Sue Ibrahim, our skin expert at Elan Medical Skin Clinic in Essex

Sue, our nurse consultant in dermatology says there are newly licensed prescription creams to manage rosacea although they are not widely available on an NHS prescription due to the ongoing expense incurred. But Sue can prescribe them, if required and our rosacea phototherapy comes in handy for flare-ups.

“We are really proud of our DermaCalm treatment programmes for rosacea that can help dramatically improve the self-esteem of our patients who suffer from it. If rosacea can be successfully managed in the early stages, it will help prevent the condition from progressing and prevent the thickening of the skin and scarring that advanced rosacea can cause,” Sue added.

The mites live in our skin pores

Kevin Kavanagh of the National University of Ireland, explains that the: “Tiny mites – eight-legged arachnids related to spiders – live in the pores of our facial skin. They are particularly fond of the hair follicles of eyebrows and eyelashes, and the oily pores most common on the nose, forehead and cheeks.

”Healthy adults have around one or two mites per square centimetre of facial skin. People with rosacea, however, can have 10 times as many.”

The mites eat sebum, the oil on our skin, and research suggests that the stress that causes flare-ups of rosacea changes the chemicals in sebum, making it better food for mites.

According to dermatology literature, Demodex mites usually do not result in any dermatological problems, but when the parasites penetrate the dermis (layers of the skin), they can cause acne, rosacea, and folliculitis.

What to do if you have rosacea

Our award-winning nurse consultant, Sue Ibrahim, has more than 30 years’ experience in dermatology, making her the ideal choice for people with rosacea. She is an expert in skin conditions and her friendly and professional manner will instantly put you at ease. Please send Sue a message – we provide a responsive service that aims to set your mind at ease and ensure you are fully informed before booking your consultation.

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Suffering with acne? Call Sue Ibrahim at Elan Medical Skin Clinic in Essex for help and advice.

Despite being one of the most widespread skin conditions affecting teenagers AND adult men and women, acne is one of the most poorly understood. There are many myths and misconceptions surrounding acne and its causes. In this month’s blog, our skin expert and nurse consultant in dermatology, Sue Ibrahim, helps separate fact from fiction.

Myth: A poor diet high in fat and dairy causes acne

Scientific research has not found any foods that directly cause acne, so far. However, eating a healthy, balanced diet is essential for your overall health and wellbeing.

Myth: Acne is caused by having dirty skin and poor hygiene

NHS scientists suggest that most of the biological reactions that trigger acne occur beneath the skin, not on the surface, so the cleanliness of your skin has no effect on your acne. And Sue says that washing your face more than twice a day could actually aggravate your skin.

Myth: Squeezing spots gets rid of acne

Although tempting, squeezing spots, blackheads or whiteheads can actually make your acne symptoms worse – and may leave you with scarring. Here are some of the acne treatments that we may recommend at Elan Medical Skin Clinic in Rayleigh Essex:

1. Prescription medications to reduce the outbreak of spots
2. Elan Medical Skin Systems for acne
3. LED Phototherapy to reduce facial redness
4. Elan Medical Skin Peels for superficial blemishes and scars
5. Intralesional Cyst Injections
6. Fractional Skin Resurfacing for deep acne scars
7. Surgical scar revision

Myth: Acne is infectious

This is a particularly nasty and hurtful myth that’s totally incorrect. You cannot pass acne to other people or catch it from close contact with someone with acne. The psychological effects of acne are often underestimated by GPs and friends and those affected can suffer from reduced self-esteem and confidence issues.

What causes acne?

The British Association of Dermatologists has a very helpful leaflet about acne, which explains:

The sebaceous (oil-producing) glands of people who get acne are particularly sensitive to normal blood levels of certain hormones, which are present in both men and women. These cause the glands to produce an excess of oil. At the same time, the dead skin cells lining the pores are not shed properly and clog up the follicles. These two effects result in a build up of oil, producing blackheads (where a darkened plug of oil and dead skin is visible) and whiteheads.

