The Skin Clinic Fremantle | Dr Sarah Boxley


  Contact : 08 9336 3066

All Posts in Category: News

Understanding different moisturisers

There is a lot of confusion out there in what to look for in a moisturiser. Not all moisturisers work in the same way or are ideal for all different environmental conditions. This is a very basic summary to try and explain the two main types of moisturiser: Emollients and Humectants…

Emollients:

Many people use the terms “moisturiser” and “emollient” interchangeably, though typically an emollient describes a particular ingredient inside a finished moisturiser.

Emollients are used to soften and smooth the scales of the outer layer of skin (stratum corneum). They can be useful in helping reduce rough, flaky skin.  They are also occlusive agents: substances that provide a layer of protection to help prevent moisture evaporation from the skin, aka transepidermal water loss (TEWL).

A few examples of emollients are vegetable oils (grape seed, sesame seed, jojoba, etc.), butters (cocoa butter, shea butter), alcohols (stearyl alcohol, cetyl alcohol), silicones (dimethicone, cyclomethicone), and petrolatum derivatives (petroleum jelly, mineral oil).

Use an emollient directly onto damp skin after a shower to lock moisture in.

Humectants:

A humectant is a substance that actually bonds with water molecules to increase the water content in the skin itself. Humectants typically draw water into the skin from a humid environment, and they enhance water absorption from the outer layer of skin. However, a pure humectant moisturiser applied to the outside of the skin in a very dry environment will not be able to draw water from the atmosphere (as there is none) and so will suck water from the deeper layers of the skin instead. Whilst this may make the top layers of skin seem temporarily more hydrated, ultimately the deeper layers will be deprived of moisture and so the skin overall can become dryer.

Glycerin is one of the more typical and effective water binding agents found in skin care products.  Other humectants include sugars (glucose, fructose, sucrose, honey), hyaluronic acid, proteins, amino acids, elastin, and collagen. Lactic acid, which is one of the alpha-hydroxyacids (AHAs), is known for its moisturising properties as well as its ability to exfoliate. Whilst most AHAs can increase the skin’s ability to trap water due to an increased production of natural hyaluronic acid, good old lactic acid’s additional humectant properties make it ideal for treating dry skin. 

A bit more info on hyaluronic acid, which is being used more and more in skincare over the last few years for increasing hydration and reversing cell damage: Hyaluronic acid (HA) is a natural moisturising factor (NMF) found in the deeper skin layers. Referred to nature’s ‘super moisturiser’, this substance is able to hold 1000 times its weight in water and when applied topically it will attract moisture to the outermost layers of skin. This plumps those layers and temporarily reduces the appearance of wrinkles and fine lines. However, remember to be wary of using HA topically in very arid or air conditioned environments for the reasons stated above. In these situations you could consider injectable moisturiser directly to the dermis, with an emollient topically to prevent TEWL. 

Many humectant’s also have emollient properties, while not all emollients are humectants. The best moisturisers have a combination of emollients and humectants. 

Who needs moisturiser?

The requirements of our skin for moisture changes as we age. The skin naturally alters as we get older – the dermis, where collagen and elastin are predominant, gets thinner, whilst the stratum corneum, the thick horny outer layer of the epidermis, gets thicker. As a generalisation, by the time we are 70 years old, our skin only holds 20% of the moisture that it did when we were 20. Using regular and effective topical moisturisers from our early adulthood can reduce this moisture loss and slow down the natural ageing processes of the skin, as well as protecting the skin from additional environmental stresses. 

Moisturisers and acne:

Patients with acne are often hesitant to use a moisturiser as they believe this will clog their pores, increase their oil production and make their acne worse. However, even acneic skins need moisture and will in fact function better and be less inflamed if they are well hydrated. A light, non greasy, non-comedogenic moisturiser is suitable in this situation – we usually recommend either Hydrogel or BrightEnlite from Synergie, or NMF by The Ordinary.  Hydrogel is a lightweight noncomedogenic moisturising gel fortified with cosmeceutical botanicals and hyaluronic acid, great for those with oily skin and enlarged pores and for skin exposed to high levels of humidity.

