Ask A Clinician: What Is The Gut-Skin Axis?
Ask A Clinician: Can I Use Active Ingredients With A Chronic Skin Condition?
Authors: Kayantha Sivalingam and Hetika Patel, Pharmacist Clinicians at Skin + Me
According to the British Skin Foundation, 60% of the population currently has a skin condition or has previously experienced a skin condition.
Skin conditions occur when the skin isn’t functioning as normal and they can be chronic, meaning they are likely to last for a long period of time. Depending on the cause, some skin conditions can improve without treatment, while others require intervention to reduce their impact.
Building a skincare routine when you have a chronic skin condition is a great way to maintain the skin’s integrity, but there are some important things to remember when it comes to using active ingredients. Today, we’ll explain how to create a gentle skincare regime that improves hydration and strengthens the skin barrier, without making your condition worse.
What are active ingredients?
Active ingredients are the main powerhouses of skincare products. They work in the deeper layers of the skin and are effective in treating specific skin concerns like hyperpigmentation, acne and rosacea. Examples of active ingredients include retinoids (e.g. retinol and tretinoin), niacinamide and azelaic acid. Active ingredients are key when targeting certain skin concerns, but they must be used with caution to avoid making the condition worse.
Inactive ingredients give the active ingredients a boost and help them work more effectively – examples of inactive ingredients include glycerin and shea butter. They help deliver long-term results and maintain the overall health of your skin. The key to achieving happy and healthy skin is the right combination of powerful active ingredients alongside nourishing inactive ingredients.
Using active ingredients with eczema
Eczema is a common inflammatory skin condition often associated with allergic rhinitis (hayfever) and / or asthma, and it can develop at any age. The skin becomes dry, red, itchy and in some cases can blister, thicken and weep. Itching can impair the skin barrier further.
Many active ingredients, including those in our Skin + Me treatments, are exfoliative in nature. We do not recommend using exfoliative treatments whilst experiencing active eczema, to avoid aggravating the skin further. Instead, we would encourage you to keep your skin hydrated to help repair the skin barrier with a gentle cleanser, moisturiser and sunscreen – look out for nourishing ingredients such as hyaluronic acid, ceramides and glycerin.
Using active ingredients with rosacea
Rosacea is a long-term skin condition that affects around 1 in 20 people, and is most commonly seen in middle-aged people.
It typically appears on the centre of the face (cheeks, nose, chin and forehead), with visible symptoms including redness and inflamed spots (also known as papules and pustules). Symptoms can be triggered by various factors, including sunlight, certain foods, exercise and alcohol.
The active ingredients commonly prescribed to help manage rosacea include metronidazole, azelaic acid and niacinamide. Metronidazole is an anti-inflammatory antibiotic, and the gold standard treatment for the spots and redness of rosacea. Azelaic acid is an antioxidant that fights inflammation, reduces redness and treats spots. Niacinamide is a form of vitamin B that improves the skin barrier and benefits rosacea-prone skin.
As rosacea can cause skin to feel more sensitive, it’s important to avoid any harsh or exfoliative active ingredients, such as retinoids, that can cause further damage to the skin barrier and worsen your symptoms.
Using active ingredients with vitiligo
Vitiligo is a chronic autoimmune skin condition, affecting 1% of the world’s population. This condition is progressive and unpredictable in nature, where melanocytes (melanin-producing cells) are gradually lost. Melanocytes are responsible for providing our skin, hair and eyes with colour. In the absence of these cells, the skin appears as milky-white patches.
At Skin + Me, we do not treat the loss of pigmentation associated with vitiligo. However we can prescribe active ingredients to help with any other skin goals you may have, such as improving your skin texture and the early signs of ageing. Depending on your skin goals and sensitivity, we may tailor your treatment to include a combination of tretinoin, azelaic acid and niacinamide.
With vitiligo, your skin is susceptible to experiencing sunburns, due to the loss of melanin. As active ingredients can also increase sun sensitivity, it is essential for people with vitiligo to use a strong sunscreen and wear protective clothing such as hats and long-sleeved shirts.
Using active ingredients with acne
Acne is one of the most common inflammatory conditions and affects most people at some point in their life. Spots develop when there is a build up of oil, dead skin cells and bacteria in hair follicles. The main types of spots are blackheads, whiteheads, papules, pustules, nodules and cysts. Acne most commonly affects the face, back and chest.
Acne can be managed by understanding your triggers, for example stress, hormonal changes and a lack of sleep. Using the right active ingredients for your skin type can also transform acne-prone skin. The active ingredients we commonly prescribe at Skin + Me to help tackle spots are clindamycin, tretinoin, azelaic acid and niacinamide.
Clindamycin is a topical antibiotic proven to reduce inflammation and reduce acne-promoting bacteria. Tretinoin is a retinoid that increases cell turnover and helps clear blocked pores. Azelaic acid has exfoliative, antibacterial and anti-inflammatory properties, while niacinamide is an antioxidant that regulates oil production.
Make sure your supporting skincare routine is gentle and non-comedogenic (i.e. your products won’t block your pores) to avoid acne getting worse.
Final thoughts
No matter what your individual skin goals are, remember to use active ingredients safely. This is especially important when you have a chronic skin condition, to avoid damaging your skin barrier and worsening your condition. Remember that everyone’s skin is different and will respond to active ingredients differently.
If you’re not sure if you have a chronic skin condition, don’t hesitate to get in touch with your GP or a Dermatology Clinician who will be able to advise and support you.
References:
https://knowyourskin.britishskinfoundation.org.uk/about
https://my.clevelandclinic.org/health/diseases/21573-skin-diseases
https://nationaleczema.org/wp-content/uploads/2018/03/FactSheet_Skincare_FINAL.pdf
https://www.cambscommunityservices.nhs.uk/docs/default-source/luton-tissue-viability/maintaining-skin-integrity.pdf?
https://www.bad.org.uk/pils/atopic-eczema/
https://dermnetnz.org/topics/vitiligo
https://www.bad.org.uk/pils/vitiligo/
https://www.nhs.uk/conditions/vitiligo/
https://www.aafp.org/pubs/afp/issues/2017/1215/p797.html
https://patient.info/skin-conditions/skin-rashes/rosacea
