The Skin Clinic Fremantle | Dr Sarah Boxley


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Ingredient focus: Lycopene

What is lycopene and why should we be using it on our skin?

Lycopene is the bright red carotene pigment and phytochemical found in red fruits and vegetables, such as tomatoes & red carrots, watermelons and papayas.

It is a powerful antioxidant and anti-inflammatory – helping protect skin from environmental agents that can contribute to clogged pores and breakouts. Most importantly for long-term skin health, it can help protect against sun damage. Studies have indicated that lycopene helps protect fibroblasts (skin cells that make collagen) & eliminate skin-ageing free radicals caused by ultraviolet rays, both UVA and UVB.

Lycopene accounts for a whopping 90% of the colour of tomatoes. As an antioxidant it is twice as effective as beta-carotene and 10 times more than alpha-tocopherol (vitamin E). Our favourite anti-ageing cosmeceutical skin product – Superserum+ by Synergie, contains lycopene sourced from hydrolysed tomato skins.

Lycopene is a relatively new product from a commercial point of view and recently it has been added to fortified foods such as yoghurt and drinks.

Can the lycopene in your diet actually help your skin?

Although the absorption via diet is still being researched, the current evidence indicates that lycopene is absorbed in the intestine and then distributed to the liver and kidneys. It appears to be excreted into the skin via sweat glands, therefore the lycopene from your diet tends to accumulate on specific regions such as forehead, nose, chin, palms etc. A small study on healthy volunteers showed that a 10-week lycopene-rich diet improved the minimal erythemal dose by 40% compared with the control group. (Minimal erythemal dose is essentially the amount of UV radiation needed to turn the skin pink) NB: Watermelons are NOT a substitute for sunscreen!

Could your skincare be delivering more than your diet?

Back to cosmeceutical skincare: Hydrolysation of tomato skins stabilises the lycopene. Once it is stabilised, it can be distributed evenly and homogeneously across the skin. It’s a clever little ingredient, naturally sourced, that boosts our skin’s ability to protect itself. “Clean science” in action. Find it in these Synergie products: SuperSerum+, Practitioner A+, BB-Flawless makeup.

 

Interesting fact: although lycopene is chemically a carotene, it has no vitamin A activity. 

 

References:
Synergie Skin Hydrolysed tomato skin (lycopene) clinical data
Furr HC, Clark RM Intestinal absorption and tissue distribution of carotenoids Nut Biochem 1997 8:364-377
Fazekas Z et al. protective effect of lycopene against ultraviolet B-induced photo damage. Nut and Cancer 2003 47(2) 181-7
Stahl W et al. Dietary Tomato Paste Protects against Ultraviolet Light-induced Erythema in Humans J Nutrition 2001
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image of a young woman applying sunscreen to her face in the morning

Sunscreen: When should you use it?

 

Research from The Cancer Council’s recent National Sun Protection Survey show that nearly one in two Australians mistakenly believe that sunscreen can’t be used safely on a daily basis. 

For some years now, we have been advising our patients about the daily use of sunscreen here in Perth. We have been very pleased to see that in the last few weeks, the peak bodies responsible for sun safety advice in Australia and New Zealand have published an updated policy on sunscreen use, which makes our advice not only evidence-based but now also the accepted recommendation in this country.

The advice is now simple: make sunscreen part of your morning routine, just like brushing your teeth.

The national policy change has come about following a national Sunscreen Summit in Brisbane last year, that examined the current evidence on sunscreen use, and was published at the end of January in the Australian and New Zealand Journal of Public Health. The publication, led by Professor David Whitman and Associate Professor Rachel Neale from QIMR Berhofer Medical Research Institute, shows that there is now clear evidence on the benefits of daily sunscreen use.

As Associate Professor Neale explains “up until now, most public health organisations have recommended applying sunscreen ahead of planned outdoor activities but haven’t specifically recommended applying it every day as part of a morning routine,”

“In Australia, we get a lot of incidental sun exposure from everyday activities such as walking to the bus stop or train station, or hanging out washing.

