Contents

Pilot Editorial Team
Reviewed by: Dr. Matt Vickers

⚡ TL;DR

• Functional skincare is different for everybody, but uses the same few really effective ingredients.
• Some skin gets worse before it gets better.
• A doctor can help you with a customised treatment plan.
• Some of the best products can also be sourced over-the-counter.


Let’s start with a simple statement of fact: great skincare is hardly at the top of every bloke’s daily regimen.

Our knowledge of how to look after our largest organ (insert obligatory dick joke here) has advanced vastly in recent decades.

But a daily routine designed to eliminate blemishes, smooth out wrinkles, and promote a healthy, radiant glow, is hardly positioned in the realm of “guy stuff”.

Which is dumb. Because medical science has advanced us to a point where we really can make our skin healthier.

You don’t need a medicine cabinet overflowing with little bottles of oil and jars of ointment to maintain a good skincare regime.

In fact, good skincare in this day and age looks more like one or two really great products, applied once daily.

🔍 Finding your “type”

Everybody’s skin is different, and depending who you ask, there are between three and 5,037 different skin types.

The truth is that, like many things concerning your body, it’s a sliding scale.

The different “types” are really just good indicators of where you might lie. To keep things simple, we like to break it down to four.

Normal

Normal skin is a lot like good peanut butter: not too oily, and not too dry. You won’t experience any severe sensitivity, your pores are barely visible, and you’ll have a well-balanced, radiant complexion.

Oily

Oily skin produces lots of natural oils (funny that), which might mean you're prone to blemishes, bigger pores, a shiny complexion, blackheads, and pimples.

Combination

Combination skin means you'll be dry in some areas and oily in others (usually around the nose, chin, and forehead aka your “T-zone”) with some blackheads, slightly shiny skin, and bigger, more open pores.

Dry

Dry skin produces less sebum (natural oils) than other skin, and might crack, peel, or become itchy quite easily, especially when it's cold out.

You'll tend to have more visible lines and red patches, and your skin will feel tight and rough, and look dull.

It’s important to note that sometimes dry skin can be seasonal. We call this “occasionally dry”.

I have no fkn idea

The unofficial fifth and most common skin type for us blokes (ha ha). As mentioned earlier, very few people slot neatly into one category, and many experience different skin types throughout the four seasons.

This is why great skincare involves talking to a doctor. They’ll be able to hook you up with treatment that is customised for your face, and not some disgustingly handsome bloke in a TV ad.

⚒️ What’s the damage?

Ageing is inevitable, and time does more damage than any external factor ever could.

However, there are multiple reasons skin ages, and there is a lot that you can do to be proactive about slowing down the ageing process.

While much of the ageing process is just a part of getting older, there’s a lot of other stuff out there that’s bad for your face.

Too much sun, smoking, pollution, stress, diet, exercise, weather, gravity – even too much smiling — you name it, and there’s a good chance it’ll have some sort of long-term impact on how you age.

👴🏽 Why do we look older?

Because blowing out candles is bad for your face? We wish it was that simple…

If you’ve ever wondered why your skin looks less plump than it did when you were younger, it’s due to your skin losing elasticity over time. Thinner lips, sunken cheeks, and a ‘double chin’ can be signs of sagging skin.

To get a bit into the technical side of it, our skin produces fewer collagen fibres as we age, and the elastin that holds these fibres together begins to weaken.

We also lose muscle mass, some skin thickness, and our skin can become dehydrated too. These changes cause skin to wrinkle over time.

Similar to wrinkles, this is caused by our bodies producing fewer collagen fibres as we age, and the weakening of the elastin that holds them together.

Sun is also a major factor: the “weather beaten” look of someone who spends a lot of time working outdoors is an example of sagging skin caused by sun damage.

🇦🇺 It’s Australia. You will probably get skin cancer. Actually.

Living in Australia means being exposed to a lot of sun, and you don’t need to be a dermatologist to know that sun and skin aren’t the best of friends.

And while the classic image of the bronzed Aussie tanning his sculpted body on the sands of Bondi is one from which we’ll probably never truly depart as a nation, the least you can do for your skin in the meantime is protect it with sunscreen.

In the same way you can’t un-fry an egg, once skin is cooked, it’s very hard to rejuvenate, even slightly.

Now here’s a really sobering statistic: two out of three Aussies are diagnosed with skin cancer before their 70th birthday.

Let’s just repeat that.

Two in three. 66 per cent. Australians. Before 70th birthday. Cancer.

