Skincare

How important is proper skincare? 

Taking care of your skin is equally important as taking care of your other organs. Did you know that your skin is the largest organ in the body? Proper skin care is essential to keep your skin healthy and for your general health; it helps slow down the effects of time and protects against the harmful effects of the environment. Our skin is a barrier to stopping things, like bacteria, from entering our bodies. So, daily skin care is worth your time and energy. 

Combining skincare with a thorough oral and haircare routine can help motivate you to eat better and exercise well, adding to a happier, healthier you. You will feel better if you look better, so having a daily skincare routine helps you look your best for facing the world. 

At what point do we need to start taking proper skincare? 

The best age to start taking care of your skin is now. Your skin will show signs of ageing in your 30s and 40s. As you get older, your skin begins to age, and natural processes, like the loss of collagen, occur. At this point, it will start to lose its elasticity and fullness, and you will see the start of fine lines, pigmentation, and wrinkles. Many people start taking care of their faces when they already suffer from wrinkles, but it is better to prevent them than wait until the damage is in place. Starting to care for your skin in your teens or 20s is a clever idea. By investing early on into proper skincare routines, you will see improvements over time. That does not mean if you are older, it is too late; you can start healthy skin habits that will help your skin at any age.  

There is a lot of “noise”; how can we determine what we need? 

Great skin is not purely a result of your DNA. How you look after your skin daily can significantly impact what you see in the mirror. There are, however, a dizzying number of opinions depending on which magazine you read or the doctor you consult. So, before you delve into pricier creams, lotions, serums, and anti-ageing treatments, here is what you should keep in mind to sort through all the noise.  

Start by establishing a consistent basic skincare regime – this is one of the best wrinkle-reducing treatments and should consist of three main steps: 

1. Cleansing – Washing your face is the most basic and essential step in your routine. Every day we need to gently remove skin encounters such as environmental pollutants, dirt, dead skin, oils and bacteria. Wash twice daily, morning and night, to avoid clogged pores, dullness, and acne. The right formula will clean your skin without removing your essential oils. 
2. Toning – Also known as balancing your skin, toning should be done after cleansing before putting on anything else. Most experts consider toner optional but an effective way to add ingredients to your skin to allow replenishment. These thin liquids deliver an extra shot of nutrients helping the other products in your regime absorb better.
3. Moisturizing – Known as hydrating the skin, moisturising should be done after toning. Skin naturally loses the ability to retain moisture after we age, and so essentially, moisturisers assist in preventing water loss through the outer layers. Everybody needs a moisturiser, but which one you will choose will depend on your skin type.  

• • Oily– Gel Moisturizer – Mainly water bases and so is lightweight and absorbs quickly. 
  • Normal or Combination – Lotion – Your classic moisturiser. More moisturising than a gel but still absorbs well. 
  • Dry– Cream – More oil-based and heavier than a lotion. 
  • Inflamed and sensitive– Balm – Heavier than cream and so suitable for dehydrated skin types. 

4. Spot Treatments – If prescribed any acne treatments, these should be applied after your skin is cleansed and dry. Apply retinol or spot treatment to reduce fine lines and pore size, reduce oil, unclog pores, and eliminate blemishes. 
5. Protect With Sunscreen – All the experts agree that sunscreen is, without doubt, the most crucial skincare product. Daily and consistent use helps prevent fine lines and wrinkles, textural imperfections, and changes in the appearance of pores over time. But most notably against the formation of certain skin cancers. We recommend a daily moisturiser with a built-in SPF (Sun Protection Factor) of at least 30. 

The final thing you need to remember is – Give it time. Whilst the science behind skincare has come a long way, there is no such thing as an instant fix. You will only see improvement through consistent use. Generally, aim to use products over at least six weeks, once or twice daily.  

Which is more critical – oral products or those applied to the skin? 

There are numerous beauty products on the market you can use to improve your skin health. There is an ongoing debate in the beauty industry on which type of cosmetic products are better for the skin. You can apply some skincare options directly to your skin; others ingested.  

