Skincare, Anti-aging, Eye Cream, Anti Wrinkle Creams, Acne Creams.

What is Acne?

Acne is a skin condition where spots develop on the face, back or chest and sometimes all three. Spots develop because too much sebum is being produced by the sebaceous glands and the excess oil binds with dead skin cells to form a plug that blocks the pores. During adolescence the hormone testosterone levels rise in both males and females and it often causes excess sebum to be produced. We all have bacteria living on the surface of the skin, but if a pore is blocked the bacteria can then infect the blocked pore and cause a spot.

Acne affects nearly all teenagers to some extent, whether it's a few blocked pores or full on pimples, spots or cysts, and although it you won't die from it, it's one of the most distressing and upsetting conditions and it is not always age related - even people into their forties can be affected. Acne is often worse during times of stress. Females can be affected by the menstrual cycle and acne can appear during pregnancy or the menopause. There's no evidence that acne is caused by what you eat, but a balanced diet will help your body to work efficiently. It is not caused by being dirty and if you rub and scrub your skin it will only make it sore! Be gentle, no harsh cleansers please.

Acne can affect the face, neck, chest and back, and can sometimes cause severe, often permanent scarring. It should be treated as early as possible to prevent this. We have found that following the skincare routine we recommend for you is often enough to control acne and prevent scarring, but sometimes a combination of medication and/or skin peels is required. Many female patients benefit from medication that decreases the effects of male hormones including birth control pills that contain estrogen.

The most important thing to do with acne skin is to control and stop outbreaks, then once the outbreaks are under control, we can deal with any scarring or hyper pigmentation that you may have been left with. There are many treatments for acne and what works for one person may not work for another - rest assured that we always find a way to help and will find a treatment that works for you! Don't forget that treatment will not work overnight and there's no such thing as a quick fix for acne - the treatment is on going and you will need to keep your skin under control. Try to think of it as you would a haircut or colour, one cut will not stop your hair growing ever again and if you colour your hair you will need to keep doing the roots or maintaining the colour. In the same way your skin will keep replacing itself, and you may still get outbreaks, but by using the recommended skincare or combined treatments it's possible to keep even the most severe cases of acne of under control and make a dramatic difference to the appearance of your skin.

Make-up and other products

Often girls with acne are told not to wear make-up as it will clog their pores and make the spots worse. Of course, if you are a female with spots the first thing you will want to do is wear make-up to cover them! And why not? I for one would never leave the house without a full face on! Well, the truth is you can wear make-up, but choose the type you use with care. You need oil-free or non-comedogenic make-up, this means it will not block your pores - there is no point in buying products to clear your skin and then piling on make-up (or other products) that will block the pores, reverse your good work and waste hard earned cash (yours or your parents!). Mineral make-up is the answer because unlike conventional make-up, mineral make-up is actually good for the skin and contains only pure, natural ingredients with anti-inflammatory and anti-microbial properties and thanks to the large molecules of the minerals, mineral make-up stays on the surface of the skin and is not absorbed. Because the mineral make-up stays on the skin's surface it acts as a barrier and actually protects from pollution and environmental damage, providing a natural physical SPF 20 too. Furthermore, mineral make-up is inert, so doesn't harbour bacteria, making it the ideal solution if you suffer with spots - providing excellent coverage that won't make the problem worse. Be sure to buy a high quality brand of mineral make-up that is talc free. Some brands of mineral make-up contain talc which blocks the pores and will exacerbate the problem. We have developed our own brand of Harley Street Skin mineral make-up that contains only 100% natural minerals.

Remember too that when using hair products it's important to protect your face so that the product does not get on your skin - this includes hair gels, styling products and spay. Likewise with perfume on your neck and chest - spray your arms, wrists, legs or even cloths....

We provide on-going support during and after treatment - there is always someone to talk to, and if you don't live close to our clinic you can talk to us on Skype - it's free too!

Acne

Acne is a result of three factors; excessive production of an oil called sebum - this blocks the pores and causes an over-growth of bacteria trapped in the blocked pores. This leads to pimples and spots and sometimes cysts. The medical name is Acne vulgaris and blackheads, whiteheads, papules and pustules and cysts are all considered to be acne, so there's not many of us that, at one time or another, haven't been affected by acne in some form.

