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Sunscreens

Sunscreens - shedding new light on an old topic

SHEDDING NEW LIGHT ON AN OLD TOPIC.

Are there any good reasons NOT to wear sunscreen? Surely not…

We know well enough of the dangers of skin cancer, which may not only be deadly as the dreaded melanoma, but also disfiguring and requiring numerous visits to the doctor’s office for multiple interventions. In addition, excessive sun exposure causes photo ageing and hyperpigmentation which is distressing to women and men alike.

Sunlight is certainly not all bad, and generally induces a sense of well-being, decreases the appetite, improves libido and assists with the synthesis of vitamin D.  South Africans are a sun loving society that embraces an outdoor lifestyle. While moderate and responsible exposure to the sun is good for your well-being, it is not possible to tan without damaging skin cells, leading to accelerated ageing, and increasing your risk of skin cancer.

As we head into 2021 hoping for a better year than the last, I thought we would relook at some of the controversies surrounding sunscreens and shed some light on new innovations and considerations concerning sunscreen use.

With conflicting information in the media many people are confused about whether they should be wearing sunscreen and uncertain of the product to choose. This can lead to them wearing no sunscreen at all. Let’s set the record straight.

The first point to make clear is that there is overwhelming scientific evidence that excessive sun exposure causes skin cancer and methods of sun protection including sunscreens can prevent this. Recent sunscreen studies conducted in Australia estimate that the current sunscreen recommendations have decreased the incidence of skin cancer by 10-15 %.

Sunscreen and Vitamin D

Possibly the current biggest controversy surrounding sunscreen use relates to Vitamin D deficiency. Reports have been conflicting. A review article published in the British journal of Dermatology last year sought to evaluate the available studies and concluded that there was not enough evidence to suggest that sunscreens decreased the production of Vitamin D. The original study that made this claim was done with an artificial light source different to what people are normally exposed to in the environment. Subsequent studies with real life circumstances could not prove a decrease in Vitamin D production with sunscreen use.

The only limitation of this review was that it didn’t take into account the newer very high protection sunscreens currently being used.

Remember that sunscreen does not fully prevent exposure to sunlight. To get maximum sun protection from a sunscreen one would need to apply 2mg/cm squared and reapply every 2-4 hours. Most people do not wear sunscreen in large enough quantities. Some of the analysis even suggested that there is still enough UV R exposure to produce adequate vitamin D even while using sunscreen.

Interestingly there are some people who do not produce enough Vitamin D even with large amounts of sun exposure, and some people with minimal sun exposure with normal Vitamin D levels. There seem to be as yet unidentified factors influencing Vitamin D synthesis.

More importantly you can get enough Vitamin D from oral supplements and diet without exposing yourself to an increased risk of skin cancer.

Sunscreen and its impact on the environment

UV filters oxybenzone,  camphor derivates, octocrylene, and octinoxate  have caused much recent controversy as they have been shown to accumulate in the water sources of the world and suspected of being responsible for the bleaching of coral reefs. They are not easily removed by conventional water treatment methods. As a result of this several states in the united states have banned these sunscreen ingredients. Of note is that the study that claimed the adverse effects on coral reefs used much larger concentration of oxybenzone than is actually found in even the busiest beaches in the world. However this is certainly a warning and has led sunscreen manufacturers to seeking alternative ingredients in their formulations.

It doesn’t however warrant a blanket boycott of all sunscreens. If anything, there is a shift towards using more physical or mineral blockers in sunscreens like zinc oxide and titanium dioxide which is recommended for sensitive skin and children.

Sunscreen and its relation to Frontal Fibrosing Alopecia

On that note physical blockers or mineral sunscreens have also been controversially linked to frontal fibrosing alopecia which is a condition that is caused by progressive fibrosis of the hair follicles of the frontal hairline resulting in hair loss and a receding hairline. Small quantities of titanium supposedly from titanium dioxide containing mineral sunscreens, have been found in the hair shafts of patients with frontal fibrosing alopecia. There is no conclusive proof yet that the sunscreens are the actual cause for frontal fibrosing alopecia.

Is sunscreen an endocrine disrupter?

Oxybenzone has been identified as an endocrine disrupter affecting the endocrine systems in rats and fish.  But for this to affect humans, one would need to apply an unrealistically large amount of oxybenzone to the skin for decades to absorb the quantities of avobenzone needed to cause any real danger. To date there have been no proven significant negative effects from oxybenzone in humans.

What about SPF ? The burning question is whether a higher SPF provides greater sun protection?

To recap, SPF or sun protection factor is actually only a measure of protection against UVB. An SPF of 30 means that you will be able to stay in the sun 30 times longer without burning, than you would be able to without wearing the sunscreen. This does not equate to 30 min and varies amongst individuals, as we all burn at different rates depending on our skin type.

