A DERMATOLOGIST’S GUIDE TO PREGNANCY SAFE SKINCARE INGREDIENTS

Our Principle Dermatologist Dr Hope Dinh recently shared her expert skincare tips for pregnant or breastfeeding mothers with beauty editor Joanna Fleming from Adore Beauty.


Just found out you’re expecting? Congratulations! Along with the excitement of falling pregnant comes a few lifestyle changes – so we asked Dr Hope Dinh, principle dermatologist and director of Hope Dermatology and mum of two, to give us her advice on pregnancy-safe skincare.

 

Which ingredients do you typically recommend women steer clear of while pregnant, and why?

If you are newly pregnant you may be noticing some big changes in your skin! Changes in hormones can result in an increase in oil, sweat, and increased circulation.  If you’re one of the lucky ones, this all results in the “pregnancy glow”. For the rest of us, increased oil and sweat = pimples and breakouts, and improved circulation = splotchy and red!  Pregnancy can also wreak havoc with your barrier protection, leading to dry, irritated or sensitive skin.

It’s important during pregnancy to review any prescription creams you may have been prescribed pre-pregnancy and check with your doctor if it is safe to continue their use.  As a hard and fast rule, ANY prescription Vitamin A product should preferably be stopped throughout pregnancy and breastfeeding. Rest assured though, studies have shown these products are often poorly absorbed through the skin and broken down quickly and have demonstrated no adverse effects to baby with accidental exposure.

Any prescription fading product containing ingredients such as Hydroquinone should also be stopped as these do have a higher rate of absorption through the skin.

Some women think they need to switch to completely natural skincare and body products during their pregnancy, is this true?

Absolutely not.  In most cases, you can continue your regular skincare regime and tweak it depending on the changes you experience and your skin’s needs.  Dry skin may require more hydration or barrier protection (hyaluronic acid, vitamin B) whilst conversely increased oil production with pregnancy may benefit from the addition of an AHA (alpha hydroxy acid such as lactic or glycolic) or BHA (salicylic acid).

Skin can become more sensitive during pregnancy and many “natural” skincare products contain plant-based ingredients which can feature quite high on the list of skin allergens and can actually irritate the skin further.

What’s the most common myth around pregnancy-safe skincare?

You’ll often hear that you should stop any skincare containing Salicylic acid (BHA, commonly found in acne or brightening serums or washes).  The rationale behind this is that regular use of these products can lead to a systemic build-up of salicylates, which can have a toxic metabolic effect.   Salicylic acid is chemically related to aspirin which when medically indicated, can be used in low doses. The amount of salicylate that is absorbed through the skin via topical skincare is negligible and risk during pregnancy is low.

Contrary to popular opinion in both the public and medical fields, over-the-counter Vitamin A products (retinol) can be used safely during pregnancy under the guidance of your doctor.  We know that oral isotretinoin medication does cause birth defects and so I advise patients using prescriptions topical tretinoin to cease use, however, widely available over-the-counter skincare containing the much less potent forms of Vitamin A such as Retinyl Palmitate, Retinol or Retinaldehyde pose very little risk when used during pregnancy.  These forms are significantly weaker, are poorly absorbed through the skin and are usually found in low concentration in skincare.

Care should certainly be taken to avoid skin irritation and I would generally recommend a low dose and titrate up in strength if well tolerated. Always consult your doctor if you have any concerns.

Pigmentation is a common skin concern that can arise during pregnancy, which ingredients are safe to use to help manage pigmentation while pregnant and breastfeeding?

Pigmentation can be such a tricky condition to treat and often requires the full arsenal of home care, prescription therapy and cosmetic procedures.  The most important thing you can do for your skin pre-pregnancy, during and post-pregnancy is to incorporate the use of a high quality, daily SPF 50+ into your skincare regime.

Pregnancy-safe products that can help reduce pigmentation include Vitamin B, antioxidants such as Vitamin C, Azelaic acid, and exfoliants like your AHA/BHA products. Some treatments, such as skin needling (without topical anaesthetic!) and lactic peels are safe both during pregnancy and breastfeeding and are an effective way to address both pigment and minor breakouts.

