POSTED: 20 Mar 2016


The skin is the largest organ in the human body and has a range of functions. It acts as a barrier between your body and microbes or toxins, it also blocks harmful UV rays from the sun and regulates your temperature and hydration. Due to its complex roles in helping regulate your internal body environment, it is of no surprise that the appearance of your skin is a reflection of your overall health. Hormonal imbalance may result in skin dryness, discolouration or acne whilst sun damage and smoking can give rise to wrinkles and pigmentation. We have blogged about how to improve your skin health by heating healthily, exercising and increasing your hydration levels. In this post we are going to look at additional ways you can take care of your skin in order to improve its appearance and overall health.

A quick guide to skin anatomy and physiology

Several layers make up the skin and can simply be divided into the epidermis, dermis and subcutis. The uppermost layer is the epidermis which contains the skin cells (keratinocytes), immune cells (langerhan’s cells) and the pigment-producing cells (melanocytes). This layer of the skin forms a barrier to the environment and protects against fluid loss as well as blocks the entry of harmful organisms and substances. The Dermis forms the supportive layer of the skin. It contains collagen and elastin which are responsible for the strength, elasticity and pliability of skin. This layer also contains nerves, blood vessels, cells and mucopolysaccharide gels which connect the tissues together. The subcutis is the inner most layer and contains fat cells, blood vessels and nerves.

Normal ageing of the skin is a process of loss and reduction of the cells and components that make up these layers. In the epidermis, there is reduction in the numbers and disrupted function of the pigment containing cells (melanocytes) which gives rise to the discolouration and patchy pigmentation of the skin. There is also allowing of the skin cell (keratinocyte) turnover, which results in reduced wound healing and dull or rough skin. The changes to the dermis are most responsible for the typical signs (e.g. wrinkles and folds) that we associate with ageing.  There is reduction in collagen production and abnormal structure of the collagen fibres. This causes thinning of skin and appearance of wrinkles. There is a similar reduction in the amount of Elastin formed, which is also abnormally structured. This leads to loss of skin pliability and elasticity. Similarly, there is less mucopolysaccharide production. This results in dehydration, elasticity and loss of skin turgor.

9 simple things you can do to care for your skin

With all this in mind, we have put together a few handy tips in order to fit taking care of your skin into a busy day with minimal effort:


  1. Wash skin with luke-warm water and if you wish, use a gentle face wash that is suitable for your skin type. Avoid products with soap or alcohol, which will strip the skin off its natural oils and cause dryness.

  2. Moisturiser is an integral part of your routine. It helps to hydrate and keep in water thus maintaining the skins barrier function.  Purchasing a moisturiser with built in SPF can combine sunscreen and moisturiser thus saving you precious time in the mornings. However, make sure that this is of adequate strength and make sure you also include the skin on your neck and ears. If you wish to use these separately, apply moisturiser then SPF. To reduce time, find a moisturiser that also contains SPF and can act as a primer where possible in order to provide the perfect base for your makeup.

  3. Eye creams are often made with a lighter moisturiser to treat the delicate skin that surrounds the eyes. Apply cream using gentle circular motions.


  1. REMOVE makeup using alcohol and perfume free makeup remover or beauty oil. Make sure you use smooth cotton balls or pads or a soft flannel and don’t be too harsh when wiping the makeup off (especially under the eyes). Also remember to remove makeup when exercising as failure to do so results in clogged pores and breakouts.

  2. Cleanse skin with an alcohol and perfume free cleanser. Gently massage the cleanser onto your face and wash with luke warm water. If you have oily skin then use an oil-free or non-comogenic formula.

  3. Night cream can be the same as your day moisturiser or if you feel like an overtime facial, use a vitamin enriched formula or beauty oil. Massage over your face and neck in circular motions. This helps the product get absorbed and also stimulates blood flow thus increasing nutrient delivery to the face.

  4. Eye cream should be applied using your little finger with gentle circular motions.


  1. Exfoliate using a flannel and any product containing a mild deramabrasive. This helps remove dead skin cells from the surface and stimulate blood flow. It also helps unclog pores. Regular exfoliation as part of a skincare regime helps achieve luminous and smooth skin. Also remember to exfoliate lips and follow up with Vaseline or lip balm.

  2. Face mask should be applied straight after exfoliating being careful to avoid the eye and mouth area. Use a mask that increases moisture and hydration. Pop a couple of slices of cucumber or cold used rooibos tea bags on your closed eyelids to help reduce puffiness and take this time to relax.

Advanced skin care and treatments

These simple steps can help you improve the appearance of your skin and protect it from further damage in order to reduce signs of ageing. If however, you have specific problem areas such as acne scarring, uneven pigmentation, wrinkles or lines that you would to smooth out then there is an array of advanced clinical solutions, which can help with specific problem areas. However its always worth remembering that to achieve the best result, you should also ensure that your skin is as healthy as possible and continue to maintain it after receiving these treatments to reap the maximum benefit. Below we give an overview of the main non-invasive skin rejuvenating treatments:

Chemical Peels

Chemical Peels are accelerated exfoliative procedures that can be used to smooth and improve the appearance of skin. This is done by applying a chemical reagent to the skin which removes the top layer of skin and allows new skin to grow back which results in smoother and younger looking skin.

