The Skin Clinic Fremantle | Dr Sarah Boxley


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Real-Men-take-care-of-their-skin

Male Grooming Tips

International Male Grooming Day

This Friday, August 18th marks International Male Grooming Day, and we are talking people, not dogs.

Its not so long ago that a man who spent too long in the bathroom was met with scorn and suspicion. Thankfully, times have changed and male grooming is now acceptably mainstream. Even so, it is easy to feel confused by the overwhelming amount of advice, opinion and small pots full of expensive gloop aimed towards the male market.

Sneakily using your female partner’s skin care products may seem like a great idea, but there are a few important differences between male and female skin that mean you may get better results using a range specifically developed for men. Men’s skin is around 30% thicker and more robust than female skin, with a thicker outer layer (stratum corneum) that effectively reduces the absorption of active ingredients in skin care products. Male facial skin produces 75% more oil than female skin, making acne and skin conditions such as seborrhoeic dermatitis more common. Shaving makes the skin more sensitive and it is a good idea to avoid harsh chemical products if you are a regular shaving.

To clarify the male skincare process, we have broken it down into some essentials, but don’t panic – it is easier than you think.

The trick is to keep things simple – you don’t need to spend a fortune on a hundred different products, or spend hours locked in the bathroom.

All you need is a quick daily routine aimed at maintenance and protection, using a minimal number of products.

1. Cleanse

Give your face a thorough clean morning and night with a gentle, chemical free cleanser to wash away environmental dirt and dead skin cells. For a deeper clean that will also stimulate the growth of new skin cells, you can alternate this once or twice a week with an exfoliating scrub. (Ensure your scrub is environmentally-friendly and doesn’t contain polyethylene “microbeads”1)

2. Regenerate

After cleansing, apply a rejuvenating anti-ageing serum to boost skin immunity and strengthen the skin. With serums, less is more and only a small amount is needed. A good serum will perform a number of multi-tasking benefits such as increasing collagen production, repairing the skin’s barrier function, boosting natural hydration, controlling oil and soothing the skin.

3. Moisturise

Moisturiser is an absolute must, and using one that doubles as a sunscreen saves both time and money. Moisturisers formulated specifically for men are less likely to upset the oil balance of the skin and tend to have more masculine scents. Look out for the super ingredient niacinamide (vitamin B3), which is often added to moisturisers. Niacinamide boosts skin immunity, improves hydration, assists in collagen production, reverses UV damage, reduces hyperpigmentation and minimises inflammation2.

4. Stay Hydrated

Your skin needs moisture from the inside as well as the outside. Make sure you are downing enough water and keep tabs on how much caffeine and alcohol is going in, as both of these have a diuretic effect and can make you dehydrated. A lot of us think we only need water when it is hot or we are exercising but air conditioning and/or heating can draw extra moisture from the skin, so if you are spending a lot of time indoors don’t forget to keep your fluids up.

5. Get enough sleep

Whilst you are sleeping, your body has time to heal, renew and eliminate toxins from the skin. During the hours you spend asleep, your body’s hydration rebalances and there’s a rise in growth hormone as it repairs itself, allowing the skin to recover moisture and damaged cells to be repaired3. Getting the recommended 7-8 hours sleep on a regular basis will stave off the signs of ageing, give skin a greater ability to retain essential moisture and protect you from environmental stressors such as the sun’s rays and everyday pollution4.

6. Load up on fruit & veggies

Carotenoids (compounds that give fruit & vegetables a yellow/red colour) are powerful antioxidants that fight off free radicals, reducing the effects of inflammation, sun damage and ageing. Upping your dietary intake of fruits and vegetables by just 2 servings a day has been shown to improve the appearance of the skin within only 6 weeks5.

7. Ditch the cigarettes

Smoking decreases circulation and collagen production, so skin loses its natural colouring and a ends up looking sallow and pale. Studies of identical twins have revealed the visible difference that smoking makes to the ageing process6.

8. Avoid Aftershave

Aftershave lotions high in alcohol content will dry the skin, reducing the natural barrier function and leading to skin sensitivity. Look for an alcohol-free moisturising lotion instead or use aftershave behind the ears if you want the fragrance without the irritation.

9. Protect your lips

Normal sunscreen just won’t last on the lips as eating and speaking removes the product within minutes. Our harsh climate means that dry cracked lips are often the first signs of sun damage. Look for a lip balm with an SPF of 30+ for day time use, and then repair and protect with a healing (non-shiny) lip balm at night.