The truth is, there are benefits to both topical and oral treatments. Topical skincare includes serums, skin treatments and moisturisers, while oral skincare may include vitamin C, E, D or Biotin supplements. 

Vitamin C is an antioxidant that protects your cells from the damage caused by UV exposure. It also stimulates the creation of collagen and inhibits melanin production, which helps thicken your dermis, minimise fine lines, and prevent dark spots or discolouration. 

Vitamin D is a nutrient that helps regulate numerous skin processes, ranging from cellular proliferation to immune functions. You can use vitamin D as an effective treatment for skin inflammation. 

Vitamin E is a necessary oral vitamin for reducing the damage caused by UV rays. It has anti-inflammatory properties that can minimise oedema, erythema, skin thickness, and UV-induced skin swelling. 

Biotin [Vitamin B-7] is a popular supplement for the hair, nails, and skin because it helps break down carbs, fats, and proteins in your body. It is a water-soluble vitamin that impacts fat metabolism, which is crucial for skin health. 

Both topical and oral skin care treatments can benefit your overall skin health depending on the skin issues you are dealing with and the needs of your body. While some may suggest one over another, you must choose which products you are more comfortable with to restore your skin’s glow. 

Proper hydration is essential to maintaining a healthy lifestyle as water helps flush out toxins during the day. You must also remember that just consuming supplements or applying products to your skin will not improve your skin health. You also need to ensure you eat a balanced diet and get enough sleep. 

What kinds of skin conditions are common in Bermuda? 

We see similar skin conditions in Bermuda to the rest of the world, but we do see an increased incidence of the following due to our climate: 

1. Pitaryasis Versicolor – Commonly known as “Bermuda Rot” is a yeast infection of the skin in which flaky discoloured patches appear on the chest and back. Pityriasis Versicolor most frequently affects young adults and is slightly more common in men than women. It can also affect children, adolescents, and older adults. Pityriasis Versicolor is more common in hot, humid climates than in cool, dry climates. It often affects people who perspire heavily. It may clear in the winter months and recur each summer. Although it is not considered infectious in the conventional sense, Pityriasis Versicolor sometimes affects more than one family member. Pityriasis Versicolor is usually asymptomatic, but it is mildly itchy in some people.
2. Sunburn – As pharmacists, we see much of this in Bermuda, especially during the summer. Sunburn is red, painful skin that feels hot to the touch. It usually appears within a few hours after too much exposure to ultraviolet (UV) light from sunshine. Intense, repeated UV light exposure that results in sunburn increases the risk of other skin damage, such as dark spots, rough spots, and dry or wrinkled skin. It also raises the risk of skin cancers such as melanoma. You can prevent sunburn and related conditions by protecting your skin, especially outdoors, even on cool or cloudy days. 
3. Heat Rash – Also known as prickly heat and miliaria, is not just for babies; it affects adults, too, especially in hot, humid conditions. Trapped sweat causes heat rash; symptoms can range from small blisters to deep, inflamed lumps. Some forms of heat rash are very itchy. Heat rash usually goes away once the skin cools down. Severe forms of the condition might need treatment from a health care provider. 
4. Bites & Stings – In Bermuda, we have many things that can cause a bite or sting: Bees, wasps, mosquitos, Jellyfish, Portuguese Man-O-War, and spiders. They might cause itching, swelling and stinging that go away in a day or two. Stings from bees, yellow jackets, wasps, and hornets might cause a severe allergic reaction (anaphylaxis). 
5. Higher Temperatures – Our climate cause more intertrigo, mainly associated with obesity and diabetes. Intertrigo is inflammation caused by skin-to-skin friction, most often in warm, moist areas of the body, such as the groin, between folds of skin on the abdomen, under the breasts, under the arms or between the toes. The affected skin may be sensitive or painful; severe cases can result in oozing sores, cracked skin or bleeding. 