These numbers are shocking, and the other stats (courtesy of The Cancer Council) aren’t much happier. Take a look:

  • Skin cancers account for around 80 per cent of all newly diagnosed cancers in Australia.
  • The majority of skin cancers are caused by exposure to the sun.
  • GPs have over 1 million patient consultations per year for skin cancer.
  • The incidence of skin cancer is one of the highest in the world, two to three times the rates in Canada, the US and the UK.

The sun is the number one thing that can damage your skin. Sun damage contributes to virtually every sign of ageing, including wrinkles, sagging skin, dehydration, and skin discolouration.

So, in the immortal words of Mary Schmich, wear sunscreen.

🧴 Solution #1: Retinoids

Retinoids are a class of highly effective medications that increase the rate of skin cell turnover.

In Australia, the most commonly used retinoid is only available via prescription so that doctors can counsel patients on the best way to use and apply it (which is also why we can’t name it here—Australia’s strict advertising laws forbid it).

Retinoids are an effective treatment for acne, photoageing (that’s ageing caused by too much sun), and irregular pigmentation.

How does it work?

Being the awesome and versatile little compounds that they are, retinoids work in a number of ways, with some of the key benefits being:

The growth of new skin cells

While they help new ones thrive, they also increase the rate at which older skin cells are shed.

Retinoids work to reduce the production of sebum (the oil on your skin), as well as reduce keratinization (that’s the production of excess skin cells). Both of these things lead to the formation of comedones (medical speak for blackheads).

For anti-ageing, the increased cell production and turnover helps to improve fine wrinkling, reduce irregular pigmentation, and smooth out any roughness.

It promotes collagen production

Collagen is the protein that contributes to our skin's strength and elasticity. As our body's collagen production reduces with age it causes our skin to sag - a key sign of ageing. Increased collagen helps to plump the skin and increases epidermal thickness.

It has anti-inflammatory properties

For inflamed acne (papules and pustules) retinoids help by reducing redness and swelling.

How do retinoids compare with everything else on the market?

The most widely recommended retinoids come in the form of a prescription medication, only available from a doctor. The strength and potency of these preparations distinguishes them from any over-the-counter products, which are typically weaker.

The most commonly prescribed retinoid is often referred to as a “silver bullet” by many doctors, because of its raft of benefits.

It comes from the same family as retinol, and both are derivative of vitamin A.

This prescription retinoid can be distinguished from plain old retinol, which is a less potent chemical and can be purchased over-the-counter as it is classified as a cosmetic product, and not a medication.

What strength should I use?

Everybody's skin is different - some are just more sensitive than others. It’s important that you use the strength of retinoids that are best for your skin. Your doctor will help you with this process.

Prescription retinoids are available in a variety of strengths: 0.025 per cent, 0.05 per cent and 0.1 per cent by weight concentration.

While these seem like minuscule amounts, these retinoids are quite potent. It's best to start on a lower strength and increase it if your skin tolerates the concentration. This process is called titration.

How long before I start to see results?

The key to getting the best results while using retinoids is to use small amounts consistently. You only need a pea-sized amount to be spread across the face.

For anti-ageing, clinical trials suggest that patients will ordinarily experience the following improvements within the first three to six months:

  • an improvement in fine wrinkles;
  • a reduction in pigmentation; and
  • more uniform skin texture.

If you’re not experiencing any changes after six to eight weeks, your doctor might recommend a change to a topical combination, or to try a higher strength (i.e. from 0.025 per cent to 0.05 per cent).

For acne, patients should see a reduction in the number of blackheads, or inflammation of pimples, within the first 12 weeks.

How do I apply it?

Every masterpiece starts the same, so let’s start with the basics (i.e. a clean canvas).

Wash your face with a mild cleanser, rinse, and pat dry with a clean towel. Wait until your skin is completely dry (usually 20–30 minutes) before applying the cream.

Some other important things to remember are:

  • Only use retinoids in the evening.
  • Wash your hands after each application.
  • Do not apply to the eyes, lips, or any irritated areas (eg sunburnt or broken skin), or in nostrils.
  • Be careful applying to “crease areas” ie. the nasal creases.

The skin is very photosensitive when using retinoid creams, so it is vital that patients using this preparation wear a broad-spectrum sunscreen, preferably SPF 30 or SPF 50+, containing a physical barrier (eg titanium dioxide) during the day. If you’re a bit confused on where to start with this, your doctor is the go-to for advice.

It’s also probably not a bad idea to pull out your favourite daggy cap (or Akubra) while using it. We’ve always been told to slip, slop, and slap, but this is of even more importance when your skin is super sensitive due to this treatment.