SPF is measured in a test environment which is nothing like real life.It does not take into account sweating, environmental factors and the varying application by the sunscreen user.

In a test environment sunscreen is applied very thickly, at 2mg of sunscreen per square centimetre which is the minimum needed to get the protection labelled on the sunscreen.

Several investigations  have found that sunscreen users rarely apply sun screen adequately and evenly.The quantity that is actually applied by people is closer to 0.5mg per square centimetre. So we are never really getting the same protection as on the label.

Using a lower SPF sunscreen at quantities lower than 2mg per square centimetre actually reduces the overall sun protection factor.

However a recent study published in the Journal of the American Academy of Dermatologists (JAAD) confirmed that realistic usage of a higher SPF sunscreen of SPF 70 and above may provide enough sun protection to protect against photo ageing and skin cancer.

Another point worth emphasising is that while it is true that SPF15 filters out 93.3% of UVB, SPF30 96.7% and SPF50 98.3%, making it seem that there is very little benefit in using the higher SPF, one needs to consider that only the amount of UV light reaching your skin is important. If you look at it this way then SPF 15 allows 6.7% of UVB to reach your skin while SPF 50 allows only 1.7% of UVB. Its not about what you are filtering out, but rather about what you are allowing to reach your skin.

Why should you consider tinted sunscreen?

Tinted sunscreens containing ‘light reflectors’ protect against visible light which causes erythema in light-skinned individuals and hyperpigmentation in dark-skinned individuals. Visible light is the light that we see and makes up 44 % of the electromagnetic spectrum reaching the earth. Conventional broad spectrum sunscreens do not protect against visible light. For a sunscreen to do this it must be opaque and visible on the skin. The newer generation of physical sunscreens made with nanotechnology use small particle sizes of zinc oxide and titanium dioxide to decrease the “white” appearance of the sunscreen and make them more aesthetically suitable for use. Ironically these fine particles can no longer reflect visible light. Tinted sunscreens containing shades of iron oxide and titanium dioxide in various combination are not only able to blend with different skin tones, but are also able to reflect visible light. In this way they can protect against disorders of hyperpigmentation like melasma, post inflammatory hyperpigmentation and lichen planus pigmentosus.  Iron oxide pigment can also be found in tinted powder or brush on sunscreens which can be conveniently reapplied during the day.

Sunscreens treating early skin cancer

The latest research in sun screen technology has seen the development of a new generation of ‘active sunscreens’ containing DNA repair enzymes. These sunscreens have very high SPF and are in the unique position to be seen as potential treatment of early skin cancer (not melanoma) rather than just preventative treatment like regular sunscreens.  Skin cells have their own mechanisms to repair DNA damage caused by UVR, but with excessive sun exposure these mechanisms are overwhelmed which can lead to permanent DNA mutations causing skin cancer and photo ageing.  Scientific studies have shown that sunscreens containing photolyase and endonuclease can enhance the DNA repair mechanisms in damaged skin cells and reduce the lesions of early skin cancer in sun damaged skin. These novel sunscreens may also protect against photo ageing and prevent the breakdown of collagen in the dermis by decreasing the enzyme matrix metalloproteinase.

Conclusion

The science behind sunscreen technology and skin cancer prevention is by no means stagnant and while new challenges emerge regarding the potential dangers of ingredients, science will continue to forge ahead bringing new solutions and replacing old ones.

At the current time sunscreens remain our best solution to the prevention of skin cancer and photo-ageing.


References

  • The effect of sunscreen on vitamin D: a review*
    R.E. Neale iD ,
    1 S.R. Khan,1 R.M. Lucas iD ,
    2 M. Waterhouse,1 D.C. Whiteman iD 1 and C.M. Olsen iD 1
  • Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Rd, Herston, QLD, 4006, Australia
  • 2 National Centre for Epidemiology and Population Health, Australian National University, Australia
  • Linked Editorial: Wolf. Br J Dermatol 2019; 181:881–882.

  • High-SPF sunscreens (SPF $ 70) may provide
    ultraviolet protection above minimal recommended
    levels by adequately compensating for lower
    sunscreen user application amounts.
    Hao Ou-Yang, PhD,a Joseph Stanfield, MS,b Curtis Cole, PhD,c Yohini Appa, PhD,a and Darrell Rigel, MDd
    Los Angeles, California; Winston Salem, North Carolina; Skillman, New Jersey; and New York, New York

  • Photoprotection beyond ultraviolet radiation: A review of tinted sunscreens
    Alexis B. Lyons, MD,a Carles Trullas, MSc,b Indermeet Kohli, PhD,a Iltefat H. Hamzavi, MD,a and
    Henry W. Lim, MDa
    Detroit, Michigan; and Barcelona, Spain

