As we rapidly hurtle towards summer and hot weather and plenty of time lounging outdoors, by pools and the beach, it is even more important than ever to be sun smart. Applying sunscreen with SPF 30 or higher daily dramatically reduces the risk of skin cancer, including the deadliest form, melanoma. Sunscreen is one of five sun protection measures (slip, slop, slap, seek, slide). Cancer Council recommends using sunscreen that is broad-spectrum, has a sun protection factor (SPF) of at least 30 and is water resistant. In addition to reducing your skin cancer risk, there is substantial evidence showing that sunscreen helps reduce your risk of skin aging. However, for some people, applying certain types of sunscreen can also cause skin sensitivity or an allergic reaction.  Reactions to sunscreen are rare and may be a result of a sensitivity or allergy to any of the many ingredients used in these products, including a fragrance, preservative, UV absorber or another component. Sensitivities to sunscreen are complex and can range from mild to severe. Reactions can be linked to a range of co-factors, including sunlight and can also be caused by or made more severe if sunscreen is used with some medications or other topical creams and lotions. Some reactions occur soon after applying the sunscreen, while others (e.g. allergic reactions) can develop after a couple of days or prolonged use of the same product. Reactions occur in a very low proportion of the population – fewer than 1% of all users, but can be upsetting when they occur.  As with all products, use of sunscreen should cease if an unusual reaction occurs. Individuals experiencing reactions should see a doctor to understand what may have caused the reaction and get advice on ingredients that should be avoided in the future. Physical vs Chemical Sunscreen  Chemical sunscreens are carbon-based compounds. They protect the skin from harmful ultraviolet (UV) light by absorbing the energy and preventing it from passing through. Physical or mineral sunscreens use ingredients such as zinc oxide and titanium dioxide which have not been reported to cause contact allergy. Mineral sunscreen is quite effective and tends to be less irritating than chemical sunscreen but it may be more difficult to spread on the skin and may leave behind a white or ashy appearance. Sunscreen ingredients are similar across all brands, and sensitivities to sunscreen are complex, so simply changing the brand of sunscreen may not eliminate a reaction. You may like to try a sunscreen that has been specially formulated for sensitive skin and begin with a test patch on a forearm for a few days to determine any potential allergies.  As always remember that sunscreen is best used together with the other 4 sun avoidance measures - a sunhat, sunglasses, seeking shade and protective clothing and is your last line of defence against sunburn, sundamage and skin cancer.   

If you've followed the series from your 20s through to now, you know the basics:  sun protection is the holy grail to ageing well  good longterm lifestyle habits are key - eating mostly well, limiting alcohol, not smoking (or quitting) and exercising regularly are all good habits to implement sooner than later  obtaining personalised medical guidance for your skin is just as important as obtaining advice on other aspects of your health as is prioritising preventive care such as regular skin checks. Prevention is not sexy, or heroic, but it is the best bang for your buck longterm and far easier than undoing damage.  In saying all that, it is never too late to begin exactly where you are, as long as you are mindful that the longer you leave it, the harder it is to reverse some of the changes, the more expensive and healing may be impeded from minimally invasive surgery due to thinner more fragile skin.  Our life expectancy is now well into our 80s in countries like Australia, and many if not most of us, will work till 70 or beyond if we hope to maintain a similar standard of living post retirement.  