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I’m a dermatologist – here are the 4 most common skin conditions I deal with and how to fix them

OUR skin – especially the skin on our faces – is almost always on show, so, it makes sense that we’d want it to look the best it can. 

However, hormones, diet, stress, sleep (or lack of), and other lifestyle factors can disrupt the health of our skin

Acne can cause lots of problems for women in the forties

This can lead to blemishes, redness and other unwanted marks, as well as skin conditions that can be difficult to get rid off. 

The skin is the body’s biggest organ, and Dermatologist Dr Surbhi Virmani, founder of London’s Cosderm clinic, deals with patients’ skin conditions every day. 

Here are the most common skin conditions she faces, the triggers behind them and how to sort them for good…

1. Pigmentation 

Our skin tends to produce some colour. In fact, all of us have the capacity to produce colour, some more than others.

“Whatever you produce should be deposited under your skin in a uniform manner, however with age and UV light, we lose capacity to deposit this skin in a homogenous manner so you see pigment dumping,” says Dr Virmani. 

Sun spots are a classic case of pigmentation.

“The simplest way to avoid pigmentation is to stay out of the sun; wear a hat, wear a scarf,” she adds.

Staying out of the sun also reduces skin cancer risks



Dr Virmani says you should top up SPF every three hours – especially if you are lighter skinned – with something being better than nothing. 

“I hardly ever encounter someone who uses SPF properly unless they are terribly pigmented, but you can get sprays and powders now to make things easier,” she says. 

As for treating pigmentation, you can opt for vitamin C and retinol creams, as well as laser treatments for more extreme pigmentation. 

Dr Virmani says that melasma takes pigmentation to another level

“Most people get it with pregnancy but we also see it with men. Essentially it can cause black spots on the cheek, often called the ‘mask of pregnancy’.”

She explains that melasma is light sensitive, so quite resistant to treatment – it’s a chronic condition and keeps coming back. 

Speak to your GP who may be able to prescribe certain treatments to help.

Dr Virmani reveals that peels and lasers can work, as well as intensive treatment for pigmentation, but it will always come back

The easiest way to avoid melasma is to stay away from all forms of UV light, including indoor LED lights,

“Indoor LED lights might save you money but you’ll need to apply sunscreen indoors.”

2. Acne

Dr Virmani says acne is a big problem for many of her clients, and it is usually hormone related.

“With acne you have three things that come together; a patient with pores, the tendency for these pores to get blocked and then maybe excessive oil secretion and bacteria which leads to acne,” she explains. 

She says it’s important to break this chain of three, and simple products such as salicylic acid can help. 

Dr Virmani also says the old wive’s tale of crushing aspirin and rubbing it into your spots can actually work as these are made of salicylic acid.

“This acid will stop the pore blockage and stop the oil secretion. If this is not enough, we add retinol which stops oil production and increases exfoliation of the skin.”

Antibacterial therapy is the next step either with antibiotics, benzoyl peroxide and hormones. 

Roaccutane is the final one. 

“It’s what you take if you have severe acne over the body with scarring and you don’t have the time to try other treatments.”

Dr Virmani sees a lot of adult acne, particularly in women in their forties.

“With levels of oestrogen going down and testosterone becoming more dominant, women may get more spots in their forties,” she explains.

“There is some value to nutrition with acne; supplements of vitamin A, zinc and B5 work wonders. Reishi mushroom extract and probiotics can work too.

“Sugar and dairy we know for sure can trigger acne.” 

Plus, she explains that what you apply to your face makes a huge difference.

“Women may plaster thick make-up on it which further blocks pores.”

Dr Virmani does reassure however that acne does not mean your skin is dirty.

“Your skin can be very clean and you will still get acne. In fact, people overwash and disturb the skin barrier more. Your skin is not dirty.”

She also recommends checking that you rinse your conditioner off properly when you wash your hair, as conditioner can be thick and greasy, blocking pores. 

3. Rosacea 

A common skin condition that can cause red flushing in the skin as well as small bumps and visible blood vessels. Skin can be hot and stingy too. 

Dr Virmani says rosacea is most commonly triggered by lifestyle factors such as autoimmune changes, sun exposure, alcohol, or anything that makes the body super sensitive.

“In half of my patients, they have Demodex skin mites (which live in human hair follicles). 

“Patients might be sensitive to their droppings and when the mites die, the bacteria can get into the skin.”

She says that rosacea can also be hereditary, and is sometimes wrongly diagnosed as acne.

“Acne spots have a common dome; an opening like a black or white head.

“Rosacea spots on the other hand are smooth bumps. If you treat rosacea with acne medicine, they will struggle.”

She adds: “With rosacea, less is more. Use a gentle face wash, pat dry, don’t rub and use SPF designed for use on sensitive skins. 

“Don’t fall into anti-aging treatments either as they can  make it worse.”

To treat redness caused by rosacea, the gold standard treatment is lasers, and with lumps and bumps, there are topical antibiotics you can apply to kill off the mites.

“Rosacea skin is very sensitive, so the less you do the better it is. 

“Use room temperature water when using a face wash. Avoid any food triggers and keep a food diary,” adds Dr Virmani. 

Make-up with tints of blue can also help disguise the redness. 

4. Ageing skin 

Loss of elasticity, wrinkles, dryness, redness and spots are all signs that skin is ageing.

The skin has a top and bottom layer.

“Sugars are kept in the top layer; the biggest sugar we all know is hyaluronic acid but it goes down each decade. 

“There is a six per cent decline of hyaluronic acid per decade in life if you look after skin. 

“However if your skin has been exposed to the sun, this decline could be up to 20 per cent.”

If you’re a smoker, Dr Virmani recommends stopping as “smoking shrinks the blood supply to the skin” which can contribute to ageing.

“SPF is vital. Multivitamin serums with C, E and A vitamins are good. Vitamin C is a strong antioxidant; it’s the gold factor for collagen production. 

“Vitamin A is retinol; it works like a hormone and penetrates the skin. It prevents the clogging up of skin and [promotes cell turnover] for smoother skin.”

She says retinol has been the holy grail of skin care for decades, however, stick to applying this at night as it’s particularly sensitive to light. 

Peptides are also recommended, which in the words of Dr Virmani are basically “botox in a bottle” – they can help stimulate your body to make collagen

As well as topical products, peptides are also found in foods such as meat, shellfish and flaxseed.

Lastly, you need a good hydrator to build the skin barrier. 

“Ceramides, the stuff our skin is normally made of, can be found in creams,” says Dr Virmani.

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