Drink more water, already!


Need I say more? Yes?  Well, here goes…

In my day to day existence as a skin care specialist, this is probably the most worn out piece of advice that I give people.  It’s also the most widely ignored.  Pretty much every person who comes through the door can benefit from taking in more H2O.  Why?  Because water is needed in everyone’s skin, regardless of what specific condition is presenting itself.  There are a host of enzymatic and chemical processes that are going on constantly which require the presence of water, and water is also needed to transport nutrients and waste products to and from the cells.  Does your skin look dull, flaky and dry?  Drink more water.  Is it feeling tight and uncomfortable?  Drink more water.  Have the lines around your eyes suddenly turned into crevasses overnight?  DRINK MORE WATER!  This I can vouch for personally, as every time I fall off the water wagon the first thing I notice is that I’ve aged about 3 years in the space of a weekend.  This happily is reversed by making sure I jump right back on that wagon (although it does take a few weeks before things are back to normal.)  I know that you all secretly wish that there is a miracle product out there which would leave your skin plump and hydrated while allowing you to neck down wine, beer and vodka as if there was no tomorrow – sadly, that magic product does not yet exist (and for heaven’s sake, drinking water is one whole lot cheaper than a product would ever be!)


It’s not the only the only thing you need to do!  There are a lot of things which make up a good skin routine, and water is just one of them.  It is not the “one thing”, but “one” of the “things”.  We can get fixated a bit and then disappointed when results aren’t forthcoming, but a good skin health practice is made up of many “things”.

So, from the beginning, what function does water fill in your overall skin health?

What doesn’t it do?  Water is used for transportation of nutrients and oxygen (via the blood and lymph), removal of waste (via the lymph), and it bathes every cell in the body as well as making up part of the interior of cells just for starters.

You know that your body needs vitamins and minerals to work at it’s best, but you  may not be aware that enzymes are needed by the cells to facilitate the metabolic functions that use these nutrients.  Water acts as a catalyst and is essential for most of these processes to occur, and it is important to keep it’s transit rate as slow as possible to help these processes to happen properly.

Dehydration is linked to premature aging and poor wound healing (which is particularly relevant if you are prone to spots and like to pick).  One of those enzymatic processes mentioned involves the production of collagen, and as cells dry out they lose their ability to repair effectively.

The most obvious enzymatic process to mention is the breakdown of bonds  between the corneocytes that form the outermost layer of your skin.  These bonds are dissolved by enzymes which require the presence of water to do their job.  When water isn’t present in sufficient quantity the result is a build-up of dead skin cells which leaves the skin with a rough texture and dull finish (refer back to the post on EFA’s for the role of omegas in this process).

To have good skin hydration, you have to have a well-functioning lymphatic and circulatory system as this is how water reaches the cells in the first place.  The water phase of blood and lymph becomes part of the interstitial fluid, a percentage migrates into the epidermis and then ultimately makes up a part of the acid mantle (the first line of skin barrier defence). The lymphatic system is only stimulated by the movement of muscles, so this is yet another reason to use your January gym membership 😀

How much is enough?

The figures regarding what percentage of water makes up the adult human body vary widely, ranging from as low as 40% to above 80% but many agree that about 60% is average with men having a higher percentage than women.  This might be because muscles contain a much higher water content than most other tissues in the body, and men generally have more muscle than women.  As babies we start out being made up of about 70-80% water, and this figure declines with age, but this may be more to do with the fact that many people drink far less water as they get older for a variety of reasons, and probably drink a higher proportion of alcoholic drinks and eat less fresh fruit and vegetables than they could (which contribute to the total water consumption over a day).  So while we might be an average of 60% water, there hasn’t been any scientific paper that I managed to find which detailed the amount of water we should have in our systems for optimum health.

2 litres a day has been the standard advice given for some time now, but as we are all made up in different shapes and sizes and have different lifestyles and environments it seems a bit of a generalisation.  Admittedly, this is the amount that I have been recommending to clients for years now and have found that it works for me, and also for the (relatively few) people who have made a concerted effort.  In researching this article I have come across a bit of information which has shed some light on this, which states that the current scientific understanding is that the human body needs about 33ml/kilogram of body weight.  I weigh around 64 kilos so according to this calculation need 2.112 litres of water daily, which may be why I have found that when I consistently drink around 2 litres a day I can notice a difference in the hydration in my skin.  So get your calculator and work out how much you need to be drinking – short people, you can be feeling smug about now.

How much is too much?

Quite a lot actually – the good news for many is that there is definitely a top limit of what you need to drink. There are cases of people who have drunk water to excess, developed water intoxication and died – however, they really drank A LOT.  Like 5-6 litres.  Most people find 2 litres a challenge, so for the vast majority of us this really isn’t something to worry about.  If you are concerned about this, read further here.

Any other benefits?

If I was to give a detailed answer on that this post would never reach publication.  Suffice it to say that water is used in some way in pretty much every process in the body.  Your brain probably uses the most water – have you ever tried drinking a few glasses of H2O when you hit the mid-afternoon brain fog rather than reaching for a coffee?  You’ll have a much longer lasting effect, as mental fatigue is a symptom of dehydration.  Our digestion obviously uses a lot of water, and when you are dehydrated constipation can result regardless of how much fibre you eat.  Actually, eating more fibre can make the problem worse, as water is needed to create bulk.  What has this got to do with skin, I hear you ask?   Actually if your digestion is sluggish it can show up on your skin, as longer transit time in the gut allows more opportunity for reabsorption of toxins through the gut wall back into the body.  These still need excretion, and the skin is a large excretory organ.

Environmental influences on skin hydration

Now that the central heating has come on, you may be finding that your skin has started to feel uncomfortably tight.   This is because the sudden drop in atmospheric humidity has sped up the process of evaporation in your skin, which is particularly noticeable if you are also low in essential fatty acids (the beneficial oils in your skin which help slow down the evaporation process).  It is particularly important to pay attention to your water intake at this time, as its very easy to let it slip once the weather gets colder.  Remember, herbal teas very definitely count towards your daily intake, or you could simply drink hot or warm water if that takes your fancy – there are some studies that suggest you absorb water better if it’s taken warm, but I would have thought that by the time it got to your gut it would already be pretty warm.  It would also appear that if you are a habitual coffee drinker (I don’t mean a caffeine fiend, but if you are a daily drinker) then your body will have adjusted and it isn’t actually especially dehydrating.  While there are other reasons that some people recommend avoiding the lovely stuff, this it would appear isn’t one of them.  Hooray!

Obviously if you are spending a lot of time outdoors during the winter months (some of us enjoy getting out in wild Scottish weather), you have the added factor of wind to deal with.  In these cases it can really help to use an occlusive product on the skin to give added protection – shameless product plug here – I love Dermaviduals Oleogel for this, it adds an extra layer of protection which locks in moisture like nothing else I’ve tried.  My boyfriend even noticed, so much so that he had me leave him some when I left early during a ski holiday!

And of course, it’s not quite as simple as just taking in more fluids…

No, of course it isn’t.  Nothing in the body is ever simple.  This brings us to the subject of diet, because even when you are drinking loads of water it doesn’t necessarily follow that you will be absorbing enough of it.  Yes folks, the bad news is you really need to have a healthy diet packed with fresh fruit, lots of green, leafy veg and a healthy handful of nuts and seeds daily in order to get the most out of your efforts to stay hydrated.  Salt, particularly that fancy, expensive and very pretty pink Himalayan variety, is required as well. Why in particular?  All these contain vital minerals which play a role in the cells in the body utilising water.  In particular, you need a good balance of calcium, magnesium, sodium, potassium and chloride.  All of these are needed, and in the correct quantities, as too much or too little of any of them can interfere with water’s ability to enter a cell.  If you are getting a varied diet then I wouldn’t be too concerned that you aren’t getting a good balance, it’s more likely supplementing where we tend to get carried away (unless you are under the care of a qualified professional).  Don’t forget that fresh fruit and vegetables contain a high quantity of water too, so also help with adding to your daily intake.  It has also been suggested that water from food will spend longer in the large intestine, allowing more time for it to be absorbed.  So get out those smoothie machines you were given for Christmas!

And finally, the importance of sleep.

Who would have thought that sleep would have any influence on hydration, but there it is, it actually plays quite an important role.  Your kidneys regulate the amount of water in your body, and therefore help keep your skin plump and gorgeous.  Obviously they still work while you are awake, but they work hard cleansing your blood while you are sleeping so give them a chance to do their job.