Accutane

Is the name of oral acne treatment derived from Isotretinoin. It decreases the size and activity of the sebaceous glands in the skin, which reduces the amount of sebum that is produced. This stops the glands becoming blocked, and means bacteria are less likely to thrive. It also reduces the inflammation in the skin.

Acne Triggers

Genetics, hormones, stress, menstruation, intense exercise, IVF and certain steroid containing medications. Heredity/genetics

AHA's

Short for Alpha-hydroxy acids - these are derived from foods including sugar cane, milk, apples, citrus fruits and grapes. AHA's loosen the glue-like substance that holds onto the top layer of dead skin and allows them to slough off easily. AHA products cause exfoliation, or the shedding of dead skin cells. If you shed dead skin cells the pores will not become blocked and oil cannot become so easily trapped in the skin, meaning you have less chance of spots. It's important to use high SPF creams every time you go out, because sun sensitivity increases after using AHA's.

Anaerobic

Technical word which literally means without air.

Androgens

Hormones that are present in males and females, although in higher levels in males. They stimulate sebaceous gland oil production and increase during puberty as part of the natural maturing process. That's why acne becomes more of a problem in adolescence. Anything that increases androgens in the body will cause a breakout of spots, including Polycystic Ovary Syndrome, stress and high intensity body building. This is termed secondary acne.

Anti-androgens

Medication to decrease the effects of male hormones.

Antibiotics

Antibiotics reduce bacteria and also fatty acids in sebum; this then reduces the inflammatory response in the skin.

Anti-microbial

A substance that is anti-microbial kills or inhibits the growth of bacteria.

Anti-inflammatory

A substance that is anti-inflammatory is used to reduce redness.

Azelaic acid

Works by getting rid of dead skin and killing bacteria

Bacteria

Bacteria are small micro organisms that are that usually live in the pores of the skin, they are anaerobic, they are not a problem until the pores become blocked and then the bacteria multiply because they only live where oxygen is not present.

Benzoyl peroxide

Works as an anti-micro bacterial to reduce and kill bacteria. Bacteria living at the bottom of a follicle cannot live with oxygen - Benzoyl peroxide provides oxygen to the follicle and the bacteria cannot multiply as they only live in un oxygenated environment. Also helps prevent dead skin blocking follicles and improves skin turn over.

BHA

Beta-hydroxy acid is oil soluble so is able to penetrate into a follicle filled with sebum and exfoliate the dead cells that have built up, excellent for blackhead and whitehead removal.

Blackhead A pore that is filled with dead skin cells and excess oil, that is not red or inflamed, the pore remains open and the debris oxidises and becomes black, hence the name. Sometimes called open comedones.

Box car scars

Angular scars that are usually on the temple and cheeks, they can be superficial or deep, they look a bit like chicken pox scars.

Chemical peels

A chemical peel simply removes a layer of skin from the face by a chemical reaction to reveal a newer, healthier layer. The chemical solution is applied which causes mild trauma to the epidermis of the skin, thus causing the outer layers to peel away. When the skin begins to heal, increased cell growth produces new, healthier skin layers. There are lots of different chemical peels available, such as glycolic, salicylic, lactic and TCA.

Co2 Laser Peels

Co2 laser resurfacing is performed using a beam of laser energy which vaporises the upper layers of damaged skin, it also puts heat energy into the deeper skin which reduces the bacteria and encourages repair. Be careful if you have olive or dark skin as you may risk hyper-pigmentation. Do not have Co2 laser treatment if you have used Isotretinoin or Roaccutane within the previous 6 months. If you suffer with cold sores take antiviral medication during the post-operative period to guard against an outbreak.

Comedone

A blocked pore or follicle can be a blackhead or whitehead.

Contraceptive pills

Contraceptive pills containing oestrogen can help acne.

Closed comedone

Commonly known as a whitehead. It is not inflamed, has a white centre and the top is covered with dead skin cells.

Comedogenic

A substance that will block pores and cause comedones - blackheads/whiteheads.

Cysts

These are the most serious type of spot caused by acne. They can be large, painful and inflamed pus-filled lumps that look similar to boils. Cysts give the greatest risk of causing permanent scarring.

