raconteur.net
INDEPENDENT PUBLICATION BY
#0374
11 / 05 / 2016
SKINCARE
& DERMATOLOGY
03
£1BN UK SKINCARE MARKET
IS A HEALTHY BUSINESS
06
Flawless, even-toned skin is the latest must-have status symbol
CLAMPING DOWN ON
COSMETIC COWBOYS
Moves are underway to regulate
the non-surgical cosmetic industry
YUMMY MUMMY?
ABSOLUTELY.
HANNAH, 35 #THISISME
Date of preparation: October 2014. UK/1055/2014b
08
ENJOY THE SUNSHINE
BUT STAY HEALTHY
Balance your vitamin D intake
this summer and use sunscreen
12
GENE SECRETS TO
CARE FOR YOUR SKIN
DNA-testing is being used for
bespoke skincare treatments
Smile at what you see in the mirror and feel great about where you are in life.
Facial fillers are the choice for millions of women who want to take action.
Ease away fine lines and wrinkles and restore fullness for fresh, revitalised
and natural-looking results.
To find out if facial fillers are right for you, read Hannah’s story or book yourself
in for a chat at an open evening: this-is-me.com
RACONTEUR
raconteur.net
11 / 05 / 2016
SKINCARE & DERMATOLOGY
03
SKINCARE
& DERMATOLOGY
DISTRIBUTED IN
ASSOCIATION PARTNER
£1bn skincare market
is a healthy business
RACONTEUR
PUBLISHING MANAGER
Rosie Baker-Williams
PRODUCTION EDITOR
Benjamin Chiou
MANAGING EDITOR
Peter Archer
HEAD OF PRODUCTION
Natalia Rosek
DIGITAL CONTENT MANAGER
Sarah Allidina
DESIGN
Samuele Motta
Grant Chapman
Kellie Jerrard
Forget must-have Birkin bags or stylish
Saint Laurent sneakers, flawless, even-toned skin
is the latest status symbol
CONTRIBUTORS
ROSIE GREEN
Award-winning journalist,
she is beauty editor at
large of Red magazine,
and was beauty director
at both Red and Elle.
LEAH HARDY
Health and beauty
writer, she is a regular
contributor to The Times,
Daily Mail, Red and
Grazia magazines.
EVIE LEATHAM
ANJALI MAHTO
LOIS ROGERS
JACQUI THORNTON
Former beauty director
at Stylist, she has worked
at Glamour and Tatler,
and contributes to NET-APORTER’s The Edit
and Grazia.
Award-winning
international journalist,
specialising in healthcare,
life sciences and public
policy, she was health
and social affairs editor
of The Sunday Times.
Getty Images
DISTRIBUTION PARTNER
Consultant dermatologist
specialising in acne and
aesthetics, Dr Mahto’s work
bridges the gap between
traditional medical
dermatology, and beauty
and cosmetic medicine.
Former health editor
at the Sun, she was
health correspondent
of The Sunday Telegraph,
and also worked at
The Daily Telegraph
and Daily Express.
AHMED
ZAMBARAKJI
Grooming editor of Shortlist
Mode and formerly with
Arena, he is a regular
contributor to Mr Porter,
GQ, GetTheGloss
and AskMen.
Although this publication is funded through advertising and
sponsorship, all editorial is without bias and sponsored features
are clearly labelled. For an upcoming schedule, partnership inquiries or feedback, please call +44 (0)20 8616 7400 or e-mail
[email protected]
Raconteur is a leading publisher of special-interest content
and research. Its publications and articles cover a wide range
of topics, including business, finance, sustainability, healthcare, lifestyle and technology. Raconteur special reports are
published exclusively in The Times and The Sunday Times as well
as online at raconteur.net
The information contained in this publication has been obtained from sources the Proprietors believe to be correct.
However, no legal liability can be accepted for any errors. No
part of this publication may be reproduced without the prior
consent of the Publisher. © Raconteur Media
BUSINESS
CULTURE
OVERVIEW
ROSIE GREEN
F
lawless skin is the most
universally desired human feature.” So said
lauded zoologist Desmond Morris in the 1960s. Half a
century on and academics, such
as evolutionary psychologist Bernhard Fink, are still convinced of its
cross-cultural appeal.
“Skin condition profoundly affects the way we judge people’s
age, health and attractiveness,”
he says from his Göttingen office.
His studies show it affects your
“mate value”, essentially being an
outward symbol of your physical
health and fertility.
Which is probably why, according
to Mintel, we spent £1.07 billion on
skincare in the UK last year, up 17
per cent since 2009. A-list cosmetic
doctor Vicky Dondos, co-founder of
London-based Medicetics, thinks
this is in large part down to skincare’s ability to tap into the huge
wellness trend.
Her stylish clients are now looking for skin that is fresh and radiates health. For them it’s less about
removing wrinkles and more about
getting the “glow”. And glow comes
from skin that is unmarked, clear of
blemishes, redness and pigmentation, all of which increase with age.
Though Dr Dondos is well known for
her work with Botox and fillers, she
works on the complexion with lasers,
peels and products. “They can take so
many years away, with absolutely no
risk of changing your look or expression,” she says. “The end-point is to
FINANCE
HEALTHCARE
LIFESTYLE
have a patient tell me they no longer Kardashian West and Jessica Alba,
is thought to be stoking the appeal.
need to use their concealer.”
Interestingly, Dr Fink believes
In Korea, China and Japan there
is a similar desire for a flawless Western women’s desire for darker
complexion, but with the addition- skin and Eastern women for palal request for pale skin. Pale is as- er, both have the same end-game.
pirational because according to US “They are actually doing the same
beauty magazine Allure: “In China thing,” he says, “trying to remove
darker skin is still associated with discolouration”, as a tan hides
peasants.” The magazine reported blotches and blemishes in the
women wearing “facekinis”, light- short term.
“It’s about homoweight balaclavas,
to ensure zero sun
geneity of skin,”
damage.
says Dr Fink. “As
At the other end
human beings we
of the spectrum is
are
hard-wired
the West’s love of
to observe that
a suntan. Despite
the more uneven
repeated
warnyour skin, the less
attractive,
less
ings about UV rays
healthy and older
causing skin canyou are perceived
cer and acceleratto be.”
ed ageing, a 2014
increase in UK skincare
Can this explain
survey
reported
spending between
2009 and 2015
the worrying trend
by The American
for the practice of
Academy of DerSource: Mintel
illegal skin bleachmatology said 59
per cent of US coling in places like
Africa and Jamailege students have
tanned indoors. A survey, reported ca? Partly yes, because uneven skin
in The Guardian, showed 50 per tone is a primary concern for many
cent of people here admitted re- women with black skin and these
turning with a tan was the single creams purport to create uniformmost important reason for going on ity.
holiday.
But there’s another reason too,
There are many reasons why says Ateh Jewel, a beauty journalist
Western women want a tan, but and creator of Jewel Tones Beauty,
its beginnings are widely attrib- a website dedicated to showcasing
uted to Coco Chanel. Her bronzed beauty products and techniques for
limbs signaling an aspirational women with deeper skin tones.
“Culturally, we’ve been told lightlife spent on beaches, yachts and
horseback, when most people were er or whiter is better or higher stastuck working in gloomy factories. tus,” she says. Evidence of this was
Now the prominence of naturally Kenyan-Mexican actress and film
honey-skinned celebrities, like Kim director Lupita Nyong’o telling Es-
17%
SUSTAINABILITY
TECHNOLOGY
INFOGRAPHICS
sence’s Black Women in Hollywood
event that, as a child, she prayed
to God she would wake up lighter
skinned. “Skin bleaching is happening here in the UK too,” adds Ms
Jewel, “but is under the counter.”
Dr Bav Shergill, consultant dermatologist at the British Skin Foundation, is concerned about its dangers and says products can contain
dangerous levels of mercury, steroids or hydroquinone. Side effects
can include increased pigmentation, foetal abnormalities and psychological damage.
Ms Jewel recalls a story about the
death of a Nigerian relative at 63,
whose kidney failure, the family
was told, was due to accumulated
toxins from 30 years of skin bleaching with illegal creams. It’s all
about as far away from skin health
as you can get. But there is some
good news with evidence of greater diversity in the media’s vision of
beautiful skin.
As the world becomes more and
more diverse – the United States
census shows the US mixed-race
population has grown by 32 per
cent since 2000 – so there will
be more and more different skin
tones. Fingers crossed this inspires a proliferation of products
and treatments that, to use a beauty buzzword, will help “optimise”
all of them.
That way everyone, from China
to Kenya via England and America,
can finally feel truly comfortable in
their own skin.
Share this article online via
Raconteur.net
raconteur.net/future-of-skincare-2016
RACONTEUR
raconteur.net
11 / 05 / 2016
SKINCARE & DERMATOLOGY
03
SKINCARE
& DERMATOLOGY
DISTRIBUTED IN
ASSOCIATION PARTNER
£1bn skincare market
is a healthy business
RACONTEUR
PUBLISHING MANAGER
Rosie Baker-Williams
PRODUCTION EDITOR
Benjamin Chiou
MANAGING EDITOR
Peter Archer
HEAD OF PRODUCTION
Natalia Rosek
DIGITAL CONTENT MANAGER
Sarah Allidina
DESIGN
Samuele Motta
Grant Chapman
Kellie Jerrard
Forget must-have Birkin bags or stylish
Saint Laurent sneakers, flawless, even-toned skin
is the latest status symbol
CONTRIBUTORS
ROSIE GREEN
Award-winning journalist,
she is beauty editor at
large of Red magazine,
and was beauty director
at both Red and Elle.
LEAH HARDY
Health and beauty
writer, she is a regular
contributor to The Times,
Daily Mail, Red and
Grazia magazines.
EVIE LEATHAM
ANJALI MAHTO
LOIS ROGERS
JACQUI THORNTON
Former beauty director
at Stylist, she has worked
at Glamour and Tatler,
and contributes to NET-APORTER’s The Edit
and Grazia.
Award-winning
international journalist,
specialising in healthcare,
life sciences and public
policy, she was health
and social affairs editor
of The Sunday Times.
Getty Images
DISTRIBUTION PARTNER
Consultant dermatologist
specialising in acne and
aesthetics, Dr Mahto’s work
bridges the gap between
traditional medical
dermatology, and beauty
and cosmetic medicine.
Former health editor
at the Sun, she was
health correspondent
of The Sunday Telegraph,
and also worked at
The Daily Telegraph
and Daily Express.
AHMED
ZAMBARAKJI
Grooming editor of Shortlist
Mode and formerly with
Arena, he is a regular
contributor to Mr Porter,
GQ, GetTheGloss
and AskMen.
Although this publication is funded through advertising and
sponsorship, all editorial is without bias and sponsored features
are clearly labelled. For an upcoming schedule, partnership inquiries or feedback, please call +44 (0)20 8616 7400 or e-mail
[email protected]
Raconteur is a leading publisher of special-interest content
and research. Its publications and articles cover a wide range
of topics, including business, finance, sustainability, healthcare, lifestyle and technology. Raconteur special reports are
published exclusively in The Times and The Sunday Times as well
as online at raconteur.net
The information contained in this publication has been obtained from sources the Proprietors believe to be correct.
However, no legal liability can be accepted for any errors. No
part of this publication may be reproduced without the prior
consent of the Publisher. © Raconteur Media
BUSINESS
CULTURE
OVERVIEW
ROSIE GREEN
F
lawless skin is the most
universally desired human feature.” So said
lauded zoologist Desmond Morris in the 1960s. Half a
century on and academics, such
as evolutionary psychologist Bernhard Fink, are still convinced of its
cross-cultural appeal.
“Skin condition profoundly affects the way we judge people’s
age, health and attractiveness,”
he says from his Göttingen office.
His studies show it affects your
“mate value”, essentially being an
outward symbol of your physical
health and fertility.
Which is probably why, according
to Mintel, we spent £1.07 billion on
skincare in the UK last year, up 17
per cent since 2009. A-list cosmetic
doctor Vicky Dondos, co-founder of
London-based Medicetics, thinks
this is in large part down to skincare’s ability to tap into the huge
wellness trend.
Her stylish clients are now looking for skin that is fresh and radiates health. For them it’s less about
removing wrinkles and more about
getting the “glow”. And glow comes
from skin that is unmarked, clear of
blemishes, redness and pigmentation, all of which increase with age.
Though Dr Dondos is well known for
her work with Botox and fillers, she
works on the complexion with lasers,
peels and products. “They can take so
many years away, with absolutely no
risk of changing your look or expression,” she says. “The end-point is to
FINANCE
HEALTHCARE
LIFESTYLE
have a patient tell me they no longer Kardashian West and Jessica Alba,
is thought to be stoking the appeal.
need to use their concealer.”
Interestingly, Dr Fink believes
In Korea, China and Japan there
is a similar desire for a flawless Western women’s desire for darker
complexion, but with the addition- skin and Eastern women for palal request for pale skin. Pale is as- er, both have the same end-game.
pirational because according to US “They are actually doing the same
beauty magazine Allure: “In China thing,” he says, “trying to remove
darker skin is still associated with discolouration”, as a tan hides
peasants.” The magazine reported blotches and blemishes in the
women wearing “facekinis”, light- short term.
“It’s about homoweight balaclavas,
to ensure zero sun
geneity of skin,”
damage.
says Dr Fink. “As
At the other end
human beings we
of the spectrum is
are
hard-wired
the West’s love of
to observe that
a suntan. Despite
the more uneven
repeated
warnyour skin, the less
attractive,
less
ings about UV rays
healthy and older
causing skin canyou are perceived
cer and acceleratto be.”
ed ageing, a 2014
increase in UK skincare
Can this explain
survey
reported
spending between
2009 and 2015
the worrying trend
by The American
for the practice of
Academy of DerSource: Mintel
illegal skin bleachmatology said 59
per cent of US coling in places like
Africa and Jamailege students have
tanned indoors. A survey, reported ca? Partly yes, because uneven skin
in The Guardian, showed 50 per tone is a primary concern for many
cent of people here admitted re- women with black skin and these
turning with a tan was the single creams purport to create uniformmost important reason for going on ity.
holiday.
But there’s another reason too,
There are many reasons why says Ateh Jewel, a beauty journalist
Western women want a tan, but and creator of Jewel Tones Beauty,
its beginnings are widely attrib- a website dedicated to showcasing
uted to Coco Chanel. Her bronzed beauty products and techniques for
limbs signaling an aspirational women with deeper skin tones.
“Culturally, we’ve been told lightlife spent on beaches, yachts and
horseback, when most people were er or whiter is better or higher stastuck working in gloomy factories. tus,” she says. Evidence of this was
Now the prominence of naturally Kenyan-Mexican actress and film
honey-skinned celebrities, like Kim director Lupita Nyong’o telling Es-
17%
SUSTAINABILITY
TECHNOLOGY
INFOGRAPHICS
sence’s Black Women in Hollywood
event that, as a child, she prayed
to God she would wake up lighter
skinned. “Skin bleaching is happening here in the UK too,” adds Ms
Jewel, “but is under the counter.”
Dr Bav Shergill, consultant dermatologist at the British Skin Foundation, is concerned about its dangers and says products can contain
dangerous levels of mercury, steroids or hydroquinone. Side effects
can include increased pigmentation, foetal abnormalities and psychological damage.
Ms Jewel recalls a story about the
death of a Nigerian relative at 63,
whose kidney failure, the family
was told, was due to accumulated
toxins from 30 years of skin bleaching with illegal creams. It’s all
about as far away from skin health
as you can get. But there is some
good news with evidence of greater diversity in the media’s vision of
beautiful skin.
As the world becomes more and
more diverse – the United States
census shows the US mixed-race
population has grown by 32 per
cent since 2000 – so there will
be more and more different skin
tones. Fingers crossed this inspires a proliferation of products
and treatments that, to use a beauty buzzword, will help “optimise”
all of them.
That way everyone, from China
to Kenya via England and America,
can finally feel truly comfortable in
their own skin.
Share this article online via
Raconteur.net
raconteur.net/future-of-skincare-2016
04
raconteur.net
SKINCARE & DERMATOLOGY
RACONTEUR
11 / 05 / 2016
RACONTEUR
A healthy diet is the ‘secret’ to good skin
WelleCo
01
AHMED ZAMBARAKJI
E
Attempting to
improve skin health
by relying solely
on the outside-in
approach is like
trying to light a fire
with a wet match
diet of high-GI (glycaemic index),
processed foods. Zits ensued. The
trial proved what we all now know to
be true that a low-GI, hunter-gatherer or “paleo” diet is optimum for
all-round health, never mind the appearance of our skin.
The gut-skin connection is so
strong that facial skin is often used
as a diagnostic tool by doctors of
Chinese medicine and nutritionists.
In traditional Chinese medicine, the
lips mirror the digestive system; the
cheeks, the lungs; the chin refers to
the kidneys.
For a nutritionist, the skin presents
clues to deeper imbalances. A vitamin B3 deficiency might show up as
hard scaly skin or poor suppleness,
a lack of copper. Neither of these
diagnostic methods is bullet-proof,
but they point to one inescapable
fact that attempting to improve
skin health by relying solely on the
02
Getty Images
very skin-boosting formula
will have its limitations, especially if you’re partial to
after-work drinks and have
maintained a ten-a-day habit for
longer than you care to remember.
Collagen will collapse, elastin will
deteriorate, cells will slow down,
and a cream made from unicorn
tears and Himalayan snow is unlikely to stall the depressing inevitability of the ageing process.
An anthropological glimpse at
how other cultures live – and consequently age – would suggest that
the elixir of youth does not exist in
cream form, but in our individual
lifestyle choices, most notably the
food we choose to put in our bodies.
The Kitavan Islanders from Papua
New Guinea, for example, are well
documented for the fact that there
isn’t a single pimple among the
tribe. It’s also worth noting they also
don’t have cases of diabetes, cardiovascular disease, heart failure, dementia or blood pressure problems.
The anomaly was relayed to the
rest of the world in the early noughties by Dr Loren Cordain, who proceeded to put the tribe on a Western
01
The Super Elixir
Alkalising Greens
supplement, by
WelleCo, with vitamins, minerals and
trace elements to
boost nutrition
and maintain a
healthy alkaline
range
02
Kitava in Papua
New Guinea is
famous for its
absence of acne,
thought to be a
result of a diet of
fresh foods such
as tubers, coconut
and fish
outside-in approach is like trying to
light a fire with a wet match.
Nowhere is the effect of diet on
skin more apparent than in the case
of acne. While hormonal levels,
emotional stress, genetics and body
mass all play a part in acne, studies
confirm that systemic inflammation
caused by GI distress is a precursor
to spotty skin. Equally, abdominal
bloating, which is a tell-tale sign of
inflammation, is 37 per cent more
likely to come hand in hand with
acne, according to research published by the Japanese Dermatological Association.
The most current studies point to
the fact that acne can even be treated
with fermented foods and probiotics.
One popular theory, from research at
New York State University, suggests
acne is due to an overabundance of
bad bacteria in the gut, which causes
the lining of the intestine to become
permeable (a condition unfortunately referred to as leaky gut). Toxins
slip through the gut wall causing allergies, inflammation and, in those
who are susceptible, acne.
“I think that this is very plausible,”
says cosmetic dermatologist Sam
Bunting. “We know that the typical
Western diet with its high-GI index
and low-fibre content is associated
with lower levels of ‘friendly bacteria’ lactobacillus and bifidobacterium. I don’t think we have any
really conclusive studies yet on the
benefits of probiotics in acne… but
that doesn’t rule out the possibility.
I always recommend oral probiotics
when I’m prescribing oral antibiotics for acne patients.”
Considerably
more
glamorous
than acne-busting
microbes are the
anti-ageing elixirs
that have flooded
the beauty market
in recent years. Formally known as nutricosmetics, these
pills and potions
play on the idea of
beauty from within.
Anti-ageing drinks,
such as Gold Collagen Fountain and
Pure HA, have taken
the UK by storm.
The global appetite for ingestible
beauty is so great that the wellness
supplements market is expected
to reach $7.16 billion by 2020, ac-
cording to Transparency Market
Research. Should you venture further afield, you might find anti-ageing marshmallows in Japan or a
tan-boosting beverage in Brazil.
