Having a bad skin day? Are pores causing major drama, or random peeling patches ruining your life (and your foundation)? Help is at hand as Cosmo’s favourite local skincare experts explain how to identify – and most importantly, how to treat – your most annoying skin issues.
Dr Lana Kashlan, MD
An American Board-Certified Dermatologist, specialising in both medical and cosmetic dermatology. Dr Kashlan is the founder and medical director of Chicago Dermatology and Cosmetic Center in Chicago, USA, in addition to being a Consultant Dermatologist at CosmeSurge, Dubai Marina.
Nesrine El Khouri
The Regional Training and Promotion Manager for La Prairie Middle East, El Khouri has spent 14 years in the beauty industry, helping women uncover their best skin. While her current focus is luxury beauty, she’s also experienced as an advanced aesthetician.
Dry patches
Itchy, flaky patches of skin? Nesrine El Khouri says that the culprit is often extreme weather and low humidity, making it an ongoing challenge for skin to retain its own hydration. Dr Lana Kashlan agrees, pointing out that skin is constantly being assaulted by harsh irritants from the environment which can strip the skin of its natural oils and built in moisturisers. “These irritants can be things like soaps, hot water, cleaning liquids, perfumes, and even fabrics. The susceptibility to dry skin depends on your genetic makeup and will vary from one person to the next. The first step in combatting dry patches is to try to avoid these potential triggers, especially excessive use of harsh soaps and hot water,” she says. Dr Kashlan recommends following a routine that caters to soothing dryness. “Get into the routine of taking warm, not hot, showers and using a gentle, fragrance-free cleanser. When you get out of the shower, pat the skin gently and while still damp, apply an oil-free moisturiser. Occasionally, very severe dry patches can evolve into eczema, an inflammatory skin condition of itchy dry skin.
If your dry skin isn’t improving with moisturisers or is very itchy, it is worth visiting your dermatologist because you may need an anti-inflammatory cortisone cream.”
Fine lines
One of the first obvious signs of ageing, the treatment of fine lines alone could keep the beauty industry afloat. “Fine lines appear on the face and deepen as you get older because the collagen and elastin beneath the surface of the skin begin the breakdown that is typical with ageing,” explains El Khouri, noting that the appearance of lines could be chronological, environmental, or due to lifestyle. “This loss is a result of a combination of intrinsic factors (your genetics, mostly) and extrinsic factors (your diet, lifestyle, environmental exposures to UV and tobacco,” adds Dr Kashlan. “More specifically the loss of collagen, elastin, and hydrating molecules called glycosaminoglycons all contribute to the altered appearance of wrinkled skin vs. smooth skin.”
While she points out that altering your genetic makeup isn’t exactly possible, the best way to prevent fine lines is by protecting yourself from the sun, not smoking, and following a good skin care regimen that contains a retinol cream. “Retinols are vitamin A derived creams that have been proven to stimulate collagen production, promote cell turnover, and reduce fine lines. I also recommend regular in office treatments like chemical peels and micro-needling to help reduce fine lines.”
Pigmentation
Whether yours manifests as small areas of discoloured skin, or larger dark patches, pigmentation can be concerning for both health and cosmetic reasons. “Some forms of pigmentation are the result of genetic factors and some are related to sun exposure,” says Dr Kashlan. “They appear due to recurring sun exposure with no protection to the skin. Usually sensitive skins suffer most from hyperpigmentation,” adds El Khouri. For prevention, Dr Kashlan recommends practising strict sun protection including wearing a daily sunscreen of SPF 30 or better and seeking shade when possible.
Wanting to erase existing dark marks? Treatment options vary depending on the cause of the pigmentation, but include chemical peels, laser treatments, and topical creams. At the beauty counter, El Khouri recommend La Prairie’s dedicated brightening range as a luxe treatment. “La Prairie’s White Caviar Crème Extraordinaire contains Lumidose, the most potent and safest molecule to inhibit the production of melanin,” she says. “Couple the cream with White Caviar Illuminating Pearl Infusion serum and you are in for a real treatment for pigmentation.”
Hormonal Break-outs
Who hasn’t had to deal with these out-of-the-blue break-out once a month? Hormonal acne is exactly what it sounds like, cropping up on the same spot every 30 days, give or take. “Oil and sebum production in the skin is controlled by hormones called androgens circulating in our bodies,” says Dr Kashlan. “Hormonal breakouts are the result of an increased sensitivity to those hormones causing increased oil production in the skin that clogs pores leading to acne.” While our experts advise that severe acne should be looked at by a doctor for hormonal assessment, most cases can be handled topically. “You cannot use the same products you were using before your break-outs,” points out El Khouri. “Instead, opt for more purifying cleansers and toners.”
Broken Capillaries
Those frustrated with these dark red marks will have to look to professional help to shrink them. “Broken capillaries or blood vessels are caused when you get a bruise from injury to the skin, becoming permanently dilated capillaries,” explains El Khouri. “Unfortunately, there is no skincare treatment for broken blood vessels, rather these can be zapped with a laser in your doctor’s office. One tip though, be gentle on your skin when you do your skincare ritual or when you go for your monthly facial.”
