So, what exactly is adapalene?

Adapalene is an active ingredient that belongs to the better-known retinoid family. Retinoids are used in the treatment of acne as they can help keep pores clear, reduce inflammation and increase the rate of skin cell turnover. Retinal, which has become increasingly popular recently, is also part of this family. Like tretinoin, adapalene is a retinoid that requires a prescription. Adapalene is generally used as the retinoid of choice for acne as it has the most evidence behind it [1].

It comes in a cream or gel formulation. Your clinician will normally recommend you apply a thin layer to the affected skin, once per day, in the evening time after cleansing your face and before moisturising. It can cause some skin irritation, particularly around the eyes, nose, mouth so try to avoid applying it to these areas.
You should also take care if you’re applying it on your neck.

Why is it prescribed?

Adapalene can be prescribed for all grades of acne. Studies have shown it is less irritating to skin than other retinoids [2].

It’s also compatible with other ingredients such as benzoyl peroxide and clindamycin which also help to slow bacterial growth, and reduce breakouts.

How will it affect my skin?

Many people will have questions when starting on adapalene. Will I get side-effects? Will my skin get worse? Will my acne finally clear up? We’ll guide you through what you can expect when you first use adapalene. When you first apply the cream or gel, you may notice your skin tingle or warm. This is a normal reaction, and should settle after a minute or two.

Adapalene helps treat and prevent acne breakouts by increasing skin cell turnover, unclogging pores and getting rid of old dead skin cells. It also works to treat existing acne by reducing any redness and inflammation in your skin, leading to a clearer complexion. As an extra bonus, adapalene can help to fade pigmentation and reduce fine lines. This can help with skin-ageing and make your skin appear more youthful.

What are the side-effects, do they affect everyone, and why do they occur?

When beginning a retinoid treatment, your skin will undergo a process called ‘retinisation’. During this time, people may experience scaling, dryness and flakiness of your skin. Most people experience this normal adjustment, so please don’t be too alarmed when this happens [3].

At the start of treatment when pores become unclogged and dead skin cells are brought to the skin surface you may also notice your acne slightly worsens initially with a breakout. This is known as ‘purging’ and is a sign of the treatment beginning to work. This can be alarming, but tends to settle within a few weeks so it’s important to persevere.

Generally speaking, if you’re finding adapalene too irritating or drying on your skin, your clinician may recommend starting treatment on an alternate-day pattern or reducing the time it’s on your skin. To do this, they may recommend washing adapalene off after about an hour, and then working towards a longer application as your side-effects start to ease [6].

Which ingredients is adapalene usually formulated with to enhance its efficacy?

Adapalene is compatible with other active ingredients. Often, a good partnership is with benzoyl peroxide, which is a name you may recognise from other spot and acne treatments. The combination of adapalene with benzoyl peroxide appears to be helpful in improving acne and has been shown to make the treatment easier for people to tolerate [4].

Adapalene can also be combined with antibiotic treatments in the cream or gel, for example clindamycin [5] or other treatments such as niacinamide or azelaic acid Niacinamide. They are anti-inflammatory, which can also help to treat hyperpigmentation.

What should my routine look like while I’m on adapalene treatment?

If you’re using adapalene, it’s important to take some extra precautions to look after your skin and general health. It’s essential to wear sunscreen to help prevent any damage to your skin, as well as prevent pigmentation or signs of ageing. We would recommend a sunscreen which protects against UVA and UVB of at least SPF30 on your face.

Maintain your daily cleansing routine, and ensure to cleanse your face each night before applying adapalene. Due to adapalene’s effect on skin turnover, you may notice your skin is more flaky or dry. Using a thicker moisturiser after applying adapalene is important to make sure your skin remains well hydrated. Maintain your daily cleansing routine, and ensure to clean your face each night before sleep.

It’s important to remember to continue to take contraceptive measures while using adapalene. If you’re trying to conceive or become pregnant, it is important to let us know so we can change your prescription to one which is suitable during pregnancy.

How do I get advice?

Hopefully, this article has given you a good overview of how adapalene works and the side-effects to watch out for. If you do have any further questions, please feel free to contact the dermatology team at Dermatica or start a consultation with us. Our experts will be happy to answer any questions you have. If you sign up for a subscription, you can get unlimited free check-ins with them, too.

References:
[1] https://medlineplus.gov/druginfo/meds/a604001.html Date accessed: 2/12/2022
[2] Tolaymat, L; Zito, PM (January 2021). “Adapalene”. PMID 29494115.
[3] https://www.webmd.com/drugs/2/drug-6442/adapalene-topical/details Date accessed: 1/12/2022
[4] Bouloc A, Roo E, Imko-Walczuk B, Moga A, Chadoutaud B, Dréno B. A skincare combined with combination of adapalene and benzoyl peroxide provides a significant adjunctive efficacy and local tolerance benefit in adult women with mild acne. J Eur Acad Dermatol Venereol. 2017 Oct;31(10):1727-1731.
[5] ​​Stein Gold L, Baldwin H, Kircik LH, Weiss JS, Pariser DM, Callender V, Lain E, Gold M, Beer K, Draelos Z, Sadick N, Pillai R, Bhatt V, Tanghetti EA. Efficacy and Safety of a Fixed-Dose Clindamycin Phosphate 1.2%, Benzoyl Peroxide 3.1%, and Adapalene 0.15% Gel for Moderate-to-Severe Acne: A Randomized Phase II Study of the First Triple-Combination Drug. Am J Clin Dermatol. 2022 Jan;23(1):93-104.
[6] https://bnf.nice.org.uk/drugs/adapalene/#patient-and-carer-advice Date accessed: 30/11/202

The post Just Started Adapalene? Here’s What To Expect appeared first on SkinLab.