The central ingredient in the
most popular supplements is collagen. Paired with keratin, collagen makes for stronger, more
resilient skin; it is the glue that
holds everything together. A close
runner-up is hyaluronic acid, the
naturally occurring sponge-like
substance that plumps skin and
cushions everything from your
joints to your eyeballs.
Levels of both these ingredients
decline with age so it seems perfectly
reasonable to assume that scarfing
down a supplement every day would
top up our levels and thus circumvent the outward signs of ageing. But
dermatologists are less convinced.
“I know of no mechanism to ‘import’ dietary collagen and hyaluronic acid molecules intact to the skin,”
says Dr Bunting. “They are broken
down into their basic building blocks
like other dietary proteins and carbohydrates, and are sent where the
body needs them most. The skin
doesn’t get special treatment.”
In other words, the body will not
reliably use the active ingredient
to improve your skin over, say, the
cartilage in your
left knee. Ironically enough, Dr
Bunting
maintains that skincare or, better
still,
microneedling would be
a more effective
route than supplements.
The other pitfall with skincare
supplements is
their
bioavailability. In layman’s terms, this is
the amount of an active ingredient
that the body is able to absorb from
a supplement. A product might deliver the right ingredients in the
Supplements have
inherent limitations
in just the same
way that skincare
has its own set of
limitations
DYNAMICS OF GLOBAL NUTRICOSMETICS MARKET
Drivers
Challenges
Growing consumer
desire to prevent
premature skin
ageing
Preference for
safe and effective
beauty solutions
High prices of
nutricosmetics
Increased consumer
acceptance of
the ‘beauty from
within’ concept
Slow results:
a key factor impeding
acceptance among
results-driven
consumers
Rising popularity
of ready-to-drink
nutricosmetic
beverages
Robust growth in
sales of collagen
nutricosmetics
Lack of awareness
of potential skin
health benefits
Source: Global Industry Analytics 2015
SKINCARE & DERMATOLOGY
CASE STUDY: COCONUT OIL
Whether they are effective or not, the appetite for supplements underlines the glaringly obvious fact that
the Western diet needs a dramatic overhaul
NUTRITION AND WELLBEING
raconteur.net
11 / 05 / 2016
Lithe, bright-skinned yoga
students use coconut oil to aid
digestion, kill candida or boost
immunity against colds. They
slather it over stretch marks,
put it into funny looking teas,
stick it on their cheekbones, use
it as a hair conditioner and as
a deodorant. It is the organic,
non-toxic alternative for just
about everything you would buy
in a chemist or supermarket.
So it was only a matter of
time before the masses would
cotton on to the versatility of
coconut oil, drawn in by its many
culinary applications. Coconut
oil, it turns out, is an ideal
replacement for plant-based
oils when cooking since it is
thermally stable and free from
cholesterol.
But its reputation as a cure-all
moisturiser may be overhyped.
On normal skin types, the
medium chain fatty acids absorb
into the skin quickly and give it
luminosity. But dermatologists,
including Dr Sam Bunting,
would prefer it was kept in the
kitchen. “It is one of the most
comodegenic oils around,”
she protests. Comodegenic
substances block pores, causing
or exacerbating breakouts.
“I see patients who are a sea
of bumps from using it as a
moisturiser.”
Less is more —
get the natural look
with Revere
Revere Clinics specialises in non-invasive beauty treatments. Our
goal is to enhance the natural beauty of our patients and make
them look better, not different. Revere offers a full range of
treatments, which will make small changes to your face and body,
making you look younger and radiant but, most importantly, natural.
GLOBAL NUTRICOSMETICS MARKET, BY PRODUCT CATEGORY
42.7%
Skin Transformation
Revere offers a spectrum of
non-surgical solutions for
skin rejuvenation, acne and
pigmentation therapy, scar
removal, skin resurfacing and
vascular treatments. We can
transform your skin without
s u r g i c a l i n t e r ve n t i o n .
Skin
18.3%
Hair
11.4%
Oral
11.4%
Others
4.9%
Sunscreen
Non-Surgical Nose Job
Tr u e a l t e r n a t i v e t o
r h i n o p l a s t y. T h i s s a f e
procedure is ideal for fixing
minor contour issues.
Through the use of fillers
we can alter the shape and
contours of the nose without
having to perform surgery.
Source: Global Industry Analytics 2015
right concentration, but it’s fairly
useless if none of it is assimilated
into your system.
And then there is the not-sosmall matter of a GI tract hellbent on breaking down everything
it encounters. A person with a
healthy gut is likely to get 25 to 50
per cent absorption from an oral
supplement or vitamin, depending on which study you read. The
only way to bypass the GI tract is
to mainline vitamins and minerals into your body intravenously,
a powerful and costly approach to
skin health that is, unsurprisingly,
all the rage on the west coast of the
United States.
As you might expect, large-scale
controlled clinical studies verifying the efficacy of supplements on
skin health are thin on the ground.
That doesn’t mean pill-popping or
mainlining antioxidants isn’t an
effective measure. It simply means
that we have to go on anecdotal
evidence most of the time. Supplements have inherent limitations in
just the same way that skincare has
its own set of limitations.
Regardless of the debate over
their efficacy, the appetite for supplements points to the glaringly
obvious fact that the Western diet
needs a dramatic overhaul. As
Michael Pollan, author of The Omnivore’s Dilemma, pointed out to
scientists in a 2009 lecture: “The
Masai subsist on cattle blood and
meat and milk, and little else. Native Americans subsist on beans
and maize. And the Inuit in Greenland subsist on whale blubber and
a little bit of lichen. The irony is
that the one diet we have invented
for ourselves – the Western diet – is
the one that makes us sick.”
Supplementing for skin health,
therefore, is not really separate
from supplementing for overall
health. The skin, after all, represents our internal wellbeing
and an attempt to plaster over
the cracks with a ‘cosmetic’ pill is
missing the point entirely. Choosing clean, sustainable foods over
healthy-looking food-like substitutes will always be more effective
than any pill. As the disclaimers
on the pack clearly state, no supplement is intended to replace a
balanced, healthy diet.
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NON-INVASIVE PROCEDURES OFFER MANY ADVANTAGES – NO DOWNTIME,
NO NEED FOR ANAESTHESIA, IMMEDIATE OR VERY QUICK RESULTS.
Revere Northwood:
William Old Centre, Ducks Hill Road,
Northwood HA6 2NP
01923 834 020
Revere London:
100 Harley Street, London W1G 7JA
0207 486 8282
Book your complementary
consultation with
Dr Sach Mohan
or Dr Sabika Karim
at Revere Clinics.
www.revereclinics.com
05
04
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SKINCARE & DERMATOLOGY
RACONTEUR
11 / 05 / 2016
RACONTEUR
A healthy diet is the ‘secret’ to good skin
WelleCo
01
AHMED ZAMBARAKJI
E
Attempting to
improve skin health
by relying solely
on the outside-in
approach is like
trying to light a fire
with a wet match
diet of high-GI (glycaemic index),
processed foods. Zits ensued. The
trial proved what we all now know to
be true that a low-GI, hunter-gatherer or “paleo” diet is optimum for
all-round health, never mind the appearance of our skin.
The gut-skin connection is so
strong that facial skin is often used
as a diagnostic tool by doctors of
Chinese medicine and nutritionists.
In traditional Chinese medicine, the
lips mirror the digestive system; the
cheeks, the lungs; the chin refers to
the kidneys.
For a nutritionist, the skin presents
clues to deeper imbalances. A vitamin B3 deficiency might show up as
hard scaly skin or poor suppleness,
a lack of copper. Neither of these
diagnostic methods is bullet-proof,
but they point to one inescapable
fact that attempting to improve
skin health by relying solely on the
02
Getty Images
very skin-boosting formula
will have its limitations, especially if you’re partial to
after-work drinks and have
maintained a ten-a-day habit for
longer than you care to remember.
Collagen will collapse, elastin will
deteriorate, cells will slow down,
and a cream made from unicorn
tears and Himalayan snow is unlikely to stall the depressing inevitability of the ageing process.
An anthropological glimpse at
how other cultures live – and consequently age – would suggest that
the elixir of youth does not exist in
cream form, but in our individual
lifestyle choices, most notably the
food we choose to put in our bodies.
The Kitavan Islanders from Papua
New Guinea, for example, are well
documented for the fact that there
isn’t a single pimple among the
tribe. It’s also worth noting they also
don’t have cases of diabetes, cardiovascular disease, heart failure, dementia or blood pressure problems.
The anomaly was relayed to the
rest of the world in the early noughties by Dr Loren Cordain, who proceeded to put the tribe on a Western
01
The Super Elixir
Alkalising Greens
supplement, by
WelleCo, with vitamins, minerals and
trace elements to
boost nutrition
and maintain a
healthy alkaline
range
02
Kitava in Papua
New Guinea is
famous for its
absence of acne,
thought to be a
result of a diet of
fresh foods such
as tubers, coconut
and fish
outside-in approach is like trying to
light a fire with a wet match.
Nowhere is the effect of diet on
skin more apparent than in the case
of acne. While hormonal levels,
emotional stress, genetics and body
mass all play a part in acne, studies
confirm that systemic inflammation
caused by GI distress is a precursor
to spotty skin. Equally, abdominal
bloating, which is a tell-tale sign of
inflammation, is 37 per cent more
likely to come hand in hand with
acne, according to research published by the Japanese Dermatological Association.
The most current studies point to
the fact that acne can even be treated
with fermented foods and probiotics.
One popular theory, from research at
New York State University, suggests
acne is due to an overabundance of
bad bacteria in the gut, which causes
the lining of the intestine to become
permeable (a condition unfortunately referred to as leaky gut). Toxins
slip through the gut wall causing allergies, inflammation and, in those
who are susceptible, acne.
“I think that this is very plausible,”
says cosmetic dermatologist Sam
Bunting. “We know that the typical
Western diet with its high-GI index
and low-fibre content is associated
with lower levels of ‘friendly bacteria’ lactobacillus and bifidobacterium. I don’t think we have any
really conclusive studies yet on the
benefits of probiotics in acne… but
that doesn’t rule out the possibility.
I always recommend oral probiotics
when I’m prescribing oral antibiotics for acne patients.”
Considerably
more
glamorous
than acne-busting
microbes are the
anti-ageing elixirs
that have flooded
the beauty market
in recent years. Formally known as nutricosmetics, these
pills and potions
play on the idea of
beauty from within.
Anti-ageing drinks,
such as Gold Collagen Fountain and
Pure HA, have taken
the UK by storm.
The global appetite for ingestible
beauty is so great that the wellness
supplements market is expected
to reach $7.16 billion by 2020, ac-
cording to Transparency Market
Research. Should you venture further afield, you might find anti-ageing marshmallows in Japan or a
tan-boosting beverage in Brazil.
The central ingredient in the
most popular supplements is collagen. Paired with keratin, collagen makes for stronger, more
resilient skin; it is the glue that
holds everything together. A close
runner-up is hyaluronic acid, the
naturally occurring sponge-like
substance that plumps skin and
cushions everything from your
joints to your eyeballs.
Levels of both these ingredients
decline with age so it seems perfectly
reasonable to assume that scarfing
down a supplement every day would
top up our levels and thus circumvent the outward signs of ageing. But
dermatologists are less convinced.
“I know of no mechanism to ‘import’ dietary collagen and hyaluronic acid molecules intact to the skin,”
says Dr Bunting. “They are broken
down into their basic building blocks
like other dietary proteins and carbohydrates, and are sent where the
body needs them most. The skin
doesn’t get special treatment.”
In other words, the body will not
reliably use the active ingredient
to improve your skin over, say, the
cartilage in your
left knee. Ironically enough, Dr
Bunting
maintains that skincare or, better
still,
microneedling would be
a more effective
route than supplements.
The other pitfall with skincare
supplements is
their
bioavailability. In layman’s terms, this is
the amount of an active ingredient
that the body is able to absorb from
a supplement. A product might deliver the right ingredients in the
Supplements have
inherent limitations
in just the same
way that skincare
has its own set of
limitations
DYNAMICS OF GLOBAL NUTRICOSMETICS MARKET
Drivers
Challenges
Growing consumer
desire to prevent
premature skin
ageing
Preference for
safe and effective
beauty solutions
High prices of
nutricosmetics
Increased consumer
acceptance of
the ‘beauty from
within’ concept
Slow results:
a key factor impeding
acceptance among
results-driven
consumers
Rising popularity
of ready-to-drink
nutricosmetic
beverages
Robust growth in
sales of collagen
nutricosmetics
Lack of awareness
of potential skin
health benefits
Source: Global Industry Analytics 2015
SKINCARE & DERMATOLOGY
CASE STUDY: COCONUT OIL
Whether they are effective or not, the appetite for supplements underlines the glaringly obvious fact that
the Western diet needs a dramatic overhaul
NUTRITION AND WELLBEING
raconteur.net
11 / 05 / 2016
Lithe, bright-skinned yoga
students use coconut oil to aid
digestion, kill candida or boost
immunity against colds. They
slather it over stretch marks,
put it into funny looking teas,
stick it on their cheekbones, use
it as a hair conditioner and as
a deodorant. It is the organic,
non-toxic alternative for just
about everything you would buy
in a chemist or supermarket.
So it was only a matter of
time before the masses would
cotton on to the versatility of
coconut oil, drawn in by its many
culinary applications. Coconut
oil, it turns out, is an ideal
replacement for plant-based
oils when cooking since it is
thermally stable and free from
cholesterol.
But its reputation as a cure-all
moisturiser may be overhyped.
On normal skin types, the
medium chain fatty acids absorb
into the skin quickly and give it
luminosity. But dermatologists,
including Dr Sam Bunting,
would prefer it was kept in the
kitchen. “It is one of the most
comodegenic oils around,”
she protests. Comodegenic
substances block pores, causing
or exacerbating breakouts.
“I see patients who are a sea
of bumps from using it as a
moisturiser.”
Less is more —
get the natural look
with Revere
Revere Clinics specialises in non-invasive beauty treatments. Our
goal is to enhance the natural beauty of our patients and make
them look better, not different. Revere offers a full range of
treatments, which will make small changes to your face and body,
making you look younger and radiant but, most importantly, natural.
GLOBAL NUTRICOSMETICS MARKET, BY PRODUCT CATEGORY
42.7%
Skin Transformation
Revere offers a spectrum of
non-surgical solutions for
skin rejuvenation, acne and
pigmentation therapy, scar
removal, skin resurfacing and
vascular treatments. We can
transform your skin without
s u r g i c a l i n t e r ve n t i o n .
Skin
18.3%
Hair
11.4%
Oral
11.4%
Others
4.9%
Sunscreen
Non-Surgical Nose Job
Tr u e a l t e r n a t i v e t o
r h i n o p l a s t y. T h i s s a f e
procedure is ideal for fixing
minor contour issues.
Through the use of fillers
we can alter the shape and
contours of the nose without
having to perform surgery.
Source: Global Industry Analytics 2015
right concentration, but it’s fairly
useless if none of it is assimilated
into your system.
And then there is the not-sosmall matter of a GI tract hellbent on breaking down everything
it encounters. A person with a
healthy gut is likely to get 25 to 50
per cent absorption from an oral
supplement or vitamin, depending on which study you read. The
only way to bypass the GI tract is
to mainline vitamins and minerals into your body intravenously,
a powerful and costly approach to
skin health that is, unsurprisingly,
all the rage on the west coast of the
United States.
As you might expect, large-scale
controlled clinical studies verifying the efficacy of supplements on
skin health are thin on the ground.
That doesn’t mean pill-popping or
mainlining antioxidants isn’t an
effective measure. It simply means
that we have to go on anecdotal
evidence most of the time. Supplements have inherent limitations in
just the same way that skincare has
its own set of limitations.
Regardless of the debate over
their efficacy, the appetite for supplements points to the glaringly
obvious fact that the Western diet
needs a dramatic overhaul. As
Michael Pollan, author of The Omnivore’s Dilemma, pointed out to
scientists in a 2009 lecture: “The
Masai subsist on cattle blood and
meat and milk, and little else. Native Americans subsist on beans
and maize. And the Inuit in Greenland subsist on whale blubber and
a little bit of lichen. The irony is
that the one diet we have invented
for ourselves – the Western diet – is
the one that makes us sick.”
Supplementing for skin health,
therefore, is not really separate
from supplementing for overall
health. The skin, after all, represents our internal wellbeing
and an attempt to plaster over
the cracks with a ‘cosmetic’ pill is
missing the point entirely. Choosing clean, sustainable foods over
healthy-looking food-like substitutes will always be more effective
than any pill. As the disclaimers
on the pack clearly state, no supplement is intended to replace a
balanced, healthy diet.
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NON-INVASIVE PROCEDURES OFFER MANY ADVANTAGES – NO DOWNTIME,
NO NEED FOR ANAESTHESIA, IMMEDIATE OR VERY QUICK RESULTS.
Revere Northwood:
William Old Centre, Ducks Hill Road,
Northwood HA6 2NP
01923 834 020
Revere London:
100 Harley Street, London W1G 7JA
0207 486 8282
Book your complementary
consultation with
Dr Sach Mohan
or Dr Sabika Karim
at Revere Clinics.
www.revereclinics.com
05
06
raconteur.net
SKINCARE & DERMATOLOGY
11 / 05 / 2016
RACONTEUR
RACONTEUR
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xx
xx / 2016
xxxx
11 / 05
XXXX
SKINCARE & DERMATOLOGY
COMMERCIAL FEATURE
Clamping down on cosmetic cowboys
VENN HEALTHCARE: RAISING THE
STANDARD IN AESTHETIC MEDICINE
Moves are underway to regulate the non-surgical cosmetic industry, but the need for greater safeguards
against poor practice remains a serious concern
01
REGULATION
JACQUI THORNTON
Getty Images
Getty Images
When it comes to high-tech beauty treatments, it’s not just the device that matters, but also the clinic and therapists using it
02
I
n the last decade, non-surgical
cosmetic treatments in the UK
have developed and expanded
beyond recognition.
The beauty-conscious customer
can now plump for anti-wrinkle injectables, dermal fillers, laser hair removal, skin rejuvenation techniques,
such as microneedling, and intense
pulsed light for skin-lightening.
Almost every high street has salons and surgeries offering a range
of procedures. It’s not surprising
that, according to industry analysts
Mintel, cosmetic interventions in
the UK are worth more than £3.6 billion, with nine out of ten procedures
non-surgical treatments.
But with this surge, rogue practitioners are attempting to muscle in
with potentially dangerous consequences, as injections performed
poorly carry the risk of infection,
nerve and tissue damage or allergic reactions.
Natali Kelly, an aesthetic nurse
practitioner at Omniya MediClinic,
in London’s Knightsbridge, says:
“The demand is so high that unethical practitioners see the industry as a quick way to make money.
In my clinic I see and correct a lot
of bad work.
“Often the public are naive or go for
a cheaper price over quality. It upsets
me that often they have no idea about
risks and side effects, and what has
been injected into their face.”
After concerns about the standards and promotion of some of
the cosmetic work taking place,
the government asked NHS England medical director Professor Sir
Bruce Keogh to carry out a review
in 2013.
Even he was shocked by the lack
of regulation and wrote: “A person
having a non-surgical cosmetic intervention has no more protection
and redress than someone buying a
ballpoint pen or a toothbrush.”
There have since been moves to
improve regulation in this area. Recently the General Medical Council
(GMC) published its first guidance
on the subject, with new rules due to
be introduced from June for cosmetic treatments.
They rule out supermarket-style
two-for-one offers and pressuring
patients to buy treatments. Instead
doctors must discuss the proposed
procedure with the patient, who
must be given time to reflect before
agreeing to proceed.
The GMC is clear about the need
to help drive up standards and ensure all patients, especially those
who are most vulnerable, are given the treatment, care and support they need.
