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Facial Health

Written by Dr. Julian De Silva

Good Health

A healthy body has a multitude of positive benefits in improving the quality and characteristics of the face, ability to deal with stress, improve stamina and positive well-being. Good health requires lifestyle choices including a healthy diet, regular exercise, adequate rest, ability to deal with stress and avoidance of factors that have a detrimental impact on health.

What is needed for Good Health and well-being?

Well-balanced diet
Sufficient hydration e.g. water
Regular exercise
Adequate sleep and rest

What should be avoided to reduce ill-health and facial ageing?

Sun worshipping or inadequate sun protection results in early aging of the skin through damage to the skin by ultra-violet rays, this promotes wrinkle formation, sun spots and poor skin quality. In addition, particularly in fair skins sun damage lead to damage to the skin at a cellular level, leading to DNA change and skin cancer.
Smoking has multiple detrimental effects to the body: damages blood vessels, reduces skin quality, and encourages wrinkle formation, fine lines and the loss of facial volume. In addition smoking contains toxic chemicals that promote cancer. Excessive consumption of alcohol or drugs of abuse has detrimental effects on facial health and skin quality.

What is a well-balanced diet?

A well-balanced diet includes regular meals and a balance of proteins, carbohydrates and fats from a variety of food sources including: meat, poultry and fish, cereals and grains, milk and diary products, vegetables and fruits.

Eat a variety of foods, different food groups for lunch and dinner
Eat smaller amounts of higher calorie foods
Eat more high fiber foods like fruits, vegetables, whole meal bread and cereals

A balance between food types is required as taking sufficient volume of food is not sufficient, a person can be overfed and overweight, and still be undernourished. The excessive consumption of animal fats, sugar and processed foods that are rich in calories yet not nutritious will promote poor skin quality. A diet rich in fruits, vegetables and fibers and low in fats and calories promotes health and good skin quality.

facial health, photo female


Vitamins A, C and E are anti-oxidants that improve health and resistance to illness and infection. Vitamin C is important for the synthesis of collagen in the skin and is often used as a treatment for skin wrinkles. Anti-oxidants neutralize free radicals that damage the body and are though to be involved in ageing. Free radicals are caused by smoking, ultra-violet sun rays and environmental agents such as pollution. Certain food types including green vegetables and fatty fish are rich sources of anti-oxidants. The human body is not able to generate these vitamins, so for a balanced diet they need to be taken in food or as supplements.



Water is essential for keeping your skin hydrated and for eliminating waste products. Drinking should include at least eight glasses of water a day. Coffee, tea and alcoholic beverages tend to cause the body to pass more urine and become dehydrated, so require increased water consumption to maintain a hydrated body.

Physical Exercise

Physical exercise increases the circulation of blood to all parts of the body including the skin, it improves the cardiovascular physiology of the body making it more able to withstand stress. Exercise burns off excessive calories (carbohydrates and fat) and relieves stress.

A minimum frequency of aerobic and anaerobic exercise is considered three times a week. Although fitness advisors often advocate a variety of exercises that may be on a daily basis. The intensity of the exercise should result in sweating and deep breathing.

As a general guide, stretching exercises should be used warm up and cool down to avoid injury. Aerobic activities (including running, cycling, and swimming) with each session should lasting approximately thirty minutes. A personal trainer can substantially improve ability to exercise and provide expert guidance on training.

Adequate Sleep and Rest

You need adequate rest to recharge your batteries. A lack of sleep may encourage the development of unsightly dark rings under the eyes and best to sleep on your back to avoid getting sleep lines.


Smoking is detrimental to general health, including the body’s ability to cope with stress and the quality of the skin. Chemical agents in the smoke trigger constriction of blood vessels in the body, reducing the amount of oxygen that is available to the skin. Over time this results in promoting aging of the skin with the formation of lines, wrinkles and loss of facial volume. In addition the contraction of the lips while smoking, results in the promotion of lines and wrinkles around the mouth. Wrinkles also develop around the eyes due to smokers closing their eyes to avoid the smoke and a loss of facial volume.