Dermal Fillers

Dermal fillers are made of synthetic or natural substances and are injection into the dermis to fill out lines, wrinkles or indentations under the skin. For acne scars the filler can be injected into the scar to fill the indentation and raise the surface of the skin making it look much smoother. It is not a permanent treatment. Your own fat could be used too, which has a similar effect but is also not permanent.

Dermatologist

A doctor who specialises in skin concerns and conditions.

Dermabrasion

The top layer of facial skin is 'sanded' off using a hand-held electrical machine with a small abrading head, or a specialised laser device. When the new skin grows back it is usually smoother and fresher than before, and imperfections are reduced. It can be particularly useful for treating raised areas of skin or scarring, which can be levelled out.

Epidermis

A layer of the skin that contains of cells called keratinocytes.

Epithelial stem cells

The epidermis of the skin contains layers of cells called keratinocytes. Only the basal layer, next to the dermis, contains cells that divide. A number of these cells are stem cells, but the majority are transit amplifying cells. The keratinocytes slowly move outward through the epidermis as they mature, and they eventually die and are sloughed off at the surface of the skin.

Erbium Yag

A laser energy that vaporises the skin tissue and heats up the skin's deepest layers. This process breaks down dead skin cells and encourages collagen production so the skin becomes firmer and smoother.

Estrogen is a hormone that comprises a group of compounds, including estrone, estradiol and estriol. It is the main sex hormone in women and is essential to the menstrual cycle. Although estrogen exists in men as well as women, it is found in higher amounts in women, especially those capable of reproducing.

Follicle

A small shaft through which hair grows and sebum is secreted to the surface of the skin.

Fraxel Re:Pair

A laser treatment for scars that uses points of light to precisely treat thousands of microscopic areas of your skin. The treatment penetrates deep into the skin to remove old, damaged skin cells, stimulating your body's own natural healing process and replacing the cells with fresh, glowing, smoother, healthy skin.

Genetics

Genes are responsible for how you look and how your cells behave, this includes, hair, eye colour, height and the way your skin behaves. Some people have a genetic predisposition to acne.

Glycolic acid

An AHA derived from sugar cane. It's the AHA with the smallest molecular size and as such has the greatest ability to penetrate the skin most easily and dissolve the glue-like substance that holds dead skin on the skins surface, dislodge dead skin cells and old sebum from blocked pores. Glycolic acid will clear blackheads and spots quite rapidly. It's important to use high SPF creams every time you go out, because sun sensitivity increases after using AHA's.

Glycolic Peel (Mild Peel)

Glycolic peels come in a variety of strengths from an at home 5% peel to a salon strength of 20 or 40% up to a medical strength of 70 - 90% that should only be performed by a doctor or nurse. You may feel a slight stinging or warming sensation during the procedure but any significant pain is unlikely and no anaesthetic is needed for a mild peel. Most people need a course of 6 for best results. It's important to use high SPF creams every time you go out, because sun sensitivity increases after glycolic peels.

Hair follicle

The small opening in the surface of your skin that each individual hair grows out of.

Hormones

A hormone is a chemical naturally produced by the body that sends messages out to other cells instructing them how they should work. Certain hormones are responsible for the transition from adolescence to adulthood and often cause acne.

Ice pick scars

Deep pits that are the most common and a classic sign of acne scarring.

Isotretinoin

A form of vitamin A taken orally, sometimes known as Roaccutane or Accutane. Isotretinoin decreases the size and activity of the sebaceous glands in the skin, which reduces the amount of sebum that is produced. This stops the glands becoming blocked, and means bacteria are less likely to thrive. It also reduces the inflammation in the skin.

Side effects can be serious and include dryness and cracking of the skin and lips, muscle pain, headaches, depression, suicidal thoughts and birth defects.

Inflammation

This is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.

Keratinocyte cells

Skin cells in the epidermis.

Laser or Light treatments

Laser resurfacing works by vaporising the top layer of skin and delivering heat energy into the deeper layers to promote collagen production and thicken and smooth the skin.

Lesion

The medical term for any damaged or abnormal skin, this could be a spot, mole or cyst.

Microdermabrasion

Different methods include mechanical abrasion from jets of zinc oxide or aluminum oxide crystals, fine organic particles, salt or a roughened surface. Particles are removed with a wand/handpiece through which the abrasive particles come.

Nodules

In acne a nodules are large hard lumps that can be seen and felt under the surface of the skin and are usually painful.

