DR ANUPRIYA GOEL

How to Get Glass Skin

Industry Secrets to Getting Flawless, Glowing Skin

PENGUIN BOOKS
 CONTENTS

1. The Secret to Glass Skin

2. Know Your Skin

3. How to Cleanse Correctly

4. The Art of Dewy Skin—Hydration and Moisturizing

5. Make SPF Your BFF

6. The Skincare Superstars: Active Ingredients and Exfoliation

7. Magic Potions for Your Skin: Serums, Essences and Facial Oils
8. Masking: Supercharge Your Skin

9. The Extras: Toners, Face Mists and BB Creams

10. How to Treat Problematic Skin

11. Your A.M.:P.M. Skincare Routine

12. On-the-Go Skincare and Workout Skincare

13. Skincare for Men

14. Superfoods, Supplements and Lifestyle

15. Quick-Fix Recipes: Treatments at the Clinic

16. How to Read a Product Label like a Pro

Footnotes
1. The Secret to Glass Skin

2. Know Your Skin

4. The Art of Dewy Skin—Hydration and Moisturizing

6. The Skincare Superstars: Active Ingredients and Exfoliation

8. Masking: Supercharge Your Skin

 10. How to Treat Problematic Skin

13. Skincare for Men

14. Superfoods, Supplements and Lifestyle

16. How to Read a Product Label like a Pro

Acknowledgements

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Copyright
 EBURY PRESS
HOW TO GET GLASS SKIN

Dr Anupriya Goel is an aesthetic dermatologist and a leading expert in non-

surgical aesthetic medicine. Her work is her passion, and she has made a
name for herself in the industry in a very short time. She is the medical
director of Berkowits Hair & Skin Clinic, with a team of more than 170
technicians and paramedical staff working under her guidance. She not only
specializes in anti-ageing treatments but also has a passion for training. She
is a senior faculty member and a certified Allergan Medical Institute trainer
for fillers and Botox. She is also a national trainer for the MINT treatment.
She is one of the four key opinion leaders of the Autologous Micro-Graft
treatment for hair loss in the country and is the only doctor in the world to
have formally achieved more than 300 cases of successful treatments by
this procedure.
Her eye for treatment and skills are not just limited to facial aesthetics
but also involves hairline designing. She has been trained in hair-transplant
procedures in a prestigious hospital in Turkey.
She educates people on skincare and haircare regularly through her
YouTube videos, which have more than 20 million views. She has also been
invited to medical conferences, FM Rainbow and the Rotary club multiple
times to spread her knowledge on skincare.
Her widespread practice is not just limited to the eleven clinics in the
NCR, but she has plans to spread her wings throughout the country and has
already set up clinics in Kolkata and Hyderabad. Berkowits products are
formulated under her guidance and with her expert advice. Each ingredient
is hand-picked by her team for best results.
Her Instagram handle is @dranupriyagoel
She can be contacted at [email protected]
 This book is dedicated to my two beautiful rays of sunshine. You are the
reason I started writing this dream, and we have been part of this journey
together

And to my husband, for always having faith in me and telling me every

single day, ‘There is nothing that you can’t do and you can achieve
everything you wish to!’
 1
THE SECRET TO GLASS SKIN

In 2018, when I was thirty-one years old, I was invited to attend the
prestigious conference on thread lifting for the face and the body—MINT
(Minimally Invasive Non-Surgical Thread)—held in Seoul, South Korea.
I was invited because I was among the few doctors in the world who were
conducting thread-lift procedures at my clinic, Berkowits. (The next year, I
was one among two speakers from India who were selected and invited by
MINT, but I had to turn down the offer because I was in my first trimester
of pregnancy, expecting twins, and experiencing nausea and vomiting in
double measure. It was impossible for me to take a long-haul flight and then
acclimatize to a new environment, even if it was only for a few days.)
In the days leading up to my trip, I may have seemed calm on the surface,
but those who knew me well knew that I was bursting with excitement
inside, because I, an aesthetic dermatologist and medical director of a
skincare chain, was going on my first trip to South Korea— the Mecca of
skincare. I was over the moon. Every doctor who specializes in the field of
skincare aesthetics looks forward to going to Seoul. For good reason.
For many years, the beauty industry in South Korea—or K-beauty, as it is
generally called—has dominated the scene. It is one of the major global
centres of innovation and trendsetting in beauty products. They’ve truly
created some radical products which have made their way across the world
and become commonplace in our skincare routines. From BB and CC
creams, essences, cushion foundations and overnight sleeping masks to the
very popular sheet masks and the infamous ten-step Korean routine, South
Korea has led the way in beauty innovation. In fact, the South Korean
skincare market is estimated to be twelve–fourteen years ahead of its
American counterpart.*
It’s not surprising, since the South Korean government also takes a deep
interest in this industry and supports its massive research and development
(R&D) centres. Other markets are also interested in getting themselves a
slice of the K-beauty pie. According to one report,

The fast growth in South Korea cosmetic industry has captured the business deal from
global cosmetics manufacturers. Top contract manufacturers in South Korea are
approached by top players of the world . . . South Korea cosmetics market is valued at
nearly USD 9.29 billion in 2017 and is anticipated to grow at a CAGR of 4.95 per cent
during the forecast period 2017-2030.*

The numbers are amazing. I prepped myself for the conference, packed my
bags and, soon, was on a flight to South Korea for the three-day affair. I
arrived in Seoul, slightly jet-lagged and out of sorts, where I was
immediately whisked away to the Ramada Hotel located on the bustling
Gangnam Road. After freshening up, I went down to the lobby to meet the
other participants with whom I was going out for lunch to a Turkish
restaurant at Coex Mall. As we tucked into our pide (Turkish pizza) and
falafels, we chatted with each other, gradually breaking the ice. But all
through lunch, I could sense something else—the palpable excitement in the
air. This was because our next destination was Myeong-dong, one of South
Korea’s biggest shopping districts.
I have always found it difficult to describe the sheer size and energy of
Myeong-dong to those who ask me. It’s like trying to put into words the
limitless vistas of Ladakh or the Grand Canyon. Myeong-dong blew me
away. It had an ‘Alice in Wonderland’ energy—mad, frenetic, bizarre but
utterly joyous.
 There was street upon street of cosmetics and beauty shops, all jostling
for attention. Outside these shops, there were hawkers selling clothes and
food on thelas, such as ice-cream vendors. Those of us who were visiting
Seoul for the first time were stumped by the abundance, the innovation and
the genius of the offerings of Myeong-dong. I saw things I’d never seen
before. Make-up brushes shaped and packed like roses; and lip glosses and
tints packed in mini tin cans, mini bottles of Coca-Cola and Hershey’s
syrups, and even in the shape of fruits and animals. K-beauty’s cute
packaging and affordable price points make it tempting to load your cart
with products, and if you’re not careful, you could easily end up spending
all your cash in just one shopping stint. The walls of beauty shops were
plastered with endless displays of pigments, while the sheet-mask sections
were mind-boggling. One can find anything from hydrogel masks and bio-
cellulose masks to acupuncture masks. And don’t even get me started on the
ingredient list. After my trip to Seoul, I can safely say that I’ve seen
everything. I’m sure you’ve heard of snail slime. But what about salmon
eggs and placental extracts? I thought you haven’t.
At one point, I walked into a café and was amazed by the sight in front of
me. All over the world, a book section or library is the natural companion to
a café. But not in Seoul. There, the best complementary accompaniment to
a cup of coffee is beauty products!
In hindsight, I realized that, yes, of course, all of it made sense.
For the South Koreans, skincare is akin to religion. But to limit it to just
this aspect is what we often get wrong about their culture. Beauty and
aesthetics are a way of life for them—it goes beyond just skincare and
beauty. Their focus is detail-oriented and permeates every aspect of their
lifestyle, from their immaculate food presentation and their minimalist and
quirky decor (I visited a restaurant that was set up like a cartoon set) to the
way they dress and carry themselves. In the time I spent in South Korea, as
I walked down the streets or people-watched at restaurants, I witnessed
their obsession with beauty everywhere.
After a little digging, I learnt that South Korean society is still deeply
influenced by Confucianism, an intellectual philosophy that originated and
developed in China during the fifth and sixth centuries BC. And this
philosophy has shaped the very lifestyle of the South Koreans. An article I
came across explains this idea succinctly:

These ideals are considered very noble and deeply inform the culture. For women, to be
modest and unadorned has always been a strong Confucian virtue . . . During Korea’s
Joseon era, which lasted from the 14th to 19th centuries, the country had its own versions
of Japanese geishas, called Kisaengs. These women were the pinnacle of beauty and set
all the mainstream make-up trends. Their bold, inky eyebrows and clean, radiant skin
inform Korean make-up standards even now.*

So that is why South Korean women focus more on clean, virginal,

glowing skin, rather than one that is heavily made-up.

Different Types of Glowing Skin

Understanding the South Korean cultural context helps illustrate why the
primary emphasis in K-beauty is glowing skin with minimal make-up. As a
skin specialist, the proof was in front of me everywhere I went in South
Korea. Both girls and women flaunted radiant, glowing skin, free of
blemishes. I soon learnt that there were various degrees of flawless skin,
with each being assigned its own terminology.
The first category is ‘dewy’ skin. This is the most common and popular
category. However, a ‘dewy’ appearance is often confused with an oily
look. The luminosity of South Korean skin is not due to excessive sebum
production but due to good skincare habits and internal health.
Then comes ‘honey’ skin, which is a step up from dewy skin. It is
another term used for even, transparent and radiant skin. So what is it
exactly? Imagine a spoonful of honey melting in your mouth. Smooth,
right? ‘Honey’ skin is so shiny, hydrated and plump that it gives the
impression of melting right away. The right skincare routine and products
are the most important steps to getting such skin.
Finally, there is the mother of all skin types—‘glass’ skin, or ‘paani-
paani’ skin, as my sister calls it. I was the most intrigued by this term.
When I asked someone what they meant by glass skin, I was told, ‘Imagine
skin so flawless and translucent that it shines like a crystal—immaculate,
perfect and absolutely transparent. Skin so succulent, radiant and clear that
it actually reflects light!’
If this was the ultimate goal for South Koreans, I was surprised to find
many, many women with glass skin there. This meant that they had
achieved the pinnacle of great skin health, and it left me confounded.

The Secret behind Glass Skin

As an aesthetic dermatologist, I know that skin, the largest organ of the

human body, is a tricky thing to master.
Our skin, or the epidermal barrier, is the outermost layer of the epidermis,
called the stratum corneum. It is made up of dead cells, a keratin-mixed
lipid-rich mass that contains cholesterol, free fatty acids and moisture. The
skin acts as a protective barrier for the body. Think of it as the Wall in
Game of Thrones. Not only does it keep the bad guys out (prevents water
loss, protects against heat and cold, and ultraviolet [UV] rays, penetration
of infectious substances and infections, etc.), but it also keeps our muscles,
veins and internal organs in place. But just like the Wall, our skin is under
attack from both internal and external forces every minute of our lives. The
skin barrier can become compromised due to many reasons. Some of them
are:

Dehydration or lack of moisture

Harsh substances
Excessive washing
Age
Smoking
Cosmetic procedures
Too much exposure to UV light
Over-exfoliation
Poor blood circulation
Pollution
 Poor diet lacking in nutrients, and consumption of dehydrating
beverages
Hormonal fluctuations

Most of us can point to one or more triggers from this list. That is why it’s
so hard to find someone with perfect skin, because all of us suffer from
some skin issue at some point in our lives. So I wondered how it was that
‘glass’ skin was so commonplace in South Korea.
My trip to the country got me thinking. I began to ask myself some
questions.
What are the South Koreans doing differently? Is it their genetic make-
up? Are they secretly drinking some ancient magic potion that their
grandparents told them about? What are their eureka skincare products? Is it
their diet, so rich in fish and seaweed, that helps them achieve glass skin?
The more I studied and dug deeper into the subject, the clearer the
answers became.
There is no one magic product that can make you get glass skin. My
apologies, I hate to burst your bubble. But there is one key factor that
makes a world of a difference. At the heart of the South Korean glass skin
are the magic words ‘hydration’ and ‘consistency’. A smart, consistent
skincare regime that has hydration at its core is what makes a world of
difference to any type of skin. It doesn’t matter if you use great products
sporadically—it does no good. Rather, you should focus on using smart
products consistently and following the skincare regime mentioned in this
book to get results.
Picture a ripe and juicy grape. Its skin is supple, wrinkle-free and taut.
Now think of a raisin—it’s wrinkled and dry. It is the same fruit, but a raisin
has had all its water content squeezed out. Similarly, hydrated skin is
plump, luscious and tight, emitting a radiant, healthy glow. Hydration also
diminishes fine lines and wrinkles, giving your skin a clearer and youthful
appearance.
As we age, our skin tends to lose its water content, thus becoming drier.
That is why anti-ageing products aimed at mature skin are usually more
emollient, or creamier, than those suitable for a younger demographic,
because older people tend to have drier skin. We can’t do anything to stop
the hands of time—it is a natural process—but we can take measures to
slow down the effects of external aggressors and maintain a hydrated,
moisture-packed skin barrier, which is ultimately the secret to glass skin.
There are many ways to keep your skin hydrated and, thus, plump. The
funny thing is that, worldwide, there are many products to cover up this
extra shine on your skin with the help of powders and mattifying primers.
Well, these products are more to cover for the oil slicks than to give you the
dewy look. Even in Yash Chopra and Karan Johar movies, matte skin and
mattifying make-up were fads for a long time, until Kareena Kapoor and
Katrina Kaif showcased their glass-like skin.

How to Get Glass-Like Skin

Glass skin is not limited to just the South Koreans. Everyone, even us
Indians, can get flawless, ‘paani-paani’ skin. In the coming chapters, I will
take you through the steps that will help you achieve this goal, taking into
account the different skin types.
But before we progress, I want to make one thing very clear—there is no
one magic product or ingredient that will help you get glass skin. Anyone
who tells you otherwise is selling you snake oil. Skincare, just like any
other ritual (think dental care—do you ever skip brushing your teeth?)
should be part of your daily lifestyle. Only then will you see results.
In short, here are the steps to achieving glass skin:

Understand your skin type. Using the wrong products, no matter

how trendy they are, for a different skin type will cause more
trouble for your skin.
Understand your skin condition. The drill is not just about
understanding your skin type but also identifying your skin
condition and picking your products accordingly.
 Arm yourself with knowledge about what skincare ingredients go
into the products before you buy them, and understand what they
do.
Get the right products for your skin.
Follow a customized skincare routine diligently without missing
even a single day. As in most areas of our life, a consistent
approach produces the best results. If you suddenly stop a
treatment, you won’t achieve the desired results.
Eat a healthy diet and include some form of exercise in your daily
routine.

The saying goes, ‘Give a man a fish and he’ll eat for a day. Teach a man to
fish and he’ll eat for a lifetime.’
So what are you waiting for? Let’s go fish.
 2
KNOW YOUR SKIN

How many times have you bought skincare products worth a pretty penny
because your favourite celebrity endorses it, because it looks and smells
attractive, or because your friend swears by it—only to find that it doesn’t
work for you? Perhaps you got an allergic reaction or broke out in pimples,
or it simply did nothing for your skin? We’ve all fallen prey to sales pitches
that include the words ‘worked wonders for me’ at some point in our lives.
But the important thing is to understand why that particular product bombed
for us. I like to use a simple analogy when thinking of skin and choosing
the right product for it: Will a Samsung Galaxy cover fit your iPhone? You
guessed right—no.
It’s the same when it comes to your skin. If you have dry and sensitive
skin, you can’t possibly use the same range of products that are designed for
someone with combination or oily skin. So many of us buy innumerable
expensive serums, lotions, anti-ageing creams and skin-brightening gels
without being sure of what our skin type is. Often, we even use the same
products as our mom or our friend, just because they said it worked like
magic for them. That is why the first step on the road to fabulous, glowing
skin is to know what your skin is like.
 Once you figure this out, you can move on to the next step, which
involves getting the right products that have been especially created for
your skin type. The science behind skincare products today is cutting-edge.
Gone are the days when our grandparents used that one Boroline or Pond’s
cream, because that was all that was available to them. Today, the market is
flooded with skincare products for all skin types and concerns. But before
you go out to buy some, let’s understand why your skin type is what it is.

Understanding Your Skin’s Physiology

Let’s talk about skin. It is the largest organ in the human body, which covers
a total area of about 20 square feet. This has always amazed me. Our skin
has innumerable roles in the normal functioning of the body. It not only acts
as a physical barrier to the environment, but also regulates body
temperature, helps us sense pain, touch and pressure, protects us from
microbes and toxins, initiates vitamin D production—essential for our
bones—and secretes sebum and sweat.*
Our skin also helps us understand each others’ emotions. For example,
we flush pink when we are blushing or turn pale when we are scared. This
means that our skin also reflects our inner emotions. Our skin has so many
important functions, yet so many of us take it for granted. We tend to ignore
it until we notice a zit or a wrinkle on it.

The Layers of Skin

There are three main layers of our skin:

1. Epidermis: This is the topmost layer. It is thin in some parts of our

body, such as below our eyes, and thicker in a few areas such as the
hands and soles of our feet. It undergoes constant renewal,
regenerating itself about every twenty-eight days. These new skin
cells are formed in the stratum basale (the lowermost layer of the
epidermis), which then travel to the topmost layer and are shed.
 This regeneration is much faster in infants and slows down as we
grow older. Hence, our skin heals from cuts and bruises much
quicker when we are younger. The epidermis also gives our skin its
colour by producing melanin.
2. Dermis: This deeper layer has many functions. It contains blood
vessels, which carry oxygen and important nutrients to the skin;
sweat glands, which regulate our body temperature; oil glands,
which produce sebum and keep our skin soft and smooth; multiple
nerves for sensations; and one of the most important things—
collagen and elastin, which are responsible for giving firmness to
our skin.
3. Subcutaneous fat: This is the third layer of our skin, which is also
known as the hypodermis. It stores fat, muscle, blood vessels and
nerve cells, and mainly acts as an insulator and regulates body
temperature.

The Colour of Your Skin

Our skin colour is determined by the pigment melanin. The production of

melanin varies among individuals and depends on their genetic make-up.
The more melanin your skin makes, the more pigmented your skin colour
will be. Melanin protects you from harmful UV radiation and, hence, is
responsible for giving you a tan or a burn.
In 1975, the useful Fitzpatrick skin typing system was invented by
Thomas B. Fitzpatrick, a dermatologist from Harvard Medical School, to
determine skin type according to the amount of melanin pigment in it and
the effect of exposure to UV radiation. This system helps predict if an
individual is at risk of having a sunburn or a tan. Skin with little melanin
has lower protection from UV rays and is at a higher risk of burning.
Increased risk of burning means a higher risk of cancer.
The more melanin (dark-brown pigment) a person has, the darker their
skin will be and the higher the likelihood of their skin getting tanned rather
than burnt; there’s also a lower risk of cancer. This skin type also has a
higher risk of developing post-inflammatory hyperpigmentation (brown
spots) after injury/acne.
This is a summary of the Fitzpatrick’s skin types:

Type Features of Unexposed Skin Tanning and Burning

Very pale skin, often with green or blue eyes and Burns without tanning
1
fair or red hair
2 White skin, often with blue eyes Burns and does not tan easily
3 Fair skin with brown eyes and brown hair Burns first, then tans
4 Light brown skin, dark eyes and dark hair Burns a little and tans easily
Brown skin, dark eyes and dark hair Easily tans to a darker colour and
5
rarely burns
6 Dark brown or black skin, dark eyes and dark hair Never burns but tans darker

Indians usually have skin types 4 and 5, and hence are more prone to
tanning than burning. It does not matter which skin type you are, sun
protection is mandatory and necessary in every single skin type.

The Importance of pH

Normal skin type, with intact stratum corneum, ideal sebum content and
good hydration, has a pH of 4–6. The term ‘pH’ refers to ‘potential of
hydrogen’. It determines how acidic or alkaline a substance is. On the pH
scale of 1–14, 7 is neutral, below 7 is acidic and above 7 is alkaline. For
example, lemon juice has a pH of 2, which is very acidic, and curd has a pH
between 4.5 and 5.5. The ideal pH environment for skin is around 4.1 and
5.8 (slightly acidic). Men’s skin tends to be more acidic than women’s,
hence the skincare products for men and women differ in a few aspects.
Newborns have neutral pH skin (about 7), and that is why they must use
very mild and gentle products.
The pH of our skin can be affected by various factors, such as genetics,
age, the production of sebum and sweat, and the use of bar soaps, foam
cleansers, cosmetic products and topical antibiotics. This change in skin pH
can play an important role in various skin diseases such as atopic dermatitis,
acne vulgaris, irritant contact dermatitis, ichthyosis, etc. When skin is more
alkaline, we are more prone to UV damage and early signs of ageing.
Therefore, it is necessary to maintain our skin’s ideal pH by using pH-
balanced skincare products (4.5–5.5). Cleansers such as syndet bars and
lipid-free cleansers (see p. 67), and topical treatments help repair our skin
barrier.
So does that mean that we should use only pH-balanced products?
It has been observed that the use of products that are acidic in nature
(such as AHA/BHA exfoliants) and alkaline in nature (such as a mineral
sunscreen with a pH of 7.5–8) bring only mild changes in the skin’s pH,
which the body self-corrects in a very short period of time. In fact, mildly
acidic products help remove dead skin cells and make the skin look smooth
and rejuvenated. However, the use of substances that are highly acidic (pH
2–3) or alkaline (pH more than 8) can harm the acid mantle of the skin and
make the skin sensitive and even trigger breakouts. If this happens, one has
to be especially careful to protect oneself from UV rays and environmental
dust, and use cleansers and moisturizers that are meant for sensitive skin
and have humectants, emollients and anti-inflammatory ingredients.

Things to Know Before You Start Your Skincare Routine

Our skin is like an onion, made up of many layers. The outermost layer of
the skin is called the stratum corneum. This is made up of brick-like cells
called corneocytes. In between these cells is fat, which acts like cement. If
the layer of the corneocytes is intact, our skin is more resistant to external
damaging factors and bacteria. The condition of this barrier also depends
upon the natural moisturizing factors (NMFs), which maintain good
hydration; the presence of sebaceous glands and the lipid bilayer, which
maintain sebum content and impart moisture to the skin; trans-epidermal
water loss (TEWL); and the pH of the skin.
Our face has a relatively thin cornified layer than the rest of the body,
which makes it more susceptible to damaging factors but also helps re-
establish barrier function fast. High proliferative activity and increased
turnover of cells, fast regeneration of the epidermis, good hydration and the
presence of abundant sweat glands and blood vessels make it ideal for faster
repair. This means that it is necessary to take good care of our facial skin.
Keeping it clean with cleansers, hydrating it well with moisturizers and
protecting it with sunscreen is necessary. It also makes our skin ideal for
undergoing controlled exfoliation by various actives. Knowledge about
these skin processes is useful before we start our skincare regime to protect
and restore the barrier function of our skin.

Your Skin Type and Skin Condition

Anaita, a twenty-eight-year-old dentist, was all set to get married in three

months and she came to me with a request common from all brides—she
wanted the perfect glow for her special day. As a doctor, I am always happy
to oblige brides, but, to my horror, I found that I had very little time to fix
her skin, because Anaita had never really taken care of her skin before. She
had been so busy with her studies and, later, her practice that she had spent
no time on skincare. She couldn’t use any fancy face masks or scrubs
because they always triggered breakouts and redness. Neither could she
bleach her face because it increased itching and even caused rashes all over
the treated areas. To top it all, she had a history of PCOS (polycystic
ovarian syndrome) and thus frequently got acne on her jawline!
Now, even though you’re not a doctor, you’ve probably diagnosed
Anaita’s skin type as sensitive. But it’s not that simple.
In my practice, I have often seen patients with a combination of various
skin types—whether it is a combination of dry, sensitive skin type and
pigmented, mature skin condition, or a combination of oily, pigmented and
sensitive types. What is challenging for dermatologists is deciding what to
treat first and what products to prescribe according to the patient’s skin
type. For example, if a patient has oily and sensitive skin, I cannot prescribe
an AHA/BHA cleanser, because it will aggravate the skin, leading to
disastrous consequences.
 So it’s important for us to know our skin type and skin condition. Many
years ago, Dr Leslie Baumann categorized the many different skin types
and skin conditions. I am only going to explain the ones that are relevant to
Indian skin.

Types of Indian Skin and Skin Conditions

Skin types

1. Normal
2. Combination
3. Oily
4. Sensitive
5. Dry

You may have any of the above skin types and also have skin conditions
such as these below:

1. Dehydrated
2. Pigmented
3. Mature (wrinkled)

The Classic Way to Determine Your Skin Type

So how do we determine our skin type? There are simple tests that can be
performed at home that can help you know what your skin type is. Just
follow these simple steps:

1. Cleanse or wash your face with a gentle, soap-free cleanser and pat
it dry. Avoid sitting in an air-conditioned room or a room with a
heater when performing this experiment. Simply sit in a room with
a fan.
2. Pat your face with a tissue paper after two hours.
T- From the centre of your forehead to your nose and chin. Also includes part of your cheeks
zone next to your nose.
C- Part of your cheeks closer to the ears and jawline.
zone

Test Results

Normal skin: The tissue will not stick to your skin and will reveal no traces
of oil.

Combination skin: You will have an oily T-zone and a dry C-zone.

Oily skin: Both the T- and the C-zones will be oily. In oily skin types, you
will also see large open pores.

Dry skin: Your skin will feel stretched. Open pores are usually shut.

Sensitive skin: Your skin will look red and feel itchy. This is a skin
condition.

The Different Skin Types Examined

Here is a guide to help you diagnose your skin type. If you agree to most of
the points in a category, select that as your skin type. Remember, you could
be a mix of two or more skin types too.

Normal Skin

Twenty-six-year-old Rama came to me for consultation on removal of

unwanted hair. Even though she did not have any particular skin concern,
she asked me what she could do to get glass-like skin. When I asked her
what her skin was, she replied saying that it was ‘season-friendly’. She also
had small pores and rare acne breakouts, and her skin appeared soft and
moist, with an even complexion. Rama is extremely lucky, because she has
what we doctors like to call the ‘lottery skin type’. That’s what normal skin
type is to most people!
People with normal skin are blessed because their skincare is fuss-free
and the result looks great all the time. They do not get acne, dark spots,
redness and dryness, and with very little care, they can achieve healthy,
dewy, glass-like skin. If you have normal skin, flip to the chapter on the
a.m:p.m. routine to enjoy amazing results in minimal time.
You have normal skin if you have:
Small pores
Soft, moist skin
No redness or dry patches
Occasional acne breakouts
Even complexion

What to Do

As you are blessed with good genes and have the skin type that everyone
envies, amp it up a little more with a good skincare regime to maintain your
youthful appearance. However, feel free to experiment with attractive facial
masks and scrubs, and treat your skin with a facial or a home remedy. Dive
in and enjoy the adventure, but make sure you always use quality products.
However, after using some peppy products, if you experience a zit or two,
avoid the ingredient that led to it.

What Not to Do

Even though you are blessed with a normal skin, do not take it for granted.
As I have mentioned before, your skin type can change with changes in
environment, climate, exposure to pollution, exposure to excessive sun,
increased stress and lifestyle habits. So if, after enjoying a holiday in the
Maldives under the sun, you realize that your skin has become dry and
sensitive, don’t be surprised. It will not be too uncommon to notice your
skin turning dehydrated if you smoke, drink alcohol and have caffeine on a
regular basis as well.

Kitchen Remedies
1. The Glass-Skin Potion: Papaya, Multani Mitti and Honey

Papaya has an enzyme, papain, which is a rich source of vitamins A, C and

E. It not only helps lighten skin tone and reduce blemishes, it also exfoliates
dead skin cells and hydrates your skin. Multani mitti (fuller’s earth)
removes excessive oil and dirt from your skin and cleans up your pores.
Honey hydrates your skin. This pack will do away with blemishes while
also firming up the skin.

A few pieces of ripe papaya

1 tbs fuller’s earth
1 tsp honey
Blend the above into a paste and apply it on your face for
about twenty to twenty-five minutes.
Wash it off with lukewarm or cold water.
Repeat this twice a week.

2. Vitamin C Potato and Strawberry Mask

Potato has the enzyme catecholase, which helps in skin brightening and
reducing dark spots. It also has vitamins C and B6, and magnesium.
Vitamin C helps in collagen formation and improves skin elasticity, and
vitamin B6 and magnesium help remove dead skin cells while also
brightening skin. Strawberry is rich in vitamin C, which also acts as a gentle
exfoliator. This pack helps boost collagen and minimize fine lines.

A few pieces of boiled and chopped potatoes

2 strawberries
1/2 tsp honey
Blend the potatoes, strawberries and honey to make a paste
and apply on your face and neck.
Wash it off after fifteen to twenty minutes.
Repeat this mask two to three times a week.

