Problem skin - with Alison Bowser
Alison Bowser, skin guru and trained counsellor, joins us in live chat to answer your questions on acne treatments, scars, wrinkle creams, moisturising and the traffic light guide to squeezing spots.
Randomgirl: I have acne, I don't have much as I use gels that I get from the GP and I'm on the pill too. But, if I stop using them I get spots really quickly. I'm 27. Will this ever go away? I should have said as well that I also took antibiotics for a number of years.
Alison: It's not as uncommon as you'd think to have problems with spots in to your late twenties. The good news is that you probably will grow out of it but you're doing the right thing treating it at the moment. The pill you mention is probably Dianette which works really well for some women.
You ask whether it will ever go, the answer is hard to know for sure but you need to keep treating your skin as you have been and do this until you find that reducing the treatment doesn't cause a flare up.
Randomgirl: Okay,thanks.
Alison: However, at age 27 and having had acne for this amount of time it might be time to talk to your doctor about seeing a skin specialist.
Randomgirl: Right...
Alison: Have you ever asked your doctor to be referred? It might be worth a try.
Randomgirl: I've not asked for a referral. I have mental health problems so I don't want Roaccutane.
Alison: I don't want to make any assumptions but it might be worth asking the question, do you feel your skin is affecting your mental health? If this is so, it might be worth still pursuing this option. There is some recent evidence that I've discovered that suggests that there isn't a problem with having mental health problems and taking Roaccutane.
I would stress though that you'd have to discuss this with the skin doctor.
Randomgirl: Thank you.
Alison: It needs to be balanced against how bad you feel your skin is when you're not treating it. Good luck.
lea: I'm 27 and still suffer from acne and blackheads.Whats the best way to deal with them? Through my teens I used to use things such as Clearasil and antibiotics. I used Dianette too,but after a while I came off it, as it started affecting my moods. I suppose I gave up with the antibiotics too soon?
Alison: Hi lea, thanks for your question. Normally, when someone has blackheads, this type of acne will respond better to a type of treatment that is applied directly on to the skin known as retinoids. These are really good at helping to loosen the plugs and stop new blockages forming.
Unfortunately, these tiny blockages in the skin may lead to inflamed types of spots and these will normally respond better to antibiotics. I'd suggest returning to your doctor to explain your worries and ideally you will ask for two different treatments as I've just described. Stick at the treatments, its a hard slog but it'll be worth it :)
lea: I'll do that,thanks.
Alison: Great, that's good to hear.
Leanne: I have polymorphic lighteruption (PLE), so my skin sometimes reacts to the sun and I get a rash on my chest and sometimes my arms. As it has been winter I have kept covered up so haven't had a rash yet but I know once we get more warm and sunny weather, I'll get the rash. When I have the rash I keep it covered by wearing long sleeves or jackets which can be difficult when it is really hot. Is there anything I can do or use to make it look less noticeable?
Alison: Thanks Leanne. This is a really miserable condition to have and usually affects older people so I'm sorry to hear you have this problem. The thing about PLE is to reduce the amount of time you are in the sun. So, whilst staying locked away indoors isn't perfect, do try to seek shade whenever you're outside.
I suspect you know all this already but if there's any extra advice I can offer it would be this:
Apply the maximum sun protection factor (SPF) that you feel you need (this may be a factor 50) an hour before you go outside. Remember to rub it in to all areas that are exposed to sunlight and pay particular attention to your neck, hands and feet.
There are a few websites that promote sun protection clothing; although this can be expensive, it might be worth investing in a few tops to see you through brighter days. I hope that's useful :)
Leanne: Yeah, I put a high factor on anyway as I burn. It is, thank you :)
Scary Monster: Is there any link between where you get acne and what causes it? For example, is acne on your jaw line more likely to be due to stress or is it hormonal?
