Dermatology

Skin health

To explore the skin's anatomy, learn about the causes of ageing and find information about common skin conditions dermatologists can help treat, please visit our Skin Health page now.

How can cosmetic dermatology help?

What if it's too late to prevent skin damage and premature ageing? Of course, the moment we desire smooth, firm, blemish-free skin is the moment we no longer have it. As teenagers we were probably too busy lathering on the tanning oil to worry about what effect the sun's rays would have on our skin in 20 years time. At that age it's easy to imagine we'll remain smooth and wrinkle-free forever.

Of course, none of us really stay wrinkle-free forever. Even the most genetically blessed among us can't hold off the effects of time and gravity for very long. Celebrities like Cameron Diaz and Madonna, who manage to look unbelievably flawless and youthful well into their 40s and 50s, are not genetic miracles: they have their dermatologists to thank.

Dermatologists are medically trained to administer a huge range of treatments designed to reduce the look of skin disorders, skin damage and ageing.

Combining medical knowledge with beauty expertise, cosmetic dermatologists treat the skin by:

1. Reducing lines and wrinkles.

2. Boosting volume and contour.

3. Improving skin surface and texture.

1. Lines and wrinkles

Lines and wrinkles appear naturally over time as the skin's levels of elastin and collagen gradually deplete and dynamic wrinkles (the creases that form when we make facial expressions) become static wrinkles (lines and creases that remain visible even once the face has returned to the neutral position).

We all know lines and wrinkles are an inevitable part of getting older, and we also know from the age-defying celebrities in the media and the multi-million pound wrinkle cream industry, that lines and wrinkles unfortunately do not fit into the modern idea of beauty. It is for this reason that Britons spend around £544 million a year trying to get rid of the lines and wrinkles across their bodies³.

Dermatologists tend to view lines and wrinkles in terms of levels of severity, adapting the course of treatment for each individual's own needs. The levels are:

Class 1: Fine wrinkles that develop early on.

Class 2: Fine to moderate deep wrinkles accompanied by a moderate number of fine lines.

Class 3: Lots of fine lines and deep wrinkles all over the face.

2. Volume and contour

Lines and wrinkles are not the only signs of damaged and ageing skin: gravity is as much of a culprit as time. As we grow older, our bodies gradually sink downwards, unfortunately giving us that hollow, sallow look associated with old age.

3. Skin surface and texture

Surface and texture is also important for the overall look and health of the skin. Researchers found that most people are able to accurately predict a person's age simply by looking at a single patch of their skin.

Irregular pigmentation (darker patches of skin) can make a person look older, less attractive and less healthy. Dermatologists use a wide variety of methods to improve the colouring, surface and texture of the skin to create a smooth, younger-looking complexion.

Dermatological treatments

There is a huge range of dermatological treatments available to treat lines, wrinkles, volume, contour, skin surface and texture. Here is a list of some of the most common dermatological treatments available:

Botox

Botox is the brand name for botulinum toxin, a chemical that, when administered in extremely small doses, causes localised paralysis in facial muscles. Dermatologists inject botulinum toxin into particular areas of the face to limit the movements of tiny muscles that control facial expressions. Because dermatologists very carefully select only certain areas to inject, the untreated facial muscles are left free to move normally while the treated muscles remains paralysed - thus reducing the appearance of lines and wrinkles. Botox is used to treat:

• deep frown lines between the eyes at the top of the nose
• expression lines on the forehead
• crow's feet around the eyes.

The price of Botox starts at round £150.

To find out more about this form of treatment and whether it's right for you, please visit our Botox page.

Chemical peel

The chemical peel is a dermatological procedure involving the application of acid solution to the skin to remove the top layer and expose a new, healthier layer of skin beneath. Chemical peels can be used to treat:

• acne scars
• fine lines
• sun damage (dark spots, freckles)
• mild scarring
• dark patches caused by pregnancy
• dull skin.

Chemical peels cost between £70 and £500.