Tell us, what are your own skincare go-to’s when pregnant or breastfeeding?

Sunscreen. Sunscreen. Sunscreen.  And an active AHA/BHA serum to target breakouts, with a hydrating, non-occlusive moisturiser at night to prevent sensitivity.

I tend to switch my moisturiser during pregnancy as I find my skin becomes more oily. And I slow down with some of my active skincare (alternate nights) as I find I get slightly more sensitive.

Hope Dermatology Dr Hope Dinh

Dr Hope Dinh is the principle Dermatologist/ Director at a busy dermatologist practice, Hope Dermatology in South Melbourne

She has a 2-year-old and a four-year-old (and her skin breaks out with pregnancy every time!)

IN THE MEDIA – Rosehip Oil

Read Dr Hope Dinh’s full interview with the Australian Women’s Weekly (May 2019 issue) on her thoughts on Rosehip oil and is it as good as it smells?!

Here is the interview excerpt with Dr Dinh (in Q & A form!)

What solid benefits do they have for skin?

Rose hip oil is good for pigmentation issues, scars and fine lines. This is because in addition to nourishing and moisturising omega-6 essential fatty acids and antioxidants, it also contains vitamins A and C which help to increase cell turn-over; producing a retinol-like effect.

Plant oils are commonly used for cosmetic purposes and have been found to have many benefits . Rosehip oil is rich in antioxidants including Vit C, E, B and abundant in unsaturated fatty acids (linoleic) which are shown to reduce transepidermal water loss (TEWL) and reduce irritation through barrier repair.

Rosehip oil can also help with acne due to its high concentration of linoleic acid, allowing for an anti-inflammatory effect.

Are there any drawbacks (from my understanding so far, the fragrance component of rose oil is irritating and inflammatory)?

Fragrances in general are high on the list of allergic contact dermatitis.  Rosehip oil is widely available as a pure oil and so irritation from fragrances as such is not necessarily an issue.  Care should be taken in sensitive skin when using products containing Rosehip oil as other additives can cause irritation, particularly because of the high concentration of antioxidants such as Vitamin C and Tocopherol (Vitamin E), can be an allergen.

Anything used in high quantities and without regard to how the individual persons skin is reacting can potentially cause irritant contact dermatitis. You don’t necessarily have to use it daily to reap the benefits. By using the oil less frequently, there may be less risk of skin irritation for those who are prone to sensitivity.  End message I give most of my patients is to start at low frequency application e.g. every 2-3 days and then after a while can slowly titrate up frequency, carefully looking for irritation or other side effects.

How to choose a sunscreen – SPF myths and misconceptions

 

 

UV radiation from sun exposure is the greatest risk factor for developing skin cancer.  Here in Australia dangerous melanomas are the third most common types of cancer diagnosed. 
Simple sun protection measures including daily use of a broad-spectrum sunscreen can reduce you and your family’s risk of developing skin cancers later in life.  If this is not compelling enough to encourage you to protect yourself, see our earlier post on UV photo ageing.  Wrinkles! Argghhhh

 

 
Our Cosmetic Nurse Kristie breaks down the jargon and myths surrounding sunscreen use.
 
“What does SPF even mean?”

SPF is an acronym for Sun Protection Factor and is a measurement of how effectively a sunscreen will protect the skin from UVB rays (it does not measure UVA, this is important! More on this later).

Confusingly, it talks about time e.g. if it takes 10 minutes to burn without cream, applying an SPF 15 means it will take approximately 150 minutes to burn (a factor of 15 times longer).  THIS DOES NOT MEAN YOU CAN STAY IN THE SUN LONGER OR THAT YOU CAN GO LONGER WITHOUT REAPPLYING.  Sunscreen should always be reapplied after 2 hours to ensure continuous protection.

Misleading I know.

“So, what SPF should I be using?”

The SPF (Sun Protection Factor) scale is not linear, in that an SPF 30 is not “twice” as protecting as an SPF 15.  In fact, SPF 15 blocks 93% of UVB rays, SPF 30 blocks 97% of UVB rays and SPF 50 blocks 98% of UVB. The difference from an SPF 15 to SPF 30 is only 4%.

