. Jung J, Kwon H, Hong J, Yoon J, Park M, Jang M, et al. Effect of dietary supplementation with omega-3 fatty acid and gamma-linolenic acid on acne vulgaris: a randomised, double-blind, controlled trial. Acta Derm Venereol. 2014;94:521–5.
16. NHS Eat Well. Fat: the facts. www.nhs.uk/live-well/eat-well/food-types/different-fats-nutrition/, reviewed April 2020.
17. Caperton C, Block S, Viera M, Keri J, Berman B. Double-blind, placebo-controlled study assessing the effect of chocolate consumption in subjects with a history of acne vulgaris. J Clin Aesthet Dermatol. 2014;7(5):19–23.
18. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021

The post Can Diet Prevent Acne? appeared first on SkinLab.

And now, of course, you need to know how to maintain that clear-skinned glow and keep the blemishes at bay. Scroll to find out more.

How your formula cleared your skin

If you’ve been dealing with acne, you’ve probably been using topical retinoids, most likely adapalene or tretinoin.[1,2] These are powerful vitamin A derivatives applied directly to the affected areas of your skin.

Retinoids work by speeding up skin cell turnover, removing dead skin cells and preventing the build-up that clogs pores.[3] Your formula may also contain a bacteria-fighting ingredient, such as benzoyl peroxide or clindamycin.[4]

It may have taken a few weeks or months to get the results you’re after, but you’ll no doubt agree it was worth the wait. And now your skin is clear, you want it to stay that way.

Treatment, not cure

It’s important to remember that topical treatment is not necessarily a ‘cure’. The underlying issues that caused acne in the first place won’t necessarily have gone away. These could include increased oil production, skin bacteria, build-up of skin cells, and inflammation.[5]

Acne, especially in women, can persist into your 30s, 40s or beyond.[6] But, since you can’t know for sure that it won’t return, controlling your acne – and keeping it away – usually calls for an ongoing commitment to a good skincare routine.

Keep up the active treatment

Everyone’s skin is different. For the lucky ones, acne will clear and not come back. But relapses are common.

Your skincare expert will probably recommend that you keep using a retinoid formula.[7] So, for example, a 6 or 12-week course of daily treatment that has worked well might be followed by a less-frequent use of the same formulation.[8,9] Retinoids will continue to lighten pigmentation and improve the skin texture, which is often present due to the inflammatory process of the skin. Furthermore, they help to stimulate collagen production and reverse fine lines caused by UV radiation (photodamage) which will help improve the overall complexion!

Adapalene, either alone or combined with clindamycin, or benzoyl peroxide, is the most commonly used agent for maintenance treatment.[10] We also use other ingredients that help to fade blemishes, pigmentation and inflammation, such as azelaic acid and niacinamide. This is an effective acne treatment and might be especially beneficial if you have post-acne hyperpigmentation or scarring.[11]

What happens if I stop my treatment?

There’s a risk of your acne returning if you don’t stick with the active ingredients you’ve been prescribed. In one study among people whose acne improved with adapalene and clindamycin, 92% had an increase in lesions at a 2-year follow-up if they hadn’t continued to use adapalene.[12]

It’s a good idea to review your regimen again around three months into the maintenance phase to see how things are going.[13] Our Dermatology Team will review your progress every few months to see how you’re getting on and adjust treatment accordingly. They’re always here beforehand as well if you have any questions.

Stick to a simple skincare routine

To reduce the risk of breakouts and minimise irritation, it’s best to stick with a simple routine, using tried and tested products.

Cleanser and moisturiser – plus your maintenance formula – are really all you need. Veer with caution with products that can irritate your skin, including astringents, toners, and exfoliants.[14] Retinoids are powerful exfoliants in themselves, and it’s important to let your skin adapt to this before trying other active ingredients.

Remember to never forget your sunscreen. It’s important to use it every day, even when it’s cloudy, to protect your skin from the sun’s harmful rays. Make sure to apply it about 20 minutes before heading outside to give it time to absorb into your skin. And don’t forget to reapply every two hours or immediately after swimming or sweating. Also, be sure to follow the instructions on the bottle when it comes to how much to apply – it’s usually a lot more than you think.

