Skin care

Dr Levashni Naidoo: Treating pigmentation in summer

I have a complicated relationship with summer: I love feeling the warmth of the sun on my skin, but I don’t love the unevenness with which it marks my complexion.

With summer’s seasonal return, I’ve learned that the sun usually kisses and tells. This can be concerning to those affected by pigmentation problems, so let us look at common factors that may worsen your excess pigmentation and follow our tips to help you with this challenging condition.

Why treat pigmentation?

I’ve treated many patients with pigmentary disturbance. I’ve seen their frustration at having to cover up a condition they wish they could rather spend time improving medically. I’ve witnessed the anxiety they face at the idea of going make-up free. I’ve come to understand the difficulties they face in terms of lowered self-esteem and how self-conscious they feel following the onset of unexpected pigmentary alterations.

Pigmentary disturbance remains a challenging condition to treat. There are over 152 genes that regulate pigment production! This has an impact on how individuals respond to topical treatments, and finding the correct treatment is a process.  It is important to understand that there is no quick fix. I do, however, believe that if dermatologists work closely with our patients, we may embark on a pathway to improvement.

The skin complexion we inherit is influenced by

External Factors

Sunny Days

South Africa is amongst the sunniest countries in the world and sun-induced pigmentation ranks first as both cause and aggravator of many pigmentary disturbances. We all understand that ultraviolet UVA and UVB rays cause photoaging (sun-induced ageing) and increased pigment production. But we also realise now that the visible light spectrum and infrared radiation play a significant role in contributing to skin damage and uneven skin tone through generation of reactive oxygen species (free radicals) within the skin.

Sun exposure may lead to a general increase in pigmentation where skin is exposed, as well as a darkening of pre-existing freckles and the appearance of sun spots.

Heat Waves and Close Shaves

Heat itself from any external source or trauma to the skin may stimulate increased activity of melanocytes (pigment-producing cells in the skin.)

Internal Factors

Heavy-handed hormones

Melasma (hormonal hyperpigmentation) is a common form of pigmentary disturbance. It frequently occurs during pregnancy or when a susceptible person starts using a combined oral contraceptive pill. The increase in oestrogen concentration stimulates melanocyte activity, increasing the production of melanin. This increased pigmentation is commonly found on cheekbones, forehead, nose and occasionally around the mouth.

The aftermath of inflammation

During the active phase of many inflammatory skin disorders – such as acne, eczema and lichen planus – inflammation in the skin may activate pigment production pathways. When the skin is healed, there may be an increase in pigmentation, called post-inflammatory hyperpigmentation (PIH).

Popping pills

Certain types of medication may lead to pigmentary disturbance. These include non-steroidal anti-inflammatories used for pain relief, the combined oral contraceptive pill, antihypertensive (blood pressure), antimalarial, antibiotic and anti-epileptic medications. Telltale signs that you may have drug-induced pigmentation include darkening of your nails and mucosa (lining of the mouth, etc.).

Should you treat pigmentation in summer? Yes!

Treatment of pigmentation has two arms:

One: use one or a combination of treatment agents that effectively decrease pigment production and,

Two: prevent further worsening of pigmentation from continued sun exposure.

The most important aspect of treating pigmentation over sun-exposed sites is to ensure that you protect vigilantly from the sun.

  • This includes avoiding peak-intensity sunlight hours between 10 am and 3pm outdoors.
  • When you’re outdoors, wear protective clothing in the form of sun hats, scarves and long sleeves,
  • Always remember to apply a broad-spectrum sunscreen with both UV, visible light and infrared radiation protection, such as Bioderma Photoderm range

 

What treatment should you use?

Here are your A, B, Cs for treatment of excess pigmentation in the summer months:

A

Always use sun-protection. A broad-spectrum sunscreen should be applied daily in appropriate quantities (a R5 coin amount for your face alone). Re-apply every couple of hours if you are spending time outdoors. Remember, no sunscreen lasts the entire day.

