Niacinamide...why I love it plus a bonus pigmentation lesson

I started using niacinamide (topical vitamin B3) when The Ordinary first brought out their products and I practically purchased all of the range.

Little did I know, I had actually been using niacinamide for far longer, I just wasn't aware of it because it wasn't "trendy" a few years ago. I had actually been using La Roche Posay Effaclar Duo Plus which has the triple whammy of salicylic acid, benzoyl peroxide and niacinamide. This tackles acne from all angles - unclogging the pore, reducing inflammation and improving the health of the skin and its ability to heal, as well as improving any pigmentation caused by the acne.

Why I love it

1) It is amazing for acne - it helps to regulate the oil flow in the skin, thus, allowing your protective barrier to remain in tact (the barrier can be damaged by harsher products like salicylic acid or benzoyl peroxide), but also reducing the risk of pore clogging leading to comedones and spots. I particularly like The Ordinary's formulation as it is combined with zinc, another great anti inflammatory product which is an amazing gentle help for acne

Which leads onto point 2...

2) Niacinamide boots the production of ceramides ( a natural fatty component of skin which almost acts like scaffolding to hold the skin cells together). If you imagine your skin as a sieve, throughout the day and night your skin wants to leak all the lovely things that keep your face looking plump and hydrated. This leads to dryness, dullness, and loss of plumpness. Thus, we need to do as much as we can to close the holes in the sieve in order to keep all the good stuff in. Niacinamide is awesome at that.
Because of this, it is also great as a buffering agent underneath any product that may cause irritation, such as peels, retinols etc. It is also compatible with pretty much every other skin care active (ignore the historic belief that vitamin C and niacinamide should never meet), making it great for layering.

3) Pigmentation buster.

Pigmentation can be tackled at 3 points.

• Prevention of production of melanin by the production cells - known as melanocytes. The melanocytes are stimulated by UV rays and in some cases, even by heat and visible light, mainly delivered to the skin via infra red rays 
• This can be done by:
• Blocking the UV rays from stimulating the melanocytes (i.e. sunscreen - see my favourites here) and blocking free radicals which cause DNA damage via antioxidants such as vitamin c (best as Ascorbic acid)
• Via agents such as hydroquinone (or natural derivatives such as arbutin), kojic acid, and azelaic acid which block the action of tyrosinase (the enzyme responsible for kick starting the melanin production process)
• Prevention of transfer of the melanin to the surface of the skin (the keratinocytes)
• Removal (exfoliation) of the pigmented area from the surface of the skin using AHA's and retinol to boost the turnover of the skin

Niaciamide acts on the second aspect. Whilst it has no activity on the melanocytes themselves, it can stop the transfer of the melanin to the surface of the skin, thus blocking pigmentation. In fact a study in the British Journal of Dermatology found that niacinamide at only a 2-5% concentration gave a 35-68% inhibition of melanin transfer, leading to decreased hyperpigmentation and increased skin lightness in only 4 weeks. 

4) Decrease of lines and wrinkles - Niacinamide boosts collagen (plumpness) and elastin (firmness) so you tackle this from both angles. As mentioned above, it also allows your skin to tolerate stronger active ingredients, especially higher concentrations of retinols, so this allows a double whammy on anti ageing front

5) Skin dullness fixer - as an antioxidant, this can work in the same way as vitamin C to restore brightness to the skin

Simple.




Mentioned paper

Br J Dermatol. 2002 Jul;147(1):20-31. The effect of niacinamide on reducing cutaneous pigmentation and suppression of melanosome transfer.

6 weeks Roaccutane (Accutane/Isotretinoin) free

Thought I would do a little update for you now it has been about 6 weeks since finishing my Roaccutane. This seems to be the agreed amount of time that the drug takes to clear from the body (although some of the side effects can last much longer, all of it has been metabolised and cleared now).

Skin dryness
Dryness has almost completely gone. My lips were back to normal by week 2 and any dry patches of skin from using products that were too strong have now completely gone. My skin is still combination.

Skin reactivity
The ferocity to which my skin reacts to products seems much reduced. My tolerance to retinols and acids has definitely increased.
I have not noticed and increase chance of burning from the sun, however I am being VERY careful - hat, sunglasses and SPF 50.

Joints
Knee pain has almost completely gone. I was lucky to never suffer from back pain but did have a significant amount of neck and shoulder pain and this reduced a lot, especially between weeks 4 and 6. My foot and ankle pain/ache is the only thing that is remaining but that has also reduced significantly.

Spots
I got my first spot around 4 weeks after being off Roaccutane. Turns out I was also due on my period! This came and went within a few days. Panic over. The issue with Roaccutane now is that people are put on it for much less severe acne than they were 10 years ago. If you have full face, severe, cystic acne, then an improvement for you will be much different to someone who gets 5 or 6 spots a month.
Because the 5-6 spots a month group are now being put on Roaccutane, the expectations for an "acne cure" are much higher, but this is not the reality. You will still get spots however they should be less frequent and less severe. 