10. Step up to specialised products

Adding in a vitamin A serum at night will give you additional protection against the ageing process, reducing fine lines, wrinkles & pigmentation, as well boosting cell growth and improving skin tone. For the keen amongst you, using a home dermal roller for 5 minutes a night will increase the absorption of active ingredients through that thick outer skin layer by up to 80%.



1. https://www.thefactsabout.co.uk/plastic-microbeads—in-depth/content/251
2. Forbat E, Al-Niaimi F, Ali FR. “Use of Nicotinamide in Dermatology”, Clin Exp Dermatol. (2017) Mar;42(2):137-144
3. HR Colten and BM Altevogt, ‘Sleep Disorders and Sleep Deprivation’, National Academies Press, (2006)
4. ‘Esteé Lauder Clinical Trial Finds Link between Sleep Deprivation and Skin Aging’, University Hospitals, (2013),
5. Pezdirc K et al. “Can dietary intake influence perception of and measured appearance? A systematic review. Nutr Res. 2015 Mar;35(3):175-97
6. https://www.businessinsider.com.au/how-smoking-ages-the-face-of-identical-twins-2013-11?r=US&IR=T

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Melasma on forhead - treat hyperpigmentation

How to Treat: Hyperpigmentation

No matter the natural base colour of our skin, an even and consistent skin tone is universally associated with youthfulness and health.

Unfortunately, excessive patchy pigmentation of the facial skin is incredibly common, particularly in women with darker skin types who are naturally capable of making greater levels of melanin, the substance in skin that gives it a brown colour. Here we discuss a common type of pigmentation issue, what causes it and the most effective ways of controlling it.

“Melasma” is the medical term given to a common, benign skin condition characterised by symmetrical overly-pigmented patches with irregular borders, most often on the face.

The forehead, cheeks, upper lip and chin are the areas most likely to be involved.

The condition is caused by an overstimulation of melanocytes, which are the cells within the skin that produce melanin. These cells can be kicked into overdrive by sunlight and by hormones, specifically the female hormone oestrogen. Melasma is therefore most commonly seen in women who live in geographical areas that have a high degree of UV light, who are pregnant or on the oral contraceptive pill.

Although not medically harmful, the discolouration of the skin that occurs in melasma can be psychologically distressing. Many patients with melasma report feeling they look “dirty” or “old” because of the pigmentation patches. Whilst some are happy to cover the patches with makeup, others would like to remove the excess pigmentation and return their skin colour to a more even tone.

N.B. Not all brown patches on the skin are simple pigmentation, and some forms of skin cancer can present in a similar way. It is important to get your skin assessed by a doctor with experience in skin cancer diagnoses prior to starting any treatments or therapies targeted at pigmented patches.


There is usually no simple solution to melasma, but getting to grips with the complex mechanisms underlying the condition is fundamental to successfully controlling it.

The layers of human skin (diagram)

The diagram above represents human skin. Melanin pigment is manufactured by the melanocytes, which are situated along the basal layer, in the mid portion of the skin where the dermis meets the epidermis. The melanin is then transported down the spider-like arms of the melanocytes and moved over into a different skin cell, the keratinocyte. Keratinocytes migrate upwards through the layers of the epidermis as they mature, until they are shed from the stratum corneum, a process that generally takes around 6 weeks in facial skin.

It is helpful to think of the process underlying excessive pigmentation as having 3 stages:

  1. Production of melanin
  2. Transportation of melanin
  3. Retention of keratinocytes

Rather than addressing only one aspect of this pigmentation process, the most successful treatments for melasma are those that tackle all these stages:

Stage 1: Production of melanin

  • Pregnancy
  • Hormonal contraception
  • Sunlight

The most common ways in which melanocytes are overstimulated are through exposure to sunlight and to oestrogen. If melasma has been brought on by the higher oestrogen levels associated with pregnancy, the melanocytes will tend to continue their overproduction until delivery, after which the hormones settle back to their usual levels and the melanocytes will calm down, however the pigment may remain trapped in the keratinocytes of the upper skin layers.

Oral contraceptive pills that contain derivatives of oestrogen can also be a cause of melasma. Changing to a lower dose pill or to an alternative form of contraception can be helpful in some cases, and this should be discussed with your medical practitioner if it applies to you.

