What is the difference between acne vulgaris and “acne” rosacea?

What is sensitive skin, and do I have it?

No other skin condition is more misunderstood that sensitive skin.  In fact, almost 90% of the population report having sensitive skin at one time or another! To understand whether you have sensitive skin, you first have to understand what causes it.

Sensitive skin is a genetically-inherited condition that predominantly affects very fair-skinned individuals, usually of Northern European ancestry.  Someone with truly sensitive skin is highly prone to blushing, has a very fine complexion and may experience bad hay fever, allergies or asthma.

What most people suffer from is in fact sensitised skin.  Rather than a result of genetics, sensitised skin is a reflection of your environment, lifestyle and physiology.  Pollution, stress, hormonal imbalance, cosmetic allergies, alcohol a poor diet and over exfoliation can all trigger the sensitised skin condition.

The good news is that sensitised skin can be treated.  The bad news is that, left untreated, the skin’s response can actually result in permanent cellular damage, which can lead to premature ageing.

How can I Avoid trigger factors?

A few lifestyle modifications can usually solve most people’s skin sensitisation.  Maintaining the skin’s barrier function is vital, so remember to apply your Dermalogica moisturiser after every cleansing and whenever your skin feels tight or dry – our Barrier Repair was developed with this specific goal in mind.  Skin Hydrating Booster is the ideal addition to your skin care regime to optimise the water level of your skin.  Also, always avoid over-exfoliating your skin – remember, more exfoliation is not better!  If you notice redness or tightness that lasts more than a few hours, you should discontinue the use of your exfoliant for a few days.

Sun protection is also critical because sensitised skin is even more vulnerable to UV damage.  Dermalogica Ultra Sensitive FaceBlock SPF25 is a chemical-free sun shield that was developed specifically for sensitised skin.

Lastly, avoid trigger factors such as hot drinks, spicy foods, msg, alcohol, caffeine and nicotine can help your skin recover and rebuild it’s normal resistance.

What can I do for my skin when it’s sensitised?

We all know the discomfort of an attack of sensitisation – the skin feels tight, red and swollen, and it seems like everything you do just makes it worse!  The first step is to avoid all trigger factors.  Then, you need to follow a special regime to help your skin recover.  Cleansing with Dermalogica UltraCalming Cleanser, an extremely gentle gel/cream and tissue off formula, will remove all irritants from the skin’s surface.  Follow with Soothing Protection Spray to mist on anti-ozonate protection that will help shield the skin from further assault.  Barrier Repair provides the last step, creating an invisible silicone barrier against the outside world.  Your Environmental Control regime doesn’t replace your existing skin care routine – think of it as a temporary emergency response.

How is rosacea different from sensitised skin?

Rosacea is a skin condition as misunderstood as sensitive skin, and as frequently misdiagnosed.  In it’s early stages, Rosacea exhibits the same symptoms as skin sensitisation – redness, blushing and tightness – as well as the same trigger factors.  However, the similarity ends there.  A disorder of the facial blood vessels, Rosacea is a progressive inflammatory disorder that, when left untreated, develops additional complications that include burst capillaries, facial swelling and spots on the face that look like acne breakouts, causing people to confuse Rosacea with acne.

One in twenty people – mostly women – are affected by this misunderstood disease.  See your professional skin care therapist and receive a Face Mapping to determine if you are experiencing Rosacea or a sensitised skin condition.

Fortunately, Rosacea is manageable.  Avoiding trigger factors is critical, as a Rosacea attack begins the same way skin sensitisation does.  For milder Rosacea, we recommend our sensitised skin care regime of Environmental Control products.  There are also an increasing number of prescription medications recommended by your dermatologist that can halt the progression of this disorder.

What is pigmentation?

The pigmentation of one’s skin is the result of millions of years of evolution, which explains the wide range of skin tones we see in everyday life.  People with origins close to the Equator, where the sun is the most intense, had to develop protection against dangerous UV rays.  The result? An increase in the production of melanin, a natural skin and hair colourant that absorbs UV radiation and protects the body from damage.  In fact, the epidermis of a dark-skinned person absorbs up to 25% more UV radiation than that of a light-skinned counterpart.

How do I prevent unbalanced pigmentation?

Pigmentation disorders are caused by a myriad of factors, which include sun damage, hormonal imbalance and skin trauma or disease.  Of all these causes, sun damage is both the most common and the most easily prevented! Simply applying a sunscreen with a minimum of SPF 15 everyday, and avoiding peak sun times around midday, will do a lot to prevent the sun damage that can make your skin’s pigment act up.  Dermalogica Solar Defense Booster SPF 30 provides optimum daily sun protection.

