In my clinic I see many patients with acne or rosacea and it is truly heart breaking to see how much the state of their skin can influence their confidence, mental well-being and quality of life. Once I have worked with them and their skin has begun to clear, it is equally touching to see how much peoples’ lives change once their skin looks healthy and beautiful again. Over the course of a treatment I have seen patients gradually smile more, start to carry themselves in a more happy and confident way and even dress differently, a very rewarding part of my job.

One thing that most breakout prone patients miss out on is the opportunity to go for regular facials, which the majority of women do without a thought. Imagine the amazing experience of feeling deeply relaxed and pampered, while knowing that you are giving your skin a great treat at the same time. Forgetting about your daily stresses, recharging your battery and simply ‘floating’ for an hour or so – sounds great doesn’t it? Well, unfortunately for people suffering with breakouts this isn’t as straight forward. Many of you will have had the experience that your high street facial didn’t actually have the promised benefits on your skin – or even worse: aggravated your skin problem! This is a very, very common problem for acne and rosacea sufferers – the reason being that most high street beauty therapists are not well trained enough to deal with problem skin, and have not had the advantage of working closely with a dermatologist.  Their facials are therefore often completely unsuitable for problem skin. I have seen spas marketing so-called ‘acne facials’, which when looking into it, turned out not to be suitable for breakout prone skin at all. Chances are you might end up with worse skin than before.

And that’s the reason why we are so proud to offer our very special, Dermatologist developed acne and rosacea facials for men and women with breakout prone skin. Not only will they give you an amazingly relaxing experience (an hour of pure ‘me time’) and help to keep your skin beautiful and young looking, but our specialist facials are also highly effective in helping to improve acne and rosacea. Our mission is to revolutionize facials – this is very different from what you typically find on the high street. We set out to allow people with problem skin to be able to enjoy a new type of facial – Relax in the knowledge that you are in trusted hands, with the added peace of mind that should you need additional help to turn your skin around, there is a Dermatologist at hand to help with prescription treatments where needed.

There’s no doubt in my mind that using a good skincare regime with effective cosmeceuticals benefits skin immensely. The problem is, the timescale needed to reap real benefits isn’t always reflected by the manufacturer’s claims, or the media’s enthusiasm, come to that. There are too many ‘miracle’ creams on the market promising dramatic, visible skin improvements after a mere two to four weeks – or even immediately. But in the real world, can we believe them?  Let’s have a closer look at those claims.

Anti-ageing creams invariably promise both instant and long term results. What you should notice immediately after application is improved hydration – your skin looks fresher and feels softer, more moist and comfortably elastic. But does looking and feeling better mean your skin has physically changed for the better? Sadly, it’s not that simple.

What I expect from an anti-ageing cosmeceutical formula goes beyond pure hydration. While it’s helping to protect my skin from environmental damage, I’d like to know it’s boosting production of good quality, wrinkle-preventing proteins including collagen and elastin. In other words, I want actual changes in my skin’s biology. And I realise this won’t happen overnight.

Let’s get real, girls – and boys, too! I’m talking months to years, rather than days to weeks. Embarking on a good cosmeceutical skincare regime is like joining a gym. You wouldn’t expect major miracles after only a couple of weeks’ exercise, would you? Remember that in your 20s nature more or less determines how your skin looks – but past 30, it’s down to you! A good skincare regime is a serious investment in your skin’s future – like a fund you keep paying into to enjoy the benefits on maturity. Bear in mind that these benefits might not show in exactly the way you expected. You’re not likely to look in the mirror one day and think ‘Wow! I look 10 years younger than last week!’  Instead, it’s my experience that after your 35^th or 40^th birthday you’ll suddenly begin to realise you’re looking so much younger than friends who haven’t taken their skincare seriously.  So don’t trust overnight miracles.  It’s long-term investment that pays off in the end.

Most people see botulinum toxin (often incorrectly referred to as ‘Botox’ following one of the brand names) as something for correcting significant lines and wrinkles once they are older. In clinic I often hear sentences like “When I am 50 or 60 years old, I might go for ‘botox’, but at the moment I am way too young”. Botulinum toxin is often seen as a kind of ‘last resort’ or ‘extreme measure’ to consider only once significant signs of skin ageing such as deep lines and wrinkles have already appeared. This is a misconception.

To understand why, let me give you an important piece of background information on lines and wrinkles. When we first develop lines, these are usually ‘dynamic’ lines. Dynamic lines (or ‘mimic’ lines) are caused by contraction of facial muscles. They include ‘frown lines’ between the eyebrows, ‘worry lines’ on the forehead, ‘bunny lines’ on the nose and ‘crow’s feet’ at the outer eye corners. They are visible when we contract certain muscles (for example when frowning or smiling), but smooth out when we relax our face. However, once we have had these dynamic lines for a while, they become partly independent of muscular movement and stay visible to some extent all the time. These are then so-called secondary ‘static’ lines.