Our environment and climate are unique – what products should Bermudians focus on purchasing? 

As mentioned, sunscreen is easily the most critical skincare product we should be focusing on purchasing. Sunscreen protects your skin from the sun’s ultraviolet, or UV, light. Two types of UV light can harm your skin: UVA and UVB. UVA is the long wavelength of light that penetrates the deep layers of skin. UVA leads to skin damage over time that can prematurely age your skin, causing wrinkling and age spots. UVB is the shorter wavelength of light that penetrates the skin’s surface and causes sunburn.

The best sunscreens, labelled as “broad-spectrum” or “full-spectrum”, offer protection from all UV light. 

Physical sunscreen blocks UV light from reaching your skin by either reflecting the light or absorbing it. These products contain zinc oxide or titanium dioxide. Some people don’t like to use physical sunscreen because it remains visible on the skin after you apply it. It also can be hard to wash off. However, physical sunscreen provides significant, lasting protection from UVA and UVB light. It also tends to be less irritating to the skin than chemical sunscreens. That can be particularly beneficial for younger children and individuals who have sensitive skin. Chemical sunscreens work by absorbing the UV light and causing it to undergo a chemical reaction that prevents it from damaging your skin. Many chemical sunscreens are available. 

As you choose sunscreen, check its sun protection factor, or SPF. This number gauges how well a sunscreen blocks UVB rays. Experts agree that an SPF factor of 15 is the minimum needed to prevent skin damage from UVB. Sunscreens with SPFs higher than 50 provide only a slight increase in UVB protection compared to SPF 30 or SPF 50. That means high SPF sunscreens, such as SPF 100, may not be worth the added expense you pay for them compared to the protection they offer. 

The key to getting the total amount of SPF protection from sunscreen is applying it generously and frequently. Most people do not use it enough. For example, about two tablespoons of sunscreen, or about enough to fill a shot glass, is only enough for your face, neck and the back of your hands. Apply sunscreen generously to the rest of your exposed skin as well. Reapply sunscreen at least every two hours and more often if you’ve been sweating or swimming. Sunscreen may be water-resistant, but no sunscreen is waterproof. 

Is “organic” or “all-natural” better than products laden with chemicals? 

The truth about the “Natural vs Chemical” debate is that different situations call for differnt skin care measures. Natural products have their place and serve their purpose. Many natural ingredients have proven benefits, but some are just marketing tools to sell products. Manufacturers know that people are on the “natural” bandwagon and play that to their advantage. 

On the other hand, some situations call for chemicals to treat specific skin issues effectively. There are medicinal creams and topical treatments that, although not natural, are not harmful and can be effective. On the other hand, some chemicals in products can be potentially toxic to your skin and your body, and you should be wary of them. These include ingredients like parabens, petrochemicals, preservatives, Sodium Laureth Sulfate and perfumes which can cause skin irritations in some people. 

What you put on your body is just as important as what goes into your body. With so many different claims on personal care product packages, such as “natural”, “organic”, and “free of synthetics”, you may be left confused or misled about what’s really in the products. Here is what you should know about the most common claims: 

Natural – The term “natural” represents ingredients directly derived from nature and not created in a lab. The Food and Drug Administration (FDA) has never legally defined the term and has no regulations on its use. Sometimes natural ingredients are safer and better than synthetic alternatives. But many naturally occurring substances used in personal care products are not safe. For example, contaminated clays may include toxic heavy metals, and certain additives can cause an allergic reaction. 

