Are You Fall­ing Apart?

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Cosmopolitan Middle East - - CONTENTS -

SARAH* sits in the mag­no­lia-walled of­fice of a der­ma­tol­o­gist’s of­fice. An­gry red bumps line her chin, climb­ing all the way up to her cheek on the right-hand side of her face. She twirls her ch­est­nut-brown hair anx­iously. There used to be a lot more of it there. Now, there is dry flak­ing scalp where baby hair used to sprout. Some­one at the front desk calls her name. A woman in a white coat with a clip­board says that the psy­cho­der­ma­tol­o­gist will see her now.

As you prob­a­bly al­ready know,

there’s some­thing strange go­ing on with our Bright Young Things – those twentyand thir­tysome­things speed-walk­ing along­side me through the city streets and bustling down the hall­ways of my glossy of­fice build­ing. Hair loss, break­outs, cys­tic acne, der­mati­tis or eczematic erup­tions on their bod­ies or even faces have gone from un­lucky fluke to un­com­fort­able norm in just a few short years. And not only can we barely keep up with the raft of new prod­ucts sup­pos­edly de­signed to help stem the prob­lem (that’s those grown-up spot serums, red­ness-sooth­ing cleansers and fol­li­cles­tim­u­lat­ing scalp scrubs) – but a grow­ing num­ber of clin­ics are ad­ding psy­cho­der­ma­tol­o­gists to their ros­ter of ex­perts. Spe­cial­is­ing in treat­ing the psy­cho­log­i­cal causes (and ef­fects) of skin and scalp dis­or­ders along­side the phys­i­cal ones, they take a 360° ap­proach to what are clearly mush­room­ing prob­lems.

But why on earth is it that a gen­er­a­tion cred­ited with be­ing the most clued-up cos­metic con­sumers and skin-tel­lec­tu­als that ever ex­isted has its beauty goals so blighted by break­outs, an­gry rashes and fol­lic­u­lar is­sues? And, more im­por­tantly, what can re­ally be done to tackle it?


Alexia Inge knows a thing or two about what makes young women (and men) tick. As the co-founder of Cult Beauty (the on­line beauty em­po­rium), she’s taken the pulse of the twenty- and thir­tysome­things of the UK and found them… anx­ious. “Ques­tions about adult acne make up 35 per cent of all skin­care queries, hav­ing grown to a point of real con­cern,” she says. ‘What are the rea­sons for hair loss in women?’ is the fastest­grow­ing search term on her site, she tells me, while sales in the hair- and scalp-treat­ment cat­e­gory saw lifts of 250 per cent year on year. Equally telling, ac­cord­ing to a re­cent study from Min­tel,† is that mil­len­ni­als re­port roughly dou­ble the in­stances of acne, spots, al­ler­gies and eczema than the UK pop­u­la­tion as a whole. The rea­son that we’re all fall­ing apart, one pore at a time? Yep. You guessed it. Stress.

Of course, as most of us will know from ex­pe­ri­ence, the fact that we’re ex­posed 24/7 to ma­jor wor­ries about ca­reer, hous­ing and the world go­ing to pot can lead to sal­low, sleep­less com­plex­ions. But it’s the more in­sid­i­ous ways stress can chip away at your health (and, by ex­ten­sion, your looks) that are ac­tu­ally caus­ing the most trou­ble. At least that is the gospel ac­cord­ing to Dr Alia Ahmed of Lon­don’s Eudelo clinic. She’s a con­sul­tant psy­cho­der­ma­tol­o­gist, and the fact that she’s seen an uptick in the num­ber of young women lin­ing her wait­ing room is al­most cer­tainly a sign of the times.

“The re­lent­less so­cial pres­sure to be a high achiever and the gen­eral aware­ness of ‘im­per­fec­tion’ are a real threat to mil­len­ni­als’ phys­i­cal and emo­tional health,” she tells me. A steady diet of so­cial me­dia, not known for its warts-and-all de­pic­tions of re­al­ity, leads, she says, to height­ened and frankly un­re­al­is­tic ex­pec­ta­tions of life, love, looks and ev­ery­thing else.

“My young pa­tients of­ten don’t even re­alise how over­whelmed they are. They have adapted to a state of chronic stress to the point where it feels ‘nor­mal’, but their tear­ful­ness and skin is­sues are just some ways the body’s telling them it is not,” says Dr Ahmed.

What en­sues is the per­fect storm at the heart of con­di­tions such as acne and rosacea, as well as the seem­ingly ran­dom skin rashes that bring Ahmed’s young pa­tients flock­ing to her: “Stress causes skin dis­ease and skin dis­ease causes stress,” she says. “Anx­i­ety af­fects the im­mune sys­tem, driv­ing al­ler­gic-type re­ac­tions and man­u­fac­tur­ing chem­i­cals in the body that set off in­flam­ma­tion and dis­rupt skin’s pro­tec­tive bar­rier.”

