Expert Q&A on understanding and caring for spot and acne prone skin with Dr. Anjali Mahto

What type of skin do you have?

Misconceptions/Myths

What is the biggest myth about acne?

I would say there are four areas where the biggest myths lie.

Firstly, diet. People often think that their skin is directly influenced by diet. However, clinical trials confirm that acne is more down to hormones and genetics, for example the makeup of your microbiome and size/density of your oil glands, which is hereditary. Diet can play a role, but not in the instantaneous way that some might think. A small select group of people find that cutting out dairy can affect their skin positively, but improvement will happen over time rather than within days.

Next, lack of cleanliness and poor hygiene are often thought of as a cause of acne. This just isn’t the case, in fact people with acne are very aware of hygiene and are more prone to over-washing or cleansing which can makes things worse.

Thirdly, it is a myth that oily, or acne prone skin doesn't need moisturiser. Remember, oily skin does not mean hydrated skin, you still need a moisturiser to help support the skin barrier.

Finally, sunscreen. Many believe that sunscreen will block your pores and cause spots. In fact, acne prone skin can be more in need of sun protection as UV exposure can increase pigmentation. Prolonged sunlight can also drive comedones (blocked pores that form a bump) or blackheads so it can actually make your acne worse. Short term ultraviolet light can be good for the skin as it can be antiinflammatory, but we all need to be protected from long term damage.

How does bacteria affect the skin, which then causes a spot?

The cause of acne is primarily from the increase or change in hormones during adolescence, whichcauses the oil gland to produce too much oil, blocking the pores. The bacteria that live on the skin can act on this blocked pore causing deeper inflammation. It’s a perfect storm.

Teen acne is caused when hormones like androgens, testosterone and dihydrotestosterone, which females have too, spike, then the oil glands get bigger and release more oil.

What advice can you give for dealing with teen acne-prone skin?

My advice for tackling teen acne would be:

1. Get into a good skincare routine by cleansing the skin, morning and evening using products that contain useful ingredients such as salicylic acid, zinc, niacinamide, sulphur. These reduce or regulate the oil production in the skin. Moisturise with a gentle moisturiser- again look for useful ingredients such as salicylic acid, lipids like ceramides or squalane, zinc, sulphur, AHA, BHA, PHA. Used twice a day, this approach can help to maintain balanced skin- reducing oiliness, protecting from dryness etc, reduce redness and soothe skin.

2. Use sunscreen, SPF, on a daily basis, as it helps to reduce red marks (post inflammatory erythema) and dark marks (post-inflammatory hyperpigmentation) from getting worse in sunlight.

3. You can also incorporate over-the-counter medicinal spot treatments into the daily routine: there are treatments which help kill the key bacteria that causes the inflammation in spots, and ones that help reduce inflammation, for example.

4. And finally, don’t be afraid to consult with a doctor regarding prescription options if things are not improving and it is impacting mental health. A health professional will be able to advise on the next step depending on extent and severity of acne as well as taking into account your mental health and how you feel about it all.

What is your advice on using “active” cosmetic ingredients like retinol etc on teenage skin?

My advice for using active ingredients on teenage skin would be not to use them if you don’t have any skin concerns. It’s not a case of ‘starting early’ to see benefits in the long term, if you have balanced skin that shows no concerns, you don’t need to use active ingredients.

If you are tackling a skin concern and are trying active ingredients, then try to be patient. Don’t expect a miracle overnight. Give the routine and products time to work because the skin cycle is roughly every 28 to 32 days meaning this is how often skin cells shed and blackheads can form. In fact, most acne clinical trials run for a minimum of 12 weeks because it takes a few cycles to see a difference/benefit.

In terms of the products, remember that properly formulated products, particularly those made for sensitive acne prone skin, will include the active ingredients you need so there is no need to layer products on top of products. I would also suggest starting off using the product once or twice a week.

Don't use the product two days in a row, give your skin time to recover. Then if there is no redness, peeling, flaking or soreness, gradually build up to three nights a week or four nights a week.