Two retinoids you’ll hear us talk about are tretinoin and adapalene. But what’s the difference, and which one is right for you? Let’s take a look.

First, what’s a retinoid?

Retinoids are a group of chemicals derived from vitamin A. They’ve long been the go-to for treating acne and ageing, because they are so effective. ,

Retinoids come in many forms. Some feature as the active ingredient in over-the-counter skincare products, available in any pharmacy or supermarket. These include retinyl palmitate, retinol, and retinaldehyde (retinal). ​​Retinol is the natural form of vitamin A that you can find in cosmetics, which needs to oxidise twice before it converts to the active form, known as retinoic acid. Retinal needs one step. When we look at retinoids that are on prescription such as tretinoin, this is actually retinoic acid which is the active molecule which can get to work on the skin.

Alternatively, there are more potent, prescription-strength retinoids — which you can get on prescription, or of course, from the dermatology experts at Dermatica.

All retinoids work in a similar way, by increasing cell turnover. This stops the build-up of skin cells, increases skin renewal and unclogs pores. Retinoids also have an anti-inflammatory effect, which can be especially helpful for some types of acne. They also help to stimulate collagen production, reverse fine lines caused by photoageing, and can lighten pigmentation due to their exfoliating effect.

Essentially, these hero ingredients can help deliver a smooth, clear complexion.

Tretinoin

Tretinoin, also known as retinoic acid, is the most widely-researched and potent retinoid. It’s been used to treat acne for at least four decades. It’s prescribed at different strengths, often starting as low as 0.015% and increasing to 0.05% as the skin adjusts.

What are the benefits of tretinoin?

Where do we start with this wonder ingredient? Tretinoin has been widely researched and shown many skin benefits in studies. It’s a great all-round anti-ager, and can bring about significant changes in the structure of your skin, affecting how it looks and feels. The proven benefits include a significant improvement in:
Fine lines
Pigmentation
Texture
Elasticity

All-in-all, tretinoin will help to reverse the signs of ageing, including natural, chronological changes as well as photoageing caused by sunlight.

Tretinoin also offers excellent benefits for acne. Studies have shown it effectively improves:,
Blackheads
Whiteheads
Papules (small bumps)
Pustules (pus-filled spots)

What are the side effects of tretinoin?

It’s effective, yes. But it can be associated with skin irritation when you start using it. Skin may become red or blotchy and flaky, and may burn or sting. This is called retinisation, and it’s really just a sign that the treatment is working, because it shows your skin is starting to exfoliate.

Everyone is different though, and if you don’t get any irritation, that doesn’t mean tretinoin isn’t effective for you.

The irritation will improve as your skin adjusts to the ingredients. And there are a few simple steps you can take to reduce this side-effect:
Prep your skin: Try using a barrier-boosting moisturiser for two weeks before starting treatment. Look for one containing niacinamide, panthenol, and tocopheryl acetate.
Start low and slow: We usually recommend the lowest dose to begin with, and suggest you only apply it twice a week. You can build up in frequency and strength as your skin adjusts.
Make a skincare sandwich: Apply moisturiser before and after your treatment.
Skip a day if you need to: You might need to give your skin a little break, and that’s fine. Wait until your skin has recovered and then re-introduce gradually.

Stick with it — this is strong stuff, but the results are worth it.

Adapalene

Adapalene is a relatively new kid on the retinoid block. It’s a synthetic version of vitamin A with a slightly different structure to tretinoin.

It has similar properties to tretinoin, but it’s a more stable chemical. This means it won’t lose its potency if exposed to sunlight, as tretinoin can. It also means adapalene can more easily be combined with other ingredients to combat acne, such as bacteria-flighting benzoyl peroxide, or clindamycin, an antibiotic.,

What are the benefits of adapalene?

There’s good evidence that adapalene can work wonders for acne. Many studies have compared it with tretinoin, and found that it’s just as effective, and in some studies even more so, for treating both inflammatory and non-inflammatory acne.

There is some evidence for its use as an anti-ageing tool too — it’s been shown to reduce pigmentation and improve wrinkles., But we need more studies in this area to understand its full potential.

What are the side effects of adapalene?

This is where adapalene may have the edge on tretinoin.

Multiple studies have shown that adapalene causes less skin irritation than tretinoin. This has been shown in several different strengths and formulations — even versus tretinoin at 0.025%, which is at the lower end of prescribed concentrations.

Which should I use?

Anti-ageing

If your aim is anti-ageing, tretinoin is your answer. There is currently more evidence for tretinoin than there is for adapalene when it comes to achieving younger-looking skin.

You may need to be prepared for the side effects of the retinisation process. But follow our advice, and you can minimise irritation. You can be fairly confident that you’ll achieve noticeably more youthful skin if you stick with it.

As evidence builds for adapalene, this may become the first choice for anti-ageing. But until then, we’ll suggest you try tretinoin first. You may need to switch to adapalene if your skin just can’t tolerate tretinoin.

