A perfect nose for Christmas in your lunch break

Everybody now seems to know that you can soften lines and wrinkles with ‘botox’ and fillers, and that cheeks can be nicely augmented with injectable ‘volumisers’. One procedure that most people are still unaware of however is non-surgical nose-shaping - and yet the results are amazing and the procedure is very quick and uncomplicated.

Non-surgical nose shaping is a relatively new variation of treatment with a hyaluronic acid filler. In our clinic we use a filler with added local anaesthetic, so that the procedure is virtually painless in most patients. 

Not everybody is suitable for this treatment, but if you are, then this is a great alternative for a surgical ‘nose job’ (rhinoplasty). We can treat for example bumps on the bridge of your nose and an uneven shape to the bridge of the nose (for example after trauma or surgery). Often the nose might even appear smaller compared to before treatment. I also frequently have patients coming to see me in clinic, complaining that they can’t wear glasses or sunglasses, as these tend to slide down, due to the flatter shape of their nose. Through means of non-surgical nose shaping we can now build up flat noses, giving them a beautiful, even profile and thus reducing the problem of ‘sliding glasses’. 

Looking Great in 2011

I am pleased to announce that on the 28. January I will be holding an exiting work-shop with two brilliant colleagues on how to look your best in 2011. This will take place in our Chelsea Bridge Clinic. Places are filling up quickly, so to book your place call: Tel. 020 7467 8500 

Are you feeling the seasonal itch?

Have you noticed over the past week or so that your skin seems drier? You’re not the only one. Dry skin is an extremely common complaint that affects up to 40% of us. Interestingly, the paler your skin, the drier it’s likely to be although science hasn’t yet discovered precisely why.

I’m sure you’ve already guessed that the changing weather might be causing your drier skin. But why does winter make our skin drier? Well, there’s something in the air. Outside, it’s getting colder, drier and windier while inside, central heating parches the atmosphere, meaning moisture evaporates faster from the skin surface. This ‘double whammy’ significantly lowers the water content of the skin’s horny layer. So what does that mean, exactly?

The skin is composed of three main compartments -  from the bottom up, the subcutis, or deep skin ‘cushion’ of fatty tissue, the dermis of firm connective, supportive tissue and the epidermis, the skin’s outer protective layer. Most surface signs of ageing such as wrinkles and loss of elasticity begin deep in the dermis. But it’s the epidermal top layer which regulates water homeostasis - the skin’s moisture quota. In most parts of the body, the epidermis is paper-thin and it is the most superficial sheet of the epidermis - the stratum corneum, or ‘horny layer’ that plays the most crucial role. 

Think of this horny layer as a microscopically tiny mortar/brick wall. The bricks are flat, horny dead skin cells and the mortar consists of lipids - ceramides, free fatty acids and cholesterol - which cement them together. This protective horny barrier has two key functions - to keep environmental hazards out and to keep water in. And it usually does both pretty well.

But certain internal and environmental conditions can reduce the lipid content between cells, so that water evaporates more easily from the skin surface. A genetic tendency to dry skin, hormonal influences, metabolic diseases (an underactive thyroid gland, say, or diabetes), impaired kidney function and, of course, age all compromise skin lipids. Medication such as Vitamin A acid tablets and drugs that lower cholesterol as well as certain blood pressure lowering drugs won’t help. Neither does an unbalanced diet, excessive weight loss or sadly, increasing age.

So if you are suffering from dry skin and ‘winter itch,’ here’s the strategy. Try to reduce contact with water and limit your use of soap and detergents. If you’re wrapping up against the chill, avoid scratchy fabrics such as wool and opt for soft thermal cottons and fleeces instead. And give that stressed, horny skin layer a helping hand.  A lipid-rich moisturizer will help to reinforce the skin’s protective barrier, minimize water loss and calm itching instantly. My top tip is to apply it when your skin’s still damp from the shower to trap even more moisture in the surface layers. Now that’s a soothing thought.

Can Botox make you happier?

I just read a very interesting study* performed at the highly reputable School of Psychology at Cardiff University. In this paper the investigators wondered whether injections with botulinum toxin (botulinum toxin is the active ingredient in ‘Botox’) might be useful in cases of depression.

It has long been believed in psychological circles that the actual act of frowning itself can make us feel unhappier. This is believed to happen via facial feedback mechanisms. What this basically means is that if you frown, your brain ‘thinks’ you must be unhappy and provides the corresponding feeling to your facial expression. Cosmetic botulinum toxin treatment on the other hand temporarily reduces the activity of the facial muscles we need to frown. So the question is, if we are no longer able to frown, would that lead to a less negative emotional state? In other words, can we ‘trick’ our brain (by not allowing our frown muscles to do their job) into ‘thinking’ that we must be happy?

Lewis and Bowler put this theory to the test and compared the mood of people who had received cosmetic botulinum toxin treatment with people who had received other cosmetic treatments. Amazingly they found that cosmetic botolinum toxin treatment does indeed correlate with a significantly less negative mood.