Cleansing tips:

Avoid the temptation to over-cleanse. Yes, you want to keep your skin clean. But acne is not caused by poor hygiene. Over-washing could make things worse and cause irritation.[15] Double cleansing is only needed when you need to remove makeup or SPF.
Cleansing twice daily – morning and night – is all you need.[16] You should also cleanse after sweating with exercise.[17]
Go for products that are pH neutral or slightly acidic, to match the natural pH of your skin.[18]
Choose a gentle formulation that removes dirt and excess oil, without drying your skin.
Always remove your makeup at the end of the day.[19]
Look for oil-free products and those that are non-comedogenic. This means that they have been tested and proven not to block pores.

Moisturising tips:
Check your moisturiser is non-comedogenic – that means it won’t clog your pores. It should say this on the packaging.[20]
If you need an extra cleanse after exercise, use your moisturiser too. But you don’t need to re-apply your active formula, as long as it’s had a few hours to work its magic.
Pick a moisturiser that will help strengthen your skin barrier and reduce any irritation from active ingredients. Look for one containing niacinamide, panthenol, tocopheryl acetate, ceramides and hyaluronic acid, as there’s good evidence that these are excellent at protecting and hydrating the skin.[21,22,23]
If your retinoid is causing irritation such as redness, peeling, burning or a dry, tight feeling, take a break until your skin feels back to normal and increase it gradually from there. Applying a small amount of moisturiser before applying your Dermatica formula, followed by regular application of moisturiser can help it absorb into the skin more gradually. This is sometimes known as ‘buffering’ or the sandwich technique.

Dermatica offers simple skincare basics that are expertly formulated to work in balance with our evidence-based active ingredients.

Follow our simple steps, and you can keep on enjoying your clear skin and the confidence it brings.

For a skincare solution personalised to you, start a free online consultation today and speak to our dermatology experts.

References
1. Zae nglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. 2016;74(5):945-73. e33.
2. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
3. Thielitz, A., Abdel-Naser, M.B., Fluhr, J.W., Zouboulis, C.C. and Gollnick, H. (2008), Topical retinoids in acne – an evidence-based overview. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 6: 1023-1031. https://doi.org/10.1111/j.1610-0387.2008.06741.x
4. Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. 2016;74(5):945-73. e33.
5. Piskin S, Uzunali E. A review of the use of adapalene for the treatment of acne vulgaris. Ther Clin Risk Manag. 2007 Aug;3(4):621-4. PMID: 18472984; PMCID: PMC2374937.
6. Piskin S, Uzunali E. A review of the use of adapalene for the treatment of acne vulgaris. Ther Clin Risk Manag. 2007 Aug;3(4):621-4. PMID: 18472984; PMCID: PMC2374937.
7. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
8. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
9. Acne. NHS Health A-Z. https://www.nhs.uk/conditions/acne/treatment/, reviewed July 2019
10. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
11. Kircik LH. Efficacy and safety of azelaic acid (AzA) gel 15% in the treatment of post-inflammatory hyperpigmentation and acne: a 16-week, baseline-controlled study. Journal of drugs in dermatology: JDD. 2011;10(6):586-90.
12. Zhang JZ, Li LF, Tu YT, et al. A successful maintenance approach in inflammatory acne with adapalane gel 0.1% after an initial treatment in combination with clindamycin topical solution 1% or after monotherapy with clindamycin topical solution 1% J Dermatol Treat. 2004;15:372–8.
13. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
14. Acne: Tips for managing. American Academy of Dermatology. https://www.aad.org/public/diseases/acne/skin-care/tips, published 16 November 2022
15. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
16. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
17. Acne: Tips for managing. American Academy of Dermatology. https://www.aad.org/public/diseases/acne/skin-care/tips, published 16 November 2022
18. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
19. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
20. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
21. Draelos, Z.D., K.D. Ertel, and C.A. Berge, Facilitating facial retinization through barrier improvement. Cutis, 2006. 78(4): p. 275-281.
22. Meckfessel, M.H. and S. Brandt, The structure, function, and importance of ceramides in skin and their use as therapeutic agents in skin-care products. Journal of the American Academy of Dermatology, 2014. 71(1): p. 177-184.
23. Milani, M. and A. Sparavigna, The 24-hour skin hydration and barrier function effects of a hyaluronic 1%, glycerin 5%, and Centella asiatica stem cells extract moisturizing fluid: An intra-subject, randomized, assessor-blinded study. Clinical, Cosmetic and Investigational Dermatology, 2017. 10: p. 311-315.

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