Organic – The FDA regulates personal care products, but not the term “organic” for these products. The Department of Agriculture (USDA) controls organic claims on cosmetics, but these regulations only apply to the agricultural ingredients used in personal care products. The USDA allows two categories of certification to display its organic seal: 

• 100% Organic– This certification indicates that a product contains only organically produced ingredients. 
• Organic– This certification signifies that at least 95 per cent of a product’s ingredients are organically produced, and the remaining elements are on an approved list of substances. If a manufacturer claims a product to be organic but does not carry an official seal, the product may not meet USDA organic standards. 
• Free of Synthetics – A synthetic ingredient is anything synthetically derived and neither found nor harvested directly from nature. Research links several synthetic chemicals to cancer, hormone disruption, developmental disorders and other harmful health effects. Companies turn to synthetic versions of certain ingredients to maintain their products’ safety and purity. Synthetics ensure a product is always effective and identical in each batch made. 
• Hypoallergenic – Manufacturers claim that hypoallergenic cosmetics produce fewer allergic reactions than other cosmetic products. Consumers with hypersensitive skin, and even those with normal skin, may believe that these products will be gentler to their skin than non-hypoallergenic cosmetics. However, no federal standards or definitions govern the term “hypoallergenic.” 

The best way to know what is in your products is by reading the list of ingredients. 

Are expensive, top-shelf products better than the drugstore variety? 

The sheer size of the skincare market means it has products to suit all budgets. As people tighten their belts, budget skincare is becoming increasingly popular. When it comes down to drugstore vs luxury, there is no answer. Many factors influence the difference in price between drugstore and luxury skincare. However, the price of a product has nothing to do with how efficacious it is.

Luxury skincare comes down to the cost of production, such as packaging, quality and concentration of ingredients, and the name. Some ingredients, like vitamin C, have specific packaging requirements to keep the active stable, which can drive up the cost. Other products require specific, custom packaging depending on the needs of the product, which drives up the cost for the brand significantly, and trickles down to the consumer. 

The main difference between drugstore and luxury skincare is some of the ingredients. When it comes to hydrating and cleansing the skin, the ingredients are inexpensive, which is why drugstore brands hit it out of the park with their cleansers and moisturisers. In contrast, the ingredients necessary to treat acne, ageing, and hyperpigmentation haven’t historically been available in inexpensive formulations. As the skincare industry evolves, we’re seeing an influx of affordable products addressing those concerns. But because high-end brands have had the monopoly on anti-ageing and treating skin ailments all this time, those formulations are what have dominated dermatologist offices and celebrity skincare routines. 

But, it’s about more than just the ingredients in your products; it’s also about what’s not in them, like fragrance, dye, and parabens and making sure that the brand is cruelty-free or vegan if that’s important to you. Clean products that don’t contain preservatives tend to require more expensive ingredients to keep the product stable. These ingredients often have shorter life spans, driving up costs because companies want to ensure constant stock levels and new products on shelves.  

Are there any products that we should avoid altogether? 

The Top 12 Ingredients to Avoid In Skincare: 

