Summer is gone: time to assess and repair the damage.
At the end of summer our skin needs some special attention: it has been exuberantly exposed to the sun’s dangerous UV-A and UV-B rays, it has been soaked in chlorinated swimming pools, dried in the salty sea breeze, it has been dehydrated and it may have recovered from several mild or serious sunburns. But we acquired a nice and fashionable sun tan … which will gradually disappear again when we return to the real non-holiday working life.
The main problems which our favourite season may have blessed us with could be dry flaking skin, hyperpigmentation, acne breakouts or post inflammatory pigmentation, redness or rosacea or pores that appear larger than before.
The Solar Spectrum
The solar spectrum consists of light with wavelengths ranging from 200 to 1.800 nm (nanometre). The shortest wavelengths are the ultraviolet rays. However we don’t see them they are the most energetic and potentially the most damaging to the human skin. Ultraviolet light can be further subdivided in:
Ultraviolet A with wavelengths from 320 to 400 nm: is always present in sunlight, in winter and summer. It penetrates clouds, glass and most fabrics and penetrates deep into the dermal layer of our skin (up to the basal part).
Melanin (from the old Greek word “melas” which means “black”) is a natural pigment found in most living organisms. The production of melanin happens in the lower (basal) part of the epidermis of the human skin and the process is induced by UV-B radiation, because melanin is our own natural protection against the sun.
Ultraviolet B with wavelengths from 290 to 320 nm: is mainly present in strong sunlight and it causes skin burns. It penetrates our skin up to the top of the dermis and triggers the production of melanin.
Ultraviolet C with wavelengths shorter than 290 nm: is plain dangerous and carcinogenic, but because it is almost entirely absorbed by the atmosphere, more specifically by the ozone layer, it has little effect on us. As long as we keep the ozone layer intact, of course (thank you environmentalists for your hard work convincing the rest of the world to reduce the emission of CO2 and CFK’s).
With apologies for the boring explanation above, but you will understand the problem non-protected sunbathers are confronted with: UV-B rays triggering the production of melanin in the basal layer of our dermis to protect us from burning while at the same time UV-A rays penetrate this basal layer and disturb the melanin production process, causing hyperpigmentation and pigmentation disorders.
Skin damages caused by the sun
Hyperpigmentation results in flat, darkened patches of skin that are light brown to black in colour and can vary in size and shape and they invariably react on sun exposure by becoming darker.
Pigmentation spots (lentigo solaris), age spots (lentigo senilis) and freckles (ephelides) are caused exclusively by sun exposure. They appear mainly on body parts that are frequently exposed such as the face, chest, hands and arms. They tend to be small darkened patches of skin and are generally referred to as “photo damage”.
Melasma or Chloasma affects 90% of pregnant women, which is why it is commonly referred to as “pregnancy mask” (however men may get it too). It occurs due to hormonal changes during pregnancy but also because of the effects of birth control pills or hormone replacement therapy and it causes dark and irregularly shaped areas on the face or arms that can be quite large. Sun exposure darkens these melasma spots further.
Post inflammatory hyperpigmentation occurs when a skin injury or trauma heals and leaves a flat area of discoloration behind. It is commonly found among acne sufferers and can also be caused by cosmetic procedures such as dermabrasion, laser treatments or chemical peels.
Important note: hyperpigmentation spots are always flat. If you find anywhere on your skin a dark spot or patch which is not flat do not treat it as hyperpigmentation. If such a spot or patch would change shape or colour or would start itching or bleeding, consult your dermatologist immediately.
Ultraviolet radiation breaks down the skin’s connective tissues (collagen and elastin fibres) which lie in the deeper layer of the skin (dermis). Without these supportive tissues, the skin loses its strength and flexibility. Solar Elastosis is characterised by vertical creases, deep wrinkles and loose or sagging skin – all together resulting in an extreme acceleration of skin ageing. If you will compare the skin of a 60 year old Scandinavian lady with that of an equally aged Mediterranean woman you will understand what is meant.
To get an idea of the destructive power of the sun, take a look at this picture on the left: it is a real case of a now 66 year old man, William McElligott, who was driving his milk truck for 28 years around Chicago with the left half of his face continuously exposed to the sun while the right side was shaded by the cab (source: The Guardian 05/06/2012).