“So why do I need a higher SPF?”

Flip it around and think about what you are letting through.

SPF 15 (93% protection) allows 7 out of 100 photons through. SPF 30 (97% protection) allows 3 out of 100 photons through. That’s twice as many skin damaging photons!

“I don’t need sunscreen because I’m not outdoors?”

Not true.  UVA, which is responsible for ageing of the skin and contributes to skin cancer formation can pass through glass.  And incidental sun adds up.  Walking to the train, sitting in the window, driving.  So you don’t need to be “outside” to be exposed.

I always tell people to invest in a broad-spectrum product containing SPF 30-50 that they like enough to wear every single day.

Why?

The Anti-Cancer council recommends that sunscreen is required on days when the UV index is 3 or greater (typically in the warmer months between 11-3 pm), which is the threshold at which the UV is strong enough to damage the skin.  HOWEVER, we are creatures of habit and I find in myself and many of my patients that if your skincare routine is not just that, a ROUTINE, then things go to the wayside and before you know it, it’s mid-September, 12 noon and you find yourself in a café without sun protection!

A broad-spectrum sunscreen is important as SPF measures only UVB and we know UVA is a big culprit in causing skin damage.  A broad-spectrum sunscreen will protect against both UVA and UVB.

“What is the UV index?”

It’s “sciency”.  There are a LOT of variables that can influence the amount of UV reaching us.  But scientists are all over this and we highly recommend everyone download the Sun Smart App which will tell you what the maximum UV index for the day is forecast to be and when it is at its highest.

Thank you science!

“Do I need to reapply?”

Yes. All sunscreens need to be reapplied after two hours to maintain their SPF role. Are you going to reapply your sunscreen over your makeup at lunchtime in the middle of winter when you’re in the office? Probably not. And that’s ok.

1/ Because the UV index is low then

2/ Most of the damage from UV comes from accumulated exposure. Our skin is like a data bank for sun damage! So having your base SPF on for incidental sun when you leave the house helps reduce your lifetime UV exposure and associated damage. Unless your office desk is next to a window. Then see my earlier point about UVA passing through glass.

The reason to reapply is often unclear?  Is it wiping off? Does it have a time-limit of efficacy? Does it breakdown?

The answer is all of those things.  You will touch, rub, wipe, smear, and remove some of your SPF protection without noticing.  If you are sweating, exercising, swimming, etc we are pretty clear on the fact that your sunscreen will not withstand that.  Reapply.

Some chemical sunscreens do break down when exposed to sunlight. This is less of a concern with mineral (zinc or titanium oxide) sunscreens but this does mean that if you are outdoors, in the sun, your sunscreen DOES have a lifespan and it DOES breakdown.  It lends merit the argument that if you are in an office, away from all windows and will have minimal incidental sun (and don’t touch your face AT ALL) then your sunscreen MAY last longer.  I would definitely encourage you to reapply if you are planning on spending significant time (>1 hour) outdoors.

“I heard Nanoparticles were dangerous?”

They’re not.  The worry here was that the smaller nanoparticles which allow higher concentrations of our physical blocks containing zinc and titanium dioxide to be used in creams and still feel lovely and light on the skin were able to be absorbed though the skin and enter our bodies and cause harm.

This is not proven. The current evidence is that these particles do not penetrate the skin and remain on the surface as intended so the risk is negligible.  If applied to damaged or compromised skin there can be some penetration of the outermost layer of skin but they are not absorbed systemically (i.e. they don’t circulate throughout the body).   Be more concerned about inhaling spray sunscreens! Stay away from light sprays that flow with the wind and avoid these on the face.

“But what about Vitamin D?”

According to the Cancer Council sensible sun protection does not put people at risk of vitamin D deficiency and several studies have shown that sunscreen use has minimal impact on Vitamin D levels over time.  Incidental exposure, a few minutes most days is all most people require for adequate Vitamin D production.  If you are deficient in Vitamin D increasing UV exposure is not recommended and you should speak with your GP regarding supplementation.

