Giving You More Options with Medical Grade Skincare As I’ve branched into skincare and injectables, I field many enquiries regularly about skin regimens, if I know any that are worth spending on, evidence-based and what I would recommend.   As women, we feel a real pressure in a society that judges us first, by our looks. Sometimes our looks are seen as the only worthy thing about us.  While I don’t believe this is the only thing that defines us, I know most of us want to look our best, at any age! Additionally, I’m regularly approached by women with skin concerns that haven’t been addressed- rosacea, thin skin, adult acne, hyperpigmentation, prominent surface vessels and more. 1. Aspect Dr skincare products and chemical peels range which I’ve decided to stock. I shall cover these in more detail in another post, but in summary: chemical peels for skin maintenance, pigmentation, problem skin, including rosacea and ageing. 2. Rodan and Fields, from the USA. It is formulated by the two dermatologists who created Proactiv for teenage acne, and this brand targets sun damaged skin. I have some sample packs of these to those looking for a skincare regime for their sensitive skin, to combat general ageing and who are fighting hyperpigmentation and sun damage. The best part? All R+F regimens and products are backed by a 60 day empty bottle guarantee so you’ve literally nothing to lose. This is also a great option for those who are hesitant to try injectables, or simply don’t have the time for in-clinic appointments.  If you’d like to know more, here’s my website:  It contains a Skin Solutions Tool that’ll give you an idea of your skin needs which may help you (and me) determine which of the two will suit you better! Want to discuss it further with me? Book here for a consultation to discuss your expectations, budget and cost for you. Hope to see you in a clinic soon! Any questions? email us at contact@skinessentials.com.au

Previously we wrote about the types of acne and its causes. In this blog we'll discuss the long term effects and some of the treatments for problem acne. What is the treatment for acne? Mild acne Creams, gels and washes, OTC as well as prescribed, often work well, as part of a regular and basic skincare regimen to get into the habit of. With the confusing array of over-the-counter (OTC) products available, it is often wise to seek the advice from a doctor with training and an interest in acne across all stages, who can advise on the best products and active ingredients and also recognise their limitations and when to refer on.  For young women, the Pill can often work well as the oestrogen works to improve skin quality and have a positive  effect on hair and skin   Chemical peels of higher strength overseen by a doctor, using acids, may work well within 3-6 sessions - to be used with caution in skin of colour and under supervision by a doctor LED and laser therapy can also work well over a treatment course which may be as frequent as twice weekly initially for a few weeks and then for maintenance, every few weeks as needed. Moderate acne a variety of medications in conjunction with treatment options for mild acne above Severe acne Referral to a dermatologist for more restricted medication with more significant side effects, not usually used as a first line agent Lasting Effects of Acne  Unfortunately, depending on the severity of the acne, the duration as well as what was used to combat the issue, common outcomes include such complications as scarring and in many skin types, post inflammatory hyperpigmentation, PIH.  While these are often reminders of the acne one had, they can often significantly affect a person’s confidence in a time when we are bombarded with images of perfect skin. A personalised consultation and treatment plan will ensure that a plan specific to you, your skin type with its unique qualities, will be used, to help improve skin quality and may involve one or more of several methods, beginning with skin needling, a series of chemical peels and even laser treatment and subcision, which is a way to break up the scarring that tends to cause skin to tether, giving rise to a pockmarked appearance.   How do you know what is the appropriate treatment plan for you?  Book an appointment so we can begin with a personalised treatment plan for you, addressing your specific concerns, overseen by our doctor and undertaken with our trained staff.

Acne is a common, ongoing skin disorder affecting the skin, hair follicle and the glands in the skin that produce an oily substance called sebum.  Acne typically first may be noticed around the onset of puberty due to hormonal and other changes associated with it. It affects men and women of all races and ethnicities but is more common in adolescents and young adults though it may occasionally be seen in children and older adults also.  Science does not exactly understand the cause of acne, but it is believed that many factors may contribute, including a family tendency, use of steroid hormones, particular strains/ species of bacteria that live on the skin (we ALL have bacteria that live on the skin and help maintain its health) as well as dietary and other factors that are not as well known.  Certain medical conditions may also make acne worse, such as women with Polycystic Ovarian Syndrome, certain medications and perhaps, a diet high in dairy and highly processed foods.  When doctors examine a person suffering from acne, we will often examine the skin on the face, but it may also involve other parts of the body, usually the shoulders, neck, chest and back, depending on the individual.  Based on what we see, and certain features, we will then classify the acne in terms of severity.  For mild and moderate acne, there are many options that are over-the-counter(OTC) in combination with prescribed medication by your family doctor that will take commitment and care on your part, as well as patience. Skin, on average takes about 3-6 months to really begin to show signs of positive change, and patience is one of the hardest things to come by when one is affected by what one sees in the mirror, but it does take time and commitment.  For those with severe acne, a medication prescribed by dermatologists works really well, but is not without significant and serious side effects, which are not to be taken lightly.  As a GP myself with a background in surgical training as well as in skin, I love working with skin conditions in my dual role as a GP as well as a Cosmetic Physician, as the combination of prescribed medication with medical grade cosmetic treatments can work wonders for skin issues, especially in those with skin that does not respond quickly or easily, or with skin of colour, which often responds differently to Caucasian skins. If you are undecided as to your acne type and severity, it is best to seek a consultation with a doctor you know and trust who has an interest in skin - healthy and unhealthy skin!  Next week I will continue on the topic of acne. I will cover a range of treatments for acne, as well as other possible treatments once the acne is under control.  

