Putting Back the Clock

Some tips for a youthful, healthy skin

It is a universal truth that young people believe themselves to be invincible.
There is no point in telling a teenage binge drinker, for instance, that if they carry on they are likely to destroy not just their liver but also their brain by middle age. Or to advice a young smoker to quit- when they are well able to ignore the sober warnings already emblazoned in bold type on each cigarette packet.
However, put a female smoker or sun worshipper in front of a mirror and point out all of the external visible signs of premature aging that their habit is causing, and there will probably be some reaction. No one wants to see the effects of sun damage – a face etched with wrinkles, lines around the mouth or a lacklustre skin speckled with pigmentation problems and brown marks.
According to oculoplastics and aesthetic surgeon Jane Olver, smoking and sunbathing are the joint worst contributing factors to premature aging.
“Skin changes are amongst the most visible signs of aging and there is no doubt that smoking and sun damage contribute significantly to the aging process.
“Sun damaged skin looks older because of dehydration and the sebaceous glands also produce less oil with age, there are also pigment changes, thinning and wrinkles”, Jane explains.
So what can be done at Clinica London to put the clock back?
“Obviously each patient’s needs will be different and carefully assessed. The treatment for sun damaged skin with all its related problems is highly effective. Usually it will include specific procedures such as chemical peels such as trichloroacetic acid (known as TCA), botulinum toxin A (Botox®) and the use of fillers such as Restylane®.”
The in depth consultation includes diet advise as well as looking at the overall skin care regime -Jane recommends using factor 50 protection from April to November and factor 30 for the rest of the year – (link to “Healthy Summer Skin the Clinica way”),emphasising that these products are now much improved and include easily absorbed, lightly tinted versions.
“When a patient comes in to me for an assessment of their face and eyes from a cosmetic, aesthetic point of view the first thing I am going to do is look at their skin and ask them about their skincare regime.
“It is very likely that I will prescribe them some form of Tretinoin cream. This comes in different strengths -one of them is Tretinoin cream (0.025%, 0.05%, and 0.1%) and another Retin-A- both can only be acquired via a prescription.
“I will suggest using it around the eyes and on the eyelids- above the crease line- between three times a week and daily at night. This would be known as a “light peel” and it will produce new skin with an improved texture and luminescence – this skin will also be smoother and stronger.”
Treatment of melasmas and other light freckles require a slightly stronger Tretinoin mixture combined with hydroquinone and a weak steroid cream. When this is applied nightly a more intense peel of the pigmented area will follow.
“Here at Clinica London we are especially careful when examining any pigmented areas of the skin – we have a low threshold for biopsy – and want to make sure that it is not masking a malignant melanoma.
“With Tretinoin, the new skin will be hyper sensitive and could go red and feel sore if exposed to the sun before it is fully formed after treatment”, warns Jane. “I would also recommend not to use Tretinoin for two weeks before going on a sunny holiday.”
In some cases of sun damaged skin, non-surgical treatments alone might not be sufficient. If so facial surgery including blepharoplasty (link) could be required.
Chemical peels – often known as TCA peels – are a more intense non surgical skin treatment and, as such, would only be carried out during the winter months.
“TCA peels will improve the overall skin texture and the appearance of very fine wrinkles and some melasmas – although the brown marks can reoccur”, says Jane.
“At Clinica, typically TCA peels are often carried out at the same time as blephoroplasty surgery. I will apply the product around the eyes, feathered out over the cheeks and the forehead. It improves skin texture and fine wrinkles – whereas deeper wrinkles will benefit from Botox® and fillers like Hyaluronic Acid Gels.”
There is a recovery period following a TCA peel.
“You can have some skin changes afterwards for between ten days and two weeks. A sunburn reaction will follow in which the dead skin sloughs off from day six to ten.”
Patients whose skin might benefit from laser treatment or who have more extensive skin problems will be recommended to one of Jane’s dermatological colleagues.
London, 24th June 2011