To summarise

  1.  At the top of the list, drink more H2O!
  2. To boost absorption, include a good handful of nuts and seeds in your diet daily, plus a good quantity of green, leafy veg – all high in essential minerals needed for this purpose. You can also make your own homemade sports drink by adding 10ml apple or orange juice to every 100ml water plus a pinch of salt – giving you a blend of healthy sugar, sodium and water for improved absorption.
  3. Get moving – a healthy lymph and circulatory system is vital to get water to your skin, not to mention the added benefits of improved delivery of oxygen and nutrients.
  4. Get a good night’s sleep – your kidneys need rest to do their best work.
  5. And finally, drink more H2O!





Skin nutrition: Vitamin C

A complaint that comes up frequently is “there are so  many products out there, I don’t know which to choose – what is going to be best for my skin?”  A good starting point is giving your skin the nutrition it needs to function, or as superstar lecturer Florence Barrett-Hill is fond of saying, “what it needs for lunch.”  Even skin which isn’t misbehaving in any way has some basic requirements in order to work efficiently and stay glowing and healthy, in exactly the same way that  your body does.  I’ve already covered Vitamin A and essential fatty acids in previous posts, this post is going to look at Vitamin C and it’s place in daily skin health.

Always read the label!

Incredibly tiny print and long Latin names, coupled with the fact that most wouldn’t have the first clue about what the ingredients actually do, means that not many people bother reading the label on the product box.  Even when you do know what you are looking for you can slowly lose the will to live as well as permanently damage your eyesight trying to determine what is actually in your product.  It’s so much easier to rely on the much more legible information on the front of the box – however, in most cases taking the time to do so can really help you in choosing something that may actually make a difference.  Ingredients are listed in the order of greatest percentage to least percentage, and while it isn’t always true that having a lot of a particular active ingredient is better, in the case of Vitamin C it is a case of the more, the merrier (up to 20% of the total ingredients) so you don’t really want it to be near the end of the list, unless it’s a very short list.

You also need to take note of which formulation of Vitamin C is used, as not all types are able to pass through the skin’s barrier. L-ascorbic acid is one of the most commonly used types and has an acidic pH of at least 3.5.  This version is more stable in higher concentrations but this can cause problems with sensitive, compromised skins and result in irritation, so may not be the best choice for some.  Magnesium ascorbyl phosphate (a water soluble form) is preferable in this case, as it has good effect in significantly lower concentrations which means that potential irritation is greatly reduced. The combination of ascorbic acid, magnesium and phosphate trick the skin cell to uptake a higher dose than just ascorbic acid alone, and once inside the cell this compound is converted to its individual elements and used within the cell.  Ascorbyl tetraisopalmitate (an oil soluble form) is a highly stable version of vitamin C.  Due to its molecular structure (there are four molecules of palmitic acid to one of ascorbic), it is less irritating than L-ascorbic acid and due to it’s lipophilic nature it can pass easily through the lipid bilayers of the stratum corneum and reach the target cell walls.  Ascorbyl palmitate is another very commonly used form of vitamin C, and works in synergy with vitamin E to help protect the cell membranes from lipid peroxidation.  Ascorbyl glucoside has been used effectively along with niacinamide in skin lightening products.  Other beneficial forms include sodium ascorbyl phosphate, ascorbyl stearate, erythorbic acid/isoascorbic acid, aminopropyl ascorbyl pphosphate, vitamin C palmitate, L-ascorbyl-6-palmitate and 3-oxo-L-gulofuranolactone 6-palmitate.

That’s all very interesting, but what does it do?

Vitamin C is probably most well know as an antioxidant, but it also has a marked effect on collagen production, helps reduce pigmentation and has an anti-inflammatory effect.  It needs to be replenished daily due to it’s unstable nature (it oxidises easily), and so it is an important  ingredient in your daily skin care and nutritional programme.

How does it do it?

Vitamin C and the treatment of hyperpigmentation: Vitamin C is an incredibly effective treatment for the prevention and improvement of pigmentation. It blocks the action of the enzyme tyrosinase, and by doing so inhibits all future steps of melanogenesis (formation of melanin, the pigment in the skin).  Tyrosinase is the enzyme which catalyses the reaction between the amino acid tyrosine and other metabolites which leads to the formation of melanin within the melanosome.  The catalyst requires an oxidising environment within which to work, and Vitamin C being an antioxidant effectively alters this.  By blocking tyrosinase, the formation of melanin is reduced and a lightening effect on the pigment patches is achieved.  It is particularly important in this instance to keep feeding your skin with vitamin C, as the skin cells which are producing the hyperpigmentation are doing so because they are damaged, and will continue to do so forever more.  Daily treatment is essential to maintain the positive effects of a treatment programme.

Vitamin C and collagen synthesis:  Vitamin C is one of the ingredients which is required for collagen synthesis and facilitates hydroxylation, or conversion of the amino acids proline and lysine to hydroxyproline and hydroxylysine.  These substances assist the binding together of collagen fibres, creating the strong triple helix structure that you may be familiar with.  Without both vitamin C and iron, hydroxylation does not take place and collagen fails to produce triple helixes, resulting in weak connective tissue.  This is what causes the bleeding gums associated with scurvy, and for the brainiacs out there the word ascorbic comes from the Latin ascorbus, which means “no scurvy”.  It also seems to play a role in stimulating fibroblasts to create collagen (http://www.ncbi.nlm.nih.gov/pubmed/7518857), which is always good news. In addition, it also stimulates the expression of the agent which inhibits the production of the enzyme which breaks down collagen.  So as you can see, it plays many roles in keeping the skin strong.

Interestingly, there is evidence to suggest that vitamin C has a inhibitory effect on elastin synthesis, which initially gave me a bit of a start as I’d always believed that it was a vital ingredient in any anti-aging formulation and this sounded counter-intuitive.  On digging deeper I found this inhibitory effect is in fact anti-aging in itself, as when the skin is exposed to UV radiation it has a boost in elastin production.  While this sounds good (stop right now if you are running out to bathe in the last rays of sun we are having this summer!), it is actually very detrimental to the skin as it isn’t healthy elastin but an accumulation of abnormal elastin that forms in the spaces between the cells.  Over time this leads to a condition known as solar elastosis, characterised by dry, thickened skin with deep furrows and a yellowish colour.  So no, an overabundance of elastin isn’t a bonus in this case.

Vitamin C as an antioxidant:  All the cells of our bodies are constantly doing a dance with reactive oxygen species (ROS), otherwise know as free radicals.  The simple act of breathing is an oxididative process* and as every cell in our body needs to breathe, we just can’t avoid it.  What I’m getting to here is that there is no way for anyone to manage a life without encountering free radicals, so what we need to do is make sure we are getting a constant supply of antioxidants to help counteract this.  Vitamin C is highly effective in this capacity throughout the entire body (so be sure to get plenty of fresh fruit and veg in your diet daily) but as far as the skin is concerned it has an indispensable function to protect it from the formation of ROS formed by UV radiation.  What exactly is a free radical?  It’s a compound which is formed when oxygen molecules combine with other molecules, yielding an odd number of electrons.  This means the compound is unstable, and will seek to become stable by stealing an electron from another molecule, leaving that molecule damaged.  Vitamin C enters the field and donates an electron, effectively stabilising the free radical.  It’s got proven benefits to the skin for both pre- and post sun exposure – tests have shown that skin treated with vitamin C prior to sun exposure has noticeably less redness, fewer sunburn cells (basal epidermal cells which have undergone cell death or apoptosis in response to being damaged by UVB), and decreased tumour formation after UV exposure.  Vitamin C also works synergistically with vitamin E, another important antioxidant in the skin, where they both reactivate the other after neutralising free radicals.

Oral versus topical

When talking about using vitamins topically I am often asked whether its necessary to use vitamin based products on the skin, as surely if you eat a healthy diet and perhaps take supplements you will be getting the same effect?  While you absolutely should be eating a diet rich in a variety of fruit and vegetables since your skin reflects your overall health, you have no control over where your body decides to send these nutrients or knowledge of how well you are absorbing them.  Vital organs will always be taken care of first, and whether your skin is producing it’s optimal amount of collagen just doesn’t really hit your body’s survival radar.  If you are looking to deliver vital nutrients to your skin to keep it in optimal health, then using products which deliver these nutrients to exactly where you want them makes sense.

It’s not enough for a product to contain vitamin C, the format of vitamin C, its delivery system, processing, packaging and shelf life needs to be considered too.  Even more so than vitamin A, this ingredient is susceptible to degradation on exposure to light and air so products need to be packaged in a pump dispenser which also protects the contents from exposure to light (i.e. not clear glass), or in a collapsible tube (like an aluminium tube which stays constricted once squeezed).  If the product is in a jar, then once open the active ingredient oxidises and is quickly rendered useless – it still contains vitamin C, but it won’t be doing you any good.


As you can see this is a extremely important ingredient in the maintenance of skin health and structural integrity, and should be included in every person’s daily skin care routine.