There has been a recent surge of interest in thread lifts and I have been getting some questions around them. There are different types of threads that can be used to lift areas of the face that are traditionally less responsive to the use of fillers, which typically can help add some volume to parts of the face, traditionally the mid face (cheeks, temples). For patients who are bothered by jowls and sag around the lower face, the best way to manage it, provided it has not been left too long, is via threadlifts. Usually, the best result is still in women who would benefit from a combination of dermal fillers, some anti wrinkle treatments and thread lifts. I tend to work from a top down approach - beginning with adding volume to the mid face to help fill sagging skin up, which may add a small amount of lift, so that when we get to the lower face, the threads can be used to lift sagging skin that is not responsive to fillers. Here are some examples of people that I have done this procedure on. I myself underwent the procedure in November 2018, so I could understand the process from a patient’s point of view. Key take home points: The procedure is slightly more uncomfortable than dermal fillers It may be undertaken using local anaesthetic, or if you prefer, under light sedation If done while awake, it takes about an hour from start to finish A needle is used to pass fine threads under the skin, which are then pulled to stretch lax skin taut. You may go home straight after the procedure (someone will need to drive you home if you opt for sedation) You may return to work the next day You may not exercise for 3 weeks afterwards and will be advised to sleep on your back for 3 nights afterwards. Over the following two weeks, as you move your face, there will be gradual sag of your skin. Over time, the threads will cause new collagen to form under the skin, which may last around 1.5-2 years. At that point, due to the ageing process, you may need revision of the procedure to adjust the tissue again Depending on your face and areas of concern, you may have between 2-4 threads on each side of the face.The cost begins around $3000 but is dependent on the number of threads needed, which varies based on the patient - their age, their concerns, their skin quality and more. This procedure is best for people in their 30s and 40s, but my oldest patients have been in their 60s, who wanted some improvement, without the cost of a facelift ($20-50k). As with all procedures that involve the face, commonest side effects are bruising, bleeding, and a small risk of infection especially if you have other medical concerns. We advise that you not undertake any significant medical procedures 2 weeks prior to any travel, or any big events such as weddings, parties and similar due to bruising and time to settle being the commonest side effects, which may cause anxiety. If you would like more information on thread lifts, and to discuss options and a personalised treatment plan for you, please get in touch on 02 9734 8845 or email us on contact@skinessentials.com.au Get in touch to organise a personalised consultation with Dr Joshi to plan your treatment for your best skin ever.

In consultation with patients, I’m frequently surprised by the confusion and misinformation that exists out there, even among otherwise educated patients. It’s no surprise then, that the beauty industry is as successful as it is, with so many markets selling regimens that aren’t based in fact or evidence. At Skin Essentials we try our best to stick to evidence, and to what works while acknowledging and stressing to patients that as with anything that has a human component to it, individual results may vary. One of the commonest problems I encounter, as a Woman of Colour (WOC) myself, is that of pigmentation in its various forms. Whether it’s Melasma, Post Inflammatory Hyperpigmentation (PIH), photo ageing or a mixed form, uneven pigmentation, especially on the face, can be quite distressing and hard to remove completely. It is a pigment disorder that most commonly occurs in women of childbearing age, though it may affect women at other stages of life, as well as postmenopausal women. It is also far more likely to affect women (1:4) than men (1:20) Commonly known as the “mask of pregnancy”, it’s causes are varied- from genetics, to ethnicity (more commonly affects women with light brown skin from sunny areas in the world) to the use of hormonal contraceptives, pregnancy and lack of sunscreen use. Once present, it is typically hard to remove completely and requires meticulous care and treatment to prevent it worsening. There is so much misconception that abounds about Melasma, and improvement is typically seen with a combination of skin treatments, typically a course of religious sunscreen use, a skincare regimen formulated with Melasma in mind, as well as a course of skin treatments such as graded medical grade chemical peels and/or skin needling. On the flip side, due to the likelihood of these skin types to be more prone to pigmentation problems, if not undertaken carefully and with a thorough understanding of underlying issues, including any medical conditions that may predispose to it, one may find the condition worsening. So what works? While each skin and person is different, here are some general guidelines. Sunscreen- always, rain or shine, winter or summer, reapplied frequently through the day. Enough to leave a shiny hue on the skin on initial application. Sun protection, always - even an hour of sun exposure can undo weeks of treatment. A skincare regimen that incorporates a combination of ingredients that will facilitate increased skin cell turnover and even out skin tone. A series of skin treatments eg 3-6 sessions of graded chemical peels and/or a series of 3-6 sessions of skin needling if you are on hormonal contraceptives, consider coming off them as they all have potential to worsen hyperpigmentation Consider a twice yearly course of SkinBoosters, non-lifting injections of hyaluronic acid under the skin to stimulate collagen and improve evenness of tone and texture. These are usually conducted under the supervision of a doctor, and once maintenance is achieved, ongoing care as directed. When is a good time to begin these treatments? Anytime, but the best time in the Australian climate is often winters- reverse sun damage, and take advantage of the cooler weather to achieve significant gains on skin improvement in time for summer and the holiday season. Ready to get started? Get in touch to organise a personalised consultation with Dr Joshi to plan your treatment for your best skin ever.