What is medical grade skincare? Is it snake oil? Does it work? What's the point? We know you're either totally in the dark about medical grade skincare, or cynical of its effectiveness. So we asked Dr Claire Ashley, a GP and one of the UK's leading experts on skin problems (she really knows her stuff!) to answer your top questions about medical grade skincare. Watch Claire's brilliant video here!
Dr Claire is a practicing GP and became interested in skin care when she decided that, at the age of 28, she needed to tackle her adult acne. Now, having been trained by some of the top medical aesthetician companies in the UK, she is able to provide medical aesthetic treatments, including basic and advanced anti-wrinkle treatments, derma fillers, microneedling and skin treatments for acne, hyperpigmentation, radiance, fine lines and wrinkles, and chronic inflammation.
Dr Claire, you're a big fan of medical grade skincare aren't you?
I love using medical grade skin care for my patients. Our skin is something that we wear every day, and it forms a large part of how we feel about ourselves and our confidence. What I love about using medical grade skin care is that in treating someone's skin problems and making their skin look better, you can also make the patient feel better. So it's one of the things that I really love to talk about with patients, and I love seeing the results.
What makes skin care medical grade?
Medical grade skin care is skin care that has been developed to target medical problems. The problems that are typically treated with medical grade skin care are acne, rosacea, hyperpigmentation and fine lines and wrinkles. However, medical grade skin care can be used to treat other skin care issues as well - things like pores, texture, radiance and brightness. Medical grade skin care sometimes requires a prescription but not all of them do, however, you can't buy these products over the counter and you need to have a consultation with a specifically trained medical professional in order to access them.
Is medical grade skin care better than standard skin care?
Medical grade skin care has the advantage of having a high percentage of active ingredients compared to high street and over-the-counter skin care. So if you're treating an issue such as acne, then you will probably get better results, because you'll get a higher concentration of active ingredients. The other advantage is that because you're having a consultation with a specifically trained medical professional, they will know which products will suit your skin and your particular needs. Another difference with medical grade skin care is the way that the product is delivered in the skin is different to high street skin care products. For instance, I work with pHformula, which has developed a delivery complex (a system) that allows the product to penetrate down to the deepest layers of the skin and then work on the skin from the inside out. Quite a lot of high street skin care products just sit on the top of the skin and then are not absorbed and so they don't work in quite the same way.
So to summarise, with medical grade skincare, you have a combination of having skin care that is tailored specifically for you, product that works from the inside out and a high percentage of active ingredients. While there are some lucky people who don't have any skin care problems and they're fine using high street products, for some of us, high street skin care is not sufficient to treat the problems that we've got, in which case medical grade skin care is better.
How long does it take medical grade care to work?
This is variable. I normally advise my patients is that it takes, on average, two to three months for medical grade skin care to really start making a difference. In clinic I would take photo at the start of your treatment course and then refer back to see what the changes have been. For some people changes can occur almost instantly, I have had some patients who see a difference within a matter of days and their skin has completely transformed. But equally, I also have some patients who have quite stubborn problems that have been difficult to treat, and it takes much longer than two to three months to really get their skin to start to settle down. I always try to manage expectations in terms of how quickly it's going to take for these products to work but I would normally say two to three months, depending on the severity of the issue and the problem that we're treating.
There are lots of medical grade skincare brands available. Obagi and AlumierMD are probably the best known brands. I'm trained in Obagi, but the other skincare brand that I am trained in and I use in my clinic is pHformula. I wouldn't say that any are particularly better and they are all really, really good! But the reason why I work with pHformula is because they are relatively small, family owned, family run brand, and as such I get a really good level of service for not only for myself, but also for my patients. If I have a patient query, I can text my contact when I'm in the clinic, during the consultation, and I'll get answers straight away and therefore my patients get really good direct, relevant and real-time advice. The other thing about pHformula is that the products don't require a medical prescription and they're also slightly keener priced so more accessible than other medical skincare brands, but you still get the great results!
Who can sell medical grade skin care?
For prescription-only products obviously you need a prescriber, so that would only be be a nurse prescriber, a doctor or a dentist or pharmacist who would be able to sell those products to you. Some of the products are not prescription-only products, but the person that is selling them to you would still have had to have had specialist training in order to sell you the correct products for your skin type. I had to complete a two day face-to-face training course in order to sell the products that I do in my clinic, ongoing CPD, as well as future training events in the pipeline.
What is in medical grade skin care?
Medical grade skin care has active ingredients in it to target specific medical problems such as acne, rosacea, hyper pigmentation and fine lines and wrinkles. They also have a particular delivery system so that it delivers the product to the deeper layers of the skin and therefore the product can work from the inside out.
In terms of the active ingredients, it depends on what you're treating! A couple of common ones, are Vitamin A and Vitamin C. Vitamin A, which is also called Retinol, is really fantastic medical grade skincare ingredient. You can buy it in lower concentrations on the high street, but you'll get higher concentrations and better results with medical grade retinol.
Vitamin C is an interesting component as it's not very stable and so quite often in the formulations that you get on the high street, they'll claim that there will be a huge percentage of vitamin C in their product, but that won't be the active form of the product (so your skin won't absorb it). Therefore, Vitamin C is a really great product to buy from a medical grade skincare company, because you know that the percentage that you're getting is the right percentage of the active ingredient.
What medical skin care is good for acne?
You need to treat the cause of the acne, which is bacteria that grows on the skin. It is typically fuelled by hormones and the aim is to reduce oiliness, reduce the appearance of pores and reduce the activity of that bacteria on the skin, in order to treat the acne.