There are different depths of skin peels (light, medium and deep) whereby the deeper peels provide the most resurfacing but the healing time is longer. A light chemical peel usually contains glycolic acid or salicyclic acid. This removes the epidermis and reduces the appearance of fine lines wrinkles as well as corrects some acne and discolouration. The glycolic acid or salicyclic peels often involve a weekly treatment over six weeks but they don’t require any pain relief and results are usually visible after a week.

Medium peels are comprised of trichloroacetic acid often in combination with glycolic acid to remove the epidermis and top part of the dermis providing treatment for wrinkles, acne scarring and pigmentation. Medium peels are less frequently repeated and may last up to 12 months, however they may involve more discomfort and often a longer healing time than light peels. Deep chemical peels involve application of carbolic acid (phenol) to remove the epidermis and up to the lower parts of the dermis. They are most suitable for deep wrinkles and scars but require analgesia and may involve sedation. The appearance of new skin usually takes 14 days after a deep peel but there maybe on going swelling, redness and cysts for several months.

Collagen induction therapy with microneedling using a Dermaroller

Dermaroller is a handheld device which employs microneedling to create tiny microscopic punctures in the top layers of skin which stimulates collagen and elastin production. This may reduce lines, wrinkles, discolouration, acne scarring and tighten pores. The benefit of dermaroller is it requires shorter recovery time than lasers and chemical peels as the top layer of the skin is not removed.

Laser resurfacing

Similar to chemical peels and microneedling, laser resurfacing can reduce the appearance of wrinkles, sun damage, discolouration and scarring by removing the top surface of the skin. However, in the hands of skilled and fully trained professional, lasers can resurface skin with more precision by removing dead skin layer-by-layer. This allows new healthy skin to grow and the end result is a smoother and more youthful appearance. As with peels, several courses maybe necessary, sedation or general anaesthetic is often needed and recovery time maybe long.

Anti-wrinkle injections using Botox and other Botulinum Toxin A preparations

Botulinum Toxin A was discovered to reduce the appearance frown lines in the 1990s by Dr Carruthers and has been increasingly popular in the treatment of wrinkles since then. Botox was the first product to be approved and is licensed for use in a variety of conditions including oversweating, forehead wrinkles and crow’s feet.  It is also commonly used to treat other facial and neck wrinkles whether alone or in combination with dermal fillers. Botox treatment works by immobilising the function of muscles which reduces the appearance of lines and wrinkles. This effect usually takes around a week to appear and lasts for 3-4 months on average. In addition to Botox, there are several other brands of Botulinum Toxin A. These are Dysport (Azzalure) and Xeomin (Bocouture) which are all similarly used for anti-wrinkle treatments. These are all prescription medicines and their use will depend on the outcome of the consultation with your practioner.

Dermal Fillers using hyaluronic acid

Hyaluronic acid is one of the major mucopolysaccharides in the dermis of the skin. It plays a part in providing structure to the skin as well as drawing in water to maintain hydration. Dermal and lip fillers such as Juvederm are made from a modified form of hyaluronic acid. They come in different thickness and are designed for use in smoothing out wrinkles of various depths. In addition fillers can be used to restore volume of cheeks and other areas of the face in order to provide a fuller and more youthful looking appearance. Thinning of lips can also be corrected by injecting hyaluronic acid. As a lip filler, hyaluronic acid provides plumper and better defined lips. If applied by a skilled and qualified professional, the appearance and feel of lips can be natural and results are immediately visible during the treatment. Hyaluronic acid fillers often last 6-12 months and can be removed using hyaluronidase if there is an adverse reaction or if the result is not desirable. In addition to Juvederm, there are several other licensed brands of dermal and lip hyaluronic acid fillers such as Teosyal, Restylene and Belotero.  How and when they are used will be determined by your doctor based on your requirements and proposed treatment.

The issue of skin care lies with the simple principle of gentle cleansing and protection against photo-damage from the sun as well as moisturising. In addition to looking after your skin on the outside, overall health also determines the appearance of skin, which acts as a mirror to the internal system. Alongside healthy skin, specific signs of ageing such as uneven skin tone, dull appearance, scars, volume loss to lips and cheeks as well as wrinkles can be reduced using an array of non-surgical treatments. However for optimum results, advanced skin treatments like chemical peels, lasers, Botox, dermal fillers and microneedling should be viewed as complimentary to healthy skin and a good skincare regime.

Authored by:

Dr Amel Ibrahim
Aesthetic Doctor & Medical Director
Founder City Skin Clinic
Member of the Royal College of Surgeons of England
Associate Member of British Association of Body Sculpting GMC Registered - 7049611

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