Dermabrasion

Otherwise known as 'dermasanding', or 'dermaplaning', dermabrasion is a surgical procedure that 'sandblasts' the surface layers of the skin to reduce the appearance of scars and wrinkles. The patient is usually given a localised anaesthetic and sedation before the dermatologist uses either a wire brush, or a tool containing diamond particles, to scrub away the top layers of the skin.

Dermabrasion can be used to treat:

• wrinkles
• pigment change from sun damage
• raised or sunken scars from acne
• chicken pox
• surgical scars
• tattoos.

Dermabrasion can treat small, select areas (e.g. the lines around the lips) as well as larger areas of the face.

The price of dermabrasion depends on the size of the treatment area but it can cost anything from £1000 upwards.

Sclerotherapy

Sclerotherapy is a form of treatment involving the injection of salt solution into troublesome veins. Sclerotherapy is used to treat:

• varicose veins
• spider veins (enlarged blood vessels visible on the skin - especially the legs, face and nose).

It works by irritating the lining of the blood vessel so the walls swell and stick together, causing the blood to clot. Over time, this causes the blood vessel to become scar tissue that eventually fades from view.

You can expect to pay around £100 for one Sclerotherapy session.

Collagen injections

Over time, the skin's supporting structure (comprising mostly of collagen) begins to deplete, resulting in sagging and a loss of volume and contour. Dermatologists can administer bioengineered human collagen injections straight into the dermis layer to revive the plump, youthful look of the skin. Although the skin will normally accept the new collagen as its own, the levels will still gradually deplete once again over time and you may be required to have around two to four treatments a year. Brand names for collagen injections include:

• Sculptra
• Restylane
• Juvederm.

Collagen injections can cost anything from £250 upwards.

Laser skin resurfacing

Dermatologists administer laser skin resurfacing to remove very precise areas of the skin with pulsating and continuing light beams. Laser skin resurfacing is designed to treat:

• wrinkles
• warts
• birthmarks
• enlarged oil glands on the nose.

This procedure requires anaesthetic and sedation. The treated skin should take 10-21 days to heal fully.

Laser skin resurfacing can cost anything between £600 and £1000 for a single treatment.

Endermologie cellulite treatment

As well as wrinkles, age spots, dry skin and blemishes, 80% of woman⁸ also have the small matter of cellulite to deal with. Characterised by the 'orange-peel' effect on the skin of our buttocks, thighs and stomachs, cellulite cannot be tackled easily with diet and exercise alone. Because cellulite forms in the hypodermis later of the skin, it is in fact down to dermatologists to rid us of this unwanted guest.

Endermologie involves a mechanical massaging process designed to improve circulation, improve skin tone and reduce the appearance of cellulite.

Endermologie costs around £40-£70 per treatment. It usually takes around 6-10 sessions to get the desired effect but many dermatologists offer discounts on bulk bookings.

To find out more about this treatment, please visit our Endermologie page.

What training and experience should a dermatologist have?

All dermatologists working in the UK must be registered by law with the General Medical Council (GMC). Below we have provided general details of the GMC but if you wish to find out more about this organisation, please follow the purple link.

General Medical Council (GMC)

The General Medical Council (GMC) is the independent regulatory body for doctors in the UK. The GMC has strong and effective legal powers (established under the Medical Act of 1858) designed to protect the public and uphold the highest possible standards of practice. The GMC puts patient safety first, supports good medical practice, promotes fairness and equality, and ensures all registered doctors uphold accountability, integrity and transparency.

References

¹BBC, 'Help needed for people suffering from skin conditions'

²Yahoo News, 'Understanding dermis'

³Daily Mail, 'Buzz off, wrinkles: An anti-ageing cream with an electric charge isn't as shocking as you think'

⁴Farage, MA. Miller, KW. Maibach, HI. 'Textbook of Aging Skin'. Springer: Berlin, 2010.

⁵Guardian, 'Percentage of the population living in cities'

⁶New York Times, 'Twin studies explain wrinkles of aging'

⁷Chacha.com. 'How thick is human skin?'

⁸ivillage, 'Cellulite dos and donts'

⁹NHS, 'Psoriasis'

¹⁰NHS, 'Rosacea'