“In recent years, it has become clear that the DNA damage that causes skin cancer and melanoma accumulates with repeated small doses of sunlight.

“At last year’s Sunscreen Summit, we examined all of the evidence around sunscreen use and we have come to a consensus that Australians should apply sunscreen every day when the maximum UV level is forecast to be three or higher.”

“For much of Australia, that means people should apply sunscreen all year round, but in areas like Tasmania and Victoria there are a few months over winter when sunscreen is not required.”

Facts you need to know:

  • Australia has one of the highest skin cancer rates in the world.
  • Research shows undoubtedly that sunscreen helps prevent skin cancer, including the deadliest form, melanoma.
  • There is consistent and compelling evidence that sunscreens are safe for human use
  • Adverse reactions such as allergies occur in a very low proportion of the population
  • Clinical trials have found that people who use sunscreen daily have the same levels of vitamin D as those who don’t.
  • The recommendation to apply sunscreen every day is to protect against the little bits of incidental UV exposure that most of us get each day, that cause damage over time.
  • Sunscreen is not a suit of armour – if you are planning outdoor activities you should also seek shade, wear a hat, protective clothing and sunglasses, and reapply your sunscreen every 2 hours.
  • Regular skin checks can save lives  – get your skin checked annually by your GP, a Skin Cancer Clinic (a list of accredited doctors can be found here) or a Dermatologist.

So what is the NEW RECOMMENDATION?

Sunscreen* should be applied and used regularly:

  • During everyday activities which add up over time (e.g. travelling to and from work; doing household chores; shopping etc)
  • During any planned or prolonged outdoor activities (e.g. doing outdoor work; gardening; playing or watching sport; going to the pool or beach; exercising outdoors etc)
Sunscreen for everyday activities

When the UV index is forecast to reach 3 or above, it is recommended that sunscreen is applied every day to the face, ears, scalp if uncovered, neck and all parts of the body not covered by clothing. Ideally, this would form part of the morning routine. This protects the skin from the harmful effects of everyday sun exposure.

Sunscreen for planned or prolonged outdoor activities

During planned or prolonged outdoor activities, for the best protection it is recommended that sunscreen is used along with other sun protection measures (i.e. clothing to cover as much of the skin as possible; hats; sunglasses; shade and scheduling outdoor activities to avoid the middle part of the day).

When the UV index is forecast to reach 3 or above, sunscreen should be applied to the face, ears, scalp if uncovered, neck and all parts of the body not covered by clothing.

Sunscreen should be re‐applied every 2 hours or more frequently if swimming, sweating or towel drying.

Sunscreens should not be used to promote tanning, but rather as one of five strategies (along with shade, hats, clothing, sunglasses) to reduce exposure to harmful UV radiation.

So, based on the average daily maximum UV index, residents in Australia’s capital cities should apply sunscreen daily in the following months:

Brisbane, Perth & Darwin

All year round

Sydney

Every month except June

Canberra & Adelaide

Every month except June & July

Melbourne

Every month except May, June & July

Hobart

Every month except May-August

 

*“sunscreen” means sunscreen with an SPF of 30 or more and compliant with Australian/New Zealand Sunscreen Standard AS/NZS 2604:2012.

To read the full recommendation “When to apply sunscreen: a consensus statement for Australia and New Zealand” click here

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make up brush on pink background at the skin clinic fremantle

Make-up and dermal filler procedures – what is the problem?

Make-up brush applicator on pink background. The Skin Clinic Fremantle

Do you ever wonder why we ask you to remove your make-up when you come in for a dermal filler procedure with us?

Quite simply, both your makeup and indeed your own skin are an infection risk. There is increasing evidence that the complications of dermal fillers that were once thought to be caused by our own immune system are in fact due to infection. The most likely time for introduction of infection is at the time of injection1,2.