But it isn’t only that our al­ways-on life­styles are chem­i­cally chang­ing our bod­ies. It’s the dis­tor­tion of re­al­ity that some doc­tors are most con­cerned about. Take, for ex­am­ple, con­sul­tant der­ma­tol­o­gist Dr Sam Bunt­ing. Ac­cord­ing to her, the spike in young pa­tients with acne com­plaints might have as much to do with a real in­crease in cases (she tells me she has “no doubt” we are in the mid­dle of an acne epi­demic) as it does with their zero-tol­er­ance at­ti­tude to any­thing that doesn’t re­sem­ble the fil­tered and Face­tuned faces of their In­stau­ni­verse. “Many think a flaw­less com­plex­ion with zero im­per­fec­tions is a re­al­is­tic goal.” (News­flash: it’s not.) Dr Esho, of the Esho Clin­ics in Lon­don and New­cas­tle, whose pa­tient base is pre­dom­i­nantly those aged 25 to 35, adds, “I’ve had pa­tients Facetune their pho­tos in front of me to show me what they ex­pect.”

Dr Bunt­ing ad­mires the knowl­edge and re­search in­volved in seek­ing so­lu­tions, but wor­ries about the ex­treme “pore-gaz­ing” that en­sues: once acne im­proves, these pa­tients im­me­di­ately move on to the next skin gripe with­out paus­ing to recog­nise their progress. This, in turn, can cause anx­i­ety and stress and… the en­tire cy­cle starts again.

Too much too young

The “more is more” at­ti­tude to both skin and hair­care is also, un­for­tu­nately, both a symp­tom and a cause of the rise in prob­lem con­di­tions. Clin­i­cal treat­ments like peels and laser-based “photo­fa­cials” are be­ing sought out far too soon and of­ten, sen­si­tis­ing skin to a point of no re­turn.

It’s all re­flected in beauty-buy­ing habits: ac­cord­ing to re­cent Min­tel re­search, twenty- and thir­tysome­things spend their money on “in­stant hit” masks and overnight plump­ing treat­ments. Acid ton­ers and serums have also seen a sales boom, led by breath­less re­views for po­tent “skin-trans­form­ers” like Glossier So­lu­tion and Sun­day Ri­ley Good Genes. The goal: in­stant, ’Grammable re­sults, fast. The re­al­ity? An­gry break­outs ga­lore.

Be­cause, ac­cord­ing to the ex­perts, this end­less prod­uct-hop­ping has un­fore­seen con­se­quences.

In­spired by mul­ti­ple, but not nec­es­sar­ily ex­pert, sources on­line, “my younger pa­tients of­ten suf­fer from both break­outs and ir­ri­ta­tion”, says Bunt­ing (who, by the way, also sin­gles out beauty edi­tors for their slap-happy, der­mati­tis-prone ways). “They’ll com­bine ‘nat­u­ral’ prod­ucts, such as cleans­ing balms and es­sen­tial oils, with pow­er­ful ‘techie’ acids and retinols. And they top it all off with long-wear, pore-plug­ging foun­da­tions that are in­cred­i­bly hard to re­move. ‘Too many prod­ucts’ is one of the most com­mon di­ag­noses I make.”

Hair ap­par­ent

Scalps are suf­fer­ing from closer scru­tiny, too. Ac­cord­ing to der­ma­tol­o­gist Sharon Wong, clients’ hyper-crit­i­cal eyes (com­par­ing their re­al­ity to on­line im­ages that are, more of­ten than not, cre­ated with hair­pieces or air­brush­ing) are part of the rea­son she’s seen a rise in mil­len­nial women vis­it­ing her hair clinic. That, and dam­age caused by over-styling and ex­ten­sions sus­tained in an ef­fort to keep up with the In­sta-Jone­ses. But she has also noted more hair shed­ding, or “tel­o­gen ef­flu­vium” (TE), among young women. Con­sumers cer­tainly think stress is at fault: the Google search term “hair loss due to stress” was up 350 per cent in the past year.** Yet, while Wong con­firms it’s one cause of TE (push­ing hairs out of their growth phase pre­ma­turely, re­sult­ing in a spate of hair loss three to four months af­ter an in­tense pe­riod of stress), she says that hor­monal and nu­tri­tional is­sues are at least as great a threat to our locks.

Low pro­tein, low iron lev­els and over­all re­stricted calo­rie in­take are bad news for hair growth, mean­ing the cur­rent vogues for ve­g­an­ism (un­for­tu­nately not all new ve­g­ans know to main­line their non-an­i­mal pro­teins) and “healthy” juic­ing re­ally aren’t help­ing.

Un­for­tu­nately hor­monal dis­rup­tions are ag­gra­vated


by pretty much ev­ery­thing the av­er­age mil­len­nial can’t or won’t avoid: pol­lu­tion, the wrong foods, cer­tain chem­i­cals in prod­ucts, hor­monal med­i­ca­tions like the Pill (con­sul­tant der­ma­tol­o­gist Dr Nick Lowe blames teenage up­take of the pill for a “de­layed pu­berty” af­ter women come off it) and that word again – stress. “A surge in cor­ti­sol (the stress hor­mone) throws off your oe­stro­gen and pro­ges­terone bal­ance and can spike your testos­terone lev­els. Po­ten­tial re­sult: cys­tic, oily break­outs (the fact that we see so many of them erupt­ing on jaws and chins is a sure sign of hor­mones at work) and hair loss,” ex­plains holis­tic GP Dr So­hère Roked.