I have a huge fear when compiling these articles that somewhere along the line I’m going to put in a throw-away phrase which  is factually incorrect.  This leads to some obsessive checking (thank God for the internet!), and one of the phrases I suddenly caught myself wondering about was “breathing is an oxidative process”.  “What if it isn’t? Have I got that wrong? Will that throw doubt on all of the information in my blog?” I wondered.  So quickly Googled the phrase, and came up with a link to a site called breathing.com.  I kid you not.  It got better – apparently there are people out there who are concerned about breathing too much (??!!!) due to the fact that it produces free radicals.  Please don’t be one of those.


Cosmetic Chemistry byFlorence Barrett-Hill

Cosmetic Dermatology by Leslie Baumann, MD

Dr Saukar Pamori Telang, Vitamin C in Dermatology (National Institute of Health)

SUNSCREEN – there’s a little bit more to it than just slapping it on.

Chile UV index alert

Even the construction workers care about the UV index in Chile! The health and safety people deserve a medal.

It seems a bit odd writing a post about sunscreens during what is possibly the most dismal summer I’ve seen in the UK for a while (at least up in Scotland, rumour has it that the sun has been making an appearance further south), but we could see sun again before winter sets in and it’s always good to be prepared.  And people have been known to jump ship to catch some sun further afield… Protecting your skin against UV radiation is important to prevent signs of photo damage (wrinkles, patchy pigmentation and the like) and skin cancer, but it isn’t true that in terms of SPF more is necessarily better.  The incorrect use of sunscreen can come with some risk.

I have always been a big advocate of wearing sunscreen, ever since I was in college and saw first hand what a difference it makes.  Growing up in South Africa, even though I did believe that taking care of your skin made a difference, I still thought that people just looked a certain way as they got older and there wasn’t that much you could do to dramatically change the effects of the passage of time.  That all changed in my second year, when I was going through a consultation with a facial client and nearly fell off my chair when I discovered she was ten years older than I would have placed her at.  It turned out that she had been wearing sunscreen on a daily basis since the age of 17, which effectively ended my love affair with trying to get a tan.

What does the term “SPF” mean exactly?

The SPF, or sun protection factor, is the term used to indicate the level of protection against UVB rays which result in burning.  So if you take 5 minutes to burn when not wearing sunscreen, when wearing an SPF 20 you will be able to stay in  the sun without burning for 5×20 minutes or a bit over 1 and a half hours.  During this time you would probably be getting a tan.  Why is this?  Because the SPF is not an indication of protection against UVA, and it is this spectrum of rays which penetrates to the dermal layer creating a tan, and all the damage listed above. This is why you can tan without burning when using a sunbed – hopefully it is clear when reading this that sunbeds are not a “safe” way to get a tan. An interesting statistic released recently by a survey done in the US was that the incidence of sunbed related skin cancer was double that of that of smoking related lung cancer. DOUBLE!!!  UVA star ratings are becoming more and more common now so be sure to look for both when shopping around.

How do sunscreens work?

Sunscreen ingredients work in one of two ways – reflective (zinc and titanium dioxide) or absorptive (the rest).  The reflective type sits on the surface of the skin and is what can give you an undesirable whitish appearance (although modern technology has mostly overcome this) while the absorptive type penetrates the skin and absorbs UV rays, converting energy into heat and getting broken down in the process. The unfortunate side effect of this process is the production of free radicals which will now be present under the skin’s surface.

IMPORTANT NOTE:  This problem can be dealt with by using antioxidant products alongside your sunscreen – it does not mean sunscreens are dangerous, but it helps to be aware of this fact.

Isn’t a tan healthy, though?

In short, not necessarily.  Although there are definite benefits to getting out in the sun, vitamin D production and mood improvement being high up on the list, what is going on in the skin when the melanocytes kick into action and release more melanin than normal is the skin is doing it’s best to protect itself from the harmful effects of UV radiation. That’s it.  That’s all a tan is. The melanin granules collect on the outermost side of the nucleus, shielding it from UV because the free radical cascade that results can do DNA damage which means that when the cells divide, they don’t replicate themselves perfectly.  At the very least this results in accelerated aging, and at the very worst it leads to skin cancer.

All that being said, it doesn’t mean that you need to avoid all sun exposure and use a high factor sun screen on a daily basis if you tend to spend the majority of your time indoors.  While it is true that a tan is your skin trying to protect itself, it is also an important part of its defence system and if there is no stimulation of the melanocytes for an extended period of time they start to lose their ability to respond quickly when they are exposed.  It may also be that vitamin D production – 80% of which is formed in the skin as a result of sun exposure – can be affected, leading to problems such as osteoporosis down the line.  How sunscreen can affect your vitamin D production is actually, like pretty much everything involving the skin, dependant on a variety of factors. The amount of UV exposure needed to maintain vitamin D levels depends on the time of year, location, skin type, day-to-day activity and individual circumstances.  Click the link below for more detailed information on sunscreen and vitamin D production – note that sunscreen is not needed when the UV index is 3 or below (this is easily checked online). During the winter in the UK the UV index rarely goes above 4, so if you are using a product which contains vitamin A this will give you sufficient protection and an additional sunscreen won’t be required for occasional exposure.


My skin tans easily and I never really burn, do I still need sunscreen?

Yes, if you want to avoid getting pigmentation problems when you get older.  Even if you aren’t at risk of developing skin cancer (and skin colour is no longer the determining factor, the red-head gene can still be present in your makeup if you have dark skin), the melanocyte is still damaged by prolonged exposure.  It is recommended to wear a low SPF containing antioxidants which slow down the production of melanin, such as beta carotene and vitamin C.

My skin is really fair, isn’t it better to wear a very high factor sunscreen?

Not always.  As has been said previously, the SPF only refers to the UVB protection but doesn’t take into account UVA exposure, and it’s UVA which causes the damage.  While you can still reapply every hour, people tend to get complacent because they aren’t burning.  So for normal conditions where you are in a situation where you are able to reapply regularly, you only need use around factor 20 – 30.  I will use a factor 50 if I am rock-climbing and might not be able to slap on another layer as I’d rather avoid burning, but then will apply an antioxidant product later to mop up the free radicals which will have formed.

Size matters

In order to get the level of protection advertised you need to be putting the right amount on, which is normally 2mg/square centimetre or about the size of a 50p piece for an area the size of the face. Many people put the bare minimum on, and think they are getting the full SPF – this is particularly true when relying on makeup or moisturiser, to get the advertised protection from applying foundation would mean you would have to really cake it on.


1. Wear a lower factor sunscreen (SPF 20 to 30) and reapply every hour.

2. Make sure your sunscreen includes physically reflective titanium dioxide or zinc oxide as part of the protection.   This not only protects your skin but protects the absorptive sunscreen components, lessening the production of free radicals.

3. If you are wearing a chemical sunscreen try and find one containing antioxidants, or apply a product containing antioxidants over the top to protect the absorptive components as well as mopping up any free radicals formed.   Beta carotene is a very good antioxidant for this purpose.

4. Pre- and post care of the skin with Vitamins A, C and E as well as a cocktail of antioxidants ensures that the skin is in the best possible health to get the maximum benefit with minimum damage from your time in the sun.  Taking antioxidant food supplements such as lycopene, starting a few weeks before your holiday and then throughout your stay, gives you a superior protection internally that boosts everything you are doing externally.  I’ve really seen great results with this when treating a client with pigmentation.  Normally when treating this condition, no matter how diligent you are with products, hat and sunglasses there is a darkening of the patches during a sunny holiday.  This client had no visible change afterwards which was a record first for me!

5.  Put on a generous amount of product, not the thinnest smear you can manage.

6.  As has been said many times before, don’t lie out in the sun between 11am and 3pm, and wear a hat.

A note on re-applying

If, like me, you thought that if you get two hours protection with one application of sunscreen then if you reapply at the end of two hours you will get a further two hours of protection, think again.  Here is how it breaks down:

Take the example of a person who takes 4 minutes to burn when not wearing sunscreen, who applies an SPF of 30.  This will give them 120 minutes of sun exposure before reaching 100% Minimal Erythema Dose (MED), the dose of UV which gives you sunburn. Should they reapply another dose of SPF 30 at the halfway mark 60 minutes, this will not give another 120 minutes of protection as 50% of the MED will already have been received.  The re-application acts as a booster to the initial application, meaning that when the 120 minute mark is reached they will have received approximately another 25% of their MED. Should they not reapply at this time, they will reach 100% MED at around 150  minutes. If they do reapply at the end of 120 minutes the final 25% will be used up at approximately 165 minutes from the initial exposure time.  So to summarise, reapplying twice during 120 minutes only gives you about 45 minutes extra exposure time.