The acne bacterium (known as Propionibacterium acnes) lives on everyone’s skin, usually causing no problems, but in those prone to acne, the build-up of oil creates an ideal environment in which these bacteria can multiply. This triggers inflammation and the formation of red or pus-filled spots.

Click here to read the full leaflet

Testosterone

Teenage acne is thought to be triggered by increased levels of testosterone, which occurs during puberty. The hormone plays an important role in stimulating the growth and development of the penis and testicles in boys, and maintaining muscle and bone strength in girls.

The sebaceous glands are particularly sensitive to hormones. It’s thought that increased levels of testosterone cause the glands to produce much more sebum than the skin needs.

We can help

If you suffer from acne, get advice early – please don’t suffer in silence. If you would like to ask our medical director & nurse consultant, Sue Ibrahim a question, by all means do. We provide a responsive service that aims to set your mind at ease and ensure you are fully informed before booking your consultation. At Elan Medical Skin Clinic in Essex, all new patients receive a thorough consultation and medical assessment prior to treatment.

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With a Dermatology Nurse Consultant you know your face is in a safe pair of hands.

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Worry not, for most you will find that these skin issues resolve themselves following the birth of your baby.  Here are some of the most common skin problems women encounter during pregnancy—and what you can do about them.

Pregnancy should be a time of excitement

Skin Sensitivity

Go easier on your skin now that you’re pregnant. You might get red more easily if you use a facial scrub, your normal facial might verge on painful, and the perfumed lotion you wear might irritate your skin (and make you nauseated, but that’s a different story). That’s why many mums-to-be switch to unscented products and start choosing products that do not contain harsh chemicals, preservatives and fragrances. “You certainly don’t want anything causing micro-tears on your skin,” says Sue Ibrahim, our dermatology nurse consultant.  “The more cuts and wounds on your skin, the easier it is for chemicals to be absorbed into your bloodstream. Ingredients to stay away from in soaps and body washes include sodium laureth sulphate, parabens and fragrance.” These ingredients aren’t just potential irritants—some say they could pose health risks to baby. We say believe it, because (not surprisingly) a lot of products aren’t tested directly on pregnant women. If you are using prescription topicals on your face you need to tell your doctor that you are pregnant as most prescription creams are not licensed for use during pregnancy either. At Elan Medical Skin Clinic we advise our patients to use our Elan Medical DermaCalm range during pregnancy, because they are free from fragrances and preservatives. They also contain mild anti-inflammatory ingredients that can soothe irritated skin.

Acne breakouts during pregnancy

During pregnancy your hormones are all over the place, and that might mean pimples like you had when you were a teenager. The cruel joke, of course, is that many of the treatments that are prescribed for acne cannot be used during pregnancy. Prescription medications like Tetracyclines, Isotretinoin (Roacutane(R)) and the anti-androgen hormone therapies are definite no-nos. And the jury’s out on over-the-counter creams, since they haven’t been tested specifically on pregnant women (yup, you find that a lot with products). Ingredients like benzoyl peroxide and salicylic acid can be absorbed into the bloodstream, so they’re not worth the risk either. “You can safely use lactic acid and biosulfur to treat acne,” Sue Ibrahim says. Don’t touch, pick or squeeze pimples— just wash with a mild cleanser twice a day. “A lot of women find Acne Phototherapy beneficial during pregnancy and it is perfectly safe for both you and the baby.

Sun Sensitivity

Sorry, mums-to-be, but “pregnancy glow” does not refer to a bronzed, sun-kissed complexion. You should actually try to stay out of the sun as much as you can while you’re pregnant. That’s because your surging hormones make you susceptible to dark patches on your skin—known as melasma, or the ‘mask of pregnancy’, which is triggered by sun exposure. So pull out the big floppy hat, find a beach umbrella and be diligent about wearing sunscreen with an SPF of at least 30 every day. If you are unlucky and do get Melasma during pregnancy it may resolve on its own following the birth of your baby, if not then you will need the help of a dermatologist I’m afraid.