Oily Skin

Twenty-four-year-old Mallika is a student of mass media. She aspires to be

a top TV reporter one day and, hence, is quite conscious of her skin. The
problem is that Mallika suffers from oily skin. Whenever she touches her
face, her fingertips come away oily. She finds herself running to the
washroom many times a day to touch up her make-up, because all of it
slides off her extra-shiny and oily skin. On the field, she frequently uses
blotting paper or face powder to matte up the oil slick. When she came to
me, she was desperate for a way out of this.
There is a thin line between glassy skin and looking like an oil slick. The
American Academy of Dermatology says, ‘The key to healthy skin is
maintaining its natural moisture without excess oil.’* Oily skin also comes
with a whole host of other issues such as enlarged pores, blackheads and a
grimy, heavy feeling. But if you have oily skin, remember this—your skin
will take the longest to show signs of ageing.
You have oily skin if your skin:
 Looks shiny.
Feels greasy, slimy, slippery, dirty and grimy. Your face feels like
an oil refinery.
Feels warm and as though you have an additional layer of skin on
it.
You sweat heavily, so much so that sweat just runs down your face.
Is more prone to acne breakouts or has increased comedones
(whiteheads are closed comedones and blackheads are open
comedones).
Has lots of large open pores.

What Causes Oily Skin

Oily skin is usually caused because of hyperactive sebaceous glands. These

glands produce sebum/oil and their production varies in the course of one’s
life. Their activity is at its peak during birth, puberty, pregnancy and
menopause in women and until the sixth to the seventh decade of men’s
lives. The hormone androgen is mainly responsible for the activity of the
sebaceous gland and oil production. The average rate of oil production in an
adult every three hours is 1 mg/10 sq cm.
Here are some factors that cause oily skin:

Genetics: Oily skin usually runs in the family. Larger and

overactive sebaceous glands can be inherited from parents. If your
parents have oily skin, there are high chances of your having it too.
Gender: Males have higher skin hydration, sebum production and
skin thickness than women due to high testosterone levels. That is
why men usually having oilier skin than women.
Hormonal changes: The hormone androgen is responsible for
sebum production. A spurt in this hormone is seen during puberty,
just before the monthly menstrual cycle, and during pregnancy and
menopause. That is why teenagers usually have acne and why
women break out before their period.
 Climate: Summers and a humid climate will make your skin oilier.
Diet: Dairy products and food with a high glycaemic index (GI),
such as sugar and refined carbohydrates, can lead to overactive
sebaceous glands.

What to Do

Wash your face at least twice a day: You can even wash after
exercise to clear clogged pores and remove dirt and bacteria to
prevent breakouts. Use a foaming facewash or a gel cleanser,
preferably.
Toner: You can add a toner to your skincare routine, especially if
you have open pores. However, make sure you use an alcohol-free
toner, because you don’t want to damage or over-dry your skin.
Moisturize: Many people believe that if you have oily skin, you
shouldn’t use any creams. No matter what your skin type,
moisturizing is an essential step in skincare. Choose a lightweight
lotion, a gel-based moisturizer or a mattifying oil-control
moisturizer instead of creamy textures.
Use a gel or lotion-based sunscreen: This will increase skin
hydration and barrier repair, and prevent dark spots, which can be
due to skin irritation, especially in darker skin tones.
Use blotting paper: This is to remove excess oil from your face.
Just gently dab it on your skin and do not rub it around—this will
avoid its spread to other areas.
Look for oil-free products: Skincare products labelled ‘oil-free’
and ‘non-comedogenic’ will help. Even water-based make-up is a
good option.

What Not to Do

Having oily skin does not give you the certificate to use bar soaps.
It’s always better to use mild skincare products and avoid harsh
 chemical soaps until a medicated soap is recommended by your
dermatologist.
Say no to scrubbing and physical exfoliation, especially if you have
active acne. The friction involved in using a scrub can irritate your
already inflamed skin and make it look worse. If you have oily skin
without acne, you can gently exfoliate your skin once or twice a
week, at the most.
Do not touch your face and do not pick on your acne. This can
spread the bacteria from your hands to other parts of your face and
further aggravate acne. This can also lead to permanent scarring.
Avoid consuming food with a high GI, such as colas, pastries and
foods rich in carbohydrates, as they can contribute to sebum
production in skin. Even dairy products are known to cause
acne. However, you can make your own ‘food diary’ to know
which food item is aggravating acne, as it can differ from one
individual to another.

Kitchen Remedies

These are home-care tips I followed in my teenage years when I got

breakouts. I hope they help you too.

1. Orange and Milk Mask

Orange peel not only has antibacterial and antimicrobial properties, it also
helps absorb excess sebum in oily skin. Being rich in antioxidants, it also
works as a skin-lightening agent, reducing your dark spots. Raw milk is rich
in AHAs, B vitamins and other antioxidants. It shrinks your pores and
draws out excessive sebum from oily skin without making your skin dry
while also hydrating and moisturizing it.

Take an orange peel, dry it in the sun and make a powder out of it.
You can store it in an airtight container and use it over the next six
months.
 Mix this powder with low-fat, raw milk and make a paste enough to
cover your face. Apply this paste on your face on alternate days and
wash off after twenty minutes, rubbing it in circular motions very
gently.

2. Multani Mitti and Rose Water Pack

Multani mitti has anti-inflammatory properties, and keeps your skin clean
and acne-free. It helps clean up your pores by removing excess oil, dirt and
sweat. This also helps get rid of comedones and prevents further stages of
acne. It has a mattifying effect on skin. Rose water is calming and cooling,
helps maintain the pH balance of your skin, controls excessive oil
production and removes dirt from pores. As it also has anti-inflammatory
properties, it can help reduce redness in irritated skin.

Mix multani mitti and rose water to make a paste enough to cover
your face.
Apply this paste on your face; wait until it dries (not more than
twenty minutes) and wash it off.
Repeat the process not more than twice a week. Make sure you
moisturize your skin after you apply the face pack to avoid any
dryness.

Combination Skin

Radhika, a twenty-two-year-old, visited me to get her skin analysed. Her

concern was that only her T-zone was oily, while her cheeks and her jaw
area were completely dry. When she used products meant for oily skin, her
T-zone felt fine but the rest of her face was tight and dry and, in the reverse,
when she chose products designed for dry skin, her cheeks were happy but
not her T-zone. She was really frustrated by this conundrum. Little did she
know that there were many others who faced the same issue because this is
the most common skin type I come across in my practice. This is usually
because the T-zone has the highest density of sebaceous glands in the face
and can thus easily turn oily.
Radhika’s situation is the classic catch-22 that all combination skin types
face. Combination skin can be a little tricky to treat, as different parts of the
face need different treatments. A ‘one size fits all’ approach doesn’t work
here. You might have to use different skincare products on different parts of
the skin, and this process can be quite cumbersome. But there is a way you
can have a good skincare routine that addresses both the dry and the oily
aspects of this skin type.
You have combination skin if:

Your T-zone is oily and greasy, but your cheeks and jawline are dry
to normal.
There are open pores and blackheads on your nose.
In hot and humid weather, the T-zone turns oily, and in cold and dry
weather, the cheeks and jawline may get dry and flaky.
Your face can get dry, flaky patches and breakouts at the same time.

What Causes Combination Skin

The cause of combination skin is the presence of overactive sebaceous

glands only in the T-zone of the face, which can be hereditary. These oil
glands can produce more oil because of the same causes listed under ‘Oily
Skin’ and the rest of the skin can become drier due to the same causes listed
under ‘Dry Skin’.

What to Do

Use an alcohol-free toner on your T-zone and avoid your cheeks if

they are dry and patchy.
Use a serum to deliver all the potent ingredients to your skin and
follow it up with a lightweight, non-comedogenic moisturizer. If
 your skin is extremely dry on your cheeks, you might require
another layer of richer emollient moisturizer there (see p. 82).
Apply a gel-based or lotion-based sunscreen before you go out in
the sun.
Follow the same last three tips mentioned for oily skin to avoid any
breakouts.

What Not to Do

To take care of your combination skin, you must resist the same temptations
listed under ‘Oily Skin’ and ‘Dry Skin’. This will help avoid any sort of
breakouts in your T-zone and prevent your skin from becoming extremely
dry in the rest of the face.

Kitchen Remedies

1. The Four Galore: Milk, Honey, Lemon Juice and Almond Oil

Milk has lactic acid, which draws out excess sebum from your skin and
hydrates it. It also acts as a skin-lightening agent. Honey helps moisturize
skin. Lemon juice decreases oil present on the skin and keeps the T-zone
oil-free. Almond oil, rich in vitamin E, hydrates the dry areas on the cheeks.

Mix 1 tablespoon of milk with 1 tablespoon of honey and apply it

on your face.
Take a few drops of lemon juice and apply it only on the T-zone.
Apply a few drops of almond oil only on the cheeks.
Leave this on for twenty minutes and wash off with water.
Use this face pack twice a week.

2. The Triple Ripple: Curd, Rose Water and Honey

This is an excellent face pack for combination skin. Curd is rich in lactic
acid and has probiotic properties. Rose water soothes the skin and acts as a
toner, closing your pores. Honey keeps the moisture intact.

Mix 1 tablespoon of curd and 1 tablespoon of honey to make a

paste.
Add a few drops of rose water to it and apply it on your face. Leave
it on for twenty to thirty minutes and wash off with water.
Use this face pack two to three times a week.

Sensitive Skin

Twenty-three-year-old Tara came to me quite troubled about her skin. She

was a student in an MBA college and had always been extremely fond of
skincare. Until a few months earlier, she had enjoyed normal skin type and
had had no skin woes throughout her school and graduation. She followed
many influencers on YouTube, who suggested a variety of products every
other day. Being so passionate about skincare, she had dozens of
facewashes, toners, scrubs, face masks, acids and serums in her skincare
routine. She tried a new active every other day without any specialist’s
advice. Simultaneously, she also got her skin bleached, after which her skin
never came back to what it once was. For the past six months, she had been
unable to use any skincare product with acids as her skin experienced a
burning and tingling sensation. Her skin often became red when exposed to
heat. Tara once had a normal skin type, but now she had shifted to a
sensitive skin type.
Skin types are never permanent. They keep changing from time to time,
depending on season, lifestyle and even uninhibited use of cosmetics and
skincare products. Even people with the ‘jackpot’ skin type can end up
having sensitive skin if they use acids overzealously and because of skin-
barrier damage.
You have sensitive skin if you experience:

Irritation and/or your skin easily reacts to cosmetic and skincare

products
 Increased sensitivity or a heightened burning and tingling sensation
to cosmetic or skincare products
Red or erythematous (prone to redness) skin, which gets triggered
by changes in environment, temperature and exposure to pollution

What Causes Sensitive Skin

The main reason behind sensitive skin is a change in the epidermal barrier
or in the acid mantle protective layer of the skin. As the permeability of the
skin increases, there is increased TEWL and higher susceptibility to
penetration of harmful substances, which can induce an inflammatory
change and cause intolerance to products when they come in contact with
the skin. So much so that even the nerves in the skin become hyper-reactive
to external stimuli, which increases the sensitivity of the skin.
Changes in the epidermal barrier are caused due to:

Gender: About 50–60 per cent women have sensitive skin, as

compared to 30–45 per cent men. This is not just because men have
thicker skin, but due to hormonal factors that affect skin hydration.
Location of sensitivity: The skin below the eyes is usually more
sensitive than the other areas of the face because the skin barrier is
thinner there.
Presence of other skin conditions: Skin conditions such as
seborrhoeic dermatitis, atopic dermatitis, acne and rosacea usually
alter the skin barrier, which, in turn, makes the skin more sensitive.
Environmental and lifestyle causes: Sun, heat, cold and wind
exposure, and pollution are all responsible for sensitive skin.
Cosmetic products: The presence of irritating substances such as
AHA, alcohol and fragrances in cosmetics and skincare products
can alter the pH (5.5) and epidermal barrier of the skin, triggering
sensitivity.

What to Do
 Cleanse gently: A syndet bar is a good option for you. Remember
not to overwash your face. Limit yourself to twice a day.
Up your hydration: The focus for those with sensitive skin should
be the repair of your skin barrier, and hydration—both water and
topical treatments are essential. Hydrate your skin with a good
emollient and moisturizer (refer to the chapter on moisturizers),
which does not include perfume and other irritating ingredients.

What Not to Do

Don’t touch your face: A study says that on an average, a person

touches their face 3000 times a day. Before COVID-19, so many of
us did not realize how often we touched our face. Now, given that
we have been made to become ultra-aware of this habit, it’s bound
to change. Dermatologists have always told their patients to stop
touching their faces because their hands contain and pick up many
germs through the day, which they then transfer to their face. This
is especially bad for people who suffer from existing skin
conditions.
No hot water: This is the most common irritant for sensitive skin.
Try to stick to using normal to lukewarm water, even in the winters.
Hot water dries out the skin, leading to more trouble for those with
sensitive skin.
Don’t use too many products on your skin: It’s a good idea to
layer products with different properties, but don’t overdo it if you
have sensitive skin. Stick to a maximum of three products or you
may risk irritating the epidermis.
Physical scrubs are a complete no-no: The large bead-like
particles in scrubs can cause micro tears on the skin’s surface,
making it irritable and red. Be wary of using face masks too. Don’t
get tempted to enjoy those attractive, colourful, fragrant face masks
your friends with combination or normal skin use. Make sure you
 go through the list of ingredients well (see p. 153) and choose those
that are hydrating and boost moisture.
Avoid too many home remedies: We Indians have a home remedy
ready for every ailment. We believe that there’s an ingredient in our
kitchen for any problem that crops up. For some people, aloe vera
can work wonders as it has anti-inflammatory properties, but it can
also trigger the immune system, leading to allergy and swelling.
Stick to just one or two home remedies that suit sensitive skin.

Ingredients to Avoid in Skincare if You Have Sensitive Skin

Glycolic acid
Propylene glycol
Sodium lauryl sulphate
Urea
Alcohol
Preservatives such as formaldehyde and parabens
PPD in dyes
Fragrances

Kitchen Remedies

Whenever my patients visit me for consultations, they are happiest when I

give them home-remedy tips, rather than recommendations on skincare
products. Here are some that I usually recommend:

1. Honey and Cucumber Juice

Honey has anti-inflammatory, antibacterial and antiseptic properties, and

cucumber is rich in antioxidants, soothes irritation and has hydrating
properties. This remedy will not only calm and hydrate your skin, it will
also make it glow.
 Mix 2 tablespoons of cucumber juice and 1 tablespoon honey.
Apply on your face, and keep for fifteen to twenty minutes.
Rinse off.

2. Aloe Vera Gel, Almond Oil and Rose Water

Aloe vera is rich in vitamin E and has anti-inflammatory properties that

help relieve itching and burning. Its high water content also hydrates the
skin. Almond oil is rich in vitamin E, and helps nourish and moisturize the
skin. Rose water has anti-inflammatory properties and soothes irritated skin.

1 tbs aloe vera gel

1 tbs rose water
1 tsp almond oil
Mix the ingredients well and apply on your face for thirty to
forty minutes.
Wash off and enjoy glowing, hydrated skin.

Dry Skin Type and Dehydrated Skin Condition

Beauty and Sweety are two sisters who live in Kolkata and are my regular
clients at the clinic there. Beauty is thirty years old and has rough, itchy
skin; she inevitably wakes up with flaky skin every morning. She used to
have good skin in her teens, but in her twenties, her skin started showing
these concerns. She also has a history of frequent allergies. A year younger,
Sweety’s once-beautiful, glowing skin has grown dull; she has even
developed prominent under-eye dark circles. She also complains of mild
itching around her eyes. The sisters live together, and this is one of the
reasons they were under the impression that they have the same skin type.
The first time they came to me, they wanted my recommendations on what
products they should use. But they assumed I would prescribe the same
products for both. There was a tiny factor the sisters were not aware of—
that they had different skin types. Although they seemed to have similar
skin concerns, on examination it turned out that Beauty had a dry skin type
while Sweety had a dehydrated skin condition. Dry and dehydrated skin are
cousins of the same family, with a few differences. So how do you know
which one you have?
According to the American Academy of Dermatology, you have dry skin
type if you experience:

Rough and scaly skin

White flakes on skin, itching and irritation
Grey, ashy skin in people with dark skin
Cracks on skin, which may bleed in severe conditions
Chapped or cracked lips

You have dehydrated skin condition if you experience:

Dull skin
Tired eye appearance; under-eye dark circles may be prominent
Mildly itchy skin
Increased incidence and early appearance of fine lines or wrinkles,
especially around the eyes

Dry skin and dehydrated skin may sound like two sides of the same coin,
but they have different underlying causes and require completely different
skincare regimes. I chose to discuss this overlapping skin type and
condition together, so you can understand it better. Dry skin occurs when
there is lack of oil, sebum and lipids, whereas dehydrated skin is usually a
result of lack of water in the skin’s topmost layer. You may not have
dehydrated skin if you have dry skin, and vice versa. As I have mentioned
before, an individual can have two different skin types or different skin
types and conditions at the same time. So a person with acne-prone skin can
also have dehydrated skin.

Causes of Dry and Dehydrated Skin

As discussed before, our skin barrier is mainly made of the stratum
corneum (the skin protectant), natural humectants (NMFs), which attract
and bind water to the skin to keep it hydrated, and the lipid layer or oils
such as ceramides, free fatty acids (FFAs) and cholesterol. These factors
keep the skin soft and supple. To add to this, there are oil glands that
produce sebum, forming a film on top of the skin.
When the skin’s sebaceous glands produce less sebum and the lipid layer
has inadequate ceramides, FFAs and cholesterol, the skin starts to dry up.
Since the skin has little to no oil and lipid production, it loses its lubrication
and gives way to rough and flaky skin. The water content of the epidermis
should usually be at 30 per cent. If it is less than 10 per cent, it manifests as
dry skin.
Dehydrated skin, on the other hand, is skin that is thirsty. When skin
loses its essential NMFs, which are responsible for keeping the skin
hydrated, it becomes dehydrated and begins to look dull.
Here are a few factors that cause dry skin:

Genetics: Dry skin can be inherited from parents and grandparents.

Age: You may enjoy perfect skin in your teens but with advancing
age, your skin can become thinner and drier, and hence wrinkles
can become more prominent.
Hormones: Women going through menopause or individuals with
hypothyroidism usually have dry skin.
Climate: Living in a dry, arid or cold climate can suck moisture out
from the skin.
Skin conditions: People with atopic dermatitis, psoriasis,
seborrhoeic dermatitis, ichthyosis and vitamin A deficiency may
also have dry skin.
Occupation: House helps, maids, nurses, factory workers and hair
stylists, and people whose skin comes in contact with water
frequently usually suffer from dry skin.
Swimming: High levels of chlorine in swimming pools can lead to
dry skin.
Dehydrated skin is not inherited. It is caused by various external factors and
lifestyle issues, such as drinking too many dehydrating beverages such as
alcohol and caffeine, smoking or prolonged exposure to the sun, pollution
and dust.
It can be a little challenging, however, to determine whether you have dry
skin or dehydrated skin without consulting a doctor.

What to Do for Dry Skin

Moisturize: Apply a moisturizer containing essential oils and shea

butter immediately after a bath to trap existing moisture. If you
have dehydrated skin, look for products where the main ingredient
is hyaluronic acid. Use this immediately after a wash or a shower.
Cosmetics: Opt for cream foundations instead of powder-based
ones. Always moisturize your skin well before using any cosmetics
to avoid your skin looking flaky and dull.
Use shea butter or coconut oil for lips: Chapped or cracked lips
are a common side effect of dry skin. Apply a lip balm that contains
shea butter to soothe your lips. Coconut oil is a good option. Seal in
the moisture by applying Vaseline or petroleum jelly on top of it.
Face mist: Use this regularly to hydrate your skin.
Hydrating sheet masks: These are the perfect way to deliver a
quick dose of hydration to your parched skin.
Consider a humidifier: If you live in a very dry climate or are
always in an air-conditioned environment, consider buying a
humidifier. This will add moisture to the air, which is beneficial for
both dry and dehydrated skin.
Wear gloves: If you have dry skin, your hands might be the first
place you notice it. Wear gloves when cleaning or using detergents.
If your hands get wet frequently, make sure you moisturize them
after contact with water. Use non-irritating ‘hypoallergenic’
detergents in case of very dry skin.
 Wear loose cotton clothes: Especially under your silks and wools if
they irritate your skin.

Star Ingredients for Dehydrated Skin

Look for these ingredients in your skincare products:

Hyaluronic acid
Glycerine
Aloe
Honey
Lactic acid

What Not to Do

No hot baths: Avoid taking a bath with very hot water, as it strips
the skin of natural oils. Use warm water instead. Many places in
our country still have hard water, which contains limestone. This
may draw out water from the skin, making it dehydrated. Limit
your shower to ten minutes, at the most.
Avoid these products: Anything that contains alcohol, retinoids and
AHA/BHA (except lactic acid, which can be a gentle exfoliant) will
further dehydrate your skin.
No heaters: In the winters, try to limit the use of heaters and
heating pads, as they will further dry out your skin.
No toners, harsh scrubs and clay masks: If you want to exfoliate
your skin, use a creamy scrub or a low-percentage lactic-acid peel
(5–10 per cent) once a week.

Kitchen Remedies for Dry Skin Type

1. Oily Olive Magic

You don’t have to ‘burn the midnight oil’ to get this kitchen remedy going
for your dry skin. You can use either olive oil or coconut oil to lubricate
your skin. Olive oil has excellent moisturizing properties. Rich in
flavonoids and polyphenols, it prevents skin from free radical damage and
gives it a beautiful, healthy glow. Coconut oil enhances skin-barrier
function, nourishes the skin and locks in moisture. This brings a natural
shine to your face.

Take some warm coconut or olive oil, and massage it gently on

your face and neck with your fingertips in a circular motion.
Leave it overnight on your face and wash it off the next morning
for adequate moisturization.
You can repeat this every night or every alternate night, depending
on the extent of dryness you have.

2. Milky Moisture

Milk cream, or malai, is an excellent ingredient to moisturize dry skin and,

when mixed with honey, keeps the moisture intact.

Mix 1 tbs malai and 1 tbs honey and gently apply on skin in
circular motions.
Rinse after twenty minutes.
Repeat daily or every alternate day, depending on how dry your
skin is.

Kitchen Remedies for Dehydrated Skin Condition

1. Aloe Vera and Honey

Aloe vera has hydrating properties and honey is a humectant. When applied
together, they will hydrate the topmost layer of the skin, giving it a healthy
glow.
 Mix 2 tablespoons of aloe vera and 1 teaspoon of honey and apply
on your entire face.
Massage it in with your fingertips.
Rinse after thirty minutes.

2. Glycerine Glow

Glycerine is not just an excellent humectant, it’s also an emollient that

moisturizes your skin effectively. Just take 1–2 teaspoons of glycerine and
apply it on your face every day for thirty to forty minutes to see the magic
yourself.

Rules for All Skin Types

Dos

Use a soap-free, gentle cleanser or a hydrating cleanser. Avoid

soap bars, which can strip your skin of natural oils.
Always moisturize according to skin type.
Use sunscreen. This is the most important step, because it
protects the skin from harmful UV radiation. Wear sunscreen not
only when you are about to go out in the sun but also when you
are at home (see more on p. 96).
Use non-comedogenic cosmetics, as they do not clog pores and
are less likely to cause breakouts and irritate the skin.
Make sure you wash your sponges and brushes at least once a
week to keep them germ-free.

Don’ts

Do not overwash your face, as this can stimulate the oil glands to
produce more sebum to balance out the dryness.
 Do not sleep with make-up on! Make it a habit to ideally double-
cleanse (refer to the cleansing chapter) to keep the skin’s pores
clean.
Avoid toners with alcohol, especially if you have sensitive skin.
It strips the skin of the protective lipid coating, making it more
vulnerable to dryness and irritation. Use thermal water mist
instead, which will calm your skin.
Avoid prolonged sun exposure, as UVA rays can cause free
radical damage and make your skin dry, flaky and dehydrated.

Your Skin Type Can Change

Our skin type can change over time—it is never permanent or the same
throughout the year. It is also important to remember that your skin type
may vary according to your lifestyle and seasons. So you need to be
observant about how your skin behaves.
The reasons your skin type can change are:

Seasonal change: Someone who has oily or combination skin in

summer and monsoon might find that it has changed to normal or
dry during autumn and winter.
Diet: This is a big factor, which determines the type of skin you end
up with. Alcohol, caffeine and not drinking enough water can
dehydrate your skin. Foods with a high GI can cause breakouts.
Environment: Wind, cold air, dry air and too much exposure to the
sun, pollution, air-conditioning and central heating can make
normal skin dry, itchy and flaky.
Genetics and hormonal changes: Like an increase in androgens or
a condition such as PCOS can increase sebum production and make
your skin oily.
Lifestyle: Stress, a poor skincare routine, smoking, using
the wrong products and medication (including birth-control pills,
isotretinoin) can also change your skin type.
 Age: Did you struggle with acne and oily skin as a teenager? This
is not going to last your entire life because, as you age, the amount
of oil/sebum produced by the sebaceous glands reduces, which then
leads to a reduction of sebum and fewer incidents of acne.

How to Determine Your Skin Condition

Determining skin condition is very different from determining skin type. It

can be done by observing particular features you’ll find in the following
chapters. Remember that skin conditions can change from time to time, and
can be corrected when a proper skincare regime is followed.

Pigmented Skin Condition

Pradeep is a thirty-five-year-old man who developed dark patches of

pigmentation on his cheeks, forehead and nose. Rama, a forty-five-year-old
woman, is a traffic cop. She developed small, dark spots on her cheeks,
which have been present for two years now. Naisha, an eighteen-year-old
girl, frequently develops brown spots post acne, which are difficult to get
rid of. All of them have pigmented skin condition.
Hyperpigmentation is one of the most bothersome skin concerns, which
can take months to fade. It can present itself in localized areas or in diffused
areas of altered pigmentation. Instability of melanocytes is the main reason
behind hyperpigmentation. These pigment-producing cells can become
overactivated by triggers such as UV damage, inflammation in skin, harsh
chemicals, hormonal fluctuations, nutritional deficiencies and even an
immune response, leading to pigmented spots.
Why is it important to discuss this skin condition? Because many of the
patients who visit dermatologists or buy over-the-counter medicated creams
suffer from a pigmented skin condition.
Some people are more susceptible to pigmented skin conditions, which
are determined by their genetic make-up. People belonging to the
Fitzpatrick skin type 4, 5 and 6, with more baseline melanin in their skin,
are more susceptible to developing hyperpigmentation. However, people
with darker skin colours, who have an even skin tone and no dark spots, do
not fall into this category. People with any skin type—normal, combination,
oily, sensitive or dry—and any age can have simultaneous pigmented skin
condition too. There can be various causes of hyperpigmentation. Refer to
Chapter 10 to find out more.

What to Do

If you think you can just sit back and relax, and your pigmented spots will
fade on their own, let me tell you the bitter truth—they won’t. However,
with a little effort, you can prevent and also treat hyperpigmentation. Most
effective treatments begin with eliminating the cause. For treatment, there is
no single therapy that can cure your pigmentation, but a multimodality
approach, combining topical agents and in-clinic treatments.
Here are a few points to keep in mind:

Sunscreen is the first line of defence to preventing pigmentation.

Broad-spectrum sunscreen, SPF 30 or greater, min PA+++, water-
resistant, every day—even on cloudy or cold days.
Avoid the sun during peak hours, from 10 a.m. to 4 p.m., and make
sure you follow stringent measures of sun protection by wearing
full-sleeve clothes, a hat and sunglasses.
Use a vitamin C serum—a powerful antioxidant—in the morning to
further protect your skin and prevent spots.
Nightly applications of alpha arbutin and retinol can also combat
hyperpigmentation. See Chapter 6 for more details.
Make sure you visit a dermatologist to get your skin condition
diagnosed correctly and follow a proper treatment plan.
Opt for in-house clinic treatments for faster and more effective
treatment of your dark spots.
Refer to Chapter 10 to know about various actives that can be used to treat
hyperpigmentation.

What Not to Do

Avoid putting random kitchen ingredients on your face—this might

further increase pigmentation.
Avoid touching or scratching your skin frequently, as this can
trigger inflammation and further darken your skin.
Avoid application of steroid- and hydroquinone-containing creams
without the advice of a doctor.
Avoid retinol during the day, as it can cause photosensitivity and
further increase brown spots.
Do not have unrealistic expectations. It takes patience and diligent
care to correct hyperpigmentation.

Kitchen Remedies for Pigmentation

It is essential to know your skin type before you use any kitchen remedy for
your hyperpigmentation. Here are the most suitable ones for pigmented
skin:

Normal skin: Glass skin potion

Combination skin: Triple ripple

Oily skin: Orange and milk mask

Sensitive skin: Aloe vera, almond oil and rose water

Dry skin type: Milky moisture

Mature Skin Condition

Latika just turned thirty. She has normal skin type and falls in the
Fitzpatrick skin type 4. She has always enjoyed her skin, owing to the
jackpot skin type (normal skin). She never cared to apply a sunscreen and
seldom used moisturizing cream. She works in a call centre and thus works
erratic hours and has a disturbed sleep pattern. She is a regular smoker. For
the past three months, she has noticed that the brightness of her skin has
reduced significantly and that she has started developing fine lines under
her eyes. Latika has mature skin condition.

Causes of Ageing

Ageing is inevitable. Natural ageing, which is determined by our genetic

make-up, is beyond our control. This is called intrinsic ageing. As time
unfolds, everybody gets visible lines on their face, the skin becomes thinner
and drier, and our face loses its youthfulness and brightness. Extrinsic
ageing, on the other hand, is a result of various external factors such as sun
exposure, pollution, smoking and inadequate diet. Our environment and
lifestyle choices can lead to premature ageing of skin and early
development of signs of ageing.