What to avoid

There are some sunscreen ingredients which are still widely used but really should be avoided at all costs.  One of these is oxybenzone, which is a quite common chemical sunscreen that has been identified as a photosensitiser.  It also creates free radicals during it’s action as a sunscreen as it is broken down.  Another to watch out for is Ethylhexyl Methoxycinnamate, which does the same.  It is particularly important when using chemical sunscreens to flood the skin with antioxidants pre and post sun exposure in order to treat this problem.

And finally…

People in the UK often forget that UV is still present even on a cloudy day.  The heat you feel from the sun is actually infra red rays, UV rays emit very little heat.  This means that if the UV index is over 3 then you should be wearing sunscreen even if it’s overcast.  This is particularly true if you are somewhere where there are reflective surfaces such as water, sand or snow.  Altitude also affects how strong the sun’s rays are, so the index goes up proportionately – if you are on the slopes then sunscreen should be applied as a matter of course.

For those of you who feel that life is not worth living if you can’t enjoy a sunny holiday, please don’t think that this all means the sun is the devil – just please enjoy it safely!


Cosmetic Chemistry by Florence Barrett Hill

Cosmetic Dermatology by Leslie Bauman, MD


Starting from scratch – how do I set up a completely new business?

At last, we are letting the grass grow under our feet again. Finally back in the UK, after extending our trip a few months more than anticipated (due in part to the snow in the Alps – don’t get too excited, we were living in a van again), I can say we definitely will be settling in Scotland as Tom’s job is now confirmed.

It’s great being back, I think it’s helped that we returned at the tail end of winter.  Spring has such a lovely energy, birds are singing, the flowers are out – I will be honest and say that the UK is really the place I want to be at this time of year.  It’s also good to be getting my brain back into work mode, I’ve had lots of time to catch up on reading that I was too exhausted to do before I left.  Thankfully I had made sure my textbooks were easy to find (I’d even put a post-it note with my tax return to tell me where  the most important ones were – that was a clever idea!) so am able to be looking at skin again with a fresh mind.

I now have the somewhat daunting task of starting a whole new business. However, thanks to Tom and his admittedly superior understanding of business planning, I have a kitchen full of post-it notes and a general game plan to get along with. I have also spent the Easter weekend sitting front of a computer while Tom has been gallivanting in the Lakes, but as I have had the best part of 15 months off I really can’t complain.

The first task on the rather extensive to-do list has been to research the demographics of the areas in Edinburgh that I think are good bets.  This has been interesting and frustrating in turns, some areas I thought were in the running didn’t come out quite as well in the survey as expected – but that is all depending on whether the information is accurate, of course.  I used three different sites for comparison, and some points varied wildly.  For instance, under the section titled general age group one area had either mostly 20-44 year olds or in another survey, mostly 45-85 year olds.  Alternatively, one area was populated by either a) mostly people in full time employment or b) a high percentage of unemployed.  Are you riveted?  Me neither.  It has largely been helpful though, and now the next task is one I am really not looking forward to.  Yes, now I am going to be walking the streets, clipboard in hand, and harassing passers by in the hopes of getting some idea of which areas have the best footfall of potential clients.  It is helpful, I am sure, to set up shop in an area which is likely to be populated by people who would be interested in what I have to offer.  All the same I suspect a large glass of wine,  a rom-com and a long pep-talk from a friend who can reassure me that I am not a pariah will be in order after spending the day trying to catch someone’s eye while they rush past me in an effort to look too busy to stop.  With luck I will have some karma in the bank after all the times I have taken pity on people doing market research.

Now that I have successfully managed to avoid doing  meaningful work on my business plan for the past couple of hours (largely due to forgetting to save the first draft) I will leave this here.  My next post on skin is going to be on inflammation, which is at the root of a whole host of skin concerns from acne to aging.


Essential fatty acids

This post has come out a bit later than expected – I had every intention of getting it out weeks ago but have been sidetracked with this topic.  Essential fatty acids are not just important for the skin but for the general functioning of the body – a total re-write was needed as I’d veered completely off topic.

Continuing the theme of skin nutrition, this post is focusing on essential fatty acids which are more commonly known as omega oils. There are several different families of omega oils, but for the purpose of this post I will be concentrating on omega 3 and 6 as currently they are the most pertinent in skin care.

The functions of omega oils in the skin

Omega oils have a wide range of functions, and their lack affects every skin condition.

  1. They are a key ingredient in the composition of the skin cell membrane and keep it fluid, meaning that the cells are able to perform their functions at optimum efficiency.
  2. They make up an important part of the lipid bilayers in the stratum corneum, which slow down trans-epidermal water loss (the passage of water through the skin). This not only keeps the skin hydrated, but stops the skin feeling dry and rough as it plays a key role in the skin’s natural ability to shed dead cells. This is also an important part of the skin’s barrier defence system.
  3. They refine the texture of oil secretions, benefiting problematic skin as sebum becomes more free-flowing and therefore less inclined to clog pores. Keeping the pores free of blockages is the first step in controlling breakouts.
  4.  Omega 3 is a potent anti-inflammatory, so is helpful in treating all skin conditions that relate to inflammation.
  5. They transport fat-soluble antioxidants into the skin, which protect against lipid peroxidation. Lipid peroxidation is a root cause of many skin problems as it affects the integrity of the cell membrane and therefore all its functions.
  6. They help prevent and treat pigmentation problems.
  7. They are used by the body to make eicosanoids, hormone-like substances which regulate many processes including inflammation. Though they have an important function in forming part of the phospholipid membrane, they are effectively there in storage to be released as needed which explains why you need to ensure you are constantly replacing them through your diet.

Omega oils make up an important part of the cell membrane

There are two main families of omega oils which are important for skin health, omega 3 and omega 6. There are others too, but these are the ones that are of particular interest in skin care at the present moment. They are called essential fats as our body can’t manufacture them so we need to either eat them or apply them topically in order to metabolise them.

Why is the integrity of the cell wall so important?

  1. A healthy, intact and fluid cell membrane allows active and passive transport of oxygen, nutrients and cell waste in or out of the cells. If there aren’t sufficient omega oils present in the wall, it becomes brittle and rigid which means transport across it is impeded.
  2. It houses transport proteins which help this process.
  3. It contains receptor proteins which allow cells to communicate.
  4. It contains marker proteins which identify the cell.

Western diets often contain too much omega 6.

Although we need both omega 3 and 6, it is important that we have them in the correct ratio. From an evolutionary standpoint, our diet for most of our history involved fruit and vegetables, nuts, seeds and seafood, a small amount of red meat and little to no grain. With the advent of agriculture this has changed so that now we eat a lot of grains, grain products and grain fed meat and much less fruit, vegetables, nuts and seafood. Grains and grain products (such as soybean oil and other grain oils) contain a lot of omega 6 fatty acids, which are used extensively in processed and convenience foods. We do actually need these fatty acids, as they are an important part of our immune system – governing inflammation and pain response. A healthy ratio of omega 6 to omega 3 is considered around 4:1, but the Western diet can give you around between 15:1 or 30:1.

If we need omega 6, then where is the problem?

Our bodies use linoleic acid (an omega 6) to make arachidonic acid, which is stored in the cell membrane to create a pro-inflammatory eicosanoid (a hormone-like substance). Inflammation is an important part of our body’s ability to fight disease and infection, but if there is too much omega 6 present then it can create unnecessary inflammation and this is considered a root cause of a wide range of degenerative diseases. It has implications in heart disease, cancer, inflammatory bowel disease and dementia to name but a few, and in the skin it influences acne, eczema, psoriasis and any other condition which is related to inflammation and its frequent partner, impaired barrier function.

Note! There are several members of the omega 6 family. It is linoleic acid which forms arachidonic acid that is pro-inflammatory and most prevalent in our Western diet. This is not to be confused with the omega 6 gamma linoleic acid (GLA), which is found in evening primrose and borage oils and has an anti-inflammatory effect.

Why you should check your intake of omega 3 if your skin feels dry, rather than reach for the exfoliant.

Exfoliating seems the most obvious thing to do if your skin is feeling dry and flaky. After all, you get instant results and assume you have treated the problem. As you will understand, this is a very short-term solution, and here’s why.