Hormonal imbalance, a cause of pigmentation mostly affecting women, can occur during any time that the body’s natural hormone balance is disturbed.  These triggers can include hormonal changes, such as those that happen during the menstrual cycle, menopause, prolonged stress, pregnancy or even when taking birth control pills.  Unlike pigmentation related to trauma or sun damage, hormonally-induced hyperpigmentation generally disappears when balance is restored to the body, and it can be treated during the interim period with topical skin brighteners.

The pigmentation related to skin trauma (cuts, wounds, scrapes and the like) is difficult to prevent in the case of accidental damage to the skin.  Picking at acne lesions is also, of course a big no-no, and will only exacerbate the pigmentation associated with the wound healing.

What are my treatment options?

When it comes to hyperpigmentation (when pigment-producing cells are damaged and produce too much colour) there are two possible treatment approaches – chemical and botanical.  Chemical lighteners, predominantly those containing Hydroquinone, are recognised as effective skin lighteners.  However, Hydroquinone has been linked with many negative side effects and can cause severe skin allergies and worsening of the pigmentation condition.  (This is why Hydroquinone is now actually banned in much of Asia and Africa.)

Botanical skin brighteners are a much safer approach for brightening the skin, and are as effective when used consistently in a professional brightening regiment.  Brightening agents to look for include Liquorice, Bearberry, Rice, Kiwi and Mulberry, coupled with Lactic Acid and Vitamin C...  Your skin care therapist will be able to prescribe the regime best for you.  But it will most likely begin with a professional series of skin brightening treatments.  These highly-active treatments include a professional-only exfoliation to smooth away the unevenly pigmented skin cells, followed by the application of a powerful botanical serum.

Of course, your at-home regime is also vitally important.  After cleansing in the morning, use Dermalogica Day Bright SPF15, which contains optical illuminators, and will help protect your skin from further sun damage while actually helping to combat melanin production at the cellular level.  At night after cleansing, use Dermalogica Daily Microfoliant,a rice based powder that smoothes and brightens the skin.  Then apply Night Bright, which penetrates deep into the skin and delivers a potent dose of eleven botanical brighteners to regulate melanin production.

What results can I expect from treatment?

How much you can reduce the appearance of hyperpigmentation depends largely on what is causing the problem as well as how deeply in the skin the pigmentation extends.

Generally speaking, most people see results within 8-10 weeks of beginning a treatment programme. Keep in mind, however, that all sun exposure must be avoided during this time – even one unprotected day in the sun can reverse all positive treatment results.

What can I do about Premature Ageing?

Far from natural! Now, we wouldn’t suggest for a minute that there’s anything wrong with growing old gracefully. The natural ageing process is defined in our very genetics, resulting in the complex hormonal and physical transformations that take place throughout life.  Premature ageing refers to the unnatural acceleration of the natural ageing process, primarily due to damage from sun exposure and an unhealthy lifestyle. While the natural ageing process cannot be slowed, most people who exhibit signs of ageing are actually suffering from premature ageing.  Sound far fetched? Consider this: not only are over 99% of wrinkles caused by sun exposure, but premature ageing can add up to twenty years to your appearance!

How do you avoid it?

Taking care of your skin early on can help your skin stay healthy well into your golden years.  It’s an investment that only takes minutes a day!

Avoiding unprotected sun exposure is the most important measure you can take to protect your skin.  General lifestyle factors are also important – a diet too rich in highly-processed foods and alcohol, and lacking in fresh fruits, vegetables and whole foods, can have a significant impact on the health of the skin.

Take control of premature ageing

Let’s face it – we’ve all done things in our pasts that our skin would rather forget! And, while the damage may be done, there are a number of ways in which you can treat the signs of premature ageing.  It all starts with regular visits to your skin care therapist, who can work out a prescriptive regime based on a detailed skin analysis using Face Mapping.  More than likely, you will begin with an intensive series of Multivitamin Power Exfoliation treatments, a hydroxy acid and Retinol approach that is designed to dramatically smooth away debris and increase new cell renewal.  Then, regularly-scheduled Multivitamin Power Treatments will keep your skin on track.

Your at home regime will also play a crucial role.  Using vitamin-enriched products, specifically those containing stabilised Vitamins A, C and E, can deliver the vital nutrients that the skin needs to help firm and improve elasticity.  Dermalogica Multivitamin Power Concentrate and Multivitamin Power Firm for the eye and lip area applied on a daily basis, along with our Multivitamin Power Recovery Masque 1 to 2 times weekly, will very effectively deliver these critical vitamins to your skin.  And don’t forget your hands, which are one of the first areas to show signs of premature ageing and sun damage – Multivitamin Hand and Nail Treatment was developed specifically to counter this.

Topical vitamins….do they work?