What is the ideal skin care routine for acne/spot prone skin?

The ideal skincare routine depends on the severity of your acne and whether you are also using concurrent prescription medication (creams or tablets).

For general skincare, I would suggest a morning routine of cleanser, moisturiser and sunscreen, with an evening routine of makeup remover, cleanser and then use the gentle light non comedogenic moisturiser without SPF.

For those with mild to moderate acne, which is defined as mostly whiteheads and blackheads, with varying levels of papules and pustules depending on the severity, I I would recommend speaking to a pharmacist about trying over the counter products for a few weeks. If you then find this is not working, getting worse, or affecting mental health, go to the doctor who may prescribe a cream. In this case, I would recommend a morning routine of cleanser, moisturiser, SPF and an evening routine of makeup removal, cleanser, prescription product and then 20 minutes later applying a thin layer of a noncomedogenic moisturiser to help reduce peeling, flaking and redness which can happen when using treatments. You always want your medicinal products to go on first so they can be fully absorbed to do what they need to do.

If you are experiencing severe acne, which is defined as lots of large, painful papules, pustules, nodules or cysts, with potentially some scarring, and you are on oral antibiotics or a hormonal treatment or the contraceptive pill, I would suggest a morning skincare routine of very gentle cleanser, moisturiser, protective SPF and an evening routine of very gentle cleanser and moisturiser. Many treatments oral pills or creams can make skin quite dry or sensitive, so its important not to use daily skincare with drying or exfoliating active ingredients in - too many ‘active’ products will strip the skin, making redness and the dryness and peeling worse.

What is the difference between physical and chemical exfoliants?

Physical exfoliants are products that physically abrade or exfoliate the skin such as scrubs, flannels or cleansing devices. Data that shows that these can be more effective, particularly clearing the skin around the nose. However, if people use them too harshly or too often, this can break down the skin and irritate the skin barrier.

Chemical exfoliators work by using chemicals or exfoliating acids, such as alpha hydroxy acids (AHA), polyhydroxy acids (PHA) and beta hydroxy acids (BHA).

o AHAs are glycolic acids, lactic acids, and mandelic acids which are good for pigmentation, dark marks left from spots and removing the upper layer of dead skin cells.

o PHAs are gluconolactone and lactobionic acid. They have the same benefits as the AHA but are gentler and often more hydrating. They are more suitable for sensitive skin or irritated skin.

o BHAs are salicylic acid which are really good at reducing oil production which unblocks pores. For acne prone skin, you want a product that is gentle enough and contains both a salicylic and polyhydroxy acid as this helps tackle acne and improve skin texture and tone by reducing pigmentation.

What is the difference between an occasional spot compared with acne?

In terms of in the development process, there is no difference between an occasional spot and acne. It starts with the oil gland reacting to the hormones - the highest density of oil glands is on the face, chest and back, which is why those areas often seem worse. The oil builds up and combines with dead skin cells, forming a sticky clump which blocks the pores, becoming a lesion or ‘comedone’. Mild acne is actually defined as mostly blackheads and whiteheads with few to no inflammatory lesions.

As acne severity increases and more blocked pores, or “comedones”, develop over time, moderate acne can occur. “Moderate acne” is simply a descriptive term used by dermatologists (where there are 20- 100 black/whiteheads, 15-20 inflamed bumps or 30-125 total lesions). A comedone is a primary type of acne lesion (whether on the skin surface, or deeper underneath the skin surface) and when it’s forming, the skin microbiome plays a part in causing inflammation, creating a spot. To give it the technical term, the process of a spot forming is called pellicular hyperkeratinisation.

Many women find that they get acne flares pre-menstrually due to the hormone changes. The first half of a female cycle is oestrogen heavy. Then after a woman ovulates, her cycle is progesterone heavy, which is a hormone (similar to testosterone and DHT dihydrotestosterone) that has an androgenic effect, which triggers the oil gland and causes acne lesions.

