A skincare regime is just as important in the bleak midwinter: How to save face in colder temperatures



22:30 GMT, 29 December 2012

The sky is constantly grey, the rain never ends, and much of our time is spent avoiding being out of doors. So unsurprisingly at this time of year, the last thing most people think about is sun protection.

But as an NHS plastic surgeon specialising in facial reconstruction after skin cancer, I spend a lot of my time advising patients, and friends, on skincare regimes, including wearing an SPF on their face, even in the bleak midwinter.

Not a week goes by in which I don’t see a patient who is suffering at the hands of poor skincare, most notably as a result of overexposure to sunlight.

No rest for the wicked: Your skin needs care - even during the winter months

No rest for the wicked: Your skin needs care – even during the winter months

At best this will result in premature ageing and wrinkles – the main reason women and men come to me requesting non-surgical rejuvenation such as Botox and fillers or even facelifts. At worst, the result is skin cancer.

There are three main reasons why our skin ages. Genetic inheritance – our parents’ skin – plays a large role. Then there is sun exposure and smoking.

It is impossible to overemphasise the importance of sun protection, in terms of skin appearance and health.

Despite heightened awareness, rates of skin cancer continue to rise. These patients range in age from their mid-30s to their 90s.

Surgery varies from a small excision with two or three stitches, to reconstructing noses, whole cheeks, eyelids and lips – often over several operations.

Protection: Antioxidants in Vitamin C protects the skin from UV light

Protection: Antioxidants in Vitamin C protects the skin from UV light

The patients I see are not all sun-worshippers. The majority would say they were not. Different individuals can tolerate different amounts of sunlight depending on their skin type, so the amount of sunlight that will damage an individual’s skin is relative.

UV light triggers the production of unstable molecules called free radicals in skin cells that, over time, damage the skin’s connective tissues, inhibit the production of collagen and alter the skin’s DNA.

This is what causes the skin quality to decline, leading to wrinkles. DNA mutations caused by UV are also believed to trigger cancer.

And don’t think winter is a chance to let your regime slip. Light might be weaker, but UV is still present.

Cleansing should aim to slough off the uppermost layer of dead skin cells to expose fresher, more plumped skin as well as stimulate circulation, which ensures a healthy skin-cell turnover, in the epidermis. A facial wash with glycolic acid will do this. While some of us suffer with severely dry skin, others produce more than adequate levels of oil to keep the skin supple and comfortable. Put simply, a moisturiser temporarily changes the water and oil content of skin. If you don’t suffer with tight, flaky or uncomfortable skin, you may not need additional moisturiser.

Wearing one unnecessarily won’t cause long-term damage but it may make your skin feel sensitive, clog your pores and cause a breakout.

Use a broad-spectrum, high-SPF sunscreen – between factor 30 and 50 with a four- or five-star UVB rating – and apply a strong topical antioxidant.

The sun block will protect from the sun’s UV rays but antioxidants – Vitamin C is used most commonly – will soak up the free radicals produced by UV exposure that eventually disrupt the internal workings of a skin cell.

Cream on: Applying sunscreen is key to healthy skin all year around and the sun does not completely go away during winter so do not forget your SPF

Cream on: Applying sunscreen is key to healthy skin all year around and the sun does not completely go away during winter so do not forget your SPF

Using Vitamin C does not mean rubbing an orange on your face, however. You need a stable formulation that uses the L-ascorbic acid form of Vitamin C in high enough concentrations and of a pH that will penetrate the skin, such as those produced by Skinceuticals or Environ.

The benefits of effects of Vitamin C on the skin have been widely reported, with studies such as the one at Tulane School of Medicine, New Orleans, demonstrating that topical Vitamin C was useful in preventing ageing and deterioration of the skin. The one downside of UV protection is that your skin will not be exposed to high enough levels of UV light to produce its own Vitamin D.

I would advise taking a supplement of 400iu per day, which will help maintain healthy bones and teeth as well as your immune system.

It can be tempting to try at-home anti-ageing kits, such as dermarollers and acid peels, which are readily available online.

Almost all anti-ageing treatments aim to boost the skin’s natural collagen production – or, put bluntly, to cause scarring – to gain taut skin and require the hands of a qualified practitioner.

Dermarollers obtained over the internet often have shorter needles than those needed to stimulate real collagen production, and only someone trained in using them can guarantee equal pressure being administered across the entire region.

If you do want to go for an anti-ageing cosmetic procedure, it is far more effective to have treatments little and often rather than try to save time and money with a one-off or less regular treatment.

While Botox is not permanent, too large a dose can lead to a paralysed facial expression, making it obvious to everyone that you have had treatment (precisely the opposite of what most people want).

Similarly, small doses of non-permanent fillers are far less risky than permanent.

I’m certainly not looking to do myself out of a surgical job, but there’s been a change in medicine from treatment to protection.

Skincare lends itself to prevention beautifully, which will hopefully delay the need for the surgeon’s knife, for medical reasons or otherwise.