Signs of Mature Skin

Other than the inevitable signs of ageing as a person grows older, he/she is
said to have mature skin when they show early development of wrinkles
and experience loss of hydration, which is not in coherence with their age.
Hence, ‘perceived age’ becomes an important factor in determining mature
skin in an individual.
A study on Indians showed that dull skin and loss of brightness in their
thirties made them look older than they were.* People from forty onwards
experienced wrinkles around the eyes (crow’s feet and under-eye wrinkles),
at the corners of the mouth and even on the glabella (the centre of the
forehead, showing frown lines), which gave people an increased perception
of ageing. People in their fifties had wrinkles on their upper lip, a loss of
hydration of skin, increased skin roughness and crow’s feet. Nasolabial
folds and wrinkles at the corners of the mouth were a common finding in
people in their sixties. Knowing these signs of ageing is extremely
important, as it can help take necessary precautions to prevent its early
development.

What to Do

Moisturizing is a must. This step is necessary to protect the barrier

of your skin and make your skin bright.
Make retinoids part of your night-time skincare routine to stimulate
collagen formation (see Chapter 6 to know more).
Anti-ageing actives such as hyaluronic acid, which hydrates your
skin; vitamin C, a potent antioxidant; niacinamide, which increases
cell turnover; and copper tripeptides and coenzyme Q10, which
stimulate collagen and elastin production, should become part of
your skincare routine.
Eat a balanced, healthy diet rich in fruits and vegetables.
Have supplements containing antioxidants and collagen.
Exercise regularly, which helps increase circulation to the skin,
making it more youthful.
Get good sleep, because sleep increases blood circulation in the
skin and enhances collagen repair.
Opt for in-clinic procedures such as dermal fillers, laser therapies
and mesotherapy, as they help fight the early signs of ageing and
maintain youthfulness.

What Not to Do

Avoid going out in the sun without sun protection.

Avoid smoking.
Avoid repeated facial expressions—contraction of the same muscle
repeatedly can make your facial lines permanent.
 Avoid sugar.
Avoid too much caffeine and alcohol.

Kitchen Remedies

With age, our skin becomes thinner, drier and less elastic, which enhances
the development of creases and wrinkles and makes our skin look dull. No
home remedy can get rid of the creases on your face. However, they may
notch up hydration in dry and dehydrated skin. Hence, kitchen remedies for
mature skin should focus on brightening and hydrating your skin.

1. The vitamin C potato and strawberry mask (refer to kitchen

remedies section for normal skin) can be used for normal, oily and
combination skin types with mature skin condition. This can also
be used if it is coupled with pigmented skin condition.
2. Opt for kitchen remedies for dehydrated skin condition: Aloe vera,
honey and glycerine are ideal skin hydrators.
3. Kitchen remedies for dry skin: Milky moisture and oily olive magic
will work wonders for dry, mature skin.
 3
HOW TO CLEANSE CORRECTLY

Anamika Singh, a twenty-eight-year-old interior designer, is the perfect

client. She always follows my advice to a tee. Over time, she has achieved
supple, glowing skin, and takes pride in flaunting it. Her Punjabi mother, on
the other hand, has a radiant personality but not radiant skin. Since she is in
her early fifties, she blames it on her age. Anamika usually brings her
mother along when she visits me. At our last meeting, she asked me about
the double-cleansing routine she had been hearing good things about.
Listening to her daughter, Mrs Singh said with a sigh, ‘Doctor, girls
today are not satisfied with simply washing their face once—they want to
do it twice. What a waste of time! Look at my skin. I have no problems at
all. I agree it is not as good as her skin, but that’s because of my age. I used
to glow when I was in my twenties. And ask me what I used to wash my
face every day—simple soap and water!’
The thing is that Mrs Singh had the solution to her problem. She could
still have glowing skin if she just put in a little effort. But I don’t blame her.
Back then, when she was in her twenties, soap and water to cleanse the face
was the thing to do. My mother, too, followed this routine until five years
ago, when I insisted that she include a few more steps to her skincare
routine.
 I knew it would be difficult to break all of Mrs Singh’s habits in one day,
so all I said to her was, ‘My mother is just like you. She’s never really had
any skin issues, but ever since I advised her to use a cleanser that suits her
skin type and follow a regular skincare regime, her skin has started to look
more radiant than ever before.’
This piqued Mrs Singh’s curiosity. ‘Really? Is that true?’ she asked
earnestly.
‘Yes,’ I replied.
And then the floodgate of questions broke open.
‘So what is my skin type? What cleanser should I use? Should I also
adopt this double-cleansing technique? Will my skin glow?’
I smiled. I love how the human connection of actual case studies
resonates more with people than any advert. So I told the curious Mrs Singh
everything she could do, beginning with the most fundamental skincare step
—cleansing.

***

Cleansing is the most vital part of skincare because our skin constantly
undergoes renewal, which leads to a pile-up of dead skin cells,
accumulating dirt, sweat, make-up and other microorganisms. Proper
cleansing can help reduce the build-up of unwanted substances, exfoliate
the top layer of the skin and unclog your pores. It is a non-negotiable step in
any skincare routine. But if done incorrectly, cleansing can also damage
your skin, stripping your skin of its top layer.

Remember . . .

Your skin should never feel dry after cleansing. If your skin feels dry,
that means you have been too harsh with your cleansing routine.

Various Types of Cleansers

There are two main types of cleansers—the waterless facial cleansers and
the rinseable facial cleansers. The waterless cleansers (commonly called
make-up removers) are mainly used to wipe off dirt, oil and make-up from
your skin, which, when followed by a rinseable cleanser (commonly called
a face wash), leaves your skin fresh and clean.
The various types of waterless facial cleansers for the first cleanse:

1. Micellar water: This is one of the most commonly and commercially

used cleansers for the first round of cleanse. These are essentially called
make-up removers in layman’s terms and are nothing but surfactant
solutions that combine with dirt, oil and sebum to clean the skin’s surface.
These were originally designed for those rare times when one had no access
to water, and hence these could be used as a replacement for rinseable facial
cleansers. Micellar water is a great product and I recommend it to many of
my patients. However, never consider it as a replacement for the second
round of cleanse. Both steps are extremely important and irreplaceable.

Who can use them: These can be used by all skin types.

2. Cleansing lotions and creams: These are lotions or cream formulations

ideal for the first cleanse, which not only remove dirt and make-up, but also
leave the skin smooth and supple.

Who can use them: Ideal for sensitive and dry skin.

3. Cleansing gels/milk: Available as a translucent gel that can convert into

a milk-like texture to remove make-up gently.

Who can use them: All skin types.

4. Cleansing oils: This formulation is one of my favourites, because it is

easy to use and has multiple benefits. These are lipophilic solvents that
work on the principle of ‘like dissolves like’. These remove oil-based
impurities such as make-up, sunscreen, excess oil or sebum, and any other
impurity your skin might have collected in the course of the day, without
disturbing the lipids and ceramides between skin cells.

Who can use them: All skin types.

5. Cleansing balms: These work on the same principle as cleansing oil, but
come in a wax-like texture and other more solid formulations. These work
on the principle of ‘like dissolves like’ too, and thus remove excess oil from
skin. They feel luxurious to use and are rather therapeutic. This one is
definitely a skincare enthusiast’s favourite.

Who can use them: Ideal for normal, combination and oily skin type. Those
with dry skin type, active acne and dehydrated skin condition should avoid
this.

The Art of Double-Cleansing

Most of us in India live in a hot and humid climate, and the chances of us
doing a ten-step South Korean beauty regime are negligible. However,
many women still end up with a few layers of skincare products on their
faces before they head out to work or college. A little toner, some BB cream
or a slap of foundation, sunscreen and a sprinkling of finishing powder are
the staples for most people. After a day out, there are other layers such as
dust, pollution and smoke that attach themselves to our skin. So when we
come back home, it is crucial that we take off all these layers thoroughly.
But how many of us manage to clean out all the stuff that goes into our
skin?
Here’s something I would like you to try.
The next time you come home after a long, hard day of work, wash your
face with a simple cleanser. Then take a white towel and wipe your face. If
you examine the towel closely, you will find that there are still traces of
make-up on it. This means that your skin is still holding on to some of the
products that you used in the morning. Now think of all those days you
went to bed thinking you had a clean face by just doing one round of
cleansing.
If there is one thing you will hear all dermatologists shout from their
rooftops, it is that you should never go to bed with make-up on. Yet, if a
simple cleanser cannot cleanse your face completely, what are you to do?
This is where double-cleansing comes in.
The double-cleansing technique is such a wonderful method that once
you get the hang of it, it will become second nature and you won’t want to
wash your face any other way. It is a sure-shot way of getting rid of
stubborn products that need a bit more of a push than what a regular
cleanser can achieve.
This is followed by a water-based cleanser, which clears away non-oil-
based, surface-level impurities such as sweat and pore-clogging dirt. This
leaves your skin clean, soft and supple without making your face raw, dry
and tight. It also makes it much easier for oils, serums and moisturizers to
be absorbed and do their job.
So, basically, the first cleanse is to remove dirt, grime, make-up and SPF,
which stick to your skin; and the second cleanse is to wash and clean your
face.
Ideally, a double-cleanse is to be done just once at night when you are
back home from a long day’s work. Even if you are at home, you must
apply sunscreen, and SPF must be removed with the double-cleanse
technique, as a sunscreen is meant to stick to your skin.

Rinseable Facial Cleansers

These cleansers are used for the second cleanse, right after the first cleanse.
This step makes sure that your skin is ready to hop on to the journey to
getting glass skin and enjoying all the steps that will come thereafter.
Before we discuss about the various types of cleansers, let’s get some
knowledge on cleansing bars, which have been around for a long time but
haven’t got their due in the market yet.
 Cleansing bars aren’t the most glamorous skincare products, but
these old-school beauty products have made a major comeback. They are
not only less expensive than their liquid counterparts but many are also free
of harsh and drying ingredients such as sodium lauryl sulphate. Even today,
most of the Indian population (especially people from Generation X and
baby boomers) use cleansing bars to wash their faces. They can frequently
cause skin dryness and irritation as they have an alkaline pH (9–10), but the
addition of humectants and moisturizers modifies their irritation potential.
Some of the most frequently prescribed soaps by dermatologists are syndet
and medicated bars.
Syndet bars are synthetic detergent bars with a pH close to our skin, i.e.,
5.5–7. As they have less than 10 per cent soap content, they do not damage
the lipids on the stratum corneum and hence cause less skin dryness. They
also have a high fat content, which adds a moisturizing advantage and
maintains skin hydration. They are said to have the least irritancy potential
among all cleansing bars. Some examples include the Dove moisturizing
bar and the Bioderma Atoderm soap.
Medicated bars contain antibacterial agents that inhibit bacterial growth
and limit body odour. These bars also include anti-acne soaps with
ingredients such as azelaic acid, salicylic acid, glycolic acid, zinc oxide, tea
tree oil and neem oil. These soaps suppress harmful bacteria but can be
drying to the skin and may cause irritation. Some examples are Sebamed
Clear Face Cleansing Bar and Dermadew Acne Soap.
Transparent soaps, or glycerine bars, even though not frequently
prescribed by dermatologists, are popular in the market and primarily made
of a combination of glycerine and alcohol. They have a lower pH, are
gentler on the skin and help the skin retain its natural moisture, which
makes them ideal for use in winters and by dry, dehydrated and sensitive
skin types. They usually do not lather well and can be more expensive than
syndet bars, but come in attractive packaging and are aesthetically pleasing
to use.

How to Choose the Right Type of Cleanser

The market is flooded with various types of cleansers, some light on the
pocket and some rather expensive. Let me tell you right away that you
should never spend too much money on a cleanser, whether for the first
cleanse or the second, because a cleanser can only do so much—that is,
cleanse your face. Save your money for products with active ingredients
that actually penetrate the skin. I will tell you more about this in the
following chapters.

Remember . . .

A good cleanser is not one that is expensive—it is one that works.

Here’s what you need to keep in mind when shopping for cleansers:

Gel cleansers are usually better and commonly used for oily skin
types, whereas cream-based cleansers are great for dry skin.
Foam-based cleansers are commonly used for oily skin. However,
make sure you avoid these cleansers if you have sensitive, dry skin
type and dehydrated skin condition.
Select a cleanser with a balanced pH (4–6.5), especially if you have
dry, sensitive and dehydrated skin.
Choose a gentle, non-abrasive, fragrance-free and alcohol-free
cleanser (especially for dry and sensitive skin).
Most cleansers marketed as ‘gentle’ remove impurities without
stripping the skin of oils. They are great at removing dirt without
overdrying and irritating the skin.
The humectants and emollients found in lipid-free cleansers help
deal with dry, atopic skin because they are easier to take off and do
not dry out the skin.

An Easy Guide to Choosing a Rinseable Cleanser for Your Skin Type

 Types of
Rinseable
Cleansers Skin Type Action Examples
(for Second
Cleanse)
Gel cleanser Normal, Effective at decongesting clogged pores, Avene Cleanance
combination, removing excess oil. Ideal for people with cleansing gel;
oily acne Bioderma Sebium gel
moussant;
Berkowits Clear tea
tree face wash
Cream Dry, sensitive Gently cleanses the skin without stripping Berkowits Nourish
cleanser it of natural oils. Ideal for those with dry gentle skin cleanser;
skin, eczema, psoriasis, rosacea and Cetaphil gentle skin
retinoid-induced dermatitis cleanser;
Episoft cleansing
lotion;
Uriage Crème Lavante
cleansing cream
Foam Combination, Lightweight cleanser, removes excess oil. Berkowits Clear
cleanser oily Must not be used in sensitive skin Sebum Watch face
wash;
Cetaphil gentle
foaming cleanser;
Dermaceutic Advanced
cleanser expert
cleansing foam
Powder All skin Powdery soft when dry, but dissolves into a Pure by Priyanka
cleanser types creamy concoction upon contact with luminous powder
water, thoroughly cleansing the skin while cleanser;
providing gentle exfoliation. Avoid using The Tribe Concept face
for sensitive skin types brightening daily
cleanser;
Juicy Chemistry
cleansing grain
Bar cleanser According to Some contain very little soap, others have Sebamed cleansing bar
skin type none at all. These are just as skin-friendly for acne-prone skin;
and luxurious as their liquid counterparts Dove cream bar;
Bioderma Atoderm
Intensive Pain ultra
rich soap for dry skin
type and mature,
dehydrated skin
condition
 Remember . . .

The irritancy potential of a cleanser may increase if left on the skin for a
longer time. Wash it off within thirty seconds, especially if you have dry,
sensitive skin.

Summary: Rules for Cleansing Your Face

1. Cleanse your face every single day.

2. First cleanse: Use a waterless facial cleanser to remove oil, make-
up, sunscreen and dirt.
3. Always keep the waterless facial cleanser on the stubborn make-up
(especially when you want to get rid of your mascara and eye
make-up) for about five seconds; let it soak inside your skin and
wipe it with a cotton pad in a single swipe!
4. Second cleanse: Next, use a gentle rinseable facial cleanser to
remove any remaining impurities.
5. Moisturize your face immediately after cleansing: This helps trap
moisture in your skin and prevents it from drying out.
6. Always choose a gentle face wash, not something that is drying and
harsh to your skin.
7. Never cleanse your face to the point where it feels dry or tight,
which is when you know you’re stripping the top layer of your
skin.
8. Use cleansers with special ingredients for specific indications such
as acne, hyperpigmentation, dry, xerotic and sensitive skin.
9. Never use hot water to rinse your face. Warm water is okay. If you
have dry and sensitive skin, always use cold water.

My Favourite Cleansers for the First Cleanse

1. Micellar water: Bioderma Sensibio H20 micellar solution

2. Cleansing lotions and creams: Sesderma Hidraderm cleansing
milk
3. Cleansing gel/milk: Earth Rhythm cleansing jelly gel to milk
4. Cleansing oil: Clinique Take the Day Off cleansing oil
5. Cleansing balm: Clinique Take the Day Off cleansing balm, Dot
& Key cleansing balm

My Favourite Cleansers for the Second Cleanse

1. For acne-prone skin: Berkowits Clear tea tree face wash

2. For hyperpigmentation: Bioderma Pigmentbio foaming cream
3. For oily to combination skin: Avene Cleanance cleansing gel
4. For dry, sensitive, mature and dehydrated skin: Cetaphil gentle
skin cleanser
 4
THE ART OF DEWY SKIN—HYDRATION
AND MOISTURIZING

When I wrote this chapter, I had completed thirty-six weeks of pregnancy.

My swollen feet, itchy hands and growing belly made it a challenge to
simply lie down for a long time. The COVID-19 lockdown has been a
blessing in disguise for me, because it was a time I could spend exclusively
with my family—sharing a co-working space at home. During this time, I
could also feel my twins, in their little co-growing space (my belly!),
through their little kicks and movements!
During the COVID-19 lockdown and pregnancy, one of the biggest
changes I saw in my skin was that it became dry, dehydrated and itchy.
Long hours of sitting in an air-conditioned room, frequent washing of hands
and regular use of sanitizer completely dehydrated my skin. Additionally,
the surge in pregnancy hormones added to the itch. The most frequent
skincare product that I used during this time was a moisturizing cream.
Moisturizer is the king product. You may not find serums, actives or
masks in someone’s skincare arsenal, but chances are you will find a
moisturizer. It is the jack of all trades and an essential product that’s always
in our kitty through all seasons. Application of a moisturizer is like
wrapping your skin in cotton wool, all snuggled and safe. A good
moisturizer maintains skin-barrier function and decreases TEWL. Since
moisturization is one of the most vital skincare steps, the question arises—
do we need to buy an expensive product? My answer is a definite no!
Do not undermine the importance of moisturization, but you also don’t
need to spend a fortune on it, because a moisturizer’s primary function is to
hydrate the superficial layer of skin, improve barrier function and make
skin soft and supple. The truth is—most moisturizers can do this. Think
about it like this: Will a Rolex tell you the time better than a Titan watch?
As a rule, always spend your money on a serum rather than on a
moisturizer, because of how these two products work. A serum is loaded
with actives, which go deeper into your skin, thereby tackling your problem
areas, while a moisturizer usually only forms a protective coating on the
skin. A serum is like wearing socks (inner protection), whereas a
moisturizer is like wearing shoes—a safety cover that makes you
comfortable and allows you to step out into the world!

The Science behind Moisturizers

The most superficial layer of the skin—the stratum corneum—contains 10–

30 per cent water.* This is one of the most essential features to keep the skin
barrier healthy. When the skin cells are tightly organized and interlocked
with lipids such as ceramides, cholesterol and free fatty acids, the function
of the skin is intact and leads to decreased TEWL, keeping the skin
hydrated. Moisturizers help restore the function and strength of this skin
barrier, preventing water loss and replacing skin oils, making the skin
appear smooth and soft. A good moisturizer not only protects skin-barrier
function by hydrating the skin, it also has an anti-inflammatory and
antipruritic action, which has a soothing effect, reduces skin itching and
keeps our skin healthy.

Various Formulations of a Moisturizer

Moisturizers come in many different formulations, which are tailored to
different skin types, skin conditions, environmental factors and personal
preference of textures. You should always select a moisturizer based on
your skin type and conditions as discussed in Chapter 2 (see p. 20). Here’s
an insight into the various textures of moisturizing creams.

Gel

This is a lightweight, clear, water-based formula that is a treat for those with
oily skin or those who live in warm and humid climates. This is light and
looks like wobbly jelly in your hand, which we all loved when we were
children. These semisolid emulsions are easy to apply, have quick
absorption and are non-oily and non-comedogenic. Gel-based moisturizers
are usually water-based formulas that are packed with hydrators such as
hyaluronic acid, glycerine and aloe vera, which replenish the moisture in
our skin, making it plump and smooth. But the biggest concern I have
always had with gel moisturizers is that they never make skin feel
moisturized enough. I always have to couple it with either a sunscreen or a
lotion, so that my skin doesn’t feel dry and stretched. This is primarily
because the quantity of oil or oil-soluble substances in gel-based
moisturizers is usually much lower when compared to a cream or a lotion.

My verdict: I prefer recommending moisturizers with a gel formulation to

people who have acne-prone skin. Gel formulations are also available as
aloe vera masks, which are cooling and hydrating.

Ideal for: Oily to acne-prone skin type.

Lotion

Liquid formulations that are created by adding powder in water have a high
water content, a thin consistency, sink right into your skin and sit
comfortably on your face. They have very good moisturizing capacity and
can be used on larger surface areas as they spread easily. They have higher
oil-soluble substances than gel formulations, so they strengthen the natural
moisture barrier effectively, increase skin elasticity and hydrate your skin.

My verdict: Lotions are my favourite formulations because they can be used

for the face and the body.

Ideal for: All skin types.

Creams

This is the most commonly used formulation of a moisturizer. Since the

time I remember, there’s always been Pond’s or Nivea moisturizing creams.
This type of creamy moisturizer is an oil-in-water or water-in-oil
formulation, which is thicker in consistency and contains heavier lipids and
a higher oil content than a gel or a lotion. It leaves behind a thin film of oil
on the skin, which helps retain moisture and keeps the skin soft and supple.
In fact, today we have non-comedogenic moisturizing creams for oily skin
too. These formulations are not very heavy on the skin and do not block
your pores.

My verdict: It’s a must to have a moisturizing cream in your kitty, whether

you are any age or any skin type.

Ideal for: All skin types.

Ointments

Ointments are not a common formulation in aesthetic skincare but are used
in dermatology in topical medicated formulations. These are greasy, sticky
preparations with an oil base, which are preservative- and fragrance-free.
Unlike creams that have a higher concentration of water, ointments usually
have higher oil concentrations. As they are good occlusives, they trap
moisture and stay on the skin for a longer time while also penetrating
deeper than other types of formulations.

My verdict: As they are usually available in medical-grade preparations, let

your doctor decide if you need them.

Types of Moisturizers*

When a product is extremely common and also the most essential for every
individual, the chances of error in deciding the perfect product might also
increase. Choosing the best moisturizer for your skin is a matter of trial and
error. So it’s important to know how the different types of moisturizers do
their work, so you can select the ideal one for your skin. The four primary
types of moisturizers are:

Occlusives

Think of occlusives as a cling film. They seal the skin and help prevent loss
of water from its surface. Petroleum jelly is the most effective occlusive,
which reduces water loss by about 98 per cent. Remember that occlusives
do not hydrate the skin. They are always applied as a final step in a skincare
routine. Occlusives are the most effective when applied on slightly moist or
damp skin. Even though they are very effective, they can be greasy to the
touch and will just sit on your skin.

Various Occlusives

Petroleum jelly (Vaseline)

Mineral oil
Paraffin
Squalene
Silicones (dimethicone)
 Vegetable oils, such as coconut, olive and grapeseed
Beeswax
Cetyl alcohol and stearyl alcohol
Lanolin (secreted from the oil glands of sheep)
Cholesterol

When you should use them: Occlusives are ideal for dry, cracked skin. But
do not make the mistake of applying them as a first layer on dry skin,
because these products are not at all moisturizing. Hydrate your skin first by
application of creams rich in emollients and then coat it with an occlusive to
reduce water loss.
A common mistake I see is people applying Vaseline (petroleum jelly) as
a first layer on chapped lips or cracked, dry skin. When this step brings no
result, it adds to their frustration. First, hydrate your skin or lips by applying
a moisturizing lotion or a cream rich in humectants or emollients (this will
hydrate your skin) and then layer it with Vaseline to reduce moisture loss.

Ideal for: Dry to very dry skin type as a second layer.

Humectants

These are substances that do not form a film or a barrier on the skin to
prevent water loss. Instead, they bind with water molecules in the
environment and attract water to the skin. This sounds like a dream, right?
But there is a catch. If the humidity in the atmosphere is more than
70 per cent, humectants work really well. They attract water from the
environment to fill the empty buckets in your skin. But if the air is dry and
lacking water, humectants will draw water from the deeper layers of the
skin instead. To reduce loss of water from your skin and prevent dryness,
always make sure you use an occlusive moisturizer on top of any product
with humectant properties.
To give you a wholesome product, cosmetic companies usually formulate
moisturizers that have both occlusive and humectant properties. Creams
usually contain more occlusives while lotions primarily have humectant
properties.

Various Humectants

Hyaluronic acid
Urea (10 per cent)
Glycerine
Lactic acid (up to 12 per cent)
Honey
Propylene glycol
Sorbitol

Ideal for: The above ingredients are ideal for dry skin type and dehydrated
skin condition.

Emollients

These are rich in fatty acids, lipids and oils, which lubricate the skin and
help in barrier repair, making skin soft and smooth. Lipid and fat
application are very beneficial for ageing skin, as, with time, natural lipids
in the skin gradually get depleted due to environmental exposure, hot
showers and mechanical exfoliation. They also help reduce itching and
irritation.

Ideal for: All skin types.

Various Emollients

Cholesterol, shea butter, ceramides, stearic acid, linoleic acid, lanolin

(wool fat), oils (such as palm oil, coconut oil, canola oil) are various
 types of emollients commonly used in products.
Emollients can further be classified as dry, fatty, protective and
astringent.* So this component can be used on all skin types. However,
mentioning all those ingredients would make this book an encyclopaedia.

Rejuvenators

These replenish and restore the proteins in skin, such as elastin and
collagen, which get degraded with age. Rejuvenators help combat fine lines
and soothe the skin. Collagen, elastin and keratin are common examples of
rejuvenators.

Ideal for: Mature skin condition and for people above the age of thirty to
prevent the formation of fine lines.

Pro-tip

The more solid a moisturizer feels, the more occlusives it is likely to

have. The more watery it feels, the more likely it is to contain
humectants.
Moisturizers with a thinner consistency are ideal for oily and acne-
prone skin.

Your Ideal Moisturizer and How to Apply it

While writing this chapter, I asked my mother what her favourite

moisturizer was. She answered succinctly, ‘It depends on the texture of the
moisturizer and whether my skin likes it.’ I thought to myself—just the
texture and not what it’s made of? As an expert, I’m obsessed with the
ingredient list of the products. However, I realized that most people buy a
moisturizer only if they like how it feels on their skin, because it determines
whether they’ll use it or not. That is very important indeed. Consistency in
skincare (especially when it comes to a moisturizer) is the most important
routine. There’s no point using fancy products irregularly.
Always apply a moisturizer on damp skin, whether it is after a toner, a
serum or directly after a shower. After spraying on a face toner, which will
balance your skin’s pH, follow up with a serum, ideally one with hydrating
ingredients or with actives suited to your skin condition. Finally, seal it all
with a moisturizing cream that contains occlusives.
Do not rub the product between your palms to warm it up. By doing this,
you are actually just moisturizing your hands. Don’t waste so much
product. The best method is to use the dot-dot technique for application. To
do this, take the required amount of moisturizer in your palm, then dot it all
over your face, finally spread it around and evenly with your fingertips.

Pro-tip

Always use a moisturizer according to your skin type and select a skin
serum according to your skin condition.

Other Ways to Hydrate Skin

1. Drink water: Many people think that if they drink a lot of water,
they can achieve glass-like skin. If this were true, we could all have
had glass skin. The harsh truth is that there is little data that proves
the connection between water intake and hydrated skin. However,
drinking water does help flush the system at the cellular level and is
hydrating for our entire body. But simply drinking water will not
bring a glow to our skin. Another caveat to remember is that
dehydrating substances such as caffeine, alcohol and smoking
negatively impact our skin and must be avoided.
2. Humidifiers: A humidifier works in the opposite way from an air-
conditioner or a heater for our skin. While air-conditioners and
heaters suck all the moisture out from our skin, humidifiers
 counteract dry air and prevent evaporation of moisture from the
skin, keeping it hydrated.
3. Facial mists and toners: These products increase skin hydration
significantly. Use a toner after cleansing, while your skin is still
moist, then immediately top it up with your favourite serum and
seal it with a moisturizer. Never let your toner dry up completely
before moving on to the next step. You can spray on a face mist
even later in the day (over your make-up and sunscreen) to add that
extra glow. To learn about face mists and toners in detail, see
Chapter 9.
4. Sheet masks: These are a quick hydration fix. Sheet masks are
dipped in a pool of serum and provide an instant dose of hydration
and other actives to the skin. Use sheet masks with actives such as
glycerine, hyaluronic acid, honey, aloe and rose water.
5. Overnight sleeping masks: These creamy formulas are perfect for
those with dry or dehydrated skin, because they hydrate your skin
at a deeper level while you snooze. You can see results, albeit
temporary, with a single use. I swear by sleeping masks. They are
what I reach for during the cold and harsh Delhi winters. Except for
oily and acne-prone skin, all other skin types can use these masks
twice a week. Use one fingertip unit of product and adjust
according to your face. Your skin should feel comfortable, not wet
or damp.
6. Oral moisturizers: These are not a replacement to your regular
a.m.:p.m. routine, but, rather, an integral part of it. Various
supplements containing ceramosides, vitamin E, fish oil, vitamin D,
zinc and evening primrose oil effectively boost skin hydration
levels.
7. Facial oils: These are wonderful moisturizers for your skin,
because they contain a higher quantity of occlusives. Make sure it
is the last product on your skin at night, because any product
applied after this won’t get absorbed into your skin. For more
details on facial oils, refer to Chapter 7.
 Pro-tips

1. Moisturizers should be applied along the direction of the hair

follicles to prevent oil folliculitis.
2. After eight hours, only 50 per cent of a moisturizer remains on
the skin surface, so remoisturizing in a day becomes essential.