How can we predict who will suffer from acne?

There are a couple of factors that can pre-dispose you to acne. If a first-degree family member suffers with acne this increases your chances of suffering with it by 50%-90%. Genes have large part to play in the makeup of your skin.

It is also very common for women who have polycystic ovarian syndrome (PCOS) to suffer with acne and this condition is far more common that you think affecting 8-10% of the female adult population.

Your skin tone can also play a part, with some tones more pre-disposed to oiliness.

What is your advice for tackling body acne?

People who go to the gym or wear tight gym gear for an extended period of time can get more spots on their chest, back and bottom because of the heat and sweat generated and compressed in those areas. I would always suggest showering soon after your workout and avoid sitting in your gym wear. Ideally, sportswear should be limited to the gym rather than wearing it as everyday clothing, particularly so when the weather is hot.

If you are prone to chest and back acne, there's absolutely no reason why you can't use your face washes and products that you would use on your face wash containing active ingredients like salicylic acid, niacinamide or zinc to wash your chest and back as well.

What is the role of the skin microbiome?

We all have bacteria that lives on our skin, just like we all have bacteria that lives in our gut. It's not just bacteria that make up the microbiome, it's bacteria, viruses, yeast, mould and fungus all together. However, from an acne perspective, it seems to be the C acnes bacteria (Cutibacterium acnes) strain that leads to more inflammation i.e. formation of spots in acne.

How long does it take for bacteria to cause a blemish?

It’s not as simple as saying it will take three days or five days to develop a spot, because the initial process (a blocked comedone) will have kick-started roughly 28 to 32 days prior. Sometimes people will say they had dairy recently and now they’ve got a spot. However, chances are that spot was brewing underneath the skin several weeks before.

What should people with acne-prone skin avoid doing?

I have three key watch-outs for people with acne-prone skin.

Firstly, picking. I know this is one of the hardest things to do, as it can be so tempting. The issue with picking is scarring, because when you pick the skin you damage the your epidermis or dermis, which will make things worse in the long-term.

Next, squeezing blackheads or attempting to do a home extraction. While extractions can be beneficial for removing blackheads, they do need to be done by a professional like a facialist or an aesthetician. If squeezing or home extractions are done wrong, all you're doing is pushing that inflammation deeper into the skin, creating a deeper spot rather than getting all the gunk out.

Finally, spending lots of money buying new products and chopping and changing your skincare routine too regularly. I would really encourage people to think of acne as a medical problem, not a beauty or a cosmetic one. You need to make sure your skincare is right and that you're using the right active ingredients from reputable brands. But if you've been doing that for a period and haven't found the right cleanser or the right moisturiser, remember it’s not your fault and it might actually just be a sign that you need to escalate treatment. If you had a problem like diabetes or asthma, you wouldn't think twice about seeing a doctor. But with acne people think it's a beauty ‘problem’ and they just keep changing products. It's heart-breaking how much money people will spend before they realise this isn't working.

What tips do you have for using makeup for acne prone skin?

There is clinical trial data which shows that wearing makeup will give acne sufferers more confidence.

Make up alone doesn’t cause acne, likewise, going make up free won’t stop excess oil, bacteria or dead skin cells shedding in the pores or control the spot-causing bacteria. I definitely don't think we should be shaming people for wearing makeup, as long as they are guided on the types of products they should be using and the application process.

Here are my tips for make up on acne-prone skin:

1) Make sure that you are using clean hands, clean makeup and brushes. I would recommend that makeup brushes are cleansed on a weekly basis.

2) Prep your skin correctly, meaning do your base routine with your cleanser, moisturiser and sunscreen before you put your makeup on.

3) If you're acne prone, you may find it helpful to just use makeup in the areas that you need it and allow the skin where you've got no acne or blemishes to remain uncovered.

4) If you still want to go for a heavy base or a heavy concealer, look for products which are noncomedogenic. These can include mineral based products which can help dry up the skin and tend to be more mattifying.