Always remove pigmentation-stimulating agents, such as exacerbating drugs. Speak to your doctor about changing medication, if possible.

B

Brightening agents

Dermatologists may use the following in-clinic treatments to reduce pigmentation:

Chemical peels containing alpha-hydroxy acids like glycolic acid. The strength of the peel will depend on what is clinically suitable for your skin type to minimise inflammation, especially in those with darker skin types. Peels should gently encourage exfoliation of the uppermost layer of the skin, lifting epidermal pigmentation and helping active brightening ingredients from skin care products to penetrate the skin.

Dermafrac is a newer treatment combining microdermabrasion, micro-needling, simultaneous deep tissue serum infusion, and light emitting diode (LED) therapy. In addition to stimulating skin rejuvenation, the procedure also helps with uneven skin tone and hyperpigmentation through delivery of select ingredients into the dermal layer to damp down pigment-producing pathways. This procedure is particularly recommended for those with darker skin types. where stimulation of inflammation through more aggressive treatments may actually worsen pre-existing pigmentary disturbances.

Laser therapy should only be carried out under the care of trained medical professionals. The selection of laser is dependent on the cause of the pigmentation, with careful consideration given to the skin type of the patient.

C

Care at home

In cases of chronic hyperpigmentation, a more intense acute phase of therapy is often followed by a tailored, safe long-term management programme. Treatment in the acute phase may include ingredients like hydroquinone that are prescribed for a short period under supervision of your dermatologist.

Due to side-effects with continued hydroquinone use, a switch to a non-hydroquinone- based ingredient or combination of ingredients is advised.

Skin brightening agents work on various different pigment activities:

  • they may block the formation of melanin,
  • inhibit the transfer of melanin from the melanocyte to other skin cells,
  • suppress melanocyte activity
  • limit inflammation and
  • enhance skin cell turnover

Caution!

Systemic skin-lightening agents have become increasingly popular in recent years. Fernbloc has proven safety and efficacy, but we strongly advise against using other agents such as intravenous glutathione because of severe side-effects, which include renal and liver impairment as well as documented life-threatening adverse drug reactions including Steven Johnson Syndrome.

My recommendations for home care treatment of pigmentation and sun protection

  1. Essential: Sunscreen with a broad- spectrum UVA and UVB cover, as well as cover for visible light. I recommend Bioderma’s Photoderm M  if you have been diagnosed with hormonal melasma as it effectively extends cover to this visible spectrum range. Sun protection is especially important if you have had in-clinic treatments and are using active ingredients such as hydroquinone, retinol, AHA, etc.
  1. Noreva Trio White depigmenting range  is a combination of reductol (a phytonutrient that protects keratinocytes), as well as vitamin C and arbutane that limit melanin production
  2. Esthederm’s Esthewhite range: a combination of murine exopolysaccharise that enhances skin cell turnover, glucosamine and glabridine that regulate melanin production, and vitamin C with added anti-oxidant benefit.
  3. Topical retinoid at night: For first-time retinoid (vitamin A) users, I start with Esthederm’s Intense Retinol Serum – a 0.3% retinol preparation combined with papyrus and apricot oils rich in omega 3, 6 and 9, which improve tolerance of the retinoid. As you develop tolerance, and should added strength be required, I upscale treatment to a prescription-grade retinoid.

Find out more about the Esthederm range here.

Here’s wishing you happy summer days,      

Lev

Dermatologist Dr Levashni Naidoo

 

XOXO

 

 

All new Mustela must-haves

There are a bunch of new kids on the Mustela block.

And they’re just what you’ve been looking for

Cradle cap woes?

Still struggling to get rid of cradle cap? Not for very much longer. Mustela’s legendary Stelaker’s had an upgrade. Now called Cradle Cap Cream, it contains Mustela’s avocado Perseose patent to help improve the appearance of your baby’s scalp, as well as borage oil to moisturise and keep the scalp smooth and clean. This product has high skin and eye tolerance, is hypoallergenic and fragrance-, paraben-, phthalate- and phenoxyethanol-free. Leave on overnight and rinse off in the morning with Foam Shampoo for Newborns and voila!