  1. As mentioned, omega oils make up a substantial portion of the phospholipid membrane of the cell. The epidermal skin cell goes through several stages of differentiation on its journey from the basal cell layer to the stratum corneum, and as it reaches the final stages the cell releases little granules containing lipids which react with the water present in the extracellular matrix (the fluid that surrounds and bathes the cells). There the lipids and water molecules organise themselves to form the lipid bilayers, which act to slow down the passage of water through the skin (transepidermal water loss, or TEWL). Think of how oil sits on top of water, and would therefore stop it from evaporating so fast.
  2. This is relevant as water is required as a catalyst for several enzyme processes that are constantly going on within the skin. In this instance the bonds (called desmosomes) which hold the skin cells together require an enzyme to break them down. When the skin is functioning optimally, this process happens continually and keeps the surface feeling smooth and soft. It’s only when there isn’t enough free water present (either due to fast TEWL or being dehydrated) that the bonds aren’t broken, leading to a dry, flaky, rough appearance.

As you can see, simply exfoliating isn’t enough. It is far better and more effective long-term to take a look at your oil and water intake (both are important) to keep you skin feeling smooth.

When can you expect to see a difference?

Take supplements every day, up to the maximum recommended by the FDA (which is 3000mg of omega 3) or make sure you get the equivalent through your diet, and drink at least 2 litres of water daily – more if you exercise regularly, and therefore sweat more. Do this for a minimum of 2 weeks and you should be seeing a difference.

Hasn’t the 2 litres a day theory recently been refuted?

Yes, it has. However it has been both my and my clients’ experience that our skin improves when taking this amount in. For the record, there have been reports in both directions, so you can choose whom you believe. I can’t give a scientific basis for this, but I do know is that it isn’t a placebo effect as in two separate cases my clients were drinking more water than normal for completely separate reasons, and noticed their skin had improved as an added extra. I have tried it myself on several occasions, generally when the central heating has come on and I haven’t quite adjusted t0 drinking more. I noticed that my skin was feeling particularly uncomfortable and tight and wasn’t responding to any of the products which should help, and then I realised I had stopped taking my omega oils and wasn’t drinking much water at all. So I ran an experiment, taking in a high dose of omega 3 and drinking 2 litres of water a day, and found that the problem had gone away in about a fortnight.

Omega oils benefit problematic skin in several ways
Taking in extra omega oils (particularly omega 3) has several benefits to problematic skin.

1. It assists in the formation of the lipid bilayers in the skin, which has the knock-on benefit of slowing down TEWL and assisting with the shedding of dead skin cells, helping prevent clogged pores.

2. By helping form the lipid bilayers it also improves the skin barrier function, keeping out allergens and thereby preventing the inflammatory response.

3. It thins down the texture of the sebaceous (oil) secretions, which also helps to keep the opening of the pores clear. If your diet contains a lot of saturated fat (found in fast food and convenience food) and little omega oils then the oil secretions become thick and sticky, mixing with dead skin cells and other debris found on the surface of the skin and creating blockages.

4. By creating a healthy cell membrane that allows oxygen and nutrients across it, it assists in maintaining a good metabolism in the cell and therefore good cell turnover. This will reduce the occurrence a build-up of excess dead skin cells which can lead to a breakout.

Omega 3 oils are a potent anti-inflammatory agent

The release of EFA’s from cell membranes and conversion into prostaglandins is a complex enzymatic process.

1. In brief, both the omega 3 and omega 6 EFA’s use the same enzyme to be converted further in the cascade which eventually produces eicosanoids. If there is enough eicosapentanoic acid (omega 3) present, it displaces the omega 6 arachidonic acid from the cascade – resulting in anti-inflammatory or less inflammatory eicosanoids being produced. If there is not enough omega 3 present then the omega 6’s get preferred, leading to the production of pro-inflammatory eicosanoids.

2. The presence of alpha-linolenic acid (omega 3) also inhibits the release of an enzyme involved in releasing arachidonic acid from the cell membrane, and therefore a reduction in the pro-inflammatory eicosanoids.

It’s interesting to note that this is the same pathway in which non-steroidal anti-inflammatory drugs work, which are commonly used as pain-killers.

Note! In the case of acne, the problem of sugar (and high glycaemic load foods – foods which cause a sharp spike in blood sugar levels) must also be considered. When blood sugar levels rise, the body produces insulin to remove glucose from the blood stream. Insulin increases the production of arachidonic acid, which as we know leads to inflammation. Therefore both an increase of EPA and a decrease in high glycaemic load foods is needed in this instance.

A healthy cell membrane is the most important factor in skin care

EFA’s transport fat soluble anti-oxidants to cells, which protect the cell membrane from lipid peroxidation.

Vitamins A and E are fat-soluble anti-oxidants, which mean that they need to be bound to fat molecules in order to be absorbed, transported and stored in the body. They prevent the oxidation of lipids in the cell membrane caused by free radicals. Lipid peroxides alter the function of the cell membrane and cause possibly irreversible damage to metabolic pathways. In the skin, this can lead to:

  1. Premature aging through inactivated vitamin A receptors in the cell membrane.
  2.  Oxygenation loss due to reduced permeability of the cell membrane, inhibiting the passage of oxygen into the cell. This results in the formation of new capillaries in order to increase the flow of blood and therefore oxygen in the skin, which we will see as thread veins or the misnamed “broken” capillaries.
  3. Oxygenation loss also leads to sluggish, lazy oil flow, poor wound healing, accelerated aging, slow cell turnover, and excess keratinisation.
  4. Pigmentation patches, as the dendrite arms of the melanocyte become shortened.
  5. Shortening of the dendritic arms of the Langerhans cell. Its function is to process antigens, which would be impaired if the cell membrane was affected and its dendrites consequently shortened.

There are many more consequences to an impaired cell membrane, but even with these you can see that it is the first consideration for all skin concerns.

EFA’s play a role in treating pigmentation

Pigmentation can’t be treated without first addressing essential fatty acid deficiency, as no treatment programme will be effective long term without it.

When there are not enough essential fatty acids to keep the cell membrane fluid and healthy, this causes a number of problems which influence the appearance of pigmentation.

  1. Each melanocyte cell has dendrite arms which reach around 30 keratinocyte cells, delivering melanin granules to them as needed.
  2. When the cell membrane is compromised, this alters the length of the dendrites. This means that the melanocyte is still producing the same amount of melanin but is being dispersed unevenly, which results in patches of pigmentation.

EFA’s help transport fat soluble antioxidants, helping protect the cell membrane from lipid peroxidation

What is lipid peroxidation?

It is the compounded and untreated form of oxidative stress where the cell membrane has suffered an oxidative breakdown of lipids and oil soluble antioxidants. It is the process whereby free radicals steal electrons from the molecules of phospholipids within cell membranes.

How does this affect pigmentation?

Melanosomes, the granules containing the pigment which causes a tan, are produced in the melanocyte and then travel to the ends of the dendrite arms where they are released through the cell membrane into the keratinocyte cell they are protecting. The cell membrane needs to be healthy, fluid and intact to ensure even placement of the pigment granules.  If it isn’t, this can effect the length of the dendrite arms, meaning that the cells produce the same amount of pigment but it is not distributed evenly.

If this condition is left untreated, it can lead to mitochondrial DNA damage as the cell membrane surrounding the mitochondria (the powerhouse of the cell, where its energy for all functions is produced) becomes oxidised. This condition has far reaching consequences as all skin cell functions are affected by this.

Can I get enough from my diet?
The recommended dosage of omega 3 per day is 2-4% of your daily caloric intake. So, for a 2000 calorie/day diet, you should be taking around 2-4g of omega oils per day.

To get this, you would need to eat:

3 ½ oz – 4oz portion of oily fish 2-3 times a week
¼ cup of walnuts and a tablespoon of flaxseeds daily (gives around 3g)

You could also include any of the following:
1 cup of kidney beans or soya beans gives about 0.3g of omega 3
1 cup of winter squash gives about 0.3g
4oz tofu (raw) gives about 0.4g
4oz cod gives about 0.3g
Olive oil 1oz gives about 0.2g

If you are looking to get your omega oils from fish or olive oil, please don’t fry them. The intense heat of frying destroys the oils so there will be no benefit from them.

If you eat any or all of these on a weekly basis, making sure you are taking in the recommended daily amount, then you are probably getting enough and of course benefiting from other nutrients that are present. It is very easy, however, to not realise that you haven’t met the requirements when life gets busy and for a week or so you may not have had the most balanced diet. It’s for this reason that supplementing helps, but it should never substitute a healthy, balanced diet.

What makes a good quality supplement?

Fish oil supplements are the most beneficial, as the body uses them more easily than vegetable oil alternatives. However if you are allergic to fish or are a vegetarian/vegan, then hemp seed or flaxseed capsules are good sources of omega 3. You can also find these oils in liquid form and can use them for salad dressings.

Most fish oil capsules will say they contain 1000mg of fish oil. This is not actually relevant, as it’s the proportion of EPA and DHA (types of omega 3) that matters. You are looking for the highest quantity of these that you can find and this varies hugely – unfortunately the more expensive are generally better, although if you think about how many of the cheaper capsules you would need to eat to get a similar amount of omega 3 then they probably aren’t much different. I find that the internet is a good source as you can check this easily, and shop bought products generally don’t compare.