5) Where necessary, use colour correctors. A lot of people with acne find that it's the redness or the discoloration that bothers them. The truth is you can hide the redness, but you can't hide the bump or texture. If it's discoloration or redness that is the main issue, someone with lighter skin tones might get away with just using a green colour corrector that will neutralise redness with a little bit of concealer rather than applying a heavy foundation everywhere.

Similarly, those with darker skin tones who experience dark marks rather than redness, using peach colour correctors underneath their makeup or concealer can help neutralise dark marks.

Can getting facials help with spots?

Facials are ok to get if suffering with blackheads or oily skin. It can be beneficial for both. Facials are not suitable for more severe inflammatory types of acne lesions.

However, if you have inflammation which is deeper in the skin, no amount of facials or anything that you apply to the skin surface is going to get rid of that. Therefore, it’s crucial to seek medical advice to have your skin assessed and the appropriate treatment planned.

If you think about the skin, there are different layers. The epidermis is the outer-most layer, and the dermis sits beneath it. When you're getting deep spots like nodules and cysts, inflammation is sitting in your dermis, so nothing you're applying on your epidermis is penetrating to where it needs to go.

However, if you've got blackheads which are sitting quite superficially in the epidermis, chemical peels, a little bit of LED and some careful extraction probably will get those out. And in that case, you should be looking at doing those treatments roughly once a month with a facialist who is experienced in this skin type. That goes back to the life cycle of the comedone, which is 28 to 32 days, which is why peels and facials are normally recommended on a monthly basis.

Is acne prone skin more susceptible to pollution damage?

Yes, acne-prone skin can be more susceptible to pollution damage and pollution itself may also worsen acne. There's data from China that shows that pollution is something that can drive oil production – one of the precursors for acne developments. However, I would caveat that with those studies, they've only been done in one city, in one area. The question is whether or not that can be extrapolated in general to everybody.

I'd say, if you live in London, it may be something to consider, but if you're living in the Highlands somewhere, it’s probably a far less of a concern. Regardless, it’s another reason why cleansing is so important, especially that night-time cleanse to remove any particles sitting on your skin.

Is it possible to prevent post acne marks and scarring?

No, I wish there was a way to prevent marks and scarring – you have to stop the process (i.e. the inflammation itself) causing it in the first place! It's just the way that skin heals and some people will heal better than others, and that comes down to each person’s genetics of wound healing. Anything you can do to reduce the initial inflammation can be helpful – so no picking and instil good habits to manage your acne.

If you do have pigmentation, the best thing you can do is to use skincare ingredients that can help fade or reduce it, things like polyhydroxy acids, mandelic acid and glycolic acids.

If the marking is more severe and simple skin care won't get rid of it, chemical peels can help people who get redness following a flare up. Redness will eventually fade over time, however a good laser facial with IPL can help to speed this up.

Time itself will improve majority of these marks, but the only real prevention is to stop the process that's causing it in the first place.

Is there such a thing as a ‘quick fix’ for spots? So, if a spot developed and you've got a wedding the next day, what can you do, if anything?

Sadly, nothing is an instant total fix for spots! It also depends on the severity of the spot as to what you can do about it. For a deeper cyst or nodule flaring up and causing you concern, you’d see a dermatologist for advice and any treatment, ideally. For more superficial spots, some targeted cosmetic spot products e.g. with 2% salicylic acid, or absorbent spot patches with salicylic acid directly on the red mark may help reduce its visibility/shrink it down somewhat in a period of several hours to overnight.

Microbiome

Can you provide some background about the role of the microbiome in skincare, and how probiotics skincare could help?

Firstly, the skin microbiome is not just bacteria, it is a combination of bacteria, viruses, fungi, yeast, mould mites, and demodex mites, which can be an issue in rosacea.