Does this mean that people with depression should now receive botolinum toxin injections instead of counseling, psychotherapy and anti-depressants? A good friend of mine, Dr Malin, a lovely Norwegian psychologist practicing in London, comments “It has to be remembered that this study does not indicate that Botox can successfully treat depression and that it can as such replace other treatments for depression. I would therefore highly encourage anybody going through a depressed stage to seek appropriate psychological help."  I couldn’t agree more. However, this is a very interesting study and I am looking forward to further studies in this area.

*J Cosmet Dermatol. 2009 Mar;8(1):24-6 

The day our skin sins finally give us away

When we holistically access a cosmetic patient in clinic, dermatologists look at three key problem areas – a) lines and wrinkles; b) loss of volume and contour; and c) skin surface and texture problems. While early cosmetic treatments were all about ‘chasing’ lines and wrinkles, over the past couple of years there has been plenty of hype about re-contouring and volumising the face. There’s no doubt that plumper cheeks and a firmer jawline give a more youthful profile. Yet a good daily skincare regime can work wonders for your skin surface and texture, while improving elasticity, irregular pigmentation, fine lines and wrinkles.

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There’s no doubt that the right skincare can also delay the need for minimal invasive procedures and even surgery. But here’s the problem. There’s a jungle of extremely appealing skincare products on beauty shelves and counters out there - even practitioners find it hard to judge which ones come with serious scientific back-up. Marketing bumf can be so misleading….

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In clinic, patients are always asking me what skincare regime I recommend as a dermatologist. That’s why I have developed EudeloBoutique.com. Here I give expert tips and advice on how to look after your specific skin type and offer a hand-picked choice of must-have products I believe will work. It’s my hope that this new website will change the way people look after their skin and help them to stop wasting cash on so-called luxury products that frankly don’t deliver.

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As a dermatologist, I can't stress strongly enough how crucial skincare is. In our 20s, mother nature helps us to hide most of our 'skincare sins'. But from our 30s onwards, our skin is much less forgiving and it becomes more and more obvious how well it’s been looked after over the years and whether or not we’ve used regular sun protection. So don’t think skincare doesn’t make a difference. It’s no quick fix - we’re talking months to years, rather than days or weeks. But it’s worth it in the long term. So my advice is to choose your skincare wisely - and stick to it.  

Summer and skin – a love / hate relationship

We so deserve the gorgeous weather we’ve been having recently - even the odd shower doesn’t seem too bad now. But sitting in a London park recently for my lunch break, I couldn’t help but notice all those pale skins turning red in the sun. Surprising?  We’re in the UK - not Spain or Italy - after all.  Sorry to rain on your parade, but the average skin ‘suntype’ in the UK is simply not made to deal with the sun’s harmful rays, even on home turf. Yet we’re always so relieved when our summer finally starts, many of us forget to take precautions and bask in the direct sun at high noon without sunscreen - gradually turning into lobsters. Maybe most people assume that since we’re here and not somewhere in the Med, the sun can’t be that bad, can it?

Well, you might be surprised to hear that we have extremely worrying skin cancer rates in the UK. Our rate of melanoma - the most serious type of skin cancer - is above the EU average. Interestingly, skin cancer rates in affluent areas are much higher compared to those in more deprived areas, but overall cases are rising steeply, with almost a third of all cases affecting women under 50. According to the British Association of Dermatologists, the incidence of melanoma is increasing faster than any other common cancer - rates are doubling every 10-20 years and projections suggest they’ll continue to rise until 2024!

One reason must be that we still see a tan as so attractive, it’s worth the risk - as I observed in the park the other day. But the good news is that at least we’re starting to teach our kids about sun protection. I was delighted to receive a letter from my children’s head teacher last week, reminding parents to apply sun protection to their kid’s skin each morning and send them to school with sun hats. An excellent start.

So here’s a thought. If we adults protected our own skin as well as our kids’, we’d have a win-win situation. Serious sun protection includes not sitting in direct sun, especially around noon and always apply a good broad-spectrum sunscreen product of at least SPF30 regularly.  For everyone’s sake - save your skin.

Feet that look fab in flip-flops and legs worth showing off? I've found the perfect solutions

At last, it's time for bare legs and strappy sandals. Dreading exposing those pasty-pale legs and rough, dry heels? You're not alone. A long winter's neglect - not to mention central heating - can leave the skin on your feet dry, thickened and maybe even cracked. Plus, it's a fair bet that your legs haven't seen daylight in months. But whoa there, no knee-jerking - sunburn's not the way to give your legs a dress-friendly glow. I've found far more effective solutions to prepare you for the great summer reveal.

So, feet first. Let me introduce you to the perfect pedi - in a jar! Minor miracle 'NeoStrata Problem Dry Skin Cream' contains high strength (20%) alpha hydroxy acids, which will progressively soften and smoothen even very dry, tough skin on your heels. (In fact if it doesn't do the job, you may have a skin condition that needs medical attention - see me in clinic if you're worried).

Now for those legs. Flatter them with GloMinerals Body Glisten, a refreshing lotion with a wonderfully subtle shimmer that gives skin a smooth, even glow that also helps to make them look more slender and shapely - a best-kept celebrity secret.

Now flex those feet and liberate those limbs!