V
GLOBAL NON-SURGICAL PROCEDURE MARKET
NUMBER OF PROCEDURES (M)
Injectables
Facial rejuvenation
Other
Botulin toxin
4.83
Hyaluronic acid
2.69
Calcium hydroxylapatite
Poly-lactic acid
0.19
0.07
Chemical peel
0.49
Laser skin resurfacing
0.48
0.37
Microdermabrasion
Dermabrasion
0.08
1.28
Hair removal
Scierotherapy
0.10
Source: ISAPS 2015
The guidance has been well received. James Bird, medical director at private dermatology
clinic Ethos Medical, says: “We
wholeheartedly
welcome
the
GMC’s guidelines. The industry
has grown hugely over the past ten
years and treatments, which were
once considered the preserve of
the rich and famous, have now become, for many, part of a regular
grooming regime, akin to visiting
the hairdresser.
“Sadly, this expansion has also
seen a worrying increase in substandard procedures being performed by underqualified personnel, in unsanitary surroundings,
using inferior products.”
Bruce Richard, a consultant plastic
surgeon who works in the NHS and
privately through Medstars.co.uk,
says that for those who are already regulated and properly trained, the guidance should have little impact on their
business beyond increased customer
demand. But the guidance will ultimately help to improve trust and confidence within the industry, he says.
However, some say that while
helpful, the guidelines cannot possibly address all the issues in this
very complex area.
For a start, the guidance applies
only to doctors, when many other
health professionals, such as nurses
and dentists, and even non-health
qualified practitioners such as
01
Botox, the brand
name for botulinum
toxin, is the world’s
most popular nonsurgical treatment,
with 4.83 million
procedures
undergone in 2014
02
Patient undergoing
intense pulsed light
treatment, used
for hair removal,
photorejuvenation
and acne
beauticians, are allowed to perform
many of these techniques.
Mr Richard says the changes could
push other professional bodies, such
as the dental or nursing councils, to
regulate their members undertaking such procedures.
But Dr Mervyn Patterson, a former
GP who runs Woodford Medical with
five clinics across the country, says
until that happens: “It’s not a level
playing field. Nurses and dentists do
not have to follow the same rules.
“The vast majority of those having
injectable treatments have them
done by people who are not affected by this guidance, which doesn’t
keep people any safer.”
He believes that
if doctors have
to give patients a
cooling-off period
for a filler, they will
simply choose an
alternative clinic
which will do it immediately, giving
them a competitive
advantage.
Others say it is ludicrous that those
who present the least risk to patient
safety – namely doctors – are being
regulated more than laymen who
can act with impunity. While only
doctors, nurses and dentists can
prescribe injectables, anyone can
administer them.
A further issue is that clinics in
England which offer cosmetic surgery, such as facelifts, have to be licensed by the Care Quality Commission (CQC), the same health body
which inspects hospitals. It carries
out announced and unannounced
checks, and these clinics also often
offer non-surgical treatments.
But centres which only offer anti-wrinkle injections, chemical
peels, laser and intense pulsed
light treatments, such as hair removal or skin rejuvenation, do
not have to be licensed by the
CQC. According to a CQC spokeswoman, any extension of the
body’s remit would be a matter for
the government.
All eyes are currently on Scotland where private clinics offering
non-surgical cosmetic treatment are
now regulated by Health Improvement Scotland, the equivalent of the
CQC north of the border.
With the absence of state intervention, a number of initiatives have
been set up involving voluntary
regulation, including clinics joining
independent registers which use a
quality kite mark.
One is Save Face, which accredits
individual doctors, dentists, nurses
and clinics. The organisation gathers information on registration,
insurance, training and consent
procedures
from
an online questionnaire, then a nurse
assessor visits the
establishment. It
is now in the final
stages of becoming
accredited by the
Professional Standards
Authority,
which means it will
be recognised by the Department of
Health and others.
Director Ashton Collins says she
is delighted that there are now almost 400 practitioners on the register. “We’re passionate about eradicating unsafe practice from the
non-surgical cosmetic industry by
raising standards throughout the
country,” she says.
So what of the future? Health
Education England, the body responsible for standards within the
healthcare workforce, has published
a report setting out the qualification
requirements for practitioners who
perform these types of treatments.
One thing is agreed that the industry is only going to get bigger – making the issue of regulation a hot topic.
enn Healthcare, a leading
supplier
of
aesthetic
devices, offers not only the
highest standards in technology and
training, but also a groundbreaking
way to ensure the best treatments,
every time.
Advances in non-surgical skin
treatments have transformed the
anti-ageing landscape. Innovative
devices can lift, brighten, tighten
and even volumise skin in a way that
was previously impossible without
resorting to surgery.
While aesthetic technology has
advanced rapidly, the regulations
governing the industry have not
kept up. Many clinics are doing a
great job; however, in a new survey
58 per cent of dermatologists and
plastic surgeons said they had treated
patients for complications caused by
non-surgical procedures.
The survey by the Clinical Standards
Authority for Non-Surgical Cosmetic
Interventions and Joint Council for
Cosmetic Practitioners highlights
what they describe as a “need for
improved training and oversight” in
the aesthetics industry.
As a result, Chris Schiel, chief
executive of Venn Healthcare,
has introduced an unprecedented
360-degree package of training,
support and audit tools for clinics.
“Venn Healthcare’s ethos stems
from its medical background. Patient
safety, research and proven efficacy
are key to all we do,” he says.
Patient safety, research
and proven efficacy are
key to all we do
“We are the exclusive UK
distributors for three trusted
global companies, K-Beauty brands
Lutronic and Classys, and Swissbased Storz Medical, all with stateof-the-art devices and a growing
The demand is so
high that unethical
practitioners see the
industry as a quick
way to make money
Share this article online via
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Lutronic’s NEW LASEMD
share of the global market. We
partner with leading clinics in the
UK, and train and educate clinicians
to the highest standards.”
And now, says Mr Schiel, Venn
Healthcare has moved another step
forward encouraging participation
in ASSERT, a transparent system
for clinics to gather independent,
unbiased, measurable and long-term
data on aesthetic treatments.
Professor
Nicola
Maffulli,
ASSERT’s joint principal investigator,
says: “ASSERT has a proven track
record in orthopaedic and sports
medicine, has international ethics
approval and is accepted by NICE,
the National Institute for Health
and Clinical Excellence, and the
NHS. This is a unique opportunity
to deliver the same benefits into the
aesthetics arena.”
By collecting specific data on
results over time, including patient
satisfaction, quality of life outcome
measurements and complications,
ASSERT helps clinics to manage
patient
expectations,
improve
their protocols and know when a
particular practitioner could benefit
from the latest training to achieve
even better results.
Fellow joint principal investigator
for ASSERT, Dr Tapan Patel of PHI
Clinic in London’s Harley Street,
says: “Applying NHS auditing
standards in non-surgical aesthetics
is an exciting development and a
sign of our commitment to achieving
the best results for our patients. We
hope collecting independent data
on patients’ results becomes an
industry-wide initiative.”
Esther Fieldgrass, founder of EF
MEDISPA, welcomes the system,
adding: “I’m always eager to
incorporate new ways to improve
results and customer satisfaction.”
The ASSERT protocol can be
applied to all Venn Healthcare’s
treatments, including its newest
device, Lutronic’s LASEMD laser
cosmeceutical
delivery
system,
launching exclusively at PHI Clinic.
The LASEMD combines fractional
laser energy with bespoke vitamin
serums to boost the skin’s ability to
heal itself from the inside out. The nopain, no-downtime treatments come
with Venn Healthcare’s promise of
results delivered with care.
Mr Schiel concludes: “We want
every patient treated with a Venn
Healthcare device to know they can
relax with the confidence of knowing
they are in the best possible hands.”
www.vennhealthcare.com
GOLD STANDARD TREATMENTS FOUND IN THE BEST PLACES
EF MEDISPA Group
EF MEDISPA, founded by Esther Fieldgrass
in 2006, offers a host of advanced treatments
in four stylish, award-winning clinics in
Kensington, Chelsea, St John’s Wood and
Canary Wharf.
3D SkinLift by Ultraformer
Ultrasound energy penetrates deep below
the skin for immediate and long-lasting
lifting and tightening effects on both
the face and body. The no-downtime
treatments take 30 to 45 minutes. One to
four sessions give the best results.
www.efmedispa.com
020 3627 8674
PHI Clinic
Founded by internationally renowned
cosmetic dermatologist Dr Tapan Patel, the
multi-award-winning PHI Clinic in Harley
Street offers state-of-the-art non-surgical
procedures with five-star service.
Lutronic Infini
Radio frequency waves are delivered deep
into the skin via gold-coated microneedles
for noticeable wrinkle reduction, collagen
boosting, skin tightening and plumping.
Infini can be used on the face and body.
One to three treatments are required, with
best results seen after four to six weeks.
LASEMD
The LASEMD “baby-face laser” creates
microscopic channels in the skin to allow
delivery of advanced cosmeceutical
compounds to the deepest layer of the
skin to trigger repair and rejuvenation.
Unique technology ensures nano-sized
ingredients, such as vitamin C, retinol
and resveratrol, stay fresh without
preservatives. Treatments can improve
wrinkles, skin-sagging, loss of volume,
texture and pigmentation, with no
downtime.
www.phiclinic.com
020 7034 5999
Premier Laser & Skin Clinics
Led by managing director Lucy Xu,
Premier Laser & Skin Clinics are proud to
be one of London’s leading laser and skin
destinations with eight high-tech skin
clinics across London and Surrey.
SPECTRA XT
The SPECTRA XT Carbon Peel Treatment
is an effective solution for enlarged
pores, pigmentation and overall skin
rejuvenation. A carbon-based lotion
is painted on to the face, after which a
laser gently removes the carbon, while
also exfoliating, decongesting pores and
removing sebum, to leave skin looking
clearer, fresher and more youthful. Laser
energy also stimulates collagen production
for tighter pores. Suitable for all skin types,
with results seen after just one treatment.
www.londonpremierlaser.co.uk
0203 131 2843
2
07
06
raconteur.net
SKINCARE & DERMATOLOGY
11 / 05 / 2016
RACONTEUR
RACONTEUR
raconteur.net
xx
xx / 2016
xxxx
11 / 05
XXXX
SKINCARE & DERMATOLOGY
COMMERCIAL FEATURE
Clamping down on cosmetic cowboys
VENN HEALTHCARE: RAISING THE
STANDARD IN AESTHETIC MEDICINE
Moves are underway to regulate the non-surgical cosmetic industry, but the need for greater safeguards
against poor practice remains a serious concern
01
REGULATION
JACQUI THORNTON
Getty Images
Getty Images
When it comes to high-tech beauty treatments, it’s not just the device that matters, but also the clinic and therapists using it
02
I
n the last decade, non-surgical
cosmetic treatments in the UK
have developed and expanded
beyond recognition.
The beauty-conscious customer
can now plump for anti-wrinkle injectables, dermal fillers, laser hair removal, skin rejuvenation techniques,
such as microneedling, and intense
pulsed light for skin-lightening.
Almost every high street has salons and surgeries offering a range
of procedures. It’s not surprising
that, according to industry analysts
Mintel, cosmetic interventions in
the UK are worth more than £3.6 billion, with nine out of ten procedures
non-surgical treatments.
But with this surge, rogue practitioners are attempting to muscle in
with potentially dangerous consequences, as injections performed
poorly carry the risk of infection,
nerve and tissue damage or allergic reactions.
Natali Kelly, an aesthetic nurse
practitioner at Omniya MediClinic,
in London’s Knightsbridge, says:
“The demand is so high that unethical practitioners see the industry as a quick way to make money.
In my clinic I see and correct a lot
of bad work.
“Often the public are naive or go for
a cheaper price over quality. It upsets
me that often they have no idea about
risks and side effects, and what has
been injected into their face.”
After concerns about the standards and promotion of some of
the cosmetic work taking place,
the government asked NHS England medical director Professor Sir
Bruce Keogh to carry out a review
in 2013.
Even he was shocked by the lack
of regulation and wrote: “A person
having a non-surgical cosmetic intervention has no more protection
and redress than someone buying a
ballpoint pen or a toothbrush.”
There have since been moves to
improve regulation in this area. Recently the General Medical Council
(GMC) published its first guidance
on the subject, with new rules due to
be introduced from June for cosmetic treatments.
They rule out supermarket-style
two-for-one offers and pressuring
patients to buy treatments. Instead
doctors must discuss the proposed
procedure with the patient, who
must be given time to reflect before
agreeing to proceed.
The GMC is clear about the need
to help drive up standards and ensure all patients, especially those
who are most vulnerable, are given the treatment, care and support they need.
V
GLOBAL NON-SURGICAL PROCEDURE MARKET
NUMBER OF PROCEDURES (M)
Injectables
Facial rejuvenation
Other
Botulin toxin
4.83
Hyaluronic acid
2.69
Calcium hydroxylapatite
Poly-lactic acid
0.19
0.07
Chemical peel
0.49
Laser skin resurfacing
0.48
0.37
Microdermabrasion
Dermabrasion
0.08
1.28
Hair removal
Scierotherapy
0.10
Source: ISAPS 2015
The guidance has been well received. James Bird, medical director at private dermatology
clinic Ethos Medical, says: “We
wholeheartedly
welcome
the
GMC’s guidelines. The industry
has grown hugely over the past ten
years and treatments, which were
once considered the preserve of
the rich and famous, have now become, for many, part of a regular
grooming regime, akin to visiting
the hairdresser.
“Sadly, this expansion has also
seen a worrying increase in substandard procedures being performed by underqualified personnel, in unsanitary surroundings,
using inferior products.”
Bruce Richard, a consultant plastic
surgeon who works in the NHS and
privately through Medstars.co.uk,
says that for those who are already regulated and properly trained, the guidance should have little impact on their
business beyond increased customer
demand. But the guidance will ultimately help to improve trust and confidence within the industry, he says.
However, some say that while
helpful, the guidelines cannot possibly address all the issues in this
very complex area.
For a start, the guidance applies
only to doctors, when many other
health professionals, such as nurses
and dentists, and even non-health
qualified practitioners such as
01
Botox, the brand
name for botulinum
toxin, is the world’s
most popular nonsurgical treatment,
with 4.83 million
procedures
undergone in 2014
02
Patient undergoing
intense pulsed light
treatment, used
for hair removal,
photorejuvenation
and acne
beauticians, are allowed to perform
many of these techniques.
Mr Richard says the changes could
push other professional bodies, such
as the dental or nursing councils, to
regulate their members undertaking such procedures.
But Dr Mervyn Patterson, a former
GP who runs Woodford Medical with
five clinics across the country, says
until that happens: “It’s not a level
playing field. Nurses and dentists do
not have to follow the same rules.
“The vast majority of those having
injectable treatments have them
done by people who are not affected by this guidance, which doesn’t
keep people any safer.”
He believes that
if doctors have
to give patients a
cooling-off period
for a filler, they will
simply choose an
alternative clinic
which will do it immediately, giving
them a competitive
advantage.
Others say it is ludicrous that those
who present the least risk to patient
safety – namely doctors – are being
regulated more than laymen who
can act with impunity. While only
doctors, nurses and dentists can
prescribe injectables, anyone can
administer them.
A further issue is that clinics in
England which offer cosmetic surgery, such as facelifts, have to be licensed by the Care Quality Commission (CQC), the same health body
which inspects hospitals. It carries
out announced and unannounced
checks, and these clinics also often
offer non-surgical treatments.
But centres which only offer anti-wrinkle injections, chemical
peels, laser and intense pulsed
light treatments, such as hair removal or skin rejuvenation, do
not have to be licensed by the
CQC. According to a CQC spokeswoman, any extension of the
body’s remit would be a matter for
the government.
All eyes are currently on Scotland where private clinics offering
non-surgical cosmetic treatment are
now regulated by Health Improvement Scotland, the equivalent of the
CQC north of the border.
With the absence of state intervention, a number of initiatives have
been set up involving voluntary
regulation, including clinics joining
independent registers which use a
quality kite mark.
One is Save Face, which accredits
individual doctors, dentists, nurses
and clinics. The organisation gathers information on registration,
insurance, training and consent
procedures
from
an online questionnaire, then a nurse
assessor visits the
establishment. It
is now in the final
stages of becoming
accredited by the
Professional Standards
Authority,
which means it will
be recognised by the Department of
Health and others.
Director Ashton Collins says she
is delighted that there are now almost 400 practitioners on the register. “We’re passionate about eradicating unsafe practice from the
non-surgical cosmetic industry by
raising standards throughout the
country,” she says.
So what of the future? Health
Education England, the body responsible for standards within the
healthcare workforce, has published
a report setting out the qualification
requirements for practitioners who
perform these types of treatments.
One thing is agreed that the industry is only going to get bigger – making the issue of regulation a hot topic.
enn Healthcare, a leading
supplier
of
aesthetic
devices, offers not only the
highest standards in technology and
training, but also a groundbreaking
way to ensure the best treatments,
every time.
Advances in non-surgical skin
treatments have transformed the
anti-ageing landscape. Innovative
devices can lift, brighten, tighten
and even volumise skin in a way that
was previously impossible without
resorting to surgery.
While aesthetic technology has
advanced rapidly, the regulations
governing the industry have not
kept up. Many clinics are doing a
great job; however, in a new survey
58 per cent of dermatologists and
plastic surgeons said they had treated
patients for complications caused by
non-surgical procedures.
The survey by the Clinical Standards
Authority for Non-Surgical Cosmetic
Interventions and Joint Council for
Cosmetic Practitioners highlights
what they describe as a “need for
improved training and oversight” in
the aesthetics industry.
As a result, Chris Schiel, chief
executive of Venn Healthcare,
has introduced an unprecedented
360-degree package of training,
support and audit tools for clinics.
“Venn Healthcare’s ethos stems
from its medical background. Patient
safety, research and proven efficacy
are key to all we do,” he says.
Patient safety, research
and proven efficacy are
key to all we do
“We are the exclusive UK
distributors for three trusted
global companies, K-Beauty brands
Lutronic and Classys, and Swissbased Storz Medical, all with stateof-the-art devices and a growing
The demand is so
high that unethical
practitioners see the
industry as a quick
way to make money
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Lutronic’s NEW LASEMD
share of the global market. We
partner with leading clinics in the
UK, and train and educate clinicians
to the highest standards.”
And now, says Mr Schiel, Venn
Healthcare has moved another step
forward encouraging participation
in ASSERT, a transparent system
for clinics to gather independent,
unbiased, measurable and long-term
data on aesthetic treatments.
Professor
Nicola
Maffulli,
ASSERT’s joint principal investigator,
says: “ASSERT has a proven track
record in orthopaedic and sports
medicine, has international ethics
approval and is accepted by NICE,
the National Institute for Health
and Clinical Excellence, and the
NHS. This is a unique opportunity
to deliver the same benefits into the
aesthetics arena.”
By collecting specific data on
results over time, including patient
satisfaction, quality of life outcome
measurements and complications,
ASSERT helps clinics to manage
patient
expectations,
improve
their protocols and know when a
particular practitioner could benefit
from the latest training to achieve
even better results.
Fellow joint principal investigator
for ASSERT, Dr Tapan Patel of PHI
Clinic in London’s Harley Street,
says: “Applying NHS auditing
standards in non-surgical aesthetics
is an exciting development and a
sign of our commitment to achieving
the best results for our patients. We
hope collecting independent data
on patients’ results becomes an
industry-wide initiative.”
Esther Fieldgrass, founder of EF
MEDISPA, welcomes the system,
adding: “I’m always eager to
incorporate new ways to improve
results and customer satisfaction.”
The ASSERT protocol can be
applied to all Venn Healthcare’s
treatments, including its newest
device, Lutronic’s LASEMD laser
cosmeceutical
delivery
system,
launching exclusively at PHI Clinic.
The LASEMD combines fractional
laser energy with bespoke vitamin
serums to boost the skin’s ability to
heal itself from the inside out. The nopain, no-downtime treatments come
with Venn Healthcare’s promise of
results delivered with care.
Mr Schiel concludes: “We want
every patient treated with a Venn
Healthcare device to know they can
relax with the confidence of knowing
they are in the best possible hands.”
www.vennhealthcare.com
GOLD STANDARD TREATMENTS FOUND IN THE BEST PLACES
EF MEDISPA Group
EF MEDISPA, founded by Esther Fieldgrass
in 2006, offers a host of advanced treatments
in four stylish, award-winning clinics in
Kensington, Chelsea, St John’s Wood and
Canary Wharf.
