May 2nd 2019
What derms get done: Dr Justine Kluk on the treatments she really rates
December 13th 2018 / 0 comment
From Botox to microneedling, the consultant dermatologist shares the procedures and products that deliver when it comes to slowing down the ageing process and keeping her acne flare-ups at bay
Dermatologists spend large parts of their days advising the general public about the tweaks to their regimes that will make their complexions healthier, clearer and smoother. But what do they do themselves when their own skincare concerns flare up? One industry expert who’s been refreshingly honest about her experiences is Dr Justine Kluk - her Instagram posts not only shed light on the ups and downs of having acne, but also show how being a skincare pro doesn’t make you immune to breakouts.
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“I have suffered with acne for the past 24 years and it still manages to sneak up on me unannounced every now and then, disrupting life when there are lots of other important things to be getting on with,” she wrote in a recent Instagram caption. “...the truth is that Consultant Dermatologists are human too and my own experience means that I can absolutely relate to others without judgement because I know how rubbish it feels to turn up for work with a spotty face firsthand. It makes me even more determined to kick acne’s butt for everyone else.”
We caught up with Dr Kluk to talk all things skincare and to find out more about the treatments and products she rates for all-round good skin health.
Could you tell us more about your personal skincare concerns?
I have suffered with acne since I was about 12 years old so this is easily my primary skin concern. I’m now 36 which means I am among the 15 to 20 per cent of women over 25 who suffer with adult acne. Thankfully, intermittent prescription treatment and good skincare practices mean that I have largely been able to keep my breakouts under control over the past few years. Pregnancy has presented me with a new challenge though, as my spots have returned with a vengeance however, having advised many women with acne during pregnancy over the years, I’m following my own advice and things seem to be settling down again.
How does your skincare routine tackle your concerns?
I use a mild gel or cream cleanser in the morning, such as Avene Extremely Gentle Cleanser, £10.50, or Cetaphil Gentle Skin Cleanser, £8.99. I squeeze a 10 pence sized blob into my hands and massage it into wet skin with clean fingertips before patting my face dry gently. I don’t use a grainy scrub or any devices to exfoliate my skin as these increase redness and swelling from inflamed spots.
I follow this with Skinceuticals Phloretin CF antioxidant serum, £150, spreading four to five drops over my entire face, neck and décolleté. It’s important to me to maintain the anti-ageing component of my skincare routine during pregnancy, and vitamin C-based antioxidants help reduce collagen breakdown that leads to skin sagging and wrinkle formation. They also help regulate skin pigmentation which can become problematic in pregnancy. I find that many serums are oily and exacerbate acne, but this one doesn’t.
I am currently applying a prescription strength azelaic acid cream next in the mornings. Azelaic acid reduces pore clogging and also has a direct anti-inflammatory effect, so can be helpful for keeping spots in check. It should only be used after consultation with a consultant dermatologist in pregnancy to weigh up the benefits and risks and ensure it is safe for the baby.
I follow this with a broad spectrum UVA/UVB SPF30 or 50, such as Jan Marini Physical Protectant, £53, or Heliocare XF Gel, £28. Having completed a fellowship in skin cancer after finishing my dermatology specialist training, I am very careful about protecting my skin from UV radiation all year round to reduce my skin cancer risk and prevent premature skin ageing.
In the evenings, I remove my makeup with Bioderma Sensibio Micellar Water, £10.80, or Garnier Micellar Cleansing Water for sensitive skin, £4.99, and follow this with the same cleanser I use in the morning.
Retinol and other vitamin A-based creams are off-limits during pregnancy, so I am currently using a glycolic acid-based product in the evenings instead. My go-to is Skinceuticals Glycolic 10 Renew Overnight, £80. I apply a pea-sized amount to my face, avoiding the area directly around my eyes, and another pea-sized amount to my neck and chest. Glycolic acid brightens and smooths my skin and helps reduce fine lines and wrinkles.
