This week I sat down with consultant dermatologist Dr Anjali Mahto to pick her brain on how we can improve our skin health through our diet and lifestyle.
What are some of the biggest skin myths that you would love to bust?
1. ‘Pores open and close’
Because we are mammals, we are all covered in fine hairs over the face and body. Pores are simply the opening of tiny hair follicles onto the surface of the skin. They are not surrounded by a muscle and therefore do not have the ability to open and close. It is really common to hear myths about pore size – for example – steam or hot water will open pores. This myth is propagated by glossy magazines, beauticians, and even some doctors!
The truth is we can help improve the appearance of pore size but we cannot close them.
Those with oily skin tend to have the appearance of enlarged pores as oil tends to collect within them. Pore size can also become more apparent with age. As we get older, the proteins collagen and elastin, that give our skin its structural support, break down dragging the edge of the pore with it making it appear enlarged.
Lastly, genetics have a part to play – if your parents have large pores, chances are that you will as well. This is not to say we can’t help those that worry about their pore size. There are a number of treatments that can help minimize their appearance. These include the use of creams containing retinoids and procedures such as; chemical peels, microneedling, and laser.
2. Acne is caused by poor hygiene
Acne affects nearly all of us at some point in time. Many people still believe that acne is caused by poor hygiene and not washing frequently enough. This is absolutely not the case. If anything, those who suffer often end up over-washing or exfoliating the skin to remove excess oil. Acne is caused by a combination of hormonal and genetic influences in most cases.
3. Expensive skincare is better than cheaper products
No! Choosing the right skincare is all about choosing the right ingredients. The extra money you spend on more expensive products goes towards packaging, branding and marketing. There are extremely effective, affordable products on the market that will not break the bank.
4. Sunscreen should only be used on sunny days
This is another common myth. Up to 80% of ultraviolet light from the sun will penetrate cloud cover so it is still possible to get sunburnt on cloudy days!
5. Natural skincare products are better for the skin than synthetic ones
This is a conversation I have on a nearly daily basis with many of my patients. There is a general feeling that if a product is “natural” it is somehow better for your skin. The beauty industry relies on the fact that many of us don’t recognise or understand what the long list of chemical names on the back of our skincare products are or what they do. There is no standard definition for what makes a product “natural” and many “natural” ingredients are capable of causing skin allergy and irritation.
You have gorgeous skin! How important is our diet for good skin health, and are their any foods with proven skin benefits?
I’m now in a very fortunate position of being a consultant dermatologist and having access to a wide range of skin treatments – both medical and cosmetic. I went into this specialty after being plagued with bad acne nearly my entire life. Acne and I go back at least 25 years now – it has been a recurring problem for me so I still find it hard when people think I have good skin! I have required more treatment over the years than anyone I have ever met.
We are increasingly recognising that diet is important not for just our general health, but skin health also. This is an area of interest as we are becoming increasingly aware of the importance of preventative healthcare.
Nutrients that benefit the skin include the following categories:
- Vitamin C is essential for collagen synthesis. Collagen is one of the skin’s main structural proteins. Its levels are thought to decline by 1% per year from your mid-20s onwards
- Vitamin E reduces free radical damage in skin cells and in small studies has been shown to improve wound healing
- Beta-carotene is used in the body as a source of vitamin A and needed for skin maintenance and repair
- Lycopene can potentially help against sunburn and premature skin aging.
Fish oils/omega-3 fatty acids
- These are anti-inflammatory and consumption of eicosapentoic acid (EPA) and docosahexanoic acid (DHA) totaling 3-4 g/day over 3 months showed some protection against sunburn.
Polyphenol and flavonoids
- Consumption of green tea polyphenols in small studies have resulted in overall less solar damage compared to controls.
- Zinc is an important co-factor for many body processes including skin healing.
- Copper is an important co-factor for elastin, a major protein that gives the skin its structure
- Selenium is thought to play an important role in reducing sun damage and therefore potential subsequent skin cancer risk
What skin conditions in particular do diet and lifestyle play a key role in?