Acne

If you’re looking for an effective acne solution, adapalene is the active ingredient for you. There are a few reason why this is the one to go for:
There’s plenty of evidence that it’s effective against acne, and it may work faster than tretinoin
It results in less irritation than tretinoin
It’s more stable, which means it can be combined with other acne-busting ingredients, such as clindamycin or benzoyl peroxide

What should I do next?

If you’re looking for effective acne or anti-ageing ingredients, retinoids can help. Adapalene and tretinoin are potent treatments, which need to be prescribed and monitored carefully..

Thankfully, Dermatica makes the process easy. We offer immediate access to an expert dermatology team who offer personalised evidence-based prescription medicines to combat acne and fight ageing. Your treatment is delivered to your door, and you’ll have experts on hand to ask questions whenever you need.

So there’s nothing to slow your journey towards the clear, youthful skin you want.

References
1. Thielitz, A., Abdel-Naser, M.B., Fluhr, J.W., Zouboulis, C.C. and Gollnick, H. (2008), Topical retinoids in acne – an evidence-based overview. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 6: 1023-1031. https://doi.org/10.1111/j.1610-0387.2008.06741.x
2. Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging. 2006;1(4):327-48. doi: 10.2147/ciia.2006.1.4.327. PMID: 18046911; PMCID: PMC2699641.
3. Thielitz, A., Abdel-Naser, M.B., Fluhr, J.W., Zouboulis, C.C. and Gollnick, H. (2008), Topical retinoids in acne – an evidence-based overview. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 6: 1023-1031. https://doi.org/10.1111/j.1610-0387.2008.06741.x
4. Thielitz, A., Abdel-Naser, M.B., Fluhr, J.W., Zouboulis, C.C. and Gollnick, H. (2008), Topical retinoids in acne – an evidence-based overview. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 6: 1023-1031. https://doi.org/10.1111/j.1610-0387.2008.06741.x
5. Piskin S, Uzunali E. A review of the use of adapalene for the treatment of acne vulgaris. Ther Clin Risk Manag. 2007 Aug;3(4):621-4. PMID: 18472984; PMCID: PMC2374937
6. Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging. 2006;1(4):327-48. doi: 10.2147/ciia.2006.1.4.327. PMID: 18046911; PMCID: PMC2699641.
7. Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging. 2006;1(4):327-48. doi: 10.2147/ciia.2006.1.4.327. PMID: 18046911; PMCID: PMC2699641.
8. Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. 2016;74(5):945-73. e33.
9. Krishnan G. Comparison of two concentrations of tretinoin solution in the topical treatment of acne vulgaris. The Practitioner. 1976;216(1291):106-9.
10. Piskin S, Uzunali E. A review of the use of adapalene for the treatment of acne vulgaris. Ther Clin Risk Manag. 2007 Aug;3(4):621-4. PMID: 18472984; PMCID: PMC2374937
11. Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging. 2006;1(4):327-48. doi: 10.2147/ciia.2006.1.4.327. PMID: 18046911; PMCID: PMC2699641.
12. Draelos, Z.D., K.D. Ertel, and C.A. Berge, Facilitating facial retinization through barrier improvement. Cutis, 2006. 78(4): p. 275-281.
13. Piskin S, Uzunali E. A review of the use of adapalene for the treatment of acne vulgaris. Ther Clin Risk Manag. 2007 Aug;3(4):621-4. PMID: 18472984; PMCID: PMC2374937
14. Jain S. Topical tretinoin or adapalene in acne vulgaris: an overview. Journal of Dermatological Treatment (2004) 15, 200–207
15. Jain S. Topical tretinoin or adapalene in acne vulgaris: an overview. Journal of Dermatological Treatment (2004) 15, 200–207
16. Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. 2016;74(5):945-73. e33.
17. Ellis C, Millikan L, Smith E, Chalker D, Swinyer L, Katz I, et al. Comparison of adapalene 0·1% solution and tretinoin 0·025% gel in the topical treatment of acne vulgaris. 1998
18. Bagatin, E., Gonçalves, H.d.S., Sato, M. et al. Comparable efficacy of adapalene 0.3% gel and tretinoin 0.05% cream as treatment for cutaneous photoaging. Eur J Dermatol 28, 343–350 (2018). https://doi.org/10.1684/ejd.2018.3320
19. Kang S, Goldfarb MT, Weiss JS, Metz RD, Hamilton TA, Voorhees JJ, et al. Assessment of adapalene gel for the treatment of actinic keratoses and lentigines: a randomized trial. Journal of the American Academy of Dermatology. 2003;49(1):83-90.
20. Jain S. Topical tretinoin or adapalene in acne vulgaris: an overview. Journal of Dermatological Treatment (2004) 15, 200–207
21. Shalita, A., et al., A comparison of the efficacy and safety of adapalene gel 0.1% and tretinoin gel 0.025% in the treatment of acne vulgaris: a multicenter trial. Journal of the American Academy of Dermatology, 1996. 34(3): p. 482-485.
22. Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging. 2006;1(4):327-48. doi: 10.2147/ciia.2006.1.4.327. PMID: 18046911; PMCID: PMC2699641.
23. Cunliffe W, Poncet M, Loesche C, Verschoore M. A comparison of the efficacy and tolerability of adapalene 0.1% gel versus tretinoin 0.025% gel in patients with acne vulgaris: a meta-analysis of five randomized trials. 1998.
24. Jain S. Topical tretinoin or adapalene in acne vulgaris: an overview. Journal of Dermatological Treatment (2004) 15, 200–207
25. Irby CE, Yentzer BA, Feldman SR. A review of adapalene in the treatment of acne vulgaris. Journal of Adolescent Health. 2008;43(5):421-4.