Alison: OK, that's a really good question Scary Monster. It is believed that acne on the chin area is related to hormones. However, this is a bit misleading because actually most acne is directly related to hormones! So, whilst it's true that women who experience pre-menstrual spots are more likely to get it on the chin, there's not really any scientific evidence to back this up.
The message I always give relating to acne wherever it maybe is to keep the skin treated with suitable treatments to help stop new spots from forming. If you know, for example, that every month your skin gets particularly bad two or three days before your period, then it might be wise to step up your acne treatment a few days before.
Randomgirl: I get tinea versicolour on my shoulders and chest. Is there anything that clears it permanently? At the moment I get Nizoral on prescription but it comes back again.
Alison: Thanks for your question Randomgirl. I'm afraid this isn't my area of expertise, however I would always recommend, no matter what the problem, that you persevere with getting help from your doctor. It does require perseverance to stick at treatments for many skin conditions and its often the case that it's not the treatments which fail but us as patients. We get fed up having to apply creams all the time. Stick at it though and if the treatment you tried before worked do follow it up with your GP and ask for another course.
Randomgirl: Okay,thanks.
clementine_the_tangerine: When is the best age to start using anti wrinkle cream? No sign of wrinkles yet but I'm 24, should it be as and when it happens or should I start now?
Alison: Start now! Lol. Seriously though, its never too early to start protecting the skin from wrinkles. However, let's get this straight, its not the anti-wrinkle cream you need to worry about, it's the sun protection factor that's important as well as daily moisturising. So, keeping the sun off the skin is your easiest way by far to reduce wrinkles in the future.
It's great that you're thinking this far ahead. Your future thoughts may also save you from other damage caused by the sun such as skin cancer. The simple answer is protect and moisturise and don't forget your neck too!
helen: You mention daily moisturising - is there any product you'd recommend?
Alison: I wouldn't recommend any particular product because there are so many out there and it's important to pick the one that best suits your budget and your skin type. It's worth noting that even greasy skin may benefit from moisturising as long as it's oil free.
You can always add your favourite sun cream to your moisturiser, mix together well and apply as you would your moisturiser.
helen: Good tip!
Randomboy: When I use moisturiser on my face I get acne. Is this often the case?
Alison: On its own moisturiser is unlikely to be the cause of problem acne. However, it could be that the moisturiser you're using is too greasy in which case try changing it to a lighter type, these will be available in a range of high street chemists and will usually be marketed as gentle or suitable for sensitive skin.
It's well known amongst skin doctors that the enemy of acne is oil. This means putting oily products on to acne prone skin is likely to make it worse. I hope that helps.
"It does require perseverance to stick at treatments for many skin conditions and it's often the case that it's not the treatments which fail but us as patients. We get fed up having to apply creams all the time."
lea: Is there anything to use to fade acne scars?
Alison: Hi again lea, this will depend on the type of scars you have. If they are red and flat the good news is that these will usually fade completely, although you'll have to give them time. If they are slightly raised or pitted in to the skin this may be harder to help. Can I ask which one of these best reflects your scars?
lea: Flat and red mainly, I do have some pitted ones too.
Alison: OK, well whilst these heal and fade (which could take a few months) you can disguise them with makeup. If you're able to go to a makeup counter, ask for advice on camouflage products - these work harder than normal makeup to conceal marks and scars.
I know a lot of people believe that vitamin E oil can help fade scars but if you are prone to acne avoid putting oils on to the skin as it may make it worse.
lea: I have oily skin, but I tend to get flaky skin on my nose and forehead. Any way to sort that out?
Leanne: Ooh good question.
Alison: Just use moisturiser on those areas. If it's really dry, apply it several times during the day, this is what I call super-hydrating and is the equivalent of really drenching the skin in moisturiser. This done for a few days should really help to counteract that flaky skin.
lea: Thanks.
Leanne: I get round patches of dry skin on my face, or could it be eczema? Aqueous cream really helps though.
Alison: Yes, it could be eczema and often applying aqueous cream is fine. Again, apply as much as you think your skin can take but if the patch doesn't clear after a couple of weeks of trying this then speak to a pharmacist who may advise something stronger such as a very short course of mild hydro cortisone.
