RED ALERT: How to beat your skin miseryMore people than ever suffer from rosacea, acne and eczema
One in ten Brits suffer form Rosacea12 per cent of women suffer from adult acneCelebrities such as Cameron Diaz and Katy Perry have to disguise their breakouts on the red carpet
21:00 GMT, 25 August 2012
More Britons than ever suffer from long-term skin conditions – the most common being acne, rosacea, eczema and seborrheic dermatitis, and sometimes all four at the same time.
While not life-threatening in themselves, the psychological damage can be underestimated. Last week, it was reported that Vicky Norfolk, 31, took her own life after developing rosacea – a vascular condition that causes facial flushing and spots.
Yet many doctors still view these as minor complaints, which can make getting suitable treatment a challenge. Acne, commonly associated with teenagers, is on the rise among adults – 12 per cent of women and three per cent of men over 25 have the condition.
Actress Cameron Diaz, 39, has learned how to best manage her outbreaks of adult acne, right
Celebrity sufferers include Hollywood actress Cameron Diaz, 39, Victoria Beckham, 38, and Katy Perry, 27, who skilfully disguise the outbreaks.
But in most cases, there are effective ways to manage if not cure symptoms. Here, Dr Nick Lowe, director of the Cranley Clinic for Dermatology in London, Dr Adam Friedmann, a consultant dermatologist at The Whittington Hospital, North London, and cosmetic dermatologist Dr Samantha Bunting, who runs a clinic on Harley Street, explain the best options available.
Acne occurs when glands in the skin produce too much of an oily substance called sebum.
This blocks hair follicles, encouraging bacteria to grow, leading to infection.
HOW IT WORKS: DermaSweep microdermabrasion scrubs the skin with a brush while sucking up dead skin cells.
A treatment, such as salicylic acid that helps to increase skin cell turnover, can be applied simultaneously, ensuring it penetrates deep into the dermis.
Suction and pressure of brushes should be adjusted according to individual needs and more force is applied with each treatment.
DRAWBACKS: Must be tailored to individual needs and is not suitable for those with very inflamed acne.
COST: 185 per session (four to six sessions needed), drnicklowe.com.
HOW IT WORKS: Gel or cream contains a form of Vitamin A called adapalene.
‘Adapalene reduces the growth of surface
skin cells that can block pores and helps unblock pores and sebaceous
glands,’ says Dr Lowe.
‘This reduces the formation of blackheads and spots.’
DRAWBACKS: Increases skin’s sensitivity to sunlight. Very drying, so moisturisers must be used.
COST: On NHS prescription; and on private prescription from 15.
ECZEMA OR ACNE
TREATMENT: Cetaphil Moisturizing Lotion.
HOW IT WORKS: ‘This contains very few ingredients, which means it’s less likely to cause a reaction than other moisturisers,’ says Dr Bunting.
‘Many people who suffer with acne think they do not need a moisturiser but often their skin is dehydrated and a non-pore-blocking one such as this is ideal.’
DRAWBACKS: May not be emollient enough for those with severe eczema.
COST: 7.85 (236ml), pharmacy2u.co.uk.
Cetaphil and Aveeno Bath Powder are both recommended treatments for Eczema
The chronic condition of atopic eczema causes the skin to become itchy, red, dry and cracked. The exact cause is unknown but it usually occurs in allergy sufferers.
Most develop the condition in childhood although in more than half of cases, it clears up by 11 years old, and in 65 per cent by 16.
Most sufferers are mildly affected but some have cracked, bleeding skin, prone to infection.
TREATMENT: Aveeno Bath Powder.
HOW IT WORKS: ‘It is really important to keep the skin moisturised in eczema patients and the main constituent of this cleanser is colloidal oatmeal, which helps maintain the skin’s natural barrier and pH levels,’ says Dr Lowe.
‘Oat proteins leave a protective barrier on the skin, which helps keep skin moisturised, too.’
DRAWBACKS: The smell of colloidal oatmeal can be offputting for some patients.
COST: 10x50g sachets, 10.25, chemistdirect.co.uk.
Sunlight Therapy is available on the NHS and helps boost Vitamin D levels
TREATMENT: Sunlight Therapy.
HOW IT WORKS: ‘This can be very helpful for those with severe eczema,’ says Dr Friedmann. A recent study suggests Vitamin D may play a role. Vitamin D is linked to the production of a peptide or skin protein called cathelicidin, a substance that protects skin from viruses, bacteria and fungi.
DRAWBACKS: Overexposure to sun can cause skin cancer.
COST: Available on NHS; from 1,398 for a six-week private course, clearskin.uk.com
ECZEMA OR DERMATITIS
TREATMENT: Eumovate cream.
HOW IT WORKS: ‘This contains clobetasone butyrate, a type of topical steroid,’ says Dr Bunting.
