Justine Hextall is a noteworthy Consultant Dermatologist who has kindly indulged my endless questions about all things skincare. Read on and learn…
MF: Justine, your job as a Consultant Dermatologist must mean you see a wide range of skin problems. What is the most common misconception people have about their skin?
JH: Often people will cleanse with a harsh foaming wash/alcohol-based product and think that the tightness they feel after is a sign that their skin is clean but this is wrong – it means the skin has been stripped and is too alkaline, as skin is naturally acidic. This is one of the reasons I endorse Cetaphil, as their formulation is unique and has an acidic pH of 5.3 – many soaps made to clean the face are around 8, which is much more alkaline. If you alkalise your skin you will lose moisture very rapidly, and potentially damage the natural balance and barrier of the skin. You will then be open to irritants, inflammation and possibly infection, so the product you cleanse with is really very important.
MF: What is your advice to people who want to improve their skin in general?
JH: The well-known rules to not smoke, dehydrate or sun worship still hold true. A great deal of ageing is photoaging so the old joke that dermatologists always have brown backs from shielding their face/decolletage from the sun is certainly the case here. You do need some sun exposure, granted, but not on the face so, if you are in the sun, do try to shield your face and, obviously, wear a high SPF. This should help to stop pigmentation and blood vessels emerging.
MF: If the damage has already been done, as it were, can it be undone?
JH: The good news is that the quality of skin almost immediately improves in appearance once it’s being looking after so do use a gentle cleanser and a moisturiser daily. A chemical peel, with the right practitioner, can help and there are some products out there to help with pigmentation – I like Clinique Derma White Clinical Brightening Essence, but there really are plenty of other good ones on the market.
MF: A reader asked me to find out if there was a decent SPF which could be used daily long-term whilst travelling and would not clog skin if used with moisturiser. Can you recommend one?
JH: A nice moisturising sunblock can be used as a moisturiser – I like Australian brand Sunsense. If you use a sunscreen compatible with your skin you won’t necessarily need a moisturiser beforehand.
MF: What should we look for in a sunscreen?
JH: When looking for a sunblock you want good cover for UVA and UVB. There should be a star rating on the packaging to advice you how good the cover it. We tend to say UVA ‘A’ for ageing and UVB ‘B’ for burning. There are two types of block – chemical and physical. The physical blocks are thick, white creams and are hard to rub in, like zinc oxide, and those tend to be better for sensitive skins.
MF: Can you debunk some common skin myths? Firstly, is double cleansing a good move for skin?
JH: This very much depends on what you’re cleansing with. If you want to cleanse twice, then you must use something very gentle. Again, I would recommend Cetaphil for gentle, non-abrasive cleansing.
MF: Many brands market expensive creams claiming to entirely turn skin around. Is there such a thing as a wonder cream for skin?
JH: Any skincare is a case of what suits your skin, but in my opinion what you cleanse with and do prior to moisturising is more important than what you moisturise with. If you use a good cleanser you will require less moisturiser. Most people would do well to focus more on skincare, and less on just moisturising to counteract damage from overly-harsh cleansing agents. When looking for a moisturiser think less about big promises from companies and more about what you would like from a moisturiser. I like glycerin as an ingredient as it is a nice humectant and therefore draws moisture in and is inert. Anything with petroleum in it will sit on top of skin and stop moisture loss, so weight up what you would like to achieve. You must also think of this when buying lipbalms/creams.
MF: Is daily exfoliation good for the skin?
JH: Gentle daily exfoliation is fine, for example with a cleansing cloth, but should be avoided if you have broken vessels, as the mechanical act of exfoliation may make them worse. You don’t need to exfoliate daily to remove dirt and you won’t get a build up of dead skin cells every day, so if you do exfoliate daily ensure you aren’t overly vigorous.
MF: Will wearing make up make skin, and in particular acne or spots, worse?
JH: Any make up which isn’t too greasy won’t cause any skin problems. In fact, a foundation/tinted moisturiser is more likely to provide a barrier to skin, particularly in the city. In general, you will know if something is having an adverse affect on your skin – acne is made worse by tampering with the pH of skin, not through make up.
MF: How about make up at the gym if someone were to go straight from work?
JH: I can’t see that make up would cause any skin problems at the gym, even if you do run and sweat. If you find pores on the body becoming clogged, use an antimicrobial wash such as the Dermol range to reduce bugs on the skin and gentle cleanse. I always advise patients about the problems chlorine causes and would suggest washing directly after coming out the pool with an acidic wash, such a Cetaphil’s Restorative Body Wash. Another tip for gym users is for those who suffer from Keratosis Pilaris – bumpy and dry upper arms and thighs. If you go to a steam room you can reduce the appearance of these easily by rubbing the upper arms. Cetaphil’s Restoraderm Moisturiser will also help to settle these, as it contains an agent called fillagrin which is renowned for it’s anti-inflammatory properties. Both the Cetaphil moisturiser and wash contain Fillagrin – a lot of work is being done with it at the moment as it is felt to be important in the integrity of the skin barrier and its ability to retain moisturiser.
MF: Are regular facials important for the health of the skin?
JH: Professional steaming and the rubbing and treatment of the skin in facials is good for achieving a glow – the increased blood flow to the skin will also be beneficial for the overall health. Most effects are short term but I would say that facials in general are a good idea, especially if you suffer from whiteheads/blockages.
MF: When moisturising in the evening should a spot be avoided and are the ‘drying’ creams for spots beneficial?
JH: Try not to use too greasy a moisturiser if you have spots – I’d switch to a lotion. It is important to not make the assumption the ‘drying’ acne skin is correct – it can often be try and inflamed and in need of moisture. Topical agents, such as Epiduo, can be applied to spots to break down the blockage causing the spot to develop, while reducing inflammation. If you can control acne at the mild stage you can often avoid other treatments such as antibiotics so be vigilant during early stages.
MF: Finally, what is the benefit of cleansing in the morning?
JH: It varies from person to person – I wash my face in the morning after I’ve showered with a mild acidic wash to counteract the effects of alkaline shampoo and the hard water here on the South coast. I’ve noticed my skin is calmed and less dry from this so, as above, the thing to do is try to be aware of your skin’s needs and meet them as much as possible.