3D SkinLift by Ultraformer
Ultrasound energy penetrates deep below
the skin for immediate and long-lasting
lifting and tightening effects on both
the face and body. The no-downtime
treatments take 30 to 45 minutes. One to
four sessions give the best results.
www.efmedispa.com
020 3627 8674
PHI Clinic
Founded by internationally renowned
cosmetic dermatologist Dr Tapan Patel, the
multi-award-winning PHI Clinic in Harley
Street offers state-of-the-art non-surgical
procedures with five-star service.
Lutronic Infini
Radio frequency waves are delivered deep
into the skin via gold-coated microneedles
for noticeable wrinkle reduction, collagen
boosting, skin tightening and plumping.
Infini can be used on the face and body.
One to three treatments are required, with
best results seen after four to six weeks.
LASEMD
The LASEMD “baby-face laser” creates
microscopic channels in the skin to allow
delivery of advanced cosmeceutical
compounds to the deepest layer of the
skin to trigger repair and rejuvenation.
Unique technology ensures nano-sized
ingredients, such as vitamin C, retinol
and resveratrol, stay fresh without
preservatives. Treatments can improve
wrinkles, skin-sagging, loss of volume,
texture and pigmentation, with no
downtime.
www.phiclinic.com
020 7034 5999
Premier Laser & Skin Clinics
Led by managing director Lucy Xu,
Premier Laser & Skin Clinics are proud to
be one of London’s leading laser and skin
destinations with eight high-tech skin
clinics across London and Surrey.
SPECTRA XT
The SPECTRA XT Carbon Peel Treatment
is an effective solution for enlarged
pores, pigmentation and overall skin
rejuvenation. A carbon-based lotion
is painted on to the face, after which a
laser gently removes the carbon, while
also exfoliating, decongesting pores and
removing sebum, to leave skin looking
clearer, fresher and more youthful. Laser
energy also stimulates collagen production
for tighter pores. Suitable for all skin types,
with results seen after just one treatment.
www.londonpremierlaser.co.uk
0203 131 2843
2
07
08
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11 / 05 / 2016
RACONTEUR
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11 / 05 / 2016
SKINCARE & DERMATOLOGY
09
How to protect against too much sun and stay healthy...
Vitamin D from sunshine is good for the skin and body, but overexposure to the sun’s harmful rays comes with the risk of developing melanoma and other health problems
SUFFICIENCY OF VITAMIN D
ACROSS THE WORLD
THE ILLUSTRATION BELOW SHOWS HOW UV RADIATION LEVELS CHANGE WITH SEASON AND LATITUDE. MAXIMAL UV INDEX
VALUES ARE GIVEN FOR A RANGE OF CITIES IN DIFFERENT COUNTRIES, CALCULATED FOR THE 21ST OF EACH MONTH
EXPOSURE TO VITAMIN D
TOO MUCH SUN CAN RAISE DISEASE RISK, WHILE
TOO LITTLE RISKS VITAMIN D DEFICIENCY
NO DATA
SKELETAL
DISEASE
SKIN CANCERS,
EYE DISEASE
Source: Cell defenses and the sunshine vitamin, Tavera-Mendoza/White
UV INDEX LEVELS
Duration of
exposure
equivalent to
1 SED*
FORECAST OF UV RADIATION AT THE TIME
WHEN THE SUN IS HIGHEST IN THE SKY
JAN
FEB
MAR
Seek shade,
avoid being
outside
during
midday
Extra
hours .
protection
Make
required
sure
you seek
shade. Shirt,
sunscreen and
hat are a must
APR
MAY
JUN
12 min
or less
14 min
16 min
JUL
18 min
AUG
20 min
SEP
Protection
required
OCT
Seek shade
during midday
hours. Wear
a shirt ,
sunscreen
and a hat
25 min
30 min
PORT STANLEY Falkland Islands
WELLINGTON New Zealand
MELBOURNE Australia
CAPE TOWN South Africa
MAPUTO Mozambique
RIO DE JANEIRO Brazil
TANANARIVE Madagascar
DARWIN Australia
NAIROBI Kenya
SINGAPORE Singapore
COLOMBO Sri Lanka
PANAMA Panama
BANGKOK Thailand
HAVANA Cuba
LOS ANGELES United States
TOKYO Japan
PALMA DE MALLORCA Spain
45 min
NEW YORK United States
DEC
ULAN BATOR Mongolia
35 min
PARIS France
NOV
1 hour
10 min
No protection
required
UV index
level
Low
You can
safely stay
outside
Moderate
High
2 hours
20 min
Very
high
Extreme
*Standard erythemal dose is an erythemally weighted radiant UVR equivalent to 100 Jm-2
Source: World Health Organization/International Agency for Research on Cancer
between 15 and 34. Data from Cancer Research UK confirms that rates
of melanoma have continued to increase since the 1970s. This is likely to be related to the desire to look
tanned together with the falling cost
of holiday travel to sunny climates.
An estimated 86 per cent of melanoma cases are related to sun-exposure. Multiple sunburns, particularly in childhood, fair skin,
outdoor occupations or hobbies,
and sunny holidays abroad involving intermittent, high-intensity sunshine are all risk factors.
While most melanoma is detected
early and surgery is usually curative, survival rates remain poor
for late-stage disease. Limiting
sun-exposure is the most effective
way to reduce the risks.
The British Skin Foundation
recommends the use of regular
sunscreen throughout the year
to protect against skin cancer.
This should ideally be at least sun
protection factor 15, and provide
broad-spectrum cover against UVA
and UVB radiation.
Sunscreen should be worn on
sun-exposed sites and applied
at least 30 minutes before going
outdoors. It should be reapplied
about every 90 minutes and after
sweating or swimming. An ounce
of sunscreen is adequate to cover
an adult from head to toe; this is
approximately the amount contained in a shot glass. Half a teaspoon should adequately cover
the face and neck.
Burden of disease
INSUFFICIENT
AT LEAST ONE
MONTH
58°S
42°S
37°S
34°S
26°S
23°S
19°S
13°S
1°S
From the countries mentioned in the list below,
New Zealand and Australia have the highest
rates of skin cancers, while Sri Lanka and
Singapore have the lowest, according
to data from the World Health
Organization
VANCOUVER Canada
VITAMIN D
DEFICIENCY
SUFFICIENT
ALL YEAR
1°N
7°N
9°N
14°N
23°N
34°N
Skin type is a major factor when
determining how at risk you are from skin
cancer due to over-exposure to the sun. Due
to their relative lack of skin pigmentation, fairer
populations generally are at much higher risk than
those with darker skin. Naturally darker people can
usually safely tolerate relatively high levels of sunexposure without burning or greatly increasing their
skin cancer risk, though they are still not immune.
36°N
SKIN CANCER
VITAMIN D
DEFICIENCY
INSUFFICIENT
AT LEAST ONE
MONTH
39°N
41°N
48°N
49°N
49°N
52°N
INSUFFICIENT
MOST OF THE
YEAR
BERLIN Germany
We clearly need
vitamin D from
sunshine to maintain
health, but no one
knowingly wants
to be put at risk of
developing cancer
BALANCING VITAMIN D EXPOSURE AND SUN CARE
60°N
S
pring is here and longer
days are upon us. As we
shed our winter layers and
spend more time outdoors,
many of us seek this opportunity
to top up our vitamin D levels, having been starved of sunshine in the
greyer months.
However, there remains a strong,
resounding message from the dermatology community that we should
all be wearing regular sunscreen to
protect against skin cancer.
Often, the messages can be confusing. On the one hand, we clearly
need vitamin D from sunshine to
maintain health; on the other, no
one knowingly wants to be put at
risk of developing cancer.
So how do we go about balancing
the risks? What should we be doing
to look after both our skin and our
general health?
Vitamin D is a fat-soluble vitamin essential for
maintaining bone
health.
Shahir
Hamdulay,
consultant physician
and
rheumatologist at The Wellington Hospital in
London, explains:
“Deficiency of vitamin D is highly
prevalent
worldwide and attributed in part to inadequate sunlight
exposure.”
Deficiency will lead to
weakening of the bones, resulting in
rickets in children and osteomalacia
or osteoporosis in adults.
There is also evidence to suggest vitamin D provides protection
against some types of cancer, heart
disease, multiple sclerosis and diabetes, as well as providing benefits
to mood and wellbeing. Dr Hamdulay adds: “These important roles
need to be considered when protecting the skin.”
An individual’s vitamin D status
can be checked with a simple blood
test to measure serum 25-hydroxyvitamin D levels. Authorities generally agree that laboratory levels
below 25nmol/L are deficient.
Unprotected sun exposure is the
major source of vitamin D production for most adults and children
in the UK. Sunlight, in particular
ultraviolet-B (UVB) radiation, drives
vitamin D synthesis in skin. The
amount of UVB radiation to which
we are exposed depends on the time
of day, season and latitude. In the
UK it is highest between the hours of
10am and 3pm at the height of summer. Vitamin D production also varies from person to person, with dark
or pigmented skin requiring longer
UVB exposure to synthesise equivalent amounts.
The British Association of Dermatologists (BAD) reports a consensus
view that the time required to synthesise vitamin D in the skin is relatively short, and less than the time
needed for skin to redden and burn.
Importantly, continued sun exposure does not result in ongoing
vitamin D production; vitamin D is
converted into inert or inactive substances in the skin after prolonged
UVB radiation. There is, therefore,
no benefit in sunbathing for long
periods of time purely to increase
vitamin D levels.
BAD’s guidance recommends
being outdoors for a few minutes
around midday without sunscreen,
though individuals are encouraged to recognise their own skin to
get some idea of how long they can
spend outdoors without burning.
Apart from sunlight, vitamin D
can also be obtained from dietary
sources and supplementation.
Foods rich in vitamin D include
oily fish, such as
mackerel, salmon
and sardines, as
well as fortified
margarine, cereals
and egg yolks. Dr
Hamdulay advises
you should ensure
adequate oral intake of vitamin D,
recommended at
800 units a day,
to reduce the risks
of deficiency.
Oral vitamin D
supplementation is likely to be necessary at times. Indeed, recent National Institute for Health and Care
Excellence guidelines state that it is
not possible to get enough vitamin D
from sunlight between October and
March in the UK. The Department
of Health already recommends
supplementation for pregnant and
breastfeeding women, young children, older people and those at risk
because of low sun-exposure.
It is worth noting that over-supplementation should also be treated with caution; high levels of vitamin D – above 75 nmol/L – have
been linked to health problems.
The key, as with everything, seems
to be moderation.
What is it that makes dermatologists so concerned about the sun?
The fear is the rising rates of skin
cancers, in particular melanoma,
which is a potentially fatal skin cancer that occurs due to the uncontrolled growth of pigment-producing cells known as melanocytes.
It either develops within a pre-existing mole or manifests as a new
mole on the body. It is the second
most common cancer in those aged
ST PETERSBURG Russia
SUNSHINE
ANJALI MAHTO
MINIMUM
RISK
Low
Optimal
Personal exposure to UVR relative to skin type
Healthcare professionals are realising the importance of screening and early detection of skin
cancer. Melanoma, when identified early, has a good prognosis. The skin is the largest organ
of the body and any changes are
outwardly visible, with no real requirement for detailed internal investigation. Skin, therefore, lends
itself well to worrying changes being detected by a doctor.
Some people may
wish to make molescreening a part of
their preventative
health check
If you have any concerns about
a mole, your GP is able to check it
for you free on the NHS. If there is
any possibility of skin cancer, the
doctor will refer you to a dermatologist and you should be seen within two weeks.
Some people may wish to make
mole-screening a part of their preventative health check. There are
mole clinics available in the private sector, but according to BAD’s
website, there is no evidence
High
Source: WHO
these “can replace the experienced clinical opinion of a trained
consultant dermatologist”.
Dr Nisith Sheth, consultant
dermatologist at the Lister Hospital, Stevenage, confirms this.
“Mole-mapping with photographs
can be a useful adjunct combined
with a dermatologist examining the
skin,” he says. “Photos can provide
a useful record over time for any
changes that occur.”
He advises being wary of any system
where a dermatologist does not physically look at your skin. “Individuals
should also get into the habit of looking at their own skin once a month to
look for any changes and to seek medical attention if there is any doubt.”
There is evidence that rigorous
sun protection can lead to vitamin
D deficiency. Most dermatologists
are nevertheless in agreement that
the dangers of sun-exposure outweigh the benefits.
Vitamin D can be sourced from
diet and supplementation if levels
are low, rather than relying on the
sun as a source to drive synthesis.
There is no recognised health benefit
of over-supplementation, however,
and high levels may cause harm. The
greatest risk of sun-overexposure is
melanoma, a skin cancer that manifests as abnormal-looking moles.
Any unusual moles should always be
examined by a GP or dermatologist.
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08
raconteur.net
SKINCARE & DERMATOLOGY
11 / 05 / 2016
RACONTEUR
RACONTEUR
raconteur.net
11 / 05 / 2016
SKINCARE & DERMATOLOGY
09
How to protect against too much sun and stay healthy...
Vitamin D from sunshine is good for the skin and body, but overexposure to the sun’s harmful rays comes with the risk of developing melanoma and other health problems
SUFFICIENCY OF VITAMIN D
ACROSS THE WORLD
THE ILLUSTRATION BELOW SHOWS HOW UV RADIATION LEVELS CHANGE WITH SEASON AND LATITUDE. MAXIMAL UV INDEX
VALUES ARE GIVEN FOR A RANGE OF CITIES IN DIFFERENT COUNTRIES, CALCULATED FOR THE 21ST OF EACH MONTH
EXPOSURE TO VITAMIN D
TOO MUCH SUN CAN RAISE DISEASE RISK, WHILE
TOO LITTLE RISKS VITAMIN D DEFICIENCY
NO DATA
SKELETAL
DISEASE
SKIN CANCERS,
EYE DISEASE
Source: Cell defenses and the sunshine vitamin, Tavera-Mendoza/White
UV INDEX LEVELS
Duration of
exposure
equivalent to
1 SED*
FORECAST OF UV RADIATION AT THE TIME
WHEN THE SUN IS HIGHEST IN THE SKY
JAN
FEB
MAR
Seek shade,
avoid being
outside
during
midday
Extra
hours .
protection
Make
required
sure
you seek
shade. Shirt,
sunscreen and
hat are a must
APR
MAY
JUN
12 min
or less
14 min
16 min
JUL
18 min
AUG
20 min
SEP
Protection
required
OCT
Seek shade
during midday
hours. Wear
a shirt ,
sunscreen
and a hat
25 min
30 min
PORT STANLEY Falkland Islands
WELLINGTON New Zealand
MELBOURNE Australia
CAPE TOWN South Africa
MAPUTO Mozambique
RIO DE JANEIRO Brazil
TANANARIVE Madagascar
DARWIN Australia
NAIROBI Kenya
SINGAPORE Singapore
COLOMBO Sri Lanka
PANAMA Panama
BANGKOK Thailand
HAVANA Cuba
LOS ANGELES United States
TOKYO Japan
PALMA DE MALLORCA Spain
45 min
NEW YORK United States
DEC
ULAN BATOR Mongolia
35 min
PARIS France
NOV
1 hour
10 min
No protection
required
UV index
level
Low
You can
safely stay
outside
Moderate
High
2 hours
20 min
Very
high
Extreme
*Standard erythemal dose is an erythemally weighted radiant UVR equivalent to 100 Jm-2
Source: World Health Organization/International Agency for Research on Cancer
between 15 and 34. Data from Cancer Research UK confirms that rates
of melanoma have continued to increase since the 1970s. This is likely to be related to the desire to look
tanned together with the falling cost
of holiday travel to sunny climates.
An estimated 86 per cent of melanoma cases are related to sun-exposure. Multiple sunburns, particularly in childhood, fair skin,
outdoor occupations or hobbies,
and sunny holidays abroad involving intermittent, high-intensity sunshine are all risk factors.
While most melanoma is detected
early and surgery is usually curative, survival rates remain poor
for late-stage disease. Limiting
sun-exposure is the most effective
way to reduce the risks.
The British Skin Foundation
recommends the use of regular
sunscreen throughout the year
to protect against skin cancer.
This should ideally be at least sun
protection factor 15, and provide
broad-spectrum cover against UVA
and UVB radiation.
Sunscreen should be worn on
sun-exposed sites and applied
at least 30 minutes before going
outdoors. It should be reapplied
about every 90 minutes and after
sweating or swimming. An ounce
of sunscreen is adequate to cover
an adult from head to toe; this is
approximately the amount contained in a shot glass. Half a teaspoon should adequately cover
the face and neck.
Burden of disease
INSUFFICIENT
AT LEAST ONE
MONTH
58°S
42°S
37°S
34°S
26°S
23°S
19°S
13°S
1°S
From the countries mentioned in the list below,
New Zealand and Australia have the highest
rates of skin cancers, while Sri Lanka and
Singapore have the lowest, according
to data from the World Health
Organization
VANCOUVER Canada
VITAMIN D
DEFICIENCY
SUFFICIENT
ALL YEAR
1°N
7°N
9°N
14°N
23°N
34°N
Skin type is a major factor when
determining how at risk you are from skin
cancer due to over-exposure to the sun. Due
to their relative lack of skin pigmentation, fairer
populations generally are at much higher risk than
those with darker skin. Naturally darker people can
usually safely tolerate relatively high levels of sunexposure without burning or greatly increasing their
skin cancer risk, though they are still not immune.
36°N
SKIN CANCER
VITAMIN D
DEFICIENCY
INSUFFICIENT
AT LEAST ONE
MONTH
39°N
41°N
48°N
49°N
49°N
52°N
INSUFFICIENT
MOST OF THE
YEAR
BERLIN Germany
We clearly need
vitamin D from
sunshine to maintain
health, but no one
knowingly wants
to be put at risk of
developing cancer
BALANCING VITAMIN D EXPOSURE AND SUN CARE
60°N
S
pring is here and longer
days are upon us. As we
shed our winter layers and
spend more time outdoors,
many of us seek this opportunity
to top up our vitamin D levels, having been starved of sunshine in the
greyer months.
However, there remains a strong,
resounding message from the dermatology community that we should
all be wearing regular sunscreen to
protect against skin cancer.
Often, the messages can be confusing. On the one hand, we clearly
need vitamin D from sunshine to
maintain health; on the other, no
one knowingly wants to be put at
risk of developing cancer.
So how do we go about balancing
the risks? What should we be doing
to look after both our skin and our
general health?
Vitamin D is a fat-soluble vitamin essential for
maintaining bone
health.
Shahir
Hamdulay,
consultant physician
and
rheumatologist at The Wellington Hospital in
London, explains:
“Deficiency of vitamin D is highly
prevalent
worldwide and attributed in part to inadequate sunlight
exposure.”
Deficiency will lead to
weakening of the bones, resulting in
rickets in children and osteomalacia
or osteoporosis in adults.
There is also evidence to suggest vitamin D provides protection
against some types of cancer, heart
disease, multiple sclerosis and diabetes, as well as providing benefits
to mood and wellbeing. Dr Hamdulay adds: “These important roles
need to be considered when protecting the skin.”
An individual’s vitamin D status
can be checked with a simple blood
test to measure serum 25-hydroxyvitamin D levels. Authorities generally agree that laboratory levels
below 25nmol/L are deficient.
Unprotected sun exposure is the
major source of vitamin D production for most adults and children
in the UK. Sunlight, in particular
ultraviolet-B (UVB) radiation, drives
vitamin D synthesis in skin. The
amount of UVB radiation to which
we are exposed depends on the time
of day, season and latitude. In the
UK it is highest between the hours of
10am and 3pm at the height of summer. Vitamin D production also varies from person to person, with dark
or pigmented skin requiring longer
UVB exposure to synthesise equivalent amounts.
The British Association of Dermatologists (BAD) reports a consensus
view that the time required to synthesise vitamin D in the skin is relatively short, and less than the time
needed for skin to redden and burn.
Importantly, continued sun exposure does not result in ongoing
vitamin D production; vitamin D is
converted into inert or inactive substances in the skin after prolonged
UVB radiation. There is, therefore,
no benefit in sunbathing for long
periods of time purely to increase
vitamin D levels.