As far as your body is concerned, your skin is the last in line when it comes to getting it’s share of nutrients.  Over time, fewer of your ingested vitamins ever make it to the skin because they are diverted to the internal organs, leaving the skin starved.  Applying potent vitamins complexes topically can make up for this lack of nourishment, helping to address the signs of ageing on the cellular level and neutralise dangerous free radical activity.

Technically speaking, getting those vitamins where they need to go is a huge challenge.  Extremely reactive, vitamin complexes are generally very unstable, which means you should never use a product that comes in a bottle or jar, where it would become contaminated after first use.

Your skin craves:

Vitamin A (Retinol, Retinyl Palmitate) – essential for normal skin development, Vitamin A regulates skin growth and cell division.  Not only does it help improve moisture content, it actually promotes cell renewal and can help reverse the signs of premature ageing.  A powerful antioxidant, it also scavenges free radicals.

Vitamin C (Ascorbic Acid, Ascorbyl Palmitate) – An antioxidant, Vitamin C is a key component in collagen production, and also strengthens capillary walls for a more firm skin tone.  It has also been shown to help regulate hyperpigmentation and boost the skin’s immune system.

Vitamin E (Tocopherol, Tocopheryl Acetate) – a powerful antioxidant, Vitamin E helps to protect the skin’s moisture barrier, smooth skin, reduce inflammation and promote healing.

Pro Vitamin B5 (Panthenol) – A powerful vitamin that encourages cell regeneration, which stimulates the healing process.

What is exfoliation?

While worldwide awareness of exfoliation has exploded in the last decade, it’s a concept that is thousands of years old. Even Cleopatra’s exfoliation secrets were well documented!

Generally speaking, exfoliation refers to any technique that removes cells from the skin surface, not only immediately “refreshing” the skin’s appearance but also stimulating cell renewal. The benefits are dramatic, and, when used with professional guidance, exfoliation can treat a wide variety of skin problems – including acne, hyperpigmentation, premature ageing and scarring, to name but a few.

Of course, there is a huge variety in these techniques – scrubs, peels, masques, dermabrasion, and lasers! Fortunately, your skin care therapist can help you identify which will help you best achieve your goals.

What are hydroxy acids?

Unlike physical exfoliants that remove debris through gentle abrasion, hydroxyl acid-based exfoliants smooth the skin by dissolving the intercellular “glue” that attaches the cells to the surface. Hydroxy acids are the most common form of at-home exfoliant because they are extremely effective and, when used properly, very safe.

Of course there are several different hydroxyl acids. Glycolic Acid was the first to be used in a cosmetic application, and is still widely-used despite its high incidence of skin irritation. Lactic and Salicyclic Acids, which are as effective as Glycolic Acid, are now the choice of leading skin care professionals because they deliver the same level of results with considerably less irritation. Dermalogica Gentle Cream Exfoliant and Skin Renewal Booster are two great at-home exfoliants that use this combination of Lactic and Salicyclic Acids.

Hydroxy acids may be combined with enzymes derived from Papaya (Papain) and Pineapple (Bromelain) to help digest dead skin cells, resulting in even smoother skin. The Phytic Acid in rice Bran, the third key ingredient in our Daily Microfoliant, also effectively dissolves dead surface cells.

Who needs exfoliation?

Well, everyone exfoliates naturally. In fact, as you’re reading this, thousands of tiny skin cells are falling off your body – about a million every minute! An exfoliation regime simply helps your body along in the process, which becomes especially vital as we age. Teenagers completely regenerate their external layer of skin, on average every 14 days. By the time you’re 40, however, that rate has increased to 30-40 days. The result is dull, ashy or mottled-looking skin. An exfoliation regime can reduce the time that dulling skin cells sit at the surface of our skin for a healthier, more vibrant complexion. Depending on your age and skin condition, your therapist might prescribe a combination of exfoliation therapies. Here are some examples.

Acne-Prone Skin: A masque-style exfoliant, such as Dermalogica Gentle Cream Exfoliant, can help the skin combat extra oiliness and congestion without aggravating acne conditions.

Dehydrated Skin: Depending on the sensitivity of your skin, you might select a masque-style or scrub-style exfoliant to help remove the dry, dead debris and reveal healthy cells. Combining Skin Renewal Booster with your moisturiser is another great option.

Prematurely Ageing Skin- Prematurely aged skin is often the result of sun exposure. Sun exposure causes a build up of surface skin cells, which results in a dull, dehydrated appearance. A physical exfoliant such as Skin Prep Scrub, plus professional MultiVitamin Power Exfoliant treatments, will help slough away dead skin cells.

Uneven Pigmentation: Exfoliation is an important component of every hyperpigmentation treatment because it helps remove the pigmented surface cells. Dermalogica Daily Microfoliant, when used as part of the Skin Brightening System, is the most effective choice.

Is there after-care treatment?