Mustela-Cradle-Cap-Very-Sensitive-Skin

Sensitive skin – surely all babies have sensitive skin?

Weeeell… yes, but no. All babies have an immature skin barrier at birth, but 1 in 3 babies are born with sensitive skin. This skin tends to over-react to stresses tolerated by other babies: temperature changes, wind, detergents, even rubbing of their clothing. It reddens easily, and babies may have feelings of tightness and tingling, which will probably make them cranky!

How you cleanse sensitive skin is important, as using harsh soaps and cleansers can cause more irritation. Your favourite Mustela No-Rinse Cleansing Water is now also available for Very Sensitive Skin: No-Rinse Soothing Cleansing Water contains patented avocado Perseose to protect the skin barrier, preserve the cellular richness of the skin and moisturise, as well as schizandra berry extract to soothe and improve the appearance and sensations of very sensitive skin. It cleans ultra-gently, soothes and strengthens face, body and nappy area – with no rinsing required.

Also for sensitive skin, Soothing Cleansing Gel has all the effective cleansing properties you’ve come to expect from Mustela, while soothing even the most fragile and immature skin. It contains 98% ingredients of natural origin, including avocado Perseose and Schizandra. Importantly, very mild surfactants of natural origin clean gently while respecting very sensitive skin.

 

Moms, we haven’t forgotten you!

The legendary Mustela Stretch Marks Prevention Cream now comes in a Fragrance-Free version, so women with even the most sensitive skin may use it. Formulated for expectant and new moms, this luxurious cream helps prevent stretch marks with its unique combination of active ingredients (most of natural origin).

Mustela-Stretch-Mark-Prevention-Cream

 

Snotty nose getting you down?

All little ones get snotty noses every now and then, and that’s almost guaranteed to disrupt everyone’s sleep!

Mustela’s new Soothing Chest Rub, while not a medication, contains refreshing pine scents to help your baby relax and promote sleep. On top of that it contains shea butter and honey to soften and moisturise the skin, as well as Mustela’s patented avocado Perseose to help reinforce your baby’s skin barrier. This lovely rub is perfectly safe to use from day 1, and can be gently massaged onto baby’s chest twice a day before sleep. Its melting texture makes it ideal for massage, leaving no sticky residue. Nighty night!

Mustela-Chest-Rub-Wet-Wipes

All wipes are the same – or are they?

Mustela has taken its popular Dermo-Soothing Wipes and improved the formula. Now simply called Cleansing Wipes, these delicately scented and ultra-soft wipes are perfect for baby and child’s face, hands, nappy area and body from birth on.

These gorgeously fluffy, alcohol-free wipes contain 97% ingredients of natural origin, including: avocado Perseose to help reinforce your baby’s skin barrier; plant-based glycerine to moisturise the skin and protect it from water evaporation; Saponaria Leaf extract to cleanse and Allantoin to soften. Use them at every nappy  change or keep them with you for on-the-go clean ups.

And did you know you can also use them to remove your make-up, moms? Mustela Cleansing Wipes won the Allure Best of Beauty awards last year – voted for by moms in the know.

 

We’ve saved the best (cutest!) for last…

For a very Limited Time Only, 3 of Mustela’s favourite products are available in oh-so-fun packaging!

Say Hello to the adorable Abigail the Whale Gentle Shampoo, Phillipe the Sheep HydraBebe Body Lotion and Vincent the Elephant Gentle Cleansing Gel – three bath time friends who have a very important message – to remind your little ones (and you!) that it’s important to protect the natural habitat of their animal friends. Great for making every bath time an opportunity to learn and play. You absolutely do NOT want to miss out on this one…

 

XOXO

Meet Dr. Levashni Naidoo

 

Our resident dermatologist, Dr. Levashni Naidoo is under the spotlight this month. We get her take on skin care and beauty…

 

Why did you become a dermatologist?

