At FACE 2015 (Facial Aesthetic Conference And Exhibition) I went to many extremely interesting lectures on the latest aesthetic developments. However, the highlight for me was a question and answer session on topicals (skincare) with a panel of leading cosmetic doctors.
It was a very lively discussion and though it got heated at times there’s was also a lot of general agreement in approaches to skincare. The experts gave lots of great product recommendations, so much so, it made me wish for more faces so I could try them all out.
Professor Mukta Sachdev asked the questions and kept things on track. Following are brief bios of those on the panel followed by those all important questions and answers…
Dr Tapan Patel, Aesthetic Physician, UK
Dr Patel has over 14 years of clinical experience and is listed in the Tatler’s Top 30 Anti-Ageing Experts. He’s the owner and medical director of the award-winning PHI Clinic in London, UK. This is a state of the art cosmetic clinic offering a wide range of surgical and non-surgical procedures. His website is HERE.
Dr Zein Obagi, Cosmetic Dermatol0gist, USA
Dr Obagi brought the first medical skincare products, the Obagi Nu-Derm System, to market and thereby changed the way we treated ageing skin. He has since founded ZO Skin Health Inc and is a researcher, innovator, scientist, author, lecturer and practising dermatologist. His website is HERE.
Dr Vivian Bucay, Dermatologist, USA
Dr Bucay has been in private practice for over 25 years and is nationally recognised for her expertise in minimally invasive facial rejuvenation. She’s the author of several publications and is involved in studies evaluating emerging cosmeceuticals. She also serves on the faculty of several continuing medical educational initiatives. Her website is HERE.
Proffessor Beth Briden, Medical Director and CEO, USA
Proffessor Briden is an international expert on skin rejuvenation and has lectured in over 26 countries. She has worked closely with the founders of AHA’s, Prof Van Scott and Dr Yue, for over 25 years. She’s also the medical director and CEO of the Advanced Dermatology & Cosmetic Institute in Minnesota, USA and has repeatedly received the Top Doc award for clinical practise. Her Website is HERE.
The Questions And Answers
1. What is the one anti-ageing topical (cosmeceutical) that you’d recommend for 20-30 year olds?
Dr Obagi: Retinol for intracellular activity.
2. What is the one anti-ageing topical (cosmeceutical) that you’d recommend for those who are 40+?
Dr Patel: This is when I go to the retinoids. I prefer retinoic acid but it’s down to tolerance and a lot of people don’t tolerate it. For retinols I like Obagi and Skinceuticals. There are lots out there but these are the ones I know and can speak of.
Dr Obagi: Ageing is now established and retinol in a proper concentration delivered properly.
Dr Bucay: I don’t think you can only pick one pathway. You’re asking for one thing to do it all and I’m always very sceptical about and all-in-one. Continue on the retinol and add in Hepron Sulfate by Sente.
Professor Briden: I’m going to go with a combination product which has virtually every proven anti-ageing ingredient. It’s SkinActives by NeoStrata.
3. Which under eye creams do you recommend?
Dr Patel: Very rarely will I recommend an eye cream for dark circles as procedure based solution works best. In terms of skin improvement for the peri-orbital area I like Obagi Elastiderm.
Dr Obagi: I like to use retional and anti-inflamoty agents and non-hdroquine for bleaching because if you have pigmentation you must thicken the skin and create a more even tone. The product is Olluminate by Zo Skin Health.
Professor Briden: – I Agree with Dr Obagi. I like the combination of pumping the skin, antioxidants and potentially a light bleaching agent. I recommend Skin Actives Eye Therapy by Neostrata.
4. What do you recommend for general pigmentation ie. freckles, ageing, non-specific (not melasma)? It can be a single or combination agent.
Dr Patel: The problem with pigmentation is that it’s multi-factorial. The central ingredient would still be a retinoid. For a non-hydroquinone bleaching agent I like arbutin and kojic acid. I prefer hydroquinone (HQ) and. I certainly don’t have problems with it. I recommend a full face application of 4% HQ combined with retinoid acid for a sensible patient taking sensible sun protection measures. I find it more effective than the non HQ alternatives. That being said, there are increasing ranges that have nice combinations of non-HQ. It really depends on the patient on terms of what they’re prepared to put up with in terms of downtime and tolerance etc.
Dr Obagi: I definitely don’t use HQ for non-specific discolouration. With arbutin you have to specify the type either or arbutin A or arbutin B. Arbutin A is the more effective. I don’t use Kojic Acid. I use retinol which is essential and anti-oxidants and sun protection. My objective is to control the melanocytes, not to correct the pigmentation.
Dr Bucay: There are a lot of pathways for dyschromia . I like Lytera by Skinmedica as it addresses 4 different pathways. I also want to say Lignin Peroxidase is another option for dissolving existing pigment.
Professor Briden: I also like the combinations and starting with non-HQ I like kojic acid and curcumin. The THC in it has been shown in studies to be as effective as 4% HQ. You often have to add an exfoliating agent to get some pigment dispersion.
5. SPF – What’s the number you recommend and what kind of formulation?
Dr Patel: Knowing that some patients some will follow advice I give and some won’t, I tell my patients to use SPF 50 but then I settle for aSPF 25. I say reapply every hour and then they might reapply it every 4 hours. For quantity I advice 4 fingertip units for face, 2 fingertip units for neck and 1 fingertip unit for hands. It depends what they’re doing – if they’re going to work I say to cover the sun exposed areas. In England the biggest challenge we have is that people think sun protection is just for holidays.
Dr Obagi: The SPF issue is misleading and all SPF will wash off after 1.30 /2 hours (editor note: I’ve written about Dr Obagi’s approach to UV protection HERE). I say use a 20/30 SPF and 1gram or equivalent to 1 inch of thick toothpaste for the face. Strengthening the skin is the future of sun protection.
Dr Bucay: I do agree that just talking about SPF, that just refers to UVB, is misleading. Global protection should be used. I like mineral based sunscreen as it’s more tolerated. I like Elta SPF 46 UV clear as it contains 5% Niacinamide and is good for acne prone skin. I also like the Coloursciene SPF 50 powder. Two passes on the face powder provides good UVA/UVB protection.
Professor Briden: I like to differentiate between sunscreens for the face and body. I like a combination that uses mineral sunscreen and antioxidants. I recommend 1 tablespoon for the face and a shot glass for the body.This post contains press samples unless otherwise stated. Please visit my Disclosure page for more information