Depending on the strength of your treatment, your skin may feel a little tight and sensitised for a little while when you leave the skin care centre. This is perfectly normal, and should dissipate quickly.

The most important consideration after any form of exfoliation is to protect your super-vulnerable skin against the sun. An application of UltraSensitive FaceBlock SPF25 will help protect your skin without any chance of sensitisation. You will also want to cleanse with a super-gentle cleanser, such as UltraCalming Cleanser, and follow with your moisturiser to prevent dehydration. Your therapist may recommend Barrier Repair for extra protection.

Is stronger better?

Many people get a little exfoliation-crazy under the mistaken notion that if a little is good, a lot has to be great! (Ironically, this is why people often mistakenly opt for the more irritating Glycolic Acid – they assume that more irritation equals better results.) While every skin condition is different, and reacts to exfoliation differently, you should tame down exfoliation differently, you should tame down your exfoliation regime if your skin feels chapped, irritated or is unusually red for a long period of time. At this point, you’re not removing dead debris – you’re scrubbing away the protective barrier of epidermis, which can result in permanent sensitisation, premature ageing and a host of other concerns.

What is acne?

Acne is genetically-inherited disease, which is the result of several factors occurring in the skin. Aside from excess oil secreted by the sebaceous glands, there is a proliferation of cells that clog the pores, trapping oil in the follicle. Bacteria inhabit the follicle and digest the oils, generating waste products which then cause the irritation to the skin. Oilier skin conditions tend to experience more acne breakouts because they provide more food for the bacteria. Teenagers’ hormonal changes increase oil production, in turn increasing acne breakouts. A quick Face Mapping by your skin care therapist will identify your acne-prone areas.

What can I do at home to help my breakouts?

Excellent skin care and hygiene are vitally important to remove the excess oils and bacteria that are associated with acne. Dermalogica products are non-comedogenic and completely water-soluble, making them ideal for breakout-prone skin. Always follow a strict regime of thorough cleansing. We recommend Dermalogica Anti-Bac Skin Wash and lukewarm (never hot) water, followed with a hydrating conditioner such as Dermalogica Multi-Active Toner, and an oil-free moisturiser. Exfoliate twice a week, and use Daily Microfoliant every day, to help the skin rid itself of congestion-causing debris. Dermalogica Medicated Clearing el helps regulate sebum (oil) production, remove follicle-clogging debris and kill acne bacteria. For an existing breakout, Benzoyl Peroxide provides unsurpassed clearing, while a calming mask reduces irritation.

In addition, lifestyle changes can often improve your skin. Try to reduce stress, drink plenty of water and limit your intake of caffeine and nicotine, which may stimulate the adrenal glands and promote oil production.

And always remember never to pick or squeeze pimples, as you’ll be left with an even bigger blemish and a scar to remember it by!

How should I change my regime if I am taking prescription acne medication?

If, after a month of following your recommended regime your complexion does not clear, it may be time to involve a dermatologist. Depending on what you were prescribed, you’ll have to make some adjustments to your at-home regime to help your skin adjust to the new medication. For example, you may opt for a more gentle cleanser, such as Dermalogica Special Cleansing Gel or The Bar. Users of Retin –A, Adapalene and Accutane should not use any exfoliating products or undergo waxing on the treated areas. All users of prescription exfoliating products, as well as antibiotics should avoid sun exposure as much as possible, and apply a Dermalogica Solar Defense Product with a minimum of SPF15 daily.

Why do some people breakout in their thirties and forties?

Stress and hormonal changes are the primary cause of the re-emergence of acne well after puberty. Recent studies indicate that 40 to 50 per cent of adults between the ages of 20 and 40 are diagnosed with persistent, low-grade acne. Along with several lifestyle changes, including reducing stress and improving diet, there are several products on the market designed to address these problems. Dermalogica Oil Control System is a collection of three medicated, skin purifying formulations – a cleansing Anti-Bac Skin Wash, Skin Purifying Wipes and Oil Control Lotion – all designed to control oil and prevent breakouts.

What is the difference between acne vulgaris and “acne” rosacea?

Acne vulgaris, a more common form of acne, is caused by clogging and inflammation of the skin’s hair follicles. Rosacea, on the other hand, is not actually a form of acne at all, even though it looks that way in its early stages. Rosacea is an inherited vascular disorder in which the blood vessels of the face become swollen after repeated exposure to certain triggers such as extreme temperatures, alcohol, spicy food, etc. While it starts as a simple blushing, it advances into bumps on the face that looks like an acne breakout.

Like common acne, Rosacea is treatable…but not by the same regime! Skin prone to Rosacea must be treated gently to avoid triggering redness and inflammation and may also require a dermatologist’s prescription for special medication to control the symptoms. (See Dermalogica’s “do I have sensitised skin?” fact sheet for more information on Rosacea.)