As a teenager, I had quite severe nodulocystic acne, which made me feel incredibly self-conscious. As the condition progressed, I became increasingly reserved. When I looked in the mirror I couldn’t see beyond the blemishes, and I thought this was what others I encountered focused on.

I was fortunate to have been treated by an incredibly gentle, understanding dermatologist who prescribed a course of medication that quietened down my acne activity and prevented me from developing any permanent scarring. I cannot describe how the improvement in my skin helped my self- esteem.

A diagnosis of a skin condition differs from diagnoses in other medical disciplines. It is often a diagnosis a person wears for the world to see. I’m sensitive to this – I understand it from my own experience.  One of my greatest blessings is being in a position to help others as I was once helped. I love seeing my patients return looking and feeling more comfortable in their skin. What I love most of all is hearing their stories – how the improvement in their condition helps return their self-confidence and how this filters into and helps improve other aspects of their lives, both personal and professional.

What are the most common skin issues you see in your practice?

Skin changes can occur at any time in a person’s life. As a dermatologist, care for our patients may start from their first day. I love treating little ones. Commonly, I see infants with cradle cap, heat rash or a nappy rash. Children usually have inflammatory skin conditions like atopic eczema or skin infections. Both teens and adults often come for consultation regarding their acne.

Given our sunny climate in South Africa, disturbances in pigmentation form a significant portion of my patients’ concerns. Increased pigmentation includes photoageing, melasma and drug-induced hyperpigmentation. Other sun-exacerbated disorders range from rosacea to the more concerning end of the spectrum including skin cancers.

I also see many patients with alopecia (hair loss). This is a condition I am particularly sensitive to as many of my family members have a history of early onset alopecia.

Le Beauty Club recommends:

For acne: Noreva Exfoliac (teen acne) and Actipur (adult acne and sensitive skin), Bioderma Sébium range. These comprehensive ranges have products to treat mild to moderately severe acne, including product that complements medical treatment

For cradle cap: Mustela Cradle Cap Cream + Mustela Foam Shampoo for Newborns 

First aid in a bottle (heat rash, insect bites, irritated folds): Bioderma Cicabio Crème (non-oozing wounds), Bioderma Cicabio Lotion (oozing wounds), Mustela Stelatria

Nappy rash prevention and repair: Mustela 123 Vitamin Barrier Cream

Atopic eczema: Bioderma Atoderm Intensive range, Noreva Xerodiane AP+ Relipidant Balm, Mustela Stelatopia range

 

 

Bioderma Sebium Foaming Gel, Noreva Xerodiane AP+ RElipidant, Noreva Actipur, Bioderma Cicabio Creme, Mustela Cradle Cap, Mustela 123 VBC

 

The best skin-care advice you’ve been given

Skin care is an important aspect of self-care, and self-care is an integral component of self-respect.

 

 The skin-care advice you give your family, friends and patients

Choose your skin care as you would your friends: quality over quantity, gentle rather than agitating, substance before packaging.

 

At what age should you start using a skin-care routine? 

It’s never too early and it’s never too late to start a good quality skin-care routine.

 

What should you use? 

Sunscreen, always sunscreen! This is a mantra many have openly and thankfully embraced. Sunscreen is just one side of the coin.

The flipside includes the use of antioxidants. Effective antioxidants for the skin include vitamin C, vitamin E and selenium. Antioxidant delivery to the skin is superior when applied on the skin as opposed to taking it orally. Antioxidants are essential ingredients that combat reactive oxidative species generated by environmental toxins like pollution, smoke and radiation. Additionally, vitamin C has added benefit of improving collagen synthesis and regulating melanin (pigment) production. Antioxidants are commonly prepared as serums. I prefer my antioxidant delivered in my moisturiser. I’m a firm believer in a minimal-step-easy- to-commit to skin-care routine.

Le Beauty Club recommends:

Our comprehensive selection of leading dermatologically created and EU-approved sunscreens for all skin concerns and all ages.