Summary

All this information can be daunting if you are new to skincare. To break it
down, here’s a summary of which moisturizers are best for your skin type.

Dry skin type: Look for cream-based, thick moisturizers and even facial oils
with emollients. Occlusives must be used to moisturize as well as block
evaporation.

Combination to oily skin type: Look for water-based moisturizers such as

lotions and gels, with emollients and humectants.

Normal skin type: You can choose either a combination of emollient +

occlusive, or emollients + humectants, according to the texture and feel of
the product. Remember, consistency is key.

Sensitive skin type: The ingredients in your product are key. You may use
creams and lotions, but avoid using gels, aloe vera being an exception. But
only use a product after conducting a sensitivity test.

Dehydrated and mature skin condition: Skin hydration is key, so make sure
you use serums with ideal ingredients. A moisturizer is your second
priority. Similarly, in dry skin type, moisturization is a priority and
application of serums comes second. Always hydrate your skin first with
humectants and then apply a serum, sealing it all with a moisturizer.
 My Favourite Moisturizers

1. Sesderma Hidraderm Hyal facial cream

2. Earth Rhythm Phyto-Ceramide deep moisturizer
3. Episoft AMF Advanced moisturizing cream
4. Cetaphil DAM ultra-hydrating lotion
5. Wockhardt Nourish Oat moisturizing cream
6. Re’equil Ceramide and Hyaluronic Acid moisturizer
7. Dewderm AD cream
8. Sebamed moisturizing cream
9. Evion cream
10. Venusia Max intense moisturizing cream

My Favourite Water Sleeping Masks

1. Laneige water sleeping mask

2. Clinique Moisture Surge overnight mask
3. Dot & Key skin plumping moisture infusion water sleeping
mask
 5
MAKE SPF YOUR BFF

From 2005 to 2010, I studied MBBS at Pravara Institute of Medical

Sciences University in Maharashtra. The campus was located far from the
city, without any distraction or sign of urbanization. My friends and I would
often hang out at the college library, which was an oasis of calm. To get
from my hostel to the lecture hall, I had to take a long walk under the
relentless sun. Since I was aware of the harmful effect UV rays can have on
skin, I had bought many cosmetic sunscreens of different brands and tried
them all out. But I could never wear them for more than two days (believe
me, I tried), because they always made my skin feel sticky, making me feel
hotter and more claustrophobic in the brutal Indian summer. The thing that
usually made me abandon them was that all these sunscreens left a white
cast on my face. Despite knowing the benefits and importance of sunscreen,
I couldn’t be bothered to use these products. No way was I going to class
looking like I had plastered my face with white goop!
Do you want a reason to dress up all fancy? Well, the easiest way is to
blame it on sun protection. Wear a broad-brimmed hat, put on your
attractive sunglasses, pick up that beautiful umbrella and sing along with
‘Pretty Woman, Walking Down the Street’! We all fantasize about doing
this some day, but let’s get real, we can’t do it every day! And trust me, sun
protection is not a fling—it’s a marriage that you have to keep your promise
to and work on every single day to reap its maximum benefits.
You’ve got to remember that this was fifteen years ago, when there were
very limited sunscreen formulations available in the Indian market. So
many from my generation know the feeling of these sticky sunscreens that
left you feeling ‘chip-chip’ and left a white cast on your face. It’s one of the
big reasons many Indians don’t wear sunscreen. Those who do care about
sun damage have had to make do with these horrible products. In fact, sun
protection was barely touched upon and not considered part of one’s
skincare routine in the days I was growing up. To take it further, skincare
itself was not a common phenomenon, as it is today. So it was only natural
that many young women gave up on this step.
Today, there are sunscreens a dime a dozen. The best part is that the
formulations have truly been revolutionized. (If you still find yourself
sticky from using sunscreen, apply a thin layer of loose cosmetic powder
over it. It will suck out the stickiness.) From sprays to water-thin textures,
there’s something for everyone out there. Even though the technology
behind sunscreens has improved by leaps and bounds, it is still one of the
most underused products in India. This is because sunscreens have no
immediate, visible benefits. While sheet masks can give you an immediate
glow in as short a time as thirty minutes, exfoliators and scrubs can make
your skin baby-smooth almost immediately and a serum can improve the
texture of your skin significantly in three to four weeks, sunscreens don’t
have that kind of visible results. So, while regular skincare can be
immensely gratifying, there’s nothing going for the humble sunscreen. But
that’s where we are wrong. Trust me, even though you are not concerned
about early ageing now, you will soon be fretting about that unwanted tan,
dark spots, wrinkles and saggy skin. So get your feet wet by the application
of sunscreen every single day, day after day, for all the coming years—
under the sun or on a cloudy day, in the city or at the beach—to protect
yourself from getting those early crow’s feet!
I think the problem with using sunscreen is a lot like that of climate
change. We don’t take climate change seriously because we can’t see the
damage immediately. The big picture evades us. But if we take steps to
prevent it, it will do the environment—the thing that sustains us all—a
world of good. Similarly, sunscreen is a must in everyone’s skincare routine
because its primary job is to protect the skin. What’s the use of slathering
on expensive product after product, especially anti-ageing ones, if you are
not doing anything to protect your skin in the first place? Think about it like
this: If you have a beautiful house, filled with the best gadgets, a high-tech
TV, the most beautiful designer clothes, wealth and jewellery, would you
keep your door unlocked?
Your skin will thank you later if you apply sunscreen now, because an
unwanted tan, dark spots, pigmentation, wrinkles and sagging skin are all
symptoms of skin that hasn’t been protected in the past. Sunscreen is your
skin’s insurance. It’s better to be safe than sorry later.

The Number-One Factor that Causes Skin Damage

There are many factors that lead to skin damage or photoageing. Skin
damage can manifest as dark spots, pigmentary skin conditions such as
melasma, freckles and photodermatoses, and as early signs of skin ageing,
such as wrinkles and sagging skin. Some of these factors are smoking,
pollution, poor diet and lifestyle. But the number-one culprit behind skin
damage is exposure to UV rays.
People are usually confused about terms such as UVA and UVB when
buying sunscreens. Let me explain it to you in a simple manner.
There are three types of UV radiation: UVA, UVB and UVC.

1. UVA rays: These cause premature skin ageing (uvA: Ageing) by

causing changes at the level of the dermis, which may damage
collagen and decrease skin elasticity. These rays can easily pass
through a windowpane (i.e., can get to you in your car through its
closed windows).
2. UVB rays: These can cause skin burning/tanning (uvB: Burning)
and are also responsible for skin cancer. UV rays even from
 artificial sources such as sun lamps and tanning beds can cause
cancer.
3. UVC rays: These rays do not penetrate the earth’s atmosphere and
hence cause no harm to the skin.

The ozone layer absorbs minimal UVA rays, 90 per cent UVB rays and 100
per cent UVC rays. Thus, the depletion of the ozone layer has increased UV
transmission.
Sunscreen not only helps protect your skin from that tan, it also helps
protect you from UV-induced skin damage and skin cancer. Photo-
carcinogenesis, or skin cancer, is due to the damage of cells and DNA.
We Indians are blessed with a skin type that is more prone to tanning than a
sunburn and have a lower incidence of skin cancer than in the West. (As I
mentioned in Chapter 2, Asian skin is type 4 or 5; the presence of melanin
acts as a sieve and filters out the harmful UV rays by about five times more,
as compared to skin types 1 and 2!) So, even though we are more prone to
tanning, we are more protected against skin cancers and other toxic effects
of sunlight. But don’t get complacent. We still have to protect ourselves
from overexposure to the sun to avoid its photodamaging effects.

The Two Important Things to Look for in a Sunscreen

No matter what brand of sunscreen you buy—be it a physical or a chemical

sunscreen—the only two things that actually matter are the terms SPF and
PA. You must check the sunscreen label for both these factors.
The first one, SPF, is the most common term you will encounter when
you’re on the lookout for a sunscreen. SPF means ‘sun protection factor’.
The SPF of a product determines its protection capacity against UVB rays.
It is one of the ways in which sunscreen efficacy can be expressed. When a
sunscreen that has a high SPF is properly applied, a greater percentage of
UVB rays are blocked.
Source: ‘How to Select a Sunscreen’, Hull Dermatology & Aesthetics, 29
May 2015

SPF Percentage of UVB Rays Blocked

10 90 per cent
15 93 per cent
30 96.7 per cent
50 98.3 per cent

The other important factor to look for in a sunscreen is PA, which denotes
protection against UVA rays. PA is a star rating and a very important factor
overlooked by many when buying a sunscreen.

PA Star Rating Category Star Rating Protection against UVA Rays

** Medium
*** High
**** Higher
One of the questions I’m most often asked is this: What if I layer my SPF
products? If I use my SPF 30 sunscreen with my SPF 15 moisturizer,
followed by SPF 15 make-up, does that equal SPF 60? Logically, that
should make sense by virtue of simple addition, but that is not how SPF
works. The SPF of different products cannot be added together. It doesn’t
matter how many products you use. You will only get protection from the
product with the highest SPF. So don’t burn your cash on expensive skin-
lightening agents or make-up products with SPF. All you need is a single,
quality sunscreen to layer on top of your other products. It is always better
to enjoy the benefits of active ingredients in separate products.

Reapply Sunscreen Every Two Hours

One of the most common and troubling aspects of sunscreen usage is not
product-related. It has to do with a user’s mindset. I see it all the time in my
practice. Most of my clients will choose a quality sunscreen with a high
SPF, say 50 or 80. Nothing wrong with that. But here’s where they will get
it all wrong. They will use the sunscreen once in the morning before
stepping out to wherever they are going and think they’ve done enough to
protect their skin. The thing is you can’t blame them. They’ve invested in a
good sunscreen and use it like they do all the other products—once. We
don’t keep reapplying moisturizer or serum through the day, so why should
we do the same for sunscreen, right?
This is absolutely wrong.
Sunscreen is a different kind of product. It’s not a one-application, slap-
it-on-and-forget-about-it kind of product. The very principle behind
sunscreen usage is reapplication with the right quantity. There are two
important things to keep in mind about the very nature of sunscreen.
The first is that all sunscreens—no matter what their SPF value—lose
their efficacy after some time. This means it stops protecting your skin from
UV rays after some time. To keep its protection shield intact, you must
reapply sunscreen every two hours. So use a higher SPF if you are outdoors,
but an SPF 30 should suffice if you are indoors.
 Anyone who requires sun protection while swimming or during activities
that produce sweat must use a water-resistant sunscreen. However, no
sunscreen is completely waterproof. The FDA has banned the use of terms
such as ‘waterproof’, ‘sweatproof’ and ‘sun-block’, as they can be
misleading and overstress the efficacy of the product. Sunscreen that is
‘water-resistant’ offers protection for up to forty minutes in water and one
that is ‘very water-resistant’ offers protection for up to eighty minutes in
water. It must be reapplied if washed away with water and sweat, due to
towel-drying or when the above-mentioned time period is over, for better
efficacy.

Using Sunscreen Indoors

It is a common myth that sunscreen application is not required if you are

indoors, and so many people skip it in their skincare routines when they are
at home or indoors. The COVID-19 pandemic has led to many people
working from home and there has been a significant fall in sunscreen usage.
But here’s the catch—as I mentioned before, UVA rays can easily pass
through windowpanes. And this is the main cause of premature skin ageing.
So if you are sitting next to a window, you would still be exposed to
harmful radiation. Even at home, especially if you are sitting by a window
or in a brightly lit room, you need to follow the same skincare rules as if
you were outside.
If you are away from the window, you must still protect yourself from the
damage induced by visible light. This protection can be done by iron oxide
or ferric oxide, which are available in physical or inorganic sunscreens. If
you are indoors, away from the window, you need one application of a
sunscreen with an SPF 30 and PA+++. This should be done once in the
morning, after which you are all set for the rest of the day.

Pro-tip
 Your sunscreen should ideally have:

Broad-spectrum protection (protects from UVA and UVB rays)

SPF 30 or higher
Water-resistance, if you are swimming

How to Use Sunscreen Correctly

Now that you know sunscreens actually work, let’s look at how to use them
effectively so you are protecting your skin optimally.
Sunscreen application is one of the most important steps and almost
everyone messes this up. It is extremely important to apply the right
quantity of sunscreen to get adequate protection from the sun. According to
the FDA, about half a teaspoon (3 ml) sunscreen should be applied to the
face. But let’s get real. No one is going to measure out sunscreen with a
teaspoon every time they apply it!
The easiest way to measure the right quantity of sunscreen is with the
‘finger tip unit’ (FTU) method.
Source: Guidance on quantities for application of topical creams and
emollients and also amounts that should be applied to different parts and
fingertip unit. Adapted from Ref No 6: Kiyohara et al, 2013, Indian
Journal of Cancer

One FTU is the amount of ointment or any semi-solid cream/gel from a

tube with a 5 mm-diameter nozzle. If your sunscreen is in lotion form, take
a coin-sized amount on your palm. As mentioned in the figure, your face
and neck require about 2.5 FTUs of sunscreen (that is a little less than one
full finger, as each finger has 3 FTUs). The figure explains how much 1
FTU is. Also, make sure you apply adequate quantities in other exposed
parts of your body too.

Take Sun Protection a Step Further

 Avoid going out in the sun or seek shade between 10 a.m. and 2
p.m. as the sun’s rays are the strongest at this time.
Protect your body from the sun by wearing a broad-brimmed hat,
sunglasses and loose-fitting, coloured, full-sleeve shirts, and full-
length pants.
Be extra-cautious near water, snow and sand, as they reflect sun
rays, which increases chances of sunburn.
Pigmented make-up (such as lipstick and foundation) acts as a
physical barrier and provides an SPF of 3–4.
Car windshields provide about 70 per cent less transmission of
radiation.

Different Types of Sunscreen

There are many types of sunscreen available in the market today. You can
use this guide to help you choose the right one for your skin and your
current environment.

Physical Sunscreen

If you are a cricket fan or have watched any game of cricket in the late
Nineties (and even today), you would have noticed that the cricketers
always plaster a layer of white stuff on their faces. That, in fact, is a
physical sunscreen.
Physical sunscreens work in a different way from the types that are not
visible on your face. They sit on the surface of your skin and bat away all
the harmful radiation that comes your way like an ace batsman. They act
like a protective shield, reflecting and scattering light.
The white cast is due to the presence of the active ingredient zinc oxide.
All physical sunscreens contain zinc oxide and titanium dioxide; some also
contain iron oxide. They do not cause any proven side-effects but are not
biodegradable and, when they wash off a swimmer’s body, have the
potential to be toxic to marine life.
 These sunscreens are commonly marketed as ‘natural sunscreens’ and
claim to be free of chemicals. This usually acts as a huge selling point. But,
sadly, there is no such thing as a ‘natural’ sunscreen. All sunscreens are
made up of chemicals.

Chemical Sunscreen

A chemical sunscreen works like a sponge. It absorbs the harmful UV rays

and converts them into heat energy. To let this chemical process work
effectively, it is advised to apply these formulations fifteen to twenty
minutes before sun exposure. These do not leave a white cast on your face
and the formulation is usually easily absorbed by the skin.
Usually, sunscreens that are available in the market have properties of
both physical and chemical blockers to provide maximum protection.

Is Sunscreen Safe for Infants and Toddlers?

When I was a child, I didn’t even know what sunscreen was. I just loved to
go out, play badminton, hide-and-seek, dog and the bone, stapoo and so
many other games. I spent long hours outside and would always get a bad
tan. I can’t turn back time, but I don’t make the same mistake when it
comes to my children—I always keep a sunscreen handy.
Application of sunscreen on kids is really important, because most of UV
damage and tanning occurs in the teenage years, simply because of
increased sun exposure. Ideally, babies younger than six months should not
be exposed to the sun’s rays. If it is unavoidable, cover them up in layers of
clothes and a hat, and avoid direct sunlight as much possible.
You should start using a sunscreen for children older than six months.
Look for a sunscreen that has been formulated for children. It should ideally
be a physical blocker containing zinc oxide and titanium dioxide, which is
broad-spectrum and water-resistant, with an SPF of 30 or higher.

Sunscreen Formulations for Different Skin Types

Today there are many fancy formulations—such as oils, butters, wax sticks
and sprays—available in the market. Even more interesting is the presence
of SPF in face wipes, facial foundation/mousse, powders, body washes and
hair-care products to minimize sun damage. Whatever the formulation,
always read the labels to check for SPF and the PA factor. Any sunscreen
below SPF 30 and PA+++ is not recommended.
For those who have acne-prone skin, it is important to be mindful when
you select a sunscreen, because many are comedogenic. Make sure you use
either lotion-based or gel-based sunscreens and avoid contents such as
mineral oil in your product.

Sunscreen Skin Type and

Trade Name
Formulation Condition
Creams Dry, dehydrated, mature Heliocare gel cream sunscreen;
Episoft AC moisturizer with SPF 30
Lotions Combination, oily Avene day protector sunscreen SPF 30;
Fotoprotector ISDIN Fusion Water SPF 50
Gels Combination, oily Berkowits Protect sunscreen gel SPF 30;
La Shield sunscreen gel SPF 40
Tinted sunscreens Pigmented skin condition Bioderma Photoderm Max Aquafluide SPF
50;
Heliocare 360° Color gel oil-free sunscreen

Sunscreen Fact

Powder and spray sunscreens should be avoided on the face, as

inhalation of their particles could be hazardous. Either spray them on
your palm and apply, or restrict their use to your body and hair.

Are Hair Sunscreens Worth It?

The UV radiation from the sun can have a damaging effect on your hair in
many ways. They can damage hair lipids, which give shine to your hair,
thus making your hair dull, dry and frizzy. Melanin, which offers your hair
colour and protection, can be damaged by constant UVA exposure.
However, this change is more visible in light-coloured and artificially dyed
hair, making them look brassier. UVB radiation can attack hair keratin
(protein), making it more vulnerable to breakage.
But the good news is, because all the living parts of your hair, such as the
hair follicles, roots and the sebaceous glands, are under the skin, they are
well protected, preventing any long-term damage. However, exposure to
sun rays can affect the aesthetic appearance of your hair and make it look
lustreless and dull. Don’t worry. There are various ways we can protect our
hair from UV damage.

Use leave-in conditioners, oils and hair sprays, which have a

minimum SPF of 30. Avoid sprays with alcohol, which can be more
damaging.
You can even use a sunscreen meant for skin or a spray sunscreen
(keeping it away from your face) and apply it on your scalp.
Wear a broad-brimmed hat or take an umbrella with you before
stepping out into the sun.
Don’t step out into the sun when you have wet hair, as it is more
vulnerable to damage then. Use a spray sunscreen for protection.

Rules of Wearing Sunscreen

1. Sunscreen should always be the last or the topmost layer to be

applied on your skin. It comes after all your essences, moisturizers
and serums.
2. Always use the dot-dot technique to apply (with a fingertip, directly
on your face/concerned area) and never rub it between your palms
before its application, as this significantly reduces its efficacy.
3. Apply it fifteen to twenty minutes before you go out.
4. Apply a lip balm that is SPF 30 or higher to protect your lips.
5. Reapply sunscreen every two hours if outdoors.
6. Reapply sunscreen after swimming or sweating.
7. Wear sunscreen even on cloudy days, as up to 80 per cent of the
sun’s harmful UV rays can penetrate skin. We can get glass skin by
following the other skincare rituals, but if you want to sustain your
glass skin for a long time, apply sunscreen every single day!

My Favourite Broad-Spectrum Sunscreens

1. Bioderma Photoderm Max Aquafluide SPF 50

2. Avene Day Protector sunscreen SPF 30
3. Fotoprotector ISDIN Fusion Water SPF 50
4. La Shield sunscreen gel SPF 40
5. Berkowits Protect sunscreen gel SPF 30
6. UV Doux silicone sunscreen gel SPF 50
7. Heliocare 360° Color gel oil-free sunscreen
8. Rivela Lite sunscreen mousse SPF 50
9. Ekran Soft sunscreen gel SPF 50
10. Neutrogena Ultra Sheer dry touch sunscreen SPF 50

My Favourite Physical Sunscreens

1. La Shield Fisico matte sunscreen gel

2. Heliocare Mineral Tolerance fluid sunscreen SPF 50
3. E’clat superior physical sunscreen SPF 50
 6
THE SKINCARE SUPERSTARS: ACTIVE
INGREDIENTS AND EXFOLIATION

I say this to my clients all the time—if there is one product you should
spend your money on, it’s a product that contains active ingredients,
because only these ingredients can truly affect and change your skin’s
condition, texture and appearance.
Active ingredients are the specialist professionals of the skincare world.
Just like IT and human resource professionals, and doctors, active
ingredients have specialized roles. Each active ingredient has a particular
task and targets a particular problem. And this is just the beginning of this
vast, complex and multidimensional wonderful world. There is an active
ingredient for everyone and every skin condition. You may have dull,
ageing or pigmented skin, or dry, dehydrated, oily, clogged or sensitive
skin, but there is a treatment out there for you.
If you are looking to target problem areas or simply want glass-like
glowing skin, embrace the world of products that contain active ingredients.

What Are Active Ingredients?

An active ingredient is defined as ‘a substance used in a finished
pharmaceutical product (FPP), intended to furnish pharmacological activity
or to otherwise have direct effect in the diagnosis, cure, mitigation,
treatment or prevention of disease, or to have direct effect in restoring,
correcting, or modifying physiological functions in human beings’.* Simply,
they are potent ingredients in any skincare, hair care or pharmaceutical
product that target a specific concern and have the primary and most
powerful role in dealing with your problem. For example, if you suffer from
pigmentation, there are a few active ingredients that specifically target the
problem.

Active versus Inactive Ingredients

Think of a Bollywood film. The active ingredient is like the hero—let’s say
Shah Rukh Khan. It is usually him that will be marketed the most and will
decide how much the consumer will pay for the product. The rest of the
film crew are equivalent to inactive ingredients—they also play a huge role
in the film (because no film is complete with just one actor), to give you
amazing results, but they are less talked about.
Remember that a product can also have more than one active ingredient,
which helps boosts its efficacy and range of expertise. Products such as
these are usually referred to as formulations—a combination of different
ingredients. When a product is well formulated with different active
ingredients, you will find that it delivers extraordinary results. There are
many products in the market that are formulated to include both arbutin
with niacinamide and kojic acid, or with retinol, hyaluronic acid and
ceramides. Just as a collaboration between Shah Rukh Khan, Kajol and
Karan Johar is always a hit, so also is the case with scientifically thought-
out skincare products.
Given their claims, it is tempting to use all actives at once. However, a
word of caution—certain combinations of actives can do more harm than
good, if used excessively. I would avoid mixing retinoids and AHAs. It’s as
if retinoids are Kangana Ranaut and acids are the Khans of Bollywood—
they work wonderfully on their own but are a complete no-no with each
other.

The Star Actives: What They Are and How You Should Use Them

There are so many actives in the skincare industry that if I start writing
about all of them, this book will become a dictionary of ingredients and put
you all to sleep. So I’m going to talk about the best and most effective, and
also the upcoming ingredients in the skincare industry.

1. Anti-Ageing Actives

i. Vitamin A

My favourite megastar anti-ageing ingredient is vitamin A. This is an all-

rounder ingredient and industry gold. It is the only ingredient that has been
studied in depth and backed up by the scientific community with multiple
published studies for its magical effects on skin conditions. It is also an
FDA-approved anti-ageing ingredient. Retinoids are the main class of drugs
derived from vitamin A.

What Is a Retinoid and What Does It Do?

In the 1960s, dermatologists used retinoids to treat acne and acne scarring.
In doing so, they found that not only did retinoids heal acne and diminish
scars, they also made skin smoother, tightened ageing skin and decreased
photoageing.
Retinoids should be the first port of call for anyone who wants to
improve their skin’s condition. It not only works on wrinkled skin and
makes it smoother and tighter by boosting collagen synthesis. It is also
effective in skin brightening, as it alters melanin synthesis as well, which
treats dull skin and uneven skin tone. That’s not all, topical retinoids also
help shrink open pores and decrease sebum production. Quite an all-
rounder, right?

Types of Retinoids.*

There are many types of retinoids and their derivatives. The most
commonly found are tretinoin, retinol, retinoic acid, retinyl esters and
retinyl palmitate.
Are they all the same? Yes, and no. They are all vitamin A products, but
differ in how they deliver the magic to your skin. Essentially, all retinoids
need to convert to an essential molecule—retinoic acid—because this is the
form that can be absorbed by the skin. So all retinoids have a few steps
before they begin to start working. Think of it like a cake. Raw eggs and
flour are not cake. They need to go through a few steps before they can be
eaten as cake. It is the same for retinoids. I’m going to break them down for
you in terms of strength, going from the least to the most potent.
a. Retinyl palmitate: This is the least potent of all retinoids. It will
need to be broken down three times within the skin (going from
retinol to retinaldehyde and then retinoic acid) before it works.
Although it is the least effective, it is suitable for those who have
sensitive skin.
b. Retinol: Next is retinol. This will need to convert twice (to retinoic
acid) on your skin to work. Since retinol is less potent, it also has
fewer side-effects of redness, irritation and sensitivity than
tretinoin.
c. Retinaldehyde: This is more potent, with only a one-step
conversion to retinoic acid, before it works.
d. Tretinoin: This is the strongest form of vitamin A. It is usually
prescribed by a doctor. However, it is easily available in pharmacies
in the strengths 0.025 per cent and 0.05 per cent. A study conducted
in 2015 even confirmed that tretinoin was ten times more potent
than retinol and even mentioned ‘retinol at 0.25 per cent may be a
useful retinoid for application without occlusion because it does not
 irritate but does induce cellular and molecular changes similar
to those observed with application of 0.025% retinoic acid’.*
Tretinoin is usually prescribed for acne, scarring and diminishing
fine lines and wrinkles. It can be very irritating and should not be
used by sensitive skin types. It’s great for oily skin types too.

But all good things in life come at a price.

If used overzealously and with abandon, retinoids can lead to dry,
irritated, sensitive, red and scaly skin and can damage the skin barrier. So
make sure you follow the instructions below when you include this wonder
drug in your skincare routine. Remember that less is more, and slow and
steady wins the race when it comes to retinoids. Also, don’t use retinoids
when you are pregnant or breastfeeding. It’s an absolute no-no.

How to Start Using Topical Retinoids

It is extremely important to start this active on your face the correct way, so
that you can enjoy its many benefits. In the beginning, you might notice a
bit of flakiness or dry patches on your skin. Don’t worry, this is normal.
This just means your retinoids are working. Retinoids boost the
proliferation of skin cells and the extra ones begin to flake. To avoid any
other side-effects, follow these simple tips:*

If you are new to retinoids, introduce them into your skincare only
twice a week. Once your skin is used to this (after two to three
weeks), use it three times a week. Wait and watch. Only when you
experience no dryness, tingling or flaking should you use it every
alternate day.
Only use retinoids at night. It is not stable when exposed to UV
light.
SPF is a must, as retinoids increase skin photosensitivity. Not using
an SPF during the day can actually increase chances of
pigmentation and sensitivity.
 Tretinoin or retinoids come in various percentages—0.025 per cent,
0.05 per cent and 0.1 per cent. Always start with 0.025 per cent and
then work your way up. Remember that retinoids are not a short-
term fix. You must be in it for the long haul. The trick is to get your
skin used to it. So it’s always better to start with something your
skin has a chance with, rather than going for a potent formulation
and having your skin reject it.
Cleanse your face and allow it to dry completely. If your face is wet
or damp, retinoids can be potentially irritating.
Take a pea-size amount and dot it across your face. Do a patch test
first if you are worried. Gently massage it into your skin. Do not
rub or be rough while you do this. Try to avoid the under-eye area
or around the nose and mouth as these areas are more sensitive.
If you are extra sensitive, you can keep it on for one hour and wash
it off. Or you can apply a thin layer of cream first to buffer the
retinoid’s potency.
It can also be mixed with your moisturizing cream in a 1:1 ratio.
You can first apply a layer of moisturizing cream on your face,
followed by a topical retinoid.

Here’s an easy way to remember retinoid use: If you are in your thirties,
apply topical retinoids three times a week; if you are in your forties, apply
them four times a week; and if you are in your fifties, apply them daily!* So
don’t be scared of using topical retinoids—just use them correctly and you
will fall in love with this ingredient.

ii. Bakuchiol

This new kid on the block is being hailed as the natural alternative to
retinol. It is derived from the seeds of the Babchi plant, which grows in
India, and has anti-inflammatory and antioxidant properties. Some studies
show that it can also prevent acne.*
 In the skin cells, this potent ingredient activates various chemical
pathways, leading to improved collagen synthesis and decreased melanin
production. So if you cannot use retinoids for whatever reason, it is your
next big bet. You can derive all the benefits of retinoids without the side-
effects—irritation, redness, scaling and sensitivity to the sun. The best part
is that this ingredient can be used by all skin types.
But remember that bakuchiol is not as potent as a class A retinoid. The
amount of research done on retinol is much more extensive than this new
active. So don’t be in a rush to switch from retinol creams to bakuchiol if
your skin can handle the former.

Is Bakuchiol Safe for Use during Pregnancy and Lactation?

