Our skin is ever-changing and there is so much you can do to look after it – but when should you start using anti-ageing products? And should you ever squeeze a spot? From sunscreen to soap-dodging, dermatologists demystify skincare.
Keep it simple
“I tell my patients that their skin is a window into their general health,” says Dr Ophelia E Dadzie, a consultant dermatologist at Hillingdon hospital in Uxbridge and a specialist in skin of colour. “It is about going back to basics and keeping things simple,” Dadzie says. “This doesn’t mean spending lots of money on expensive skincare products. It is about proper nutrition, exercise, getting enough sleep, stress reduction and having a very basic skincare regime.”
“As long as you cleanse properly after wearing makeup, moisturise if required and use sunscreen on a sunny day, for the vast majority of people, that is all they need to do,” says Dr Jean Ayer, a Cheshire-based dermatologist who is a senior lecturer at the University of Manchester.
Children don’t need fancy products
Despite what TikTok would have you believe, children don’t need to start using specialised products at the age of 10. “I see lots of very young people now who ask me about hyaluronic acid and retinoids,” says Ayer. “Pre-puberty, you don’t need to use anything.” If children are interested in skincare, she says, go for safe products such as a non-comedogenic moisturiser (meaning it won’t clog or block pores) and micellar water.
For those who have eczema, a different approach may be necessary. As Dadzie explains: “For children with skin conditions, it is important that they understand their own skincare regime and why it is needed.”
If your acne is bad, seek help
Most people develop spots during puberty, and sometimes later in life. “About 80% of the population will have acne to some degree,” says Ayer. This is when you need to give more thought to what you are putting on your skin. “Use something that is oil-free, like benzoyl peroxide. This dries out the areas of skin that are producing too much oil.” If over-the-counter products aren’t helping, or if you are getting scarring, go to the GP, says Dr Bav Shergill, a consultant dermatologist in Sussex. “GPs are very competent at dealing with the majority of acne,” he says. If the products they prescribe don’t work, you will be quickly escalated to see a specialist. Give products a good amount of time to see if they are effective before switching to something else, but no more than three months, says Ayer.
Don’t start using anti-ageing products too young
“There is a school of thought,” says Ayer, “that if you start doing things earlier, then perhaps you will prevent the effects of ageing as you get older. I don’t think there is enough data to support that one way or another. If I was going back to my 20s, I would still keep it really simple, using as little as possible, and a really good sunscreen.”
When you start using anti-ageing products depends on your skin type, says Shergill, “along with how much sun exposure you have, and what you are trying to achieve. If we are talking about preventives, you could, from the age of 25 or 30, have a bit of base retinol in your products. I didn’t start to care too much about it then, but I think men are different: we age about 10 years later than women. Because of the menopause changes, women in their 40s lose collagen, so they can get signs of ageing at that time.”
Know the ingredients worth paying out for – or not
“The ingredients that have data that supports their use are retinoids,” says Ayer. “For older skin, I would use a retinoid, sunscreen and a good moisturiser. Inexpensive products are often just as effective as products at a higher price point.” However, he adds, “the data to support most anti-ageing products is often limited to small studies and therefore has to be interpreted with caution. Hyaluronic acid, for example, is an ingredient that is talked about a lot. But its molecules are quite big, so for it to penetrate through the skin would be almost impossible. When people say it is really good for hydration, actually all it is doing is sitting on top of the skin, stopping water from leaving, rather than rehydrating it.”
“Eye and neck creams overpromise,” says Dr Emma Wedgeworth, a dermatologist who runs a clinic in Harley Street in central London. “There is a limit to how much you can freshen up the skin in these places, because the change is underlying.”
Try new products with caution
Dadzie recommends doing a patch test to check if a product suits you or will cause irritation. “When you have darker skin, you are at risk of post-inflammatory hyperpigmentation, so you need to be very careful.”
“A lot of people think that retinol irritates their skin, and it can cause dryness,” says Shergill. “Use a light amount, maybe two to three times a week, and then slowly build it up. When you’re in a dry environment, over winter, you may need to go back to using retinol twice a week to avoid irritation.”