BAD’s guidance recommends
being outdoors for a few minutes
around midday without sunscreen,
though individuals are encouraged to recognise their own skin to
get some idea of how long they can
spend outdoors without burning.
Apart from sunlight, vitamin D
can also be obtained from dietary
sources and supplementation.
Foods rich in vitamin D include
oily fish, such as
mackerel, salmon
and sardines, as
well as fortified
margarine, cereals
and egg yolks. Dr
Hamdulay advises
you should ensure
adequate oral intake of vitamin D,
recommended at
800 units a day,
to reduce the risks
of deficiency.
Oral vitamin D
supplementation is likely to be necessary at times. Indeed, recent National Institute for Health and Care
Excellence guidelines state that it is
not possible to get enough vitamin D
from sunlight between October and
March in the UK. The Department
of Health already recommends
supplementation for pregnant and
breastfeeding women, young children, older people and those at risk
because of low sun-exposure.
It is worth noting that over-supplementation should also be treated with caution; high levels of vitamin D – above 75 nmol/L – have
been linked to health problems.
The key, as with everything, seems
to be moderation.
What is it that makes dermatologists so concerned about the sun?
The fear is the rising rates of skin
cancers, in particular melanoma,
which is a potentially fatal skin cancer that occurs due to the uncontrolled growth of pigment-producing cells known as melanocytes.
It either develops within a pre-existing mole or manifests as a new
mole on the body. It is the second
most common cancer in those aged
ST PETERSBURG Russia
SUNSHINE
ANJALI MAHTO
MINIMUM
RISK
Low
Optimal
Personal exposure to UVR relative to skin type
Healthcare professionals are realising the importance of screening and early detection of skin
cancer. Melanoma, when identified early, has a good prognosis. The skin is the largest organ
of the body and any changes are
outwardly visible, with no real requirement for detailed internal investigation. Skin, therefore, lends
itself well to worrying changes being detected by a doctor.
Some people may
wish to make molescreening a part of
their preventative
health check
If you have any concerns about
a mole, your GP is able to check it
for you free on the NHS. If there is
any possibility of skin cancer, the
doctor will refer you to a dermatologist and you should be seen within two weeks.
Some people may wish to make
mole-screening a part of their preventative health check. There are
mole clinics available in the private sector, but according to BAD’s
website, there is no evidence
High
Source: WHO
these “can replace the experienced clinical opinion of a trained
consultant dermatologist”.
Dr Nisith Sheth, consultant
dermatologist at the Lister Hospital, Stevenage, confirms this.
“Mole-mapping with photographs
can be a useful adjunct combined
with a dermatologist examining the
skin,” he says. “Photos can provide
a useful record over time for any
changes that occur.”
He advises being wary of any system
where a dermatologist does not physically look at your skin. “Individuals
should also get into the habit of looking at their own skin once a month to
look for any changes and to seek medical attention if there is any doubt.”
There is evidence that rigorous
sun protection can lead to vitamin
D deficiency. Most dermatologists
are nevertheless in agreement that
the dangers of sun-exposure outweigh the benefits.
Vitamin D can be sourced from
diet and supplementation if levels
are low, rather than relying on the
sun as a source to drive synthesis.
There is no recognised health benefit
of over-supplementation, however,
and high levels may cause harm. The
greatest risk of sun-overexposure is
melanoma, a skin cancer that manifests as abnormal-looking moles.
Any unusual moles should always be
examined by a GP or dermatologist.
Share this article online via
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xxxx
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XXXX
SKINCARE & DERMATOLOGY
2
11
COMMERCIAL FEATURE
The changing face of ageing
Getty Images
As more older women reject frozen faces and pillow cheeks, there are new approaches to ageing well
01
LEAH HARDY
F
rom actress Helen Mirren,
72, to model Elle Macpherson, 52, today’s active, energetic older celebrities
present a very different image to the
stereotype of the homey, grey-haired
granny. But then, in recent years, our
idea of what it means to grow – and
look – old has changed radically.
Much of this is down to the power,
culturally and numerically, of the
baby boomers, the ever-youthful
generation aged roughly between 50
and 70 years old. United Nations figures show that by 2020, one in three
women around the world will be over
50. In less than 15 years, half of all
women will be over
50 and the over50s already hold
around 77 per cent
of the UK’s wealth.
They are increasingly active, economically and socially. 2015 figures
from the Office for
National
Statistics (ONS) revealed
that the number of
women over 50 in
work has risen by
45 per cent since
2010. They are also re-entering the
dating arena at an unprecedented
rate. ONS figures revealed that in
2013, compared to ten years ago, divorce had decreased in virtually all
age groups except the over-40s.
It’s not surprising, therefore, that
a 2014 L’Oréal report concluded:
“Appearance is just as important to
over-50s as under-50s.” The beauty
market for women aged 50-plus is
estimated to be worth around £2
billion a year and analysts at market research agency Mintel found
that for women aged 55-plus, “us-
age of anti-ageing face care is almost universal”.
Increasingly, these affluent women are looking for more potent anti-ageing solutions. Last October,
Charlotte Libby, senior beauty analyst at Mintel, wrote: “Anti-ageing
beauty markets benefit from a society which is perceived to prioritise
youth; a pressure felt most strongly
by women. The ageing population
is set to expand the user base, although traditional topical products
may be threatened as treatments
and surgical procedures become
more commonplace.”
This year, a British Association of
Aesthetic Plastic Surgeons survey
found surgical facelifts were up by 16
per cent. Botox manufacturer Allergan reported a 13 per cent increase
in
anti-wrinkle
Botox treatments
worldwide for the
same period.
At the same time,
influenced by feminism and the power
of boomers, we have
seen a trend for positive ageing. Grey
hair is in fashion,
older models have
been adopted by
fashion brands and,
earlier this year,
56-year-old Nicola
Griffin became the oldest women ever
to appear in the famous bikini issue of
US publication Sports Illustrated.
Perhaps surprisingly, the anti-ageing industry too is embracing the
pro-age trend. A recent survey by
Allergan found only 20 per cent of
women would choose to look five
years younger if they had the option,
41 per cent said they wanted to look
refreshed and radiant, and 76 per
cent wanted to grow old gracefully.
Allergan’s “This is me” advertising campaign for its Juvederm filler
range uses images of real women
It used to be that
women would lie
about their age –
now they are more
likely to tell the truth
and have people say
they look well
We all know that as we age, we start to
see changes in our faces. Those fine lines
appear and ultimately what was taut
and tight succumbs to gravity, says
Sherina Balaratnam
01
‘Positive ageing’
is now in vogue
with older women
favouring subtler
approaches to
looking young
7,047
2014
2015
Rhinoplasty
(nose)
Browlift
553
670
Face/neck lift
481
1,946
1,962
1,836
3,393
3,841
2,977
6,075
6,016
7,713
6,921
6,903
Blepharoplasty
(eyelid)
02
02
Customer receiving
a red light therapy
facial at The House
of ELEMIS in
Mayfair to smooth
the appearance of
fine lines
FACIAL SURGICAL PROCEDURES FOR UK WOMEN
2013
A
Elemis
PERCEPTIONS OF AGE
ACHIEVE THE
EFFECT OF
YOUTHFUL AND
HYDRATED SKIN
Otoplasty
(ear)
British Association of Aesthetic Plastic Surgeons 2016
aged between 50 and 70, and slogans
such as “I love my wrinkles – well
half of them”.
The dermatology company Galderma ran a US campaign entitled
“Don’t freeze me” for women “who
want to lose their frown lines, but
don’t want to lose themselves”.
“At the heart of these campaigns is
the insight that women want subtle,
natural-looking results from aesthetic treatments that allow them
to stay authentic and true to themselves,” says Alisa Lask, vice president of US marketing at Galderma.
Dermatologist Dr Stefanie Williams agrees the “younger but frozen” look is over. “It’s becoming
more about empowerment and taking charge of how well you look,”
she says. “The mantra today is that
you want to look good whatever your
age. Not necessarily younger, but
simply healthy and attractive.”
Aesthetic specialist Sarah Tonks
concurs. “It used to be that women
would lie about their age – now they
are more likely to tell the truth and
have people say they look well,” says
Dr Tonks, adding that doctors treating ageing faces increasingly favour
a “cocktail” of treatments. “Energy-based devices using ultrasound
and radio frequency offer overall lift
and tightening, which looks more
natural than just treating one specific area,” she says.
Dr Tonks will often suggest professional skincare and laser or IPL
(intense pulsed light) to remove
small blemishes, such as thread
veins for a flawless finish, plus
thread lifts “as an add-on to give
more lift along the jawline”.
Ocuplastic surgeon and aesthetic specialist Maryam Zamani says:
“Everyone is bothered by pigmentation. Clear skin is more youthful
than being unlined.” Dr Zamani
offers combinations of ultherapy,
fillers, PRP (platelet-rich plasma),
microneedling, fractionated laser
and fillers for the key eye area.
Dr Williams says that although
fillers and Botox have been “dialled
down” in the anti-ageing mix, they
remain important. While dermatologist Dr Kuldeep Minochka points to
new research showing Botox and hyaluronic acid fillers not only paralyse
muscles and volumise the face, they
also rejuvenate skin by stimulating
collagen, which gives skin structure
and elastin, which gives it “bounce”.
Forget the overstuffed “pillow face”.
Plastic surgeon Kambiz Golchin says:
“The emphasis is on using small
amounts all over the face for subtle
global change.” This is the concept
behind Allergan’s 8 Point Lift template for injectors, though Mr Golchin
says an artistic eye and individual assessment remains vital.
Novel areas being filled include
the temples, the fold of the chin below the lower lip, the outer jaw and
the corner of the mouth, which all
lose volume with age.
Botox too is being used in more subtle ways. Dr Vicki Dondos describes
“sprinkling” microdroplets into the
forehead. “Professional women especially want natural, undetectable
results and are prepared to have treatments more often,” she says.
While Botox can only legally be
given by or under the direction of a
dentist, doctor or nurse prescriber,
there is no legislation around who
can administer lasers and fillers.
“There are still too many irresponsible aesthetic practitioners out there,”
says Dr Williams. “While the General
Medical Council’s recommendations
to ban two-for-one offers and ensure
patients are not rushed into procedures are sensible, most of the ‘cosmetic cowboys’ would not come under
GMC ruling as they are non-medics.”
Share this article online via
Raconteur.net
s a surgeon with a background
in plastic surgery, I know that
one of the major signs of
ageing that I see in my patients is
loss of volume.
In part this is due to the fact that
as we age our bodies produce less
collagen and elastin, the protein
structures that give skin their
youthful firmness and bounce.
But it’s also because the levels of
a substance called hyaluronic acid
start to decrease, leaving skin
less supported, allowing lines and
wrinkles to develop and our facial
structure to drop.
While smoking, sun exposure and
pollution can all accelerate the pace
at which this happens, unfortunately
it will happen to us all in the end.
In fact, research shows that
this sort of volume loss actually
happens around seven years before
gravity takes hold, so it’s not
sagging that is the initial concern,
but the loss of the contours that
used to be there. That’s where
facial fillers can help.
Facial fillers – substances injected
under the surface of the skin –
can be used to help shape the
face and restore youthful volume.
While there are some permanent
fillers on the market, like most
practitioners I tend to prefer
temporary products that break
down over time. That’s because a
patient’s face evolves over time,
so putting something permanent in
just ends up looking unnatural.
In the past, fillers have included
substances such as transplanted fat
that has been removed from another
part of the body and then reinjected
YOUR QUESTIONS ANSWERED
How do I find a practitioner?
Finding a qualified and
experienced practitioner is
essential. Search at this-is-me.
com to find one close to you,
alongside before-and-after
photographs and customer
testimonials.
What should I expect from a
consultation?
A good consultation should last
a minimum of 30 minutes. Your
practitioner should understand
why you want treatment,
carefully examine and assess
your face and skin, and explain
what they can, and can’t, do.
They should also run through
your options, answer all of your
questions, discuss costs, side
effects and what to expect from
your treatment.
What does the treatment
itself entail?
Your practitioner will go over
your treatment plan and mark
where on your face they plan
to inject before starting. Some
practitioners will numb the
area they’re injecting with an
anaesthetic cream, but as some
fillers also contain anaesthetic,
it’s not always necessary.
Are there any side effects?
You may get some temporary
tenderness, redness, swelling or
bruising where you’ve had the
injections, but this all clears within
a few days. Your practitioner will
advise the best way to care for your
skin after treatment. Most will
suggest that you avoid make-up for
12 hours and stay out of the sun
for two weeks.
into the face, and collagen usually
derived from animals.
But both these approaches had
their limitations in different ways. If
you wanted to inject fat, it required a
surgical intervention to remove it from
the body first. While if you wanted to
inject collagen, this required allergy
testing so patients often had to pay
multiple visits to the clinic.
Now I use a facial filler based on
hyaluronic acid, which is why I use
Juvéderm facial fillers.
But what exactly is hyaluronic acid?
Often shortened to HA, it’s a naturally
occurring sugar that has incredible
moisturising powers, thanks to its
amazing ability to hold water. In fact,
HA can bind up to 1,000 times its own
weight in water. You’ll find more than
50 per cent of all the body’s HA in
the skin, where, in both the top layers
and lower layers, it helps to maintain
moisture levels. But it also cushions and
lubricates joints, and it even helps your
eyeballs to keep their shape.
That’s why I really like to use HA for
facial rejuvenation. Because when you
inject HA into the skin, you’re using
something that is as close as possible to
what was there before.
As well as being a bit of a hero
in the body, in recent years HA has
become something of a buzzword
in the cosmetics world, thanks to
its moisturising abilities and waterattracting properties. Because, of
course, when it comes to skin, water
equals plumpness, which equals skin
that looks healthy and youthful –
it’s the difference between a raisin
and a grape.
But while there’s no doubting that
applying a topical product that contains
HA will help the top layer of your skin,
and there’s some suggestion that some
of it could even go deeper into the skin,
to get significant amounts of HA into
the lower layers of the skin you need to
inject it.
The beauty of HA is that it doesn’t
just replace volume, it also draws
moisture to the area so the overall
effect is dewy, luminous, hydrated and
youthful. And should you have second
thoughts, this is also a reversible
process because, as well as containing
HA, our bodies also contain an enzyme
called hyaluronidase, which naturally
breaks down HA.
The HA you’ll find in facial fillers,
such as the Juvéderm range, has
been formulated in such a way that
they are not instantly broken down
by this enzyme. Juvéderm fillers
are temporary and you can expect
results to last approximately up to 18
months before the hyaluronic acid is
broken down by the body naturally,
RIGHT
Sherina Balaratnam
Surgeon and
medical director
S-Thetics, medical
aesthetic clinic,
Beaconsfield,
Buckinghamshire,
sthetics.co.uk
Whether you’re worried about fine
lines around the lips or want to regain
volume in the cheeks, there’s a filler
that can do it
depending on the area treated and
the product used.
Whether you’re worried about
fine lines around the lips or want to
regain volume in the cheeks, there’s
a filler that can do it.
The Juvéderm Vycross range comes
in a number of different viscosities,
which allows me to layer subtly
different types of filler to create a
really natural result. For example,
I would use Voluma in the deep fat
compartments where more volume is
required, then the slightly less viscous
Volift for the more superficial fat
pockets, and finally, around the mouth
– those lines that lipstick often bleeds
into – I’d inject a little Volbella that fills
very lightly, but crucially really helps
hydrate the skin and achieve fullness
in the lips.
www.this-is-me.com
Date of prep: April 2016 UK/0283/2016
10
raconteur.net
SKINCARE & DERMATOLOGY
11 / 05 / 2016
RACONTEUR
RACONTEUR
raconteur.net
xx
xx / 2016
xxxx
11 / 05
XXXX
SKINCARE & DERMATOLOGY
2
11
COMMERCIAL FEATURE
The changing face of ageing
Getty Images
As more older women reject frozen faces and pillow cheeks, there are new approaches to ageing well
01
LEAH HARDY
F
rom actress Helen Mirren,
72, to model Elle Macpherson, 52, today’s active, energetic older celebrities
present a very different image to the
stereotype of the homey, grey-haired
granny. But then, in recent years, our
idea of what it means to grow – and
look – old has changed radically.
Much of this is down to the power,
culturally and numerically, of the
baby boomers, the ever-youthful
generation aged roughly between 50
and 70 years old. United Nations figures show that by 2020, one in three
women around the world will be over
50. In less than 15 years, half of all
women will be over
50 and the over50s already hold
around 77 per cent
of the UK’s wealth.
They are increasingly active, economically and socially. 2015 figures
from the Office for
National
Statistics (ONS) revealed
that the number of
women over 50 in
work has risen by
45 per cent since
2010. They are also re-entering the
dating arena at an unprecedented
rate. ONS figures revealed that in
2013, compared to ten years ago, divorce had decreased in virtually all
age groups except the over-40s.
It’s not surprising, therefore, that
a 2014 L’Oréal report concluded:
“Appearance is just as important to
over-50s as under-50s.” The beauty
market for women aged 50-plus is
estimated to be worth around £2
billion a year and analysts at market research agency Mintel found
that for women aged 55-plus, “us-
age of anti-ageing face care is almost universal”.
Increasingly, these affluent women are looking for more potent anti-ageing solutions. Last October,
Charlotte Libby, senior beauty analyst at Mintel, wrote: “Anti-ageing
beauty markets benefit from a society which is perceived to prioritise
youth; a pressure felt most strongly
by women. The ageing population
is set to expand the user base, although traditional topical products
may be threatened as treatments
and surgical procedures become
more commonplace.”
This year, a British Association of
Aesthetic Plastic Surgeons survey
found surgical facelifts were up by 16
per cent. Botox manufacturer Allergan reported a 13 per cent increase
in
anti-wrinkle
Botox treatments
worldwide for the
same period.
At the same time,
influenced by feminism and the power
of boomers, we have
seen a trend for positive ageing. Grey
hair is in fashion,
older models have
been adopted by
fashion brands and,
earlier this year,
56-year-old Nicola
Griffin became the oldest women ever
to appear in the famous bikini issue of
US publication Sports Illustrated.
Perhaps surprisingly, the anti-ageing industry too is embracing the
pro-age trend. A recent survey by
Allergan found only 20 per cent of
women would choose to look five
years younger if they had the option,
41 per cent said they wanted to look
refreshed and radiant, and 76 per
cent wanted to grow old gracefully.
Allergan’s “This is me” advertising campaign for its Juvederm filler
range uses images of real women
It used to be that
women would lie
about their age –
now they are more
likely to tell the truth
and have people say
they look well
We all know that as we age, we start to
see changes in our faces. Those fine lines
appear and ultimately what was taut
and tight succumbs to gravity, says
Sherina Balaratnam
01
‘Positive ageing’
is now in vogue
with older women
favouring subtler
approaches to
looking young
7,047
2014
2015
Rhinoplasty
(nose)
Browlift
553
670
Face/neck lift
481
1,946
1,962
1,836
3,393
3,841
2,977
6,075
6,016
7,713
6,921
6,903
Blepharoplasty
(eyelid)
02
02
Customer receiving
a red light therapy
facial at The House
of ELEMIS in
Mayfair to smooth
the appearance of
fine lines
FACIAL SURGICAL PROCEDURES FOR UK WOMEN
2013
A
Elemis
PERCEPTIONS OF AGE
ACHIEVE THE
EFFECT OF
YOUTHFUL AND
HYDRATED SKIN
Otoplasty
(ear)
British Association of Aesthetic Plastic Surgeons 2016
aged between 50 and 70, and slogans
such as “I love my wrinkles – well
half of them”.
The dermatology company Galderma ran a US campaign entitled
“Don’t freeze me” for women “who
want to lose their frown lines, but
don’t want to lose themselves”.
“At the heart of these campaigns is
the insight that women want subtle,
natural-looking results from aesthetic treatments that allow them
to stay authentic and true to themselves,” says Alisa Lask, vice president of US marketing at Galderma.
Dermatologist Dr Stefanie Williams agrees the “younger but frozen” look is over. “It’s becoming
more about empowerment and taking charge of how well you look,”
she says. “The mantra today is that
you want to look good whatever your
age. Not necessarily younger, but
simply healthy and attractive.”
