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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

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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. Share this article online via Raconteur.net

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

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. Share this article online via Raconteur.net

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

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SKINCARE & DERMATOLOGY

11 / 05 / 2016

RACONTEUR

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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 Raconteur.net

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

Share this article online via Raconteur.net

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

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SKINCARE & DERMATOLOGY

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. Share this article online via Raconteur.net

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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 Raconteur.net

10

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11 / 05 / 2016

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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

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11 / 05 / 2016

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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

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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

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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. 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

16

SKINCARE & DERMATOLOGY

raconteur.net

11 / 05 / 2016

81% 81% 77%

DISCOVER GENEU’S NEW AT-HOME DNA AND LIFESTYLE TEST KITS

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