Don’t squeeze spots
Squeezing spots can cause problems, says Wedgeworth: “Excess manipulation of spots is associated with scarring. So I would leave it, or use a spot sticker with salicylic acid in it. If you are getting regular spots, you need to put something in place to try to prevent them: we are much better at preventing spots than we are at treating them.”
“Often, when you wash your face,” says Shergill, “if the spot is ready to go it will just discharge itself. But you shouldn’t need to pick it out.” Benzoyl peroxide or niacinamide, an anti-inflammatory agent, are the best things to put on a spot, he advises.
Wear sunscreen
Photograph: Catherine Falls Commercial/Getty Images
“If you look after your skin when you are young and use an effective sunscreen, you will reduce your chances of skin cancer when you are older. You will also look better, because it is one of the very few things that objectively prevents sunlight-induced ageing,” says Ayer. If you live in the UK, have sun cream ready to go in March in case of an unexpectedly sunny day. Shergill keeps one bottle at the front door and another at the back, so it is easy to apply before going out.
“If you want to maximise everything you can to prevent changes like ageing and pigmentation, there is definitely a rationale for using sunscreen every day,” says Wedgeworth. “Make sure the expiration date hasn’t passed,” adds Shergill. It usually lasts for a year after being opened, but consult the label.
Use the highest SPF possible
“I always advocate an SPF of 50 or above,” says Ayer. “This is because the amount of sunscreen we actually apply to our skin is considerably less than what they test in the lab. If you apply 25% of the lab-tested amount of a factor 50, “then you are still going to get a reasonable amount of benefit from using that. But the lower you drop that SPF, the less benefit you have. In terms of skin types, if you are very fair-skinned and burn easily, the SPF (sun protection factor against UVB, which causes burning) is particularly important. For those with darker skin, what becomes more relevant is the star rating (protection against UVA), which is responsible for the effects of sunlight-induced ageing. The SPF should still be high, too.”
Apply a cream, not a spray, every two hours
“While sprays are very easy to put on, you will never get the level of coverage you actually require,” says Ayer. “When you put a cream on, you don’t want to rub it into the skin: allow it to dry into the skin, because rubbing it can decrease the efficacy. For people who are very high-risk, put a layer on, wait for 15 minutes and then reapply. Even if it says it lasts all day, our experience tells us this is seldom the case, so put some more on after two hours.” If you go in the water, reapply when you get out.
Cover up in the sun
“You cannot get better than protective clothing,” says Ayer. “Wide-brimmed hats are amazing, and you can get UPF clothing that has protection built-in.” Shergill lives near the sea and his kids always wear a rash vest when they are out in the sun: “It’s the culture here.” Normal clothes do provide protection to a point, Ayer says. She suggests you take your clothing and hold it up to the sun. “If you can see the sunlight through it, that means you are getting a bit of UV radiation through it. If you are very sensitive to sunlight, although it may seem counterintuitive, wear dark colours and a tightly woven fabric in the sun.” And in case you hadn’t guessed, “tanning machines are a complete no-no”, says Dadzie.
But don’t forget, sunlight is good for us
“There is a balance to be had, because we do need sunlight,” says Ayer. “Sunlight is essentially the only way that we generate vitamin D, so for most people supplements are a good idea. The British Skin Foundation recommends that most people with lighter skin types need 10-15 minutes of daily sun exposure to get sufficient levels of vitamin D in the UK, and people with darker skin need 25-40 minutes. If you are an easy burner, go out in the early morning or later in the evening, and then you get a little bit of sunlight exposure with a reduced UV index.”
Keep an eye on moles
“Moles are small, coloured spots on the skin, often dictated by your skin type and genetics. For most people, they are entirely normal,” says Ayer. “It is common to continue to develop moles into your late 30s. If you start developing new moles after that age, unless they are warts, they may need a GP or dermatologist to check them out.”