Post-summer skin treatments.
At the end of the summer holidays your skin has probably dried out due to sun exposure, salty sea winds and chlorinated swimming pools. It is good to use on a daily basis paraben and perfume free moisturizers and cleansers.
To improve the overall quality of the skin you could also consider a diet rich in Omega 3, 6 and 9 foods (cold water high fat fish, olive oil, flaxseed oil, evening primrose oil, black currant seed oil, acai powder, avocado, dark green leafy vegetables and generally all kind of oils extracted from nuts). You could also buy in your local pharmacy an omega fatty acid complex and follow the instructions of the manufacturer regarding the daily dose.
2. Lightening – Depigmentation
There are several ways to treat hyperpigmentation depending on your budget, your determination and your courage.
Chemical peels involve applying an acidic solution (glycolic acid, TCA, mandelic acid, etc.) on the affected areas to remove the surface layers of the skin. The chemicals cause the skin to blister and eventually peel off, revealing new and less pigmented skin each time. To completely remove hyperpigmentation you will need several treatments with intervals of 2 to 4 weeks. It is advised not to undergo chemical peels in summer due to the high risk of sunburn which would increase your problem rather than solving it. Chemical peels are usually not expensive (50 to 120 Euro per treatment + the cost of a good SPF 50 mineral sunscreen).
Lasers do more or less the same as chemical peels: they burn the surface layer of the skin, causing it to blister and peel off and after several treatments a totally new and hyperpigmentation free skin will appear. Several treatments will be needed here as well, with intervals of 2 or 4 weeks and also here we advise to refrain from doing this treatment in summer. Laser treatments are significantly more expensive: from 200 up to 800 Euro per treatment.
High Energy Light devices (IPL) transmit pulsed light into the skin at a certain wavelength so that it will be absorbed by the melanin which causes the hyperpigmentation. The treated areas are heated, but not enough to actually burn. This heat breaks down the pigmentation into tiny particles which then either rise to the skin’s surface as scabs, which are exfoliated away in a natural way within 1 – 2 weeks, or the particles are drained through the lymphatic system. The first reaction of your skin may be “peppering” or “darkening” of the pigmented areas. This will resolve in 7 to 14 days when your skin will start to flake off. Several treatments (3 to 5) may be needed with a 1 month interval. IPL treatments will cost more or less the same as laser treatments.
Skincare products. Chemical Peels, Lasers and IPL are relatively aggressive while skin care products, which need to be used daily for a longer period of time, are more gentle and less damaging.
Until recently hydroquinone was the most powerful active ingredient to treat hyperpigmentation. It is a strong medical compound which affects both DNA and RNA synthesis and it can cause a number of side-effects. The use of the pure chemical form of hydroquinone in over-the-counter skin whitening products has been banned in the USA (since 2006) and in the European Union (since 1976). Products that are relatively safe will contain very low doses of hydroquinone, available upon doctors’ prescription only and to be used for a limited period of time; however there are still doubts about possible carcinogenic effects and it can cause itself post-inflammatory hyperpigmentation as it irritates the skin.
Recent scientific research however has discovered and developed a large range of new active substances - most of which are 100% natural - that will treat all kinds of hyperpigmentation carefully and safely however some patience and prolonged use of such products will be required. Here are but a few of the large range of active whitening agents currently used in cosmeceutical creams and procedures:
Arbutin is a natural form of hydroquinone isolated from the fresh fruit of the California Buckeye (a tree which grows only in California and south-west Oregon
Azelaic Acid, extracted from wheat, rye or barley. It is also used to treat light to moderate acne and rosacea due to its ability to reduce inflammation.
Gentisic Acid is extracted from the roots of Gentiana flowers and used for the treatment of skin pigment disorders by influencing the synthesis of melanin.
Glycolic Acid (an Alpha Hydroxy Acid or AHA) is derived from sugar cane and it has proven skin lightening effects. It is used in cosmeceutical creams as well as in chemical peels.
Kojic Acid is derived from various fungal species and is also a by-product of the fermentation of Japanese rice wine (sake).
Lactic Acid (AHA) or Lactobionic Acid (a Poly Hydroxy Acid) are derived from sour milk (and sugar cane).