So far, so gloomy. So what’s the so­lu­tion?

Back to ba­sics

One re­sponse has been to at least partly throw in the towel, with hash­tags such as #freethep­im­ple and #skin­pos­i­tiv­ity pro­vid­ing an an­ti­dote to the crush­ing pres­sure of fake per­fec­tion. But, says Dr Bunt­ing, while it’s “in­cred­i­bly healthy” to take the stigma out of skin dis­eases, it mustn’t pre­vent those af­fected from tack­ling them prop­erly.

Right now, that of­ten isn’t the case: ac­cord­ing to a British Skin Foun­da­tion sur­vey, 33 per cent of mil­len­nial acne suf­fer­ers have tried 10 or more over­the-counter remedies to treat their spots. “Chronic con­di­tions like acne, pso­ri­a­sis or rosacea war­rant the at­ten­tion of a cos­metic der­ma­tol­o­gist. They can con­sider med­i­ca­tion, but they’ll also pre­scribe a con­sis­tent skin­care ap­proach, us­ing ev­i­dence-based prod­ucts and strip­ping out all the con­fus­ing noise,” says Dr Bunt­ing.

Out­side the der­ma­tol­o­gist’s of­fice, man­ag­ing re­ac­tive, flar­ing skin is a mat­ter of mild­ness, not chem­i­cal war­fare. Pare down your regime to three or four prod­ucts, avoid sul­phates, al­co­hol and any kind of fra­grance. Seek out bar­rier-build­ing ce­ramides, niaci­namide and es­sen­tial fatty acids along with an­ti­in­flam­ma­tory in­gre­di­ents such as camomile, sal­i­cylic acid and oat­meal. Even if your skin is bliss­fully nor­mal, this kind of sim­plic­ity is likely to keep it that way.

When it comes to hair loss, the same ap­plies. As with skin­care, a huge and lu­cra­tive “stress-bust­ing” hair­care in­dus­try has sprung up, tempt­ing peo­ple away from the pro­fes­sional help needed on one hand and, at the same time, from the sim­ple ba­sic strate­gies you al­ready have in your cup­board. “Many pa­tients have spent thou­sands of pounds on com­mer­cial hair-loss treat­ments to no avail,” says Wong. “So­lu­tions need tai­lor­ing to your type of hair loss, so you re­ally need to see a rep­utable spe­cial­ist (ie a tri­chol­o­gist or der­ma­tol­o­gist) to di­ag­nose your prob­lem.”

Non-strip­ping sham­poos and the odd in­vig­o­rat­ing scalp scrub are great for long-term main­te­nance, but won’t halt hair thin­ning or shed­ding. You cer­tainly don’t need to pay a pre­mium for one la­belled “growth­boost­ing” or “stress-re­liev­ing”.

As for hor­monal causes, a doc­tor like Roked, spe­cial­is­ing in holis­tic in­te­gra­tive medicine and bioiden­ti­cal hor­mone ther­apy, can cre­ate a pre­scrip­tive plan. But she also has some solid life­style tips for keep­ing hor­mones bal­anced. “Plenty of healthy fats, few re­fined carbs and sug­ars, a good amount of pro­tein with every meal, and high-fi­bre and fer­mented foods for gut health will nat­u­rally reg­u­late your hor­mones, as may sup­ple­men­ta­tion with ag­nus cas­tus (a herbal rem­edy) or B vi­ta­mins.” Weightlift­ing, she says, evens out hor­mone lev­els by build­ing mus­cle.

As for the ever-present spec­tre of stress, she also re­minds her pa­tients of the sooth­ing pow­ers of ac­tual friends. “In cities, where ev­ery­one is tran­sient and too busy to take stock, we for­get that we are so­cial an­i­mals meant to ex­ist in tight-knit com­mu­ni­ties: it’s proven to be se­ri­ously stress-re­liev­ing.”

In a world where the di­a­logue be­tween our bod­ies and our brains has never been more known, and yet less pos­si­ble to lis­ten to, it’s no won­der that peo­ple and so­lu­tions that work at the in­ter­sec­tion be­tween the two are now a grow­ing ne­ces­sity. The psy­cho­der­ma­tol­o­gists of this world and the new sa­lons and re­tail spa­ces you’ll soon see pop­ping up (specif­i­cally de­signed to heal the in­ter­nal as well as beau­tify the ex­ter­nal) will, I pre­dict, be as ubiq­ui­tous one day as the blow-dry bar.

Un­til that point, next time you’re wor­ried about your skin, your hair, or both, it could do more good than you know to re­alise you’re very, very far from alone.


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