The literature out there claims that bakuchiol can be used during pregnancy,
because it is derived from a plant—a natural resource. However, there are
no published studies in medical journals that back this up. So, I would say,
avoid it. There are hundreds of actives in the market with proven studies of
safety for pregnant women. Use those instead.

iii. Copper tripeptides*

Peptides have been around since the Seventies. These are active ingredients
that help re-texturize and thicken skin by making it firmer and plumper.
Their main action is production of collagen, elastin and
glycosaminoglycans, and hence help reduce wrinkles and improve skin
elasticity. They also help improve uneven skin tone and make skin clear
because of their antioxidant effect. It is ideal for use in mature and
pigmented skin condition. It can be used twice a day for greater benefits.

iv. Coenzyme Q10

Also known as ubiquinone, it is an effective antioxidant, which protects our

skin from UV radiation, pollution and free radical damage, and hence
prevents early signs of ageing. It helps stimulate collagen and elastin
production, which helps reduce fine lines and wrinkles. For people with
pigmented and mature skin, this is another go-to ingredient to fight some
years off. It can be applied on the skin every day and works symbiotically
with vitamin C, niacinamide and hyaluronic acid, enhancing their effects.

v. Ceramides

The anti-ageing powerhouse, ceramides are lipids (fats) that are vital in
forming a protective barrier in the outermost layer of the skin. Think of it as
the cement between the skin cells that holds them together and prevents
TEWL, while also protecting the skin from external stressors. Ceramides
are naturally present in the skin, but as we age, we begin to lose them,
which results in sagging, dry and dehydrated skin. It is a barrier-repair
ingredient, which is essential in an anti-ageing skincare routine.
Ceramides are usually formulated as serums, creams or individual single-
use capsules. They can be used both in your morning and your evening
routine.

vi. Snail Mucin*

Now this is one fancy ingredient doing the rounds of the market, thanks to
South Korean skincare. This is a thick fluid that is obtained by stimulating
(and hopefully not killing) live snails. Many Indian home-grown brands
have tried their luck in working around this, but, in my opinion, Indians still
need to step a notch higher.
Snail mucin has proven benefits in healing and there are multiple studies
published in medical journals showing its efficacy in stimulating collagen
and elastin, and treating fine lines and wrinkles. However, there will always
be a question on the quality and processing techniques of snail mucin. So
only if you are a skincare junkie and you want to try something new, go
ahead and buy a cream with this ingredient (but prefer buying it from a
South Korean brand).
vii. The Acids

When we think of acids, we conjure up images of corrosive, harmful

substances. It’s natural to be wary of them. However, things have changed
in the skincare world and, today, acids are some of our best companions in
skincare routines. What do acids do—they exfoliate the skin (remove dead
skin, clean dirt), but only chemically. Do you remember a time when we
depended on the harsh and gritty granules of St Ives or a walnut scrub to
clean dirt from our faces? That is physical exfoliation. Acids do the same
job, but more effectively and in a much gentler way. Let’s look at the
different types of acids and their specializations. Remember I compared
them with the Khans of Bollywood? That’s how good and experienced
skincare ingredients they are!

a. AHAs (Alpha Hydroxy Acids)

AHAs are derived from fermented fruits. When used correctly, with the
right formulation, AHAs are a godsend. They not only improve skin
texture, shrink pores and smoothen fine lines and wrinkles, but are also
extensively used by dermatologists to treat obstinate pigmentation. AHAs
also have the capability to thicken the epidermis. They are masters of
exfoliation.
The percentage and pH of the acid determines the extent and degree of
exfoliation. Most acids below 15 per cent are safe to use at home. However,
the FDA prefers to keep it below 10 per cent, with a pH above 3.5.* When
buying an AHA, bear in mind that a higher percentage need not necessarily
be good for you. So it’s always safer to do a patch test first before applying
it on your face.
Actually, fruit acids are derived from various food sources. Glycolic acid
is derived from sugarcane, citric acid from citrus fruits, malic acid from
unripe apples and tartaric acid from fermented grapes.

Glycolic Acid: This is the most researched and popular AHA. Other than all
the actions mentioned above, glycolic acid also gets rid of dead skin gently
and makes your skin smooth and shiny. But what makes glycolic acid stand
out from the rest is that it has the smallest molecule size and thus penetrates
deep into the dermis and acts on collagen to boost its production, making
skin firmer and delaying signs of ageing. However, collagen synthesis takes
time. Glycolic acid needs at least four months to show results.

Who can use it: Best for oily and combination skin types. Those with
sensitive and dry, dehydrated skin types should avoid it.

Lactic Acid: Cleopatra was a fan of lactic acid. We Indians are also no
strangers to it. We’ve used it as a home remedy for generations (especially
during weddings) in the forms of masks that contain curd or milk!
Fermented milk and curd are rich in lactic acid. This is the second-most
common and researched AHA after glycolic acid. It has a bigger molecule
size than glycolic acid, making it gentler and particularly good for those
who have sensitive skin. At higher percentages (more than 10 per cent), it
also targets both the epidermis and the dermis, and gently exfoliates your
skin, making it fresh and smooth, and even repairs photodamage.* It is great
for lightening pigmentation and smoothening skin. As mentioned above, pH
is an important consideration before buying AHAs. There are products in
the market that have more than 12 per cent lactic acid but are FDA-
approved to be used on dry skin. Make sure the pH value is 3–4 in such
cases.

Who can use it: Best for sensitive, dry and dehydrated skin types.

Mandelic Acid: Derived from bitter almonds, mandelic acid helps in

exfoliation, decreasing dark spots and pigmentation, and evening out skin
tone. It helps treat acne as it has antibacterial properties as well. It has the
biggest molecule size and is thus gentler than both glycolic and lactic acids.
It penetrates the skin more slowly, causing lesser irritation even in sensitive
skin. It is very popular in doctors’ clinics and is one of my favourite
chemical peels, especially when used in combination with salicylic acid, to
treat acne with pigmentation. Mandelic acid is light-sensitive, so always
chose a product that comes in opaque packaging. Many skincare products
are formulated containing about 10 per cent mandelic acid, which can be
used every night/alternate nights, depending on your skin type.

Who can use it: Anyone.

How to Use AHAs Safely and Correctly

Use AHAs only at night.

SPF is non-negotiable, because all AHAs tend to make skin
sensitive.
If you are using an AHA below 10 per cent, with a pH of 3–4, you
can use it daily only if it suits your skin.
AHAs between 11–20 per cent (especially glycolic acid) should be
used only once or twice a week, until your skin gets used to the
active. It can cause itching, redness and sensitivity—that is, they
can overexfoliate.
AHAs above 20 per cent should only be used with professional
guidance.
The pH value of the product is as important as the concentration.
The ideal pH concentration when the product is effective and gentle
is 3–4. If the pH is below 3, it can burn your skin and if it is above
5, the potency of the acid is highly reduced.
Always start slow when you are new to AHAs. If after the first use,
you experience red and irritated skin, decrease its duration of
application.
Do not use retinoids and AHAs together or on the same day.

b. Beta Hydroxy Acids (BHAs)

If you suffer from oily, acne-prone skin, BHAs are what you should reach
for. BHAs are lipophilic, meaning they are drawn to oil, so this is the
skincare holy grail for you. Products containing this ingredient will
exfoliate the top layer of skin and unclog your dirt pores, keeping those
pesky whiteheads and blackheads at bay. Just don’t use it every day and be
sure to apply a sunscreen in the mornings.

Salicylic Acid: Most of you must have come across this active in a face
wash or a cream at some point in your life. This is because salicylic acid is
the gold-standard treatment for blackheads, whiteheads, open pores
and acne.
It is a desmolytic or a keratolytic agent. This means that it targets
desmosomes—the protein bonds in skin—and also helps exfoliate dead skin
cells. Unlike AHAs, salicylic acid is lipid-soluble, which means it can
destroy the extra oil below your skin to prevent acne. Most home-care
products contain 0.5–2 per cent salicylic acid, which is effective in getting
rid of the gunk in your skin and bringing out renewed skin. This wonder
active also helps shrink pores! However, at a doctor’s clinic, higher-
percentage (20–30 per cent) salicylic acid is used as the first choice for
treating acne, and also helps decrease surface roughness and improve skin
tone.

Who can use it: It works best on acne-prone, oily skin but can be used by
everyone. If you have sensitive skin, be cautious of the percentage in your
product. Also, if you have sensitive, acne-prone skin and are using a face
wash with salicylic acid, don’t massage the face wash on your face for too
long. Wash it off within twenty to thirty seconds.

c. Polyhydroxy Acids (PHAs)

PHAs are the next-generation AHAs. They have similar skin-smoothening

and anti-ageing benefits as AHAs, with antioxidant properties. What sets
them apart is that they are also good humectants, making them perfect for
dry or dehydrated and sensitive skin types. They also help repair the skin
barrier.

Gluconolactone: This is the most popular PHA and is a must-try, because

other than having all the anti-ageing, skin-smoothening, hydrating and
moisturizing benefits mentioned above, it also protects the skin from UV
damage. It maintains skins elasticity and decreases sagging by inhibiting the
enzyme elastase.

Who can use it: Ideal for sensitive or dry, dehydrated skin types.

These are also ideal for sensitive skin, as they have the awesome benefits of
AHAs without the skin irritation. The other PHAs are lactobionic and
maltobionic acids, which possess excellent humectant properties and bind
to large amounts of water. They also treat uneven skin tone and
pigmentation. Give it a try if you have dehydrated skin.

d. Azelaic Acid

When Amitabh Bachchan entered Bollywood, he was a nobody. He was

given supporting roles because his talent was yet to be discovered. It took
him time to become the icon he is today. He is not just a superstar—he is a
megastar! To me, this is the azelaic acid story!
If you have acne-prone skin with dark spots and you have consulted me
for the same, my prescription will always contain at least one cream with
azelaic acid. Azelaic acid is multifaceted, and yet one of the most
underused and underrated actives in the beauty industry. It is a hidden gem
that I want to put a spotlight on.
Azelaic acid is a carboxylic acid found in wheat, rye and barley. It’s
neither an AHA nor a BHA, but it delivers the benefits of both. It is a gentle
exfoliant that works to lighten hyperpigmentation. Like a BHA, it also
treats acne, but with an additional antibacterial effect, working against P.
acne—the bacteria responsible for causing those troublesome zits on your
face. It not only treats pus-filled lesions, it is also extremely effective in
treating blackheads and whiteheads, with results comparable to benzoyl
peroxide and retinoids, but with fewer side-effects.* It also has anti-
inflammatory properties, making it one of the first-line treatments for
rosacea. Above all, it is absolutely safe to use during pregnancy and
lactation, which gives this active an edge over the others.
2. Brightening and Glow Actives

i. Vitamin C†

Did you know that in the eighteenth century, sailors carried lemons with
them to treat bleeding gums (a sign of scurvy), which occurred due to
vitamin C deficiency? Today, everyone knows the importance of having a
diet rich in vitamin C. It is a naturally occurring antioxidant, which can be
derived from various citrus fruits, such as lemons, papayas, strawberries,
blackberries, broccoli and green leafy vegetables. As a topical treatment,
vitamin C is also an A-lister active ingredient in the skincare world. It fights
pigmentation and helps you get that much-coveted glow.
This wonder molecule works best when used in a concentration of about
5–20 per cent over a period of twelve weeks. It helps boost collagen
production, firming up the skin and delaying signs of ageing. It also inhibits
the production of the tyrosinase enzyme (responsible for the production of
melanin, which can cause hyperpigmentation) and aids in the fading of dark
spots and pigmentation. Even though vitamin C is an effective antioxidant
that helps fight free radical injury and protects the skin from UV rays, it is
still not a replacement for sunscreen. Addition of vitamin E and ferulic acid
doubles the antioxidant and photoprotective effect of vitamin C.
The best time to use this powerful antioxidant is in the morning, after
cleansing your face, after which you should apply an SPF. You can also
apply a formulation of vitamin C at night to enjoy its benefits of collagen
production. I love vitamin C because it can be used daily for long durations
without any side-effects. It can also be used along with other actives such as
retinoids, AHAs and other antioxidants.
Remember that vitamin C oxidizes when it comes in contact with air. It is
an extremely unstable molecule. If your serum looks dark orange or brown,
it has oxidized and you should discard it. So, when buying vitamin C
formulations, look for products where the liquid is dispensed from a nozzle.
Also, use up your vitamin C serum within three months of opening it to
enjoy its maximum benefits.
Who can use it: Anyone. However, if you have sensitive skin, stick to
strengths that are below 10 per cent or you may experience itching and
tingling.

Pro-tip

Vit C + Vit E + Ferulic Acid is a magic trio, which is extremely effective

in photoprotection and has great antioxidant activity.

ii. Niacinamide/Nicotinamide (Vitamin B3)*

A hit ingredient for brightening the skin, niacinamide has been around for
ages. In fact, it’s a key ingredient in the infamous Fair & Lovely products.
Niacinamide has multifunctional properties, ranging from anti-ageing
benefits by stimulating elastin and collagen to lightening hyperpigmentation
and decreasing the yellowness of skin that comes with age. As it possesses
antioxidant and anti-inflammatory properties, it helps in photoprotection. It
is also useful in treating redness and blotchiness associated with rosacea. It
repairs the skin barrier and improves skin hydration by increasing ceramide
synthesis. Even though it is not the primary agent in treating acne, it also
regulates sebum production. You can use 4–5 per cent niacinamide for at
least eight to twelve weeks to see desired anti-ageing results, and 2–5 per
cent niacinamide to lighten pigmentation. And as mentioned in published
journals, niacinamide is one of the best studied cosmeceutical ingredients
for anti-ageing.

iii. Arbutin

This is another favourite skincare ingredient. Arbutin is an effective

brightening agent derived from plants such as bearberry, pear trees and
wheat. Arbutin is actually the ‘natural’ sibling of laboratory-produced
hydroquinone—the most effective yet unpopular skin-brightening agent.
Arbutin inhibits the production of melanin by hindering the production of
the enzyme tyrosinase.
It is present in two forms—alpha and beta arbutin. Alpha arbutin is more
effective and stable in treating dark spots, melasma and all forms of
pigmentation without causing any side-effects.

iv. Glutathione

Interestingly, many of my patients have requested the same treatment that

Kajol took to lighten her skin tone. They even somehow knew that she got
some treatment done, which sounded like this one (I still don’t know if
Kajol took this or any other treatment for skin lightening!).
Glutathione is a powerful antioxidant that is naturally present in our
body. But it reduces as we age. It was originally used to treat liver
abnormalities and has also shown benefits in protection from viral
infections and in treating diabetic complications. But, recently, there has
been a sudden spurt in its use as a skin-lightening agent in topical, oral and
intravenous forms. There have been a few studies proving the efficacy of
oral supplements and glutathione creams in temporary skin whitening.*
However, safety and results of intravenous administration are still
questionable, as even if given twice weekly over ten to twelve sessions, it
only achieves temporary results at a very high cost. Patients also have to
remember to be cautious of going out in the sun, or they can risk the
reversal of results sooner.

3. Hydration Actives

i. Hyaluronic Acid (HA)

This is another superstar ingredient that has been a skincare-industry

favourite for decades, vital for glass-like skin. It is a key molecule to retain
water and maintain skin hydration. The term ‘hyaluronic acid’ is derived
from the Greek word ‘hyalos’, which means glass. In our body, HA is
naturally present in the skin, synovial fluid and vitreous humour (a fluid
substance in our eye). Our skin contains 50 per cent of the total HA in our
body, and each gram of the acid can hold up to 6 litres of water! So,
basically, HA acts like a sponge, which can absorb water up to 1000 times
its weight. Sounds unbelievable, right? That’s why this wonder molecule is
so important to keep our skin young and youthful, and to maintain the
hydrated, dewy and glass-like effect.
As this molecule is one of my favourites, I’ll just take some liberty and
put out some more scientific details for all of you. Now, HA is present in
our body as high molecular weight (HMW) and low molecular weight
(LMW). The HMW-HA has a bigger molecular size and hence is not able to
penetrate the skin. It thus acts as a great skin protectant and surface
hydrator. The LMW-HA, on the other hand, has a smaller molecular size
and thus is able to hydrate the skin deeper. However, it still remains in the
epidermis and does not reach the dermis. It also helps maintain the
immunity of the skin and repairs it in times of need. So a lesser-known fact
—topical HA applications don’t really penetrate your skin to reach the
dermis. They are really good for surface hydration and for protecting your
skin by forming a barrier. Topical HA acts as an osmotic pump, which
increases the penetration of water-soluble ingredients. I completely agree
with cosmetic chemists at the blog Realize Beauty, when they say that HA
is an osmotic delivery system that can push water-soluble actives deeper
into the skin by forming a hydrated reservoir on the surface of it.
Whether you use HMW-HA or LMW-HA, even if you use a small nickel-
size amount of HA on your face, it instantly improves skin smoothness and
reduces fine lines. It also hydrates and moisturizes the skin instantly (within
fifteen minutes of application) and hence is one of the best products for dry,
dehydrated, aged and parched skin. If you have dehydrated skin due to
smoking, you should definitely add this ingredient in your skincare kitty.
If you want to see long-term improvement in the treatment of wrinkles
and want to plump up your skin, improve its elasticity, decrease its
roughness and improve its moisture content, start HA application twice a
day and continue for at least three months.
 Pro-tip

Smoking is the biggest menace for your skin, and this master ingredient
is a smoker’s best friend when it comes to skincare.

ii. Vitamin E*

This fantastic skin hydrator and emollient has taken a back seat in recent
times because of the introduction of so many debutant star ingredients.
However, this is an evergreen active that works very well in a team. Also
known as tocopherol, vitamin E is derived from plant sources. We also get
it from food such as spinach, nuts, olive oil and sunflower oil. This is a very
stable, easily available active and not heavy on the pocket either.
Vitamin E is a potent antioxidant and protects from free radical injury
and from UV rays, especially against UVB. Its effect consolidates when it
combines with vitamin C, and becomes multifold when also combined with
ferulic acid, which gives broad-spectrum sun protection.

Who can use it: Everyone.

iii. Squalane*

Squalane (not to be confused with squalene) is primarily derived from fish

oils and shark liver oil, but formulations today are produced from vegetable
sources. It is also found in smaller amounts in certain vegetable oils such as
from olives, peanuts, palm, amaranth and pumpkin. Squalene occurs
naturally in our sebum (13 per cent), thus offering moisturizing and
hydrating properties.
In skincare products and cosmetics, squalane acts as a great emollient. It
comes in the form of a non-sticky oil, which gets absorbed quickly without
leaving any oily residue. It also helps repair the skin barrier by reducing
TEWL. That’s not all, this active ingredient also has antioxidant properties,
which protect the skin from free radical injury.

Who can use it: This is best for dry skin types. Avoid it if you have oily,
acne-prone skin, as oxidized squalane can trigger acne.

Exfoliation

Exfoliation brings back the memory of the use of physical scrubs. These
physical scrubs do more harm than good. With no variants available for
different skin types, if used overzealously, we risk compromising the
superficial barrier of our skin, leading to damage. With the invention of
chemical exfoliants, we now have multiple choices for all skin types. As
acids are available in different strengths, a lower percentage can be chosen
for beginners, which can be increased gradually. Even the time of
application can be tweaked to avoid side-effects.
The benefits of exfoliation are that they slough away dead skin cells and
clean up clogged pores, helping skincare products penetrate deeper. They
even promote increased cell turnover, which evens out skin tone. However,
exfoliation can also be too much of a good thing. If overexfoliated, your
skin might feel extremely dry and taut and experience irritation, redness and
a burning sensation. In such a case, make sure you moisturize your skin at
least three to four times a day to repair your skin barrier and avoid
exfoliation for at least one week.

Key Actives for Your Skin Concerns

Dry skin Vitamin E, hyaluronic acid, squalane, ceramides, lactic acid
Dehydrated Hyaluronic acid, glycerine, ceramides, lactic acid and PHA
skin
Oily skin Salicylic acid, green tea extract, AHA, azelaic acid
Combination Vitamin C, retinol, glycolic acid, any skin-brightening agent
skin
Sensitive Avoid retinol. Use AHAs and BHAs with caution. All skin hydrators, ceramides,
skin lactic acid, gluconalactone (PHA)
Normal skin Jackpot! Any of the above ingredients
Pigmented Glycolic acid, niacinamide, arbutin, vitamin C, glutathione, azelaic acid, mandelic
skin acid
Mature skin Retinoid, bakuchiol, ceramides, copper tripeptide, ceramides, coenzyme Q10,
peptides
 7
MAGIC POTIONS FOR YOUR SKIN: SERUMS,
ESSENCES AND FACIAL OILS

These skincare products are hands down the most attractive ones in the
market. Just add a few drops of an oil or a serum with the unique droppers
directly on your face, let it trickle down and massage it in with the tips of
your fingers to give your face an instant glow!
We have already talked about the routine steps that are a must—
cleansing, moisturizing and application of sunscreen. Now comes the ‘luxe’
part! If you want to upgrade your skincare regime a tad, go ahead and
indulge by buying a face serum or a facial oil, which are the ‘in’ things in
the market these days. You’ll see the results before the ink is dry—or
should I say before the serum/oil is dry! You might have to pay top dollar
for that tiny bottle, but trust me, these magic potions are very potent and
have such a high concentration of powerful ingredients that only three to
four drops of the product are to be used at a time and the entire bottle lasts a
long time.

What are Serums and How Do They Work?

Serums are light, water-based liquid potions with a punch of highly
concentrated ingredients. They are usually water-based and contain water
with actives such as peptides, antioxidants, vitamins, retinol and AHAs
such as glycolic acid. These have smaller-sized molecules and hence can
penetrate deeper into the skin. A serum containing retinol will go deep into
the dermis and stimulate collagen and repair elastin. Serums are made so
they reach the buried layers of the skin and give targeted results, which are
harder to achieve by moisturizers. Hence, they are a vital step in skincare
and help in correcting various skin concerns such as fine lines, dry and
dehydrated skin, uneven skin tone and texture.

What Are Facial Oils?

As I mentioned in the chapter on moisturizers, they can be divided into

three categories—humectants, emollients and occlusives. Facial serums fall
in the category of humectants, but facial oils are either emollients, which
can be used to soften the skin, or occlusive, which form a protective
occlusive layer on the surface of the skin that seals the water inside. Facial
oils have bigger-sized molecules and are thicker in consistency as compared
to serum. As their molecule size is larger, they penetrate only the outermost
layer of the skin. So facial oils are moisturizing and increase the level of
hydration, imparting a plumped-up and refreshed look to the skin by sealing
in moisture.
They usually contain plant extracts and essential oils and provide the skin
with lipids, which reinforce the skin barrier. So oils have a rich, emollient
texture, and give a boost of nutrition and hydration to skin. Other than
having nourishing properties, depending on the ingredients, they may also
have anti-inflammatory and antioxidant properties. However, not all facial
oils are the same. Depending upon their ingredients, some can be
nourishing and some might have antimicrobial and healing properties. So
you must know about the action of actives in different facial oils before you
invest in them.
What Are Facial Essences?

This is another fabulous product that came out of the Asian market.
However, this is one product that did not spread its wings too wide.
Reason? Well, our plate is too full already with other skincare products that
can provide similar benefits. Ideally, it is to be applied after applying a
toner and before applying a serum.
So do we really need an essence? In my opinion, you should invest your
time and money in a good serum.
Essences are beloved in both Japan and South Korea, where the idea of
layering thin layers of product is more favoured rather than one or two thick
layers. An essence is basically like a serum—a concentrated burst of active
ingredients. Like serums, they have small-sized molecules, which help the
active ingredients penetrate deeper into the layers of skin. Not only do they
help amplify the effects of other skincare products, they also give you a
super hydrated and dewy appearance.
You should consider essences if you have oily, acne-prone skin or live in
a humid environment, where the application of heavier textures can make
life unbearable. Due to their mostly thin and viscous texture, they are
comfortable to wear in places such as Mumbai, Kolkata, and parts of south
India, where humidity can soar in the summer months.
However, I would still recommend a dedicated serum rather than an
essence.

Why Do We Need to Apply Serum/Oil?

Ageing can be due to external and internal factors. As we age, skin loses its
plumpness and turgor due to loss of moisture, leading to a prominence of
fine lines and wrinkles. The skin might also develop dark spots and
pigmentation due to hormonal changes and if sun protection is not
maintained. Facial serums in particular, as they have smaller-sized
molecules and can travel to the deeper layers of the skin, not only hydrate
the skin and make its collagen and elastin more resilient, but the
antioxidants present in them also fight against free-radical damage,
delaying the process of ageing.
Various studies have proven the efficacy of facial serums. When used for
treating a desired indication with an ideal key active, it can help reduce fine
and coarse wrinkles, improve skin tone, and induce texture, radiance and
glow with twice-a-day application within four weeks.
Remember, as mentioned before, our superficial-most layer of the skin,
the stratum corneum, is made up of skin cells that are like bricks and the
role of the cement that holds these bricks together is played by the oil
produced by the sebaceous glands. This protective outer layer prevents
TEWL and irritants from entering the skin, keeping our skin hydrated and
healthy. If there is a lower production of oil or sebum, it may lead to dry,
flaky skin.
Facial oils maintain the barrier of the skin and the skin moisture level.

How to Apply Essences, Serums and Oils

Essences

We always layer our skin with products from the thinnest to the thickest
consistency. Essences have the thinnest consistency among the three and
have to be applied after the toner and before the application of a serum.

Serums

After cleansing and toning and the application of an essence (if you chose
to apply any), layer on with a serum when the skin is still a little moist to
help lock in the moisture within. Massage it on your face with your
fingertips and follow it up with a moisturizer. You can also directly apply
sunscreen.

Facial Oils
These should be applied by gently massaging them on clean, damp skin on
the face.
At night, after application of a serum, follow it up with a facial oil, as it is
thicker in consistency. You must always remember to layer your products
from the lightest to the thickest consistency to make sure they are absorbed
more effectively. Serums are usually thin and watery and oils thicker in
consistency.

Challenges in Using Facial Oils

1. The content of ingredients in facial serums are all tried and tested,
and backed up by clinical trials and peer-reviewed researches. In
fact, there are multiple researches done even on various types of
facial oils and their benefits for various skin conditions such as
atopic dermatitis, eczema and psoriasis. However, no doctor will
recommend tea tree oil as the first line of treatment for acne, but
they will not shy away from prescribing a serum with a certain
percentage of salicylic acid or retinol, as there are multiple medical
journals supporting the efficacy of key actives in serums.
2. Not everybody purchases a facial oil very mindfully, as there is still
a lack of awareness about the functions of various types of oil. This
might lead to experimenting with different contents on the skin,
which might cause irritation.

Pro-tip

If you are trying a new serum or a facial oil, just mix a few drops of your
product with your moisturizing cream and apply that on your face—
especially serums containing retinol, which can irritate sensitive skin
types. If your skin reacts well to the mixture, you can apply it on your
face directly.
Key Facial Oil Ingredients and Their Properties

Facial oils are primarily extracted from different plant sources. They mainly
comprise triglycerides, free fatty acids, phospholipids and antioxidants. All
these ingredients work together in every type of oil and lead to the
following benefits:

1. Maintains the skin barrier.

2. Protects skin from free radical damage.
3. Has anti-inflammatory benefits, and decreases redness and itching
of skin.
4. Protects the skin from microbes and prevents infections.

Types of Facial Oils and Their Functions

 Facial
Properties
Oils
Tea tree Antibacterial and antifungal properties, fights acne
Grapeseed Rich in vitamin E and antioxidants such as resveratrol
oil
Almond oil An emollient; improves complexion, and reduces and prevents stretch marks
Pomegranate Rich in free fatty acids, has antioxidant and anti-inflammatory properties
seed oil
Argan oil Rich in vitamin E and fatty acids, more stable in sunlight than other antioxidants,
moisturizes skin and smooths fine lines and wrinkles
Camomile Anti-inflammatory, calms skin, reduces redness and irritation, good for patients with
oil sensitive skin and rosacea
Rosehip Treats skin discolouration;
seed oil anti-inflammatory, good for sensitive skin,
anti-wrinkle properties, improves skin elasticity, potent antioxidant—protection
against UV damage
Jojoba oil Anti-inflammatory and repairs skin, anti-ageing benefits
Kiwi seed Rich in omega-3 fatty acids, alpha linoleic acid and vitamin C, calms inflammation
oil and retains moisture
Coconut oil Effective moisturizer and good for dry skin, protects skin from UVB radiation, has
anti-fungal properties and kills acne-causing bacteria
Evening Improves skin-barrier function, heals cracked
primrose oil lips
Oat oil Colloidal oat extracts effective for sensitive skin, skin rashes, itching; helps barrier
repair by increasing ceramide levels
Borage seed Contains omega-6 fatty acids and linoleic acid, improves skin-barrier function,
oil effective in treating atopic dermatitis
Bitter Suggested effectiveness in psoriasis treatment
apricot oil

Summary

Facial serums and oils are part of luxury skincare, and are sure to give you
good results! Where facial serums act at a deeper and more microscopic
level, facial oils focus more on the appearance and glow of skin.
 If you want to splurge on one skincare product, save it for a facial serum
that suits your skin. You won’t regret it!