It has been commonly observed that the inflammatory skin conditions such as; eczema, psoriasis, acne, and rosacea, can be made worse by stress. This is definitely a common theme I hear in clinic from patients. As dermatologists, we are becoming increasingly aware of the mind-skin connection and how stress can drive flare-ups of skin disease.
Removing stress altogether in modern-day life is near impossible but it is important to think about coping strategies to minimise this as much as possible. This could be anything from ensuring a good night’s sleep, reduction in alcohol consumption, exercise, yoga, or meditation. If it is difficult to bring stress under control, despite these measures, I definitely advocate input from a clinical psychologist with an interest in skin disease.
Acne is a common skin concern that has been linked to diet.
There is data from some small studies that suggests than diets high in refined sugar and carbohydrates may drive acne. It is therefore a good idea from both a skin and general health point of view to limit these (not necessarily cut them out altogether!). The link between acne and dairy is much weaker than the link with sugar and if anything, some studies seem to suggest that low fat dairy is more of an issue than full fat dairy. If you don’t notice your acne flares up with dairy products then I would not recommend excluding them from your diet. Scientific data also suggests that nutrients such as ; vitamin A, omega-3 fatty acids, zinc and nicotinamide (vitamin B3) may help some acne sufferers.
Rosacea is another very common skin condition and emerging data shows that those who suffer with rosacea affecting the eyes (ocular rosacea) benefit from supplementation with omega-3 fatty acids. Time and more research will tell if this can be extrapolated to rosacea affecting facial skin also.
Do you recommend taking supplements to maximise skin health?
Rather than taking supplements, I think the key to maximising skin health is trying to get the right nutrients, where possible, from your diet. There is evidence that providing several nutrients together (they way it would be obtained from eating foods) is more beneficial than providing single nutrients in isolation (i.e. from a supplement). What we should be aiming for is a well-balanced diet.
What are your top 3 skincare products?
This very much depends on your skin type or concern that needs to be addressed. I think the basics of any good skincare routine should include an antioxidant serum and sunscreen in the morning and a retinoid product at night. My personal favourites are:
- Skinceuticals Phloretin CF antioxidant serum
- Heliocare 360 gel oil-free SPF 50 sunscreen
- The Ordinary Advanced Retinoid 2%
Which common skincare ingredients should be avoided?
Avoiding certain skincare ingredients is more of an issue for those with sensitive skin rather than those with normal/combination skin types.
Individuals with sensitive skin should be cautious of using products that contain the following ingredients: alcohol, fragrance, ammonium lauryl sulphate, sodium lauryl sulphate, methylisothiazolinone, essential oils, witch hazel, and menthol. It is also best to stay away from exfoliation scrubs or harsh toners.
On a separate note, I think it is worth adding that it has become fashionable to avoid products that contain synthetic preservatives such as parabens due to unnecessary fear generated some years ago. Preservatives are an essential part of skincare products. Without them, our face washes and cleansers would be teeming with bacteria, viruses, and fungi that we would then be smearing on our faces leaving us vulnerable to infection. Clearly not a good thing!
Parabens got a raw deal some years ago following a now discredited scientific study which linked them with breast cancer. Unfortunately, the mud stuck and many people still choose to avoid products that contain them. They do remain, however, one of the safest preservatives and their use is strictly regulated under European Law.
As a skincare consumer as well as a dermatologist I have no issues using products with parabens or synthetic preservatives. Due to tight regulations, at least I know with these products what exactly is being applied to my skin.
The problem with “natural” skincare is that it is not subject to the same degree of quality control as there is no standard definition of “natural”. With herbal preparations you are not aware of a number of factors, which include growing conditions or health of the plant, selection of the right part of the plant, and extraction methods to name a few. So I do think we need to be careful of making the assumption that just because it is “natural” does not necessarily mean it is better; it comes down to personal choice.