Now, what most people don’t know is that botulinum toxin works best with purely dynamic lines in people with well preserved skin elasticity. Once our lines have partly turned static and once our skin elasticity declines, botulinum toxin alone will not do the trick any longer and we would need additional procedures such as fillers and volumisers. So for botulinum toxin to work best it is good to start early enough, when your lines are still dynamic and your skin elasticity is still high. And in this case, botulinum toxin not only beautifully corrects your lines and wrinkles, but also prevents dynamic lines from becoming static. As cosmetic dermatologists, we have known this for a long time.

However, when I visited the World Congress of Anti-Ageing Medicine in Monte Carlo last month I learned that it goes much further even. Not only does botulinum toxin prevent dynamic lines from turning into static lines, it also seems to preserve skin elasticity itself. Why this is the case, we don’t know for sure yet. Might it be that countless creasing of the skin (caused by our facial muscle contractions) has a negative effect on collagen metabolism itself? I am looking forward to further scientific studies to find out what exactly causes this benefit, but it certainly seems to work, not only in the upper face, but also the lower face.

I can thus answer my initial question with: Botulinum toxin not only corrects lines and wrinkles, but also has a great role in prevention. These are truly exciting times in cosmetic medicine not only for patients, but also for us as practitioners.

With age, our lips gradually become thinner, less rounded and might develop fine vertical lines on and around them. So for a truly holistic facial rejuvenation process, we need to address this lip ‘deflation’.

However, understandably most people do not want to have their lips augmented, fearing that it will be obvious to others and also painful to do. That’s why we have developed the amazing ‘Feather Lip Smoothie’.

This treatment rejuvenates the lips by boosting hydration and adding a sensual, subtle roundness. Results will appear absolutely natural.

A ‘Feather Lip Smoothie’ is done by injecting bio-revitalisation product Restylane Vital or Vital Light with the innovative PixL ‘needle’. The new PixL ‘needle’ is flexible and non-traumatising, and is specially designed to reduce the side effects of filler treatments.

I have developed my own lip hydration approach which involves the use of one tiny entry point next to each corner of the mouth, inspired by the keyhole approach in surgery. Completely avoiding injections into the red of the lips will lead to much less swelling and bruising and causes very little discomfort. The lips will look younger and more rounded. A ‘Feather Lip Smoothie’ also helps ease ‘lipstick bleed’.

However, the treatment is not only wonderful to revive ageing lips, but also an amazing ‘Party boost’ for younger lips!

Woman and Home magazine, wrote: “Lip smoothing is one of those ‘why didn’t I think of it sooner’ treatments that work like a charm, and gives you a wonderfully soft and subtle effect. No trout pout, no over-fill, just young lip revival.”

Irregular pigmentation is a common concern for my patients. It can affect people of any ages, ethnicities and skin types, although darker complexions are more prone. Hyperpigmentation occurs when the skin produces too much pigment (melanin) – for example in response to UV exposure, hormonal fluctuations and inflammation (e.g. after acne). There are some effective treatments on the market such as hydroquinone and vitamin A acid, however, these are prescription-only creams and treatment should be carefully supervised by a Dermatologist, as there is the potential for side effects.

Some patients prefer over-the-counter products and SkinCeuticals has recently launched a new product, called Pigment Regulator. Impressively this has been shown in a scientific study to be as effective as the gold-standard, prescription hydroquinone. The Pigment Regulator contains kojic acid, which inhibits tyrosine, an enzyme responsible for the generation of melanin in our pigment building cells, the melanocytes. In addition, it also contains antioxidant rich emblica and an exfoliating mix to accelerate shedding of already existing melanin. In the clinic, we combine this home treatment with a weekly Pigment Balancing Masque, a peel containing high-grade L-Ascorbic acid (pure Vitamin C) and exfoliating agents, which I have seen excellent results with.

When treating irregular pigmentation, timing is crucial. The winter months are the perfect time of year to treat hyperpigmentation as the intensity of ultraviolet irradiation is reduced. This is important, as UV exposure will lead to a significantly less impressive treatment outcome. Another corner stone of treatment is therefore sun protection, sun protection and more sun protection, even in winter! Broad-spectrum UV filters with SPF 50-90 are crucial and should be re-applied regularly throughout the day for optimal results.

Everybody now seems to know that you can soften lines and wrinkles with ‘botox’ and fillers, and that cheeks can be nicely augmented with injectable ‘volumisers’. One procedure that most people are still unaware of however is non-surgical nose-shaping – and yet the results are amazing and the procedure is very quick and uncomplicated.

Non-surgical nose shaping is a relatively new variation of treatment with a hyaluronic acid filler. In our clinic we use a filler with added local anaesthetic, so that the procedure is virtually painless in most patients.

Not everybody is suitable for this treatment, but if you are, then this is a great alternative for a surgical ‘nose job’ (rhinoplasty). We can treat for example bumps on the bridge of your nose and an uneven shape to the bridge of the nose (for example after trauma or surgery). Often the nose might even appear smaller compared to before treatment. I also frequently have patients coming to see me in clinic, complaining that they can’t wear glasses or sunglasses, as these tend to slide down, due to the flatter shape of their nose. Through means of non-surgical nose shaping we can now build up flat noses, giving them a beautiful, even profile and thus reducing the problem of ‘sliding glasses’.

