In-clinic non-surgical procedures such as injectables and lasers are booming in popularity for their often fast and visible results – but those, despite the often eye-watering cost, are not always guaranteed.
“Patients are surprised to learn that medications, gut health, stress and even the ‘wrong’ exercise can all get in the way of treatment success, but it’s true,” says Irish cosmetic physician Dr Jennifer Owens (who also has a London residency at the Reborne Clinic). “Aligning all the internal and external factors that influence facial health really is the key to treatment, and skin, satisfaction.”
So what are some of the most pernicious tweakment disruptors? Owens reveals five, and the ways to get around them.
Does your melasma not respond to treatment? Avoid heat triggers
Melasma (sometimes called ‘pregnancy mask’) shows as large pigmented areas, often on the forehead or top lip. “It’s driven by hormones and UV exposure, but inflammation and heat play a very significant role as well,” says Owens. Melasma can be treated with targeted lasers or peels, “but relapse is common, especially in skin of colour, often because important contributing factors are overlooked.”
“You must avoid heat and anything that triggers inflammation if you want to keep melasma stable,” she says. So things like hot yoga, saunas, steam rooms and even the summer heat are out, alongside overly aggressive skincare and treatments that may improve regular pigmentation but can make melasma worse. Retinoids, acids and certain lasers are examples, Owens says: it’s a no unless in the hands or under the guidance of a specialist. And always wear sunglasses: “UV exposure to the eyes can stimulate pigment pathways and trigger melasma in the skin, even if you wear facial SPF50+ like you should, always.”
Getting less mileage out of your anti-wrinkle toxin? GLP-1 jabs may be to blame.
“Botox and other toxins help to prevent muscles contracting so the overlying skin can smooth out,” says Owens. “Rapid weight loss can cause a decline in fat but also muscle, leading to less support under the skin. With less of this ‘padding’, we get less of a smoothing effect from Botox.”
Secondly, many doctors have reported GLP-1 users’ toxin works up to three weeks less long, which may be due, says Owens, to a faster metabolism related to GLP-1s increasing the speed with which muscles ‘use up’ the toxin. Another theory, she says, is that both drug types act on the same nerve-signalling proteins, and so get in each other’s way, although, “we need more data for definitive answers.”
Expensive lasers fail to clear up your acne? Consider hygiene tweaks.
No anti-acne laser or prescription skincare will truly zap spots if you’re not also serious about zapping germs day-to-day, says Owens. Follow her top tips:
- Clean makeup brushes after each use (and keep them dust-free in a drawer). Never use sponge applicators and brushes directly attached to a tube of liquid makeup.
- Double cleanse your face: use an oil or balm cleanser to remove makeup and SPF, then a gentle water-based one to deep-cleanse your skin.
- Clean your phone regularly (it’s often a lot more disgusting than you think).
- Change your pillowcase every second night, especially when you've had a treatment.
- Cut your nails. Long nails have been shown to harbour higher levels of bacteria and don't respond as well to cleaning with alcohol gels.
Do Profhilo jabs no longer refresh your face? HRT may sort things out.
“Throughout (peri)menopause, falling oestrogen levels cause a fast depletion in collagen. This has a profound effect on the skin, but also on the success of collagen-stimulating treatments including Profhilo and polynucleotides,” says Owens. “Skin simply doesn’t have the same raw materials it once did to respond robustly: collagen loss in itself makes it harder to rebuild collagen.”
While it’s not for everyone, hormone replacement therapy (HRT), she says, can be worth considering. “It has in the long term been associated with higher collagen levels, improved skin elasticity and fewer wrinkles, and helps create an environment that responds better to collagen-stimulating treatments.” Any tweakment aimed at increasing collagen levels “works best when skin’s biology is working with you, not against you,” Owens explains.
Is your rosacea laser not reducing your redness? It may be your gut
Targeted laser and IPL treatments can work wonders temporarily reducing the visible redness of rosacea, but they “don’t address what is likely a key driver: the state of your gut,” says Dr Owens. Those with rosacea, it appears, often have measurably imbalanced microbial populations (microbiomes) in their gut and blood, contributing to the chronic inflammation of rosacea. In fact, any disturbances in the digestive system may trigger or worsen inflammatory skin conditions.
“It helps explain why creams or lasers alone may give few or short-lived results for some patients,” says Dr Owens. “A holistic approach including gut health management through diet and supplements, stress reduction and treatments will tackle redness at its root as opposed to just quelling flare-ups.”