Smoking also results in the generation of carbon monoxide in the blood, this induces the formation of free radicals that are harmful to soft tissues and cells promoting toxicity and facial ageing. Cigarette smoke contains nicotine that promotes constriction of blood vessels in the body, reducing blood flow and oxygen transport to the skin.

What is ageing?

There are two forms of ageing, chronological and biological ageing. Chronological ageing is your age in years, and increases day by day. Biological ageing is your body’s functional age which is a component of genetic, lifestyle choices and the environment. In the face ageing involves a step wise progression of symptoms and signs described in decades on the facial ageing page.

Truck Driver - photo

Can anything be done to reduce skin aging?

Biological ageing of the skin can be classified into endogenous (genetic) ageing and exogenous (environmental elements) ageing. Sun-induced damage to the skin contributes to over 90% of skin ageing. A truck driver that had sun exposure to the left side of his face for over twenty years, shows the dramatic impact of ultraviolet rays on the skin. The daily use of Sun Protection Factor creams are an effective way to reduce skin ageing.

Skin Protection

Basic skincare
Skincare is necessary to facilitate the removal of surface debris and old skin, as well as clean and protect the skin. There is a large range of skin products on the market and to add to the confusion, every actresses and models appear to endorse different brands of skincare regime to protect and revitalize the skin.

So what can you believe?

There are four main stages for maintaining good skincare:

  1. Cleansing
  2. Toning
  3. Moisturizing
  4. Protecting

What is Cleansing (Stage 1)?

The outer layer of the skin (stratum corneum) contains dead cells and are shed off. Cleansers remove dirt, dead skin cells and make-up that have collected on the skin surface. They are two main categories non-lathering cleansers and foaming cleansers.

face and neck - photo female

Non-lathering cleansers:
The non-lathering cleansers were formulated as early as 100AD by the Greeks, and originally contained olive oil, beeswax and rose petals. The three ingredients were a combination of oil (disperses dirt and dead skin cells), an emulsifier (beeswax) that combined oil and water and fragrance (rose petals). Cold cleansing creams (named after producing a cooling sensation) are essentially variations of the original Greek’s formula. Cleansing milks are similar to cleansing creams with additional water to make them more liquid. Non-lathering cleansers may be wiped off with tissue or rinsed-off with water. Cosmetics that contains oil or wax, needs an oil-based cleanser to dissolve it before it can be wiped off, as a result non-lathering cleansers make excellent cosmetic cleansers.

Foaming Cleansers
Lathering or foaming cleansers may come in several forms including lotions, gels or bars. The foaming cleansers also contain oil and a detergent to wash them off. Lathering cleansers may be soap-based or soap-free, depending on the detergent used. Soap is a mixture of animal or vegetable fat and alkali salt (e.g. sodium cocoate). A draw back of the soap products are their alkaline properties which results in a tendency for them to leave behind a residue with hard water. The soap-free cleansers, use synthetic detergents which are petroleum derivatives and less alkaline (pH-balanced). As a result they work well in hard avoiding leaving behind a residue. Other components are often added to soaps to give they more specialist properties:

Fats are often added to lathering cleansers to make them less drying,
Oatmeal may be added for its soothing soaps
Peeling agents (benzoyl peroxide, salicylic acid) for acne soaps
Antibacterial chemicals (triclosan and ingarsan) for deodorant soaps
Abrasive agents (polyethylene granules, ground fruit pips, sodium for cleansing

What are Skin Toners (Stage 2)?

Toners contain water, alcohol, witch hazel and a moisturizer. They remove traces of cleanser and produce a refreshed feeling as the alcohol evaporates. Toners tighten pores temporarily and have a tendency to dry the skin as they contain alcohol (20 – 60%). Toners may not adequately remove all traces of cosmetics, particularly if you have oily skin, in which case you should use a lathering cleanser before a toner. There are other components of the toners for more specialist properties:
Fresheners are similar to toners except that they contain minimal alcohol (0 – 20%).
Alcohol-free toners contain glycerol or rose water in place of the alcohol.
Clarifying lotions and astringents are toners with more alcohol and as a result are more drying. Glycolic acid and salicylic acid are added for exfoliation.

What are Skin Moisturizers (Stage 3)?