Aesthetic specialist Sarah Tonks
concurs. “It used to be that women
would lie about their age – now they
are more likely to tell the truth and
have people say they look well,” says
Dr Tonks, adding that doctors treating ageing faces increasingly favour
a “cocktail” of treatments. “Energy-based devices using ultrasound
and radio frequency offer overall lift
and tightening, which looks more
natural than just treating one specific area,” she says.
Dr Tonks will often suggest professional skincare and laser or IPL
(intense pulsed light) to remove
small blemishes, such as thread
veins for a flawless finish, plus
thread lifts “as an add-on to give
more lift along the jawline”.
Ocuplastic surgeon and aesthetic specialist Maryam Zamani says:
“Everyone is bothered by pigmentation. Clear skin is more youthful
than being unlined.” Dr Zamani
offers combinations of ultherapy,
fillers, PRP (platelet-rich plasma),
microneedling, fractionated laser
and fillers for the key eye area.
Dr Williams says that although
fillers and Botox have been “dialled
down” in the anti-ageing mix, they
remain important. While dermatologist Dr Kuldeep Minochka points to
new research showing Botox and hyaluronic acid fillers not only paralyse
muscles and volumise the face, they
also rejuvenate skin by stimulating
collagen, which gives skin structure
and elastin, which gives it “bounce”.
Forget the overstuffed “pillow face”.
Plastic surgeon Kambiz Golchin says:
“The emphasis is on using small
amounts all over the face for subtle
global change.” This is the concept
behind Allergan’s 8 Point Lift template for injectors, though Mr Golchin
says an artistic eye and individual assessment remains vital.
Novel areas being filled include
the temples, the fold of the chin below the lower lip, the outer jaw and
the corner of the mouth, which all
lose volume with age.
Botox too is being used in more subtle ways. Dr Vicki Dondos describes
“sprinkling” microdroplets into the
forehead. “Professional women especially want natural, undetectable
results and are prepared to have treatments more often,” she says.
While Botox can only legally be
given by or under the direction of a
dentist, doctor or nurse prescriber,
there is no legislation around who
can administer lasers and fillers.
“There are still too many irresponsible aesthetic practitioners out there,”
says Dr Williams. “While the General
Medical Council’s recommendations
to ban two-for-one offers and ensure
patients are not rushed into procedures are sensible, most of the ‘cosmetic cowboys’ would not come under
GMC ruling as they are non-medics.”
Share this article online via
Raconteur.net
s a surgeon with a background
in plastic surgery, I know that
one of the major signs of
ageing that I see in my patients is
loss of volume.
In part this is due to the fact that
as we age our bodies produce less
collagen and elastin, the protein
structures that give skin their
youthful firmness and bounce.
But it’s also because the levels of
a substance called hyaluronic acid
start to decrease, leaving skin
less supported, allowing lines and
wrinkles to develop and our facial
structure to drop.
While smoking, sun exposure and
pollution can all accelerate the pace
at which this happens, unfortunately
it will happen to us all in the end.
In fact, research shows that
this sort of volume loss actually
happens around seven years before
gravity takes hold, so it’s not
sagging that is the initial concern,
but the loss of the contours that
used to be there. That’s where
facial fillers can help.
Facial fillers – substances injected
under the surface of the skin –
can be used to help shape the
face and restore youthful volume.
While there are some permanent
fillers on the market, like most
practitioners I tend to prefer
temporary products that break
down over time. That’s because a
patient’s face evolves over time,
so putting something permanent in
just ends up looking unnatural.
In the past, fillers have included
substances such as transplanted fat
that has been removed from another
part of the body and then reinjected
YOUR QUESTIONS ANSWERED
How do I find a practitioner?
Finding a qualified and
experienced practitioner is
essential. Search at this-is-me.
com to find one close to you,
alongside before-and-after
photographs and customer
testimonials.
What should I expect from a
consultation?
A good consultation should last
a minimum of 30 minutes. Your
practitioner should understand
why you want treatment,
carefully examine and assess
your face and skin, and explain
what they can, and can’t, do.
They should also run through
your options, answer all of your
questions, discuss costs, side
effects and what to expect from
your treatment.
What does the treatment
itself entail?
Your practitioner will go over
your treatment plan and mark
where on your face they plan
to inject before starting. Some
practitioners will numb the
area they’re injecting with an
anaesthetic cream, but as some
fillers also contain anaesthetic,
it’s not always necessary.
Are there any side effects?
You may get some temporary
tenderness, redness, swelling or
bruising where you’ve had the
injections, but this all clears within
a few days. Your practitioner will
advise the best way to care for your
skin after treatment. Most will
suggest that you avoid make-up for
12 hours and stay out of the sun
for two weeks.
into the face, and collagen usually
derived from animals.
But both these approaches had
their limitations in different ways. If
you wanted to inject fat, it required a
surgical intervention to remove it from
the body first. While if you wanted to
inject collagen, this required allergy
testing so patients often had to pay
multiple visits to the clinic.
Now I use a facial filler based on
hyaluronic acid, which is why I use
Juvéderm facial fillers.
But what exactly is hyaluronic acid?
Often shortened to HA, it’s a naturally
occurring sugar that has incredible
moisturising powers, thanks to its
amazing ability to hold water. In fact,
HA can bind up to 1,000 times its own
weight in water. You’ll find more than
50 per cent of all the body’s HA in
the skin, where, in both the top layers
and lower layers, it helps to maintain
moisture levels. But it also cushions and
lubricates joints, and it even helps your
eyeballs to keep their shape.
That’s why I really like to use HA for
facial rejuvenation. Because when you
inject HA into the skin, you’re using
something that is as close as possible to
what was there before.
As well as being a bit of a hero
in the body, in recent years HA has
become something of a buzzword
in the cosmetics world, thanks to
its moisturising abilities and waterattracting properties. Because, of
course, when it comes to skin, water
equals plumpness, which equals skin
that looks healthy and youthful –
it’s the difference between a raisin
and a grape.
But while there’s no doubting that
applying a topical product that contains
HA will help the top layer of your skin,
and there’s some suggestion that some
of it could even go deeper into the skin,
to get significant amounts of HA into
the lower layers of the skin you need to
inject it.
The beauty of HA is that it doesn’t
just replace volume, it also draws
moisture to the area so the overall
effect is dewy, luminous, hydrated and
youthful. And should you have second
thoughts, this is also a reversible
process because, as well as containing
HA, our bodies also contain an enzyme
called hyaluronidase, which naturally
breaks down HA.
The HA you’ll find in facial fillers,
such as the Juvéderm range, has
been formulated in such a way that
they are not instantly broken down
by this enzyme. Juvéderm fillers
are temporary and you can expect
results to last approximately up to 18
months before the hyaluronic acid is
broken down by the body naturally,
RIGHT
Sherina Balaratnam
Surgeon and
medical director
S-Thetics, medical
aesthetic clinic,
Beaconsfield,
Buckinghamshire,
sthetics.co.uk
Whether you’re worried about fine
lines around the lips or want to regain
volume in the cheeks, there’s a filler
that can do it
depending on the area treated and
the product used.
Whether you’re worried about
fine lines around the lips or want to
regain volume in the cheeks, there’s
a filler that can do it.
The Juvéderm Vycross range comes
in a number of different viscosities,
which allows me to layer subtly
different types of filler to create a
really natural result. For example,
I would use Voluma in the deep fat
compartments where more volume is
required, then the slightly less viscous
Volift for the more superficial fat
pockets, and finally, around the mouth
– those lines that lipstick often bleeds
into – I’d inject a little Volbella that fills
very lightly, but crucially really helps
hydrate the skin and achieve fullness
in the lips.
www.this-is-me.com
Date of prep: April 2016 UK/0283/2016
12
raconteur.net
11 / 05 / 2016
Shutterstock
SKINCARE & DERMATOLOGY
01
01
DNA-testing
kits have seen a
massive rise in
recent years, with
companies able to
offer gene creams
formulated from
your DNA profile
Gene secrets that
can care for your skin
02
GENEU personally
prescribed serums
With the rise in affordable DNA-testing kits, the
skincare industry is using the technology to offer
a personalised skincare service
02
02
23andMe
T
he advent of do-it-yourself
DNA-testing kits, offering consumers a genetic
health and ancestry profile based on a saliva sample sent
in the post, has prompted beauty
brands to follow suit.
In the past DNA tests involved significant money, labs and long lead
times – and that seemed sophisticated enough – in order to map the
single nucleotide polymorphisms
or SNPs (pronounced snips), which
are the unique variations in an individual’s DNA sequence.
Now technological advances are
making anything possible from
DIY testing to in-store experiences
promising bespoke gene-creams
formulated from your DNA profile –
that is if you want to hand over your
DNA, of course, which can be an ethical step too far for some.
In London, skincare brand Geneu
has used an innovative device that
delivers rapid and accurate DNA
genotyping information within two
working days.
The device, a chip the size of a
USB stick, which won Professor
Christofer Toumazou, founder and
chief scientist at Imperial College
London’s Institute of Biomedical
Engineering, the European Inventor of the Year award in 2014, took
ten years of research and is also being used in the medical world. It allowed Geneu to launch an in-store
RACONTEUR
raconteur.net
xx
xx / 2016
xxxx
11 / 05
$
$10bn
increase in UK
skincare spending
between
2009 and 2015
Source: Grand View
Research 2016
XXXX
SKINCARE & DERMATOLOGY
2
13
COMMERCIAL FEATURE
DNA analysis of customers’ skin
and, together with the results of a
lifestyle assessment, to formulate
bespoke double serums to match.
In a similar, albeit skincare-specific vein, Ruthie Harper, a Texan-based
board-certified
specialist in internal medicine, has
developed SkinShift, an at-home
DNA test that looks at 32 SNPs,
having started with 16, which influence skin ageing. For a more
prescriptive approach, Dr Harper
also uses the test to gather patient
information at her clinic.
“We concentrate on analysing
well-understood genetic markers
of healthy skin: how successful an
individual makes and maintains
collagen; how well the skin is able
to protect itself from the sun; skin’s
innate anti-oxidant protection; and
a person’s predisposition to sensitivity and inflammatory issues,”
she explains.
“This information empowers
people to make better skincare
choices that go beyond what they
think their skin type is. In a clinic
environment it also allows us to be
much more prescriptive in treating skin concerns. For example,
we can assess whether the root of
hyper-pigmentation is reduced anti-oxidant activity, inflammation
or an individual’s increased vulnerability to the sun.”
Our ability to acquire knowledge
has never been
greater, but nor has
the gulf between
what we know and
what we can do
about it. “We might
be capable of measuring DNA, but we
cannot yet act on
that genetic information in order to
make
convincing
changes – the medical community isn’t
even close to achieving this,” says Jean
Michel
Karam,
chairman and chief executive of
MEMSCAP, and founder of IOMA, a
French skincare brand known for its
high-tech skin analysis tools, which
has had significant investment from
Unilever since 2013.
“If we could act on anti-ageing
genes, the skincare industry would
have achieved something so extremely complex and life-changing
that it is close to immortality.”
However, these tests remain of
benefit. “The results still provide
important motivation for my patients. They are much more likely
to use sun protection if they know
they have an increased susceptibility to UV damage,” says dermatologist Stefanie Williams, who
utilises DNA testing in her clinic,
European Dermatology London.
Dermatologists agree that genetic
testing tools only serve to strengthen their clinical offering, but the
majority take a cautious, albeit
optimistic, approach. Dr Williams
advises tempering overexcitement.
“Genes are not predetermined and
DNA-testing doesn’t account for
the lifestyle factors that influence
genes and often have the most
effect,” she says.
“An individual might show a susceptibility to UV yet, having rigorously protected their skin, acquire
significantly less damage than
someone with more resilience,
but a history of exposure during
their childhood or teens.” This is
because genes are not controlled
by an on or off button, but a dimmer switch that can be regulated
up or down.
The field of epigenetics studies
the way in which we can influence
and alter gene expression through
factors such as lifestyle, diet and
environment. “We need to understand how we can influence specific genes so they continue to work
as they did in our youth,” says Mr
Karam. “If we can address genes
known as receiver genes, we can
produce a cascade effect in order
to indirectly influence others and
that’s where skincare research is
focused now.”
Companies such as Estée Lauder and L’Oréal have long been
invested in understanding how
to better inf luence the genes responsible for great skin. The role
of lifestyle, particularly diet,
has also had increasing emphasis, which has seen a shift in investment to nutritional skincare
supplements. According to the
Nutritional Business Journal, the
global nutrition and supplement
market is set to be worth $60 billion by 2021.
“Unlike the liver or kidneys, the
skin is the one organ you can treat
from both inside
and out offering
us a unique opportunity,” says Dr
Harper.
While we might
not be applying
truly
bespoke
gene-creams any
time soon, innovations in tests have
given researchers
the opportunity
to study large base
sizes offering a
raft of interesting
possibilities
in
the skincare arena. Olay is making
huge strides working with personal
genetic service 23andMe. They are
comparing skin profiles against genetic markers to identify “outliers”
or those that age exceptionally better than average – that friend who
looks a youthful 35, but is in fact
pushing 50.
“We are looking into whether these
outliers – exceptional anti-agers –
have a commonality: are they born
with a genetic predisposition to
good ageing?” says Olay principal
scientist Frauke Neuser. “We can
also gain a greater understanding
of the nature versus nurture debate
and how lifestyle factors are effecting gene expression.
“The ideal would be a future
where we can identify and accurately predict an individual’s ageing patterns at 20 and preventatively treat that ageing process
with tailored skincare.”
The first set of results is expected
by the end of the year, but it is likely to remain an ongoing partnership. The study of genomics is an
ever-evolving landscape and it will
take years to truly map the terrain.
TAILOR MADE TO SUIT
YOUR SKIN
Share this article online via
Raconteur.net
THE FULL-BODY LAUNCH
Your skin, your formula – a bespoke serum can now treat skin
conditions and minimise side effects
T
here’s a long-standing problem
within
traditional
skincare.
Treatments are one size fits all,
which means patients are constantly
dealing with unintended side effects.
They may use a lotion to reduce
redness, only to suffer an outbreak of
pimples. A generic cream to treat saggy
skin can trigger dryness or blemishes.
A group of doctors, including
dermatologists, plastic surgeons, skin
pathologists, pharmacists, chemists
and a Nobel Laureate biologist, working
in a laboratory in Sophia Antipolis,
France, got together and decided to do
something about this.
UNIVERSKIN created a concept
using nanotechnology in a serum,
based around the idea that in terms
of skincare we live in an era of
microwave “ready to serve food”.
UNIVERSKIN is the first skincare
company that aims to think about
skincare like a three-star Michelin
restaurant – and the chef preparing
your skin recipe is your clinician.
With UNIVERSKIN, each patient gets
their own tailor-made serum, created
from a blend of 19 pharmaceuticalgrade active ingredients. UNIVERSKIN
is only available from specialist doctors
practising in the field of skincare.
This information
empowers people
to make better
skincare choices
that go beyond
what they think
their skin type is
GENEU
BESPOKE SKINCARE
EVIE LEATHAM
03
23andMe personal
genetics kit
RACONTEUR
A
SPECIALIST’S
VIEW
Dr Maria Gonzalez, one of the
UK’s leading dermatologists,
discusses how UNIVERSKIN
works in clinical practice…
Treatment begins with a thorough
consultation. The doctor will examine
the patient’s skin type, medical history,
lifestyle and diet. Skin condition can
often reflect underlying health issues,
so this is an essential component in
devising an effective treatment. The
patient will outline their objectives. They
may have a special event coming up
and need a treatment to achieve quick
results. They may have wrinkles and
dehydrated skin, and need a formulation
to restore natural vigour and tone.
At the end of the consultation,
the clinician will formulate a unique
blend to suit the needs of the
patient and the serum is mixed on
the premises. This bespoke approach
means a number of conditions can be
treated simultaneously. For example,
inflammation, blemishes and redness
“The UNIVERSKIN range of bespoke
serums has revolutionised my
aesthetic dermatology practice. Prior
to this I offered my patients cosmetic
products, which I had to fit to my
patients’ needs, rather than offering
products that target the specific
issues of those patients. There was
always a need to compromise.
“Now I am able to take a much
more medical approach to cosmetic
problems. I initially assess my patients
to understand fully their aesthetic
needs. Then, based on my findings,
I decide on the specific ingredients
needed to ensure that the serum I am
recommending is specifically suited to
their skin issues.
“For the first time in my aesthetic
medical career, I am able to take
To complement the facial UNIVERSKIN
serum, the brand is about to launch a fullbody emulsion, which will also be a bespoke
blend for every patient. It will be able to
treat a variety of conditions, including
stretch marks, cellulite and bruising.
Schuco, the company behind
UNIVERSKIN in the UK, has 60 years
of experience in the dermatology and
skincare industry. The company partnered
with the clinical team in Nice to rollout
the UNIVERSKIN product in the UK and
Ireland. Traditionally, Schuco has been
focused on the clinical end of skincare,
working with doctors in hospitals to treat
burns, abrasions, pigmentation disorders
and other maladies.
Currently, a handful of carefully chosen
private-sector doctors are qualified to
offer UNIVERSKIN. Over the next year
this number will grow to around 25 across
the UK and Ireland.
The move to bespoke serums for patients
is long overdue. The skincare profession
has known for years that each patient
has their own needs. UNIVERSKIN is
pioneering the use of pharmaceuticalgrade products to the skincare market in
this manner.
The ability to adapt and tailor the
treatment allows UNIVERSKIN to
deliver dramatic results – looking at
the product’s before-and-after pictures
of patients makes a profound case.
UNIVERSKIN marks the beginning of
a new era in skincare, with tailor-made
treatments for everyone.
To find out more visit
Schuco.co.uk/universkin
The bespoke approach also means
UNIVERSKIN is suitable for all ages
and all skin conditions
a more prescriptive approach to
recommending cosmetic products for
my patients. From my perspective this
is groundbreaking. My confidence in
the cosmetic products I provide has
grown exponentially as I now have
much more control over what I am
putting on my patients’ skin.
“One of the more common problems
I regularly treat is rosacea. A
significant number of my rosacea
patients have sensitive skin and
struggle to access cosmetic products
which do not irritate their skin. As
the UNIVERSKIN bespoke range
uses absolutely no preservatives or
fragrances, I have had a significant
reduction in the incidence of rosacea
patients reacting to the cosmetic
products I recommend.
“Another common group of patients
seeking
aesthetic
treatments
are those suffering with acne.
UNIVERSKIN has provided the
opportunity for me to combine
successfully
standard
medical
treatments with enhanced cosmetic
products that actually work.
“With an interest in treating
pigmentary disorders, I have a large
number of patients seeking treatment
for melasma which is notoriously
difficult to treat. UNIVERSKIN
has provided a list of high-quality
ingredients which have proven
positive effects on skin pigmentation.
I now have a reliable cosmetic
approach working synergistically with
the medical treatment that I offer to
treat this difficult problem.
can be combated at once, or in
sequence, depending on the strategy
recommended by the physician.
A key strength comes from the fact
that the ingredients are pure actives,
in contrast to the mass-produced,
long-life, generic products found on
the high street. The active ingredients
in UNIVERSKIN are hand-picked for
their efficacy. The positive medical
impact of each of the 19 ingredients
has been clinically proven in peerreviewed journals over many years.
They require specialist advice, which is
why UNIVERSKIN is not sold through
retail, in shops, online or in pharmacies.
The bespoke approach also means
UNIVERSKIN is suitable for all ages
and all skin conditions. A teenager
can get help for their acne. A woman
in her twenties can request a regime
to preserve her looks as she grows
older. The formula can also change
with the seasons. We all have our
own story to tell, our own needs and
UNIVERSKIN is the only product on
the market to recognise the individual
requirements of each patient.
“A particular benefit for patients
is found in the concentrations of
ingredients supplied which are
needed to obtain tangible results.
High-concentration,
pure-grade
retinol, vitamin C and ferulic acid
are all available for patients needing
improvement in features of sun damage.
High-concentration glycolic acid and
salicyclic acid can be used with acne
patients. Typically, these concentrations
of ingredients are not provided in most
cosmetic ranges, making it difficult to
predict the potential effectiveness.
“My patients are now extremely
satisfied with this very personalised
approach which integrates efficiently
with their aesthetic and medical
treatments. The outcome has been
happier patients with healthier skin.”