Licorice Extract is obtained from the root of the Glycyrrhia Glabra Linneva. Its depigmentation efficacy has been shown by various researchers to be even greater than that of hydroquinone.
Lingonberry or Bearberry Seed Extract is derived from berries with the same name which are native to the boreal forest and the arctic tundra. The berries contain a lot of organic acids, vitamins A, B and C and potassium, calcium, magnesium and phosphorus.
Niacinamide is a form of Vitamin B3 that affects pigmentation by hindering the transfer of melanosomes to the epidermis.
Retinoids such as tretinoin, adapalene, tazarotene and isotretinoin are structural and functional analogues of vitamin A and are a common treatment option used to ameliorate acne, photo damage and post inflammatory hyperpigmentation. Retinoids may also act as penetration enhancers when used with other lightening agents.
Vitamin C. There is an increasing awareness that Vitamin C (L-Ascorbyl Acid) has a wide variety of roles in human health and recent discoveries show that it inhibits the production of melanin.
The above are only a part of the top 20 of natural skin-whitening agents presently available. Most of them are found in the “Sun Damage” product range on our website.
Our absolute favourite is the NeoStrata Enlighten Trio: a combination of 3 products (cleanser, illuminating serum and pigment controller) which contain only harmless natural agents, including 6 fruit and 12 flower extracts, but guarantees an excellent result after a couple of weeks of use and without being too aggressive on your skin.
There are of course a number of perfect alternatives available on our website: there are the Auriga Flavo-C products (with Vitamin C and Gingko Biloba) which fight skin ageing due to sun exposure.
DermaCeutic Light Ceutic and Serum C25 contain acids and Vitamin C, while the Yellow Cream is a good alternative to hydroquinone (depigmenting and exfoliating) and should be used locally (not over the whole face – only on affected areas).
NeoStrata Face Cream Plus and Lotion Plus containing 15% Glycolic Acid are a bit stronger and correct photo-ageing and sun damage swiftly, while NeoStrata Renewal Cream with its 12% Gluconolactone combined with Pro-Retinol and Vitamin E will be appreciated by people who do not have a lot of experience with acids (and no sensitive skin).
We can also recommend the Restylane Night Serum which contains Hyaluronic Acid and Retinol and can be used in turns with your normal night cream.
SVR Clairial C10 Cream, in combination with SVR Clairial Peel or not, is a rather strong product with excellent results and has to be used locally – on affected areas only. SVR Clairial SPF 50+ can be used daily, daytime and the whole year around: it is a strong sun protecting cream which at the same time removes dark spots and evens out pigmented skin.
And don’t forget to use during any lightening/depigmentation course - and for a few weeks after completing it – a good mineral sunscreen. In fact, you should wear a sunscreen the whole year through; remember the UV-A rays!
3. Wrinkles and fine lines.
Are caused by natural ageing (be happy about that), more by daily exposure to sunlight and much more by intense summer sunlight accumulated at outdoor activities or sunbathing.
Every person has to decide at a certain point (a) to carry his/her wrinkles with dignity as a natural and unavoidable characteristic of ageing, (b) to make an effort to postpone their appearance for as long as possible or (c) to have them reduced or removed when the aforementioned fight has been lost.
To postpone the appearance of wrinkles and fine lines as long as possible or to reduce their visibility is not so difficult, with the use of the right daily skin care products. A large range of such products is available on our website under “Wrinkles and Fine Lines” but if we are allowed to mention our favourites: go for the NeoStrata Skin Active product range.
They are the absolute top of the market: produced by the American NeoStrata Company which is active in this field for over 25 years and continues relentlessly to improve and reinvent its already excellent products. Besides: pricewise they are very affordable because they focus on science and quality, rather than on luxury design packaging and expensive publicity campaigns.
To remove wrinkles and fine lines is the job of an aesthetic doctor: there are no creams or pills or food supplements or magic tricks to do this. There is a large range of dermal fillers in the market (of which, to our humble opinion, Restylane is far above all others), there are neuromodulators (Dysport or Botox) and there are the Silhouette Lifting sutures and all these different procedures can be combined to best suit your needs.
The best advice we can give in this respect: (1) go for the best product, not the cheapest and (2) choose an aesthetic doctor that knows to combine medical science and technique with the art of (re)sculpting the unique aesthetical features of the human (female) face.
20 September 2013