Another consideration is purity, as mercury and other toxins are found in oily fish. Good supplements are highly purified to remove heavy metals and should state this on the bottle and/or website. The larger the fish (higher in the food chain, such as tuna and salmon) the more likely there is to be a build up. This is another reason why supplementing to get the requisite amount of EFA’s is a good idea, as if you were to try to get it solely from your diet you need to eat a huge amount of fish and risk taking in more mercury than is safe.

Lastly, there is something to be said for enteric coating. This is a coating on the capsule surface which doesn’t get broken down by stomach acid, but allows the capsule to enter the small intestine where it is digested. There are two benefits to this, the first being that it stops the fishy “repeat” after eating which many don’t like. Secondly, we absorb fats in our small intestine, so the maximum amount reaches the area where we take it in.

Note! In compiling this post, I came across an article which stated that it is important to have a good intake of antioxidants (which one should be doing anyway) when taking omega oils as without that the oils themselves may oxidise and become harmful. If your diet is low in antioxidants, it is recommended that you up your intake of them for a month prior to starting taking omega oils. This can either be in the form of supplementation or by making sure you eat a wide variety and high quantity of different coloured fruit and vegetables. I don’t offer this advice as a trained nutritionist but as a skincare specialist, so if you are concerned about if you have the balance right I would always recommend consulting a good nutritional specialist.

In treating your skin for essential fatty acid deficiency (EFAD), you can bypass the supplementation issue if it is a worry for you and simply use topical preparations as the skin can metabolise them in this way too. I would always recommend making sure your diet contains EFA’s however, as they are so beneficial to the whole body.

Do IBS and Celiac disease cause a problem with absorbing EFA’s?
If you suffer from an inflammatory bowel condition such as IBS or celiac disease, then your ability to absorb fats from your diet will be affected. Often people with these conditions have a predisposition towards inflammatory skin conditions such as eczema or dermatitis, or complain of excessively dry skin, which is a clear indication of how deficiency can affect you.

Topical application of EFA’s works too.

For people with inflammatory bowel conditions, taking high doses of omega oils will be of little benefit as they won’t be absorbed. Fortunately, your skin can metabolise them when applied topically. Oils such as kiwi seed or chia seed are very high in omega 3 and can be used neat on the skin or made into a cream. They do have a short shelf life however, so need to be used up in a short space of time (refer to the manufacturer’s instructions).

There are also products which encapsulate the fats into liposome or nanoparticle format, which are of a structure that easily penetrates the stratum corneum and will be even more effective than simply applying the oil.

To conclude; having a diet which is rich in essential fatty acids and ensuring that there is a good ratio of omega 6 and 3 present is one of the major building blocks in effective skin care. There are numerous other benefits from making sure you are eating sufficient of these oils besides good skin health, which is why I have written mostly about supplementation, but to cover all the bases if your skin is essential fatty acid deficient you can also use topical application.

Vitamins – Vitamin A

There have been plenty of articles in the beauty media regarding different vitamins and the fact that they are beneficial to the skin. More often than not they don’t go any further than saying that they are of benefit to you or important, but don’t explain how they work. I was having a conversation recently with a client who made the observation that without having that information she is less inclined to actually use a product – she might purchase it but it tends to sit on the shelf as she is confused as to what it is actually doing for her.

The question often asked is that “surely if a person is eating a healthy balanced diet with plenty of fresh fruit and vegetables then aren’t they going to get enough vitamins through their diet, and so products containing vitamins aren’t necessary?” In answer, by all means you should be eating a healthy balanced diet for a variety of reasons including benefit to the skin, but the body will be assigning nutrients to where it feels it’s necessary (meaning vital organs first), and the skin is the last place on the list to get fed. By applying them topically, they are going exactly where you want them to go.

Vitamin A

I am starting with A not because I’m working in alphabetical order, but because it is one every person needs for optimum functioning of the skin. It has implications for acne and problematic skin, collagen production and also the prevention of skin cancer. It is what the skin cell uses to control the normal activity of the DNA of the cell’s nucleus, as well as that of the mitochondria (organelles within the cell which produce energy).

The functions of vitamin A in the skin

1. Increases collagen type 1 production, increasing skin firmness.

2. Normalises basal (the lowest layer of cells in the epidermis) cell function and replication, restoring cellular homeostasis – i.e. it governs the normal replication of skin cells and therefore guards against cancer.

3. Compacts the horny layer (stratum corneum), resulting in a smooth skin texture that reflects light evenly, creating a radiant appearance.

4. Normalises oil secretion.

5. Corrects the polarity of keratinocytes, (making them less sticky and therefore less liable to clump together, reducing the formation of comedones (blackheads).

6. Decreases the levels of transglutaminase, an enzyme responsible for cross-linking cell membrane proteins of the keratinocytes, which contributes to keratinocytes blocking pores and forming blackheads.

7. Reduces clumping of melanin (the skin’s pigment that creates both a tan and pigmentation patches) in basal cells, resulting in a reduction in the appearance of hyper pigmentation.

8. Reduces lipid peroxidation (the oxidation of oils in the skin), which has a wide range of skin benefits including treating acne, pigmentation and premature aging.

9. Reduces oxidative stress (acts as an antioxidant).

You can see from this list that vitamin A has multiple benefits and is therefore important to include in almost any effective skincare treatment program.

The pathway of vitamin A into the skin cell via the digestive system

Beta carotene from food is converted into vitamin A when absorbed through the small intestine into the lymphatic system, and is transported to and stored in the liver as the ester retinyl palmitate until required.

When needed it is released from the liver, converted into retinol, attached to proteins in the bloodstream and in this way carried to the skin.

Upon arrival in the extracellular spaces of the dermis/epidermis it reverts back to retinyl palmitate so it can enter the cell via its receptors. On moving through the cell membrane it is further converted to retinol, then retinaldehyde and finally to retinoic acid by the mitochondria, which is the form that the cell uses for DNA synthesis and to support cellular structures.

As the body will use vitamin A for the vital organs before the skin, it makes sense to apply this essential nutrient topically. Provided it is active and in a form that can penetrate the skin, it will be going directly to the cells that need it.

How vitamin A influences collagen formation

There are three main ways in which vitamin A has a positive influence on collagen formation:

1. Retinol causes an increase in the number of fibroblasts (cells that produce collagen) in the dermal layer, and therefore an increase in collagen.

2. As retinyl palmitate it has an SPF 20, which protects against the decrease in collagen production caused by UV exposure.

3. An enzyme called matrix metalloproteinase (MMP) is produced by the skin to degrade old collagen and therefore make way for new, healthy collagen. UV exposure however causes a great increase in this enzyme, resulting in too much degradation, and therefore accelerates aging. Retinoids counteract this by slowing down the expression of this enzyme.

Vitamin A and sun protection

Retinyl palmitate gives a natural sun protection factor of 20 by absorbing UV radiation. This means that (in the UK certainly, and other countries where the UV index is regularly lower than 4) you don’t actually need to wear sunscreen daily to protect your skin from photo-aging. You can in fact combine sun protection with all the other benefits listed above, in just one product.

Why it is important to replenish supplies of vitamin A to
prevent premature aging and skin cancer caused by UV exposure

Vitamin A in the skin is destroyed by UV radiation, so it makes sense to top up the supply regularly. It takes around 7 days for it to be replenished naturally (i.e. for the body to get sufficient into the skin via diet alone), while if you use a good topical treatment it only takes hours.

Its common knowledge that prolonged unprotected sun exposure is linked to the development of skin cancer. This is because UV radiation causes damage to the nucleus of the cell and the mitochondria (the energy producing organelle in the cell), inducing mutations in cellular DNA and by destroying vitamin A which is used to normalise cell replication. Damage to the DNA causes cellular mutations that lead to uncontrolled replication, resulting in a tumour. Do remember, this is why we tan. Melanin pigment is produced to act as a barrier defence between UV radiation and the nucleus.

The skin cell membrane is selectively permeable, meaning it allows certain things like oxygen and nutrients through, while keeping out harmful substances like toxins or bacteria. It lets each molecule through via receptor sites that are unique to that molecule, including vitamin A. When we are born we have an abundance of vitamin A receptor sites, but these are destroyed over the years by UV radiation (along with the vitamin that they recognise). To put it another way, baking yourself in the sun destroys the vitamin that protects you against skin cancer and premature aging as well as the delivery system by which it enters the cell – something to bear in mind next time you want to get a healthy tan.