I am pleased to announce that on the 28. January I will be holding an exiting work-shop with two brilliant colleagues on how to look your best in 2011. This will take place in our Chelsea Bridge Clinic. Places are filling up quickly, so to book your place call: Tel. 020 7467 8500

Looking great in 2011 featuring presentations with live demos, wine and relaxing chat with the experts, goody bag worth more than 30 Pounds, networking and much more.

How to get younger looking skin without surgery – Dr Stafanie Williams Dermatologist

How to loose fat and feel great – Dr Marie- Clare Wilson Wellbeing practitioner

How to enhance your looks be finding your personal style – Joy Odunsi Personal Stylist

When: 28 January 2011, 18:00h
Where: Tres, Chelsea Bridge Wharf
Cost: £20 booking fee (redeemable against treatments)

Have you noticed over the past week or so that your skin seems drier? You’re not the only one. Dry skin is an extremely common complaint that affects up to 40% of us. Interestingly, the paler your skin, the drier it’s likely to be although science hasn’t yet discovered precisely why.

I’m sure you’ve already guessed that the changing weather might be causing your drier skin. But why does winter make our skin drier? Well, there’s something in the air. Outside, it’s getting colder, drier and windier while inside, central heating parches the atmosphere, meaning moisture evaporates faster from the skin surface. This ‘double whammy’ significantly lowers the water content of the skin’s horny layer. So what does that mean, exactly?

The skin is composed of three main compartments – from the bottom up, the subcutis, or deep skin ‘cushion’ of fatty tissue, the dermis of firm connective, supportive tissue and the epidermis, the skin’s outer protective layer. Most surface signs of ageing such as wrinkles and loss of elasticity begin deep in the dermis. But it’s the epidermal top layer which regulates water homeostasis – the skin’s moisture quota. In most parts of the body, the epidermis is paper-thin and it is the most superficial sheet of the epidermis – the stratum corneum, or ‘horny layer’ that plays the most crucial role.

Think of this horny layer as a microscopically tiny mortar/brick wall. The bricks are flat, horny dead skin cells and the mortar consists of lipids – ceramides, free fatty acids and cholesterol – which cement them together. This protective horny barrier has two key functions – to keep environmental hazards out and to keep water in. And it usually does both pretty well.

But certain internal and environmental conditions can reduce the lipid content between cells, so that water evaporates more easily from the skin surface. A genetic tendency to dry skin, hormonal influences, metabolic diseases (an underactive thyroid gland, say, or diabetes), impaired kidney function and, of course, age all compromise skin lipids. Medication such as Vitamin A acid tablets and drugs that lower cholesterol as well as certain blood pressure lowering drugs won’t help. Neither does an unbalanced diet, excessive weight loss or sadly, increasing age.

So if you are suffering from dry skin and ‘winter itch,’ here’s the strategy. Try to reduce contact with water and limit your use of soap and detergents. If you’re wrapping up against the chill, avoid scratchy fabrics such as wool and opt for soft thermal cottons and fleeces instead. And give that stressed, horny skin layer a helping hand. A lipid-rich moisturizer will help to reinforce the skin’s protective barrier, minimize water loss and calm itching instantly. My top tip is to apply it when your skin’s still damp from the shower to trap even more moisture in the surface layers. Now that’s a soothing thought.

I just read a interesting study performed at the highly reputable School of Psychology at Cardiff University. In this paper the investigators wondered whether injections with botulinum toxin (botulinum toxin is the active ingredient in ‘Botox’) might be useful in cases of depression.

It has long been believed in psychological circles that the actual act of frowning itself can make us feel unhappier. This is believed to happen via facial feedback mechanisms. What this basically means is that if you frown, your brain ‘thinks’ you must be unhappy and provides the corresponding feeling to your facial expression. Cosmetic botulinum toxin treatment on the other hand temporarily reduces the activity of the facial muscles we need to frown.

So the question is, if we are no longer able to frown, would that lead to a less negative emotional state? In other words, can we ‘trick’ our brain (by not allowing our frown muscles to do their job) into ‘thinking’ that we must be happy? Lewis and Bowler put this theory to the test and compared the mood of people who had received cosmetic botulinum toxin treatment with people who had received other cosmetic treatments. Amazingly they found that cosmetic botolinum toxin treatment does indeed correlate with a significantly less negative mood.

Does this mean that people with depression should now receive botolinum toxin injections instead of counseling, psychotherapy and anti-depressants? A good friend of mine, Dr Malin, a lovely Norwegian psychologist practicing in London, comments “It has to be remembered that this study does not indicate that Botox can successfully treat depression and that it can as such replace other treatments for depression. I would therefore highly encourage anybody going through a depressed stage to seek appropriate psychological help.” I couldn’t agree more. However, this is a very interesting study and I am looking forward to further studies in this area.