My Favourite Serums

1. Sesderma C-Vit Radiance glowing facial fluid

2. Berkowits Radiate vitamin C serum with hyaluronic acid
3. Yu Reverzo Stem Intense rejuvenating serum
4. Diet Esthetic Vit C + E serum
5. Berkowits Radiate skin brightening serum
6. Berkowits Renew anti-ageing serum

My Favourite Facial Oils

1. Kiehl’s Midnight Recovery concentrate for glowing skin

2. Indulgeo Essentio rose gold oil
3. Earth Rhythm bakuchiol extract
4. The Tribe Concept kumkumadi thailam
5. Vilvah Natural vitamin E oil
6. Juicy Chemistry rosehip facial oil
 8
MASKING: SUPERCHARGE YOUR SKIN

Today, choosing a face mask is a ride down a rabbit hole because we are
spoilt for choice with the innumerable options available in the market.
What’s worse is that every product out there looks beautiful and promising.
With most face masks promising instant glow and skin brightening, I can
understand how confusing it can be for you when you go out looking for a
product.
When I was a teenager, I had no idea about skincare. Whenever I came
across the word ‘skincare’, it conjured up the image of a girl in a white
bathrobe, her hair tied up in a towel, her face slathered with a pink or a
green face mask and two slices of cucumber on her eyes. That’s how basic
and simple it used to be! And so, my favourite skincare product was a face
mask, and I always expected it to be the magic wand for my skin. I have
such a vivid memory of applying clay masks on my T-zone as a teenager
and then watching TV. It was how I relaxed. Back then, all face masks—
whether they were charcoal, mud or clay—were the same to me. All that
mattered to me then was that a face mask looked and smelt good. I was
fortunate that I didn’t have sensitive skin or I shudder to think of the
consequences of my experiments!
 Today, as a skincare expert, I’m obviously aware of the different
ingredients and the kind of masks that suit my skin and when I should use
them. A face mask is like getting on the bandwagon for starters in skincare.
It gives you a relaxed yet luxurious experience and also delivers a shot of
goodness. How many of us have posed for an Instagram pic with a face
mask on and captioned it #mood? After all, this step grabs the maximum
eyeballs. If I have to compare this step to a character in a Bollywood film, it
would have to be Salman Khan in Kuch Kuch Hota Hai—a small role that
leaves a huge impact. That’s exactly what a mask does.
Today, face masks are much more than just the clay or the charcoal
masks that were available when I was a teenager. The South Koreans have
spoilt us with sheet masks, hydrogel masks, overnight sleeping masks, mud
masks, cream masks and much, much more. Face masks today target every
skin issue too—from pigmentation and dry skin to redness. But when we’re
looking to buy a face mask, we need to consider these two questions:
Are they really effective?
Which one is right for me?

Are Face Masks Really Effective?

In our wardrobe, we always have a dress or a pair of shoes that we save

only for a party or a special occasion. Masking is like a party for our skin.
During the COVID-19 lockdown, even though people couldn’t go out and
party, most of us managed a good party for our skin. Skincare never trended
on social media as much as it did in 2020. Also, remember that face masks
are not essentials in one’s skincare arsenal, but there is no harm in having
one.
Whether it’s a face wash, a serum, a lotion, a cream or a mask, what we
need to remember is that all these are mediums to introduce various actives
into your skin. So when you are buying a face mask, keep in mind your skin
type, your skin condition and know the top actives in the mask. Because
only the top actives are the main leads of a movie—the rest are just part of
the crew that help deliver the final product. For more information on
actives, refer to Chapter 6.
Most face masks contain a delivery agent called butylene glycol, which
helps the skin absorb the actives in the product into the epidermis, which is
the farthest layer a face mask’s ingredients can reach. So don’t expect too
much from face masks. Face masks won’t erase pigmentation or smoothen
out wrinkles. They indeed have miles to go before they seep!

Three Things to Keep in Mind When Selecting a Face Mask

1. Face masks can contain a lot of fragrances and colour. They may
not cause any harm to combination or oily skin, but they can cause
significant irritation in sensitive skin types.
2. Clay masks or mud masks can be used twice a week according to
one’s skin type, but whatever skin type you have, use exfoliating
masks or masks with acids not more than once a week.
3. Always follow the instructions on the product, which will indicate
how long you should keep your face mask on. Today, some face
masks need to be kept on only for five to ten minutes, while others
have a longer application time. Be cognizant of this.

Pro-tip for Sensitive Skin Type

People with sensitive skin, I feel for you. Although there are masks
available for every skin type, people with sensitive skin should be
cautious before using them. Try looking for face masks that include
ingredients such as aloe vera and camomile, but don’t forget to first do a
patch test on your neck to avoid irritation and breakouts.

Types of Face Masks

Sheet Masks and Hydrogel Masks

Sheet masks are a perfect pick-me-up for days when you’re feeling tired
and dull. These masks are cut-outs of paper sheets in the shape of a face,
which are infused with an extra boost of actives in a serum formulation.
These masks are also perfect for sensitive skin types, as they can be
relaxing and calming. If you are unsure whether the product will suit you,
follow these instructions. Open the packet, squeeze out some of the liquid
(serum) and do a patch test on your neck for at least twenty minutes before
you apply it on your face.
But do you really need such a big dose of serum? The truth is that if you
are regular with your skincare routine and follow your a.m.:p.m. routine to
a tee, you don’t necessarily need this step. If you still feel the need for it,
use these masks once a week to pamper and relax your skin and mind. Just
remember that if you find yourself reaching for sheet masks too often, you
must revisit your skincare routine and ensure that you are following it
correctly.
Hydrogel masks, on the other hand, are more pampering. I got my hands
on this product for the first time in South Korea, and I simply loved them!
They give you a five-star experience and are extremely refreshing, cooling
and luxurious. Use them if you want to wind down and chill out!

Pro-tip

Use a sheet mask with an ingredient that is not in your daily skincare
routine. If you don’t use a cream with anti-ageing benefits or for skin
brightening in your daily routine, use a sheet mask with those specific
ingredients to bridge the gap.

Clay Masks

Almost all of us have used multani mitti in a face mask. Also known as
fuller’s earth, multani mitti is a clay that drinks up oil, dirt and pollution
from the skin, leaving it clean and polished. The main ingredients of all clay
masks are kaolin and bentonite. These ingredients help in the absorption of
excess oil, shrink pores and give the skin a smoother finish. There are
extensive studies in medical journals that shed light on the benefits of
bentonite clay not just for oily and acne-prone skin but also for irritant and
allergic dermatitis and diaper rash.* So, if you are acne-prone, face masks
containing these ingredients are the perfect choice for you. They won’t rid
you of acne, but they will help diminish the size of acne and help it dry out.*
People with dry and dehydrated skin types should skip these types of face
masks.

Mud Masks

Mud masks and clay masks are twin sisters! They may look similar but are
inherently different, having different properties. I can vouch for this,
because I have twins myself! Mud masks are water-based and have
excellent spreadability, but resist running by becoming viscous again
instantly.† They clean away dead cells and dirt from skin without drying it
out; so they are also hydrating. These types of face masks are ideal for dry,
dehydrated and normal skin types.

Cream Masks

Do you remember the famous Pond’s advertisement with the jingle,

‘Googly Woogly Wooksh’? The skin wobbling with just the flick of a
finger? Well, this is the perfect example of great marketing. No product in
the world can make your skin wobble like that in just twenty minutes. No
product can magically transform your skin into that as soft and supple as a
newborn’s (unless you are getting dermal fillers injected into your face).
But that said, cream masks do help give skin a super dose of hydration.
Cream masks are perfect for people who have droughty skin. What’s
‘droughty skin’, you ask? It’s people with dry and dehydrated skin. But
even those with combination and oily skin types, who experience parched
skin days in winter, autumn or even windy days, can use a cream mask,
which is the best rescue treatment in such times.

Bubble Masks

These are the best masks for Instagrammers! The sound of the bubbles, the
tingling sensation—these masks seem to be the most scientific yet fun
masks conceived. But is it really worth it? Think of it like this: Bubble
masks are like a Rohit Shetty film—they are momentarily fun, but don’t
expect concrete results from them. It will be full entertainment and
complete paisa vasool. These masks are essentially made of clay, so even
though the bubbles don’t do much, the clay definitely absorbs the oil and
gives your skin a smoother finish. Go on, click some selfies with your
bubble mask on and enjoy the experience—it won’t do your skin any harm.

Charcoal Masks

This is another type of face mask that has been popular for a very long time.
Many local market brands have also ventured into making charcoal sheet
masks, face masks, soaps and what not. When we think of charcoal, we tend
to have an image of oil and dirt getting sucked out of our skin. In the world
of medicine, charcoal is used in cases of poisoning for absorption of toxic
substances, which are then removed by the body. So that is why we
associate charcoal with the removal of toxins. But can charcoal face masks
really do that?
Let’s first understand what we mean by the word ‘toxins’. Toxins for skin
are really just a figure of speech. By definition, toxins are poisons produced
by organisms. When it comes to skin, toxins are dirt and pollutants. This
might break some people’s hearts, but the fact is that there is no evidence
that charcoal can remove any ‘toxin’ from our skin. However, many
companies claim that it can absorb excess oil from the pores and clean up
dirt as a clay mask does. So, if you have oily or combination skin, it’s fine
to use a charcoal mask. Just don’t bank on it being your knight in shining
armour if you are acne-prone.

Peel-Off Masks

Some people love them; some have their reservations. Even though the
peel-off technique does exfoliate your skin a bit, it is more of a marketing
gimmick. There are various articles in medical journals that state its
benefits and, hence, peel-off masks can actually stand your skin in good
stead. On evaluation of skin by a corneometer after application of a peel-off
mask, it was observed that the epidermis was more moisturized owing to a
decrease in TEWL.* So, due to the occlusive effect of the mask, your skin
becomes more hydrated. And along with that, you get that satisfaction of
peeling off dead skin cells as you peel off that mask. What else do you
want? Just choose your mask based on the actives that suit your skin type
and condition.

Which Face Mask Is Right for You?

When you are choosing a face mask, it is important to consider the

ingredients that will benefit your skin. After all, these masks are simply
vehicles to deliver star active ingredients to it. Consult this table to
understand the right ingredients for your skin type and condition.
 Skin Condition Type of Masks and/or Actives to Be Used
Oily to combination skin Clay mask, charcoal mask, bubble mask
Dry skin Mud mask, cream mask
Sensitive skin Mud mask, sheet mask with aloe vera and camomile
Dehydrated skin Mud mask, sheet mask with hyaluronic acid and vitamin
E
Normal skin Any mask of your choice
Acne-prone skin Masks containing salicylic acid and benzoyl peroxide
Dark spots and pigmentation/skin Masks with vitamin C, kojic acid, azelaic acid, AHAs and
brightening liquorice
Fine lines and wrinkles Masks with vitamin C, vitamin E, resveratrol, peptides
and retinol

DIY Face Masks

Home-made masks are a great way to pamper your skin on a budget,

because you can simply make them using ingredients in your kitchen.
However, I don’t recommend relying on them completely, since formulation
matters and DIY masks aren’t that effective. In Chapter 2, I have provided
some recipes for home-made masks. To summarize, aloe vera and cucumber
are wonderful to calm your skin; milk and yogurt can be perfect for mild
exfoliation and skin brightening; avocado and honey are skin hydrators; and
turmeric has excellent antibacterial properties. Just don’t be too
experimental—these ingredients are better eaten than used on the face!

Tips to Maximize the Results of Your Face Mask

1. Always cleanse your face before you apply a face mask. Double-
cleanse if you had make-up on.
2. After washing off the mask from your face, apply a moisturizing
lotion or a thick moisturizer (according to your skin type) to seal in
the active ingredients of the mask.
3. Use a mask at least for a month (four to eight times) to see its
maximum benefits.
4. If you have combination skin and your T-zone drips oil but your
cheeks are dry, you can even multi-mask. Use an exfoliating mask
or mask for oily skin on your T-zone, while you use a mud mask on
your cheeks.
5. Do not leave the mask on for longer than twenty minutes. This will
do no good at all.
6. Expensive masks are not necessarily the best ones. Find a mask
with appropriate ingredients according to your skin type.

My Favourite Face Masks

1. Shangpree Marine Jewel hydrating sheet mask

2. The Body Shop vitamin C glow sheet mask
3. Dot & Key glow reviving vitamin C pink clay mask
4. Earth Rhythm Australian pink clay mud mask
5. Myoho Pure by Priyanka rose blush clay mask
6. Sesderma C-Vit Radiance revitalizing mask (cream mask)
7. Dot & Key energizing bubble clay mask
8. Vilvah charcoal face mask
9. Depiwhite Whitening peel-off mask
10. Diet Esthetic Vit C+E ultra whitening peeling mask
 9
THE EXTRAS: TONERS, FACE MISTS AND BB
CREAMS

There have always been varying views on the use of toners. When I was
growing up, toners were considered an extra cleansing step, something that
took off any traces of make-up on the face after cleansing. Most toners back
then also contained alcohol and thus tended to have an astringent or
stinging sensation when they came in contact with skin. Their alcohol
content was what led many dermatologists to consider toners the villain in
one’s skincare routine. Products with a high alcohol content can strip the
skin of moisture and essential oils, irritating it, damaging the skin barrier,
leaving it dry and making it the perfect breeding ground for acne and other
infections.
When I was doing my MBBS, I heard many contrasting views from
doctors on whether toners were useful. In fact, even today, no dermatologist
or aesthetic physician actually studies about the use of toners in their
course. Since the information out there was so contrasting, three years ago,
I decided to take matters into my own hands and do a six-month test to
check whether toners really worked. I tried every toner under the sun in my
a.m.:p.m. routine. From rose water, lemon balm and tea tree to camomile,
lavender and toners with AHAs. Finally, I came to the conclusion that
toners are wonderful products, but you need to choose the right one. Not all
toners contain alcohol, and this is where the fun begins. But before we get
to the types of toners, let’s understand their function.

The Skin’s pH and Toners

The pH of water is around 7. When we wash our face with water, our skin’s
pH can turn a bit alkaline. But, ideally, the pH of our skin should be more
acidic (5.5, to be precise), because at this level, our skin health is at its
optimum. Toners act as a pH-balancing mechanism, protecting your acid
mantle and hydrating your skin.

Think of it like this: Your skin is like a sponge. When your skin is a little
wet after the use of toners (hydrated, with balanced pH and extra-beneficial
ingredients) and you apply a serum on it, the active ingredients can get
absorbed better in this wet sponge and penetrate your skin deeper.

How I Use Toners in My Routine

I double-cleanse my face, spray a toner and then apply my favourite serum.

I prefer either spraying or dabbing a toner on my face with my fingers
rather than wiping it with a cotton pad. This not only avoids extra dragging
on my face, it also leads to less wastage of both cotton pads and the
product, because cotton pads tend to absorb a larger quantity of it.
The difference I have observed after adding a toner to my skincare
routine was rather astonishing and impressive. To tell you the truth, I was
not expecting toners to do such wonders to my skin. The changes I noticed
after using them regularly (and I’m quite regular with my skincare routine)
was that my skin became smoother, shinier, dewier and my open pores
became less visible. So my skin was on its way to becoming ‘glass-like
skin’. Toners are ‘altruistic’, because the results I saw on my skin were not
just because of the effects of the toner’s ingredients but because it had a
symbiotic relationship with the serum I was using. Basically, the toner helps
the active ingredients of the serum get absorbed much better into the skin.
Everyone should include a toner in their skincare routine, but they must find
the right one. Their skin will definitely thank them for it. Refer to the
ingredients on p. 133 to check what suits your skin type or condition.

Pro-tip

Do not expect your skin to feel tighter after using a toner. If it feels tight,
you are probably not using the right type of toner. Toners should hydrate
your skin and make your skin feel fresher.
Always spray or dab the toner with your fingertips on your face and
avoid cotton pads to protect both your skin barrier and the environment.

What Are Face Mists?

There is a lot of confusion about face mists and the difference between
toners and face mists. It is even more confusing now, because both toners
and mists are available in spray bottles. The truth is that there is a very thin
line between these two products.
While toners contain certain active ingredients that clean your skin even
in the deeper layers of the epidermis, removes excess oil and dust, reverses
the effects of pollution and preps your skin for moisturization, a face mist is
more hydrating and contains nourishing oils that help lock in moisture, set
your make-up and shield your skin against pollution. So a toner is used
before you apply your moisturizer and a face mist is used after you apply
your moisturizer.
So, to put it simply:

Cleanse → Tone → Serum → Sunscreen/+ Moisturizer → BB

Cream/Make-Up → Face Mist
Do You Need Both a Toner and a Face Mist in Your Skincare
Routine?

If you want to choose between the two, choose a toner. This product works
for all skin types. If you have dry, dehydrated skin, it aids in the absorption
of the serum and the moisturizer. So it will give you long-term benefits and
improve the quality of your skin.
Not that I don’t like face mists. They give you a dewy finish and, once
sprayed, make your skin look glass-like, but they have limited long-term
benefits. So I don’t feel guilty if I sometimes skip this step in my skincare
routine. When I want the ultimate glowing skin, I make sure I spray on a
face mist. If you are a skincare enthusiast, definitely give it a go. However,
if you have just started or if money is a constraint, you can skip this step.

Pro-tip

Carry your face mist on the go. They are particularly handy in flights.
Spray it on to avoid dehydration.

Remember, only water sprays on skin can further dehydrate it.

My Favourite Toners and Face Mists

Toners

1. Juicy Chemistry Bulgarian rose water toner

2. Vilvah pure rose water facial toner
3. Earth Rhythm lemon balm hydrating toner
4. Earth Rhythm Alpha Glow Tonique exfoliating toner
5. Indulgeo Essentials pore minimizer spearmint and basil toner
 Face Mists

1. Pixi Glow mist with propolis and argan oil

2. Avene thermal spring water face mist
3. Clinique moisture surge face spray
4. La Roche-Posay thermal spring water
5. The Body Shop vitamin E face mist

BB and CC Creams and How They Work

BB and CC creams are another wonderful invention by the South Koreans.

But do we really need them? This is not a product to treat the imperfections
of skin, but, rather, to hide them! Blemish balms, as they are called, are not
as thick as foundations but are heavier than tinted moisturizers. CC creams,
or colour-correcting creams, are their elder sister. They colour-correct skin,
plus have infused active ingredients with benefits for the skin.
Theoretically, CC creams are considered to be an improved version of BB
creams, which have a more whipped, fluffy and mousse-like finish, but
practically speaking, skincare brands have different formulations of both
these products and, often, these two end up being almost the same.
Both these creams are essentially blemish-correcting creams that leave a
little tint on the face and even out the skin tone, making your skin look
flawless, with additional hydrating and antioxidant benefits on a no-make-
up day.

How to Use Them

After moisturizing and applying sunscreen, dot the cream all over your face
and blend it in. These products may also have SPF mentioned, but that will
never be enough. Always have a dedicated sunscreen product. It’s better to
buy a tinted sunscreen with a lighter formulation that won’t make you look
cakey.
What to Remember When You Buy Them

BB and CC creams are best for people who have acne or acne-prone skin,
because they are traditionally lighter in texture than foundations or
concealers. Look for an oil-free, non-comedogenic formula. Also remember
that BB and CC creams are not serums. Get a dedicated serum to do the
heavy lifting and let a BB cream do its job of hiding blemishes and giving
you a smooth finish.

My Favourite BB and CC Creams

1. Noreva Exfoliac light tinted anti-imperfections care

2. La Roche-Posay Effaclar BB blur
3. Bioderma Photoderm Max 50+ compact mineral
4. Heliocare Color oil-free compact SPF 50
 10
HOW TO TREAT PROBLEMATIC SKIN

Mountains on Our Skin: Acne, Pimples, Zits

Zits, ugh. The bane of everyone’s skincare. Just when you think you have
things under control, they appear out of nowhere, as if saying, ‘Gotcha! I’m
back!’
Acne is the villain in skincare. No one likes to have it, and everyone
should have a hero product in their skincare arsenal to battle this villain
when it appears. However, let me make one thing clear right at the start—a
zit or a pimple is not acne. Acne, better known as acne vulgaris in a
dermatologist’s world, is a serious skincare condition. Those who suffer
from acne are familiar with the toll it can take on their emotional health,
especially in their teenage years, when self-presentation takes on a crucial
meaning. Acne is no laughing matter, because those who suffer from it can
also be wracked with self-doubt, anxiety and low self-esteem. So the next
time you get a pimple or two, don’t call it acne, because someone who does
have acne will tell you to thank your lucky stars.

What Is Acne?
Acne is a disease of the oil gland, or the pilosebaceous unit. It occurs more
commonly in males. Although it is a pretty severe skin condition, it is also
extremely common and is most prevalent in adolescence, lingering on until
one’s early thirties. However, acne can also strike adults between the ages
of forty and fifty.
During the COVID-19 lockdown, patient consultation became extremely
challenging. At the time, I decided to start online consultations to reach my
patients. I was overwhelmed by the response. I consulted more than
150 patients in a matter of a few months, not just from India but also from
Dubai, Oman, Bangladesh, the United Kingdom and even Kenya. Acne and
post-acne pigmentation was a concern for more than 50 per cent of these
patients. When acne is treated with correct medication, it responds
immediately, but the pigmentation and dark spots that crop up after a bout
of acne take a few months to fade. It is crucial to know that acne scars
cannot be treated effectively with any topical agent— they require in-clinic
treatment.

How Does One Cure Acne?

It’s simple. In all these years, my answer has never changed: Go see a
dermatologist to get it treated!
Acne needs proper diagnosis and correct therapy to cure. About 20 per
cent of affected individuals can develop severe stages of acne, which can
end up scarring their face. And there is no treatment that can cure these
scars completely.* Because we Indians have brown and darker skin, we can
develop severe dark spots, which are extremely resistant and difficult to
treat. Thus, early treatment is essential, helping clear the skin faster and
preventing acne from worsening.
But before we go into cures, let’s look at acne in detail to better
understand this condition.

The Many Stages of Acne

Acne can occur on various body parts, such as our face, our back, the upper
part of our trunk and the shoulders. It has various stages and can appear in
multiple stages at the same time. I’ll explain them in an easier way. Since
almost all of us have watched The Queen’s Gambit, I’m going to describe
the various kinds of acne as if they were pieces on a chessboard.

1. Comedones: Commonly known as blackheads and whiteheads, and

also as clogged pores, these are the pawns (sipahi) on a chessboard.
They are very common and are not problematic. Blackheads, or
open comedones, sprout when the opening of the oil-gland duct is
blocked by keratin/dead skin cells and sebum on the skin’s surface.
Whiteheads, or closed comedones, develop due to blockage of the
duct below the skin’s surface.
2. Papules: These are the rooks (haathi) on a chessboard. They are
slightly more severe than comedones, but not quite. Papules are
small bumps (or hills) on your skin that are inflamed and have
associated redness/erythema.
3. Pustules: The knights (ghoda) of chess, these pus-filled lesions can
be dangerous if not taken care of.
4. Nodules and cysts: As the king and queen on a chessboard, they
have the maximum power and are the most dangerous. They must
be dealt with immediately, or you may lose the skincare game.
Most pus-filled lesions coalesce to form nodules and cysts.

What Causes Acne?*

Here are the most common causes:

1. The genetic factor: Acne is a hereditary condition, so if it runs in

your family, you have a 70 per cent chance of developing it.
2. The endocrine factor: The androgen hormone is responsible for
increased sebum production and the development of acne. Women
with masculinizing tumours can develop acne. Oestrogen is an acne
 suppressant, in a way, and the reason women are less prone to it, as
compared to men. High oestrogen content suppresses sebum
content and reduces the development of acne. Therefore, women on
oral contraceptive pills (OCPs), which have oestrogen content, have
less incidence of acne. In fact, OCPs are used as treatment. And the
time just before a woman’s period—when oestrogen levels fall
significantly—is a ripe time for acne.
3. Bacterial infection: The P. acnes (Propionibacterium acnes)
bacteria are naturally present in the oil glands and may induce the
formation of acne pustules.
4. Cosmetics: Various cosmetics, oil-based greasy products and
foundations can clog the skin’s pores and lead to acne.
5. Chemicals and drugs: Corticosteroids, chlorides, iodides,
bromides, lithium and chemicals can induce acne.* Steroids taken
by body builders are a very common cause of acne, specially on the
shoulders, chest and back.
6. The stress factor: Even though stress is not linked directly to acne,
it can increase the chances of you picking on the skin, and
mechanical excoriation (abrading skin) of acne, which can
complicate things further.
7. Diet: This may not be the single-most important factor, but dairy
products and products with a high GI can aggravate acne. The
hormones in dairy products can increase androgen levels in blood,
which can stimulate acne. Even foods with a high GI can stimulate
insulin production, which, in turn, can increase the production of
androgens and produce acne. Many patients also observe
aggravation of acne due to other food items. Therefore, I always
advise my patients to maintain a food diary, because, in my
experience, many food items such as mangoes, meat and even
brinjal can induce acne. However, this can vary from one individual
to another.
8. Weather and environment: Acne can be aggravated in hot and
humid conditions as sweat, along with sebum, dirt and dead skin
 cells, can clog the skin’s pores.

Other Common Forms of Acne

1. Pomade Acne

Do you have zits on your forehead, along your hairline, and at the back of
your neck?
Are these bumps so small that you can only feel them and sometimes not
even see them? This is pomade acne, and the main culprits behind this are
hair-oil products, gels, mousses, conditioners, hair sprays and even hair
serums. These styling products can clog your skin’s pores and lead to the
formation of whiteheads and papules (the pawns and the rooks,
remember?). If you want to prevent their formation, keep your hair off your
forehead. Bangs may be cool, but sometimes they won’t give your skin any
bang for your buck!

2. Fungal Acne

Do you have small, acne-like dots across your forehead or cheeks, which
don’t clear even with antibiotics and acne medication? If this is the case,
chances are that you have Malassezia folliculitis, commonly called fungal
acne.
Fungal acne is commonly misdiagnosed as acne vulgaris. The truth is
that it can be challenging to diagnose, because it looks similar to acne
vulgaris. However, this isn’t acne at all. There can be multiple causes of
acne—bacteria, sebum, hormones and even fungus (yeast). In the case of
fungal acne, the yeast that is naturally present in our skin multiplies and
spreads, resulting in bumps.

How to Differentiate between Fungal Acne and Acne Vulgaris

Commonly seen in adolescence, fungal acne presents itself as monomorphic
lesions that appear either as only papules (red bumps) or as only pustules.
They are usually present on the chin and the sides of the face, chest, upper
back and shoulders. They are associated with itching and redness. So if you
ever see a cluster of bumps on your face or your chin, it might just be
fungal acne.*

3. Adult Acne*†

As a teenager, I constantly suffered from acne. But it wasn’t as debilitating

for me, because many of my friends were also going through it. My friends
used to call them ‘crush pimples’, which meant that every time a pimple
appeared on our faces, it was a sign that someone was ‘crushing’ on us! I
truly believed in it, and every new pimple became a reason to celebrate.
Silly as it seems now, it helped me ride out the teens with a certain lightness
of being. In my twenties, my acne finally began to subside and I breathed a
sigh of relief, assured that I was out of the eye of the storm. But during my
junior residency in dermatology, I was surprised to learn about the frequent
occurrence of adult acne. Its horror gripped me, especially because I learnt
that the treatment that worked wonders for teenagers could be quite useless
in adults. There’s nothing more frustrating than getting acne when you’re an
adult. But here’s the thing—there’s no time limit for acne.
Adult female acne usually affects women above twenty-five years of age
and can even strike in your thirties, forties and fifties. It is commonly seen
in women going through menopause. Various triggers, such as fluctuating
hormone levels, exposure to UV rays, increased stress, sleep disorders,
obesity, smoking, cosmetics, contraceptive medication and excessive skin
washing, can aggravate it and make its course longer. It was believed that
adult-onset acne usually presents on the lower part of the face, on the
jawline and the perioral (around the mouth) region, but it can actually affect
multiple areas such as the forehead and the cheeks as well. People who
have adult acne can also suffer from more sensitive and oily skin, which can
make one’s skin more intolerant to skincare products.
How Can You Prevent Adult Acne?

We don’t have control over our hormones, but we can be mindful of our
skincare routine and the products we use on our skin. Here are three
guidelines on reducing the chances of adult acne:

1. Make sure you don’t overexfoliate your skin, and always use a
gentle cleanser that protects the skin barrier.
2. Moisturize your skin well, both day and night, to prevent TEWL.
3. Make sure you use non-comedogenic skincare products.

The Not-So-Bad Acne: Skin Purging

Sometimes, when you use a new skincare product, begin new acne
medication or go for a chemical peel, you may notice a flare-up of acne.
Your skin gets worse before it gets better. This is purging, in short. This
usually begins within a week of starting a new product or treatment and
may last for another two to four weeks. The culprits are usually various
chemical exfoliants, AHAs, BHAs and retinoids. So purging causes flare-
ups on your skin due to active ingredients in your product, which increases
cell turnover rate.
Is purging an allergic reaction? Not exactly. An allergic reaction will
make your skin red and itchy, and can also be painful. However, when the
skin purges, there will be an increased number and severity of similar
lesions that you already had. Sometimes a comedone (blackhead) might
convert into a pustule.