Non Comedogenic

Meaning a substance that will not block pores.

Oestrogen

The primary female sex hormone, responsible for fertility and female cellular health - that means skin, hair and bones. It's also involved with female characteristics and female sexual development.

Open pores

These are actually blocked pores full of sebum and dead skin.

Oral Antibiotics

Oral antibiotics are often used alongside a topically applied skincare. The most commonly used oral antibiotics for acne are tetracycline, doxycycline, minocycline, erythromycin, trimethoprim-sulfamethoxazole, trimethoprim, and azithromycin.. If you are pregnant or breastfeeding you will probably be advised to take an antibiotic called erythromycin as it is known to be safer to use during pregnancy and breastfeeding.

Papules

Small red bumps that can be tender or sore.

Pustules

These are very similar to papules but they have a white centre that is caused by a build-up of pus.

ReCell

An advanced new skin treatment that uses the patients own cells in a regenerating process to accelerate healing, minimise scarring, and reintroduce pigment to the skin. A small sample of skin (biopsy) is taken from an area close to the skin being treated to ensure the texture and colour are the same.

The sample cells will then be separated to produce a "Spray Solution" that contains all of the skin cells necessary to promote healthy skin growth, including keratinocyte cells that form the basis of healthy skin and melanocyte that produce skin colour (melanin). The cells are processed while the doctor prepares the area to be treated and are then sprayed onto the skin. Once applied, the cells then multiply and spread throughout the skin, resulting in increased healing and restoring normal skin colour to old scars or areas of hyper-pigmentation.

Resorcinol

Used to treat acne, by removing dead skin cells, but also eczema and psoriasis among other skin conditions. It is usually combined with other acne medications, usually sulfur, and rarely stands alone, it is antiseptic.

Retinoids

Retinoids come in creams, lotions or gels. When applied topically to the skin, they help by reducing sebum production and also prevent follicles becoming blocked with dead skin cells. Retinoids are derived from Vitamin A.

Roaccutane or Isotretinoin (systemic treatments)

Isotretinoin decreases the size and activity of the sebaceous glands in the skin, which reduces the amount of sebum produced. This stops the glands becoming blocked, and means bacteria are less likely to thrive. It also reduces inflammation in the skin.

Isotretinoin can have serious side effects and it's use must be supervised by a dermatologist. It is reserved for the treatment of severe acne (such as acne at risk of permanent scarring) that has not improved with standard treatment involving oral antibiotics and topical medicines. It can cause serious birth defects among other side effects such as depression, nosebleeds, muscle pain and very dry skin.

Salicylic Acid

Salicylic acid, an AHA, is derived from willow tree bark. It is anti-inflammatory and is similar to the substance that aspirin is made from. It can be very drying and may make you a little flakey. Salicylic acid is a highly effective skin exfoliator and is often used in acne products and in a stronger version as a skin peel. Salicylic Peels are usually at a strength of 20% or 30% and regular peels with salicylic acid will remove blackheads and whiteheads, diminish fine lines and wrinkles and improve acne, resulting in smoother and more even toned skin by allowing dead skin cells to be detached from the skin's surface. The main benefit of salicylic acid is that as it has similar properties to aspirin, it helps prevent any post-treatment irritation or inflammation and helps prevent excess oil making it highly effective in the treatment of acne skin. If used as part of an acne skincare treatment routine most people can achieve the same results in eight weeks - compared with approximately six months if you were just using active skincare. For a noticeable result most people need 6 - 10 sessions. Your skin may be shiny and red for a few hours after treatment. Flaking and itchiness are also possible in the first few days. It's important to use high SPF creams every time you go out, because sun sensitivity increases after salicylic peels.

Sebaceous glands

These are tiny glands just under the surface of your skin that secrete sebum, an oil that stops the skin from drying out, they are attached to hair follicles.

Scars

A scar is excessive fibrous tissue. In active acne, there is excessive formation of fibrous tissue because of chronic inflammation.

Subsission

This is when a scar is cut at its deeper point to release the tethering of the skin.

Sculptra

A treatment that can be used to fill out deep scarring, it encourages normal collagen production, you may need four treatments.

Spot injections

You can have a Cortisone based injection to help clear a large, painful spot or cyst that should shrink it within 48 hours. A great rescue plan if you have an important occasion coming up!