Leanne: Thank you.
Randomgirl: My boyfriend gets really dry skin on his hands. He applies hand cream a couple of times a day, up to 3-4 times a day in winter. Is there anything he can do to help it?
Alison: This sounds like it could be classic hand eczema. This may require stronger treatments from the doctor to help stop the cycle of dry skin leading to itching leading to redness. Continue to drench the skin in aqueous cream but step it up to as much as it needs for a few days to see if that helps. The trouble with the hands is that they're needed for everyday life so this may not always be practical. This could be why going to a doctor to get advice on stronger hand creams might be sensible.
It might even be worth investing in a pair of gloves which can be worn over the hands at night after he's applied hand cream. It may not look sexy but it could do the job and help to keep the cream sufficiently in contact with the skin. You can also try the National Eczema Society for further advice.
Randomgirl: Thanks for that, he said he'll go to the doctor.
Alison: I hope it gets better for him Randomgirl.
Jimmy: You mentioned before that sun can speed up the aging process, but can exposure help with any conditions at all? I always used to think it helped my spots, but maybe that's a myth?
Alison: This is a really good question and to a degree you're right. A little sun exposure is important for everybody to produce vitamin D which is essential for growth. However, like everything in life, it's all about balance! We don't tend to see much of the sun in the UK so when it does appear we tend to bask in it until we burn and its the burning that causes most damage.
We do know that UV can help various skin conditions such as acne, psoriasis and eczema but it's getting the balance between sun exposure and helping our skin that's important.
There will be many factors to take in to consideration such as skin colouring, and your ability to burn. The advice would be to make sure you're sensible in the sun, avoid burning at all costs, keep regularly applying sun protection (that might be up to every two hours in hot sunshine).
Leanne: Can vitamin D get through factor 50 plus sun cream?
Alison: Yes, it'll get through your sun cream Leanne!
Leanne: Haha, great!
Charlie : I wanted to ask, I have a really horrid cluster cystic spot on my forehead right now, and a date-type-thing on Saturday, what can I do to get rid of it/reduce it lots before then?
Alison: Okay Charlie, sorry to hear that, don't they just have a habit of turning up when you least need them?!
Charlie: Yes!
Alison: Here's a chance to share my traffic light guide to squeezing spots. If your spot is red and you cannot see any yellow pussy bits in it then think RED, like a traffic light, STOP: do not touch! You will be better off wearing your fringe down and using make up.
If it's yellow then it could be ready. The best way of squeezing a spot like this would be to gently pull the skin apart before you start squeezing inwards. Damage to the skin usually happens when people poke, squeeze and prod and spots that are simply not ready. So, this may mean wait until tomorrow before you touch it.
Charlie: That sounds like me. Hmm... I might put a plaster or something over it then to stop me playing with it.
Alison: You could also try using emergency spot treatments from the chemist. These usually contain either salicylic acid or benzoyl peroxide - both of which are brilliant at drying up spots. But most importantly please try to use my traffic light guide and I assure you that you will be treating your skin more kindly if you do.
Charlie: I will try very hard. In the meantime, shall I use Savlon on it to heal up the bits that have been squeezed?
Alison: Ideally after you've squeezed the spot, dab it with a tissue and leave it alone, savlon may not be best because I suspect it has a high degree of oil in it. However, if savlon works for you then carry on! If your skin tells you it's working then do it.
Charlie: It's more to heal the ones that have already been squeezed to stop me picking at the scabby bits. Thank you.
Leanne: Does toothpaste really help?
Alison: Bit of a myth toothpaste but if it works for you why not? There are much better ingredients such as benzoyl peroxide as mentioned before - these have gone through scientific tests as opposed to a blob of Colgate.
Thanks for your questions everyone.
Alison has written a book all about acne and rosacea with plenty more expert advice and treatment options if you'd like to find out more. It's called 'Acne & Rosacea: The complete guide' - published by Vermillion.