The post Adapalene vs. Tretinoin: Which Is Better For Acne & Anti-Ageing? appeared first on SkinLab.

Experts understand fairly well the role of genetics and hormones in acne, but there are other factors that are less clear. Sadly, diet is one of them.

Here’s what we know so far — and advice on what best to eat for clear skin.

First, why have I got acne?

It feels unfair. Why are you dealing with skin that breaks out, while friends are blemish free?

Unfortunately, there’s no easy answer to this. A host of factors are at play, the most important being genetics. Yes, you can probably blame skin issues on your family history.

Studies in identical twins — who share the same genetic makeup — suggest that genes account for 80% of acne. This means that in most cases either each twin or neither will have the condition.

The other 20% of the risk is down to factors that vary from person to person, and aren’t associated with any genetic tendency. This is why many experts think diet might play a role.

How does acne start?

But the processes that contribute to acne may also be impacted by diet. Acne is characterised by inflammation, excess sebum (oil) production, build-up of skin cells (hyper-keratinisation) and an increase in skin bacteria called C acnes. s.

One example is insulin, which affects levels of another hormone called insulin-like growth factor (IGF-1). This in turn is involved in various cellular processes that impact sebum production and skin cell turnover. Insulin levels are affected by the sugar we eat.

Which foods affect acne?

Sadly, it’s not easy to say. Although there’s plenty of anecdotal evidence for dietary influences on acne — who hasn’t been told to avoid chocolate? It’s unlikely that a single food will change your skin significantly but ask doctors to make specific recommendations.

But there’s a lot of research ongoing, which is starting to build up a picture of what might help.
Glycemic index/load
Glycemic index/load is looking like the most promising area of research when it comes to diet and acne.

The Glycemic index (GI) rates foods according to how fast your body breaks them down into sugar. Foods that your body breaks down quickly cause a rapid spike in blood sugar. These have a high GI. Examples include sweets, chocolate and sugary drinks, white bread and white rice. Foods that break down more slowly — such as whole grains, vegetables and pulses — have a lower GI.

The term glycemic load (GL) simply takes account of the amount of these foods. So a single sweet, which is a high-GI food, has a lower GL than a large handful of sweets.

Several studies have shown that people with acne seem to eat higher-GL diets than those without. And there’s some evidence that switching to a low-GL diet may reduce the number of acne lesions.
Scientists have also noted the complete absence of acne among certain groups of people who live on isolated islands with no access to processed, Western foods. But it’s not clear whether this is due to dietary GL, or other elements of the Western lifestyle.

The evidence suggests that trying to stick to foods that release sugars gradually, avoiding sugar spikes and surges in insulin, might be worth a try. For more information, have a look at the NHS article on the glycemic index.

Dairy

Although it often gets the blame as a spot-causing culprit, there’s mixed evidence for the impact of dairy on acne. Some studies have found a link with milk consumption, and in some cases, this link has only been shown with skimmed milk.

But the same association has not been seen with cheese. This raises the possibility that the acne connection is actually due to the effect of dairy on blood sugar, rather than specific dairy proteins.

There just isn’t enough evidence to advise every acne sufferer to give up dairy. But some people might find it helps. Keep in mind that if you do decide to skip dairy, it’s important to get your calcium from other sources.

Fats

There’s some weak evidence that the types of fats you eat could impact your acne. For example, some studies have shown a link between low fish intake and increased acne. And a diet high in trans-fat and saturated fat may also be a contributing factor.

In one study, adding an omega-3 fatty acid supplement reduced acne.

But again the number of studies is low, and there isn’t yet enough evidence to make definite recommendations. For good health, everyone should include omega-3 fats from fish, and try to limit trans-fats and saturated fats. These are generally found in animal products including meat and dairy.

What about chocolate?

The jury is still out on this one. In one study, men with acne were given capsules with either unsweetened 100% cocoa, or a control capsule. There was a statistically significant increase in acne in the cocoa group.

Other studies have also shown a link between acne and daily snacking on chocolate and sweets. But we don’t know if, again, this could just be due to all the sugar and the surges in insulin that follow.

And there’s another issue — acne can have a significant emotional impact. So could some of the acne-chocolate links be explained by comfort eating?

In short, more studies are needed before we can give definite no-chocolate advice. But if it triggers flare-ups, you might prefer to go without.

Acne advice

The best advice is to listen to your own body. If you’ve noticed that chocolate milkshakes bring on a break-out, it makes sense to avoid them.

It may not be what you want to hear, but the medical recommendation for people with acne is simply to eat a healthy, balanced diet. This should include:

Plenty of sources of high-quality protein such as lean meat, fish and pulses
Wholegrain foods rather than processed white versions.
At least 5 a day, including a colourful, varied mix of fruit and vegetables
Very little — if any — sugary, processed food and drink

This way, your diet should be naturally nutrient-rich, have a low GL, be low in trans fats and supply enough omega-3 oils.