 

Bacteria on Skin

It has been estimated that 30–50 million bacteria can be found on each square inch of human skin. The majority of these are normal, friendly microbes, and if they remain on the outside we have no problems. The skin and mucous membranes are the body’s protective barriers. Breaching these barriers (eg with a needle or a scalpel) can introduce those bacterial into the subcutaneous tissue, muscle, bone and body cavities.

We know that most surgical site infections originate from the patient’s own bacteria entering the wound at the time of surgery3. Dermal filler procedures involve multiple passes of a needle or cannula from skin to bone, so disinfection of the skin before the injection of a filler is absolutely crucial in reducing the risk of microbial contamination. If bacteria is introduced into the body with the dermal filler at the time of injection, it can use the filler substance as a food source and slowly multiply, potentially leading to the onset of lumps and hardening of the filler, and even to abscesses. Reducing the number of bacteria on the entire face, not just the site of injection, will reduce the risk of a patient developing an infection-related complication4,5,6,7.

We therefore need to thoroughly clean and disinfect your skin before and during your filler procedure. Logically, in order to do that we need to remove your makeup.

Bacteria in Makeup

Also, in addition to simply getting in the way, the makeup itself is potentially an infection hazard8. In a small study in 2015, items of out-of-date make-up were tested under strict laboratory conditions. All tested positive for enterococcus faecalis, a deadly strain of bacteria that can cause meningitis and septicaemia9. Other bacteria that were found growing in the make-up and their potential health risks include9:  

  • Ubacterium: causes bacterial vaginosis
  • Aeromonas: one of the causes of gastroenteritis and wound infections
  • Staphylococcus epidermidis: a bacterium which is resistant to antibiotics and can be deadly to people in hospital or who have catheters or surgical implants
  • Propionibacterium: one of the main causes of acne and other skin conditions
  • Enterobacter: causes urinary and respiratory tract infections

 

Make-up and photography

Makeup also interferes with our photography system – we can’t get reliable before and after photos when patients are wearing full contouring foundation, and the filters we use to highlight UV damage, vessels and wrinkles can’t see through the makeup.

 

At The Skin Clinic Fremantle

As dermal filler procedures become more and more popular, and access to them easier and easier, we find ourselves increasingly reminding patients that these are not beautician treatments. The injection of a foreign substance (that is going to last for months/years) into your face is a medical procedure and it should be treated as such.

Patient safety and outcomes are our paramount concern and so yes, despite our patients finding it inconvenient at times, we will insist on total make-up removal and thorough skin disinfection prior to dermal filler procedures.

Thank you for your understanding, Dr. Sarah 🙂

 

References

1. De Boulle K, Heydenrych I. Patient factors influencing dermal filler complications: prevention, assessment, and treatment. Clin Cosmet Investig Dermatol. 2015;8(8):205–214.

2. King M, Bassett S, Davies E, King S. Management of Delayed Onset Nodules. J Clin Aesthet Dermatol. 2016;9(11):1–5.

3. Ayliffe GA. Role of the environment of the operating suite in surgical wound infections. Rev Infect Dis. 1991;13(Suppl 10):S800–804 

4. Heydenrych I, Kapoor KM, De Boulle K. et al. A 10-point plan for avoiding hyaluronic acid dermal filler-related complications during facial aesthetic procedures and algorithms for management. Clin Cosmet Investig Dermatol.  2018 Nov 23;11:603-611

5. Signorini M, Liew S, Sundaram H. et al. Global Aesthetics Consensus: avoidance and management of complications from hyaluronic acid fillers—evidence and opinion-based review and consensus recommendations. Plast Reconstr Surg. 2016;137(6):961e–971e.

6. Wagner RD, Fakhro A, Cox JA, Izaddoost SA. Etiology, prevention, and management of infectious complications of dermal fillers. Semin Plast Surg. 2016;30(2):83–86.

7. Ferneini EM, Beauvais D, Aronin SI. An overview of infections associated with soft tissue facial fillers: identification, prevention, and treatment. J Oral Maxillofac Surg. 2017;75(1):160–166.