Many products claim to sort out the skin microbiome, but the skin microbiome is far more complex than just one type of bacteria. It's the interaction of many things. The science behind probiotic or “microbiome-beneficial skincare” is still new and emerging, and there is a lot more to learn and discover about the mechanisms and benefits for each specific skin type or skin condition.

However, I think that you can include ingredients in a formulation that may be prebiotic in nature that may help moisturise the skin and improve the skin barrier, which can benefit skin and inflammatory skin conditions.

How does the skin barrier get damaged and what can you do to fix and prevent this? Why is the skin barrier important?

One of the common ways the skin barrier gets damaged is by using too many products and active ingredients at once. I think in lockdown and the pandemic people spent a lot of time at home researching skin care and watching YouTube and as a result started using active ingredients, which are not suitable for everyone. As a result, dermatologists, myself included, saw a lot of people coming in with redness, peeling, flaking, sore skin and irritant eczema. The overuse of exfoliating assets, particularly using too much salicylic, glycolic or mandelic acid, can be another really common cause of a damaged skin barrier.

Somebody who doesn’t have oily prone skin doesn't need to apply all these acids to their skin, as these can damage their skin barrier.

How does the skin pH affect the microbiome and acne bacteria?

Our surface skin has a slightly acidic pH, this can be disrupted by using or overusing specific products. When disrupting the skin’s pH, what you're going to find is the metabolic processes that keep your skin healthy won't function as efficiently. And if they're not functioning as efficiently, that can affect how much water is lost through the skin and can affect the balance of the microbes that live and thrive on the skin (aka the microbiome).

What does a balanced microbiome mean?

The skin microbiome is made up of a combination of bacteria, viruses, fungi, yeast and mites. This miniecosystem protects against pathogens, helping to fight inflammation and promote wound healing.

Microbiome balancing is quite a vague term. You wouldn't find a scientific paper that would talk about microbiome balancing for example. A healthy/balanced skin microbiome is usually found when the skin is functioning in an optimal manner.

When the microbiome is balanced, the skin is able to complete its barrier function appropriately. It can be disrupted in different ways – for example, altering your skin’s pH or even prolonged mask wearing as we saw during the height of the pandemic.

How can the skin benefit from the below ingredients in cosmetic skincare formulations?

Glycerin

This is a common ingredient found in skincare and depending on formulation can act as a humectant (binds water, i.e. hydrating), protecting and conditioning the skin. It is also very well tolerated by all skin types.

Liquorice Root Extract

Liquorice is mainly used in products as an anti-pigmentation ingredient, so it's really good at diminishing marks. It's very good at evening skin tone if you've got discoloration. It will help to shift marks and pigmentation if you’re using it on a daily basis, but the truth is, ultimately the best approach to get rid of the marks is stopping the reason why they developed in the first place. But it can help tackle marks that have already happened.

Zinc

Zinc is an anti-inflammatory. It's sometimes recommended as an oral supplement for acne as well as topicals.

Squalane

Squalane is a moisturising agent that’s very similar to natural moisturising lipids produced by healthy skin. It's very good for all skin types and doesn't really block pores, so it's helpful to repairing and strengthening the skin barrier.

Allantoin

Allantoin is a protective and conditioning ingredient that can help soothe the skin again and nourish the skin barrier.

Vitamin E

Vitamin E is an antioxidant. It depends on the concentration whether it's being used as an antioxidant or as a moisturising agent. It would depend on the formulation of the product, but if it's being used as an antioxidant, then it can help to neutralise any potential damage caused by free radicals generated by dirt, sweat, pollution, and UV that skin is exposed to.

Gluconolactone (a Polyhydroxy Acid –PHA)

This is a PHA (ie a form of alpha hydroxy acid) and acts as a chemical exfoliant without causing irritation in the way traditional AHAs do; may also have some anti-acne benefits.

Niacinamide

Niacinamide has lots of benefits for the skin. It's anti-inflammatory and it can act as an antioxidant, and it can also be an anti-pigmentation agent. Data shows it can also regulate oil production, so it's a good ingredient to have for acne prone skin.