Ultraviolet (UV) light is a powerful stimulator of melanocytes and therefore exposure to UV should be avoided whenever possible. Daily sun protection in the form of sunscreen should be the first step in controlling the pigment production. The visible spectrum of sunlight is also involved in the stimulation and so sunscreen should be broad spectrum, preferably a physical barrier such as zinc or titanium, which will block out the visible as well as the UV light. The most recent generations of zinc-based sunscreens are easy to use, non-comedogenic and can deliver an SPF of >50. There is little point moving on to steps 2 and 3 if you are not cutting off the pigment stimulation at its source, and so when treating melasma in our clinic we insist upon a daily SPF of at least 30+ or higher.

Stage 2: Transport of melanin

As discussed above, the melanin that is made in the melanocyte factories is then moved away and into keratinocytes, which are a different type of skin cell. Keratinocytes migrate upwards and spread through the epidermis as they mature, until they arrive at the uppermost layer, the stratum corneum, where they sit until they are shed as part of the natural skin cycle. Preventing the melanin from entering the keratinocytes reduces the distribution of the pigment into the higher levels of the skin, making it less visible.

There are a number of compounds available in cosmetics, cosmeceutical or prescription creams that disrupt this transportation process. Some of these are listed below:

  • Hydroquinone
  • Retinoids (Vitamin A)
  • Ascorbic Acid (Vitamin C)
  • Niacinamide (Vitamin B3)
  • Kojic Acid
  • Tranexamic Acid

In addition, a variety of botanical products have been found to have alter to some extent both the production and transport of melanin, although many these have not been extensively studied, and therefore we do not know how effective they actually are. The more common of these agents seen in cosmeceutical products are:

Aloesin (isolated from Aloe vera) Marine algae
Arbutin (bearberry) Orchid extract
Boswellia (herb) Pycnogenol (pine bark, witch hazel bark)
Coffeeberry extract Resveratrol (red grapes)
Grape seed extract Silymarin (milk thistle)
Green tea extract Soy extract
Liquorice

Stage 3: Retention of keratinocytes

Once the melanin pigment has been transported into the keratinocyte cells, it will remain there until either natural shedding occurs (which may take many months), or the dead cells of the stratum corneum are targeted for removal by methods such as:

  • Topical vitamin A
  • Gentle dermabrasion
  • Chemical Peels – superficial/medium depth
  • Microneedling
  • Spot cryotherapy (light freezing of the skin surface)
  • Intense Pulsed Light (IPL)
  • Laser (Q-switched or picosecond)
  • Fractional Radiofrequency

Skin types that are prone to melasma are also prone to post-inflammatory hyperpigmentation, whereby inflammation in the skin kick starts the overproduction of melanin. All of the above treatments have a significant limitation in the management of melasma, in that they have the ability to cause inflammation of the basal skin layer, leading to the potential for rebound pigmentation or worsening of existing pigmentation. These treatments should be performed conversatively by practitioners that are well-trained and experienced in dealing with hyperpigmentation.

Although it may seem to have an initial benefit, any treatment that removes the pigment-loaded keratinocytes will be ineffective in the long-term unless the other steps in the pigmentation process are also addressed. Once the pigmented keratinocytes have been removed, unless the underlying stimulation of the melanocytes has also been eliminated, more pigment will inevitably form. Maintenance therapies are therefore as important as initial treatment, and non more so than daily application of a broad-spectrum, high SPF sunscreen 🙂

Contact Us for more information or to see how our team at The Skin Clinic Fremantle can help you with your skin concerns.

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Photo of smiling girl with glowing skin wearing a hat.

Winter Special Offer – 30% OFF!

A series of 3 x Enerpeel® chemical peels for just $630!
plus a FREE cosmeceutical pre-treatment home care kit from Synergie® (rrp $104)
SAVE $374

The cooler months are the perfect time to repair and strengthen the skin with a monthly chemical peel.

The 25% TCA peel by Enerpeel® uses a breakthrough technological formulation to minimise surface trauma and effectively rejuvenate the skin, with significantly less downtime than traditional peels. Ideal for fine lines, pigmentation and dullness, this peel promotes skin that not only looks fantastic but is stronger and healthier. The best results are achieved with the correct skin preparation, which is where the home-care kit comes in. Preparing the skin for a fortnight prior to each peel results in more even penetration of the peel and also a quicker recovery period.