8. Collier H. Infection control in aesthetic medicine and the consequences of inaction. J Aesth Nursing 2018; 7(7): 352-361

9. Matewele P. Out of date make up can contain lethal bacteria, London Met scientist finds. 2015. https://tinyurl.com/ybuat6o5

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young-teen-with-excessive-sweating

New Research reveals that 1 in 5 teens experience excessive sweating

Nearly 1 in 5 teens experience excessive, uncontrollable sweating.

Of those, 75% say it impairs daily life. 🙁

According to data presented by International Hyperhidrosis Society researchers at the recent American Academy of Dermatology’s (AAD) 2017 Annual Meeting, 17% of teens experience excessive, uncontrollable sweating!

That’s at least SEVEN TIMES MORE teens than previous estimates that put prevalence statistics at only 1.6% to 2.1%!

Additionally, the International Hyperhidrosis Society study found that among those teens affected by excessive sweating:

  • 75% indicate daily impairment from sweating is major or moderate.
  • More than 25% reported onset at or before age 10.
  • Average reported age of onset is 11 years.

Dr. Adelaide Hebert, co-author of the research abstract, founding board member of the International Hyperhidrosis Society, President of the Women’s Dermatologic Society, paediatric dermatologist, and professor at the UTHealth McGovern Medical School presented the data at the AAD meeting.

“Our results,” she says, “show a far greater need than previously recognized for the accurate diagnosis and effective treatment of excessive sweating in teens and children. The teen and pre-teen years are an important time in young people’s development of self-concept; helping them to thrive includes the appropriate management of impactful health conditions – like excessive sweating.”

There are a number of options available to control or treat excessive sweating when simple anti-perspirants fail to help. Neuromodulator injections to the underarm area can temporarily interrupt the nerve signals to the sweat glands, resulting in decreased sweating from the armpit for an average of 4-6 months at a time. Microwave ablation to the underarms can permanently reduce the number of sweat glands, resulting in long lasting sweat reduction. This treatment can be easily performed for teenagers that meet the clinical criteria. Sweating of the hands and feet can be improved with non-invasive simple electrical current therapy known as iontophoresis.

Read the full report from the International Hyperhidrosis Society here >

If you, or a family member are affected by excessive sweating, contact us today to see what options are available to help.

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What Clinic Award Badge

The Skin Clinic Fremantle rated ‘Best for Service’

The Skin Clinic Fremantle has been recognised with an annual award based on patient service excellence ratings from healthcare search engine WhatClinic.com.

WhatClinic looked at 12 months of data from users of its site in relation to The Skin Clinic Fremantle, including patient review scores, feedback data and clinic contact rates. In 2016 over 17 million people visited the comparison site to find and compare clinics.

The Skin Clinic Fremantle was only one of a small number of clinics on the site that met the exacting standards needed to qualify for the award. Not only must the clinic have a consistently high ServiceScore™ rating to qualify, the rating measures the clinic’s commitment to customer service over a whole year, and so represents long term commitment dealing with patients. Less than 2% of clinics on the site qualified for the award this year.

We are delighted to be recognised for our commitment to customer service. As a practice, it is something we focus on in everything we do and to receive such positive feedback from our patients is great…

-Dr. Sarah Boxley, Medical Director of The Skin Clinic Fremantle.

WhatClinic.com CEO Caelen King congratulated the team at The Skin Clinic Fremantle and said “Our awards are now in their 7th year, and this year, for the first time – we have made the ratings data that we use to calculate awards visible on our listings. Ratings are useful to both consumers and clinics. Consumers can see which clinics have rated well with lots of other users, and Clinics can evaluate their own performance against others in their market, ideally with the goal of getting better and better at serving their patients, which is ultimately good for everybody”.

“We believe that by giving consumers as much information as possible that we can improve private healthcare services for everyone. With these awards we honour clinics that are dedicated to the highest level of customer care and consistently putting the patient at the heart of what they do.”