“Only one in three melanomas [skin cancers] come from a pre-existing mole,” says Shergill. “Having said that, if you have got a mole and it starts getting bigger, or the edges get blurry, or it is a funny shape, so not symmetrical, and it’s getting darker or lighter – those are the things that you need to watch out for.” These signs of changes are referred to as ABCDE, which stands for asymmetrical, border, colour, diameter, evolving. “If you are not quite sure about a mole, go and talk to a doctor about it. It will take someone who is trained a few seconds to tell you whether it is normal or abnormal,” says Ayer.
It is not just moles that can be problematic: also watch out for rapidly growing, often skin-coloured lumps, or a spot that hasn’t healed after several weeks and is on a sun-exposed site, says Shergill. “Any suspected skin cancer should be removed as soon as possible to prevent it spreading internally. Tumours are removed surgically, usually under a local anaesthetic, and the diagnosis confirmed. Sometimes further surgery and non-surgical treatment is required to get the best cure rates.”
Keep on top of skin changes elsewhere
“Our poor body skin gets completely neglected,” says Wedgeworth. “One of the main things that I am really careful about is the type of cleanser that I use on my body. We tend to see people using quite a lot of harsh products, and in the winter months you end up with dry, flaky skin. This needs to be treated or it can become problematic. We see this a lot with hands in the winter.”
“If things aren’t looking great, do get them checked out,” says Shergill. “Don’t be embarrassed and hide it away. It could be an early warning for something quite nasty that could be going on inside.”
Ditch the soap and fragrances
What about washing with a good old-fashioned bar of soap? “I try to avoid soap,” says Ayer. “It can be very drying due to chemicals in the fragrance or sodium lauryl sulfate. There are good soaps with very little in them, but most tend to have some form of fragrance” – because we associate being clean with having a nice smell.
You are what you eat
Photograph: Yagi Studio/Getty Images
“If you stay away from excess consumption of ultra-processed foods and try to have a healthy, varied diet, it may have a good impact on skin health,” says Ayer. “The data is limited supporting the consumption of collagen or other supplements and their improvement on skin health.” Shergill aims to eat 30 different plants a week, as per Zoe guidance. “I focus on polyphenols, like black olives and spinach,” says Dadzie. She also chooses wholewheat pasta and oily fish over processed foods and too much meat.
Does sugar cause spots? Dadzie says, “I haven’t reviewed the evidence specifically on this, but in broad terms, we know that sugar causes inflammation in our bodies, so we should minimise it. I’m no angel; I do have a sweet tooth. My tip is to go for dark chocolate – it doesn’t taste as nice, so you don’t tend to eat as much.”
Sleep well and manage stress
“There have been some very interesting studies that demonstrate the effects of lack of sleep and increased stress on the skin,” says Ayer. “I see it time and time again: people’s skin often deteriorates during periods of stress. Sleep is beneficial for everything, and also impacts on stress.”
Don’t smoke
“After excess sun, smoking is one of the most problematic things you can do for your skin,” says Wedgeworth. “It impacts on blood flow to your skin: wound healing is worse with smokers, and it can cause accelerated ageing. The jury’s out on vaping, but I personally would not vape.”
Stay hydrated – but don’t go over the top
“We get asked this a lot,” says Shergill. “You don’t have to be chugging two and a half litres a day. You’re going to get a lot of your fluids from other foodstuffs. As long as you are urinating regularly, and it is not super-concentrated and you haven’t got a headache, you don’t need to be overly concerned about it.”
Use clean flannels and pat, don’t rub
Shergill gives the green light to flannels, “as long as it isn’t a really manky one that’s been around for ages. You can get a mild exfoliation with it. Towel drying is OK, except if you’ve got things like eczema: if you rub, it sets off the eczema.” The trick with towels is to “pat yourself dry. It doesn’t matter if your skin is slightly moist after you come out of the shower; you can still apply a moisturiser to it.”
“I don’t think flannels or muslins are necessary,” says Wedgeworth. “Hands and a towel are absolutely fine.”