1. Aluminium – This toxic metal can have estrogen-like effects on our systems, disrupting the healthy functioning of the endocrine system. Usually found in every personal care product, especially antiperspirant deodorants. 
2. DEA (diethanolamine), MEA [Monoethanolamine] & TEA [triethanolamine] – These clear, colourless, viscous liquids with ammonia-like odours are usually found in products that foam like facial cleansers and soaps, as well as eye makeup, fragrances, hair products, and sunscreens. 
3. DMDM Hydantion & Urea [Imidazolidinyl] – These preservatives often release formaldehyde which may cause joint pain, skin allergies, headaches, and sleep loss and are usually in skincare products, cosmetics, shampoos and conditioners, and detergents. 
4. Mineral Oil – This petroleum by-product coats the skin like plastic, clogging its pores, which is incredibly harmful because it interferes with the skin’s ability to eliminate toxins, increasing the likelihood of acne and other disorders. Usually found in creams, lotions, ointments, and cosmetics. 
5. Parabens [Methyl, Butyl, Ethyl & Propyl] – These ingredients are not always labelled, used as preservatives, and may contribute to hormone imbalance. Parabens are usually found everywhere, including skincare products such as moisturisers and deodorants. 
6. PEG [Polyethylene Glycol] – This ingredient can alter and reduce the skin’s natural moisture factor. It adjusts the melting point, thickens products, and is usually found in cleansers to dissolve oil and grease. 
7. Phthalates – These chemicals increase the flexibility and strength of plastics, are not often listed among product ingredients and are usually found in cosmetics such as fragrance oils and listed under the term “fragrance”. 
8. Propylene Glycol [PG] & Butylene Glycol – These gaseous hydrocarbons act as “surfactants” in a liquid state, penetrate the skin quickly and can weaken the protein and cellular structure. They are usually used to make extracts from herbs. 
9. Siloxanes – Ingredients ending in “-siloxane” or “-methicone” are used in various cosmetics to soften, smooth and moisten. They are suspected endocrine disrupters and reproductive toxicants (cyclotetrasiloxane). And they are harmful to fish and other wildlife. 
10. Sodium Lauryl Sulfate [SLS] & Sodium Laureth Sulfate [SLES] – These detergents that make products foam, lather, and bubble are usually in 90 per cent of personal-care products that foam! 
11. Synthetic Fragrances – Anything highlighted as synthetic or artificial should always raise a red flag. Comprised of hundreds to thousands of different ingredients not listed on the label, you are never sure what you are exposing your skin to with synthetic fragrances. These ingredients are usually in cosmetic and skincare products and many household products such as candles, air fresheners, and scented trash bags. 
12. Triclosan – This synthetic antibacterial agent may disrupt thyroid function and can degrade into a form of dioxin, a class of chemicals linked to a broad range of toxicities, including cancer. This ingredient is usually in soaps, mouthwash, shaving cream, deodorants, toothpaste, etc. 

If you only had one tip, what is the best thing we can do for our skin? 

In a nutshell, it’s sunscreen! 

Research has shown that people apply much less sunscreen than they should. Cancer Research recommends that people use sunscreen of at least SPF 15 (Sun Protection Factor) and SPF 30 for children or those with pale skin. SPF 15 sunscreens filter out 93 per cent of UV radiation, while SPF 30 filters out 96 per cent. We recommend that sunscreen is applied generously to all areas of skin exposed to the sun and reapplied every 2 hours. Ensure that children’s skin is protected as there is evidence that sunburn in childhood can triple cancer risk in later life. Here are the top five reasons why applying sunscreen should be a daily habit year-round: 

1. It Protects Your Skin from UV Rays – The depletion of the ozone layer has increased our risk of sun damage from harmful UV rays. Sunscreen blocks these rays, reducing the likelihood of sunburn. Some doctors recommend nothing below SPF 30 and use it each day. For full-body coverage, you will want to apply about an ounce.
2. It Lowers Your Skin Cancer Risk – Skin cancer is the most common cancer in the United States. According to the Centers for Disease Control and Prevention [CDC], 71,943 people were diagnosed with skin melanomas in 2013, and 9,394 of these cases were fatal. By applying sunscreen each day, you cut your risk of contracting skin cancers in half. 
3. It Prevents Premature Aging of the Skin – Sun damage from UV rays causes skin photoaging, characterised by a thick, leathery look, discolouration, and a breakdown of collagen, which contributes to sagging, fine lines, and wrinkles. Studies show that those below the age of 55 who apply sunscreen regularly have a 24 per cent less chance of developing these signs of ageing than those who don’t. 
4. It Helps Maintain an Even Skin Tone – Sunscreen helps prevent discolouration and dark spots from sun damage, helping you maintain a smoother and more even skin tone. 
5. It Protects All Skin Tones – If you have darker skin, you have some natural protection against the sun, but UV rays can still cause damage. Even if you do not sunburn easily — or at all — sun damage can show up as uneven skin tone or pigmentation that can be hard to treat, like melasma. Skin cancer may not be as common in people with darker skin tones, but it can still happen. In this case, a diagnosis often occurs later when it can be harder to treat. Wearing sunscreen can help protect people with all skin tones.