It’s important to remember that we’re still learning what causes acne itself before we can fully understand what part of the diet has to play. You can have a perfectly balanced diet, but still have severe acne, so it’s important to take any comments or advice that you see on foods exacerbating acne with a large pinch of salt.

It’s not recommended to exclude any types of food or food groups without the guidance of an expert. If you want to get any more personalised information, we recommend speaking to your Dermatologist, GP or registered dietitian as they are the best-qualified people to help.

References
1. Bataille et al. https://www.sciencedirect.com/science/article/pii/S0022202X15301019
2. Baldwin, H., Tan, J. Effects of Diet on Acne and Its Response to Treatment. Am J Clin Dermatol 22, 55–65 (2021). https://doi.org/10.1007/s40257-020-00542-y
3. Baldwin, H., Tan, J. Effects of Diet on Acne and Its Response to Treatment. Am J Clin Dermatol 22, 55–65 (2021). https://doi.org/10.1007/s40257-020-00542-y
4. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
5. Cordain, L. (2005, June). Implications for the role of diet in acne. In Seminars in cutaneous medicine and surgery (Vol. 24, No. 2, pp. 84-91). WB Saunders.
6. NHS. What is the glycaemic index? www.nhs.uk/common-health-questions/food-and-diet/what-is-the-glycaemic-index-gi/, reviewed June 2022
7. Baldwin, H., Tan, J. Effects of Diet on Acne and Its Response to Treatment. Am J Clin Dermatol 22, 55–65 (2021). https://doi.org/10.1007/s40257-020-00542-y
8. Baldwin, H., Tan, J. Effects of Diet on Acne and Its Response to Treatment. Am J Clin Dermatol 22, 55–65 (2021). https://doi.org/10.1007/s40257-020-00542-y
9. Baldwin, H., Tan, J. Effects of Diet on Acne and Its Response to Treatment. Am J Clin Dermatol 22, 55–65 (2021). https://doi.org/10.1007/s40257-020-00542-y
10. Cordain, L. (2005, June). Implications for the role of diet in acne. In Seminars in cutaneous medicine and surgery (Vol. 24, No. 2, pp. 84-91). WB Saunders.
11. Adebamowo C, Spiegelman D, Berkey C, Danby F, Rockett H, Colditz G, et al. Milk consumption and acne in teenaged boys. J Am Acad Dermatol. 2008;58(5):787–93.
12. Baldwin, H., Tan, J. Effects of Diet on Acne and Its Response to Treatment. Am J Clin Dermatol 22, 55–65 (2021). https://doi.org/10.1007/s40257-020-00542-y
13. NHS Eat Well. Dairy and alternatives in your diet. www.nhs.uk/live-well/eat-well/food-types/milk-and-dairy-nutrition/, reviewed January 2021
14. Baldwin, H., Tan, J. Effects of Diet on Acne and Its Response to Treatment. Am J Clin Dermatol 22, 55–65 (2021). https://doi.org/10.1007/s40257-020-00542-y
15. Jung J, Kwon H, Hong J, Yoon J, Park M, Jang M, et al. Effect of dietary supplementation with omega-3 fatty acid and gamma-linolenic acid on acne vulgaris: a randomised, double-blind, controlled trial. Acta Derm Venereol. 2014;94:521–5.
16. NHS Eat Well. Fat: the facts. www.nhs.uk/live-well/eat-well/food-types/different-fats-nutrition/, reviewed April 2020.
17. Caperton C, Block S, Viera M, Keri J, Berman B. Double-blind, placebo-controlled study assessing the effect of chocolate consumption in subjects with a history of acne vulgaris. J Clin Aesthet Dermatol. 2014;7(5):19–23.
18. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021

The post Can Diet Prevent Acne? appeared first on SkinLab.

And now, of course, you need to know how to maintain that clear-skinned glow and keep the blemishes at bay. Scroll to find out more.

How your formula cleared your skin

If you’ve been dealing with acne, you’ve probably been using topical retinoids, most likely adapalene or tretinoin.[1,2] These are powerful vitamin A derivatives applied directly to the affected areas of your skin.

Retinoids work by speeding up skin cell turnover, removing dead skin cells and preventing the build-up that clogs pores.[3] Your formula may also contain a bacteria-fighting ingredient, such as benzoyl peroxide or clindamycin.[4]

It may have taken a few weeks or months to get the results you’re after, but you’ll no doubt agree it was worth the wait. And now your skin is clear, you want it to stay that way.

Treatment, not cure

It’s important to remember that topical treatment is not necessarily a ‘cure’. The underlying issues that caused acne in the first place won’t necessarily have gone away. These could include increased oil production, skin bacteria, build-up of skin cells, and inflammation.[5]

Acne, especially in women, can persist into your 30s, 40s or beyond.[6] But, since you can’t know for sure that it won’t return, controlling your acne – and keeping it away – usually calls for an ongoing commitment to a good skincare routine.

Keep up the active treatment

Everyone’s skin is different. For the lucky ones, acne will clear and not come back. But relapses are common.

Your skincare expert will probably recommend that you keep using a retinoid formula.[7] So, for example, a 6 or 12-week course of daily treatment that has worked well might be followed by a less-frequent use of the same formulation.[8,9] Retinoids will continue to lighten pigmentation and improve the skin texture, which is often present due to the inflammatory process of the skin. Furthermore, they help to stimulate collagen production and reverse fine lines caused by UV radiation (photodamage) which will help improve the overall complexion!