Focusing on judicious medical aesthetics is then not only about vanity but about continuing to look our best at every age and stage, to look functional and competent to our colleagues and if we are in a service role, to our clients and patients, as well as informing our sense of self and healthy self esteem.  The desire to continue to like what we see and to feel good about ourself goes far beyond mere vanity for most of us, and at Skin Essentials we take a holistic view of this, with a roadmap drawn up especially for you, over time - weeks, months and years to come to help you age well. In return we ask for your commitment, consistency and your budgeting to allow you to follow recommended treatment plans. Without this investment, we cannot attain success.  The fact remains, however that in our 60s, no matter how diligent we were in the earlier decades, there will be inevitable changes in our skin over our entire body but treatment and care in the earlier decades can influence how much the ageing process shows up on your face and body.  Volume loss continues to be the biggest issue as we age in this decade:  there is loss of fat pads and their migration south in the face as well as bony loss around the mouth such that skin can seem to hang off a frame there is loss of skin elasticity, giving rise to fine lines and wrinkles and crepeyness in skin - around the eyes, around the mouth, and on limbs.  continued collagen loss also means that skin lacks the usual plumpness and glow of youth. In the 5 years immediately post menopause, there is as much as 30% collagen loss, and thereafter 2% per year instead of the previous 1% per year from our 20s.  So what can we do in our 60s, if we are still active and our outside seems a mismatch to our inside?  1. Surgery  As always, beyond an age, I usually raise the idea of a face and neck lift with patients in this age group and their willingness to consider it. Will their budget and lifestyle allow for it? If so, it may be a feasible option and I can help refer to a plastic surgeon.  2. Minimally Invasive Fat Loss and Skin Tightening  For many people, surgery may not be an option or a path they wish to go down. Minimally invasive fat loss and skin tightening procedures may then be a suitable alternative as discussed also in the 50s age group.  3. Volume Replacement  It is important for patients to recognise that surgery along will not replace volume loss in the face - specifically, in the temples, around the forehead, in the cheeks and more. Even if they opt for surgery, to reposition ligaments and muscles and to remove excess skin, they will also need volume replacement for best results, otherwise they risk looking windblown, as the old face and necklift cases of the past often show. Some may opt to have the surgery first and then return to us for volume replacement via dermal fillers, skin therapies that replenish collagen, or both.  4. Ablative Laser Resurfacing  With deeply etched lines and wrinkles due to sun damage, this may be a sound choice and option for patients. There is usually downtime of 7-10 days and is a treatment undertaken in clinic if you are a suitable candidate.  5. Medium Depth Chemical Peels  Medium depth peels are another way to resurface superficial skin layers and reveal fresher less lined skin underneath. They can be used on the face, neck and decollete as well as hands, depending on the concern and like lasers, have an associated downtime of several days.  6. Focus on other areas - hands, neck, decollete  For many patients who start at a younger age, the 50s and 60s can often be a time to shift focus from the face to the other exposed areas of our body that can age us - our hands, our neck and decollete.  They are all subject to sun exposure and ageing. Hardworking areas such as our hands may look thin, heavily veined and far older than our chronological age depending on how much work we do with our hands, while the neck has thinner skin and not a lot of fat, which is progressively lost with age, such that from our 40s onward, it can begin to age quite rapidly without a commitment to improvement.  As always, at Skin Essentials our aim and goal is a longterm holistic relationship with you, personalised for you and your specific concerns with a focus on honest, ethical beauty. Ready to start a conversation?   