‘It helps to break the itch-scratch cycle and should be used with an emollient [moisturiser] to help calm the inflamed patches of skin.
I refer to this kind of cream as a “bad day” cream – you should use it only when really necessary and under medical supervision.’
DRAWBACKS: Only apply to the face if GP or dermatologist advises – because it thins the skin and may cause hypersensitivity.
COST: 15g, 6.39, boots.com.
A form of eczema, caused by an overgrowth or sensitivity to a yeast called malessizia, seborrheic dermatitis is a common condition.
It causes flaky, white scales and affects the head, particularly eyebrows, ears, scalp and chest.
Those who suffer with eczema during childhood are more likely to develop it.
HOW IT WORKS: ‘Also known as tacrolimus, this ointment is a topical immunomodulator that helps to suppress inflammation,’ says Dr Friedmann. ‘It behaves like a steroid but with none of the potential side effects such as thinning of the skin.’
DRAWBACKS: It can sting slightly. Use with a broad-spectrum sunscreen because it makes the skin more vulnerable to UV light.
COST: 26.50 on private prescription.
TREATMENT: Nizoral shampoo.
HOW IT WORKS: ‘This contains ketoconazole, which is anti-fungal,’ says Dr Friedmann.
‘For those who suffer with the condition on their face, I advise they let the suds drip from the scalp onto the affected areas on the face and leave for two minutes.’
DRAWBACKS: Can dry hair out so use with conditioner.
‘Do not be tempted to use coal tar shampoos as an alternative,’ says Dr Lowe, ‘as they contain carcinogenic chemicals which are banned in the United States.’
COST: 60ml, 4.39, chemistdirect.co.uk.
DERMATITIS OR ROSACEA
HOW IT WORKS:
‘The active ingredient in this is pimecrolimus, a type of medicine
known as a skin-selective inflammatory cytokine inhibitor,’ says Dr
‘Put simply, this means that it helps reduce inflammation.’
DRAWBACKS: Works by suppressing the immune system and there is a concern that long-term use may increase the risk of certain types of cancer.
Patients should avoid strong UV light as the medication can react, damaging the skin. Not to be used during pregnancy.
COST: On private prescription from 25.
Affects one in ten Britons, causing flushing and, in serious cases, facial swelling. It may begin as a tendency to flush but can develop into long-lasting redness and spots.
The exact cause is unknown but triggers may include genetics, blood-vessel abnormalities, bacteria and a mite that usually lives harmlessly on the skin.
TREATMENT: Rozex Cream.
HOW IT WORKS: ‘This contains the active ingredient metronidazole, which is an antibiotic,’ says Dr Friedmann.
DRAWBACKS: Not yet tested on pregnant women so those planning pregnancy should avoid it. The only topical treatment known to be safe during pregnancy is erythromycin gel.
COST: On NHS prescription; from 5.90 on private prescription.
TREATMENT: Intense Pulsed Light (IPL).
HOW IT WORKS: Red-thread veins soak up light energy from IPL, encouraging the body to reabsorb veins thus eliminating them. IPL also stimulates new collagen and strengthens small blood vessels.
DRAWBACKS: ‘This is useful for those with broken capillaries but it must be administered by a qualified physician,’ says Dr Bunting. ‘Too high a burst of energy can cause permanent skin discolouration.’
COST: From 190 a session (five sessions needed), the-dermatology-centre.co.uk.
Intense Pulsed Light, or IPL, is used to treat Rosacea as well as Roaccutane, available on prescription
ROSACEA OR ACNE
HOW IT WORKS: ‘This drug contains isotretoinin, a form of Vitamin A, and was originally developed for acne but it can be used in low doses for rosacea, too,’ says Dr Friedmann.
‘There is a lot of scaremongering surrounding Roaccutane but under a dermatologist’s supervision you should have no problems, although it is usual to experience some form of eczema when you use it.’
DRAWBACKS: A last resort for sufferers and it must be used under strict medical guidance. Skin becomes extremely dry and side effects include depression and temporary hair loss.
COST: On NHS and private prescription from 25.50.
WHY YOUR GP SHOULD ALWAYS BE YOUR FIRST PORT OF CALL
by Dr Ellie Cannon
a GP, I take the skin conditions covered here very seriously. I have
seen first-hand the devastating effects even a moderately severe skin
condition can have on a person’s self-esteem and mental health: having a
visible long-term health problem is a huge emotional burden.
skin can influence every aspect of a person’s life – from what clothes
to wear to life-changing decisions related to relationships and
But the impact of
skin problems is becoming increasingly recognised by the NHS: London’s
Royal Free Hospital’s psoriasis team now includes a psychologist as well
as dermatologists. This holistic approach represents a shift in
understanding of the often distressing condition.
suffering with skin troubles should see their GP first. Many of the
treatments mentioned can be prescribed by a GP. Counselling or
psychology may also be provided through the practice.