Can my moisturiser do more?

Many modern moisturisers come mixed with other active ingredients to target different skin concerns. This is where it can get complicated. We would always recommend discussing your own skin’s requirements with a professional prior to spending money on skincare. If you are someone who has a bathroom cabinet crammed with costly products that promised miracles but don’t seem to deliver, then it may be worth a few minutes with a Dermal Therapist to design a tailored skincare regime.

My personal choices? As a middle-aged woman with naturally dry skin who spends most of my life either in air conditioning or outdoors in the harsh Perth climate, my personal choice for moisturiser is the lightweight but super hydrating and soothing MSM cream (MooGoo) twice a day. In the mornings, I follow this with UberZinc (Synergie Skin) – an antiageing moisturiser with 21% pure zinc oxide to give me effective UVA/B protection. As a body moisturiser I love Solarcare (Bernier pharmaceuticals) – a light but effective mixture of emollients and humectants with the addition of 5% niacinamide (vitamin B3) to fight environmental damage and reverse signs of ageing. 

*we do stock all the above products in the clinic but they are also easily available either online or at local pharmacies in Australia*

Would you like personalised skincare advice? Make an appointment with one of our Dermal Therapists here

Read More

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
Read More
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

Read More
Kate & Abel Hat Giveaway

Giveaway for National Skin Cancer Action Week

Image by @makersportraitperth

Awesome hat giveaway for National Skin Cancer Action Week | November 19-25 2017

WIN A HAND-FINISHED BESPOKE HAT FROM @kateandabelperth Valued at $165!!

Some scary statistics:

With two in three Australians diagnosed with skin cancer by age 70, and more than 2,000 people in Australia die from skin cancer each year. The Cancer Council estimates that Australia spends more than $1 billion per year treating skin cancer, with costs increasing substantially over the past few years.

Yet most skin cancers can be prevented by the use of good sun protection.

Each year Cancer Council Australia and the Australasian College of Dermatologists come together for National Skin Cancer Action Week, which in 2017 runs from 19th to 25th November. This year, to encourage Australians to remember to use the five forms of sun protection, the Cancer Council are inviting everyone to join the #SunSmartGeneration.

Today’s children have grown up with the SunSmart message and are our most sun savvy generation ever. Parents understand the importance of protecting their little one’s skin with rashies, hats, sunglasses, shade and sunscreen, and yet they frequently neglect their own skin and sun protection. It’s never too late to prevent further damage and parents play a hugely important role in setting a good example for their kids.

That’s why this National Skin Cancer Action Week, Australians of all ages are urged to use the five forms of sun protection. These are to:

  • slip on sun-protective clothing
  • slop on SPF30 (or higher) broad-spectrum, water-resistant sunscreen
  • slap on a broad-brimmed hat
  • seek shade
  • slide on sunglasses.

A combination of these measures, along with getting to know your skin and regularly checking for any changes, are the keys to reducing your skin cancer risk.

Many folk tell us that they struggle to find a hat that suits them, fits them, or compliments their style. Which is why, to help our lovely patients out with their own slipslopslap mission, this November The Skin Clinic Fremantle shall be GIVING AWAY a fabulous hand-finished, bespoke hat worth $165. Kate and Abel are a local company, based right here in the Many 2.0 Project in Fremantle, who have achieved international success with their one-of-a-kind hats. Whether you are male or female, young or old, big headed or small, they should be able to find the perfect fit for you.

How to enter

Entering is simple: any patient that comes to us for a skin cancer check during the month of November will be automatically entered into the draw. The winner will be picked at random on 1st December and notified via email and/or phone. Be a role model for your kids, join the #SunSmartGeneration 🙂

Read More
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.

Read More
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

Read More
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 >

Read More
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

Read More
Merry-Christmas-Skin-Clinic-Fremantle

Christmas & New Year Opening Hours

It has been a truly wonderful year!

The Skin Clinic will be closed for a break over the Christmas period from 23rd December, and will re-open on 4th January for an even bigger and brighter 2016.

We wish you all a very restful and happy holiday with lots of love and laughter.

Stay safe in the sunshine. See you all next year!

Read More