Q&A with the experts on anti-ageing
Expert: Dr Nick Lowe
Dr Lowe has written over 400 clinical and research papers and 18 books, sits on the editorial board of scientific journals and is a founding editor of the Journal Of Cutaneous Laser Therapy. He's on the specialist register of the General Medical Council and is specialist certified by the Royal College of Physicians and American Board Of Dermatology.
Questions for Dr Nick Lowe
Q. I am 27 and have lines at the sides of the eyes when I smile. Is there anything I can do to prevent this getting worse that does not involve not smiling?
A. The skin around the eyes is thin and so prone to wrinkling, discolouration, puffiness and eye bags. It is more susceptible to damage by sunlight because it is so thin, especially UVA rays, which penetrate the dermis. It is also damaged by smoking, which causes collagen and elastin breakdown.
Actions you can take to protect the eye area include:
- Use ultraviolet protective glasses whenever possible outdoors or when driving. Please note these do not necessarily have to be dark glasses although obviously in intense sunlight it is more comfortable if they are dark.
- Use an eye serum every morning or a puffy eye gel, depending on your skin problem. If you have dark circles use a dark circle cream. Let it dry and then apply a protective day cream with SPF-15 and UVA protection. You can apply this over the eye cream, but do not get it too near the eyes just up to the eyelids.
- Use a product that can tighten and lighten the skin around the eyes - the ingredients to look for here are peptides, liquorice extracts, and also look at the packaging to see if there have been any scientific tests performed on the product.
- Look at your eyes and decide what problem you have: if you have wrinkles, choose a wrinkle-reducing cream; if you have puffiness choose a puffy-reducing gel or cream; if you have dark circles choose a dark circle cream or lightener.
- Check that the skin products you choose have been tested to ensure they don't irritate the eyes, otherwise you will obviously not be able to tolerate them.
- Other options include appropriate lasers and radiofrequency, if you have intense smile lines as you are getting older.
Q. I often get confused by all the different products on the market - do I need a toner, cleanser, moisturiser, exfoliator, scrub, sunscreen or anti-ageing cream?
A. The answer is you do not need all of these. You will actually confuse yourself as well as your skin by trying to use them all.
The best approach is to identify your skin type: is it dry, is it sensitive, ie does it react to previous skin products with itching and redness, which would be a sign that you have skin sensitivity, is it oily, is it a combination of all of the above ie combination normal to dry, combination oily to dry.
Do not forget parts of your face that may be dry, such as the cheeks, and the central area, which may be more oily. Speak to skincare advisors in larger Boots stores.
Once you have identified your skin type, choose a practical skin programme that you can sensibly and easily achieve. Use a maximum of two morning products layered one on the other and use one or two evening products. So, for example, if you have a tendency to redness use a redness-calming cream, let it dry and follow this with a SPF-15 UVA protecting day cream moisturiser.
If you have dark patches or dullness, apply a skin lightening cream, let it dry and follow this with your protecting day cream.
At night, use your redness calming cream or your lightening cream.
Remember you may need to change your products with the seasons - you may need more moisturising products in the winter, when central heating and cold weather dries your skin, and you may need to take fewer hot showers and baths.
You may need to less moisturiser in the summer. Speak to your Boots advisors if you are concerned.
Q. I am not bothered about looking old, but I am bothered about looking cross, and that's why I want to sort my forehead frown lines.
A. The sorts of forehead lines you have are caused by what I term hypermobile or overactive muscles of the forehead. Do not forget to use protective day creams and sunglasses, as squinting can increase your frown lines.
Q. My skin is showing signs of sun damage due to a youth spent doing water sports and skiing. What is the best thing for me to do to look after my skin?
A. I see many patients in their early twenties in Southern California with sun damage and I am now seeing these in the UK due to holidays abroad and tanning salon sunbeds. Skin damage in childhood and teenage years shows up as sunspots and wrinkles anywhere from five to 15 years later.
It is never too late to repair this damage. A recent study we performed using a daily sun protection cream and our skin lightening cream showed significant improvement after 16 weeks, which almost equalled four intense pulsed light treatments.
The message is, whenever and whatever the other treatments you are using, use a regular day protection and appropriate night treatment cream.
Boots Number 7 and our Secret Is Out SPF15 Lifting Cream have excellent ingredients, for example matrikines, which are peptides that can rejuvenate the damaged skin collagen that occurs with sun damage.
Q. I have just turned 40 and feel I should step up my skincare routine, I have never really worn make-up, so I feel my skin is OK, but I do not really drink enough water and so find it is quite dry.