How to Prevent Purging

If you are starting to use a new skincare product containing acids or

retinoids without the guidance of a skin specialist, make sure to go slow and
steady. When it comes to active ingredients, it’s the turtle, not the hare, that
wins the race. Start with once a week. Assess how your skin reacts. Then
gradually increase application to twice a day. Keep at it until you are
confident you can use it more often. This will allow you to gauge the
suitability of the product and limit any purging in the first place.
Today, the market is flooded with acids and retinoids. If something is
already working for you, don’t be tempted to fill your skincare kitty with
shinier new things when it comes to these potent ingredients. You don’t
need a face wash, a toner and a cream with AHAs and BHAs. Less is
indeed more in this category of skincare products.

My Favourite Products for Acne-Prone Skin

Cleanser

1. Berkowits tea tree face wash

2. Bioderma Sebium gel moussant
3. Liteglo face wash

Moisturizing Cream

1. Avene TriAcneal cream

2. Acrofy moisturizing lotion
3. Cetaphil DAM ultra-hydrating lotion
4. Sebamed clear face clear gel

Sunscreen

1. Episoft SPF 30 moisturizing sunscreen lotion

2. Avene day protector sunscreen SPF 30
3. Berkowits SPF 50 sunscreen gel

PCOS and Acne

Radhika, a seventeen-year-old girl, had facial acne, coarse hair growth on
her face and back, thinning hair on her scalp and patches of dark skin on her
neck and underarms. She was also having irregular menses for the past six
months. Radhika had a classic case of PCOS.
PCOS is a hormonal and lifestyle disorder that affects 5–10 per cent of
women in the reproductive age group.* Lack of exercise and proper diet,
and stress are the major contributing factors to the symptoms. PCOS is
associated with increased levels of androgen and insulin. Due to insulin
resistance, there is a rise in blood-glucose levels, which may also cause
weight gain. The rise in androgen levels leads to symptoms such as acne,
facial hair and hair loss. Sometimes, women suffering from PCOS may
have a normal body mass index (BMI) with normal menstrual cycles, and
still suffer acne on their jawline and chin. At other times, they won’t have
acne and hair loss but will have irregular menses. Whatever symptoms they
present, it is very important to treat the underlying problem, not just the
symptom.
Whenever a patient comes to me with symptoms of PCOS, I first advise
them to change their lifestyle. Most patients get treated effectively by
lifestyle modification. A little exercise, diet control and weight loss help
balance the hormones and improve symptoms. For the rest, hormone
medications, such as oral contraceptive pills, metformin and spironolactone,
remain the mainstay treatments, which, however, should be taken only
under medical supervision.

Dark Circles

Recently, two of my regular patients—mother and daughter—visited my

clinic for the first time after the six-month lockdown. During that time, they
hadn’t taken any treatment. To my surprise, I saw that the daughter’s under-
eye hollows had significantly deepened and she looked extremely tired.
However, her mother looked fresher. In the COVID-19 era, working from
home has blurred the already-thin line between work and personal life.
People working with multinational companies are, in fact, sitting in front of
their laptops for longer hours. They can never switch off, and hence, have a
more stressful life. This has increased the occurrence of dark circles, which
can make one look tired.
Before I discuss some quick tips to treat dark circles, it is important to
know their cause—and, unfortunately, the list is long. Do your parents or
immediate family members also have dark circles? If yes, the reason for
those shadows under your eyes is hereditary and, unfortunately, there is no
treatment that can erase them. Dark circles can also occur because of the six
As and six Ss. This is just a simple mnemonic that can help you remember
the various causes.

The six As are:

1. Agitated rubbing of your eyes due to dryness, which can break the
small capillaries and lead to dark circles.
2. Increase in Age.
3. Iron deficiency, Anaemia.
4. Allergic condition called atopic dermatitis.
5. Allergy to any component of make-up, kajal and creams.
6. Increased Alcohol and coffee intake.

The six Ss are:

1. Increased exposure to the Sun.

2. Smoking.
3. Stress.
4. Lack of Sleep.
5. Increased Screen time.
6. Spectacle time—if you are myopic and avoid wearing spectacles,
the fatigue in your eye muscles can also increase the incidence of
dark circles.

Treating Dark Circles

If you can identify with any of the six As or six Ss, prevent or correct the
cause and you will see a huge improvement (about 60 per cent) within a
few months. Additionally, follow a regular a.m.:p.m. routine (see p. 206),
wear sunscreen and sunglasses or even a hat to protect your face from direct
sun exposure and further worsening the dark circles.
If nothing else works, cosmetic camouflage is an effective way to conceal
under-eye dark circles. To hide them effectively, first apply a dark-coloured
or orange corrector concealer and top it up with a light foundation to
instantly brighten up the eyes.

My Favourite Under-Eye Dark-Circle-Removal Creams

1. Sesderma under-eye K-vit serum

2. Reverzo under-eye gel
3. Wunder Eye Advance gel
4. Depiwhite eye contour gel
5. Fixderma under-eye cream
6. Avarta under-eye cream

Pro-tip

Make sure you apply the under-eye cream or serum twice a day, before
any moisturizer, so that it gets completely absorbed into the skin. Apply
it for a minimum of three months to see benefits.

Treatments at the Clinic

One of the most common concerns of millennials these days is under-eye

hollows. These hollows are called ‘tear trough deformity’. These can be
genetic, due to different skin textures and thickness of the skin below the
eyes, loss and downward shift of fat, gaps between the muscles below the
eyes, and age-related bone loss. These causes might sound a bit complicated
but the treatments are simple.
A hyaluronic acid dermal filler is a one-shot, fifteen-minute procedure
that corrects under-eye hollows instantly, and the result remains for about
twelve to eighteen months.
I have explained in detail how the treatments are done at the clinic (see p.
258). Here are some of the treatments to correct under-eye hollows in brief:

1. Chemical peels: Glycolic acid, lactic acid, kojic acid and arginine
peel are effective agents to correct dark circles.
2. Q-Switched Nd:YAG laser: This is an effective treatment to even
remove the deep pigmentation under the eyes.
3. Mesotherapy: Skin-lightening solutions can be coupled with
hyaluronic acid solutions for hydration.
4. Platelet-rich plasma: This improves collagen production, blood
supply and the overall quality of skin under the eyes.
5. Botox and threads: These are effective for crow’s feet and mild
wrinkles around the eyes.
6. Combination treatments: A combination of topical under-eye
creams mentioned above, along with clinic procedures, give the
best outcome.

Milia

Do I have milia? This is one of the most-searched skincare questions on the

Internet. And it’s because this is a unique lesion witnessed in almost all age
groups. I’ve seen milia in a five-year-old patient, my twenty-five-year-old
cousin and my fifty-five-year-old mother. The thing is, milia doesn’t
differentiate between age and gender, and works in a certain way.
Milia are keratin cysts that form due to trapped dead skin cells below the
skin. Also called ‘milk spots’, these dome-shaped, smooth, white bumps,
which are usually less than 3 mm in diameter, are commonly seen around
the eyes and on the cheeks. Most people mistake them for whiteheads. But
unlike whiteheads, you’ll find that if you squeeze them, they will not pop
and ooze gunk.
Milia can be congenital (i.e., from birth) or develop more frequently in
people who have sun-damaged skin or in those who use harsh skincare
products that cause skin abrasion. They may also develop in people who use
topical steroids for a prolonged period and due to intake of non-steroidal
anti-inflammatory drugs (NSAIDs).*

Treating Milia

Unless they are congenital, these small lesions won’t subside on their own.
If they are acquired, they will remain unless treated with topical creams or
surgical intervention. Here are some of the best treatments:

1. Topical retinoid creams: These are the most effective agents for
milia correction. However, it is a slow process and may take weeks
to show results. (These creams must not be used by pregnant and
lactating women.)
2. Radiofrequency electrocautery: This is a clinical procedure that is
effective and also much quicker.
3. Other treatments: Chemical peels, microdermabrasion, laser
ablation and cryotherapy can also be done.

Pro-tip

After treatment of milia, make sure you add a chemical exfoliant or a

retinoid cream in your regular skincare routine to prevent its recurrence.

Skincare Routine to Prevent Recurrence of Milia

 1. First-cleanse with micellar water, cleansing oil or cleansing
balm.
2. Second-cleanse with a gentle face wash (Berkowits clear face
wash or Bioderma Sebium gel moussant).
3. Tone with an acid toner such as Earth Rhythm Alpha Glow
Tonique.
4. Moisturize the skin with a light moisturizing lotion (Cetaphil
DAM ultra-hydrating lotion or Acrofy moisturizing lotion).
5. Use SPF 30/50 (Berkowits SPF30/50 sunscreen gel or ISDIN
fusion water SPF 50).
6. Use retinol creams or acid-containing creams at night.
7. Use a gentle scrub or a face mask two to three times a week.

This is not a medical prescription. If your milia still recurs, please visit a
dermatologist for prescription drugs. Retinoids should not be used when
pregnant or breastfeeding.

Ingrown Hair

This is a common skin concern for both men and women. In men, ingrown
hair is most commonly found in the beard, the scalp and the back, while for
women it’s on their legs, underarms and pubic area. Also known as
pseudofolliculitis, this condition can be caused by shaving, plucking and
even waxing. It usually happens when thick, curly hair emerges from the
skin at acute angles and gets trapped beneath the skin again, causing bumps
that may become inflamed, painful and itchy. Even if they don’t cause
painful bumps, their presence is not aesthetically pleasing and they may
also leave a dark spot behind, which can be a matter of concern to many.
Ingrown hair can resolve on its own if the particular hair is allowed to grow
to a length of 10 mm. This usually pulls out the hair spontaneously from the
growing bump.*

How Can Ingrown Hair Be Prevented?

 1. Always wash your skin with warm water or with a creamy soap or
cleanser before shaving. Women can even apply shaving cream
before they shave.
2. Always use a sharp multiblade razor to shave.
3. Do not stretch the skin taut when you shave. If you do this, as soon
as you release the tension, the hair will go back inside the skin and
your skin will react to it as a foreign body and cause
pseudofolliculitis.
4. Always shave your hair in the direction of hair growth.

Treating Ingrown Hair

Here are a few things you can do to treat ingrown hair:

1. Stop shaving for at least four weeks.

2. Try to free the ingrown hair with sterile forceps.
3. Use other hair-removal methods such as an electric razor or a
depilator. Laser hair reduction is ideal in such conditions.
4. If the above methods are insufficient, topical antibiotics such as
clindamycin and benzoyl peroxide are effective.
5. You can use salicylic acid gels (such as Canixa Zitcare-S gel or
Glowderma Sebonac gel) on the affected area once a day until there
is improvement.
6. You can gently physically exfoliate the affected area using a
pumice stone once a day. Moisturize it well after exfoliation to
ensure barrier repair.

Dark Lips

Have you noticed that when you use a certain shade of red, your teeth look
whiter? It’s the same for your lip colour. When your lips are bright, your
smile is also brighter! Beautiful pink lips have always been considered a
sign of beauty. It’s why so many Bollywood songs obsess over lips. Healthy
lips are a sign of healthy skin too. But, often, people find that their lips have
grown darker with time.

What Causes Dark Lips?

The most common culprit is smoking. I’m not going to lecture you on why
smoking is bad, because you should already know by now. Not only will it
affect your skin, smoking also negatively impacts your overall health.
Excessive sun exposure, increased caffeine intake, allergic reaction to
fluoride in toothpaste and cosmetics, using long-wearing lipsticks and not
removing them before going to bed, excessive lip licking, deficiency of iron
and vitamin B12, and intake of certain drugs such as tetracyclines and
antimalarials can also cause darkening of lips. This condition can be
hereditary too, so if it runs in your family, understand that it is in your
genes.

Treating Dark Lips

The easiest way to treat dark lips is to avoid the cause. If any of the above
factors (except it being hereditary) is part of your lifestyle, simply delete it
from your life. Here are some tips to bring some pink back into your lips:

1. Use topical creams containing depigmenting actives such as

liquorice, kojic acid, vitamins C and D, and arbutin.
2. Use a lip balm containing SPF every day. The good news is that
even opaque lipsticks contains high levels of titanium dioxide,
which protects your lips from harmful UV rays. So if you are not
allergic to lipstick, go on and colour your lips. Just make sure you
remove it every night before you hit the bed.
3. Treat your deficiencies.
4. If you are allergic to lipsticks, the most common ingredient that
causes the allergic reaction is castor oil. Switch to biway polymer
 lipsticks, which don’t contain any castor oil. These lipsticks usually
have a lip gloss on one end and a lip colour on the other.
5. Scrub your lips every other day with a home-made scrub containing
coconut, honey and sugar, which will hydrate your lips and reduce
the pigmentation on them.

Treatments at the Clinic

1. Chemical peels: Glycolic acid, lactic acid, kojic acid and mandelic
acid are excellent agents for lip lightening.
2. Q-Switched Nd:YAG laser: This is an effective treatment to
remove deep pigmentation from your lips.
3. Dermal fillers: A few drops of dermal fillers will instantly plump
up and hydrate your lips.

My Favourite Products for Lip Lightening

1. Lipzlite lip-lightening cream

2. Kojivit Plus gel
3. Sebamed lip defence balm with SPF 30

Stretch Marks

Lean structure and twin pregnancy? Hello, stretch marks!

This subject is personal to me, because in my sixth month of pregnancy,
when I started gaining significant weight, the skin around my abdomen
started to itch. During those months, I did not see the formation of any
stretch marks, but I knew that the itching was a tell-tale sign that stretch
marks were on their way.
Stretch marks don’t just happen post-pregnancy. They can occur at any
point in your life. They can be genetic, can occur in obese people due to
rapid weight gain, bodybuilders, in those with hormonal problems such as
Cushing’s syndrome, and can even happen after the use of oral and topical
steroids. Topical steroids can be problematic when used with abandon. I
have seen far too many people reach for or being prescribed topical steroids
even if they have a mere fungal infection. This rampant use of steroid
creams not just leads to the formation of stretch marks but also thins out the
skin.
It is important to know that there are two types of stretch marks, because
it is the single-most important factor that determines whether they will
respond to treatment.

1. Stria Rubrae: These are red to reddish-brown in colour and are

fresh stretch marks. They can be slightly raised and itchy. They are
more responsive to treatment and will even show response to
application of topical creams.
2. Stria Albae: These are white-coloured mature stretch marks that
narrow down and shrink. These do not respond to topical creams
significantly and must undergo clinic treatment for results.

Both types of stretch marks develop due to a sudden change in collagen and
elastin. Now, if you want effective results, it is extremely important to start
treatment immediately when they develop.

Treating Stretch Marks

It is impossible to completely stop the formation of stretch marks when you

are rapidly gaining weight. However, there are certain steps that can be
followed to restrict their development.

Use a moisturizing soap such as Dove or cleansing shower oils to

cleanse your body.
Always use lukewarm water and avoid hot water while bathing, so
you don’t dry out your skin further.
Immediately after a bath, when the skin is still moist, apply
moisturizing creams rich in shea butter and ceramides, or use
 coconut oil to maintain skin hydration.
Reapply moisturizing creams during the day and the night
whenever the skin feels itchy.
Make sure you drink at least two or three litres of water every day.

I followed these steps religiously for about three months before I had my
babies. However, if stretch marks run in the family, it is better to
incorporate these steps from the third month of pregnancy.
During my last two months of pregnancy, stria rubrae were quite
prominent. It was the first time I had ever seen a stretch mark on my body.
However, I was determined to use the topical moisturizing creams to avoid
the development of stretch marks. I stuck to this routine even after delivery
for the next three months. And my efforts bore fruit. I was so glad to see
about a 60 per cent reduction in my stria with just topical creams. Before
telling you about my favourite products to treat stretch marks, you should
be aware of the various actives that are effective. These are:

1. Almond oil: Rich in vitamin E, which improves skin elasticity.

2. Camomile extract: Decreases skin irritation and itching.
3. Hyaluronic acid: Increases skin elasticity and hydration.
4. Shea butter: Improves elasticity of skin and boosts collagen
production.
5. Tretinoin creams: Most effective for correcting stretch marks.
However, they are contra-indicated during pregnancy and
breastfeeding, and should only be used under a doctor’s
supervision.

Treatments at the Clinic

There are various treatments that can be done at a doctor’s clinic to further
reduce your stria. These are chemical peels, microdermabrasion, PRP
therapy and dermaroller. But the most effective are laser treatments such as
Erbium YAG laser, microneedling radiofrequency and fractional CO2. A
combination of topical creams and in-clinic treatments works best. But,
again, to successfully get rid of stretch marks, make sure you start treatment
when your stretch marks are still fresh.

My Favourite Creams and Oils for Stretch Marks

1. Fixderma Strallium stretch-mark cream

2. Sebamed anti-stretch-mark cream
3. ISDIN Woman anti-stretch marks
4. Bio-Oil skincare oil

Pigmentation

During the lockdown, I, like most of you, spent most of my free time
watching shows online. But I was shocked to find how series such as Indian
Matchmaking, Mismatched and Masaba Masaba still reiterated the fact that
we were obsessed with fair skin. I thought we had put all that behind us
when we had marched into the twenty-first century, and it left me with a
bad taste in my mouth. Why? Because I, too, was once a victim of this
light-skin obsession. From a very young age, we are made to believe that
fair is beautiful and made to use products such as Fair & Lovely. And this
obsession doesn’t spare anyone. Honest confession—it rubbed off on me
too! As a child, I considered my dusky complexion a lack, not a boon. The
many advertisements of Fair & Lovely didn’t help at all.
When I was seven or eight years old, I was so enamoured by fairness-
cream advertisements and the projected dreamy tales, that I fell prey to
them. I would apply these fairness creams every day and wait eagerly for
them to work their magic. It really affected my self-confidence, because
back then I truly believed that I could look good only if I were fair.
Thankfully, I grew up and my mindset changed. While I was doing my
graduation, my skincare was limited but my confidence was at its peak. I
owned my skin colour and celebrated my dusky complexion, and, trust me,
when you love yourself, the world loves you back. You don’t need a green
flag from anybody.
After entering the field of dermatology and aesthetics, I started following
a routine and taking care of my skin—not to become fair but to get ‘glass-
like’ skin, and it was then that I truly celebrated my skin.
There are various depigmenting creams available in the market that I
recommend to my patients, but it’s not with the purpose of getting ‘fair’
skin. These creams are targeted to correct any pigmentary disorder and get
an even skin tone and brighter skin. What is the difference between fair skin
and glass-like skin? Fair skin is an obsession, an expectation in many
people’s mind that their skin colour will change to that similar to Aishwarya
Rai’s if they start using skin-brightening creams. However, whatever
treatment you take, your skin colour improves only up to the most untanned
areas of your body. Also remember that beauty is not just limited to
Aishwarya Rai and Katrina Kaif. Sushmita Sen, Priyanka Chopra and Lara
Dutta, with their dusky skin tones, are just as beautiful.

Causes of Hyperpigmentation

Photomelanosis: Pigmentation of skin due to prolonged exposure

to the sun and UV rays.
Pigmentation around the mouth: Also known as perioral
pigmentation, this can be caused due to use of hair-removal creams,
fluorinated toothpastes and night creams (especially those
containing retinol). Most prominently affects the corners of the
mouth and the chin.
Post-inflammatory hyperpigmentation (PIH): Dark spots left
behind due to acne, skin injury, infection or inflammation.
Pigment contact dermatitis: This happens due to the overuse and
prolonged use of fragrances and cosmetics, and even due to allergy
to kumkum.
Melasma: This appears as brown patches of hyperpigmentation on
the cheeks, nose, forehead and upper lip. They can even present as
 a butterfly patch of pigmentation on your nose and cheeks. This
type of pigmentation can be hereditary, or aggravated by stress and
by taking birth-control pills. It can even flare up before menses or
during pregnancy.
Drug-induced pigmentation: Pigmentation may be induced by a
wide variety of drugs such as NSAIDs, antimalarials, phenytoins,
tetracyclines, and anti-psychotic and anticancer drugs. It can also
be caused due to heavy metals such as silver, gold, mercury and
lead. Some drugs may cause fixed drug eruption, which is a
localized area of pigmentation.
Friction melanosis: This type of pigmentation is caused due to the
constant rubbing of a body part against an object (for example,
elbows constantly rubbing against a table). It commonly presents
on bony prominences such as the elbows, the knees, the ankles and
the upper back. The continuous use of scrub pads and loofahs are
also a common cause for such patchy dark spots.
Acanthosis nigricans: This presents as dark skin patches and
velvety textured skin in folds of the body such as the armpits, the
groin and the neck. This usually occurs in people who are obese or
those who have diabetes, insulin resistance and other metabolic
conditions.
Macular amyloidosis: This hyperpigmentary skin condition can be
genetic or caused due to prolonged friction, rubbing and scratching
with bath sponges, pumice stones, towels and loofahs, which leads
to skin degeneration and deposition of the proteinaceous material
amyloid. This presents as dark-brown ripple patches over the upper
back and upper arm, which may be associated with itching.
Smoking, vitamin B12 and iron deficiency: These are also
common causes of hyperpigmentation.

Prevention and Treatment

Prevention is obvious—avoid the above triggers and ensure you apply
sunscreen every single day. However, if you already have pigmentation,
there is a whole range of skin-lightening agents that can be used to reduce
it. You should always see a dermatologist to correctly diagnose and treat the
specific pigmentation that you have.

The Best Skin-Lightening Agents for Pigmentation

Today, we are lucky to have so many effective products to tackle

pigmentation that are easily available in the market. I have discussed
various actives for skin lightening in the chapter on actives (see p. 124). But
just to go over them once more, these are the ones you should look out for:

1. Alpha arbutin, niacinamide, glycolic acid, lactic acid, kojic acid,

mandelic acid, polyhydroxy acid, azelaic acid, vitamin C and
glutathione.
2. If you want to double the effect of topical creams, start having oral
supplements containing glutathione, grapeseed extract and vitamin
C. Continue the treatment for at least three months and you will see
the magic. Please check with your doctor before you begin a course
of these medications.

If you are looking for faster results, go to a dermatologist, get your skin
condition diagnosed and start the treatment to get more effective results.
Treatments such as chemical peels, mesotherapy, microdermabrasion, IV
glutathione and Q-Switched Nd:YAG laser are quite effective. However,
always remember that whether you use topical creams or get in-clinic
treatments done, no treatment for pigmentation is permanent. People think
that just because they’ve invested in skin treatments, they are immune to the
damaging effects of UV rays. They hit the beach to swim and sunbathe,
and, lo and behold, the pigmentation creeps back after the holiday. Trust
me, you can’t hide from UV rays just because you’ve got some sunscreen
on. You’ve got to maintain the results of in-clinic treatments with adequate
sun protection and maintenance with topicals containing suitable actives.

Skin-Lightening Creams You Shouldn’t Use

This is one concern that baffles me. Many patients have visited me with the
concern of using creams suggested by their chemist, which gave them
magical results when they started the treatment. However, it led to further
darkening of their skin when they stopped the treatment. The biggest devil
for skin—self-use of steroid and hydroquinone-containing creams.
There are two particular types of creams that you should never use,
unless prescribed by a doctor. These are topical steroid creams and
hydroquinone.

My Favourite Brightening Products

Tan-reducing creams

1. Biluma cream
2. Phace moisturizing cream
3. Ban a Tan cream
4. Sesderma Hidroquin gel
5. Berkowits Radiate skin-brightening serum

Under-arm lightening creams

1. Litearm cream
2. Golite skin-lightening cream
3. (hydroquinone-containing lotions are the most effective, but
should be used only when prescribed by the doctor)

Pigmentation around the mouth

 1. Avelite cream
2. Melaglow cream
3. Niltan cream
4. Demelan cream

Post-acne pigmentation

1. Tri O Bloc cream

2. Fixderma Skarfix Plus cream
3. Clearz Plus cream
4. Kojivit ultra gel
5. Bioderma White Objective lightening fluid

Steroid-containing creams, especially Betnovate, are rampantly used by

people for skin fairness. But know this—when used for long periods, it can
thin your skin, and increase telangiectasia (broken capillaries on skin) and
the growth of hair on your face. On sudden disuse, it can lead to further
darkening of the skin. On the other hand, the flagrant use of hydroquinone
can lead to a skin condition called ochronosis, in which your skin can turn a
bluish-grey colour. Unless you want to end up looking corpse-like, please
refrain from self-medicating.
 11
YOUR A.M.:P.M. SKINCARE ROUTINE

A Stitch in Time Saves Nine

Now you know all the details of all the steps—cleansing, double-cleansing,
moisturization, SPF, serums, actives, exfoliants and masks. It can be a bit
overwhelming,
I agree—especially if you are just dipping your toes into the world of
skincare. South Korean beauty and its infamous ten-step routine can also
add to the confusion. But remember that you don’t need to do all those ten
steps, because a lot of it is just clever marketing. What I have detailed in the
previous chapters is the entire world of skincare. However, the foundation
to a good skincare routine still remains the same—cleanse well, moisturize
well, and use a good SPF and a dedicated serum packed with active
ingredients to target your skin concerns. To simplify all this, I’ve distilled
all this information into a skincare routine for both the morning and the
evening for all skin types.
To understand which a.m.:p.m. routine suits you best, you first have to
know your skin type. Refer to Chapter 2 (see p. 21) to know how to perform
the tissue-paper test to know your skin type. Then assess if you have any
skin condition—if you are dehydrated, pigmented or have wrinkles, etc.
After assessing your skin type and skin condition, follow an a.m.:p.m.
routine here that is tailored for your skin type. Start following it today,
because a stitch in time saves nine!

Skin Types Skin Conditions

Dry Dehydrated
Normal Pigmented
Combination Mature
Oily
Sensitive

The Basic A.M.:P.M. Routine

This is the foundational routine, no matter your skin type and skin
condition. The steps are fixed for all skin types—you just need to rotate the
skincare products. Now, the steps mentioned below may seem too extensive
for some folks, so I’ve marked a star against the steps that are MUSTs. Star
steps are non-negotiable! You can gradually incorporate the others into your
routine on your journey to glass skin. ïïŠ

The A.M. Routine

1. Cleanse: The start to the day and the most basic step. Is it
necessary? Yes, absolutely! Can you just wash your face with plain
water? Absolutely not, because washing your face with just plain
water can increase the pH of your skin, drying it out further. So
always use a face wash that suits your skin type.
You can even use the same cleanser for night and day, but if you
are a skincare enthusiast, you can have three cleansers and use them
in rotation. One cleanser for your basic skin type, which you can
use in the morning, another for your skin condition, which you can
use at night, and the third one that suits all skin types and can also
 work as a scrub and a face mask, which can be used twice in a
week.
2. Spray some toner/toning mist: I have already mentioned my love
for this step in my chapter on toners. Once you incorporate this step
into your routine, you will really see the difference in your skin. If
you are using a spray toner, you can even spray it on your eyelids—
just make sure your eyes are closed! And avoid toners with alcohol
(a glass of wine is okay, though!).
3. Eye cream: The skin around the eyes is relatively thinner than the
rest of your face. If you apply your serum and moisturizer before,
your eye cream will just sit on them and not penetrate the skin’s
layers. It’s like watching the second half of a movie first, without
watching the pre-interval part. So always apply your eye cream
first, so that it gets absorbed in your skin well and can do its job.
4. *Serum with actives: This is one of the most vital steps. Apply a
water-based serum in the morning, so that it doesn’t make your skin
‘pich pich’ or oily. Choose actives that are suitable for your skin
type and skin condition. I recommend having at least two to three
serums in your kitty. One for the daytime, for your skin type, and
one or two for the night that suits your skin condition.
5. Moisturizer: I have seen a lot of people talk about using a
moisturizer before a sunscreen, but in my experience, if you have
normal/combination/oily/sensitive skin types, you can skip
moisturizers and just go straight to a moisturizing-lotion-based or
gel-based sunscreen in adequate quantity (2.5 FTUs). After all, you
don’t want your face to be dripping with products. However, if you
have a dry skin type, use a moisturizer first, because your skin
needs it. Also, as I have mentioned before, always choose a
moisturizer according to your skin type and not your skin
condition.
6. *SPF: This is the most important step in your a.m. routine. Use a
minimum of SPF 30, PA+++, 2.5 FTU. Dot it all over your face and
spread it out evenly.
 7. BB cream or make-up: If you so wish, this is where you can start
with your make-up routine. If you have an oily skin type, opt for a
drop of BB cream for that flawless look. But the truth is that you
won’t really need this step if you follow the rest of the steps that
actually help you achieve flawless skin.
8. Face mist: Spray it and flaunt your dewy skin.
Not a necessity, but if you want to pamper yourself, go ahead and
give your face a spray.
9. Supplements: This step should also be a daily part of your
a.m.:p.m. routine. Oral antioxidants are potions of magic for your
skin, because they give you a boost of nutrition and bring on that
extra glow. If you want your skin to shine, this step is a must.