Moisturizers reduce skin flakiness by making the surface skin layer (stratum corneum) cells stick together and make the skin appear smoother. The smoother skin surface results in greater reflection of light, brightness and glow. Moisturizers also provide a smooth base for cosmetics to go on.

Many creams that are marketed for their anti-wrinkle, rejuvenating and cell renewal properties are good moisturizers. Special ingredients such as collagen and elastin, supposedly to replace those damaged skin, in truth are too large to be able penetrate the dermis. Collagen and elastin have good water binding properties and as a result make good moisturizers.

Moisturizers can be divided into day-time and night-time moisturizers.
Day-time moisturizers contain less oil and soak quickly into the skin
night-time moisturizers contain more oil and more effective at reducing skin dehydration during the night.

Moisturizers are not able to prevent wrinkles as they cannot stimulate collagen synthesis, they do is plump up the surface skin layer making the skin appear smoother. Water moisturizes the skin by stopping “transepidermal water loss” (TEWL) i.e. evaporation of water from the skin surface. There are two groups of ingredients in moisturisers reduce evaporation. The first are lubricants (mineral or vegetable oil, lanolins and silicones) that reduce water loss through evaporation by occluding the skin with a waterproof layer. The second group of ingredients are humectants which (e.g. lactic acid, urea, hyaluronic acid, propylene glycol, glycerin, sorbitol, gelatin, lecithin, and butylene glycol). Emollients are products that make the skin softer but there is so much overlap between emollients and moisturizers that they can be considered almost synonymous. Sun protection is considered more important than moisturizing, as not everyone needs moisturizing especially if the skin is oily.

What is Skin Protection (Stage 4)?

Skin protection means defending the skin against sun-damage (ultra-violet rays) which are the main cause of ageing. This means the use of Sun Protection Factor sunscreens and is an essential component of daily skin care regime. Skin protection will reduce the aging damage to skin by the ultraviolet rays which are present in all months of the year, with or without sunshine.

What are different skin types?

  • Dry skin: Pale in colour with thin skin, rough to touch, flakiness especially after washing. There are underactive oil glands, with a predisposition to fine lines around the eyes and tendency to develop telangiectasia (fine spidery blood vessels). Dry skin requires greater moisturizers to maintain skin hydration.
  • Normal skin: Looks clear with even colour, soft to touch, feels neither greasy or rough to touch.
  • Oily skin: Sallow complexion with thick skin, overactive glands causing a shiny appearance, open pores that are prone to whiteheads and blackheads. Oily skin requires greater cleansers to remove oily secretions prior to toners or moisturizers.
  • Combination skin: Oiliness in the T-zone (defined by forehead, nose and chin), dryness on the cheeks, with occasional breakouts in the oily areas.

Is Vitamin A (Retinoic Acid) beneficial to skin?

Cosmetic manufacturers have made claims that untreated dehydrated skin may lead to wrinkles. This is not necessarily true as dry skin lines are caused by a dehydrated skin and can be treated with moisturizers. Wrinkles are caused by thinning of the skin, including the degeneration of collagen and elastin fibres in the dermis. The only topical medication product that has been proven to be effective in repairing the skin is Retinoic Acid (vitamin A). Usually, creams for normal skin type will contain between 0.025% and 0.05% of retinoic acid. Below is a photograph of facial wrinkles and lines treated with topical retinoic acid for 18 months.

Retinoic - photos Before After

Are Antioxidants beneficial to the skin?

Antioxidants have been show to improve the appearance of fine wrinkles and skin elasticity when taken as oral supplements. These include Vitamin E, Vitamin C, Carotenoids (lutein, lycopene and zeaxanthin), Lipoic acid and Soy isoflavones. A whole host of other anti-oxidants have been proposed my cosmetic companies, for most of these scientific evidence is currently lacking.

What is ALA and is it beneficial to the skin?

Alpha-lipoic acid (ALA) is an advanced glycation inhibitor and a potent antioxidant. ALA has multiple properties including antioxidant, anti-atherogenic, metal chelator, anti-inflammatory and a neuroprotective agent. Foods rich in alpaha-lipoic acid are potatoes, carrots, broccoli, yams and red meat. ALA have been shown to reduce nerve damage in aging and improve memory and performance.

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