Please note! This doesn’t mean avoid the sun like the plague – just be sensible and don’t bake yourself for hours during the hottest time of the day with little or no sun protection and expect to look good when you are 50. Skin cancer is only a possibility, premature aging and pigmentation issues are guaranteed – and for younger readers please realise that you will care when you are older, and you are older for a much longer time than you are young.

It’s not all bad news, however. Even if you have had a lifetime of sun exposure, if you re-introduce vitamin A to the skin slowly then you will encourage your skin to make more receptor sites and allow the skin to repair some of the damage that has been done to it. It is honestly never too late to start caring for your skin, at any age and with any amount of damage present you can bring about an improvement if you understand what has gone wrong and apply the appropriate corrective measures.

Vitamin A and acne/problematic skin

Blocked pores are the first step towards the formation of inflamed spots. In acne patients there is a tendency for the keratinocytes to be “stickier” and therefore more likely to form blackheads due to two reasons.

1. Firstly, the effects of positive and negative charges on the cells make them stick to each other more readily, and

2. there is a higher level of transglutaminase present, which is an enzyme responsible for cross linking cell membrane proteins in the keratinocytes.

Retinoids reduce both the positive and negative charges and the levels of transglutaminase, meaning that the pores are less prone to blockages as the keratinocytes exfoliate more easily and naturally.

Another positive effect on acneic skin is that retinoids reduce the production of sebum by decreasing sebaceous gland activity.

Vitamin A and hyperpigmentation

Pigmentation is always linked to UV exposure, so all the sun protection benefits of retinoids apply. Also, in theory, the increased cell turnover of keratinocytes in the presence of retinoids means that the melanin pigment might be spread more evenly throughout the epidermis which reduces the patchy appearance.

Vitamin A acts as an antioxidant and protects against lipid peroxidation

Beta carotene is a potent oil soluble antioxidant which, amongst others, helps protect the cell membrane from oxidative stress. This is a complicated subject and will be dealt with in more depth in a future post, but in brief if the lipid components in the cellular membrane become oxidised then this will start a cascade of events leading to mitochondrial DNA damage. This means the cell does won’t be able to reproduce easily and may lead to permanent damage, cellular mutation or cellular death (apoptosis).

Any cell can be affected in this way; therefore all skin conditions will be negatively affected.

Oxidative stress is what precedes skin and other cancers, as well as a host of other conditions, so it makes sense to always have antioxidants present in your products.

Formats of vitamin A in cosmetic/cosmeceutic products

There are many formats of this active ingredient in cosmetic and cosmeceutic skin care today. Most commonly it is found as retinyl palmitate, but retinyl acetate and retinol can also be used in popular brands (there are several more but these are what I have encountered most frequently).

Beta carotene

Also known as pro vitamin A, this is a precursor to vitamin A (as explained in the digestive pathway). It is a member of the carotenoid family and a powerful antioxidant, with a single molecule being effective against a vast number of free radicals. It also reduces UV induced redness (or the visible effects of sunburn), so is a very useful ingredient in sun protection products as well as after sun care. If your skin is very sensitive to even the gentlest form of vitamin A due to a lack of receptor sites, using beta carotene will encourage the formation of these with no adverse side effects except in very rare extreme cases.

Retinyl palmitate

This form is the most common found in skincare products and the least aggressive. It amounts to about 80% of the total vitamin A found in the skin which is why it is easily accepted by most skin types and rarely causes irritation.

Retinyl palmitate has been shown to have an SPF of 20, preventing sunburn and the formation of free radicals.


Retinol is the alcohol form of vitamin A, and many consider it to be the “true” form, or the most usable by the skin. It has an advantage in that it is absorbed more quickly through the skin on surface application, but it still has to change back into retinyl palmitate in order to penetrate the cell’s membrane. A disadvantage is that it has a much shorter shelf life and is very unstable in sunlight. There has been some confusion in years past regarding this point, with the assumption being made that the reason you are advised to only apply it at night or use a sunscreen over it was because it made the skin more sun sensitive, but the advice was given so that the user would be getting the most benefit from the product. However, if you combine retinol and retinyl palmitate in a product then you are getting the SPF supplied anyway and do not need to worry.

Another slight disadvantage for some – not everyone – regarding retinol is that it can reduce the skin’s ability to produce ceramide 1, which forms part of the skin’s lipid bilayers and barrier defence system. A lack of it leads to extremely dry, tight, dehydrated and uncomfortable skin (as water in the skin evaporates out too quickly without sufficient oil within it to slow down its progress). It can also then tend to sensitivity, as outside allergens aren’t being kept out effectively. I have found that should this happen the only answer is to drop down to a milder form of vitamin A and the problem resolves itself. For some reason certain skins just don’t tolerate the more aggressive forms, but they will still get huge benefit from retinyl palmitate and shouldn’t be discouraged into thinking that unless they are using retinol they might as well try something else. This is a vitamin EVERYONE needs.

It is also worth mentioning that during the winter months our skin seems to produce less ceramides than in the summer months, particularly on our necks (if I find the reason for this I will happily post it, but at the time of going to press I honestly don’t know why this is). This means that during the winter, if you are using retinol based products, you may find that your neck is a bit itchy. If this is a problem avoid wearing woollen polo neck jumpers and scarves, protect your neck with a silk scarf, or alternatively don’t use retinol on your neck during the winter. That said, I have had at least one client who was reacting to high strength retinol have a huge improvement in her toleration when introducing products that encouraged the production of ceramide 1. It so far is only one case, but interesting to note.

Retinoic acid

This is the form that the cell ultimately converts vitamin A into, and is found in pharmaceutical preparations on prescription only. It is a highly aggressive form and will cause redness, flaking and extreme dryness if your skin is not acclimatised. All that considered it also delivers faster results for people who are willing to stick it out through the less desirable side effects, although you will ultimately get the same benefits with retinyl palmitate without any of unpleasantness if you have patience.

How much should you be looking for in your product?

Therapeutic dose is an important point, as a product can say it has retinol in it but if it’s in too small a dose then it won’t really be doing much. Vitamin A is measured in international units (IU) per gram, and when expressed as a percentage in solution 10 000IU/g is the equivalent of 1% per gram.

The recommended effective dose of topical application is between 500 IU and 10 000 IU.

Anything less than 500 IU (0.2% per gram) is generally of no therapeutic value.

Processing and packaging of vitamin A is an important consideration, as vitamin A is destroyed by light and air

To further complicate the issue, when choosing a product containing vitamin A, you must also consider how the product is processed, packaged and transported. This is an important fact to note, as all products which contain this ingredient should be in either a collapsible tube (such as an aluminium one) or more preferably in an airtight, opaque pump dispenser. If you are purchasing a beautiful pot of anti-aging cream which advertises one of its active ingredients as vitamin A, unfortunately shortly after you have opened it the cream won’t be doing the job you bought it for. It still contains the vitamin, but it is inactive and of no benefit to you.

There is also some concern that this vitamin is damaged by X-rays, so when taking your products abroad it is advisable to carry them in your hand luggage as the X-rays used may be weaker than those used to scan hold luggage.

The correct delivery system greatly enhances the effectiveness of the product

This could possibly be a post on its own. Our skin is a selectively permeable membrane, so consequently doesn’t allow everything through (when working correctly), and the best cocktail of ingredients in the world will be pretty useless if it isn’t getting to the cells that need it.

Standard good cosmetic preparations will deliver around 2% of active vitamin A to the skin, increasing to 7% in the better cosmeceutic products. However, retinyl palmitate in a liposome or nanoparticle delivery system will penetrate the skin’s barrier as well or better than retinol that isn’t in one of these formats.

And finally, don’t be shy with your treatment product!

This is an active ingredient with a short shelf life. Standard protocol states that once you have opened your pump or tube you should aim to get through it in around 3 months. After this there is a reduction in efficacy so I wouldn’t recommend trying to make your product last 6 months – that is a false economy. I have seen over the years the difference in the skin of people who use their products correctly and those who haven’t – the results may not seem dramatic in the short term but are incredible when looked at over decades, justifying the effort put in on a daily basis.

Introducing Dermaviduals: Using corneotherapy to improve skin barrier function is the first step in results driven skin care.

The important points in this post are:

1. The skin barrier function must be maintained at all times – when it isn’t conditions related to inflammation such as acne, eczema, dermatitis and premature aging occur.

2. Corneotherapy is the treatment and maintenance of the skin’s barrier.

3. Amongst other things, emulsifiers are responsible for causing problems with barrier function.

What is corneotherapy?

Corneotherapy is a treatment concept that aims to help repair and maintain the outermost horny layer of the skin (the stratum corneum), which will in turn improve the skin’s barrier function and following that it’s overall homeostasis. Think of the stratum corneum like the roof of a house – if the roof is damaged and letting in the elements then there is no use doing repair work to the rooms below until that is fixed.