With my patients, I start with medical grade cleanser, as we need to cleanse the skin properly and efficiently. You don't want a harsh cleanser, you want something that is gentle, that is going to cleanse effectively, but not strip the skin of its natural oils because if you strip the skin of its natural oils, the skin then goes into overproduction of oil that then fuels the bacteria and makes acne worse. And then, of course, you think, 'oh, my God, my acne is worse, I need to cleanse more' and so the cycle continues. We need to break that cycle and use a gentle cleanser. Following this, your skin needs some active ingredients designed to treat acne and the sorts of ingredients that you might be looking at would be vitamin B,salicylic acid and retinol in particular. Retinol is really fantastic for spots, I would definitely recommend anyone that is being treated for spots to have a retinol product in their routine. Zinc is another really good ingredient for acne.
A great product I use is called Spot On (from pHformula) that contains salicylic acid. If you feel a spot coming up under the skin and you know it's going to erupt, you can dab this on - up to four times a day - and it will stop the spot from erupting. You can also use it as a little face mask if you feel a patch of spots coming up just before you go to bed, hopefully in the morning that break out won't have happened. They also do a moisturizer in this range, which is really useful, particularly for teen skin.
Vitamin B, in conjunction with hyaluronic acid , is really helpful for moisturising the skin - yes you still need to moisturize your skin with acne! The best thing to do however is find a practitioner who is trained in medical grade skincare, find someone who has a special interest in skin care, and have a consultation with them as no two people are the same!
Claire is a big fan of Spot On Blemish Active from pHformula to nip those spots in the bud!
What medical skin care is good for rosacea?
Rosacea is a condition where you get very sensitive skin, and very red skin that typically tends to be across the cheeks, but sparing the eyes, sometimes you get spots and you also tend to get very, very light flushing as well. You need to treat rosacea differently to treating acne because there's a different process underlying the problems with the skin.
In rosacea, the aim of treatment is to restore the skin barrier, because once you start to rebuild that and improve its function, then the redness and the spots will get better. The sorts of ingredients that you need to look for in your medical grade skin care are vitamin B, which is really good for hydration and hyaluronic acid which is also great for moisture. Azelaic acid is a really fantastic ingredient for treating rosacea as well. You need a very gentle cleanser, no harsh chemicals and no alcohol at all, because you don't want your skin to be disrupted any more than it already is. Products such as oils and shear butters also really, really helpful for rosacea. A combination of those ingredients will help to restore the skin barrier and improve the appearance of the skin.
What medical grade skin care is good for hyperpigmentation?
The first thing to do is to work out how deep the pigmentation is, because to be quite honest, if the pigmentation is really, really deep in the skin, it doesn't matter what medical grade, skin care you use, that pigmentation is just not going to get any better. So for those patients, I would advise that they look at other treatment modalities, such as laser, to help lift the pigmentation. However, if the pigmentation is more superficial than medical grade skin care will help, particularly in combination with in clinic treatments such as chemical peels and skin resurfacing.
Hydroquinone is a prescription only treatment for hyperpigmentation, and quite often that's used in conjunction with retinol and vitamin C and altogether those three things help to improve the appearance of hyperpigmentation. However, it is a prescription-only product.
pHformula has developed a serum called The MELA serum, it doesn't contain hydroquinone, but it does contain an active ingredient that inhibits melanocytes - melanocytes are the things that produce pigmentation - and in clinical trials this has been shown to be more effective than hydroquinone. I personally recommend this product with retinol and vitamin C, for my patients who have hyperpigmentation.
The thing I would caution is that whilst these products will make a huge difference to hyperpigmentation, it does take time. And sometimes as the pigment is lifting, it will temporarily look worse before it starts to look better. So, again, it's about managing expectations in terms of results and the time it's going to take to improve pigmentation but it can definitely be done with medical grade skin care.
Will medical grade skin care help with hormonal acne?
So with hormonal acne, what women complain of is that typically around the time of that period, that acne gets worse and they have breakouts. Medical grade skin care can definitely help with this and with time, the peaks and troughs will kind of level out. Sometimes we can't get rid of the breakouts completely if we're just using medical grade skin care, so you might have maybe a couple of spots at the time of the month, but the breakouts will have nowhere near the severity that you used to have and you'll find that your skin will be clear the majority of the time.
Once you've got your skin care routine sorted, your saviour is the Spot On cream, because if you start to feel a breakout occurring around the time of your period, you just put this product on and it will settle everything down for you nicely.
Aside from skincare, and this is the GP in me talking now, it might be worth considering the combined pill. Now, I know that for some patients, they're not able to go into the pill because of medical reasons and some people don't like being on hormonal treatments for acne, but I would always discuss that with my patients as a potential treatment for them as well.
What's your can't-live-without skincare product?
It has to be the pHformula Vitamin A cream, it's phenomenal. I have Polycystic ovary syndrome (PCOS)I'm also of a certain age and I'm starting to notice the development of fine lines and wrinkles. Retinol is an amazing product for treating both spots and the development of fine lines and wrinkles. I personally have triedall sorts of retinol products, I started with high street skincare, I then progressed to prescription-only skin care, so I got my retinol prescribed for me for a period of time. And then when I started aesthetics, I started using this cream. Now, I'm not just saying this because I work with pHformula, but this product has been the best retinol product that I've tried, ever. And now you're going to have to pry it from my cold, dead hands before I ever give it up!