Find out more about peels here >

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Photo of a ladies lower half with a flower.

Lets talk about vaginas..

Genital rejuvenation technology can revolutionise lives, yet most women who would benefit from it are not even aware that it exists……

Even in our current society of assessable digital information and public “oversharing”, talking about the vagina is still a social taboo. Unfortunately for those of use who possess a vagina, and for those who like to recreationally enjoy a vagina, the plump, well lubricated playground of our youthful 20s inevitably dries and shrivels as we get older, affecting intimate relationships, self-esteem and general well-being. Many of us put these problems down to simply “getting older” and do not realise that there is an effective treatment available.

When many of us hear the words ”genital rejuvenation” we think of surgical tightening of the vaginal or of surgical trimming of the labia. Whilst these procedures do exist (and have their place), the rejuvenation techniques that have the biggest lifestyle impact are actually aimed at turning back time, restoring the vaginal walls to their former plump, springy, well-lubricated existence.

When the vaginal walls reduce their secretion output, the vagina itself becomes dry and in some cases sex becomes uncomfortable, painful or even impossible. Vaginal secretions are packed full of a family of molecules known as glycosaminoglycans (GAGs), that serve as a food source for the healthy bacteria that live there. Without this food source the ecosystem down there is disrupted, opening the door for recurrent vaginal or urinary infections as well as chronic inflammation, burning and itching sensations. Another feature of the maturing female genital area is the development of urinary stress incontinence, a distressing and embarrassing condition that can have a major impact on social life, physical activities and even clothing choices.

A simple, quick and non-surgical procedure using a small laser probe can bring life back into the vaginal walls in the exact same way as laser facial rejuvenation.

The laser makes little “dots” in the lining of the vagina and the body’s natural healing response then stimulates the production of new collagen and elastin, rebuilding the skin of the vaginal wall and allowing secretions to flow once again. The whole procedure takes 5-15 minutes, is done in the same position as a PAP smear but is far less uncomfortable. Generally, an initial course of 3 treatments spaced a month apart is followed with an annual maintenance treatment. Patients report significant improvements as early as one month after the first treatment, most commonly a sensation of a tighter, better lubricated vagina with less urinary issues.

Women that can be helped by laser vaginal rejuvenation include those going through menopause (either natural or medication-induced such as after a hysterectomy or as a result of chemotherapy), those with postpartum vaginal laxity, minor urinary incontinence, or with symptoms of atrophic vaginitis and decreased sensation. Patients range in age from their early 20s up to their 80s, some of whom have been putting up with symptoms for many years.

Since we have been performing laser vaginal rejuvenation, we have found the biggest challenge for patients is getting the information that they need and becoming aware that a treatment does actually exist for troublesome vaginal issues, that it is safe, successful and pain-free. So please speak up, don’t be embarrassed – we would love to talk vaginas with you 🙂

More about MonaLisa Touch™ Vaginal Rejuvenation >

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Fresh fruits and vegetables

Adult Female Acne – what you need to know about lifestyle factors

A recent study published in the Journal of the American Academy of Dermatology has shed some light on risk factors for developing female acne in adulthood, and how these differ from the risk factors for adolescents. The researchers looked at environmental and personal factors in 270 women with adult acne (mean age 32.2yrs) and compared them to similar women without acne. These are the things they discovered are associated with acne in adult women, listed in order of highest to lowest risk:

  • A personal history of acne in adolescence
  • A family history of acne in parents
  • Hirsuitism (abnormal patterns of excessive hair growth)
  • Having a high degree of psychological stress
  • A low fresh fish consumption
  • A family history of acne in siblings
  • A low weekly fruit/vegetable intake
  • Working in an office rather than being unemployed or a stay-at-home mum
  • No previous pregnancies

Interestingly, unlike in adolescent acne, there was no association with a high intake of milk or with body mass index (BMI). They also found that acne in adult women was more likely to involve inflammatory lesions such as cysts and pustules, as opposed to comedomes (whiteheads), with 75% of the adult women in the study having inflammatory acne, with 30% of them having acne involving the trunk (chest or back).

Clearly, some of these risk factors are not adjustable, but correction of the lifestyle factors identified – particularly increasing the amount of fresh fish, fruit and vegetables consumed, may well be worth trying.

Reference: J Am Acad Dermatol 2016;75(6):1134–41

If you are an adult women suffering from acne and would like to talk to us about treatment options, including non-prescription options such as light therapy or biophotonics Contact Us to arrange an appointment.