Glycolic acid

Glycolic acid is an alpha hydroxy acid and essentially removes the upper layer of dead skin cells. This helps remove and improve skin cell turnover in the stratum corneum.

Salicylic acid

2% is the highest strength salicylic acid you can get in a cosmetic skincare product in the UK. In theory, 2% will be stronger than a 0.5%. However, with efficacy, it does also come down to the overall formulation and the pH of the salicylic acid being used.

Hyaluronic acid

Hyaluronic acid (HA) is not an exfoliating acid and is in fact a moisturising agent, despite the fact that it has ‘acid’ at the end of it. It's known as a humectant ingredient, so binds water in the skin. It’s really good at plumping the skin and improving the appearance of lines or dehydrated skin. The amount of HA found naturally in the skin decreases with age.

Retinol/Retinoid (Retinaldehyde)

Retinoids are an umbrella term for all vitamin A products, so retinol, retinaldehyde, and retinoids all technically fall under the retinoid category.

Retinols are probably where people tend to start. They come in varying strengths, but most people will probably start on at 0.1% to a 0.3%. You can go all the way up to 1% strength

All retinoids work by improving skin cell turnover; they’re also good at removing pigmentation, so they're often used in products for acne. They're also used in products for anti-ageing as well. Some Retinoids are prescription only.

Ceramides

Ceramides are moisturising ingredients, they are naturally found as part of the skin barrier. They can be very good at moisturising the skin, so cleansers and moisturisers are normally where you'd find them.

Lots of these ingredients have the same properties, how do you choose between them?

It can feel quite overwhelming! There are subtle differences between them though. Let’s look at alpha hydroxy acids for example, so lactic, mandelic and glycolic acid are the three most common that are used in skincare now.

Lactic has a slight benefit of hydrating, so if somebody wanted an anti-pigmentation product but also didn't want to strip their skin due to sensitivity, lactic acid is a good approach to take.

Glycolic is good for just generally brightening the skin as well as removing dark marks, so glycolic is a good anti-aging option.

Mandelic is really good for anti-pigmentation. So if somebody's not bothered about anti-aging properties and is just concerned about their pigmentation, I would recommend mandelic.

Are there particular ingredients that are better suited to younger/teen skins.

For acne prone teenage skin, the answer is no. It's not too young to be using a retinoid or an exfoliating acid because you're using it for an acne purpose, provided it's incorporated in the right way of course.

If somebody's got teenage skin without break outs or spots, then there's no reason to put those active ingredients into their routine. A good old cleanser and moisturiser without any of these active

ingredients will work just fine. There's no point trying ingredients/acids if you don’t need to as you are essentially disrupting a good skin barrier.

It comes down to the individual skin type rather than age of the person that you're treating.

Do antibacterial ingredients such as tea tree and witch hazel benefit acne prone skin, and if so, how?

Yes, they can as both tea tree and witch hazel are anti-inflammatory. There is data on both of those to show that they can be of benefit in acne prone skinvi vii. The problem with tea tree oil is sometimes

people will use neat tea tree oil directly onto their spot. If you use it neat rather than in a properly formulated cleanser or moisturiser, you might find it will irritate the skin and leave pigmentation behind.

Would you suggest that people start off with natural products?

Natural is largely intended to mean that it comes from a plant-based or botanical source, rather than a chemical one. But what makes a big difference is how the plant is itself is grown and what part of the plant you're using.

Natural products still need processing, so what you end up with tends to be very different to the core plant ingredient that you started with.

More traditional, chemical synthetic-based products have got far more data behind them and are much more resistant to changes in temperature when products are packaged, stored and transported. Often products described as natural are much harder to quality control, as they tend to contain less tried and tested preservatives.

My preference would always be to use something that's got a lot of data and been tried and tested and quality controlled.

What would be your number one ingredient for acne prone skin be?

Salicylic acid would be my number one ingredient for acne prone skin. The combination of salicylic plus niacinamide plus a PHA, is a good combination in my book.