Problem skin - with Alison Bowser
Alison Bowser, skin guru and trained counsellor, joins us in live chat to answer your questions on acne treatments, scars, wrinkle creams, moisturising and the traffic light guide to squeezing spots.
Randomgirl: I have acne, I don't have much as I use gels that I get from the GP and I'm on the pill too. But, if I stop using them I get spots really quickly. I'm 27. Will this ever go away? I should have said as well that I also took antibiotics for a number of years.
Alison: It's not as uncommon as you'd think to have problems with spots in to your late twenties. The good news is that you probably will grow out of it but you're doing the right thing treating it at the moment. The pill you mention is probably Dianette which works really well for some women.
You ask whether it will ever go, the answer is hard to know for sure but you need to keep treating your skin as you have been and do this until you find that reducing the treatment doesn't cause a flare up.
Randomgirl: Okay,thanks.
Alison: However, at age 27 and having had acne for this amount of time it might be time to talk to your doctor about seeing a skin specialist.
Randomgirl: Right...
Alison: Have you ever asked your doctor to be referred? It might be worth a try.
Randomgirl: I've not asked for a referral. I have mental health problems so I don't want Roaccutane.
Alison: I don't want to make any assumptions but it might be worth asking the question, do you feel your skin is affecting your mental health? If this is so, it might be worth still pursuing this option. There is some recent evidence that I've discovered that suggests that there isn't a problem with having mental health problems and taking Roaccutane.
I would stress though that you'd have to discuss this with the skin doctor.
Randomgirl: Thank you.
Alison: It needs to be balanced against how bad you feel your skin is when you're not treating it. Good luck.
lea: I'm 27 and still suffer from acne and blackheads.Whats the best way to deal with them? Through my teens I used to use things such as Clearasil and antibiotics. I used Dianette too,but after a while I came off it, as it started affecting my moods. I suppose I gave up with the antibiotics too soon?
Alison: Hi lea, thanks for your question. Normally, when someone has blackheads, this type of acne will respond better to a type of treatment that is applied directly on to the skin known as retinoids. These are really good at helping to loosen the plugs and stop new blockages forming.
Unfortunately, these tiny blockages in the skin may lead to inflamed types of spots and these will normally respond better to antibiotics. I'd suggest returning to your doctor to explain your worries and ideally you will ask for two different treatments as I've just described. Stick at the treatments, its a hard slog but it'll be worth it :)
lea: I'll do that,thanks.
Alison: Great, that's good to hear.
Leanne: I have polymorphic lighteruption (PLE), so my skin sometimes reacts to the sun and I get a rash on my chest and sometimes my arms. As it has been winter I have kept covered up so haven't had a rash yet but I know once we get more warm and sunny weather, I'll get the rash. When I have the rash I keep it covered by wearing long sleeves or jackets which can be difficult when it is really hot. Is there anything I can do or use to make it look less noticeable?
Alison: Thanks Leanne. This is a really miserable condition to have and usually affects older people so I'm sorry to hear you have this problem. The thing about PLE is to reduce the amount of time you are in the sun. So, whilst staying locked away indoors isn't perfect, do try to seek shade whenever you're outside.
I suspect you know all this already but if there's any extra advice I can offer it would be this:
Apply the maximum sun protection factor (SPF) that you feel you need (this may be a factor 50) an hour before you go outside. Remember to rub it in to all areas that are exposed to sunlight and pay particular attention to your neck, hands and feet.
There are a few websites that promote sun protection clothing; although this can be expensive, it might be worth investing in a few tops to see you through brighter days. I hope that's useful :)
Leanne: Yeah, I put a high factor on anyway as I burn. It is, thank you :)
Scary Monster: Is there any link between where you get acne and what causes it? For example, is acne on your jaw line more likely to be due to stress or is it hormonal?