  • DNA repair enzymes in sunscreens and their impact on
    photoageing—A systematic review.
    Hanna Luze1,2 | Sebastian Philipp Nischwitz1,2 | Iris Zalaudek3 | Robert Müllegger4 |
    Lars Peter Kamolz1,2

  • Review of environmental effects of oxybenzone and other sunscreen active ingredients.
    Samantha L. Schneider, MD, and Henry W. Lim, MD
    Detroit, Michigan
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Vitamin C – The Difference

There is an overwhelming amount of new vitamin C containing skincare products on the market, with marketing campaigns and social media urging one to use vitamin C in their skincare regimen. But what exactly does vitamin C do for the skin, and why is it important to invest in the right product?

Vitamin C is present in virtually all tissues in the human body and normal skin contains high levels of it.
Humans are unable to make Vitamin C so we need to get it from food. It is absorbed into the skin from blood vessels in the dermis with the help of sodium-dependent transport channels.

Vitamin C is a potent antioxidant which can be supplemented orally or applied topically as an anti-ageing ingredient in skincare.
Though oral Vitamin C has numerous benefits to the body, we are unsure of how much eventually filters through to the skin.
We do know however that supplementation whether oral or topical does increase the concentration in tissues with measurable benefits.

What are the benefits of vitamin C in the skin?

-Vitamin C as an antioxidant-
Vitamin C is a potent antioxidant that works by neutralising reactive oxygen species (ROS).
ROS formed by sun exposure and cellular processes causes damage to cellular DNA, cell membranes and collagen. The result is ageing skin and skin cancers.
Sunscreens are unable to fully protect against ultraviolet light (UVA, UVB) reaching the skin.
Comprehensive sun protection requires a topical antioxidant as well as a sunscreen.
In addition, recent evidence suggests that sunscreen is unable to protect against newly discovered environmental aggressors like infrared and pollution that contribute to declining skin health.

Vitamin C is able to bridge this gap in skin vulnerability.
Clinical studies have shown that sun exposure and smoking depletes vitamin C in the skin, while regular topical application can lead to a replenished skin reservoir.
Overall topical application of vitamin C will help treat and prevent the changes associated with skin ageing and skin cancer.

-Vitamin C in collagen synthesis –
Vitamin C is a co-factor in collagen synthesis, so it is vital for collagen formation. It also works by increasing the gene expression for collagen synthesis and reducing the breakdown with a resultant overall increase in the amount of collagen formed. In this way vitamin C plumps up the dermis to increase the thickness of ageing skin.
Studies have shown that topical application of Vitamin C increases collagen production in young skin as well as photo damaged skin meaning that the benefits can be seen from an early age.

-Vitamin C and hyperpigmentation-
Vitamin C inhibits the enzyme tyrosinase decreasing melanin production.
It stabilises melanocytes which react in particular to sunlight. The overall effect is reduced pigment production and improvement in uneven skin tone. Vitamin C can therefore be used in the prevention and treatment of disorders of hyperpigmentation including melasma and post inflammatory hyperpigmentation(PIH). It is used in combination with other skin lightening agents.

-Vitamin C as an anti inflammatory-
Vitamin C inhibits pro inflammatory cytokines interrupting the inflammatory cascade. It can be topically applied to reduce inflammation in skin conditions like acne and rosacea.
In rosacea it calms down inflamed skin and reduce redness.
In acne, the suppressive effect of Vitamin C on melanocytes and inflammation prevents the development of post inflammatory hyperpigmentation (PIH).

-Vitamin C in wound healing-
Vitamin C promotes the migration and proliferation of fibroblasts to areas of skin injury. In this way it promotes new collagen formation and aids in wound healing.

-Vitamin C for dry skin-
Topical application of Vitamin C is reported to improve the appearance and feel of rough, dry skin. Studies have shown that Vitamin C promotes the formation of the lipids in the upper layer of the skin. This helps to maintain the integrity of the skin barrier locking in moisture and alleviating dryness.

So we know the benefits of Vitamin C, but how do we get it to the skin?
A variety of Vitamin C preparations are available. Not all are equal and it is important to look for a reputable brand.
The challenge is getting topically applied vitamin C into the dermis where it can have optimal benefit.
L-Ascorbic acid is the biologically active and best studied form of Vitamin C and generally the form you should look for in skincare products.
There are other forms with varying clinical benefits.

L- Ascorbic acid is hydrophilic, which is why absorption through the skin surface which has lipophilic properties is not easy.
However studies have shown that L-Ascorbic acid in the right formulation with a pH lower than 4, can effectively penetrate into the skin. The optimum concentration is between 10-20%. Lower concentrations are suitable for sensitive skin types while higher than 20 % can be irritating to the skin.