Adapalene, either alone or combined with clindamycin, or benzoyl peroxide, is the most commonly used agent for maintenance treatment.[10] We also use other ingredients that help to fade blemishes, pigmentation and inflammation, such as azelaic acid and niacinamide. This is an effective acne treatment and might be especially beneficial if you have post-acne hyperpigmentation or scarring.[11]

What happens if I stop my treatment?

There’s a risk of your acne returning if you don’t stick with the active ingredients you’ve been prescribed. In one study among people whose acne improved with adapalene and clindamycin, 92% had an increase in lesions at a 2-year follow-up if they hadn’t continued to use adapalene.[12]

It’s a good idea to review your regimen again around three months into the maintenance phase to see how things are going.[13] Our Dermatology Team will review your progress every few months to see how you’re getting on and adjust treatment accordingly. They’re always here beforehand as well if you have any questions.

Stick to a simple skincare routine

To reduce the risk of breakouts and minimise irritation, it’s best to stick with a simple routine, using tried and tested products.

Cleanser and moisturiser – plus your maintenance formula – are really all you need. Veer with caution with products that can irritate your skin, including astringents, toners, and exfoliants.[14] Retinoids are powerful exfoliants in themselves, and it’s important to let your skin adapt to this before trying other active ingredients.

Remember to never forget your sunscreen. It’s important to use it every day, even when it’s cloudy, to protect your skin from the sun’s harmful rays. Make sure to apply it about 20 minutes before heading outside to give it time to absorb into your skin. And don’t forget to reapply every two hours or immediately after swimming or sweating. Also, be sure to follow the instructions on the bottle when it comes to how much to apply – it’s usually a lot more than you think.

Cleansing tips:

Avoid the temptation to over-cleanse. Yes, you want to keep your skin clean. But acne is not caused by poor hygiene. Over-washing could make things worse and cause irritation.[15] Double cleansing is only needed when you need to remove makeup or SPF.
Cleansing twice daily – morning and night – is all you need.[16] You should also cleanse after sweating with exercise.[17]
Go for products that are pH neutral or slightly acidic, to match the natural pH of your skin.[18]
Choose a gentle formulation that removes dirt and excess oil, without drying your skin.
Always remove your makeup at the end of the day.[19]
Look for oil-free products and those that are non-comedogenic. This means that they have been tested and proven not to block pores.

Moisturising tips:
Check your moisturiser is non-comedogenic – that means it won’t clog your pores. It should say this on the packaging.[20]
If you need an extra cleanse after exercise, use your moisturiser too. But you don’t need to re-apply your active formula, as long as it’s had a few hours to work its magic.
Pick a moisturiser that will help strengthen your skin barrier and reduce any irritation from active ingredients. Look for one containing niacinamide, panthenol, tocopheryl acetate, ceramides and hyaluronic acid, as there’s good evidence that these are excellent at protecting and hydrating the skin.[21,22,23]
If your retinoid is causing irritation such as redness, peeling, burning or a dry, tight feeling, take a break until your skin feels back to normal and increase it gradually from there. Applying a small amount of moisturiser before applying your Dermatica formula, followed by regular application of moisturiser can help it absorb into the skin more gradually. This is sometimes known as ‘buffering’ or the sandwich technique.

Dermatica offers simple skincare basics that are expertly formulated to work in balance with our evidence-based active ingredients.

Follow our simple steps, and you can keep on enjoying your clear skin and the confidence it brings.

For a skincare solution personalised to you, start a free online consultation today and speak to our dermatology experts.

References
1. Zae nglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. 2016;74(5):945-73. e33.
2. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
3. Thielitz, A., Abdel-Naser, M.B., Fluhr, J.W., Zouboulis, C.C. and Gollnick, H. (2008), Topical retinoids in acne – an evidence-based overview. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 6: 1023-1031. https://doi.org/10.1111/j.1610-0387.2008.06741.x
4. Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. 2016;74(5):945-73. e33.
5. Piskin S, Uzunali E. A review of the use of adapalene for the treatment of acne vulgaris. Ther Clin Risk Manag. 2007 Aug;3(4):621-4. PMID: 18472984; PMCID: PMC2374937.
6. Piskin S, Uzunali E. A review of the use of adapalene for the treatment of acne vulgaris. Ther Clin Risk Manag. 2007 Aug;3(4):621-4. PMID: 18472984; PMCID: PMC2374937.
7. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
8. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
9. Acne. NHS Health A-Z. https://www.nhs.uk/conditions/acne/treatment/, reviewed July 2019
10. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
11. Kircik LH. Efficacy and safety of azelaic acid (AzA) gel 15% in the treatment of post-inflammatory hyperpigmentation and acne: a 16-week, baseline-controlled study. Journal of drugs in dermatology: JDD. 2011;10(6):586-90.
12. Zhang JZ, Li LF, Tu YT, et al. A successful maintenance approach in inflammatory acne with adapalane gel 0.1% after an initial treatment in combination with clindamycin topical solution 1% or after monotherapy with clindamycin topical solution 1% J Dermatol Treat. 2004;15:372–8.
13. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
14. Acne: Tips for managing. American Academy of Dermatology. https://www.aad.org/public/diseases/acne/skin-care/tips, published 16 November 2022
15. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
16. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
17. Acne: Tips for managing. American Academy of Dermatology. https://www.aad.org/public/diseases/acne/skin-care/tips, published 16 November 2022
18. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
19. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
20. Acne vulgaris. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/acne-vulgaris/management/primary-care-management/, revised June 2021
21. Draelos, Z.D., K.D. Ertel, and C.A. Berge, Facilitating facial retinization through barrier improvement. Cutis, 2006. 78(4): p. 275-281.
22. Meckfessel, M.H. and S. Brandt, The structure, function, and importance of ceramides in skin and their use as therapeutic agents in skin-care products. Journal of the American Academy of Dermatology, 2014. 71(1): p. 177-184.
23. Milani, M. and A. Sparavigna, The 24-hour skin hydration and barrier function effects of a hyaluronic 1%, glycerin 5%, and Centella asiatica stem cells extract moisturizing fluid: An intra-subject, randomized, assessor-blinded study. Clinical, Cosmetic and Investigational Dermatology, 2017. 10: p. 311-315.