The pictures below are me now. No make up. No filter (as always).

As those who work in hospital or in a dental surgery will know, there is no more honest, or less flattering light, than what they use in a dental surgery or hospital. I thought this would be a good light to show you my skin because you will see it, warts (/scars) and all. 

My skin care routine

AM

1.       Non foaming cleanser (I used antibacterial, anti acne, anti anything good for the skin    cleansers for years until a dermatologist told me this is the worst thing you can do!) I use Cereve hydrating cleanser, or cetaphil. Both super cheap from Boots
2.       Hyaluronic acid serum – I use the one from - The Ordinary hyaluronic acid and B5 serum  
3.       La roche posay effaclar duo plus – this has salicylic acid, niacinamide and benzoyl        peroxide which are the 3 best acne and pigment fighting ingredients
4.       Skinoren 20% azelaic acid cream - just around my chin and lips where I have comedones and pigmentation
5.       Oil free moisturiser – this is key. I have a post on my blog about my faves and I tend to rotate between them. I mix this with the ordinary 100% L ascorbic acid powder (which is pure vitamin c). This will work on the marks left behind by the spots, it also acts as a bit of a skin protector from UV
6.       SPF in summer (if you spend any amount of time outdoors or in the car in daylight you will need this year round, I spend most my time in a basement of a hospital with no natural daylight). I’m trying a few new ones out at the moment and will be doing a blog post soon

PM:

1    

1.        Cereve cleanser with my Foreo Luna mini
2.        AHA/BHA toner (unless I am about to follow with a stronger retinol) 
3.        Niacinamide serum (I love The Ordinary 10% niacinamide and zinc serum )
4.        Oil free moisturiser if I am using a higher strength retinol to buffer
5.        Retinol. I have a post on my blog (the “wait that line wasn’t there yesterday) with my       favourites. I had to drop down the The Ordinary Granactive retinoid 2% due to my skin    reactivity but am now up to 0.5% retinol in Neostrata Retinol NAG

The Ordinary product review. Nothing ordinary about it.

I genuinely believe this is the best range I have ever tried. The carrier systems and feel of the products may not be the most sophisticated but I love them as:

 1) you know what concentration the active ingredients in (which quite frankly is the only bit of the product I care about)

2) the active ingredients are in a stable form – you can find plenty of products on the high street with active ingredients such as vitamin c (cough Aldi cough), but as soon as you mix them with water the ingredient is no longer active and effective

3) the packaging is appropriate for the product i.e. dark glass for vitamin c products to avoid UV oxidation AND mostly recyclable due to the use of glass vs plastic

4) they are mega affordable so if you skin does not agree with a certain ingredient you have only lost a fiver

I have tried A LOT of products from the range so will do a quick rundown of my favourites, and some that I have used but may not be repurchasing