Alison: OK, that's a really good question Scary Monster. It is believed that acne on the chin area is related to hormones. However, this is a bit misleading because actually most acne is directly related to hormones! So, whilst it's true that women who experience pre-menstrual spots are more likely to get it on the chin, there's not really any scientific evidence to back this up.
The message I always give relating to acne wherever it maybe is to keep the skin treated with suitable treatments to help stop new spots from forming. If you know, for example, that every month your skin gets particularly bad two or three days before your period, then it might be wise to step up your acne treatment a few days before.
Randomgirl: I get tinea versicolour on my shoulders and chest. Is there anything that clears it permanently? At the moment I get Nizoral on prescription but it comes back again.
Alison: Thanks for your question Randomgirl. I'm afraid this isn't my area of expertise, however I would always recommend, no matter what the problem, that you persevere with getting help from your doctor. It does require perseverance to stick at treatments for many skin conditions and its often the case that it's not the treatments which fail but us as patients. We get fed up having to apply creams all the time. Stick at it though and if the treatment you tried before worked do follow it up with your GP and ask for another course.
Randomgirl: Okay,thanks.
clementine_the_tangerine: When is the best age to start using anti wrinkle cream? No sign of wrinkles yet but I'm 24, should it be as and when it happens or should I start now?
Alison: Start now! Lol. Seriously though, its never too early to start protecting the skin from wrinkles. However, let's get this straight, its not the anti-wrinkle cream you need to worry about, it's the sun protection factor that's important as well as daily moisturising. So, keeping the sun off the skin is your easiest way by far to reduce wrinkles in the future.
It's great that you're thinking this far ahead. Your future thoughts may also save you from other damage caused by the sun such as skin cancer. The simple answer is protect and moisturise and don't forget your neck too!
helen: You mention daily moisturising - is there any product you'd recommend?
Alison: I wouldn't recommend any particular product because there are so many out there and it's important to pick the one that best suits your budget and your skin type. It's worth noting that even greasy skin may benefit from moisturising as long as it's oil free.
You can always add your favourite sun cream to your moisturiser, mix together well and apply as you would your moisturiser.
helen: Good tip!
Randomboy: When I use moisturiser on my face I get acne. Is this often the case?
Alison: On its own moisturiser is unlikely to be the cause of problem acne. However, it could be that the moisturiser you're using is too greasy in which case try changing it to a lighter type, these will be available in a range of high street chemists and will usually be marketed as gentle or suitable for sensitive skin.
It's well known amongst skin doctors that the enemy of acne is oil. This means putting oily products on to acne prone skin is likely to make it worse. I hope that helps.
lea: Is there anything to use to fade acne scars?
Alison: Hi again lea, this will depend on the type of scars you have. If they are red and flat the good news is that these will usually fade completely, although you'll have to give them time. If they are slightly raised or pitted in to the skin this may be harder to help. Can I ask which one of these best reflects your scars?
lea: Flat and red mainly, I do have some pitted ones too.
Alison: OK, well whilst these heal and fade (which could take a few months) you can disguise them with makeup. If you're able to go to a makeup counter, ask for advice on camouflage products - these work harder than normal makeup to conceal marks and scars.
I know a lot of people believe that vitamin E oil can help fade scars but if you are prone to acne avoid putting oils on to the skin as it may make it worse.
lea: I have oily skin, but I tend to get flaky skin on my nose and forehead. Any way to sort that out?
Leanne: Ooh good question.
Alison: Just use moisturiser on those areas. If it's really dry, apply it several times during the day, this is what I call super-hydrating and is the equivalent of really drenching the skin in moisturiser. This done for a few days should really help to counteract that flaky skin.
lea: Thanks.
Leanne: I get round patches of dry skin on my face, or could it be eczema? Aqueous cream really helps though.
Alison: Yes, it could be eczema and often applying aqueous cream is fine. Again, apply as much as you think your skin can take but if the patch doesn't clear after a couple of weeks of trying this then speak to a pharmacist who may advise something stronger such as a very short course of mild hydro cortisone.