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fat-freezing-bikini-belly-fat

What is Fat-freezing??

An insiders guide to Cryolipolysis.

One of the hottest treatments around at the moment, fat-freezing or “cryolipolysis” is an effective, non-invasive method of destroying fat cells. It works best on hard-to-shift pockets of fat that do not respond to diet and exercise but should not be used as a weight-loss technique.

How does fat freezing work?

We have known for a long time that by reducing the temperature of the fat layer in a controlled manner, it is possible to cause selective death of the adipose (fat) cells without harming the skin1, as fat cells are more susceptible than skin to temperature changes. Research has shown that cooling the fat tissue to between -8 and 10°c results in local controlled fat cell death and the release of cytokines and inflammatory mediators2.

The lipids from the fat cells are slowly released over the next few months and are transported by the lymphatic system to be processed and eliminated from the body, reducing the thickness of the fat layer. The loss of fat cells treated in this way is permanent3. Commercial cryolipolysis machines have been around since 2009 and have been shown to be safe & effective. With these devices, it is possible to target specific fat areas by using a vacuum action that sucks the skin into an applicator head. The powerful suction causes a temporary reduction to blood flow through the targeted area, making the fat cells easier to freeze.

Is fat freezing just hype or does it actually work?

Research into cryolipolysis technology has shown that the average fat reduction in a particular area is around 25% after one session4,5, although in real life, results can vary from person to person. Post-procedural massage has been shown to improve results6. For large amounts of fat it is possible to repeat the treatment more than once in the same area. Treatment outcomes can be seen by 2-3 months2, at which time a repeat treatment can be performed if required. There is published evidence to show that the results last for at least 5 yrs3 and it is probable that the effect is sustained beyond that period.

Whilst a reduction in localised fat has been well-documented following cryolipolysis, these non-invasive fat removal procedures do not achieve a significant amount of weight loss, or any improvement in visceral fat (internal fat around organs). They also do not improve the appearance of cellulite. If you are generally overweight, cryolipolysis is not going to make you drop kilos and you will probably be disappointed with the outcome. However, if you have a BMI of <30 with specific areas of fat that you would like to smooth out, and are willing to wait a few months to see results, then you could be an ideal candidate for treatment. A number of cryolipolysis devices are currently available which vary slightly in terms of their treatment parameters of suction strength and temperature. All are indicated for treatment of the abdomen, arms, flanks (muffin tops), thighs and knees.

Are there any contraindications?

Contraindications to cryolipolysis.

Like most medical and aesthetic procedures, there are some situations where it is not possible to use this technology. These include:

  • Pacemakers or heart valve replacements
  • Heart, liver or kidney disease
  • Arterial disease
  • Autoimmune conditions such as cryoglobulinaemia, paroxysmal cold haemoglobinuria or cold urticaria
  • Metal implants in the treatment area
  • Past history of keloid scarring in the treatment area
  • Epilepsy
  • Cancer
  • Pregnancy or lactation
  • Anti-coagulant drugs
  • Recent surgery in the treatment area

What are the down-sides to fat freezing

After cryolipolysis is it usual to have redness and possibly bruising in the treatment area, both of which can take 2 weeks to subside. It is also possible for the skin of the treated area to feel slightly numb for up to a month, although research has shown that the effect on the peripheral nerves is not permanent7. An uncommon (1 in 1500) side effect associated with treatment is severe shooting pain, although this is reported to resolve without any lasting effects after 1-4 weeks8.

There is no effect on blood fat levels or liver function9 and no reported systemic side effects to date. With the increase in popularity of cryolipolysis, the rare (1 in 20,000) side effect of “paradoxical adipose hyperplasia” has emerged10. This results in a delayed enlargement beyond baseline of the fat cells in the treated site. The reason for this remains unclear and there is no effective way to predict who will be at particular risk for this side effect, although it is more common in men.

What is a treatment like?

In general, the cryolipolysis procedure takes about 60 minutes per treatment area. Treatment times vary depending upon body site, type of machine and number of applications. Some of the newer machines in the market have double applicator heads, enabling 2 areas to be treated at once (i.e. both thighs, both muffin-tops, or both upper and lower abdomen), which has seen a significant reduction in the time taken to complete the treatment and therefore is more cost-effective for both the client and the clinic. Some machines have specific applicators for thighs and chins that are a different shape or size to the ones used for abdominal fat.