We hope this clears up some common excuses people use for NOT applying sunscreen every day.  There are no excuses!  We KNOW skin cancer is directly related to UV exposure and we KNOW sunscreen protects us from this.  

 

There are so many nice, easy-to-use sunscreens available these days for every budget.  If you need a hand choosing one, call us today on 9039 5644 and book a consultation with our Cosmetic Nurse Kristie and we will get you on the right track.

UVA and PHOTO DAMAGE

This image has been doing the rounds in the cosmetic world since it was first published in the New England Journal of Medicine in 2012.

This gentleman was a truck driver who over his career was exposed to consistent, daily UV exposure to the left side of his face.

Ageing is inevitable and dependent on time and genetics. However it is thought that 80% of age-related changes in our skin are the result of extrinsic factors, namely UV photodamage.  Extrinsic ageing (vs intrinsic, chronological “just getting old” ageing) is the result of external factors such as excess sun exposure (photo-damage) and other lifestyle habits such as smoking.  Photoaging can be avoided with good sun protection habits and in this blog we hope to clear up many misconceptions that we commonly find amongst our patients with regards to sun exposure and protection.

The first question I ask during a skin consultation is whether the patient uses SPF on a daily basis and what that SPF is.  If it’s not an immediate yes then I know I’m going to hear “I don’t really go outside”, “Only when I know I’m going to be outside”, “Only in summer” or a flat “no”.

UVA radiation in particular plays a significant role in photo-ageing as it is able to penetrate more deeply in the skin than UVB affecting the deeper dermal layers.  Here it can damage collagen and elastin – leading to deep wrinkling and reducing the skins’ resilience; damage vascular structures causing telangiectasia (visible blood vessels at the surface of the skin); and more superficially causes pigmentation irregularities and lesions.

What you may not know about UVA

  • UVA is present in equal strength all year regardless of season.
  • UVA accounts for 95% of the UV radiation we are exposed to with sun exposure
  • UVA can penetrate through both clouds and GLASS e.g. your office, bus, car, café window
  • Incidental sun adds up. Waiting for the bus, ducking out for your morning coffee, hanging out the washing.

We live a very long life and here in Australia our winters are relatively mild. We aren’t snowed in 3months of the year and we’re showing it on our faces (and necks, chests, hands…)

As well as this, UVA has been shown to cause damage in the more superficial layers of the skin in the epidermis where most skin cancers such as basal cell carcinomas (BCC’s) and squamous cell carcinomas (SCC’s) occur.

So how can we prevent photo ageing?

If you want to slow down your extrinsic ageing process the use of a DAILY high protection, broad spectrum sunscreen is a MUST, year-round.

Be aware of the daily UV index! Download the Sun Smart app to find out what the expected UV is for the day and how much protection you may require. UV levels are typically highest between 11am-3pm.

Wear sun-protective clothing such as a broad-rimmed hat, sunglasses, long-sleeved clothing and seek shelter during this time where you can. Sit under a tree, veranda, stay indoors.

Is it too late for me?!

Don’t panic. We’ve got you.

What you can do
  • Start wearing SPF 30+ – SPF 50+ EVERY DAY. Face, neck, chest and hands.
  • Active skincare such as AHA’s (alpha hydroxy acids), Vitamin C serums, topical retinoids (Vitamin A) will help to increase skin cell renewal, brighten dull skin, reduce and prevent pigmentation changes
  • Vitamin B products and moisturisers will help improve dry and flaky skin and restore the skins’ natural barrier protection.

Can we turn back the clock?

Treatments to reverse the damage
  • Dermal filler to re-volumise and plump any areas of deficit and soften deep furrows
  • Anti-wrinkle injections to reduce dynamic facial lines (expressive lines) and prevent existing lines from becoming deeper
  • Vascular and Pigment laser for colour irregularities
  • Resurfacing procedures such as peels, micro-needling, RF, RF needling, ablative lasers
  • Tightening and lifting treatments such as Rf, RF needling, Micro-focused Ultrasound

Are your days of tanning catching up with you?

Call us on 9039 5644 for a consultation with our Cosmetics Nurse for skin assessment and treatment plan.