For many years scientists have viewed the stratum corneum as just a layer of dead cells, and therapists have spent their time taking off as much of it as possible in exfoliating and skin resurfacing treatments. But now there is a new understanding of the importance of preserving this vital layer of skin cells, and there are very few occasions where thinning down the epidermis is actually beneficial.

Professor A. G. Kligman, who is considered the founder of cosmeceuticals (products that bridge the gap between cosmetics and pharmeceuticals), coined the term “corneotherapy” in the early ‘90’s, having spent decades researching this idea. He has found that using the appropriate moisturisers and lipids can rebuild the horny layer and further the regeneration of the deeper skin layers, and the recovery of the skin will also help in preventing premature aging.

Why do we need corneotherapy?

In recent years, there has been a rise in skin conditions such as eczema, dermatitis and acne, all of which are conditions related to inflammation. The skin’s barrier is designed to protect the underlying layers from attack from outside aggressors but when it is impaired it can’t do this function properly. This results in allergens getting past the outer layer of cells where they can trigger the immune response which leads to inflammation.

How does the skin’s barrier get impaired?

This can happen either through using products which strip the skin of its natural oils, or in some cases people can be born with a genetic mutation that predisposes them to having an impaired skin barrier.

Most products on the market today contain emulsifiers. Emulsifiers have previously been overlooked as an ingredient as they are simply there to bind the oil and water phases in the product together, and their influence on the skin was not considered. In the past few decades it has been shown that emulsifiers can penetrate the stratum corneum, binding with the oil in the skin and when the skin is then washed, binding with the water that is used and “washing out” the oil from the skin leaving it feeling dry and tight. Other factors that contribute to barrier function impairment include over-exfoliating, over-cleansing, having insufficient omega 3 oil in the diet, not drinking enough water, and spending a lot of time in either centrally heated or air-conditioned spaces. The last three all relate to what is commonly known as dehydration, which also influences the barrier function. Please note this is not an exhaustive list but just some of the most common issues that create the problem.

The factors listed above are all things which will affect healthy, normal skins and create problems. There have been recent studies which show that some people are born with a genetic mutation which pre-disposes them to developing eczema as their skin’s barrier function is already impaired with no help from external factors. These people have problems with skin sensitivity from an early age but if they use products that are helping to strengthen their skin then the problem should be greatly reduced, possibly preventing more severe conditions from developing in later life.

Lipid bilayers act to slow down water loss from the skin.

The lipids, or fats, that make up the lipid bilayers which are found in the very outermost layers of cells in the SC are vital to good skin health. They are a bi-product of the differentiation of the epidermal cells as they travel up from the base of the epidermis and become corneocytes (the very last stage skin cells goes through before they are shed) and act to slow down the movement of water from deep inside the skin to the outside atmosphere (otherwise known as trans-epidermal water loss or TEWL). Even if you are drinking the recommended 2 litres of water a day, if your skin doesn’t have enough of these fats present, then water will evaporate out too quickly. Why is this relevant? There are many enzymatic processes going on all the time in your skin, and they all need the presence of water to happen. This includes the shedding of old, dead skin cells – so if you haven’t got enough of the correct fats (omega 3’s) in your diet, and/or you are using skincare with emulsifiers in it, your skin won’t have enough oil to trap the water. This leads to a build up of dead skin cells on the surface, and a rough, dry and flaky appearance. Many would then reach for the nearest exfoliant in order to get rid of this problem, but in fact if your skin care supports your skin’s natural functioning then most people wouldn’t ever need one, as a properly functioning skin sheds dead cells without any external help.

Dermaviduals is the first skincare range to embrace the concept of corneotherapy and bespoke skincare.

Even though vitamins are vital skincare ingredients which work brilliantly in treating a range of concerns from acne to aging, they aren’t the only things that a skin requires to function properly. The first consideration is to make sure that the barrier function is operating at its best, allowing all the other functions to in turn operate at their best.

Where Dermaviduals is so unique is that the structure of the DMS (Dermal Membrane Structure) creams mimics the structure of the lipid bilayers present in the stratum corneum. Rather than sitting on the surface and occluding the skin, the cream melts into the outer layers and repairs the damaged lipid bilayers. This in turn slows down trans epidermal water loss, leaving the skin plump and glowing. In addition, actives can be added to the base creams, creating a moisturiser or serum that is tailored to your specific skin concern. These actives are mostly in nanoparticle and liposome format, and as such penetrate the stratum corneum easily to reach the targeted skin cells, effectively delivering their treatment.

How I got to be writing a blog

This blog was started in order to provide information to help unravel some of the media hype that surrounds the skincare industry. Every week magazines have to promote new treatments and products, as they can’t keep saying the same things – after all, how dull is that? This can lead a lot of confusion as the average person has no idea which of the latest “must haves” are right for them. I would like to say at this point, there is no substitute for a personal skin analysis with a trained professional. I have seen countless people over the nearly 20 years I have spent in this industry who come in and tell me what their skin type is – and be completely wrong. They are of course treating their skin with products that they believe are suitable, and again they are wrong. This can lead to less than desirable results – it’s no reflection necessarily on the product being used, just that it’s being used in error.

The information found here is not designed to be a substitute for a proper skin analysis (and by this I do not mean going into a department store and speaking to the lady behind the counter – I mean going to a trained skin specialist. Feel free to ask how to find one in your area, if I can help I will.) What I am aiming to do is break down how treatments and products work, along with information about how the skin works so that you are armed with more accurate facts, allowing you to ask relevant questions when discussing your skin concerns with your specialist.

How it all began:

My interest in skincare started very early, when I began “borrowing” my mother’s moisturiser at the tender age of 13. So it was not really a surprise that I ended up in my chosen profession as a skin therapist, graduating in 1996 with a CIDESCO diploma in Beauty Therapy. But even though I believed in theory that good products could make a difference to one’s skin, I would never have guessed how much of a difference the correct skincare could make. In the past 10 years the knowledge available to the professional skin therapist has increased exponentially and our understanding of the structure and function of the skin, along with how cosmetic chemistry can affect those functions, means that much of the guesswork has been taken out of prescribing treatments and products.

I worked in several different salons for the first few years of my career, and although I had managed to help some clients with their skin problems, there was an element of hit and miss. It was very frustrating when someone came to me with a problem and I followed the prescribed treatment path of whichever product house I was using at the time, but didn’t achieve the desired results and worst of all, I couldn’t get an answer as to why. Over and over, questions were deflected with vague protocol and reasons from product representatives who were toeing the party line, but clearly didn’t have a clue themselves and for professional reasons weren’t able to say so. After working with established cosmetic ranges that made very bold statements regarding the efficacy of their products and not really seeing the evidence of it, I had become disillusioned with the whole industry and although still felt that “good quality” skincare beat anything off the shelf hands down, I didn’t feel convinced that the products I recommended were any better or worse than what could be bought over the counter in a department store.

That all changed when I was introduced to the idea of cosmeceutics (products that bridge the gap between cosmetics and pharmaceuticals) about 10 years ago when the salon I was working in took on Environ, a vitamin A based South African product line (which I have used very happily until I discovered Dermaviduals, but more on that in a later post). For the first time I was starting to see real changes in my clients’ skin, which was unbelievably exciting and reignited my passion for skincare. The question of “these anti-aging products, do they REALLY make a difference?” no longer filled me with dread. Prior to working with Environ, all I could say was that the (extremely expensive) products on offer would slow down the effects of time, but I hadn’t seen them turn back the clock. Now I had, and could say with complete confidence that indeed they did work. One of the most beneficial aspects of working with that company was their commitment to educating the therapist so that they have the knowledge required to understand how ingredients in products can effect changes. Through them I was put on the road to learning in detail how the skin functions and what treatments and active ingredients (I don’t say products, as it is the actives and their delivery systems which make the real difference) can really bring about change. It as through them that I was introduced to one of the most amazing independent educators in skin theory, Florence Barrett Hill, who taught me the Pastiche Method of Advanced Skin Analysis as well as cosmetic chemistry, courses which have given me the confidence to separate the truths from the hype that litters the beauty media. After talking myself hoarse in the treatment room and realising my clients were getting slightly overwhelmed by all the information, I thought I would start blogging relevant topics so that they could read them at their leisure.

So many treatments on offer today have a lot of merit, but mostly they concentrate on what goes on in the dermal layer of the skin as that is where collagen and elastin are formed, or in removing the outermost layer of the skin to improve the surface appearance. This is not necessarily wrong, as some good results can show, but these results could be so much better if there was a better understanding of how vital the stratum corneum (the very outer layer of the epidermis) is to the overall functioning of the skin. This leads me on to the next topic, which is the new concept called Corneotherapy.