L-Ascorbic acid is unstable, especially when exposed to light and heat, so it should be in an opaque or amber bottle and stored in a cool, dark place.
Lots of effort has gone into keeping Vitamin C in stable formulations so that it is still active when applied to the skin. When vitamin C has oxidized it becomes brown in colour.

Vitamin C is often combined with other antioxidants like Vitamin E and Ferulic. Combination formulations have a synergistic effect multiplying the antioxidant and photo-protective benefits and in some cases improving stability.

Vitamin C is safe to use with multiple clinical benefits to ensure a healthy and younger looking skin. At Skinsmart we stock a range of products that offer the benefits of Vitamin C – contact us to assist you in finding the Vitamin C formulation best suited to your skin type and skin concern.

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Troubleshoot Your Sunscreen

With summer in full swing, we thought this would be a great time to share some of our helpful tips for keeping your skin well protected from those damaging rays.

Seriously… there are very few reasons not to wear sunscreen, and we thought we would share the
complaints we have heard numerous times, with our recommended solutions.

1. I DON’T LIKE TO WEAR SUNSCREEN BECAUSE IT LEAVES A WHITE RESIDUE ON MY SKIN 
The “white cast” from sunscreen comes from the physical UV filters, titanium dioxide and zinc oxide.
Newer sunscreens are formulated with microfine particles of zinc oxide and titanium dioxide which don’t leave a white residue.
Some sunscreens contain smart colour adaptive particles that blend with most skin tones.

We recommend:
SkinCeuticals Sheer Physical UV Defense SPF 50 which is a broad-spectrum protective fluid with a weightless matte finish.
Or SkinCeuticals Physical Fusion UV Defense SPF 50 with translucent colour spheres to enhance your natural skin tone. It’s also water resistant for up to 40 minutes.

2. WEARING SUNSCREENS GIVE ME BREAKOUTS
Oily or cream formulation sunscreens can occlude the pores and cause acne breakouts. Go for ultrafluid sunscreens or those advertised as “non-comedogenic”.

We recommend:
La Roche Posay Anthelios XL 50+ Ultrafluid provides sun effective protection but with a soft, non-greasy light texture suitable for normal to combination skin.
Or SkinCeuticals Sheer Physical UV Defense SPF 50 offers broad spectrum sun protection with a sheer mattifying texture that is ideal for sensitive, rosacea-prone and post-procedure skins.

3. MY SKIN BECOMES SHINY WHEN I USE SUNSCREEN 
Mattifying or dry touch sunscreens contain ingredients that absorb oil on the skin surface leaving a matte finish throughout the course of the day. This is perfect for those with an oily skin or a humid environment.

We recommend:
SkinCeuticals Physical Matte UV Defense SPF 50 which offers maximum broad spectrum protection in a comfortable oil absorbing base with colour adapting tint.
Or Heliocare 360 Gel oil free contains antioxidant formula Fernblock FC and Bioshield technology in a unique oil free dry touch formulation. It protects against damage from UVA/UVB, infrared and visible light.

4. MY SKIN IS TOO SENSITIVE FOR SUNSCREEN
Sensitive or eczema-prone skin can develop irritation and itchiness with the application of sunscreen. It is mainly the chemical filters or added ingredients in the sunscreen that can cause contact allergy.
If you tend to have a sensitive skin or suffer from rosacea or eczema try mineral sunscreens which are chemical filter free.

We recommend:
Heliocare 360 Mineral. An innovative mineral fluid ideal for sensitive, acne-prone skin types, atopic dermatitis, post-procedure use and children.

5. I DON’T REAPPLY SUNSCREEN DURING THE DAY AS IT WILL MESS UP MY MAKE-UP
Solution 1
Brush on powder sunscreens are available in different shades to suit your skin.
Simply reapply over your make up as you would powder.

We recommend:
Colorescience® Sunforgettable® brushes are a unique self-dispensing powder sunscreen that make re-application simple throughout the day.
These are one of the few effective SPF products that can be applied over make-up.

Solution 2
Tinted sunscreen or sunscreen ‘make-up’ compacts.
Some sunscreens are conveniently available in different shades to blend easily with your skin tone, making them suitable to double up as make-up and easy to reapply.

We recommend:
Heliocare Gelcream which comes in brown and light shades Or Heliocare Compacts oil-free, which are also perfect to throw in your handbag.

6. I DON’T WEAR SUNSCREEN ON MY FACE BECAUSE IT MAKES MY EYES BURN
Sunscreens may run into the eyes with sweating, causing burning and irritation.
Try sunscreens with safe eye technology.

We recommend:
ISDIN Fotoprotector Fusion Water SPF 50+ is a unique high protection facial sunscreen that is quickly absorbed into the skin providing an invisible layer of silky, matte protection. Safe-Eye Technology ensures it does not sting the eyes, making it perfect for cycling, running and other sports.