Stretch marks

Now you’ve got another big skin concern: stretch marks. Anytime someone’s body grows quickly, they’re at risk for stretch marks, so the fact that baby is growing exponentially in there puts you right in the high-risk zone. Of course, not every mum-to-be gets stretch marks. “For most people, whether or not they get stretch marks has to do with genetic predisposition,” says Sue Ibrahim. But you can do your best to head them off by gently exfoliating and thoroughly moisturising your belly, boobs, stomach, hips and thighs as much as you can. As for what moisturizer to use, it’s hard to make a recommendation. “A lot of products make claims,” Sue Ibrahim says. “Some may help but aren’t really proven to prevent stretch marks.” If you are left with troublesome stretch marks following the birth of you baby, it is worth looking into the skin tightening treatments we offer at Elan Medical Skin Clinic.

Skin rashes during pregnancy

If you’ve got red, itchy skin, it’s important not to ignore it. Itchy feet and hands could be a sign of cholestasis of pregnancy, a scary complication that can cause liver problems for baby. Your doctor can do a simple blood test to make sure that’s not causing your rash. Another common pregnancy rash is PUPPP (pruritic urticarial papules and plaques of pregnancy), which often starts in the abdomen and spreads from there. PUPPP is actually harmless to baby, but it will be completely aggravating for you. Book in for a Dermatology Consultation if you are concerned.

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Let’s understand what causes ageing skin

Many things cause our skin to age. Some things we cannot do anything about; others we can influence. One thing that we cannot change is the natural ageing process. It plays a key role. With time, we all get visible lines on our face. It is natural for our face to lose some of its youthful fullness. We notice our skin becoming thinner and drier. Our genes largely control when these changes occur. The medical term for this type of ageing is “intrinsic ageing.”

Let’s look good for our age

We can influence another type of ageing that affects our skin. Our environment and lifestyle choices can cause our skin to age prematurely. The medical term for this type of ageing is “extrinsic ageing.”

• The sun – UVA and UVB rays are present 365 days per year. USA rays can penetrate through four inches of glass. So think about this when you are sitting next to a window in the office or driving in your car.
• Smoking –  I know, we are all told how smoking is bad for your health but smoking greatly speeds up how quickly skin ages. It causes wrinkles and a dull, sallow complexion. Why, because the toxins in cigarette smoke replace the oxygen content of your blood.
• Alcohol – Alcohol is rough on the skin. It dehydrates the skin, and in time, damages the skin. This can make us look older. So drink alcohol in moderation and for every alcoholic drink, drink two glasses of water. This will help to re-hydrate you.
• Unhealthy diet – Findings from a few studies suggest that eating plenty of fresh fruits and vegetables may help prevent damage that leads to premature skin ageing. Findings from research studies also suggest that a diet containing lots of sugar or other refined carbohydrates can accelerate ageing.
• Lack of exercise – Findings from a few studies suggest that moderate exercise can improve circulation and boost the immune system. This, in turn, may give the skin a more-youthful appearance.
• Over Moisturising – Believe it or not, over moisturising the skin will send your skin cells to sleep. When your skin is slightly dry, your skin cells react by producing more collagen. If you over moisturise the skin, you will be inhibiting your own collagen production. Use a sunscreen in the morning instead! Mind you, it needs to be a UVB and UVA Sunscreen of at least factor 30 for it to really protect your skin.
• Skin Scrubs –  Scrubbing your skin clean can irritate your skin. Irritating your skin accelerates skin ageing process. Gentle washing helps to remove pollution, makeup, and other substances without irritating your skin. Some anti-ageing products prescribed by a dermatologist may burn or sting. When using a prescription anti-ageing product, this can be okay.

Even people who already have signs of premature skin ageing can benefit from making lifestyle changes. By protecting your skin from the sun, you give it a chance to repair some of the damage. Smokers who stop often notice that their skin looks healthier. By taking some preventive actions, we can slow the effects that this type of ageing has on our skin.