Awarded by
WhatClinic.com

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Young boy applying sunscreen to his face

Update on the use and safety of zinc & titanium in sunscreen

Zinc oxide (ZnO) and titanium dioxide (TiO2) are highly effective UV filters and have been used as ingredients in sunscreens for over 30 years.

However, in their macroparticulate (bulk) form in sunscreens, they are visible on the skin as an opaque layer, which discourages consumers from their use. Sunscreen manufacturers have attempted to address this undesirable visual effect by decreasing the particle size of these metal oxides to the much smaller nanoparticle (NP) form. When used in this NP form, these oxides retain their sunscreen properties but cannot be seen on the skin.

These nanoparticles of ZnO and TiO2 are particularly useful in sunscreens because of their ability to filter both UVA and UVB, providing broader protection than any other sunscreen agent. However, concerns understandably have existed as to whether the small particle size of the NP oxides are able to penetrate the skin to reach viable cells, and if so, whether they have any potential toxicity.

The Australian Therapeutic Goods Administration (TGA) continuously monitors the emerging scientific literature in this area and works cooperatively with international regulatory agencies to ensure that appropriate regulatory action is undertaken if any unacceptable risk of harm/toxicity is identified. A review on these issues was first published by the TGA in 2006, updated in 2009, 2013 and now again in 2017.

Key points from the 2017 updated review include:

  • There is conclusive evidence from in-vitro studies that in the presence of UV light, both ZnO and TiO2 NPs can induce reactive oxygen species (ROS) that have the capacity to damage cellular components of the skin.
  • The current weight of evidence suggests that TiO2 and ZnO NPs do not reach viable skin cells (even in compromised skin) or the generally circulation, but remain on the skin surface and in the outer layer of the stratum corneum, a surface layer of non-viable keratinised cells. It is therefore highly unlikely that if sunscreens are used as is intended, NPs from sunscreen applied to the skin will not achieve significant concentrations in the systemic circulation.
  • Since, the compounds are not absorbed through the skin, it is highly unlikely that NPs can induce the cytotoxic responses or pathological outcomes found in the in vitro or animal studies, respectively.

    The data from the reviewed in vitro experiments should be interpreted with caution given that the findings from studies conducted in cell lines are of limited value in assessing the potential toxicity NPs pose to humans from topically applied sunscreens. Similarly, the limitations of the reviewed animal studies, where NPs were administered at relatively high concentrations through exposure routes that are not relevant in the context of sunscreen use and at high frequency, should also be acknowledged.

    Given the majority of studies found no evidence of skin penetration of NPs when applied dermally, it is highly unlikely that the high systemic NP concentrations attained in these experimental animals would be achieved in people, even if accidental intake occurred via these non-dermal routes. Therefore, any deductions made regarding the safety of topically applied sunscreens in humans by extrapolating these findings in animals to humans, are of limited value.

On current evidence, neither TiO2 nor ZnO NPs are likely to cause harm when used as ingredients in sunscreens.

The current state of knowledge strongly indicates that the minor risks potentially associated with NPs in sunscreens are vastly outweighed by the benefits that NP-containing sunscreens afford against skin damage and, importantly, skin cancer.

Find out more >

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hand ageing treatment

Focus on Hand Ageing

“Believe me, you can hide a lot of things, but the hands always give it away,” – Joan Rivers

The telltale signs of ageing not only include crow’s feet and grey hair, but also older looking hands – the kind of hands with skin that just doesn’t bounce back anymore when you pinch it.

Over time the backs of our hands lose volume, making the veins and ligaments appear more prominent. The skin becomes loose and crepey and the harsh effects of the sun cause brown marks and rough spots. However, don’t give up just yet as there are plenty of thing you can do to slow down hand ageing and even reverse the ageing process of your hands.
 


Hand Ageing | Here are our top tips for younger-looking hands:

 


Take action now


UV protection


Moisturiser


Anti-ageing treatments for your hands


Chemical peels


Dermal fillers


 

Peel away the summer with our Hand Ageing promotion >

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