A glycerine pad is applied to the skin underneath the applicator head after which you simply lie back and relax for an hour. Some clients have a facial at the same time, others prefer to relax and listen to music or watch videos. In our experience, the suction should not be painful, although some clients experience a tickling or a sucking sensation. Surprisingly, the treatment does not actually feel cold, although the area will feel cold to touch for a short time afterwards.

How much does cryolipolysis (fat freezing) cost?

The cost varies according to machine type, number of applications and cost of consumables. At time of writing, average costs in Perth are around $850 per application area. We are able to offer cryolipolysis at $450 per application area as our machine has significantly less consumable and running costs than some of its competitors, with comparable results.
 
Read more about cryolipolysis here >


or Contact Us to Arrange Your Appointment
 

 


 
Author: Dr. Sarah Boxley MBBS BSc(Hons) MRCGP FRACGP FSCCA


1. Epstein EH Jr, Oren ME. Popsicle panniculitis. N Engl J Med 1970;282(17): 966–7
2. Manstein D, Laubach H, Watanabe K, Farinelli W, Zurakowski D, Anderson RR. Selective cryolysis: a novel method of non-invasive fat removal. Lasers Surg Med 2008;40(9): 595–604.
3. Bernstein EF. Longitudinal evaluation of cryolipolysis efficacy: two case studies. J Cosmet Dermatol 2013;12(2): 149–52.
4. Dierickx CC, Mazer JM, Sand M, Koenig S, Arigon V. Safety, tolerance, and patient satisfaction with noninvasive cryolipolysis. Dermatol Surg 2013;39(8): 1209–16.
5. Krueger N, Mai SV, Luebberding S, Sadick NS. Cryolipolysis for noninvasive body contouring: clinical efficacy and patient satisfaction. Clin Cosmet Investig Dermatol 2014;7: 201–5.
6. Boey GE, Wasilenchuk JL. Enhanced clinical outcome with manual massage following cryolipolysis treatment. A 4-month study of safety and efficacy. Lasers Surg Med. 2014;46(1): 20-26
7. Coleman SR, Sachdeva K, Egbert BM, Preciado J, Allison J. Clinical efficacy of noninvasive cryolipolysis and its effects on peripheral nerves. Aesthetic Plast Surg 2009;33(4): 482–8.
8. Dover J, Saedi N, Kaminer M, et al. Side effects and risks associated with cryolipolysis. Annual Meeting of the American Society for Laser Medicine and Surgery, 2011; Grapevine, TX
9. Klein KB, Zelickson B, Riopelle JG, Okamoto E, Bachelor EP, Harry RS, Preciado JA. Non-invasive cryolipolysis for subcutaneous fat reduction does not affect serum lipid levels or liver function tests. Lasers Surg Med. 2009;41(10): 785–90
10. Jalian HR, Avram MM, Garibyan L, Mihn MC, ANderson RR. Paradoxical adipose hyperplasia after cryolipolysis. JAMA Dermatol. 2014;150(3): 317-9

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Important Notice – Until 23 Sept ’16

If you have an appointment at our clinic between Monday 29th August and Friday 23rd September 2016, please be advised that there will be extensive works being carried out on the front of our building and entrance via the front of the building will likely be blocked during this period.

The map below shows how to access the clinic via the car park on Leake Street. Please look for The Skin Clinic sign board at the rear of the carpark, showing the way to the back door. When entering, please proceed down the corridor and turn left, walk down this corridor and you will arrive at The Skin Clinic.

At times there will be access but we will not have advance notice of this. Please contact us on the morning of your appointment if you wish to know about access on that day.

We apologise for the inconvenience. If you have any concerns regarding this please contact us on 9336 3066.

See you soon!

Map of access during roadworks

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Saturday Skin Checks Fremantle

Saturday Skin Checks

Autumn and winter are the ideal time of year to get your skin checked, and often the best seasons to undergo any necessary treatment whilst the UV levels are slightly lower and less time is spent outdoors. We appreciate that it is difficult to fit everything in when you work full time and preventative health care can be easily sidelined. With that in mind, we have an additional skin cancer doctor joining us who will be available for skin cancer checks on Saturday mornings as well as during the week.