Product	Pros - Why I liked it	Cons
Hyaluronic acid and B5 serum	Cheapest way to get good quality hyaluronic acid into the skin	It is a bit sticky. This is not a problem if you only layer a moisturiser over, but I have found if you layer it over niacinamide or use a vitamin c powder mixed with the moisturiser it will causing some pilling
Ascorbyl Glucoside Solution 12%  Ethylated Ascorbic Acid 15% Solution	Pleasant to use, no stinging, no grittiness so good to apply makeup over. Dark bottle to avoid oxidation	I did not really see any results from either of these products so swapped to a higher concentration
Ascorbyl Tetraisopalmitate Solution 20% in Vitamin F	Feels lovely to apply.	Oil base so this was donated to my mum who has a drier and non acne prone skin
Vitamin C Suspension 23% + HA Spheres 2%	Great for resurfacing and brightening	Doesn’t feel great to apply, gritty. This does go after 5/10 mins as it absorbs and warms to the skin, but you would probably want a primer if applying foundation over
100% L-Ascorbic Acid Powder	This is my current form of vitamin C. You can make it as potent or diluted as you like. Minimal tingling. No gritty feeling.	I find it works better mixed with a moisturiser vs a serum as sometimes it does not dissolve fully in a serum and leaves white patches on the skin. The problem completely disappeared when I mixed with moisturiser.
Granactive Retinoid 2% Emulsion	Lovely product. Lovely lightweight serum, did not cause any peeling or irritation. I did not even need to use a moisturiser over this	None I prefer this formulation to the Granactive Retinoid 2% in Squalane
Granactive Retinoid 5% in Squalane	Great product, you skin feels like silk in the morning.	This caused absolutely no irritation or breakouts on my skin however I had to switch to oil free products for my comedones, so this got moved to use on my neck only. My neck cannot seem to tolerate the higher strength retinols that I use on my face, so this is perfect
AHA 30% + BHA 2% Peeling Solution	This may well be my favourite product from the range. The concentration of the acids is great and is the highest performing mask of this kind that I have tried. Glass skin ahoy	It burns and tingles. Beware if a first-time user of acids. Start with leaving it on for just 2 minutes and work up slowly. When you’re mad like me, you can even run your foreo over it at the end of the 10 mins to activate it further
2% Salicylic acid serum	2% is the percentage you need for it to have a true pore cleaning effect, so this is perfect	I prefer my la roche posay effaclar duo as it provides the triple spot fighting whammy with salicylic acid, benzoyl peroxide and niacinamide so I stick with this to avoid having to apply 10 different products
100% Organic Cold-Pressed Rose Hip Seed Oil	Lovely texture, absorbs quite quickly but can also be layered to do a massage or for a healing boost. I had a burn from a product (too strong a retinol) on my neck and this was the only thing that solved it and stopped it being sore and itchy. If you do not have any pore blockage issues this would be great to use on the face too	Doesn’t smell great, which actually is fine by me because I do not want added fragrance in my products.
Natural Moisturizing Factors + HA	Lovely simple moisturiser. No oil, no fragrance. Great for cuticles and nails too (tip from Mr Truaxe himself)	None
Niacinamide 10% + Zinc 1%	Great concentration of the actives. The added zinc is also great for my acne prone skin. No irritation	If you layer this under hyaluronic acid, make sure you only use a small amount of the niacinamide otherwise the hyaluronic can leave little white patches, however these disappear as soon as you layer over a moisturiser.
Caffeine Solution 5% + EGCG	If you are at all prone to puffiness – going through a break up, massive Chinese food binge – slap this on the night before and again in the morning and it’ll disappear. The other wonderful benefit of this product is it can be mixed into other things. For example, when I’m on a real summer kick, after dry body brushing my legs (which I do daily) I mix a good squirt of the caffeine solution into my body cream and slather on for some skin firming action	This is drying (it’s kind of the point of the product) so I apply this onto clean, dry skin, let it absorb for a couple of minutes while I brush my teeth etc then layer my eye cream or moisturiser over the top
Lactic Acid 10% + HA	Lovely texture, easily absorbed, good resurfacing	For some reason this worsened my acne. I am lactose intolerant but that is a digestive thing so shouldn’t have affected the skin but either way, I stopped using this and donated.

In summary, my must haves are the aha bha peel, the caffeine solution, vitamin c powder and niacinamide. For beginners, I would definitely get the hyaluronic acid serum and the retinoids.

Wait...that line wasn't there yesterday

Myths and truths about "anti ageing"

This is an extremely hot topic and besides acne, signs of ageing are probably the most frequent skin concerns. Unfortunately, a lot of products provide little more than false hope due to their vast marketing strategies and fancy packaging.

This post is going to be "real talk" about ageing and products to combat it.

So...first of all we need to break down the term "ageing", because it can mean so many different aspects.
Lines
Wrinkles
Loss of firmness
Loss of elasticity
Dryness
Pigmentation and age spots
Dullness

All of these aspects are improved by completely different ingredients and therefore the miracle "anti ageing moisturiser" that claims it tackles all of these is quite frankly, nonsense.

The only products clinically proven to be anti aging in terms of tackling most, if not all of these skin concerns, and those that you can legally claim to do so, are:
SPF and UVA protection - i.e. things that block the damage of UVB and UVA
Retinols and all their derivatives

The combination of the above 2 products will tackle all the above signs of ageing.

All the other products have no role in reversing or preventing skin aging, they can just improve "the look" of ageing - look closely at the declarations products make on advertising and you will see "improve the appearance of..." as this is the maximum they can claim the products do.

I will be going through individual ingredients on "ingredient of the week" to discuss the benefits they can have on one of more of these ageing concerns  as helpful ingredients like vitamin C and hyaluronic acid can have a major impact in improving the look and health and therefore youth of the skin

It is my strong belief that SPF should be chemical and not physical. Let's have a sun cream lesson to explain.

Chemical sunscreen is the form that the majority of high street SPF's will come in. Unless it SPECIFICALLY says it is a physical sunscreen, it will be chemical. Similarly, a lot of products may be a combination of both.

Chemical sunscreens have to absorb into the skin in order to work. This is why you have to apply them 30 minutes before sun exposure.

Therefore in order for you chemical sunscreen to protect from burning (UVB), the rays need to penetrate the skin. Imagine the chemical like a chain. When UVB is absorbed, it breaks the bonds in the chemical sunscreen chain and then the by products are scattered into the skin. Imagine milk going sour, this is effectively the bonds degenerating and the by products of this process produce the terrible smell.