The 50s are often the decade where it may feel like it all goes downhill, especially if you are female.  Perimenopause may have begun to make its mark known from your mid 40s, but it is often not until menopause that many women begin to struggle - the plummeting in oestrogen levels can cause an impact on most of our systems, from mood, to brain fog to dry skin, hair loss and more.  This is the time, if it is appropriate to do so, to talk to your primary care provider about your options including and especially for MHT or HRT, aka hormone replacement therapy. Menopause is nature's way of allowing us a reprieve from the draining and exahusting role of childbearing and caring for young children but with improved quality of life and function, many of us will live to our 80s and it makes no sense to be chronically miserable in our skin (literally!) and body and deprived due to outdated ideas of what we ought to accept as being normal; additionally a holistic approach will ensure that any in-clinic procedures we formulate with and for you will strengthen each other to help you live life to the best of your ability.  That said, your 50s are the time when if you've maintained some degree of care of your skin in the preceding decades, you will begin to see them pay off dividends now, as you continue to build on it.  Many women tell me they look in the mirror and no longer recognise themselves. Others regularly get unsolicited comments from colleagues and friends and family about how tired/ cranky they look as well as questions asking if they are ok. If these women are still working outside the home, this can be challenging and sometimes demoralising since we place such an emphasis on the way we present to the world and how we are seen based on it.  Even if you've thus far done the bare minimum or even neglected your skin, it's never too late to begin, as long as you have realistic expectations of what is and is not possible.  For many women who have done nothing to date and who find themselves disliking what they see in the mirror now which is usually a myriad of things- age spots (brown discolourations), deepening wrinkles even at rest and sagging skin due to volume loss. Sagging is by far, the biggest issue for this age group.  Many non invasive techniques may be insufficient and this may be the perfect time to consider minimally invasive surgical options or,  if budget and downtime allows, we can refer to plastic surgeons who can address this concern with you if needed via a face and neck lift.  If surgical options are not feasible for you, read on to see what else you may wish to consider to help improve your skin quality over the years and decade to come.  1. Eyelid Correction Surgery Often recommended for people in their 40s, this continues to be a staple for many people in their 50s also, not just for vanity but also because in many people the drooping eyelids which began in their 40s begin to affect functional ability, especially at the end of the day or when tired, when they might droop a bit more, or with the use of anti wrinkle when even a judicious dose of treatment to the forehead lines causes discomfort. Some patients also report chronic headaches that resolve post eyelid correction surgery.  This surgery is undertaken in clinic under local anaesthetic and most patients tolerate this very well. There is some downtime as with most procedures involving the eye area, and we would suggest a week or two of time off work, not due to any disability but due to expected swelling and bruising as the wound heals. Results are permanent and last years until further skin sags over the eyes again.  2. Dermal Fillers  If you first explore medical aesthetics in your 50s, it may be sagging and volume loss that brings you in for an opinion. Hollowing under the eyes, eyebags (which may only be amenable to surgery), excess skin around the eyes as well as jowling around the lower face and deep smile lines may be causes for concern as well as the seemingly overnight appearance of a double chin due to volume loss and sagging of skin from above.  Used judiciously dermal fillers may be used to replace some of the volume loss while we work on the deeper underlying issues, which will take longer and require planning, time and budgeting. The risk of too much dermal filler of course, is that they risk overfilling and leading to a caricature so it is best to stick to a practitioner who understands medical aesthetics and whose work you like.  3. Skin Therapies  By far and away, the mainstay of skincare in your 40s and up is effective skincare that is personalised to you and your concerns. In our 20s and sometimes even our 30s, we may get away with dabbling and trying every new trend that erupts on the scene, but by our 30s, we begin to see signs of a childhood with too much sun, or active facial muscles or chronic sun damage that never quite turned into an actual sunburn.  Fine lines and wrinles on animation as well as the appearance of dark discolouration on the skin begin to accelerate with age and over time if we do nothing in addition to progressive collagen loss that leads to a loss of plumpness and glow in our skin.  For most patients who are adequately volume replaced, my go-to in clinic is a combination of collagen induction therapies using biostimulator fillers 6-12 monthly as well as a series of skin therapies personalised to your skin concerns, with our skin therapist.  Most skin therapies take time, and a series of regular treatments to begin to see effects - usually 3-6 months minimum, in conjunction