I leave the glycolic acid to soak in for 15 to 30 minutes and then apply Medik8 Liquid Peptides, £45, generously all over my face, neck and décolleté for its hydrating, collagen boosting and skin plumping benefits.
I don’t use a separate eye product at present because peptides are great for rejuvenation around the eye area as well.
How is your skin changing as you age?
Having had lots of sun exposure as a child growing up in South Africa, dark spots and pigmentation have become a concern as I get older. I’ve also started to notice fine lines creeping in around my eyes and on my forehead in the last five years or so. Using vitamin A creams religiously every night before I was pregnant and carefully protecting my skin from the sun are two of the ways I try to combat these issues.
What’s your skin philosophy?
Keep it simple. I take this approach to skincare and to cosmetic procedures. On the skincare front, it is so easy to end up with confused, congested and irritated skin if you chop and change your skincare products all the time and don’t allow them enough time to work. The same goes for trying to combine too many different ingredients into a routine. A few key items will do – you don’t have to use EVERYTHING just because you can.
On the procedure front, less is more. If you do start to have treatments like botulinum toxin or fillers, do a little at a time and adjust or tweak gradually as needed. Trying to change everything at once can almost guarantee an unnatural result.
What non-surgical treatments do you have?
Microneedling is an effective, low risk and minimal downtime option for boosting collagen production. Not only does it help with rejuvenating ageing skin, it is also an excellent option for improving acne scarring and it is easily one of my favourite treatments.
I’m not having any injectable treatments at present as I am expecting a baby in the next few months, however, I have had botulinum toxin treatment over the past two to three years to reduce my crow’s feet, forehead wrinkles and also to improve my gummy smile.
I have small doses only, with the intention of reducing, but not completely freezing muscle movement, so that I still look like me but am not repeatedly weakening the skin and deepening creases every time I squint, smile or frown.
Any surgical or non-surgical procedures?
I’ve had my eyebrows microbladed and have also had laser hair removal in the past. These were both complete game-changers for me in terms of time-saving. I haven’t had to wax or shave my legs or underarms for years, which means I am holiday ready at all times, and I don’t have to agonise every morning about neatly penciling my eyebrows in.
I’ve never spoken about having surgery as I think this is something that is deeply personal. I am also honest, and wouldn’t like to pretend that changes happen magically. I was always very self-conscious about having a hump in my nose as a teenager and avoided having my photograph taken from the side for years. As I grew older, I became more self-confident and thought about it less, until getting my wedding photos back last year. I decided to see an expert ear, nose and throat surgeon to ask what could be done to improve my profile and had a procedure during the summer. The change is very subtle and I am delighted with the result.
Are there any new procedures that you’re having great results with in your clinic?
My specialty within dermatology is treating acne, and as a result, I also see lots of patients with acne scarring. Sometimes a combination of treatments are needed and potential options include medical needling and subcision for depressed scars, cortisone injections for flattening raised or lumpy scars, chemical peels and surgical scar removal.
On the skin rejuvenation front, I have treated a number of patients with the injectable treatment Profhilo (which contains hyaluronic acid) in the past year. It is used on the face, and sometimes also the back of the hands and neck, for hydrating, smoothing and tightening loose, lined or crepey skin. I’ve not had it myself yet, but would certainly consider it for the future.
Which treatment or regime do you think gives women most bang for their buck?
The gold standard treatment for keeping our skin looking fresh as we age is vitamin A. Using an over the counter retinol or retinaldehyde, or a prescription strength topical retinoid if appropriate from a consultant dermatologist, from our mid to late twenties onwards slows the breakdown of collagen, and in a relatively inexpensive way, reduces the need for pricey interventions further down the line.
What’s the best lifestyle habit that works for you for great skin?
Stay out of the sun. Apply SPF30 or 50 to exposed skin every morning come rain or come shine. Wear a hat if you’re in direct sunlight for prolonged periods and top up your protection every couple of hours if you’re spending the day outdoors and after swimming, sweating or towelling off. After genes, sun exposure is the most important factor in the skin ageing process and easy to avoid if you take appropriate steps.