Does your skin throw temper tantrums over just about anything? Sensitive skin can be a frustrating and confusing condition to deal with! This skin type will usually experience redness, tingling, tightness, heat and occasionally itching on a far too frequent basis. A genetic predisposition, impaired skin barrier or various other factors such as wind, cold, heat and diet may aggravate your sensitive skin.
Sensitive skin can have any level of sebaceous activity (Oil production). Whether normal, dry or oily, it is very noticeably delicate in look and feel.

This skin often suffers from chronic acne or rosacea and can present signs of:
Dehydration
Inflammation
Dilated capillaries and
Flushed cheeks
What is Rosacea?

Rosacea is a common, yet misunderstood, chronic, inflammatory skin condition. It mostly affects the face, and sometimes other areas of skin. Constant redness can be accompanied by acne and dilated blood vessels. It is thought to be caused by a variety of unproven theories including blood vessel abnormalities, genetics, large numbers of Demodex Mites (tiny mites) on the skin and bacteria found in the digestive system, just to name a few.

It can often be mistaken for adult acne.There is a type of rosacea called Papulopustular Rosacea with acne-like pimples and pustules. Problems may occur when harsh, over-the-counter acne treatments are used as these will likely worsen symptoms. A correct diagnosis is needed. Consider seeking the expert advice if you are unsure of what you are dealing with.

Rosacea is also more than skin deep.Many sufferers often report low self esteem and significant emotional stress and anxiety associated with the psychological impact of living with permanently angry, red and sometimes painful skin. This resulting stress can then often be a trigger that aggravates a rosacea skin further, leading to a difficult path of healing.

Factors that can trigger or irritate a Rosacea skin:
Wind
Hot and cold temperatures,
Exercise
Spicy foods
Alcohol
Hot drinks
Physical or psychological stress.

Rosacea can be successfully controlled. Due to rosacea being a chronic condition, treatment is therefore centred on management and prolonging the duration of remission and not on curing. Unfortunately you cannot completely cure this condition. Rosacea responds best to a holistic approach of treatment, considering that stress and diet are huge factors in both causing or eliminating outbreaks. Identifying triggers will help to address Rosacea at the root cause instead of just suppressing it through conventional treatments.

Tips for dealing with Rosacea:
Less is more. Have a simple skincare routine and avoid overloading your already stressed skin with too much to handle.
Be Gentle with your skin. Pat dry and avoid harsh and abrasive products.
Avoid the sun and ensure that you always wear a factor50 SPF.
Keep it on the cooler side and stray away from a steaming hot shower or bath.
When outdoors be cautious as any significant change in temperature aggravates rosacea. Protect your face from wind and cold.
Consider lowering your intake of dairy, sugar, gluten, coffee, alcohol, processed and fried foods and red meat as these may aggravate your skin. Before you panic! This doesn’t mean you can’t ever have a glass of red wine again, just be aware it may trigger some irritation.

Before you sign up to live in a bubble, take back control by investing in the correct skin care, avoiding the harsh elements and ensuring adequate sun protection on a daily basis.

Dr Wade’s Recommendation For Sensitive and Rosacea Skins:
Book an online consultation with one of our skin specialists, so they may analyse your skin and go through your skincare history in order to develop the most effective treatment plan going forward.
At home skin care products:
Exuviance Gentle Cleansing Creme
Heliocare 360 Mineral Tolerance Fluid SPF 50
Mesoestetic Couperend

Irregular pigmentation is the most common skin condition that we as skin care professionals see on a daily basis. The enormous range and variations we see in skin colour is due to the pigment called melanin.  Hyperpigmentation is the overproduction of Melanin. Every person has the same number of Melanocytes (cells that produce the pigment melanin), the difference is that some melanocytes are more active in some individuals than others. 

When identifying the cause of pigmentation generally all causes will be found in conjunction with UVR exposure coupled with one of the following; medication, hormonal influence, vitamin A and C deficiencies, a chemical substance as well as essential fatty acid deficiencies. 

The general rule of thumb when identifying hyperpigmentation:

• Hormonal pigmentation is generally found central-facial (top lip, cheekbones and forehead) e.g. Melasma.
• Sun Damage is found on the outer areas of the face towards the hairline.
• Irregular shaped pigmentations that are found in odd places are usually due to trauma and termed post inflammatory hyperpigmentation. 

Melasma And Its Triggers

Melasma is perhaps the most challenging pigmentary disorder to treat. It is often also referred to as Chloasma or the mask of pregnancy. While it can occur in both men and women it mostly affects women of child bearing age.

This pesky hyperpigmentary disorder is often brought about by pregnancy, the contraceptive pill as well as mild ovarian or thyroid dysfunction and some photosensitising medications. A genetic predisposition is also a common factor in the development of Melasma. Fitzpatrick skin types 3 and 4 (light brown skins) are more prone to the development of Melasma although lighter skins also have a high risk of development especially if it is evident in their family history.