How to transition onto a retinoid cream

A good way to start your treatment is by using retinoids every third night, and seeing how your skin reacts.

If your skin is tolerating the treatment, you can increase the frequency of application to every second night. If your skin continues to tolerate the cream then you can increase frequency to every night.

At the end of the day, you’re the only one who knows how your face feels. Be guided by how your skin feels and whether it is tolerating the treatment.

If your skin becomes irritated (eg redness, peeling, stinging), apply it less often and take a break for a few days. Note that it is normal to feel some irritation (mild stinging), but this should reduce as you continue to use the treatment. If it persists or is severe, stop treatment and contact your doctor. For most people, the skin gradually gets used to this treatment.

If you have sensitive skin, you can wash the treatment off after an hour or so.

What about side effects?

Many patients experience dryness, irritation, redness, or peeling if they use a concentration that is too strong for their face, or if they use it too frequently. This is often referred to as "Tret Face" which occurs when the patient's skin does not tolerate the treatment.

There are a number of ways you can manage this transition: you can apply a moisturiser first as a barrier, start by using it less frequently, or apply the retinoid cream for a short period each evening, washing it off the face after a few hours. A doctor will also help you through this process.

If you are using retinoids to treat your acne, then you may experience some “purging”. For those prone to acne, there may be a two to four week period where you experience acne breakouts before your skin clears up.

This is a product of the acne surfacing as the skin cells are regenerated by the retinoids going to work, and is pretty normal.

Some handy ways to reduce irritation are...

  • Wait until your skin is completely dry (usually 20–30 minutes) before applying the cream.
  • Apply a thin layer (using too much increases irritation and won’t make it work faster).
  • Avoid using other acne medications on the skin, unless advised to by your doctor.
  • If your skin shows signs of not tolerating this particular treatment, you may use a moisturiser as a barrier, prior to applying the treatment.
  • This should probably go without saying, but avoid waxing treated areas.

What are the risks?

This type of prescription skincare increases cell turnover, so your skin needs to be treated gently whilst using it.

That means you should stop using exfoliants, acids, over-the-counter retinol, abrasive scrubs, and invasive skin treatments such as microneedling, dermaplaning, or facial waxing while starting the cream.

You can reintroduce these into your routine once your skin tolerates the medication, and there is no dryness, redness, irritation or peeling.

  • Tell your therapist that you’re using a retinoid treatment in advance of invasive skin procedures like lasers, light treatment, and facial waxing. And if you are going to use any of these treatments, give your skin a one-week buffer in between.
  • Every medication has potential side-effects. While these are rare, you should stop using retinoids immediately and get back in touch with your doctor if you experience:
  • Swelling, pain, redness, or weeping in the treated areas.
  • Darkening/lightening in tone of treated areas.
  • Severe burning, rash, itching, or hives on the skin.
  • Difficulty breathing, wheezing, swelling of the face, lips, tongue, or other parts of the body.

💊 Solution #2: Niacinamide

Niacinamide is a medication that’s available in both oral (tablet) and topical (cream, serum, or gel) forms. You might have heard of it referred to as Vitamin B3 Nicotinamide, or Nicotinic Acid Amide.

When used in skincare, it’s most commonly referred to as Niacinamide. It’s available over-the counter, but can occasionally be prescribed by a doctor or dermatologist.

Niacinamide has an excellent reputation within skincare, and for good reason—it can do great things for your skin.

While it’s often used to combat the signs of ageing, as it can increase skin brightness and elasticity while reducing wrinkles and fine lines, it’s also been used to fight everything, from acne to eczema—and it has even been suggested that it might prevent some skin cancers.

How does it work?

Exactly how Niacinamide works its magic is something that scientists are still trying to figure out. One major theory is that Niacinamide can stop—and even repair—damage done to the skin by free radicals.

WTF is a “free radical”?

TL;DR: free radicals are bad for your skin.

You might have heard the term “free radicals” before, because it gets mentioned around skin care a lot. Magazines and television ads warn us about the free radicals on our skin, but don’t always say a lot about what they are, what causes them, or how skin care products and medications can fix them.

So here comes the science: free radicals are atoms or molecules that have an uneven number of electrons. Electrons normally like to exist in pairs, so when a free radical emerges it will seek out other atoms and molecules to steal an electron from so it can even itself up.

Free radicals are sometimes created by the body as it goes through its normal metabolic processes, but they can also be generated in larger amounts by outside sources like cigarette smoke, pollution, chemicals, and the sun.