A. This question reveals one myth: that drinking water helps to moisturise skin. Drinking sufficient water to be healthy is clearly vital and you should drink at least two pints of fluids a day to maintain a healthy fluid balance. But what moisturises the skin is having a good skin barrier to prevent water loss, which then allows the skin to retain moisture, and using good moisturising skin products.
Many of Dr Nick Lowe products and Boots products have been tested to prove this. Ingredients to look for are humectants (which trap moisture in the skin) such as Glycerin, Hyaluronic Acid, Sodium Hyaluronate, Stearate and Lecithin. All of these are sometimes combined with natural moisturising factors, which mimic the skin's own moisture 'factory'.
Don't forget that as well as your face, your arms, body and legs can all dry out severely, so use moisturising cream cleansers and lotion washes in these areas when they are dry.
Q. Can a product actually change or improve the skin, or does it just look a bit better temporarily?
A. Some products (excluding cosmetics) can give long-term skin improvement, for example reduction in the appearance of fine lines, blotchy pigment and skin redness. They need to have scientifically tested ingredients to achieve these. Boots and Dr. Nick Lowe products have been formulated and tested to deliver these benefits.
Some products can also give temporary improvement. For example, moisturisers' humectants can actually improve skin quality and 'plump' up your skin, and skin-tightening ingredients such as peptides, particularly the hexapeptides, can give temporary tightening.
Q. I am a 30-year-old recent ex-smoker with an outside job. How can I avoid looking like an old handbag in years to come, in particular my hands. Sunscreen might help my face but will it just get washed off my hands?
A. Congratulations on stopping smoking. Daily SPF 15 UVA protection with moisturiser and night creams will improve your skin now that you have given up smoking.
As regards your hands, can you improve the protection you're using at work? Protect your hands with gloves whenever possible, and apply moisturising creams underneath your gloves. Reapply sun protection and hand cream (make sure this has added moisturiser) as often as possible. Keep it wherever you regularly wash your hands.
Another important note on hand protection is that whenever you're driving, your hands are exposed to UVA that coming through window glass and it ages the skin. Always put on SPF 15 UVA protecting hand cream when driving.
Q. I have developed age spots or hyperpigmentation following two pregnancies and also developed puffy eyelids. I suddenly feel old and tired looking. I have tried remedies for both of these issues and not seen any improvement, what should I be doing?
A. Age spots are actually not from age, they are from sun exposure. Pigmentation on your face from the pregnancies, which is known medically as melasma, is a result of hormones stimulating your pigment cells in your skin to respond more to UVA. Use a skin-brightening lightening cream, then put SPF15 UVA day protection cream on top after it has dried - you can layer these every effectively. Once those two are dry, you can use your make-up on top.
Reapply your lightening cream at night. This will gradually work, but do not expect an immediate effect - it will take several weeks or months of continued use to show benefits. Excellent light creams include Dr Nick Lowe Super Light Skin Tone Perfector and Boots No 7 Dark Spot Corrector.
Puffy eyes have several causes, including small fat pads under the eyes, fluid build-up and sun damage leading to weathered skin. The best remedies are to use a puffy eye gel, eg Dr Nick Lowe Puffy Eye Gel, and apply this twice a day. Remember to protect your eyes with sunglasses and use your day protective creams just up to your eyelids. You can put your puffy eye gel on, let it dry and follow it with your day protective cream.
At night, use an extra pillow to elevate your head and also use your puffy eye gel. Our puffy eye gel contains the active ingredient caffeine, which reduces the water content.
Another trick is to use cold cucumber slices out of your refrigerator and apply them to the eyelids for 10 minutes. As they dry slowly, they evaporate and reduce the puffiness of your eyes.
Q. I am 23, but look older. I think this is due to my skin being quite dull. What should I use to make it brighter? Also, I have pores on my forehead and nose, is there any way to make these more even?
A. Your skin is probably dull because you have not been using daily sun protection and also because possibly your skin may be dry. Skin can also be dull in smokers.
My suggestion is that if you are smoking you stop, and if you're not a smoker, don't start. Apply a daily SPF 15 UVA protection after cream cleansing. You can use a nightly brightening cream and use a gentle scrub one to two days a week. Do not over-scrub as it can make the skin too dry.
Pores are necessary channels in your skin that naturally drain your oil glands (sebaceous glands). It is possible that large pores are related to acne and increased oiliness of the skin.
Non-prescription creams you should look for are those containing Salicylic Acid, Willow Bark or Niacinamide. These will help to reduce the pores and also the oiliness.
If your oiliness and pores are more severe, then more powerful prescription creams like Tretinoin or Isotretinoin cream or gel may be helpful. For these you can only get these from a consultant or dermatologist and only if you are suitable.
Q. My non-sleeping children have added a decade to my skin - dark circles and ashen colour? What can I do to perk up my complexion despite having no sleep?