Leanne: Thank you.
Randomgirl: My boyfriend gets really dry skin on his hands. He applies hand cream a couple of times a day, up to 3-4 times a day in winter. Is there anything he can do to help it?
Alison: This sounds like it could be classic hand eczema. This may require stronger treatments from the doctor to help stop the cycle of dry skin leading to itching leading to redness. Continue to drench the skin in aqueous cream but step it up to as much as it needs for a few days to see if that helps. The trouble with the hands is that they're needed for everyday life so this may not always be practical. This could be why going to a doctor to get advice on stronger hand creams might be sensible.
It might even be worth investing in a pair of gloves which can be worn over the hands at night after he's applied hand cream. It may not look sexy but it could do the job and help to keep the cream sufficiently in contact with the skin. You can also try the National Eczema Society for further advice.
Randomgirl: Thanks for that, he said he'll go to the doctor.
Alison: I hope it gets better for him Randomgirl.
Jimmy: You mentioned before that sun can speed up the aging process, but can exposure help with any conditions at all? I always used to think it helped my spots, but maybe that's a myth?
Alison: This is a really good question and to a degree you're right. A little sun exposure is important for everybody to produce vitamin D which is essential for growth. However, like everything in life, it's all about balance! We don't tend to see much of the sun in the UK so when it does appear we tend to bask in it until we burn and its the burning that causes most damage.
We do know that UV can help various skin conditions such as acne, psoriasis and eczema but it's getting the balance between sun exposure and helping our skin that's important.
There will be many factors to take in to consideration such as skin colouring, and your ability to burn. The advice would be to make sure you're sensible in the sun, avoid burning at all costs, keep regularly applying sun protection (that might be up to every two hours in hot sunshine).
Leanne: Can vitamin D get through factor 50 plus sun cream?
Alison: Yes, it'll get through your sun cream Leanne!
Leanne: Haha, great!
Charlie : I wanted to ask, I have a really horrid cluster cystic spot on my forehead right now, and a date-type-thing on Saturday, what can I do to get rid of it/reduce it lots before then?
Alison: Okay Charlie, sorry to hear that, don't they just have a habit of turning up when you least need them?!
Charlie: Yes!
Alison: Here's a chance to share my traffic light guide to squeezing spots. If your spot is red and you cannot see any yellow pussy bits in it then think RED, like a traffic light, STOP: do not touch! You will be better off wearing your fringe down and using make up.
If it's yellow then it could be ready. The best way of squeezing a spot like this would be to gently pull the skin apart before you start squeezing inwards. Damage to the skin usually happens when people poke, squeeze and prod and spots that are simply not ready. So, this may mean wait until tomorrow before you touch it.
Charlie: That sounds like me. Hmm... I might put a plaster or something over it then to stop me playing with it.
Alison: You could also try using emergency spot treatments from the chemist. These usually contain either salicylic acid or benzoyl peroxide - both of which are brilliant at drying up spots. But most importantly please try to use my traffic light guide and I assure you that you will be treating your skin more kindly if you do.
Charlie: I will try very hard. In the meantime, shall I use Savlon on it to heal up the bits that have been squeezed?
Alison: Ideally after you've squeezed the spot, dab it with a tissue and leave it alone, savlon may not be best because I suspect it has a high degree of oil in it. However, if savlon works for you then carry on! If your skin tells you it's working then do it.
Charlie: It's more to heal the ones that have already been squeezed to stop me picking at the scabby bits. Thank you.
Leanne: Does toothpaste really help?
Alison: Bit of a myth toothpaste but if it works for you why not? There are much better ingredients such as benzoyl peroxide as mentioned before - these have gone through scientific tests as opposed to a blob of Colgate.
Thanks for your questions everyone.
Alison has written a book all about acne and rosacea with plenty more expert advice and treatment options if you'd like to find out more. It's called 'Acne & Rosacea: The complete guide' - published by Vermillion.