Here in the Southern Hemisphere, we consider ourselves lucky that summer coincides not only with school holidays, but also, Christmas, New Year and the end of one year and the beginning of another. As the busy year begins to wind down, it seems the perfect time to lie back, take some time off no matter how hard we have worked through the year, and relax with family. Summer Daze.... When I think of summer, I think of long, lazy days, lots of water activities and books, cool drinks and food! Already, when walking around, I see fellow Aussies out and about, enjoying the sun, and while I don't like to think of myself as a party pooper, my main concern is for their skin. Although most people love the warmth and light of the sun, too much sun exposure can significantly damage human skin. The sun's heat dries out areas of unprotected skin and depletes the skin's supply of natural lubricating oils. The sun's ultraviolet (UV) radiation can cause burning and long-term changes in the skin's structure. The most common types of sun damage to the skin are: Dry skin — Sun-exposed skin can gradually lose moisture and essential oils, making it appear dry, flaky and prematurely wrinkled, even in younger people. Sunburn — Sunburn is the common name for the skin injury that appears immediately after the skin is exposed to UV radiation. Mild sunburn causes only painful reddening of the skin, but more severe cases can produce tiny fluid-filled bumps (vesicles) or larger blisters. Actinic keratosis — This is a tiny bump that feels like sandpaper or a small, scaly patch of sun-damaged skin. Unlike suntan markings or sunburns, an actinic keratosis does not usually go away unless it is frozen, chemically treated or removed by a doctor. It develops in areas of skin that have undergone repeated or long-term exposure to the sun's UV light, and is a warning sign of increased risk of skin cancer. About 10% to 15% of actinic keratoses eventually change into squamous cell cancers of the skin. Long-term changes in the skin's collagen — These changes include photoaging (premature aging of the skin because of sun exposure). In photoaging, the skin develops wrinkles and fine lines because of changes in the collagen of a deep layer of the skin called the dermis.   Over a lifetime, repeated episodes of sunburn and unprotected sun exposure can increase a person's risk of malignant melanoma and other forms of skin cancer.   So what does skin damage look like? Sun-damaged skin may shows the following: Dry skin — The skin appears dry, flaky and slightly more wrinkled than skin on other parts of your body that have not been exposed to the sun. Dry skin is also one of the most common causes of itching and ageing skin gets drier, so needs more care to keep it hydrated. Sunburn — Mild sunburn causes pain and redness on sun-exposed skin. In most cases, there are clear boundary lines where the skin has been protected from the sun by shirt sleeves, shorts, a bathing suit or other clothing. More severe cases of sunburn produce painful blisters, sometimes together with nausea and dizziness. Actinic keratosis — An actinic keratosis appears as a small bump that feels like sandpaper or a persistent patch of scaly (peeling) skin that may have a jagged or even sharp surface and that has a pink, yellow, red or brownish tint. At first, an actinic keratosis may be the size of a pimple. Rarely, an actinic keratosis may itch or be slightly tender. Long-term changes in the skin's collagen — Symptoms of collagen changes include fine lines, deeper wrinkles, a thickened skin texture and easy bruising on sun-exposed areas, especially the back of the hands and forearms.   Outcomes Sun damage may result in a permanent cosmetic concern, only some of which may be treatable, but not usually reversible, with judicious use of personalised skincare regimen, careful sun protection for life and treatments as recommended by your doctor - chemical peels, laser and light treatments, prescription medications as well as injectables. Some treatments for actinic keratoses can leave a pale (de-pigmented) area of the skin surface. More important than appearance is the long-term impact of sun damage on your chances of developing skin cancer. The more unprotected sun exposure you have during your lifetime, the greater your risk of skin cancer, especially if you have a light complexion so it is important to have your doctor care for these and check your skin regularly and to keep monitoring it yourself for any new changes. As an example, I have attached an example of what happens with the most simple measures that most of us ignore - suncare. Using the app Sunface, I took a pic of myself, and then compared myself in 5, 15 and 15 years, with daily sunscreen vs no sun protection. See the results for yourself. In someone with lighter/fairer skin, the damage is faster and deeper, as would be the lines. In someone with darker skin, it is slower, but still unavoidable if one is not careful about sun protection.   Take home message? It is NEVER too late to care for your skin. it begins with simple measures such as sun protection - all day, everyday, sun or rain, winter or summer - hat, sunscreen, glasses and clothing regular reapplication of sunscreen during the day apply sunscreen 15 mins before getting in the car - the windshield and windows don't block out sun rays SPF 30+ regularly through the day, 5mls (teaspoon) to the face reapply more often when sweating, or in the water References  Weird things that happen as we get older.