7. IT’S DIFFICULT TO REAPPLY SUNSCREEN AFTER BEING IN THE WATER OR ON SWEATY SKIN 
It can be bothersome to completely dry your skin after a swim, or to properly reapply your sunscreen during sport.
Try sunscreen that can be effectively applied to damp or wet skin.

We recommend:
ISDIN Fotoprotector® Transparent Spray Wet Skin is a unique and revolutionary water-friendly sunscreen. It can be applied directly to wet or dry skin without the white emulsion effect derived from oils found in most sunscreens.

8. IT’S TOO LATE TO USE SUNSCREEN AS I ALREADY HAVE SUN DAMAGE
It is never too late to start protecting your skin! If you already have sun damage there is now a solution for you as well. New sunscreen technology includes DNA repair enzymes to help prevent and treat sun damage.

We recommend:
Heliocare 360 AK FLUID contains unique key ingredients Fernblock FC and Roxisomes  prevent to repair DNA damage caused by solar radiation.
It is an elegant oil free formulation that feels light on the skin.
Or ISDIN Eryfotona AK-NMSC with Repairsomes to prevent DNA damage caused by sun exposure

So, this season, whilst enjoying the warm summer days, there is no excuse not to take the best care of your skin and limit sun damage by using the right products – all available on www.skinsmart.co.za. Happy Holidays!

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Winter Skincare tips

So we know that winter really does leave us with a compromised skin barrier, and dry and sensitive skin. How can we remedy the situation?

Here are some useful tips on how to change our skincare and winter behavior to help keep our skin hydrated and comfortable!

Cleansers : Most of us make use of the same cleanser throughout the year, no matter the season. During a harsh, dry winter season one could consider avoiding cleansers with high concentrations of sodium lauryl sulphate (soap), as well as those with high concentrations of acids, like salicylic acid and glycolic acid. While these are useful to control an oily skin type, they can strip away essential moisture, leaving the skin dehydrated and sensitive. Rather opt for a milk or gel cleanser in winter that will gently cleanse the skin of make-up and impurities, without leaving the skin dehydrated or vulnerable.

Moisturisers : Change your daily moisturiser during the colder months to one that is more nourishing, and provides a protective barrier to environmental elements. Hyaluronic acid in moisturisers is a natural moisturising ingredient that nourishes the skin while also having a plumping effect. If you enjoy your current daily moisturiser, and do not want to change, you could supplement your daily regimen by adding a hydrating or antioxidant serum underneath your moisturiser. A good tip when applying your daily moisturiser is to do so immediately after your bath / shower, when the skin is still warm and slightly damp. This will allow for better penetration.

Sunscreens : Do not stop applying your sunscreen during the winter months. Although there may be less UV exposure, due to cloud cover, you will still be exposed to UV damage, particularly UVA, which causes free-radical damage. Sunscreens containing antioxidant ingredients also protect against exposure to atmospheric and environmental aggressors, such as UVA, UVB, Infra-red, and ozone pollution, which may lead to dehydration, pigmentation and ageing.

Humidifier : Indoor fires and heaters, underfloor heating and air conditioning dries the air and worsens dry skin problems. Before you invest in bulk quantities of lotion and lip balm to rehydrate your skin, think about rehydrating the air. Use a humidifier to add moisture to the air and to prevent dryness of the skin, nose and throat.
While you will still need a good moisturiser, humid air is a great first step toward lessening dry skin issues.

Should you exfoliate?

When the skin is overly dry or dehydrated, it becomes less efficient at sloughing off dead skin cells which build up on the surface of the skin resulting in a dull, flaky appearance. Gentle exfoliation of the skin on a regular basis will help to improve the appearance of dull skin. Superficial to medium peels gently break the bonds between these dead skin cells, removing them and exposing healthier, more youthful, glowing skin. This exfoliation also allows for better penetration of hydrating ingredients into the skin.

Microneedling: This treatment technique is designed to address poor skin quality by creating a controlled injury to the skin so that it regenerates and repairs itself naturally. Microneedling is also referred to as ‘collagen induction therapy’. The principle behind microneedling is that it breaks down old collagen and stimulates certain growth factors to promote the production and deposition of new collagen and elastin.

Dr Kesiree Naidoo offers a range of non-invasive procedures including Microneedling, to book your appointment contact her practice on 021 531 1107 or via email on [email protected]

If you are not sure what product would be best for your winter skin, take our free Skin Assessment or email our medical skin therapist Annika on [email protected]

Register on Skinsmart and start banking your Smart Rewards

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Skincare in pregnancy – what is the evidence?