12
raconteur.net
11 / 05 / 2016
Shutterstock
SKINCARE & DERMATOLOGY
01
01
DNA-testing
kits have seen a
massive rise in
recent years, with
companies able to
offer gene creams
formulated from
your DNA profile
Gene secrets that
can care for your skin
02
GENEU personally
prescribed serums
With the rise in affordable DNA-testing kits, the
skincare industry is using the technology to offer
a personalised skincare service
02
02
23andMe
T
he advent of do-it-yourself
DNA-testing kits, offering consumers a genetic
health and ancestry profile based on a saliva sample sent
in the post, has prompted beauty
brands to follow suit.
In the past DNA tests involved significant money, labs and long lead
times – and that seemed sophisticated enough – in order to map the
single nucleotide polymorphisms
or SNPs (pronounced snips), which
are the unique variations in an individual’s DNA sequence.
Now technological advances are
making anything possible from
DIY testing to in-store experiences
promising bespoke gene-creams
formulated from your DNA profile –
that is if you want to hand over your
DNA, of course, which can be an ethical step too far for some.
In London, skincare brand Geneu
has used an innovative device that
delivers rapid and accurate DNA
genotyping information within two
working days.
The device, a chip the size of a
USB stick, which won Professor
Christofer Toumazou, founder and
chief scientist at Imperial College
London’s Institute of Biomedical
Engineering, the European Inventor of the Year award in 2014, took
ten years of research and is also being used in the medical world. It allowed Geneu to launch an in-store
RACONTEUR
raconteur.net
xx
xx / 2016
xxxx
11 / 05
$
$10bn
increase in UK
skincare spending
between
2009 and 2015
Source: Grand View
Research 2016
XXXX
SKINCARE & DERMATOLOGY
2
13
COMMERCIAL FEATURE
DNA analysis of customers’ skin
and, together with the results of a
lifestyle assessment, to formulate
bespoke double serums to match.
In a similar, albeit skincare-specific vein, Ruthie Harper, a Texan-based
board-certified
specialist in internal medicine, has
developed SkinShift, an at-home
DNA test that looks at 32 SNPs,
having started with 16, which influence skin ageing. For a more
prescriptive approach, Dr Harper
also uses the test to gather patient
information at her clinic.
“We concentrate on analysing
well-understood genetic markers
of healthy skin: how successful an
individual makes and maintains
collagen; how well the skin is able
to protect itself from the sun; skin’s
innate anti-oxidant protection; and
a person’s predisposition to sensitivity and inflammatory issues,”
she explains.
“This information empowers
people to make better skincare
choices that go beyond what they
think their skin type is. In a clinic
environment it also allows us to be
much more prescriptive in treating skin concerns. For example,
we can assess whether the root of
hyper-pigmentation is reduced anti-oxidant activity, inflammation
or an individual’s increased vulnerability to the sun.”
Our ability to acquire knowledge
has never been
greater, but nor has
the gulf between
what we know and
what we can do
about it. “We might
be capable of measuring DNA, but we
cannot yet act on
that genetic information in order to
make
convincing
changes – the medical community isn’t
even close to achieving this,” says Jean
Michel
Karam,
chairman and chief executive of
MEMSCAP, and founder of IOMA, a
French skincare brand known for its
high-tech skin analysis tools, which
has had significant investment from
Unilever since 2013.
“If we could act on anti-ageing
genes, the skincare industry would
have achieved something so extremely complex and life-changing
that it is close to immortality.”
However, these tests remain of
benefit. “The results still provide
important motivation for my patients. They are much more likely
to use sun protection if they know
they have an increased susceptibility to UV damage,” says dermatologist Stefanie Williams, who
utilises DNA testing in her clinic,
European Dermatology London.
Dermatologists agree that genetic
testing tools only serve to strengthen their clinical offering, but the
majority take a cautious, albeit
optimistic, approach. Dr Williams
advises tempering overexcitement.
“Genes are not predetermined and
DNA-testing doesn’t account for
the lifestyle factors that influence
genes and often have the most
effect,” she says.
“An individual might show a susceptibility to UV yet, having rigorously protected their skin, acquire
significantly less damage than
someone with more resilience,
but a history of exposure during
their childhood or teens.” This is
because genes are not controlled
by an on or off button, but a dimmer switch that can be regulated
up or down.
The field of epigenetics studies
the way in which we can influence
and alter gene expression through
factors such as lifestyle, diet and
environment. “We need to understand how we can influence specific genes so they continue to work
as they did in our youth,” says Mr
Karam. “If we can address genes
known as receiver genes, we can
produce a cascade effect in order
to indirectly influence others and
that’s where skincare research is
focused now.”
Companies such as Estée Lauder and L’Oréal have long been
invested in understanding how
to better inf luence the genes responsible for great skin. The role
of lifestyle, particularly diet,
has also had increasing emphasis, which has seen a shift in investment to nutritional skincare
supplements. According to the
Nutritional Business Journal, the
global nutrition and supplement
market is set to be worth $60 billion by 2021.
“Unlike the liver or kidneys, the
skin is the one organ you can treat
from both inside
and out offering
us a unique opportunity,” says Dr
Harper.
While we might
not be applying
truly
bespoke
gene-creams any
time soon, innovations in tests have
given researchers
the opportunity
to study large base
sizes offering a
raft of interesting
possibilities
in
the skincare arena. Olay is making
huge strides working with personal
genetic service 23andMe. They are
comparing skin profiles against genetic markers to identify “outliers”
or those that age exceptionally better than average – that friend who
looks a youthful 35, but is in fact
pushing 50.
“We are looking into whether these
outliers – exceptional anti-agers –
have a commonality: are they born
with a genetic predisposition to
good ageing?” says Olay principal
scientist Frauke Neuser. “We can
also gain a greater understanding
of the nature versus nurture debate
and how lifestyle factors are effecting gene expression.
“The ideal would be a future
where we can identify and accurately predict an individual’s ageing patterns at 20 and preventatively treat that ageing process
with tailored skincare.”
The first set of results is expected
by the end of the year, but it is likely to remain an ongoing partnership. The study of genomics is an
ever-evolving landscape and it will
take years to truly map the terrain.
TAILOR MADE TO SUIT
YOUR SKIN
Share this article online via
Raconteur.net
THE FULL-BODY LAUNCH
Your skin, your formula – a bespoke serum can now treat skin
conditions and minimise side effects
T
here’s a long-standing problem
within
traditional
skincare.
Treatments are one size fits all,
which means patients are constantly
dealing with unintended side effects.
They may use a lotion to reduce
redness, only to suffer an outbreak of
pimples. A generic cream to treat saggy
skin can trigger dryness or blemishes.
A group of doctors, including
dermatologists, plastic surgeons, skin
pathologists, pharmacists, chemists
and a Nobel Laureate biologist, working
in a laboratory in Sophia Antipolis,
France, got together and decided to do
something about this.
UNIVERSKIN created a concept
using nanotechnology in a serum,
based around the idea that in terms
of skincare we live in an era of
microwave “ready to serve food”.
UNIVERSKIN is the first skincare
company that aims to think about
skincare like a three-star Michelin
restaurant – and the chef preparing
your skin recipe is your clinician.
With UNIVERSKIN, each patient gets
their own tailor-made serum, created
from a blend of 19 pharmaceuticalgrade active ingredients. UNIVERSKIN
is only available from specialist doctors
practising in the field of skincare.
This information
empowers people
to make better
skincare choices
that go beyond
what they think
their skin type is
GENEU
BESPOKE SKINCARE
EVIE LEATHAM
03
23andMe personal
genetics kit
RACONTEUR
A
SPECIALIST’S
VIEW
Dr Maria Gonzalez, one of the
UK’s leading dermatologists,
discusses how UNIVERSKIN
works in clinical practice…
Treatment begins with a thorough
consultation. The doctor will examine
the patient’s skin type, medical history,
lifestyle and diet. Skin condition can
often reflect underlying health issues,
so this is an essential component in
devising an effective treatment. The
patient will outline their objectives. They
may have a special event coming up
and need a treatment to achieve quick
results. They may have wrinkles and
dehydrated skin, and need a formulation
to restore natural vigour and tone.
At the end of the consultation,
the clinician will formulate a unique
blend to suit the needs of the
patient and the serum is mixed on
the premises. This bespoke approach
means a number of conditions can be
treated simultaneously. For example,
inflammation, blemishes and redness
“The UNIVERSKIN range of bespoke
serums has revolutionised my
aesthetic dermatology practice. Prior
to this I offered my patients cosmetic
products, which I had to fit to my
patients’ needs, rather than offering
products that target the specific
issues of those patients. There was
always a need to compromise.
“Now I am able to take a much
more medical approach to cosmetic
problems. I initially assess my patients
to understand fully their aesthetic
needs. Then, based on my findings,
I decide on the specific ingredients
needed to ensure that the serum I am
recommending is specifically suited to
their skin issues.
“For the first time in my aesthetic
medical career, I am able to take
To complement the facial UNIVERSKIN
serum, the brand is about to launch a fullbody emulsion, which will also be a bespoke
blend for every patient. It will be able to
treat a variety of conditions, including
stretch marks, cellulite and bruising.
Schuco, the company behind
UNIVERSKIN in the UK, has 60 years
of experience in the dermatology and
skincare industry. The company partnered
with the clinical team in Nice to rollout
the UNIVERSKIN product in the UK and
Ireland. Traditionally, Schuco has been
focused on the clinical end of skincare,
working with doctors in hospitals to treat
burns, abrasions, pigmentation disorders
and other maladies.
Currently, a handful of carefully chosen
private-sector doctors are qualified to
offer UNIVERSKIN. Over the next year
this number will grow to around 25 across
the UK and Ireland.
The move to bespoke serums for patients
is long overdue. The skincare profession
has known for years that each patient
has their own needs. UNIVERSKIN is
pioneering the use of pharmaceuticalgrade products to the skincare market in
this manner.
The ability to adapt and tailor the
treatment allows UNIVERSKIN to
deliver dramatic results – looking at
the product’s before-and-after pictures
of patients makes a profound case.
UNIVERSKIN marks the beginning of
a new era in skincare, with tailor-made
treatments for everyone.
To find out more visit
Schuco.co.uk/universkin
The bespoke approach also means
UNIVERSKIN is suitable for all ages
and all skin conditions
a more prescriptive approach to
recommending cosmetic products for
my patients. From my perspective this
is groundbreaking. My confidence in
the cosmetic products I provide has
grown exponentially as I now have
much more control over what I am
putting on my patients’ skin.
“One of the more common problems
I regularly treat is rosacea. A
significant number of my rosacea
patients have sensitive skin and
struggle to access cosmetic products
which do not irritate their skin. As
the UNIVERSKIN bespoke range
uses absolutely no preservatives or
fragrances, I have had a significant
reduction in the incidence of rosacea
patients reacting to the cosmetic
products I recommend.
“Another common group of patients
seeking
aesthetic
treatments
are those suffering with acne.
UNIVERSKIN has provided the
opportunity for me to combine
successfully
standard
medical
treatments with enhanced cosmetic
products that actually work.
“With an interest in treating
pigmentary disorders, I have a large
number of patients seeking treatment
for melasma which is notoriously
difficult to treat. UNIVERSKIN
has provided a list of high-quality
ingredients which have proven
positive effects on skin pigmentation.
I now have a reliable cosmetic
approach working synergistically with
the medical treatment that I offer to
treat this difficult problem.
can be combated at once, or in
sequence, depending on the strategy
recommended by the physician.
A key strength comes from the fact
that the ingredients are pure actives,
in contrast to the mass-produced,
long-life, generic products found on
the high street. The active ingredients
in UNIVERSKIN are hand-picked for
their efficacy. The positive medical
impact of each of the 19 ingredients
has been clinically proven in peerreviewed journals over many years.
They require specialist advice, which is
why UNIVERSKIN is not sold through
retail, in shops, online or in pharmacies.
The bespoke approach also means
UNIVERSKIN is suitable for all ages
and all skin conditions. A teenager
can get help for their acne. A woman
in her twenties can request a regime
to preserve her looks as she grows
older. The formula can also change
with the seasons. We all have our
own story to tell, our own needs and
UNIVERSKIN is the only product on
the market to recognise the individual
requirements of each patient.
“A particular benefit for patients
is found in the concentrations of
ingredients supplied which are
needed to obtain tangible results.
High-concentration,
pure-grade
retinol, vitamin C and ferulic acid
are all available for patients needing
improvement in features of sun damage.
High-concentration glycolic acid and
salicyclic acid can be used with acne
patients. Typically, these concentrations
of ingredients are not provided in most
cosmetic ranges, making it difficult to
predict the potential effectiveness.
“My patients are now extremely
satisfied with this very personalised
approach which integrates efficiently
with their aesthetic and medical
treatments. The outcome has been
happier patients with healthier skin.”
14
raconteur.net
11 / 05 / 2016
RACONTEUR
Getty Images
SKINCARE & DERMATOLOGY
Cosmetics that
actually do what
it says on the jar
Skincare is moving into a new era of
cosmeceuticals – medical-grade skincare
cosmetics containing active ingredients
clinically proven to work on the skin
LOIS ROGERS
G
rowing numbers of consumers are willing to invest substantial sums to
maintain their looks, but
in return they want proof that new
products are having a genuine effect.
Cosmetics companies have in the
past relied on various forms of barrier moisturisers that simply reduced
water loss. Now they are crossing
continents for DNA samples from
plants, animals and insects in a relentless search for new ingredients
that will slow down or even reverse
the ageing process in human skin.
Hundreds of natural substances
are being shown to have biological
effects, replacing or preventing the
breakdown of collagen, the primary skin plumping agent, reducing
wrinkle formation or promoting
skin resurfacing.
These functions are being demonstrated because of the advent of
high-throughput gene-chip technology, which allows scientists to
observe whether proteins from naturally occurring compounds stimulate or suppress the function of different genes.
The primary aim is to find new ingredients with the potential to boost
the activity of genes involved in skin
maintenance and repair.
There is already laboratory evidence
explaining the beneficial mechanisms
02
of traditional remedies such as aloe
vera for wound-healing, witch hazel
for skin inflammation and evening
primrose oil as a moisturiser.
Specialist skincare scientists are
continually finding more and more
of these natural bioactives that can
be adapted for cosmetic use.
This new age of so-called cosmeceuticals allows cosmetics companies to get round the legal restrictions on pharmaceutical products.
New molecules for use in drugs have
to go through a ten-year process of
laborious safety and efficacy studies
before they are approved for human
use. Molecules from natural sources
already present in the environment
do not need this approval.
However, educated consumers
increasingly expect peer-reviewed
publications in scientific dermatology journals and companies need
the research results to support the
claims they make for their products.
Although technically not considered an organ, the skin is actually our
most vital and complex body part, a
water and infection-resistant barrier
that also keeps us in touch with the
outside world. We are covered by an
average of two square metres of it,
and it is specifically designed not to
absorb foreign materials, even if they
are being introduced with the best
of intentions of keeping our faces
young, soft and wrinkle-free.
The outer stratum corneum is
composed mainly of relatively
tough keratinocyte cells, which are
01
Sales of clinically
proven cosmeceuticals are seeing
huge growth
02
Natural bioactives
such as aloe vera
have antioxident
and antibaterial
properties
Getty Images
COSMECEUTICALS
RACONTEUR
raconteur.net
xx
xx / 2016
xxxx
11 / 05
already dead. Beneath are several
layers called the epidermis, where
various ages of keratinocyte cells
are working their way to the surface, where they will flake off, in
a cell turnover process that takes
about five weeks. The epidermis
also produces melanin, the pigment that protects us from sunlight damage.
Below the epidermis lies the dermis, a spongey layer criss-crossed by
blood vessels and nerves, and largely made up of fibroblast cells sitting
in a mattress of collagen and elastin,
called the extracellular matrix. Fibroblasts secrete the raw materials
to make and maintain the extracellular matrix, and all the other factors required for wound-healing and
damage-repair.
The dermis also contains sweat
glands and sebaceous glands that
secrete an oily lubricant for hair
and skin.
There are at least 13 different cell
types, more than 400 genes and
about 19,700 proteins involved in skin
maintenance, and the efficiency of all
these elements declines with age.
Long-term damage is caused by
smoking and ultra-violet light exposure, with increasing numbers of
fair-skinned northern Europeans
enjoying sun-drenched tropical
holidays they were never physically
designed for.
Ageing facial muscles lose elasticity and the dermis shrivels from the
loss of collagen, losing up to 80 per
cent of its thickness over a lifetime,
and leaving a network of wrinkles on
the surface.
As we all live longer and stay at
work for longer, the importance of
maintaining a face that looks young,
healthy and employable will go well
beyond
vanity.
This social trend
has further fuelled
the rise of cosmeceuticals.
“Gone are the
days when anti-ageing skincare
was ‘hope in a jar’,”
says Kathy Rogerson, a science
spokeswoman for
Olay, Proctor &
Gamble’s biggest
brand.
“Women
are far more savvy nowadays and
need to know that
the products they are buying really
will work; that’s why we use proven
ingredients with data published in
peer-reviewed publications.”
In the past year alone, there have
been hundreds of new scientific publications from laboratories
around the world investigating any
number of new mechanisms. One
This new age
of so-called
cosmeceuticals
allows cosmetics
companies to get
round the legal
restrictions on
pharmaceutical
products
GLOBAL COSMECEUTICALS MARKET ($BN)
32
2012
35
2013
37
2014
study shows that niacinamide, a
compound derived from natural
vitamin A, can inhibit the melanin
malfunction that produces brown
age spots. Another demonstrates
skin regeneration thanks to a product derived from the stem cells of
apples. A third shows retinol, another vitamin A derivative, can boost
natural skin moisturisation and
cell regeneration in
menopausal women, when applied as
a facial peel.
Dr Chris Flower,
director-genera l
of the Cosmetic,
Toiletry & Perfumery
Association,
believes cosmetics
companies probably
now
have
the know-how to
achieve dramatic
improvements in
ageing skin, but are
reluctant to reveal
their research.
“They are either limiting the
claims they make for products or
limiting the use of new ingredients because, if they show a significant biological effect, there
is a risk they will be classed as
medicines,” he says. “The manufacturers will need to show longterm safety data and that, if they
can switch on biological activity
in the skin, they can also switch it
off again.”
Possibly for this reason, Mike Bell
skincare scientific adviser at Boots,
believes some women are turning
away from products which make
bigger claims of a biological effect.
“We think they want to be reassured
that products contain ingredients
they are familiar with, and whose
performance they trust and believe
in,” he says.
Cosmeceuticals are not only
creams to be applied to the skin,
increasingly they are emerging
as products you swallow. Nestlé
and L’Oréal have jointly developed
Innéov, a scientifically validated
skincare product based on the nutrient lycopene found in tomatoes.
40
2015
47
43
2016
2017
Source: RNCOS 2014
2
15
COMMERCIAL FEATURE
Despite the fact Innéov generated
£40 million in worldwide sales, it
was withdrawn in 2014 and neither company will comment on
what is being developed instead.
Meanwhile, the use of liquid collagen is booming. Professor Steffen Oesser of the University of Kiel
in Germany has shown that it is
possible to replace collagen in the
body, and has published research
showing extra collagen molecules
from drinks migrate to areas of
damage in the skin and joints. “It
would be naive to say that taking
oral collagen can stop you ageing
altogether, but it can boost body
repair processes,” he says.
Collagen Gold has become the
best-known UK version. Based on
purified collagen derived from fish
scales, it has been so successful the
company has invested £5 million
in academic studies, at universities in Britain and elsewhere in Eu-
rope, to gather further evidence of
its regenerative effects on ageing
skin fibroblasts, and on hip and
knee joint restoration, where collagen is also important.
Early results have been encouraging and the first research findings are due to be published later
this year.
“There is no doubt that interest in
cosmeceuticals is growing because
of the evidence these products really do have an effect,” says Dr Martin
Godfrey, the company’s spokesman.
“We are very optimistic that the
combination of collagen and other
ingredients in our formulations will
have a demonstrable benefit.”
Liquid collagen remains expensive, however, and has yet to break
into the mass market.
