Skin Articles

When did you first realise that you had a special interest in skin and skin conditions?

When I was in medical school in the 1970s, I often found that I was the only student attending dermatology teaching ward rounds and outpatients. I found it strange that my colleagues didn’t show an interest in the area even though the dermatology teaching was so good. I went on to win the Grainger prize in Dermatology in my final year as a student.

You have been working as a dermatologist for over 35 years, which areas of skincare excite you the most and why?

I find helping patients who suffer with eczema or psoriasis extremely rewarding because making relatively simple changes to a patient’s lifestyle can transform their skin. Clearing a young person’s acne for good is life changing and wonderful to see too. Also recognising melanoma at a very early stage is so important.  

How have you seen dermatology change over the last 35 years, why do you think it has changed in these ways?

The changes I have witnessed have been revolutionary. Treatment regimens in the 1970s were often messy, smelly, time-consuming and didn’t work awfully well. Now, we have hugely effective, clean, safe topical treatments. The most dramatic changes have been driven by our understanding of the structure of the skin and immune pathways.

You often speak about more controversial areas of dermatology, why is it important for you to share your knowledge on these topics?

So many people just accept and repeat the mantra they were taught, without thinking about the facts for themselves. I believe, some critical areas of medicine should be open to much more debate. I like to challenge people’s attitudes and provoke more dialogue and reflection. Sometimes, examining the wider picture and exploring all the facts can reveal a completely different opinion.

What are some common misconceptions that surround skincare and sun?

Lots of people don’t know that the benefits of sunlight are not restricted simply to vitamin D, they also include lowering blood pressure. Many are also unaware that most ageing effects from sunlight are caused by certain wavelengths of ultraviolet light – this wavelength barely burns but it does go through glass and clouds, and is just as damaging in the winter, as in the summer. One more! Did you know that Factor 50 UVB sunblock only blocks 1-2% more UV light than factor 30 sunblock?

Does the sun affect our skin in different ways as we age?

Absolutely. I believe that children under 11 years old shouldn’t be exposed to any ultraviolet light (they should therefore be given vitamin D supplements). This is because, as we get older and get to know our own skin, we become better at predicting how much sun exposure we can afford to expose ourselves to without burning. The better we know our skin, the less likely we are to be affected by the sun!

How can people with chronic skin conditions benefit from exposure to the sun?

Most ‘inflammatory’ skin conditions, such as acne, eczema and psoriasis are improved by non-burning sunlight exposure. That’s why we sometimes use UV light as a treatment for these conditions. On the other hand, some other skin conditions, such as lupus, are caused or seriously aggravated by UV light.

What can too much sun do to our skin in the long term?

UVA ages the skin. It causes permanent wrinkling, pigmentary changes and worsening skin elasticity in the deeper layers of the skin. As a consequence, the skin gets an aged, ‘weathered’ look. UV light also increases the risk of skin cancers, although it is certainly not the only important factor!

What’s your best advice for enjoying the sun whilst maintaining healthy skin?

UVA light goes through glass and cloud, so a good quality UVA filter is needed all year round to protect the skin from the ageing effects of sunlight.

Never burn or use a sunbed!

Remember to wear UV protection for your eyes, as UV light causes cataracts.

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