A. Try to get some sleep, if possible get away from your children - at least temporarily! Or get some help and advice in getting them to sleep.
One approach is to try daily exercise - this can help to relax you, give you a break from the kids and stimulate your circulation, which can help to perk up your complexion. Daily protection creams with SPF 15 and UVA, moisturising, skin lightening creams and gentle facial scrubs once to twice a week can all help.
For dark circles, apply a dark circle cream and make sure you use sunglasses when in sunlight or when driving. Good luck with the non-sleeping children.
Q. When using an eye cream, should I use anything else as well? I do not want to overload the skin under my eyes.
A. Eyelid skin protection is vitally important because the skin around the eyes is already very thin, can be easily wrinkled and become puffy and discoloured.
Gently cleanse with a cream cleanser on a cotton ball, apply the appropriate eye serum, puffy eye gel or dark circle cream, let it dry and then apply a day protection SPF 15 UVA cream on top of that as a gentle layering.
At night use the specific eye cream (see my answer to question one) to target your eye problem.
Q. I do not understand what a serum is supposed to do? Also, where does the 'cream' come in, is that not a moisturiser?
A. In general, serums are lighter, thinner preparations than creams and dry more quickly. Serums are great ways of rapidly delivering important ingredients to the skin, such as skin rejuvenators, lighteners and those that can tighten the skin.
The serum can be applied as the first layer to the skin, followed by a sunscreen containing day cream, followed by your cosmetic cream. If you are going out in the evening, then a serum can be applied before your evening cosmetic to smooth the skin before your make-up is applied.
Q. I am 25, should I start using a skin face cream now? I use a light moisturiser, but do I need something with an SPF to prevent wrinkles?
A. Yes, this is a great idea. Sun damage starts when you are young and shows up 10 to 15 years later, so start using a face cream such as an SPF 15 UVA moisturising cream. Apply this to your whole face after gently cleansing the skin and it will definitely help to reduce your skin ageing.
Q. I have oily skin, but spend a lot of time outdoors, so I know I need a sunscreen. Also I have a couple of sunspots on the top of each cheek. Is there anything that can lighten their appearance, or is the damage permanent?
A. There are facial creams that you can find formulated for your skin, for example Dr Nick Lowe's Supercharged SPF 15 day cream, which will not be heavy and will be easy for you to use. In addition, tailor your skin cleansing routine to reduce the oily areas of your face, for example the Dr Nick Lowe oil reducing sebum control cleanser or purifying foaming cleanser. These can be alternated with a moisturising product.
Your sunspots may be completely benign sunspots, but some brown spots can be precancerous or cancerous. See a consultant dermatologist for an accurate diagnosis and they will then be able to make the correct treatment recommendation.
There are many different ways of treating benign sunspots, but only after they have been diagnosed as benign. Some of those include lightening day creams, sun protection day creams, as well as prescription lightening creams.
Q. I would like some advice for when I go out and stand on the edge of a rugby pitch for 90 minutes in this British wintry weather, supporting my son.
A. In the winter months there is little sunburn, but there are UVA rays that can damage your skin and you will get considerable drying from the cold winter weather. Then when you go into hot, dry rooms, this will dry out your skin even more.
What you need to do is to use a daily moisturising SPF 15 UVA cream. For example, Dr Nick Lowe’s Secret is Out SPF 15 UVA day cream has been shown to be highly moisturising and contain important anti-ageing ingredients. Apply this after cleansing, and then allow it to dry for two minutes and then reapply your make-up.
Don't forget to take a protective lip balm when you're standing outdoors, to stop your lips drying out and to protect the sensitive skin of the lips from sun damage. If it is a sunny day, then you should also be using (even in winter sun) protective sunglasses.
Q. I am 44 and starting to look a bit wrinkly, but I also have oily skin. Can you recommend something that will help fight the wrinkles, but not give you spots?
A. Some of the lighter-texture day creams, such as the Dr Nick Lowe Supercharged SPF 15 day cream, may be very satisfactory for your skin protection.
The most important thing also is to choose cleansers very carefully: if you have oily skin then you should use something like that Dr Nick Lowe oil reducing cleanser on a cotton ball and for the rest of the face the hydrating foaming cleanser.
During the winter months, your cleansers and face cream may need to be more moisturising, for example the Secret is Out Cream cleanser.
If you continue to get acne spots, then you should consult a dermatologist for treatment. In the meantime, the Dr Nick Lowe spot gel anti-blemish range can be very helpful - apply two to three times a day to new spots to stop them developing. An oil control day cream can also help to reduce skin oil and blemishes.
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Last updated: almost 2 years ago