When we have an excess of free radicals our skin can experience oxidative stress.

Erm … “oxidative stress”?

Oxidative stress occurs when those free radicals start taking electrons from our healthy cells to restore their balance. This damages the cells, and exponentially speeds up the ageing process.

Think of it as a car with the headlights on. It might take a while, but that battery is going to get drained at some point.

It has been suggested that part of the reason Niacinamide is so effective at reducing the appearance of aged skin is because it’s an antioxidant: that is, a chemical that can donate an extra electron to free radicals without becoming a free radical itself (pretty cool, huh?).

Boost your skin layers

Niacinamide can also boost the outermost, protective layer of our skin by increasing production of ceramides and lipids, improve skin elasticity and reduce fine lines and wrinkles, increasing collagen production, and decreasing blotchiness, hyperpigmentation, redness, and sallowness of the skin.

In essence, while it goes to work on the layers beneath the surface, it also props up the top layer, helping it to look better, sooner.

It can also directly combat acne by reducing sebum production, and retain skin moisture while reducing oiliness.

No wonder it has such a good reputation.

Who can use it?

Niacinamide can be used by anyone with acne, ageing skin, dull skin, dry skin, or oily skin.

So, basically all of us.

Topical Niacinamide has very few side effects and skin irritation after usage is rare, which means it’s an excellent choice for people who have sensitive skin.

It’s also highly compatible with many other medications, ingredients, and skincare products.

One study showed that applying a moisturiser containing Niacinamide prior to treating skin with topical retinoids reduced irritation (when compared with a moisturiser that did not contain Niacinamide).

What about side effects?

Of course, as with every medication and skincare ingredient, negative reactions are possible—but in the case of Niacinamide, very unlikely.

If you have particularly sensitive skin you can try using Niacinamide every other day and building up to daily usage. You can also try using a product with a lower concentration of Niacinamide: some products have up to 10 per cent Niacinamide, but two to five per cent can also be effective.

How is it used?

Topical Niacinamide should be used as part of a skincare regimen to get the best results, rather than just by itself.

Start by washing your hands to make sure they’re clean, and apply a cleanser. Include a toner in your routine for extra points.

Hypo-allergenic, non-comedogenic, and oil-free products are best, as they will reduce the chance of a negative reaction with your skin, help prevent comedones (clogged pores), and won’t add any oil to your face!

After your cleanser and toner, you can use the Niacinamide. Pump a pea-sized amount onto the back of your hand and apply it to your entire face, not just where you notice acne or fine wrinkles. Just make sure you avoid the sensitive skin of your eyelids and lips.

Last, you’ll need to apply a moisturiser. If you have oilier skin, you can choose a lighter moisturiser like a gel or a serum, and if you have drier skin you can go for a cream or lotion moisturiser.

If it’s the beginning of the day, don’t forget to top all of this off with sunscreen that provides at least SPF30+ protection.

What can I expect?

Niacinamide takes between eight to twelve weeks to really show an effect, but you might start to see changes in your skin within a week or two of beginning treatment.

Over time, you’ll notice a decrease in oil (sebum) production which can help decrease acne, a decrease in the appearance of fine lines and wrinkles, an increase in skin brightness, some pore shrinkage, and a reduction in skin redness and sallowness.

Consistent and long term use

Niacinamide can do a lot for the skin, but it needs to be used consistently and for an extended period to take effect. Once you start to see changes you can either continue using the same dosage or in a lower concentration.

Rest assured, you can use Niacinamide indefinitely, as a key part of your skincare regime.

🕵🏽‍♂️ Finding what works

Skin is one of the most complicated and curious parts of our bodies. It’s the largest, most visible, and most easily forgotten about (until something goes wrong).

And because ageing is gradual, it can be easy to wake up one day looking older without having realised it’s even happened.

There’s every chance that what works in a lab, or for your partner, won’t be the right thing for you.

Which is why, while we can show you all the clinical trials and studies in the world, what ultimately makes a difference is getting a doctor to tailor a great skincare regime for you specifically.

Everybody’s skincare path is different, but with the wonders of modern science it’s a simpler and more effective process than many of us probably realise.


Sources:

Dermal Institute
Medline Plus
• Cancer Council
• Australasian College of Dermatologists
NCBI (i)
NCBI (ii)
• DermNet NZ (i)
DermNet NZ (ii)
Wiley Online
NCBI (iii)
NCBI (iv)
NCBI (v)
Medical News Today
NCBI (vi)
NCBI (vii)
NCBI (viii)
• Facilitating Facial Retinization Through Barrier Improvement