This is why sunscreens also have to be reapplied, as eventually all the bonds are broken and it is no longer effective protection. The issue with this, is that the by products and the chemical filter itself are really not great for your skin. They are also difficult to cleanse from the skin at the end of the day. So all your hard work and skin care will be of limited effectiveness.

Now, onto why physical is better. Physical sunscreen form a mirror-like layer on top of the skin, therefore no chemical nasties are absorbed into the epidermis. The molecules reflect the UVA and UVB rays so gives protection against both in one swoop. This also means the rays do not penetrate the skin in any way so do not produce any nasty by products which can harm the skin.

Similarly, because it does not absorb into the skin, it is easier to remove and significantly better for acne prone skin, or any of us that go on holiday, look amazing, then 2 weeks later look like a drug addict covered in spots.

It is a little harder to find but I will list some below. All of them are tinted as physical sunscreens can give a white cast to the skin. This can easily be covered by make up but why not make things easier for yourself!

https://www.dermacaredirect.co.uk/skinceuticals-mineral-radiance-uv-defense-spf50.html

https://www.amazon.co.uk/UV-Clear-TINTED-Broad-Spectrum-SPF/dp/B00ZPWR0N8

https://inen.strawberrynet.com/skincare/jan-marini/skin-research-marini-physical-protectant/159835/


So onto my next miracle product - retinols

This is a tricky one and is a product that confuses many people. Retinol is the form of vitamin A that is effective on the skin.

They work by boosting the turnover of the skin, and forcing the body to produce more collagen. Therefore, the new cell that come to the surface get there more rapidly, and are more plump and better adhered to the surround cells therefore giving a smoother, more glowy, firmer and younger looking skin. The other benefit is the improvement they will give to acne prone skins. By increasing turnover you are removing the cells that block the sebum escaping, therefore reducing risk of spots or comodones forming, you also improve the scarring or pigmentation left behind by old spots. WIN.

The downsides are that if the underneath cells are not ready to come to the surface, peeling, dryness and redness will occur until the skin is used to this more rapid turnover of cells. This is why you should build up your retinols slowly, and why the results from the stronger versions take months.

Topical vitamin A comes in many forms which, in simple terms, have different molecule sizes which determine how much they can penetrate the skin and also have to go through different numbers of processes by the body in order to make them into an active end product which will work on the skin. It is due to these 2 factors that different forms of topical vitamin A have different strengths of action on the skin.

In order for any form of topical vitamin A (retinol) to be used within the body and the skin, the body must convert it into retinoic acid.

Therefore, the starting version of your vitamin A product will dictate how many stages it has to go through to be made into something useful for the skin. 

Retinyl palmitate/Acetate/Linoleate/Proprionate à retinol à retinaldehyde à retinoic acid

Most high street or starter products contain retinyl palmitate, which is still very effective on the skin for newbies, but as you can see, has low strength, and is in fact about 20% less potent than retinol

A pure retinol will penetrate further and be more active and therefore have a stronger effect, but also come with more side effects

If you want pure retinoic acid (tretinoin) then you will need a prescription from a dermatologist as these are the strongest form with the most side effects .

The strength also depends on what the product is mixed with, if it is not in a stable form, it will degrade as soon as you start using it. Similarly, if it is combined with an oil or a silicone it will slightly buffer the skin to reduce peeling or redness. The hardcore prescription versions have no such niceties.

It is worth noting that no form of retinoid, retinol or vitamin A should be used when pregnant, trying to become pregnant, or breast feeding. Sorry!

My favourite retinols:

The Ordinary and Neutrogena - retinoic acid ester

https://theordinary.com/product/rdn-advanced-retinoid-2pct-30ml

https://www.amazon.co.uk/Neutrogena-Rapid-Wrinkle-Repair-Moisturizer/dp/B004D2C4Q4

La Roche Posay 0.3% retinol

http://www.boots.com/la-roche-posay-redermic-anti-wrinkle-treatment-30ml-10160065

The Ordinary 0.5% retinol

https://theordinary.com/product/rdn-retinol-05pct-in-squalane-30ml

Neostrata - 0.5% retinol but due to the other components is higher strength than The Ordinary version

https://www.neostrata.com/product/neostrata+skin+active+retinol+-+nag+complex.do

Similarly - Retriderm's 0.5% retinol is a great product

http://www.facethefuture.co.uk/shop/aestheticare/retriderm-vitamin-a-05-retinol-skin-serum.html

Going up a level is Retriderm 1% retinol

http://www.facethefuture.co.uk/shop/aestheticare/retriderm-vitamin-a-ultra-10-retinol-skin-serum.html?

Paulas choice 1% retinol is another goodie.

https://www.paulaschoice.co.uk/clinical-retinol-treatment-m8010.html