Pregnant women are wary of causing harm to their unborn babies during this vulnerable period in development. There is significant modification of lifestyle practices with huge emphasis on safer and healthier options. More than 50% of pregnant women also question their skincare regimen and seek guidance on the use of personal care products.

What are the common things that most women are most concerned about making them question use in pregnancy?
Women are concerned that certain ingredients in skincare products may be carcinogenic (causing cancer), teratogenic (harmful to the fetus) or unsuitable for their changing skin needs in pregnancy. In this article we explore the available evidence on a few commonly used ingredients to help you understand which products can be used safely when your pregnancy tests positive!

Vitamin A/ retinol
There is lots of evidence for the potential teratogenic effects of oral vitamin A and the drug commonly used for acne called isotretinoin. We do not actually know how much topically applied vitamin A is absorbed by the skin to eventually reach the circulation and the growing baby. There are however a few cases where birth defects were reported after using topical Vitamin A in pregnancy. The consensus opinion is that women should avoid products containing retinol during pregnancy, whether oral or topically applied.

Benzoyl peroxide
Benzoyl peroxide is a widely used over the counter treatment for acne. Minimal amounts are absorbed into the skin after topical application, but there have not been any reported ill effects in the babies whose mothers used topical treatment. Therefore this is one of the acne treatments considered safe for breakouts in pregnancy.

Topical antibiotics
Topical clindamycin and erythromycin are prescription antibiotics used mainly to treat acne. Studies have found both topical ingredients to be safe for use in pregnancy.

Salicylic acid
Topical salicylic acid is quite a common ingredient in acne treatments. The concentration in products as well as the amount of absorption into the blood stream varies. However it is still considered a small amount which is unlikely to cause any harm.

Glycolic acid
Glycolic acid is an alpha hydroxy acid found in many brands of resurfacing anti-ageing products. It is also used in face washes and creams to treat acne and hyperpigmentation.
There is minimal systemic absorption from topically applied glycolic acid so it does not pose a risk in pregnancy. However glycolic acid may be irritating to the skin especially in high concentrations, so first time users in pregnancy should be cautious.

Hydroquinone
Hydroquinone is a prescription skin lightening ingredient, banned as an over-the-counter product in South Africa. It may however be prescribed by doctors and dermatologists. There is a large amount of hydroquinone that is systemically absorbed after topical application. There is no conclusive evidence to suggest that hydroquinone will have an effect on your growing baby, but because of the large amount that is absorbed, it is not recommended for use in pregnancy.

Sunscreens
Sunscreens generally have very little systemic absorption and are safe to use in pregnancy.
The general consensus is that the benefits of sunscreens outweigh any unsubstantiated risk.

In summary, apart from notably hydroquinone and retinol there is no evidence to suggest that most other common topically applied skincare ingredients will cause harm to a developing baby.

Bear in mind that does not exclude the possibility of a localized cutaneous reaction (skin reaction) to the ingredients as we must take into account that pregnancy may cause a change in your skins’ condition and its ability to tolerate products.

In addition to this, skin reactions to skincare products may occur irrespective of whether you are pregnant or not.
Remember that a product recommendation or prescription given before you fell pregnant may no longer be safe or appropriate once your status changes, and its best to confirm with your doctor.

At Skinsmart we have a tailored pregnancy skin assessment to assist you with your product choice. We recognise that pregnant women would also like to look and feel their best without compromising the health of their babies.

Please email us on [email protected] to book an appointment  if you would like more specific advice.

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When to start using an antioxidant?

It is advisable to start using an antioxidant as a young adult.
Topical antioxidants serums have the added benefits of stabilising melanocytes, promoting the formation of barrier lipids, and being anti-inflammatory, thus assisting with management of acne and resultant post inflammatory pigmentation (post acne marks), while providing younger skin with comfort and hydration.
Use of an antioxidant along with a good quality broad spectrum sunscreen is the perfect way to start (and continue) taking care of your skin.

It’s not too late for those who already have sun damage and a history of skin cancers. While antioxidants cannot treat skin cancers, they can help to prevent further DNA mutations and new skin cancers and improve the appearance of dry, sun damaged skin by boosting barrier lipid production and collagen repair.

Even though many products may contain antioxidants, the efficacy of an antioxidant is only as good as the stability of the product formulation as antioxidants are unstable. The products sold on Skinsmart are of the highest quality, with proven efficacy supported by scientific research. If you are not sure about which product is suitable for you , please email us and ask for advice from our skin therapist.

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What does SPF mean?

SPF or sun protection factor is a measure of protection against only UVB.
An SPF of 30 means that you will be able to stay in the sun 30 times longer without burning, than you would be able to without wearing the sunscreen.