Dr. Alan Cryer has a wealth of experience and qualifications in primary-care skin cancer. His Saturday clinic appointments will be preferentially for patients who are unable to come for a check during normal working hours. So if you work 9-5, work shifts, or struggle with childcare during the week, one of these slots may be ideal for you.

Appointments can be made online or by calling the clinic on 08 93363066

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Mothers Day Gifts

Mother’s Day 8th May

Treat your mum to a Mother’s Day Gift Voucher Pack!

Spoil your mum for Mother’s Day with this very special offer from The Skin Clinic Fremantle. This 2-part Gift Voucher can be downloaded by you or sent straight to your mums inbox. It includes a Hydrafacial Facial Treatment, after which your mum will receive a Synergie LipService to take home.

All for just $160! (Purchased separately this pack is valued at $202.)


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woman applying cream

Focus on Vitamin A

Vitamin A is often found in skincare products in its various forms to address photoageing of the skin.

Cosmeceutical preparations tend to use retinol, which is gentler and less irritant, whereas prescription strength creams/gels use tretinoin/retinoic acid, which is more effective but can be harsher on sensitive skin. Makers of the non-prescription creams and gels don’t have to say how much retinol their products contain, and in the short term, the products might not be as effective as tretinoin.

Cosmeceutical vitamin A preparations will however smooth out the skin and minimise the effects of sun damage, although generally, it can take about 3 to 6 months of daily use to notice a difference. With prescription retinoids, a patient might notice smoother, more even-toned skin in as early as 6 to 8 weeks. Before recommending a particular vitamin A preparation, we always take a full skin history and examine the skin to determine which would be most appropriate for an individual patient.

What is photoageing?

Photoageing is a term used to describe the visible changes in skin that we see over time due to a cumulative lifelong exposure to UV radiation, specifically to UVA.

The uppermost layer of the skin (stratum corneum) becomes thicker, giving the skin a dull, rough texture. The pigment in the skin becomes abnormally distributed, leading to freckles and “liver spots”. Wrinkles start to appear in the skin, initially under the eyes and on the cheeks, and pores become visibly more noticeable. As photoageing progresses, the wrinkles become more marked and the skin develops a thick leathery appearance, often with a yellowish tint. In some patients, the skin can develop a pebbly texture with scattered open comedones (blocked pores).

photo-ageing

How does vitamin A affect photoageing?

Retinoids work in a number of ways to reduce and reverse the clinical signs of photoageing. They prompt surface skin cells to turn over and die rapidly, making way for new cell growth underneath. They hamper the breakdown of collagen and thicken the deeper layer of skin where wrinkles get their start. Retinoids will not thin the skin – they typically cause peeling and redness in the first few weeks of use, but they actually thicken the skin. For brown spots that give the skin an uneven tone, retinoids slough them off and curb the production of melanin, a darker pigment.

Clinical Action of vitamin A (retinoids) – what happens within the skin

Visible Effect of vitamin A (retinoids) – what improvement is seen

Thins and compacts the stratum corneum Smoother, softer skin texture
Thickens the epidermis Tightening of the skin
Reverses keratinocyte atypia (skin cells containing abnormal DNA from repeated UV damage) Improves or eradicates actinic keratoses (“sunspots”)
Disperses melanin throughout the epidermis Improves blotchy hyperpigmentation
Stimulates dermal collagen deposition Increases dermal volume and tightens the skin
Increases glycosaminoglycan (GAG) deposition Increases dermal hydration and tightens the skin
Increases neovascularization (growth of new blood vessels) in the dermis Gives a pinker rosy hue to the skin

Preventing further damage

When using any active vitamin A product, it is important to stop, or reduce, ongoing photoageing. It makes little sense to improve the quality of the skin and then subject it to further damage from chronic ultraviolet (UV) light exposure.

Complete avoidance of sunlight for several years can actually reverse some histological signs of photoageing as the skin has the ability to repair itself if it is protected from continual photodamage.

In Australia total sun avoidance is difficult if not impossible for most people. Therefore we must settle for the next best thing – sun protection. The concept of sun protection encompasses sun protective clothing (including hats) and sunscreens.

The easiest to use and most reasonable protection for most people is sunscreen. Sunscreen should be worn every day, whether the person is outdoors a little or a lot. Because UV damage is cumulative in its effects, the prevention of even small daily amounts of sun damage over a long period of time can have a profound impact on the total amount of UV-induced damage.

Synergie Ultimate A

About Synergie Vitamin A Serum

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