 

 

At what age should you start considering treatment against environmental damage?

We’re blessed with a beautiful sunny climate for most of the year in South Africa. A disregard for moderation in sun exposure can carry significant consequences, ranging from premature skin ageing to skin cancers.

Protection from excessive ultraviolet, visible and infrared light exposure should start from infancy – with appropriate protective clothing and keeping to shaded areas when you and your loved ones do have to be outdoors.

Sunscreen use in little ones used to be recommended from 6 months onwards. Currently the recommendation has been altered to allow for earlier use of sunscreens where protection may not be completely afforded by the use of protective clothing and where keeping in the shade is not possible.

Le Beauty Club recommends these child sunscreens: Mustela Very High Protection Sun Lotion SPF50+, Bioderma Photoderm Kid SPF 50+

 

Your skin is… a complete reflection of how you feel from day to day and the space you find yourself in. In embryology, we learn that the skin cells develop from the same space as the brain cells – the neuroectoderm – and so there exist these amazing channels between how we feel and the way our skin presents itself. This is an association that must be respected and appreciated when trying to care for the skin holistically. 

 

My make-up reflects how I feel or what I want to project. Most often I’m drawn to soft, neutral elegant shades, but there are days when I love the glamour of a powerful bright red lip.

 

XOXO

Skin Care Gets Serious: Our Top 5 for Late Winter

 

September may be here, but the chilly temperatures mean your skin needs extra care. Warm up your routine with some of our favourite picks.

Skin Care on Le Beauty Club

1. CC Cream news

CC creams are your skin’s favourite slashie: moisturiser/anti-ager/SPF/colour corrector all-in-one, making it a seamless base for your daily routine or your one-stop cream if you’re in a rush. Our top pick: We love Noreva’s new IKLEN+ CC Crème Anti-Ageing & Anti-Dark Spot Unifying Day Cream (phew!), which adds yet another string to its bow: it’s the first tinted CC cream specifically formulated for skin with pigmentation issues, evening out your skin tone, for an even better day 😉 Read more about its fabulous properties by clicking here.

 

2. Sunscreen

‘Whaaat? It’s winter, why do I need sunscreen’, you say. Well, it’s nearly spring, and sun protection is a must – throughout the year – especially where we live. And if your sunscreen has other skin benefits, you’ve got a real winner on your hands! Our choice is the Bioderma Photoderm MAX Aquafluide SPF 50+. It offers optimal protection against the harmful effects of UV rays, protects your skin cell DNA, and its light, non-greasy texture leaves skin moisturised with a velvety dry-touch finish (tinted, too, if you prefer). It’s great for barefaced weekends.

3. Day Treatment

As work ramps up for the final big push for the year, or maybe final exams are approaching like an express train, stress hormones can give our face unwelcome visitors. We need a product that will keep skin clear without drying it out or irritating it (especially for those of us who have adult acne). We recommend Noreva Actipur Anti-imperfections Day treatment – with one application a day, it restores your skin’s equilibrium and leaves it feeling moisturised, silky, with a matte finish.

 

4. Coming clean

After a long day, we like to double cleanse, while still leaving our skin comfortable and hydrated. First sweep: remove eye make-up and cleanse with our favourite micellar cleansing waters – Bioderma Sensibio or Hydrabio H2O. Step 2: Use Bioderma Sensibio Gel Moussant Mild Foaming Gel, which clears remaining residue, soothes and cleanses, leaving skin clean and comfortable and ready for your night prep. In the morning, just wipe the night away with your favourite H2O, and you’re set.

 

5. Baby boon

Any baby expert will tell you that the best way to give you and your baby a good night’s sleep is through baby’s bedtime bath ritual. The bonding time, warm water, massaging action plus the drop in body temperature after the bath all make for sleepy bubs. Mustela has you covered with Gentle Cleansing Gel for hair and body, and Baby Massage Oil.

XOXO

Skin Care on Le Beauty Club

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