General skincare concerns

How do you know what skin type you have?

Many people will have normal combination skin, which is not too dry and not too oily, but there may be a slight tendency of an oilier T zone. Their pore size isn't massively prominent, they don’t really break out and don’t really have dry patches.

If you've got dry skin, you will know because your skin will get flaky, be red and scaly at times. It often tends to be worse in the winter months, when the weather gets cold and cold air dries out the skin. Pore size is very small with dry skin.

For oily skin, you will know because the skin feels oily and greasy. Pore size is prominent, and skin may be prone to blemishes or spots. Oil production itself has got a circadian rhythm, or a 24-hour rhythm, so people will notice their oil production peaks at in the afternoon, resulting in shine.

For sensitive or rosacea prone skin, people will know because when they apply products they get burning, tingling or tightness symptoms on their skin. The skin goes red, or it flushes quite easily.

Those are the major skin types of people will generally fall into. They'll know if their skin needs the extra moisture, or if they're constantly using blotting paper to get rid of oil. And if they're neither of those extremes, they probably are normal combination.

Do higher priced products make any difference?

You do not need to spend an absolute fortune on good skin care. I think it's really important this message gets out, as products that are formulated well work similarly.

If you look at really expensive products and budget-friendly, high-street products, they often will contain exactly the same ingredients. The money often goes into the extra marketing, packaging and branding.

Is there a difference in day versus night products?

The main difference between day and night products is that day products will also contain ultraviolet filters (SPF) which you clearly don't need at night-time.

For normal combination skin, you probably don't need different products in the morning and evening.

For oily skin, using a light moisturiser morning and evening should be fine. You don't need to be using separate products.

The one place where there can be a benefit of using a separate night cream is for those with very dry skin or mature, postmenopausal skin where the skin gets very dry and very tight. In those cases, I think using a thick heavy night cream or layering night creams can be of benefit, because even water loss has got a 24-hour circadian rhythm and whilst we sleep we do lose a lot of moisture through the skin.

Can your skin get acclimatised to certain products making them less effective?

No, our skin cells shed every 28-32 days, so anything you've applied to the surface, those cells are gone in a month and new cells have taken their place. So, you can't ‘get used’ to products, you can keep using retinoids or exfoliating acids or cleansers and moisturiser.

Do anti-aging products actually work?

Effectiveness will come down to the formulation of product, the concentration of the active ingredient, its pH and the stability of the product itself.

Anti-aging products, they can only do so much. There is data that finds exfoliating acids can help shift pigmentation, as well as data that retinoids, prescription retinoids and retinaldehyde can help remove fine lines and wrinkles.

What we have to remember with the aging process, is that it’s not just the skin that's aging, it's the fat, muscle and bone underneath the skin. Unfortunately, nothing being applied to the surface can tackle the changes of the bone, muscle or fat underneath.

Therefore, they can do a little bit provided they are formulated correctly, but they're still not going to give you sort of plumpness or firmness if the problem there is loss of fat or loss of bone mass.

Do different skin tones need different care or different products?

For over-the-counter products, the answer is no because products are being used in the way that have been directed on the label and the concentrations are suitable for everybody of all skin types.

However, what happens in black and Asian skin is if you get problems with a lot of irritation, or skin barrier disruption because you've overused exfoliating acids for example, there is a risk that then you will get inflammation or eczema, which can then leave dark marks.

For all skin tones, I would recommend not overusing products and taking care not to disrupt your skin barrier.

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1. These Q+A’s will form the basis of an ‘interview’ style discussion between event host and Dr

Mahto. Dr Mahto is fully media trained and will be aware of the final agreed approved

responses and will be only responding with what is approved as per this document.

2. These Q+A’s will be a bank of quotes for use by PR agency in Press Releases/Pitches on the

subject of caring for spots and Acne prone skin between Sept and December 2022.

GB-PU-2200006|September 2022