This does not equate to 30 min, and most importantly is different for each person, as we all burn at different rates depending on our skin type.
SPF is measured in a test environment which is nothing like real life.
It does not take into account sweating, environmental factors and the varying application by the sunscreen user. In a test environment sunscreen is applied very thickly, at 2mg of sunscreen per square centimeter. The quantity that is actually applied by people is closer to 0.5mg per square centimeter. So we are never really getting the same protection as on the label.

While it is true that SPF15 filters out 93.3% of UVB, SPF30 96.7% and SPF50 98.3%, making it seem that there is very little benefit in using the higher SPF, one needs to consider that only the amount of UV light reaching your skin is important. If you look at it this way then SPF 15 allows 6.7% of UVB to reach your skin while SPF 50 only allows 1.7% of UVB.

Dermatologist associations worldwide recommend you wear at least an SPF of 30.

SPF says nothing about the UVA cover of a sunscreen. There is at present no universally applied measure of UVA protection. Look for UVA with a circle around it on your sunscreen bottle. This denotes high UVA protection.

A final word is that we must remember that 80% of sun exposure is incidental and happens during the course of our day to day life, while we are not actively “lying down to tan”. UVA penetrates through windows and causes sun damage without causing sunburn.

If you find that you are getting sunburned, and notice the increasing appearance of “sun spots”, you are getting more exposure than you thought and need to re-look at your sun protection measures.

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Sun protection – how to stay safe and when to worry

UVB(ultraviolet B), UVA (ultraviolet A) and visible light make up a small, yet significant portion of the electromagnetic spectrum of light entering the earths atmosphere.

UVB causes us to burn while UVA, which has a longer wavelength, penetrates deeper into the skin. It does not cause sunburn, but is most significant in causing photo-ageing (ageing from the sun) and skin cancer. Photo-ageing and skin cancer are both consequences of excessive cumulative sun exposure and are almost always talked about together.

Sunlight is certainly not all bad, and generally induces a sense of well-being, decreases the appetite, improves libido and assists with the synthesis of vitamin D. We also use controlled light sources of UVB and UVA to treat a range of skin conditions like psoriasis and eczema.

The harmful effects of UV light can be divided into:
Acute (short term) and Chronic (long term effects).
Acute exposure to UVB causes sunburn which damages the DNA of our skin cells. Acute exposure to UVA suppresses the immune system in our skin which protects us against skin cancer and skin infections.
Chronic exposure to UVA causes skin ageing and both UVA and UVB cause skin cancer.
Compare the skin on sun exposed areas of your body to non sun exposed skin if you would like to see the added effect of photo-ageing to the normal process of ageing, which we call chronological ageing.
Features of photo-ageing include wrinkles, sagging skin, yellowing of the skin, pigmentation, freckles, broken veins and easy bruising.
Solar (actinic) keratosis, basal cell cancer, squamous cell cancer and melanoma are examples of precancerous and cancerous lesions.

While moderate and responsible exposure to the sun is good for your well-being, it is not possible to tan without damaging skin cells, leading to accelerated ageing, and increasing your risk of skin cancer.

Tips for sun protection
1.Minimise your exposure to direct sunlight and ensure that you never allow yourself to burn. Always seek the shade if you have to be outdoors. In general, peak UV exposure is between 11am to 3pm, but this varies with the season and location.
2. Wear a wide brimmed hat, sun protective clothing and sunglasses. Covering up is the best protection from the sun.
3. Wear sunscreens on areas that cannot be covered.
Apply sunscreen, liberally, evenly and repeatedly.
Apply sunscreen 30 min before you leave the house and reapply every 2-4 hours especially after sweating or swimming.

Sunscreens past and present.
Sunscreen technology has come a long way since the greasy, cosmetically unacceptable formulations that made you sticky and grey.
Sunscreens come in creams, lotions, sprays, milks, oils and make up compacts. They are available in tinted, non tinted and sheer forms.
The sunscreen industry has made it virtually impossible for you not to find a sunscreen you will be happy with as the worldwide consensus is the best sunscreen for you is the one that you will wear!

Sunscreen active ingredients are divided into categories of physical and chemical blockers. These protect against different wavelengths of light in the spectrum and are often found in combination to ensure maximum protection and stability of the product.

Physical blockers, titanium dioxide and zinc oxide have broad spectrum cover and are suitable for children and sensitive skins.
Older sunscreens only protected against UVB, while the newer sunscreens almost always cover UVB and UVA.

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Summer skincare tips

It’s summer and you want to look your best!
You may find yourself confronted with some skin problems that leave you feeling less confident.

Here we look at a few common summer skin concerns with advice on how to manage them.

DRY SKIN
Chemicals and salt water from swimming pools can cause excessive skin dryness. Similarly, air conditioning in offices and cars removes essential moisture from the skin, resulting in dehydration, dryness and sensitivity.