Pimples
Though pimples were just for those hitting puberty? Us too. Sadly, we’ve found out the hard way that break-outs can follow a girl long into adulthood. “The two main kinds of acne are adolescent acne and adult female acne/hormonal acne,” explain Dr Kashlan. “Adolescent acne is typically on the forehead, cheeks, and chin and is characterised by smaller red pimples, pustules, and blackheads. Adult female acne is a different breed all together. It shows up mostly on the jawline and chin and is made of deeper, sometimes painful nodules and cysts, usually without a lot of blackheads. It tends to worsen around patient’s menstrual cycles and can occur in people who never had acne as a teenager.” Great.
As adults, we can experience non-inflammatory and inflammatory acne, reports El Khoury. “The non-inflammatory acne: blackheads, whiteheads and sebaceous filaments. These are easy to deal with at home with the proper skincare ritual where you cleanse well, exfoliate and moisturise with an oil-free hydrating emulsion. The inflammatory acne known as papules, pustules, nodules and cysts are more serious and they require a visit to a dermatologist in most cases.”
Facial hair
Has your facial hair gone beyond the usual peach fuzz – totally normal FYI – to something thicker and coarser, that affects your confidence? “Excessive facial hair is mostly the result of a combination of genetics and hormonal factors,” says Dr Kashlan. Check with your doctor first to make sure it’s not a sign of severe hormone imbalance, but if the hair persists, laser hair removal may clear it up for you in six to eight sessions. “Bear in mind that not all people benefit from laser hair removal treatments and that it is not permanent, per say,” reveals El Khoury. “Since women go through hormonal changes in their life time, the facial hair might re-appear. If you’re not the best candidate for laser, due to the hair being too light or fine, waxing or threading can be an option.”
Closed comedones
These little bumps can affect the texture and appearance of your skin, but have a simple explanation behind them. “A comedo, or basic acne lesion, is a hair follicle that has become clogged with oil and dead skin cells,” describes El Khoury. “Comedones (the plural of comedo) can then develop into bumps called whiteheads.” Causes include the use of products that are too rich or heavy for your skin, or a lack of exfoliation. To treat comedones, Dr Kashlan recommends regular use of a retinoid cream. “Retinoids are vitamin A derived creams that re-program the way skin cells exfoliate so that pores will not clog and stay open,” she explains.
In addition, she recommends heading to your derm every couple of months for skin-smoothing maintenance, with pore decongesting treatments such as a Hydrafacial or a peel helping prevent these bumps. “Skin problems can cause tremendous emotional stress and affect a patient’s confidence, but dermatologists can help,” notes Dr Kashlan. “We can’t always cure a skin problem, but we can control them. My goal for every patient is to get them skin that is so clear they can go makeup free.”
Dehydrated skin
If your skin is looking dull and less than glowy, you may have dehydrated skin. La Prairie’s El Khoury ranks dehydration as the most prominent concern for the region, with 98 per cent of her clients in 11 years here presenting with dehydrated skin. “The climate in the region is very harsh, and we mainly live in air-conditioned environment, which sucks all moisture from the skin,” she reveals. “It will then cause the skin to break into lines, because of the lack of elasticity.” We suggest adding in a lipid, such as jojoba oil to top up the skin’s natural reserves, and layering that with a moisturiser containing hyaluronic acid. Sipping on two litres of water every day will also work wonders.
Tired eyes
Dark circles, crepe-y skin, and fine lines – there’s a lot going on in the sensitive eye area as we age. The delicate skin around the eyes is less than a millimetre thick, and so needs some extra TLC, says El Khoury. “The typical day’s 28,800 blinks are also a source of stress on the skin. Add to that a low supply of oil glands and our grubby fingers moving from iPhone screen to keyboards to our itchy, tired eyes, and there’s a lot working against the area. Beyond just being highly susceptible to signs of aging, the skin around our eyes is among the most noticeable on the entire face.” She recommends La Prairie Skin Caviar Luxe Eye Lift Cream to help increase firmness and elasticity and inhibits the appearance of dark circles with the restorative algae extract.
Freckles and Moles
First up, our experts are eager to point out that there’s a big difference between the two. Although they are both indicative of sun damage, and caused by the same molecules, one is far more concerning than the other, points out Dr Kashlan. “One easy way to distinguish between moles and freckles is that freckles are typically flat, while moles can be raised,” she says. As explained by El Khoury, freckles can happen after excessive sun exposure or due to an uneven distribution of melanocytes which leaves your skin damaged. “This damage essentially confuses the melanin pigment, causing the melanin to cluster abnormally on the top layer of your skin. This results in the discoloured spots you recognise as freckles,” she says.
“Moles, on the other hand, are composed of active melanocyte cells that have grown in a cluster as opposed to spreading evenly throughout the skin. Due to their more complex composition, moles are generally wider than freckles and are slightly raised. They can also appear bumpy or rough, and can be abnormally shaped. Since they’re active cells, this means moles have the potential to continue growing into a form of cancer, such as melanoma.” Don’t start freaking out – the majority of moles are not cancerous.
However, both of our experts recommend keeping an eye on the size, shape and colour of your moles, and seeing your doctor for an examination if you notice any changes. As for freckles, they can be treated as any hyperpigmentation with brightening products and chemical peels or even a laser treatment if they are particularly stubborn.