A well-cared for and beautiful skin is an unequivocal symbol of health and beauty, that is why its care is one of the things that most obsess the female sector (and increasingly the male). As we have already mentioned on other occasions, the basis for showing off beautiful skin is hydration. No matter what treatment products we use, if there is not a good hydration base, they will be of no use.
On the other hand, during the different times of the year the care and needs may vary. In winter, for example, we will be more likely to dry out and dehydrate.
We have spoken with the dermatologist Marta María Moratinos (C / Caceres 35, 28045 Madrid) to give us her point of view on different issues related to skin care. From facial cleansing, the fanaticism of recent years for Korean routines, dry skin as a pathology, among other things.
Let’s start with something basic. According to your point of view, what should be the basic care routine according to skin type?
Basic skin care must always include four fundamental steps : Cleanse, hydrate, protect and help regenerate the skin . Depending on the type of skin (dry, oily or combination) we will recommend some products or others at each step.
Oily or combination skin
For example, on oily or combination skin, I usually recommend a cleansing foam with glycolic and a toner with witch hazel for its astringent effect.
For the day we will choose an oil-free moisturizing cream or in gel-cream or serum format , and then we will apply a high factor sunscreen , also in oil-free fluid format, in mist or brush (powder) to avoid adding more oil To the skin.
At night we will repeat the cleaning routine and apply a cream that stimulates the production of collagen , which contains retinol or glycolic, salicylic or azelaic acids, which will also help us to regulate the production of sebum.
Skin with acne
If it is also a skin with acne , apart from the previous recommendations, in the case of women, I carry out a hormonal study , since very often the excess production of sebum and consequently acne, are due to a alteration in the production of androgens , either in relation to mild hereditary disorders, such as the deficiency of the enzyme 21-Hydroxylase that manifests as an elevation of 17HydroxyProgesterone with or without elevation of peripheral androgens as in Androstendiol.
On other occasions, it may be secondary to the presence of insulin resistance , which secondarily induces an elevation in androgens. The detection of these alterations is important to give a specific treatment, either with medicines with an antiandrogenic effect, such as spironolactone, contraceptives or medicines that regulate insulin resistance, such as metformin.
In the case of dry skin , the handling is somewhat more complex. I usually recommend cleansers in the form of a cream and the subsequent application of a toner with chamomile, calendula and rose water that cleans in depth while providing us with hydration.
Now comes the complication of these skins. It is very important to distinguish well between truly dry skin , because it has decreased sebum production, from a false dry skin , which is actually oily or mixed but has an alteration of the skin barrier with inflammation that makes it appear scaly. In the latter, I will recommend the best skin clinic in south delhi, so I am going to focus on dry skin itself. In these patients I usually recommend a cream with Retinol to stimulate the production of collagen and restore the skin barrier, since it will facilitate the penetration of other active ingredients that I like very much, such as hyaluronic acid, panthenol, madecassoside, which will provide hydration and improve the texture and thickness of the skin.
Do you recommend food supplements?
I also usually recommend the use of oral food supplements, specifically those made from sea buckthorn oil . There are multiple studies that support the beneficial effect of sea buckthorn on the skin, since it increases skin thickness and improves collagen synthesis in the skin , in addition to contributing to the correct production of skin sebum, which leads to an improvement in hydration and nutrition for dry and aging skin.
In addition, many of these patients tend to have associated problems of dry mucosa, either secondary to menopause or due to immunological processes such as Sjögren’s syndrome, which is why they also benefit from these supplements (sea buckthorn oil moisturizes skin and mucous membranes ).
There is a lot of talk lately about Korean, Japanese and even Nordic beauty. Are you in favor of concepts like double cleaning? What things should we learn from other cultures?
Double cleansing is a concept that is based on the facial cleansing routines that Asian women follow, specifically Korean and Japanese. It is based on the concept of layered cleaning or “layering” and consists of doing a first cleaning with a micellar oil , to remove traces of makeup and dirt, and doing a second wash with an aqueous foam to remove excess fat. Products such as micellar water can also be used. The cleansing routine ends with the application of a toner, moisturizer and sunscreen.
In the case of Nordic cleaning, use exfoliating plants and activated charcoal to absorb excess oil and clean the sebaceous duct in depth.
My opinion is that there is no magic formula that works for all patients, when making the recommendation, various factors must be taken into account, such as the patient’s preferences (a patient with oily skin often dislikes using a cleanser oily) and the time you have available (not everyone can afford to do a complicated cleaning routine before going to work.
You cannot propose very complex routines to an adolescent because they will not comply with the treatment, for example. You have to look for routines that meet the following requirements: get a good cleaning, do not harm the skin, be pleasant and easy to comply with . It is important to seek patient compliance.
As I have explained in the previous point, in my opinion, the cleaning routine seems essential to remove makeup remains, dirt, pollution, sweat and excess sebum and restore the skin barrier favoring the subsequent penetration of active ingredients that are applied later in the form of a serum or moisturizer.
What are the most common skin conditions?
In the consultation I treat a multitude of conditions. If I had to opt for the ones I treat most frequently, it would be acne, rosacea, alopecia and the signs associated with photoaging.
When is dryness a problem? Tell me about the dryness of both skin and mucous membranes.
The skin is the largest organ in our body, which among others fulfills a barrier function , preventing the entry of infectious and irritating agents and preventing the evaporation of excess water. Also, it fulfills an immune function , regulates temperature, etc. There are circumstances that cause the barrier function to be altered and more water to evaporate than it should, causing a chapped-looking skin. This may be due to genetic factors (deficiency of essential fatty acids), hormonal (menopause), environmental (tobacco, sun exposure, use of inappropriate cosmetics) or insufficient fluid intake, taking medication, some diseases, etc.
In the case of the skin, the most frequent manifestations are the presence of a feeling of tightness, peeling, itching and / or inflammation , because it is more permeable to environmental irritants. In the case of mucous membranes, the symptoms depend on the affected area. In the case of the eyes we will have a sensation of sand in the eye, stinging or itching; sticky and dry sensation in the mouth , burning, taste changes, wound formation and even infections; and in the case of the genital mucosa , loss of elasticity with discomfort when having sexual intercourse, pain and itching.
To treat this type of pathology, do you recommend the use of food supplements?
I usually recommend food supplements very frequently, since my experience with some of them has been very good and there are also more and more scientific studies that support these results. In particular, I usually recommend sea buckthorn oil , due to its high content of omega 3, 6, 7 and 9 acids.
In addition to increasing hydration, both on the skin and on the mucosa, it has a regulating effect on inflammation that is very beneficial in my patients with chronic eczema, psoriasis or atopic dermatitis. I also usually recommend it in patients who consult due to dry skin or mucous membranes, such as patients with Sjögren’s syndrome, dry mouth due to taking medications, menopause, skin aging due to sun damage, among others.