Share this article online via
Raconteur.net
TOP FIVE ACTIVE INGREDIENTS
01
XXXX
SKINCARE & DERMATOLOGY
01
HYALURONIC ACID
A natural lubricant found throughout the body, the
production of hyaluronic acid declines with age. It is produced in
large volumes for cosmetics from a variety
of sources, including genetically modified
bacteria, but also from glucose or yeast
extract. Its large, slippery molecules mainly
sit on or just beneath the surface of the
skin and are not absorbed, creating a soft,
plump moisture-retaining surface. It is also an
anti-inflammatory and will help to heal minor
blemishes such as insect bites.
02
03
04
05
NIACINAMIDE
Derived from nicotinic
acid and otherwise known as
vitamin B3, niacinamide is a
water-based soluble compound,
and is found in whole grains, green
vegetables, meat, milk and yeast.
It is a potent cell-communicating
ingredient that offers multiple
anti-ageing benefits. A synthetic
form of niacinamide is a key
ingredient in the world’s bestselling Olay moisturisers. As
well as its
anti-ageing
properties,
it can help
to even out
skin tone
and reduce
blemishes.
ANTIOXIDANTS
Antioxidants are most
commonly vitamin C derivatives
or resveratrol, a synthetic
version of a compound found
in the skin of red grapes. These
ingredients stimulate collagen
production and reduce uneven
pigmentation. Ascorbic acid,
the most active form of vitamin
C, is hard to stabilise and has
limited shelf life. Skin scientists
have developed a variety of
newer versions which only break
down once
they are in
contact with
the outer
few cell
layers of
the skin.
PEPTIDES
Synthetically
manufactured versions of natural
compounds, peptides trigger
production of new collagen,
elastin and other proteins
involved in maintaining skin
“scaffolding” and preventing or
reducing wrinkle formation. The
best known are branded Matrixyl
(palmityl pentapeptide) or
Argireline (acetyl hexapeptide-8)
and are found in Olay and Boots
No7 brands. Like other
popular
ingredients,
peptides also
reduce the
inflammation
or uneven tone
of older skin.
VITAMIN A
Derivatives of vitamin
A called retinoids, listed among
ingredients as retinyl palmitate or
retinyl acetate, are also synthetic
versions of the compounds
found in eggs or vegetables
such as carrots and spinach.
They boost cell-signalling, help
regulate turnover of surface skin
cells and repair damage caused
by sunlight exposure. Stronger
concentrations of retinoid creams
are often used for spots and acne
because they
prevent dead
cells from
clogging skin
pores and
causing spots
to form.
SWITCH YOUR SKIN
BACK ON
Is your skin looking dull, tired and losing its bounce? It might just
need a wake-up call
S
kin specialists at ELEMIS have
created a remarkable new
skincare range that can revive
your skin’s energy at a cellular level,
with clinically proven results.
A revolutionary new understanding
of skin ageing has paved the way for an
innovative new skincare range.
Scientists have discovered that
just like us, skin cells can lose
their energy. How? Within each
skin cell are tiny powerhouses of
energy called the mitochondria.
These produce a substance called
ATP, dubbed “the currency of life”
and which plays a vital role in skin
function and appearance.
When these mitochondria are at their
peak, skin looks and functions as it did at
its most youthful and healthy. Your skin
cells can resist environmental damage
and rebuild collagen and elastin for
natural bounce, radiance and glow.
However, ageing and the menopause,
pollution, poor diet, sun-exposure,
medication, smoking and stress all drain
BIOTEC Skin Energising Day Cream, clinically
proven to increase cell energy*
our skin’s bioenergy. The result? Skin
looks dull, slack and, frankly, tired.
But what if we could somehow
switch our skin energy back on and
reverse these changes? This was the
remarkable idea behind ELEMIS’ most
extraordinary skincare launch to date
– BIOTEC Energising Skincare System.
Born out of a desire to revitalise
skin from the inside out, the BIOTEC
System uses a patented, proven and
groundbreaking cocktail of ingredients
that combine the healing power
of plants with the latest scientific
technology. It has been proven to boost
cell energy by an incredible 27 per cent.*
Noella Gabriel, co-founder and
creator of ELEMIS therapies, explains:
“Cell energy is crucial to skin health.
I wanted to create a system that
would turbo-charge the skin from
within, delivering true vitality to the
complexion. This is groundbreaking
technology, where the best of science
and the best of nature are harnessed
for extraordinary results.”
Key to the power of the BIOTEC
System is the ELEMIS BIOENERGY™complex.
Ms
Gabriel
says: “The ingredients were carefully
chosen. Copper exists naturally in our
own skin tissue and is amazing at tissue
regeneration. Zinc is a mineral and is
key for overall skin health, and is also
found in every cell in your body. They
are encapsulated to preserve their
effectiveness, where they kick-start
cell energy.”
The ELEMIS BIOTEC Energising
Skincare System consists of three
highly effective products, which work
synergistically together.
The BIOTEC Skin Energising
Cleanser kick-starts the regime with a
trio of powerful, skin-reviving acids –
succinic acid, lactic acid and ferulic acid.
These are delivered via an electrolyte
solution containing trace elements
and minerals to gently remove surface
oils and impurities, while a moisture
complex with alisma, sodium PCA and
cranberry seed oil leaves skin soft and
beautifully revived.
Follow this with the BIOTEC Skin
Energising Day Cream, which also
contains the BIO-ENERGY™ complex,
plus the trio of acids blended with a
potent phyto-bioactive, together with
anti-ageing, plant-derived peptides
and antioxidants.
At night, the BIOTEC Skin Energising
Night Cream, powered by the BIOENERGY™complex and enriched
by hydrating calcium PCA, helps to
restore and revive skin, so you wake
up looking vibrant, smooth and radiant.
You can use the BIOTEC System
as your year-round regime or as an
energy-boosting supplement to
make your preferred skincare even
more effective.
And for ultimate skin beauty and
health, the range is complemented
by a choice of super-effective,
clinically proven high-tech BIOTEC
facials available at the most advanced
spas and wellness centres, including
ELEMIS’ luxurious flagship spa, The
House of ELEMIS, in London’s Mayfair.
These combine the pioneering
BIOTEC ingredients with the latest
skin technology for beautiful results,
whatever your skin type or age.
“ELEMIS has always brought together
the best of science and the best of
nature,” says Ms Gabriel. “Together, they
deliver ultimate skin wellness.”
*Independent test on BIOTEC Skin
Energising Day Cream, based on glucose
uptake test 2014
WWW.ELEMIS.COM
14
raconteur.net
11 / 05 / 2016
RACONTEUR
Getty Images
SKINCARE & DERMATOLOGY
Cosmetics that
actually do what
it says on the jar
Skincare is moving into a new era of
cosmeceuticals – medical-grade skincare
cosmetics containing active ingredients
clinically proven to work on the skin
LOIS ROGERS
G
rowing numbers of consumers are willing to invest substantial sums to
maintain their looks, but
in return they want proof that new
products are having a genuine effect.
Cosmetics companies have in the
past relied on various forms of barrier moisturisers that simply reduced
water loss. Now they are crossing
continents for DNA samples from
plants, animals and insects in a relentless search for new ingredients
that will slow down or even reverse
the ageing process in human skin.
Hundreds of natural substances
are being shown to have biological
effects, replacing or preventing the
breakdown of collagen, the primary skin plumping agent, reducing
wrinkle formation or promoting
skin resurfacing.
These functions are being demonstrated because of the advent of
high-throughput gene-chip technology, which allows scientists to
observe whether proteins from naturally occurring compounds stimulate or suppress the function of different genes.
The primary aim is to find new ingredients with the potential to boost
the activity of genes involved in skin
maintenance and repair.
There is already laboratory evidence
explaining the beneficial mechanisms
02
of traditional remedies such as aloe
vera for wound-healing, witch hazel
for skin inflammation and evening
primrose oil as a moisturiser.
Specialist skincare scientists are
continually finding more and more
of these natural bioactives that can
be adapted for cosmetic use.
This new age of so-called cosmeceuticals allows cosmetics companies to get round the legal restrictions on pharmaceutical products.
New molecules for use in drugs have
to go through a ten-year process of
laborious safety and efficacy studies
before they are approved for human
use. Molecules from natural sources
already present in the environment
do not need this approval.
However, educated consumers
increasingly expect peer-reviewed
publications in scientific dermatology journals and companies need
the research results to support the
claims they make for their products.
Although technically not considered an organ, the skin is actually our
most vital and complex body part, a
water and infection-resistant barrier
that also keeps us in touch with the
outside world. We are covered by an
average of two square metres of it,
and it is specifically designed not to
absorb foreign materials, even if they
are being introduced with the best
of intentions of keeping our faces
young, soft and wrinkle-free.
The outer stratum corneum is
composed mainly of relatively
tough keratinocyte cells, which are
01
Sales of clinically
proven cosmeceuticals are seeing
huge growth
02
Natural bioactives
such as aloe vera
have antioxident
and antibaterial
properties
Getty Images
COSMECEUTICALS
RACONTEUR
raconteur.net
xx
xx / 2016
xxxx
11 / 05
already dead. Beneath are several
layers called the epidermis, where
various ages of keratinocyte cells
are working their way to the surface, where they will flake off, in
a cell turnover process that takes
about five weeks. The epidermis
also produces melanin, the pigment that protects us from sunlight damage.
Below the epidermis lies the dermis, a spongey layer criss-crossed by
blood vessels and nerves, and largely made up of fibroblast cells sitting
in a mattress of collagen and elastin,
called the extracellular matrix. Fibroblasts secrete the raw materials
to make and maintain the extracellular matrix, and all the other factors required for wound-healing and
damage-repair.
The dermis also contains sweat
glands and sebaceous glands that
secrete an oily lubricant for hair
and skin.
There are at least 13 different cell
types, more than 400 genes and
about 19,700 proteins involved in skin
maintenance, and the efficiency of all
these elements declines with age.
Long-term damage is caused by
smoking and ultra-violet light exposure, with increasing numbers of
fair-skinned northern Europeans
enjoying sun-drenched tropical
holidays they were never physically
designed for.
Ageing facial muscles lose elasticity and the dermis shrivels from the
loss of collagen, losing up to 80 per
cent of its thickness over a lifetime,
and leaving a network of wrinkles on
the surface.
As we all live longer and stay at
work for longer, the importance of
maintaining a face that looks young,
healthy and employable will go well
beyond
vanity.
This social trend
has further fuelled
the rise of cosmeceuticals.
“Gone are the
days when anti-ageing skincare
was ‘hope in a jar’,”
says Kathy Rogerson, a science
spokeswoman for
Olay, Proctor &
Gamble’s biggest
brand.
“Women
are far more savvy nowadays and
need to know that
the products they are buying really
will work; that’s why we use proven
ingredients with data published in
peer-reviewed publications.”
In the past year alone, there have
been hundreds of new scientific publications from laboratories
around the world investigating any
number of new mechanisms. One
This new age
of so-called
cosmeceuticals
allows cosmetics
companies to get
round the legal
restrictions on
pharmaceutical
products
GLOBAL COSMECEUTICALS MARKET ($BN)
32
2012
35
2013
37
2014
study shows that niacinamide, a
compound derived from natural
vitamin A, can inhibit the melanin
malfunction that produces brown
age spots. Another demonstrates
skin regeneration thanks to a product derived from the stem cells of
apples. A third shows retinol, another vitamin A derivative, can boost
natural skin moisturisation and
cell regeneration in
menopausal women, when applied as
a facial peel.
Dr Chris Flower,
director-genera l
of the Cosmetic,
Toiletry & Perfumery
Association,
believes cosmetics
companies probably
now
have
the know-how to
achieve dramatic
improvements in
ageing skin, but are
reluctant to reveal
their research.
“They are either limiting the
claims they make for products or
limiting the use of new ingredients because, if they show a significant biological effect, there
is a risk they will be classed as
medicines,” he says. “The manufacturers will need to show longterm safety data and that, if they
can switch on biological activity
in the skin, they can also switch it
off again.”
Possibly for this reason, Mike Bell
skincare scientific adviser at Boots,
believes some women are turning
away from products which make
bigger claims of a biological effect.
“We think they want to be reassured
that products contain ingredients
they are familiar with, and whose
performance they trust and believe
in,” he says.
Cosmeceuticals are not only
creams to be applied to the skin,
increasingly they are emerging
as products you swallow. Nestlé
and L’Oréal have jointly developed
Innéov, a scientifically validated
skincare product based on the nutrient lycopene found in tomatoes.
40
2015
47
43
2016
2017
Source: RNCOS 2014
2
15
COMMERCIAL FEATURE
Despite the fact Innéov generated
£40 million in worldwide sales, it
was withdrawn in 2014 and neither company will comment on
what is being developed instead.
Meanwhile, the use of liquid collagen is booming. Professor Steffen Oesser of the University of Kiel
in Germany has shown that it is
possible to replace collagen in the
body, and has published research
showing extra collagen molecules
from drinks migrate to areas of
damage in the skin and joints. “It
would be naive to say that taking
oral collagen can stop you ageing
altogether, but it can boost body
repair processes,” he says.
Collagen Gold has become the
best-known UK version. Based on
purified collagen derived from fish
scales, it has been so successful the
company has invested £5 million
in academic studies, at universities in Britain and elsewhere in Eu-
rope, to gather further evidence of
its regenerative effects on ageing
skin fibroblasts, and on hip and
knee joint restoration, where collagen is also important.
Early results have been encouraging and the first research findings are due to be published later
this year.
“There is no doubt that interest in
cosmeceuticals is growing because
of the evidence these products really do have an effect,” says Dr Martin
Godfrey, the company’s spokesman.
“We are very optimistic that the
combination of collagen and other
ingredients in our formulations will
have a demonstrable benefit.”
Liquid collagen remains expensive, however, and has yet to break
into the mass market.
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TOP FIVE ACTIVE INGREDIENTS
01
XXXX
SKINCARE & DERMATOLOGY
01
HYALURONIC ACID
A natural lubricant found throughout the body, the
production of hyaluronic acid declines with age. It is produced in
large volumes for cosmetics from a variety
of sources, including genetically modified
bacteria, but also from glucose or yeast
extract. Its large, slippery molecules mainly
sit on or just beneath the surface of the
skin and are not absorbed, creating a soft,
plump moisture-retaining surface. It is also an
anti-inflammatory and will help to heal minor
blemishes such as insect bites.
02
03
04
05
NIACINAMIDE
Derived from nicotinic
acid and otherwise known as
vitamin B3, niacinamide is a
water-based soluble compound,
and is found in whole grains, green
vegetables, meat, milk and yeast.
It is a potent cell-communicating
ingredient that offers multiple
anti-ageing benefits. A synthetic
form of niacinamide is a key
ingredient in the world’s bestselling Olay moisturisers. As
well as its
anti-ageing
properties,
it can help
to even out
skin tone
and reduce
blemishes.
ANTIOXIDANTS
Antioxidants are most
commonly vitamin C derivatives
or resveratrol, a synthetic
version of a compound found
in the skin of red grapes. These
ingredients stimulate collagen
production and reduce uneven
pigmentation. Ascorbic acid,
the most active form of vitamin
C, is hard to stabilise and has
limited shelf life. Skin scientists
have developed a variety of
newer versions which only break
down once
they are in
contact with
the outer
few cell
layers of
the skin.
PEPTIDES
Synthetically
manufactured versions of natural
compounds, peptides trigger
production of new collagen,
elastin and other proteins
involved in maintaining skin
“scaffolding” and preventing or
reducing wrinkle formation. The
best known are branded Matrixyl
(palmityl pentapeptide) or
Argireline (acetyl hexapeptide-8)
and are found in Olay and Boots
No7 brands. Like other
popular
ingredients,
peptides also
reduce the
inflammation
or uneven tone
of older skin.
VITAMIN A
Derivatives of vitamin
A called retinoids, listed among
ingredients as retinyl palmitate or
retinyl acetate, are also synthetic
versions of the compounds
found in eggs or vegetables
such as carrots and spinach.
They boost cell-signalling, help
regulate turnover of surface skin
cells and repair damage caused
by sunlight exposure. Stronger
concentrations of retinoid creams
are often used for spots and acne
because they
prevent dead
cells from
clogging skin
pores and
causing spots
to form.
SWITCH YOUR SKIN
BACK ON
Is your skin looking dull, tired and losing its bounce? It might just
need a wake-up call
S
kin specialists at ELEMIS have
created a remarkable new
skincare range that can revive
your skin’s energy at a cellular level,
with clinically proven results.
A revolutionary new understanding
of skin ageing has paved the way for an
innovative new skincare range.
Scientists have discovered that
just like us, skin cells can lose
their energy. How? Within each
skin cell are tiny powerhouses of
energy called the mitochondria.
These produce a substance called
ATP, dubbed “the currency of life”
and which plays a vital role in skin
function and appearance.
When these mitochondria are at their
peak, skin looks and functions as it did at
its most youthful and healthy. Your skin
cells can resist environmental damage
and rebuild collagen and elastin for
natural bounce, radiance and glow.
However, ageing and the menopause,
pollution, poor diet, sun-exposure,
medication, smoking and stress all drain
BIOTEC Skin Energising Day Cream, clinically
proven to increase cell energy*
our skin’s bioenergy. The result? Skin
looks dull, slack and, frankly, tired.
But what if we could somehow
switch our skin energy back on and
reverse these changes? This was the
remarkable idea behind ELEMIS’ most
extraordinary skincare launch to date
– BIOTEC Energising Skincare System.
Born out of a desire to revitalise
skin from the inside out, the BIOTEC
System uses a patented, proven and
groundbreaking cocktail of ingredients
that combine the healing power
of plants with the latest scientific
technology. It has been proven to boost
cell energy by an incredible 27 per cent.*
Noella Gabriel, co-founder and
creator of ELEMIS therapies, explains:
“Cell energy is crucial to skin health.
I wanted to create a system that
would turbo-charge the skin from
within, delivering true vitality to the
complexion. This is groundbreaking
technology, where the best of science
and the best of nature are harnessed
for extraordinary results.”
Key to the power of the BIOTEC
System is the ELEMIS BIOENERGY™complex.
Ms
Gabriel
says: “The ingredients were carefully
chosen. Copper exists naturally in our
own skin tissue and is amazing at tissue
regeneration. Zinc is a mineral and is
key for overall skin health, and is also
found in every cell in your body. They
are encapsulated to preserve their
effectiveness, where they kick-start
cell energy.”
The ELEMIS BIOTEC Energising
Skincare System consists of three
highly effective products, which work
synergistically together.
The BIOTEC Skin Energising
Cleanser kick-starts the regime with a
trio of powerful, skin-reviving acids –
succinic acid, lactic acid and ferulic acid.
These are delivered via an electrolyte
solution containing trace elements
and minerals to gently remove surface
oils and impurities, while a moisture
complex with alisma, sodium PCA and
cranberry seed oil leaves skin soft and
beautifully revived.
Follow this with the BIOTEC Skin
Energising Day Cream, which also
contains the BIO-ENERGY™ complex,
plus the trio of acids blended with a
potent phyto-bioactive, together with
anti-ageing, plant-derived peptides
and antioxidants.
At night, the BIOTEC Skin Energising
Night Cream, powered by the BIOENERGY™complex and enriched
by hydrating calcium PCA, helps to
restore and revive skin, so you wake
up looking vibrant, smooth and radiant.
You can use the BIOTEC System
as your year-round regime or as an
energy-boosting supplement to
make your preferred skincare even
more effective.
And for ultimate skin beauty and
health, the range is complemented
by a choice of super-effective,
clinically proven high-tech BIOTEC
facials available at the most advanced
spas and wellness centres, including
ELEMIS’ luxurious flagship spa, The
House of ELEMIS, in London’s Mayfair.
These combine the pioneering
BIOTEC ingredients with the latest
skin technology for beautiful results,
whatever your skin type or age.
“ELEMIS has always brought together
the best of science and the best of
nature,” says Ms Gabriel. “Together, they
deliver ultimate skin wellness.”
*Independent test on BIOTEC Skin
Energising Day Cream, based on glucose
uptake test 2014
WWW.ELEMIS.COM
16
SKINCARE & DERMATOLOGY
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