The post How To Maintain Clear Skin After Acne Treatment appeared first on SkinLab.

Fear not, we’ve got you covered. Here are our answers to the most frequently asked questions about retinoids.

What are retinoids, and why can it cause skin purging?

Retinoids are treatments that are man-made forms of vitamin A [1]. They are used for certain skin conditions because of how they regulate skin cell turnover. This has important roles in acne and hyperpigmentation treatment, as well as in reducing the signs of ageing, such as improving the appearance of fine lines and wrinkles by stimulating collagen production [3].

“Skin purging” is a term used to describe an initial flare of acne at the start of treatment with a retinoid before their skin starts to improve. This can be frustrating when it first happens, but this tends to settle within a few weeks. Due to its effects on increasing cell turnover, dead skin cells and oils which block pores will be brought to the skin’s surface temporarily. This may lead to a breakout, but will only be temporary and treatment should be continued.

How do retinoids affect the skin? What do they do?

Retinoids primarily affect the regulation of skin cell growth and speed up skin cell turnover. They are easily absorbed by the skin and work to improve skin function as well as appearance. Retinoids are scientifically proven to have beneficial effects on skin inflammation and work to prevent and treat acne spots and comedones (blackheads). They also work to improve fine lines and wrinkles by increasing the production of collagen and softening rough, sun-damaged skin. [4].

What is purging and how long does it last?

Purging is the temporary initial worsening or breakout of acne when first starting to use retinoids. This happens due to the process of increasing skin cell turnover, which can unblock pores leading to more spots than before.

Purging can be frustrating when it initially happens but don’t worry too much, thankfully it shouldn’t last long. Within two to three weeks, most people’s skin will have settled and you will hopefully be beginning to see the helpful effects of the retinoid on your skin, so hang in there! [6]

Do some retinoids cause purging more than others?

Not all retinoids are made equal. The main differences are how many steps it takes for them to be converted by our skin into the active component: retinoic acid, which has the beneficial effects.

As prescription strength retinoids such as Adapalene or Tretinoin are stronger than over-the-counter retinols, they are more likely to irritate your skin and lead to purging This is because the retinoids speed up the turnover of your skin cells. The dead cells will be removed quicker than normal, which can lead to redness and irritation.

The stronger the retinoid is, the more skin purging or side-effects you will most likely experience, so it’s really important to strike a good balance. This is where strong advice from our dermatology team at Dermatica comes into play!

Can you avoid purging, and does purging mean you’re doing something wrong?

Purging is a totally normal reaction when beginning retinoid treatment, so if you’re experiencing it, it doesn’t mean you’ve done anything wrong or the treatment isn’t working. There are also easy ways to help make the purging process less of a bother.

As part of your personalised plan, it is likely your dermatology team at Dermatica will start with a lower dose of retinoid – and build up the dose gradually as your skin adjusts. So, for example your clinician might recommend applying the cream or gel once daily to begin with. If you have irritation, they may recommend to reduce the frequency gradually, but they’ll guide you through this process. It may take some time to adjust to the new treatment.

Additionally, you may wish to apply a layer of moisturiser as a barrier to sensitive sites such as around the eyes and mouth to avoid retinoid coming in contact with these areas. Applying a small amount of a layer of moisturiser first before the retinoid treatment can also help to ease side effects.

If you have any questions about the purging you’re experiencing, our experts at Dermatica are always happy to answer any questions you have.

What skincare routine should you use to protect and nourish your skin without clogging pores?

Maintaining a good skincare routine is really helpful to minimise the purging you experience, and help your skin to tolerate the product and get maximum outcomes.

You’re probably aware that you need to protect your skin from the sun to prevent signs of ageing and skin cancer. When using retinoid treatment, it becomes even more important to be disciplined with your sunscreen. We would strongly recommend a sunscreen which protects against UVA and UVB at a minimum of SPF 30.

Keep up your skincare routine. Cleanse your skin before applying your retinoid and make sure to moisturise your skin at least once daily. If you experience side effects from your retinoid such as dry, flaky skin, using a thicker moisturiser more regularly is advisable. Retinoids themselves are exfoliating by nature, so we recommend avoiding exfoliating until you feel you can tolerate it, and to always avoid physical exfoliants (cleansing brushes, scrubs) as they might lead to further breakouts or irritation.