Epidermal Melasma, meaning that it sits in the layers closer to the surface of the skin, is known to fade over time after women have given birth or gone off contraceptive medication. Chronic sun exposure can aggravate Melasma and cause it to extend deeper into the skin thus becoming dermal melasma which can be a very complicated condition to treat. 

Treatment of Melasma

When treating Melasma the most important step is determining the cause. Once the cause has been identified, we can then address the particular cause and have a more effective outcome with combined treatment of at home skincare products and in clinic treatment. Hormone induced Melasma is best treated when you are finished breastfeeding or have changed your contraception medication. Precaution needs to be taken when exposing your skin to heat as well as UVR as you can inadvertently worsen the melasma by triggering inflammation in the skin. Melasma can worsen during times of stress due to the stress hormone cortisol causing inflammation.Tackling the inflammation before the pigmentation therefore may be the best course of action for some individuals.

Key points to remember when treating melasma: 

• Identify the cause.
• Have a strict skincare routine that cuts out exposure to heat and sun.
  • Discipline with sun protection is the most important key factor.
• Persistence and patience is key to keep the pigmentation at bay. 
  • Treating melasma takes time and unfortunately there is not a once off fix. 

Dr Wade’s Recommendation for Treatment of Melasma: 

• Book for an online consultation with one of our skin specialists so they may analyse your skin and go through your skincare history in order to develop the most effective treatment plan going forward. 
• At home Skin Care Products: 
  • Mesoestetic Meso Protech SPF 130+
  • Mesoestetic Melan Tranex Kit 
  • Lamelle Ovelle D3 Supplements

Dryness occurs when your skin doesn’t have enough water or oil (sebum) and can affect anyone at any time. Ideally we need to strive for a healthy balance of oil and water in the skin. The purpose of the sebum is to maintain the suppleness of skin and hair as well as to protect the skin from damages caused by external factors and dehydration. If the skin becomes dehydrated, the enzymes in the skin do not function properly, leading to a sluggish cell turnover and a dull sallow appearance.

A dry skin and a dehydrated skin are two different conditions that often influence each other. A dry skin refers to a skin that lacks oil and a dehydrated skin refers to a skin that lacks water. To understand how the two are connected we need to have a look at the skin’s acid mantle.

What is the Acid Mantle (Skin Barrier) of the Skin?
The Acid Mantle of the skin is the skin’s first line of defence and is a fatty film made up of oil and water that covers the skin’s surface.
Your skin’s acid mantle is made up of the following:

Water
Lactic acid
Urocanic acid
Fatty acids/Ceramides
Pyrrolidine carboxylic acid
Eccrine glands which secrete amino acids

So these protective oils, waterproof skin and help keep the skin cells tight and flat, protecting you from the elements like wind, cold and water and also making it harder for bacteria and other microbes to infect your skin.

The layer of oil sits on top of the layer of water and prevents Transepidermal Water loss (TEWL) in turn preventing dehydration. The Acid Mantle has a pH of about 5.5 which generates an acidic environment. This barrier can be washed or scrubbed away and it can also be neutralized by alkaline soaps and body washes that raise the pH of your skin above 6. If you get that tight squeaky clean feeling after washing, you’ve probably just stripped away your acid mantle which increases your chances of skin damage and infection. Other factors such as medication, illness and chemical treatment can also impair the barrier. Therefore choosing the correct products is of utmost importance and can influence your skin’s entire response to treatment.

Signs that you have skin barrier dysfunction:
“I feel like my skin is dry yet I am experiencing acne breakouts.”
“After I cleanse my skin, I experience a tight squeaky clean feel.“
“Every product that I use tends to sting and irritate my skin causing it to always be inflamed. I am therefore very cautious when purchasing skincare products”
“My skin is excessively oily”.- Overproduction of oil can be the skin’s way of protecting itself.
“My skin is constantly dry and flaky and always looks irritated.”
How to Repair your Skin Barrier function:
We like to follow the KISS principle when treating dry skin and barrier dysfunction; “Keep it simple silly! ”

Limit your skin care routine to three products that aim to repair, hydrate and replenish the natural Ceramides of the skin.
Purchase cosmeceuticals that are backed by studies and avoid drug store bought skincare.
Avoid harsh and abrasive facial scrubs as well as soap on your skin.
Seek advice from a skincare professional if you are unsure.
Once your barrier is repaired – and trust me you will feel the difference – then look at adding additional products such as antioxidants and hydrating serums into your routine. Your skin will also now accept and react positively to any in office treatments.

Dr Wade’s Recommendation for Treatment of Dry Skin and Impaired Barrier Function:
If you suspect that you are experiencing barrier dysfunction, book an online consultation with one of our skin specialists, so they may analyse your skin and go through your skincare history in order to develop the most effective treatment plan going forward.
At home skin care products:
Lamelle Serra Cleansing Gel
Lamelle Serra Soothing/Restore Cream
Heliocare 360 Mineral Tolerance Fluid SPF 50