Sulphur

Sometimes called the healing mineral because of its ability to promote circulation and decrease inflammation, it also helps shed dead skin cells.

Systemic treatments

A treatment that works within the body.

Testosterone

It is the principal male sex hormone it plays a key role in the development of male and female sexual maturation. It is also essential for health and and acts as the prevention of osteoporosis. In women it increases during the growth spurt of adolescence, although it doesn't reach the same levels as in men, it can still stimulate the acne process.

Trapped Sebum

Sebum trapped just under the skins surface, often seen around the corners of your nose or on the middle face, usually it results in blackheads and whiteheads too. If the sebum is trapped a little deeper in the skin you may get some pimples. And sebum trapped deeper still will result in a puss filled pimple that's called a pustule, very deep trapped oil will present itself as a painful, very inflamed cyst, it will be very raised, not have a head and feel like a small nodule. This is the most severe form of acne.

TCA Peel (Medium Peel)

TCA stands for Trichloroacetic Acid, which is derived from the acid that gives vinegar its pungent smell and taste. It is a medium to deep peeling agent that is normally used in 10 to 35% concentrations. This can be a painful peel where the skin blanches (frosts and turns white), but works well for specific skin conditions. A topical anaesthetic or pain relief will be administered to help you stay comfortable during the treatment. The peel works by causing trauma to the skin's layers and the top layer of the epidermis may be removed, where stronger solutions are used the treatment may extend deeper into the dermis. The damaged layers of skin will peel away and the healing process encourages increased cell growth as well as collagen production and reorganisation in the dermis that produces new, healthier skin layers, giving the face a more youthful, rejuvenated appearance. Good for removing acne scars, uneven pigmentation, treating fine lines and wrinkles and on some occasions, TCA peels have been used to remove and prevent the growth of pre-cancerous lesions. However, this treatment is not recommended for dark, fine or sensitive skin. Acne scars and uneven pigmentation will be visibly reduced after a course of treatment. You may need one to three treatments, a month apart. Allow up to a week to recover. A protective layer of petroleum jelly may be applied following the procedure to keep the area moist and protected. You will most likely notice the outer layers of skin peeling away within a few days of treatment and new skin will begin to appear in one to two weeks. As the skin will be more sensitive to sun exposure it is extremely important to protect the skin with SPF30 in daylight hours after the treatment.

Topical Treatments

These are treatments applied directly to the skin and include Benzoyl peroxide, antibiotics such as Zineryt, retinoids such as Retin A, Retinova, and AHA's such as glycolic and salicylic acids. These may be gels, lotions or creams.

Topical Antibiotics

They help kill the bacteria on the skin and come in either a lotion or gel form.

Treatment Medication

Oral antibiotics can help reduce bacteria and help control moderate to severe acne, acne that resists topical treatment therapy and acne that covers large body surface areas. Oral antibiotics that may be prescribed to treat acne include tetracycline, doxycycline, minocycline, erythromycin, trimethoprim-sulfamethoxazole, trimethoprim, and azithromycin. Females are often prescribed birth control pills that contain oestrogen or other medication that can reduce the effects of male hormones.

Treatments for Scarring

There are various treatments that can greatly improve acne scarring, these include; laser resurfacing,

Roaccutane or Isotretinoin (systemic treatments)

Isotretinoin can have serious side effects and its use must be supervised by a dermatologist. It is reserved for the treatment of severe acne (such as acne at risk of permanent scarring) that has not improved with standard treatment involving oral antibiotics and topical medicines. It can cause serious birth defects among other side effects such as depression, nosebleeds and very dry skin.

Co2 laser, Erbium Yag, chemical peels, AHA's dermal fillers, Sculptra and steroid injections. Individual skin types react differently to treatments so it may be necessary to try combination and individual treatment protocol to find the most effective treatment for you - what works for one may not be so effective for another.

Tretinoin

This is the acid form of vitamin A, a retinoic acid, also known as all-trans retinoic acid or ATRA. It is very often used to treat acne. It is available as a cream or gel brand names Aberel, Airol, Renova, Atralin, Retin-A, Avita, or Stieva-A

Types of spots

Blackheads, whiteheads, papules, pustules, nodules, and cysts.