References:

[1] https://www.mountsinai.org/health-library/supplement/vitamin-a-retinol Date accessed: 01/12/2022
[2] “National Psoriasis Foundation” Date accessed: 01/12/2022
[3] https://www.webmd.com/beauty/ss/slideshow-retinoids-for-aging Date accessed: 1/12/2022
[3] Zasada M, Budzisz E. Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments. Postepy Dermatol Alergol. 2019 Aug;36(4):392-397.
[4] https://skinwellness.com/learn/the-ultimate-guide-to-understanding-the-hierarchy-of-retinoids/ Date accessed: 01/12/2022

The post Retinoids: Why Skin Purges And How Long It Lasts appeared first on SkinLab.

Applying sunscreen to your skin protects you from the damage caused by UV exposure, and the active ingredients that help them do that are called SPF filters. There are two main types of filters used in SPF products: chemical and mineral. Some sunscreens use both, while others contain only one — but what’s the difference between them? This is how each type of filter works, what their benefits are and who should use them.

What are chemical and mineral SPF filters?
Chemical filters are also sometimes called ‘organic filters’. That doesn’t mean they’re living or natural — in the chemistry world, ‘organic’ is a type of chemical structure. If you’re looking for them on an ingredients list, here are some examples of common chemical filters:
Ethylhexyl salicylate
Octocrylene
Butyl Methoxydibenzoylmethane

There are two mineral — or ‘inorganic’ — filters commonly used in sunscreens: titanium dioxide and zinc oxide.

How do they work?
Chemical filters are made up of a type of molecule called chromophores, which absorb harmful radiation. When you apply them to your skin, they absorb the UV rays from the sun and release them harmlessly as heat. Sunscreens often contain a blend of chemical UV filters, because each one only blocks certain UV wavelengths — you can learn more about different UV wavelengths here. The filters are usually categorised by the part of the UV spectrum they deal with, either UVA or UVB. Throughout the day, chemical filters absorb UV light, and that changes their chemical structure. This means they only keep you protected for a limited time. So, to stay protected, it’s important that you reapply sunscreen often if you’re out in the sun, sweating or swimming — never trust just one application.

Many people think mineral filters work by reflecting radiation away from your skin, but they mostly work in a similar way to chemical filters, absorbing radiation and releasing it as heat. In fact, they only reflect around 4–5% of the UV radiation they’re exposed to. They also remain on the surface of your skin, but remember, you still need to regularly reapply mineral sunscreen. It won’t stay on your skin for a long period of time, especially if you’re sweating, swimming or it comes into contact with your clothing. Their chemical structure and the way they work is what we call ‘broad-spectrum’, which means they’re able to protect you from a large range of UV wavelengths. So, there might be a smaller ingredient list on mineral sunscreen you buy because fewer filters are needed to protect you. Unlike chemical filters, mineral ingredients aren’t very reactive when they’re mixed with other UV filters, so they’re also easier to add into sunscreen formulas.

I have sensitive skin — which SPF filter should I use?
Chemical filters have been linked to skin sensitivity in the past, and some ingredients can trigger existing skin conditions like acne, rosacea or melasma. The evidence of irritation with these filters is low, though, so if you’ve found a chemical sunscreen that works for you, you don’t need to change your routine.

Mineral filters can sometimes trigger acne symptoms, but there’s otherwise very little evidence that mineral sunscreens cause skin reactions themselves — any reactions could be due to the thickness of the formulation, for example. This means they’re usually recommended for people with sensitive skin or skin conditions, as well as children.

Which SPF filters leave a white cast?
One downside to mineral filters is that they often leave a white cast, which makes them more visible on black and brown skin. This is due to the increased particle size of molecules in the formula, and because it stays on the surface of the skin. To make them more inclusive to all skin tones, some mineral sunscreens are tinted to make them blendable.

Chemical filters are popular because their formulas are lightweight and easy to apply. They also tend to be colourless and absorb UV exposure in a different way, so they don’t leave a white cast behind on black or brown skin.

Are mineral sunscreens safer than chemical sunscreens?
There’s no concrete evidence that one type of SPF filter is safer than the other. There’s been discourse that some chemical filters can absorb through your skin and be harmful. These studies only looked at people applying a very large amount of sunscreen to their bodies, not the recommended dose, so they need to be taken with a pinch of salt. It’s also important to balance the benefits of sunscreen in preventing skin cancers — which have been proven — with the risks, which are very low.

Are SPF filters harmful to the environment?
The environmental impact of sunscreens is a big talking point right now. During lab testing, some chemical SPF ingredients have been shown to affect coral and fish, and they’re also thought to build up in the environment. The actual consequences of this in nature aren’t certain, but many regions have banned certain ingredients until we learn more about them.

There are also some studies that show mineral filters may be harmful at high concentrations, and could damage the environment. We still don’t know enough about whether this is true with normal usage, though, because all these tests have happened in lab conditions with very concentrated products.

Looking for more sun safety guides? Check out our blog.

If you haven’t started your Dermatica journey yet, complete a free online consultation today. Your formula is designed by dermatology experts with science-backed ingredients to help you achieve your skin goals.

The post What’s The Difference Between Mineral And Chemical SPF Filters? appeared first on SkinLab.