Solution: Don’t forget to moisturise your skin in summer. You may want to change to a lighter moisturiser or serum for the day, and opt for a richer night cream. Apply your daily moisturiser before your sunscreen. Apply moisturiser after cleansing, when the skin is still warm and slightly damp for maximum absorption. A weekly masque could give you an added boost of moisture.

Recommended Products:

Neostrata Bionic Face Serum
Obagi Skin Rejuvenation Serum
Obagi Advanced Night Repair
SkinCeuticals Hydrating B5
SkinCeuticals Phyto Corrective Masque

SUNBURN
Excessive sun exposure can cause damage to the DNA of skin cells leading to photo-ageing (fine lines, wrinkles and solar keratosis) and skin cancer.

Solution: Stay out of direct sunlight. Wear a hat, sunglasses and UV-protective clothing when outdoors, and reapply a broad spectrum sunscreen (at least SPF 30). Choose a sunscreen that protects against UVA and UVB. Apply sunscreen half an hour before sun exposure and reapply every 2 hours, particularly after swimming.

Recommended Products:

Heliocare 360 Mineral
Heliocare Spray SPF 50
Heliocare Ultra Capsules
SkinCeuticals Physical Fusion UV Defence SPF 50
SkinCeuticals Physical Matte UV Defence SPF 50

BREAKOUTS

Acne and skin breakouts may worsen in the summer months because of humidity and perspiration. Occlusive and oily sunscreens can contribute to the problem.

Solution: Cleanse the skin with an appropriate facewash to target blocked follicles. Ingredients like salicylic acid and glycolic acid help remove dead surface skin cells. A weekly masque may also be beneficial. Don’t be tempted to squeeze or scratch acne spots as this could lead to pigmented marks and blemishes with sun exposure.

Recommended Products:

Neostrata Clarifying Facial Ceanser 4PHA
SkinCeuticals Blemish and Age Defense
SkinCeuticals Clarifying Clay Masque

Enjoy summer, but take care and don’t allow yourself or your loved ones to burn!

Complete our skin assessment for more product recommendations. If you need any help with choosing a suitable product, email our skincare therapist who is always available to assist.

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What is a skin peel?

Superficial skin peels involve the application of a chemical peeling agent to the skin in order to remove the damaged outer layers, resulting in the appearance of new, regenerated skin which is smooth-textured, even-toned and less wrinkled. These controlled peels range in strength from superficial peels, which can be performed by doctors and aesthetic therapists, to much deeper peels which are only conducted by medical professionals.

 

Superficial chemical peels are generally safe because they only affect the epidermis and can have beneficial effects on an array of skin concerns, including acne, pigmentation, melasma, sun damage and ageing. Even though penetration is superficial, positive changes can also be seen in the deeper layer of the skin, with the stimulation of collagen production in the dermis. Collagen is important for anti-ageing and skin repair.

There are a number of ingredients that can be used to peel the skin, but the most commonly used are alpha hydroxy acids (AHA), eg. glycolic, lactic, citric and malic acids, and Beta Hydroxy acids (BHA), eg. Salicylic acid.

AHAs occur naturally in sugar cane, milk, and a variety of fruits, and have been used on the skin for thousands of years, beginning with the Ancient Egyptian women who would bathe in sour milk to smooth their skin.

Patients usually tolerate the peel well, and will experience a tingling or itching sensation, or a feeling of warmth. The degree of tingling or itching is usually indicative of the overall condition of the skin, ie if the client is using good homecare products and the skin is well-hydrated, she may not feel the peel as intensely as a patient that has not looked after her skin well. Once the peel has been ‘neutralised’ the skin will once again feel comfortable, and only perhaps a little warm. This is due to increased blood circulation.

When the acids are applied to the skin, they break down the bonds between dead skin cells and the skin then sloughs off these cells over the next 2-3 days. As a result, the patient may experience a sand-papery texture, mild flaking or a tight feeling of the skin.  It is important at this time to keep the skin well-hydrated and to apply a good quality sunscreen.

Following this short period of dryness or flaking, a more youthful, healthier looking skin becomes visible. So the skin typically looks it’s best 3-4 days post treatment, with a beautiful radiant glow!

Post peel care is vitally important. The skin has been sensitized by the peel, so excessive sun exposure must be avoided for the next 48 hours. Heavy cardiovascular exercise should be avoided for 48 hours as perspiration will burn the skin, and will make the skin more vulnerable to bacterial infection. Do not use products containing active ingredients, like Vitamin A for 3 days pre- and post-peel.

It is always advisable to do a series of skin peels in order to achieve best results on specific skin concerns, and consult with your therapist regarding other aesthetic procedures like laser, microneedling and microdermabrasion, and how to structure good in-clinic routine treatments for optimal results.