There is so much conflicting advice out there

If signs of ageing skin bother you, you may ask a beauty therapist for advice. However, this may result in you spending a lot of money on treatments and cosmetic creams that make no difference to your skin at all.  Why not consult a dermatologist instead? Yes, you will have to pay for a consultation, but you may end up spending a lot less money in the long run. Why? Because prescription skincare contains the right amount of active ingredients that are designed to penetrate deeper into the skin. New treatments and less-invasive procedures for smoothing wrinkles, tightening skin, and improving one’s complexion are giving many people younger-looking skin.

Treated by Sue Ibrahim, these photographs were taken four weeks apart.

If you are worried about the effects the ageing process is having on your skin, then why not book in to see Sue Ibrahim. With over thirty years working within the medical and cosmetic dermatology sector, Sue has helped thousands of women and men improve the texture and appearance of their skin. Her professional but friendly approach is well known throughout the industry. Sue will never sell you any treatment that you do not need. As a Nurse Consultant in Dermatology she has won a number of industry awards and constantly receives a string of positive reviews about the treatment and service she provides.

Book your consultation today!

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Woman talks to skin experts at central London’s Elan Medical Skin Clinic about Roaccutane

Roaccutane is a brand name for the oral drug Isotretinoin, which is closely related to vitamin A. Oral Isotretinoin works in a variety of ways, targeting several of the factors that cause acne and other skin conditions including the production of sebum (an oily substance produced by the skin) and the production of keratin (outer scales of skin) that block the pores of the hair follicle and cause acne.

Due to ongoing concerns, a review of psychiatric reactions was carried out in 2014, which considered all available evidence from published literature and individual case reports. Conflicting study results and limitations in the data determined it was not possible to identify a clear biological mechanism by which Isotretinoin would cause psychiatric disorders.

Acne itself is associated with psychiatric disorders and the age that many patients take isotretinoin is also the age that some psychiatric disorders are commonly diagnosed. However, patients on Roaccutane require careful monitoring, which should include monthly blood tests and close supervision regarding low mood. The drug is now generally prescribed at a lower dose for a longer period of time.

Who can prescribe it?

Roaccutane Isotretinoin is licensed in the UK and commonly used to treat moderate and severe acne, often where there is risk of scarring. Your dermatologist may occasionally use Roaccutane to treat other skin conditions such as hidradenitis suppurativa and rosacea. In the UK Roaccutane may only be prescribed if you are under the care of a consultant dermatologist.

Will Roaccutane cure my acne?

A large proportion of patients (about 9 out of 10) see a significant improvement in their acne with a single 16 to 24 week course of Roaccutane, although during the first few weeks of treatment the acne may worsen before it starts to improve.

A small number of patients continue to have milder, although improved, acne following Isotretinoin that can be controlled with conventional therapies, such as antibiotics. Others may relapse after stopping treatment with Roaccutane, and occasionally, a prolonged or second course of treatment is required.

Who can’t have it?

According to Government guidelines, the following people should not receive treatment with Roaccutane:

• children aged 12 years or younger
• women who are, or who might be, pregnant (please download the leaflet below)
• women who are breast-feeding
• people with impaired liver function
• those with high levels of fat in their blood
• people with hypervitaminosis A – the presence of too much vitamin A in the body, symptoms of which include:
  • fatigue
  • irritability
  • skin changes
  • hair loss
  • headache
  • stomach ache

Isotretinoin should be used with caution in people with:

• a history of depression
• diabetes
• dry-eye syndrome
• impaired kidney function
• people who are allergic to peanuts, soya, or the sugar sorbitol as some brands of Isotretinoin may contain these ingredients

What are the rare side effects of Isotretinoin?

More serious side effects may occur although these are fortunately rare. Isotretinoin can lead to changes in mood and/or behaviour and less commonly, unusual experiences including thoughts of self-harm and suicide. There have also been reports of patients attempting suicide.

If you have ever had low mood, suicidal ideas or any other mental health problem, please discuss this with your doctor before starting treatment. If you have a history of depression your dermatologist may ask a psychiatrist to see you before starting Roaccutane to determine if it is safe for you to take.

For more information, please read the leaflet attached below that has been produced by the British Association of Dermatologists or contact Sue Ibrahim.

British Association of Dermatologists Isotretinoin leaflet

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