The P.M. Routine

The evening routine is equally, if not more, important for your skin. Before
you hit your bed and go to sleep, follow the steps mentioned below so that
your skin gets time to absorb all the correct actives at night.
1. *First cleanse: This step is a must if you’ve used sunscreen or any
make-up during the day. As application of sunscreen is a must
every single day, even if you are indoors, double-cleansing is
necessary every night. So use a micellar water/cleansing
lotion/gel/oil/cleansing balm to remove all traces of make-up and
sunscreen. Follow the instructions on the product you are using.
Take time to gently remove the make-up from around your eyes,
from your lashes and your lips, as make-up can bury itself into the
creases of the skin in these parts.
2. *Second cleanse: Use a water-based cleanser, according to your
skin condition. If your skin is perfectly good, you can still add a
different face wash to bring a good glow. Wash your face and pat
dry.
3. Toner: In the evenings, you can use an acid toner or a toner
containing AHAs or BHAs. If you are using a retinoid, use toners
 that are gentler on your skin (like a rose-water or a camomile
toner). Always follow the instructions on the product you are using.
Allow it to dry.
4. Eye cream: You know the drill. Just be gentle while you apply it
around your eyes.
5. *Serum: Apply a serum that suits your skin condition. If you have
more than one skin condition, you can either use a serum with
multiple actives or use a different serum on alternate days to
address your concerns. You can even use a retinoid serum at night.
Once again, don’t mix retinoids with other potent actives, as
mentioned in Chapter 6
(see p. 109).
6. *Moisturizing cream/night-treatment oil: Once you’ve applied
your serum, it’s best to lock in all the goodness with a nourishing
moisturizing cream. Some people are afraid that using a rich
moisturizing cream won’t allow their skin to breathe at night. This
is one of the biggest myths in skincare. Your skin doesn’t breathe.
Trust me, leave that function to the respiratory system.
Use a cream that works both as an emollient and an occlusive,
which will seal in all the actives. In fact, if you have two skin
conditions (for example, dark spots and wrinkles), you can apply a
serum that targets your dark spots and a moisturizer that contains
retinoids to tackle your wrinkles.
If you are just getting into skincare, all these steps can be rather
confusing. Don’t worry. It’s just about layering products in a
correct manner so that your skin derives the maximum goodness
from all the things you’ve bought. Layer your products from the
lightest to the thickest consistency (except for eye creams, which
go on the skin before the serum). Do this and your skin will thank
you forever!

The Extra Squeak

Whenever you clean a glass and are on the last step of cleaning it to make it
shine, have you heard the squeaking sound? Well, these are steps that bring
some extra squeak to your skin to get you that shine!
1. Exfoliation: Perform this step twice a week to get rid of the dead
skin cells that build up constantly. I always recommend using a
chemical exfoliant over a physical one, because not only are they
more effective than physical scrubs, but they are also more gentle
on the skin. Think about it like this: Would you want to watch a
movie on a VCR when Netflix is available? It’s the same for
skincare. The technology and science in our products today trumps
some of the older products and techniques, so make use of it.
2. Masking: Once or twice a week, or when you feel the need for it,
use a face mask for a boost of skincare goodness and some wind-
down time! However, I never recommend doing it more than twice
a week.

The Skincare Table

I have formulated a skin care routine for every skin type below. Check out
the basic steps to follow in the first few columns, which cater to different
skin types. Choose your products mindfully. After mentioning various skin
types, I have mentioned various products according to skin condition.
Steps that are to be followed according to skin type/skin condition have
been mentioned in the first column. BB cream and face mists are optional
steps for all skin types and skin conditions. Facial cleansers for the second
cleanse at night may be chosen according to skin condition. However, it is
not a thumb rule. You may even use the same cleanser that you use in the
morning.
Certain products can be used in all skin types, but in this table I have
mentioned those that are most ideal for a skin type/condition.
If you have oily, combination or normal skin type, which is both
sensitive, dehydrated, pigmented and mature, you should tackle your
concerns in this exact order:
 1. First tackle the sensitivity.
2. Then dehydration.
3. Then you can use a moisturizing cream that has ingredients catering
to both pigmented and
mature skin.

In the table on the next page, you can zero in on your skin type across all
age groups. So what are you waiting for? Dive in!

A.M.:P.M. Routine for All Skin Types

A.M. Routine
P.M. Routine
Skincare Routine through the Ages

Before 18 Years

You are still in school and skincare might not be on the list at all. I
understand that there are other priorities you must focus on, but do not
forget to follow the below steps, as they are necessary to maintain healthy
skin.
You can start by using an SPF right from six months of age. Along with
an SPF, a moisturizer and a cleanser can be incorporated in your skincare
routine right from the beginning. If you apply kohl, you must double-
cleanse. So your steps are—first-cleanse with make-up remover, second-
cleanse with face wash, moisturizer and sunscreen.
Ingredients such as ceramides, shea butter and squalane are hydrating,
protect the barrier function of your skin and can be incorporated in your
skincare regime.

18–25 Years

You have just entered college and you might have just started paying
attention to your skincare routine now. Do the basic steps—make-up
remover, cleanser, moisturizer and sunscreen. Add on the use of an
antioxidant serum containing vitamin C and E. They won’t have any side-
effects and will, rather, be protective. Use a cleanser containing salicylic
acid if you have oily, acne-prone skin. You can even incorporate a toner and
a face mist containing flower extracts such as rose water, tea tree or
camomile, according to your skin type. Use hyaluronic acid-containing
products if you have dehydrated skin. Lactic acid is also a safe acid to
include in your skincare routine. You can also use
BB creams, a weekly face mask or a scrub.

25–35 Years

A lot of you have started working. The working hours have increased and
so has the stress. Early-morning flights might also have become routine for
some. And for my fellow medicos, night duties have reached their peak.
As the stress on your skin increases, so should your skincare routine be
tweaked. Start using an eye cream to prevent the early development of
under-eye hollows and dark circles. You might be pressed for time to follow
a skincare routine, but, trust me, it just takes five minutes of your day.
Also, once you cross twenty-five, make sure to incorporate chemical
exfoliants into your routine. Actives such as glycolic acid, mandelic acid,
PHA and azelaic acid are the best to start with. Look for serums that contain
these ingredients to get their maximum benefits. This is also the right time
to start an anti-ageing cream. Retinoids, bakuchiol, coenzyme Q10,
niacinamide and copper tripeptides are the suitable actives. Also look for
creams that include anti-ageing ingredients. Facial oils and sleeping masks
are other wonderful options to give your skin a boost of hydration. Sheet
masks, scrubs and face masks are always an option to make your skin party-
ready. Add on some supplements at this age—this is the right time to reap
their benefits.

35–50 Years

Skincare regime at this age follows the same principles of what you would
do after the age of twenty-five. However, eye creams and anti-ageing
actives become non-negotiable now. Always look for anti-ageing actives in
serums, because they penetrate deeper into the skin and delay signs of
ageing. You must also incorporate hyaluronic acid into your routine,
because as we age, the levels of natural oils and cell turnover rate decreases
and the skin tends to get drier. Retinoids, snail mucin, resveratrol and other
anti-ageing ingredients should be your go-to actives. Facial oils are a must
to maintain skin.
As you enter your thirties, you may consider in-clinic treatments to
renew your skin. Skin boosters containing hyaluronic-acid fillers will
significantly hydrate your skin and delay signs of ageing. Dermal fillers,
Botox, mesotherapy, PRP, laser and even IPL treatments may be
considered.

50 Years Onwards
After you cross your silver jubilee, you may notice that a regular skin care
routine needs a helping hand to amp up your skin, thanks to sun damage
over the years—which further slows down your cell cycle, which heaps up
the dead skin cells—and a steady decrease in oestrogen levels in women,
which may make your skin look drier. Let go of your reservations and book
an appointment at the clinic.
 12
ON-THE-GO SKINCARE AND WORKOUT
SKINCARE

Even though all of us want to delete the year 2020 from our memories, the
truth is, who can forget it? The COVID-19 pandemic has rocked the world
and challenged all of us in so many ways. Staying indoors, being out of
work, the fear of getting infected and the fear of getting unknown
complications from this unpredictable disease, the misery of not meeting or,
worse, losing, our loved ones has been devastating.
This year has been overwhelming for me too, but in a different way. I
was blessed with twins—adorable baby girls who are the light of my life in
these trying times. As I write this chapter, I express gratitude to the universe
for giving me time to spend with them and also giving me the opportunity
to write my dream book. I pray in my heart for this time to pass soon, so we
can once again experience life as we knew it. I wish for us to be able to get
back our livelihoods, throw our arms around friends and family, and once
again be able to travel.
Before the pandemic, I travelled very often—for consultation in my
outstation clinics, for multiple conferences, and also because I love
travelling. But long flights were not only mentally draining, but they also
wreaked havoc on my skin. Frequent flying or flight journeys longer than
three hours can dehydrate and dry skin out. The air-conditioning and
recirculation of air saps out any humidity in the cabin, drawing out moisture
from the skin’s mucous membrane. Everyone feels the effects of this, but
people who have dry or dehydrated skin feel the impact doubly. This is why
I am extra-cautious about packing skincare products first into a convenient
travel-size skincare pouch, which I always have at hand. When you are
buying skincare products, keep an eye out for minis or travel sizes, as they
are particularly useful for flights and road trips.
Here are a few essential items to consider for your travel pack:

1. Moisturizer: This is a saviour when you are travelling. Don’t just

apply it before you hop on to the flight and think the job is done.
Ideally, carry a travel-size moisturizer in your handbag and apply it
liberally—on your hands, arms, face and literally anywhere else—
after take-off.
2. Lip balm: I am addicted to lip balms. I don’t just have it at my
bedside, I have one in my bag and an extra one in my make-up kit,
just in case! Your lips are usually the first victims of dry air because
of the thinner skin found in these areas. A roll-on stick is more
hygienic than a balm in a pot, because it doesn’t involve you
sticking your fingers into it and transferring germs into the product.
3. Thermal water spray: This is another wonderful product you can
use liberally throughout your flight to hydrate your skin. Rose-
water toners serve a dual purpose too. Not only do they hydrate the
skin, they also make you smell good!
4. Sunscreen: Whether you are travelling on a holiday or just for a
short work-day trip, you need sunscreen in your bag at all times. At
30,000 feet, you are especially exposed to UVA and UVB rays. Go
to town on your sunscreen. And if you have a window seat, pull the
shutter down to block out the light.
5. Sheet masks: They can be the pampering element when you are on
a long flight and not just to cool down your skin but even your
mind.
 6. A refillable water bottle: Not a skincare product, but water is
essential for your skin. A small bottle of water will keep your skin
and body hydrated. So try and carry at least a 200 ml bottle or a
tumbler with you at all times.

My Favourite On-the-Go Products

1. Sebamed moisturizing cream for face
2. Berkowits Anytime Hydration cream for hands and body
3. Cetaphil DAM ultra-hydrating moisturizing lotion
4. Sebamed SPF 30 lip balm
5. Avene thermal water mist
6. Pixi glow mist
7. Bioderma Photoderm MAX Aquafluide teinte claire SPF 50+
8. Episoft AC moisturiser SPF 30

Skincare for When You Are Exercising

Exercise is vital for good health, but it is also amazing for your skin.
Younger-looking, radiant, glass-like skin is not just achieved by a regular
skincare routine—it is also enhanced by regular exercise. Exercise increases
blood flow to the skin, which brings a radiant glow and increases better
lymphatic flow. This, in turn, decreases puffiness around the eyes. Exercise
also releases endorphins, the feel-good hormones, which help reduce stress.
Although no one can escape some amount of stress, which is part of normal
life, chronic stress can be harmful for your skin and can trigger conditions
such as psoriasis, atopic dermatitis and acne. Increased stress triggers the
release of cortisol, which can increase blood sugar, which, in turn, can
increase advance glycation end products that can bind to collagen, cause its
damage and lead to increased signs of ageing. So exercise is not just vital
for glowing skin but also to delay signs of ageing. But before you go for
that early-morning walk or swim, or even if you are just hitting the gym in
the evenings, you need to prepare your skin, to work up a sweat.

Pre-Workout Skincare

1. Take off any heavy make-up: Should you wash your face every
time you go to the gym? Can’t you apply just a little bit of tinted lip
balm and tinted BB cream? I get asked these questions all the time.
After all, going to the gym these days is also about social
interaction! Yes, you can use a bit of make-up when you are
working out but make sure not to apply any thick concealers or
foundation. Doing so may give you an unwanted zit. Foundations,
primers and concealers can block your pores and prevent
evaporation of sweat. Instead, apply a non-comedogenic BB cream
or a tinted sunscreen, which do both the jobs perfectly. However, if
you already have make-up on, clean it with an oil-based make-up
remover or a cleansing balm before you head out.
2. Wear your SPF: Whether it’s a morning or an evening walk, or you
are simply going to the gym, before you break into a sweat, you
need to turn up your sunscreen game. As I have mentioned in the
chapter on sunscreens, you are exposed to UV rays even indoors.
So, if you are exercising in a place with no windows or exposure to
natural light, skip the SPF but always use a water-resistant one
outdoors or if exposed to UV rays. If you are swimming, your
sunscreen needs to be a ‘water-resistant’ product. Look out for the
term on the product before buying it. You also don’t want the
excess chlorine in pool water to harm your skin.

Pro-tip

If you are playing a sport outdoors, always be heavy-handed

with SPF around the cheeks and the nose, as these areas are most
 prone to photodamage.

3. Avoid heavy moisturizers: A moisturizer that is very heavy or too

emollient can block your pores. Look for lighter formulations or
hyaluronic acid toners, which will hydrate your skin while feeling
almost non-existent on it.
4. Keep your hair tied back: Never work out with open hair. It is best
to keep it pulled back with a hair tie or a sports headband. Allowing
hair on your face during workouts means you are allowing the
natural oil in your hair to be smeared all across your face. This can
cause breakouts. Also remember to wash your headbands after
every workout.
5. Buy a gym towel: Gym towels are usually made of microfibre.
These are less absorbent than bath towels but because of their lower
density, can be easily rolled up and put into bags. They shouldn’t be
used post swimming or after taking a bath, because they aren’t very
good at drying the body—they are simply meant to wipe away
sweat. As the weight of the towel (GSM—grams per square metre)
is lower than bath towels, they dry much faster and you don’t have
to wait too long to use them again after washing.

Post-Workout Skincare

1. Double-cleanse: Clean your face properly and bathe immediately

after your workout to remove the sweat and grime. Blocked pores
will lead to blackheads, pimples and an uneven complexion. Do not
miss this step at all costs. If you have oily or acne-prone skin, wipe
your face with salicylic acid pads. These pads work like a face
wash on the go. They reduce the production of oil and remove any
excess sweat and dirt. You can also use these wipes on your chest
and back if you are prone to acne on these areas.
2. Tone: If you have sensitive skin, pamper your skin with hydrating
toners, thermal water mist or toning pads. Thermal water mists
 have a cooling effect on the skin and help minimize excessive
redness. Just spray it on your face and let it dry on its own.
3. Treat yourself: If you enjoy using face masks, post-workout is the
best time to do so. Once you have cleaned your face, use a clay
mask, facial ubtan or even a multani mitti home remedy. My
favourite routine is to apply a facial ubtan mixed in aloe vera gel.
This concoction cools down my skin and also tightens my pores.
4. Moisturize: Apply a thin layer of moisturizer to hydrate your skin.
This step is non-negotiable.

My Favourite Products to Have in the Gym Bag and Post-Gym

Routine

Sunscreens

1. ISDIN Fotoprotector 50+ fusion water

2. Avene Sun Cleanance sunscreen SPF 50+
3. Bioderma Photoderm Max Aquafluide SPF 50+ (for a tint
without make-up)
4. Sebamed multi protect sun lotion SPF 50

Moisturizers

1. Episoft moisturizing cream

2. Sebamed moisturizing cream for face
3. Cetaphil moisturizing lotion
4. Uriage Hyseac 3-Regul

Thermal water mists

1. Avene thermal water mist

2. Earth Rhythm lemon balm hydrating toner
3. Juicy Chemistry rose-water toner
Face masks

1. Earth Rhythm Australian pink clay mud mask

2. Vilvah facial ubtan + Vilvah aloe vera gel
3. Pure by Priyanka facial ubtan + Pure by Priyanka aloe vera gel
4. Avene Cleanance absorbing mask
 13
SKINCARE FOR MEN

Traditionally, skincare has always been marketed for women. It’s as if men
don’t have skincare issues at all. In our grandparents’ and parents’
generations, shaving and application of coconut oil on hair as well as on the
face and the body (yes, you heard that right) was the only step in a man’s
skincare regime! The truth is that skincare was not considered ‘masculine’
enough for men, which is a shame, given that skin is the largest organ in a
human being. As the medical director of Berkowits hair and skin clinics,
which primarily caters to aesthetics and haircare for men, I understand
better than most people the necessity for a dedicated market that caters to
men’s skincare needs. In fact, it’s not just at my clinics where men are
equally curious patients about their skin’s issues—on my YouTube channel,
about 40 per cent of all queries and concerns are from men.
The fact is that men need to care for their skin just as women do. And,
fortunately, today men understand that looking after their skin is as
important as, say, building a six-pack or eating a healthy diet.
I have observed that men’s interest in skincare loosely falls into these
three categories. I’ll give you an example from my own family. I live with
three men—my father-in-law, my brother-in-law and my husband—and all
three of them fall into completely different categories when it comes to
skincare.
My father is a minimalist. He is a sportsperson and is ageing too. He
prefers using just one skincare product that works across the board.
My husband has oily, acne-prone skin; he is an actualist. He prefers
using products that target his skin concern and give him results.
And my brother-in-law is the new-age man, who does not shy away from
an occasional face mask or a dash of Botox and fillers to enhance his
appearance. I have seen these three categories in all age groups. Which
category do you fall into?

How Is Male and Female Skin Different?

There has also been a lot of research conducted to compare the difference
between male and female skin.* The only vital difference boils down to
hormones. To put it simply, men have androgens and women have
oestrogen, and that’s the main reason for the differences in their skin’s
properties.
It has been observed that female skin is more hydrated than men’s.* Men
have thicker, oilier skin and a larger pore size than women. Women age
faster than men and these signs of ageing are not just seen in the superficial
skin, but also in the dermis. That said, men show deeper and more
pronounced facial wrinkles, especially on the forehead, when compared to
women.
Many artists make their female models lighter-skinned as compared to
male models. Interestingly, there is some biological truth to this. Various
studies have shown that male skin has 2–3 per cent points lesser reflectance
(reflection of light) than females.†
High reflectance means that women have paler skin. But another
important fact is that having paler skin is not equivalent to being beautiful,
and fair is not always lovely. Finally, Hindustan Lever got the point, and I
hope everyone else does too!
What Should the Basic Steps in Men’s Facial Routine Be?

It is said that men who do not perform a daily skincare regime experience
impaired barrier function, increased sebum amount and a tacky feel to their
skin. So don’t make the same mistake. A skincare routine will take just five
minutes of your day and save you a host of skin problems in the future.
Whether you are a minimalist, an actualist or the new-age man, there are
certain steps every man must follow in his skincare routine every single
day. If you follow me on Instagram and have checked out my videos, you
might have seen this one too. If you haven’t, I’ll keep it simple for you.
Everyone should follow the CTM (cleanse, tone, moisturize) routine, but
instead of the toner, you can use a sunscreen. I call this the CSM routine,
which follows in the order below:

1. Cleanser
2. Sunscreen
3. Moisturizer

Make sure you cleanse your face twice a day, as outlined in the cleansing
chapter (see p. 58), use a moisturizing sunscreen even if you are at home
and at night, after you cleanse your face, and use a moisturizer that suits
your age, skin type and skin condition.

Since Men Have Oilier Skin than Women, Do They Need to Use
Products Designed for Oily Skin?

This is the obvious question that arises when discussing skincare for men.
However, it is not necessary that all men have oily skin. Yes, men have
more oil glands than women, but men also have different skin types. As a
matter of fact, one of the most common skin conditions I have seen in men
is dehydrated skin! People who are exposed to outside dust and pollution
frequently and smoke regularly have dehydrated skin condition, which
makes moisturization and hydration of skin doubly important. Men also
tend to reach for a bar of soap to clean their skin, which I do not
recommend. Aggressive soaps, no matter your skin type, will only further
dry out and irritate your skin.

Should Men Use the Same Skincare Products as Women?

Have you ever noticed the difference in men’s and women’s skincare
products? A product designed for men will focus on oil control, acne or
lightening of the skin tone. They are also packaged in standard ‘masculine’
colours such as blue and black. And all of them have a musky, lemony
fragrance (fragrance should come in a separate bottle of perfume, not in our
skincare). Now here’s a truth bomb many of you won’t appreciate: Products
designed specially for men is all one huge marketing gimmick. Because,
as I mentioned earlier, not all men have oily skin. In fact, as we age,
testosterone levels decrease, making our skin drier. So the next time you’re
in the market for a skincare product, ignore the packaging and look for
ingredients that suit your skin type and condition. Never mind if it comes in
a pink tube—the most important thing is that the skincare product works for
you.

Shaving

Shaving is probably what most men have in common in their daily routines.
And most men have also suffered from razor burns and irritation on facial
skin when they have shaved in a hurry or used poor techniques. It is crucial
to maintain hair softness while shaving and restoring skin hydration after
that, so one’s skin is always at its optimum health. Men should make sure
they follow a three-step skincare regime to reduce incidence of any side-
effects associated with shaving:

1. Use a shaving cleanser.

2. Use moisturizers containing glycerine and emollients post shaving
to improve barrier function.
 3. Make sure you use an SPF after the application of a moisturizer.

These steps will significantly improve your skin’s appearance, clarity and
smoothness, while also reducing pore size and wrinkles, and minimizing
razor burn and photodamage.

Advanced Skincare Treatments for Men

Men and women have completely different facial structures. The ideal
aesthetic facial shape for women is oval, while for men it is square. Usually,
women prefer to enhance their lips or elongate their chin, while men prefer
a square chin shape. Men have sharper jawlines, squarer chins, hollow
cheeks, flatter cheekbones and low-set eyebrows. So their priority when it
comes to treatment is completely different from a woman’s. A man’s facial
structure can be significantly enhanced by Botox and dermal fillers. This is
my favourite treatment, because it offers instant results. So, if you want to
fix an element in your face that you are not satisfied with, don’t hesitate to
consult an aesthetician.

***

Thoughts such as ‘ladke rote nahi hain (men don’t cry)’ and ‘ladke cream
nahi lagaate (men don’t use creams)’ are a thing of the past. We are
marching towards a world of equals, even though there is still a long
distance to cover. There is no reason why a man cannot have his own
personalized skincare routine. There is nothing ‘masculine’ about poor skin
health. Whether you are a man or a woman, self-care should always be
priority, because it isn’t only just relaxing, but good skin also boosts one’s
confidence. Following a regular skincare regime is equivalent to going to
the gym—the latter maintains your body while the former maintains your
skin.
For the best product recommendations, refer to the chapter on skin type,
where I discuss in detail the right products for each skin type and different
skin conditions.
 14
SUPERFOODS, SUPPLEMENTS
AND LIFESTYLE

‘Stay healthy, stay beautiful.’ This is my motto in life. If you follow me on

YouTube or Instagram, you’ll know that I stress on the fact that one’s skin
is a reflection of what one eats and drinks. I have made several videos on
superfoods for skin, hair and even how they help tackle acne. These videos
went viral in a few months of posting and I was really glad to realize that so
many people were interested in knowing details about how a good diet
could affect skin and hair. In this chapter, I will go over the best foods and
supplements targeted for skin and hair.

My Top Five Superfoods for Skin

It is rightly said that beauty comes from within. I cannot stress enough the
importance of following a regular skincare regime. Yet, it is equally
important to have a healthy diet if you want to nourish your skin from
inside. Incorporate these superfoods in your life and you will see the magic
happen.
1. Nuts and seeds: I have vivid memories of my mother giving me a
handful of nuts and raisins, which I stowed away in my pocket
every day, especially in winters, before I set off for school. As a
child, I didn’t like eating these, and I much rather preferred a
chocolate bar with fruits and nuts. But as the years passed,
I realized the many benefits of that handful of nuts and made sure I
incorporated the ritual of having at least five almonds and walnuts
every morning.
Walnuts, flaxseeds and chia seeds (even fish and salmon) are rich
sources of omega-3 fatty acids. They help fortify the membranes of
the epidermal cells, which helps improve skin-barrier function.
They also help fight against free-radical damage and inhibit UV-
induced skin pigmentation while also helping treat dry and
dehydrated skin conditions. Almonds are rich in vitamin E and help
combat dryness and prevent collagen degradation, which helps your
skin look firmer and younger while imparting it a wonderful glow.

When to eat: Make sure you have at least five walnuts and almonds
every morning with your breakfast to enjoy their benefits. You can
even have 1 tablespoon of flaxseeds with a glass of water in the
morning on an empty stomach.

2. Eggs: Proteins and their by-products are the building blocks of skin
tissue. Amino acids help in the production of collagen, which
maintains skins elasticity and firmness. Additionally, they also
strengthen your hair and nails. Eggs are a rich source of protein.
Other sources that are rich in protein are chicken, soya, dal and
dairy products.
Eggs and my pregnancy went hand in hand. When I found out
that I was expecting twins, I made a pledge to have babies who
were born with a normal weight, and that required a lot of protein.
I researched different egg recipes that I could eat for breakfast so
that I didn’t get bored of eating the same dish every day. In the
 evening, I had bites of paneer as a snack. In my last few days of
pregnancy, when I could barely eat anything, I was determined to
eat at least one egg a day. I must have crossed a double century of
eggs in these months, but the end result was totally worth it.
Despite having twins, their weights were 2.4 kg each! ☺
When to eat: One portion of egg every day during breakfast to
enjoy healthy hair and skin.

3. Citrus fruits: These juicy offerings are rich in a variety of vitamins,

especially vitamins C and E, which are laden with antioxidants.
Vitamins are important for maintaining optimum health, appearance
and skin function. They protect the skin from harmful UV rays and
free-radical damage. This prevents early degradation of collagen
and, hence, delays signs of ageing.

4. Vitamin A: During my MBBS and MD days, even though I had

enough time to go to the market and buy fruits for myself, it
seemed like such a Herculean task that I always procrastinated. I
never cared about eating fresh fruits and salads, and seldom had
any fruit juice.
Unhealthy eating = bad skin. And thus I experienced poor skin
for many years. However, after I had burnt my fingers and learnt
my lesson, I now make sure I have a portion of fruits or at least a
glass of juice every day for a dose of these essential vitamins.
Retinoids and carotenoids are two forms of vitamin A available
in a wide variety of fruits and vegetables. Dairy products, carrots,
pumpkins, papaya, sweet potato, green leafy vegetables, mangoes,
apricots and plums are some of the many fruits and vegetables rich
in vitamin A. This wonderful nutrient strengthens our immune
system by aiding new cell production, which helps even out skin
tone and delay signs of ageing by strengthening our collagen stores.
When to eat: Have a portion of freshly cut fruits every evening and
squeeze them with a dash of lemon for that extra dose of vitamin
 C.

5. Yogurt: This is perhaps the only superfood I have always enjoyed

eating, even as a child. Yogurt is a powerhouse of multiple
nutrients, which include vitamins B6 and B12, zinc, calcium, lactic
acid and proteins. It is also an effective probiotic, which is great for
gut health. The zinc in yogurt helps regulate oil production from
sebaceous glands, and is thus a boon for those suffering from acne.
It also contains lactic acid, which is great for moisturizing and
works as an exfoliant. It helps reduce the visibility of wrinkles and
fine lines. Calcium helps skin renewal and prevents dry skin.
When to eat: Eat a bowl of this superfood every morning or
evening.

Skin Stressors

Here are some skin sins you should give up ASAP if you want to enjoy
glass-like skin.

1. Carbs and sugar: I don’t want to go all headmistress on you and

tell you to completely give up eating sugar or carbs, but the clue is
in the word itself—‘desserts’ when spelt backward is ‘stressed’.
The fact is that there’s nothing sweet about sugar or carbs when it
comes to skin health.
In fact, all food items with a high GI, such as white bread, candy,
soda, chips, pasta, baked food, salad dressings, ketchup and corn
products, are not only disastrous for health but also play havoc on
your skin. Ingestion of these products leads to insulin spikes, which
can cause inflammation of your skin and be a major cause of acne
flare-up in some. Besides, foods with a high GI produce advanced
glycation end (AGE) products, which can bind with collagen,
leading to its breakdown and thus accelerating signs of ageing.
 You don’t have to completely cut out sugar from your life—just
be mindful of how much you are consuming. If you have a sweet
tooth, try switching to natural alternatives such as dates, fruits and
vegetables, or desserts made with jaggery instead of refined sugar.

2. Salt: Even though salt is vital for us, excess sodium intake has its
own disadvantages. Excessive salt, especially at night, when the
body’s metabolism slows down, can cause puffy eyes. High salt
intake can also break down collagen, causing early signs of ageing.
So, go easy on those pakoras and salty curries. However, if you are
one of those who live to eat, ensure that you doubly hydrate
yourself after a salty snack. This helps cut down the harsh effects of
sugar and salt on your body.

3. Alcohol: When we talk about glass skin and South Korean beauty,
we have to talk about soju. This was one of the staple drinks in
Seoul. It’s not my favourite, but since it was the local flavour of
South Korea, I couldn’t miss out on it. But I was careful to keep it
to a minimum, because alcohol can be disastrous for skin health.
When taken in moderation, alcohol is not bad, but drinking like a
fish will have dreadful consequences.* Alcohol causes the dilation
of blood vessels and broken capillaries, dehydrates skin completely,
which can accelerate the appearance of fine lines, and makes skin
look dry and dull. That’s why I always tell my patients to drink at
least two glasses of water after one glass of wine to keep hydrated.
Also, if you want to have a drink that gives you a true South
Korean flavour, have their non-alcoholic boricha (roasted barley
tea) instead! It is rich in antioxidants. This can be served both hot
and cold, and is a staple in all South Korean households.

Lifestyle Habits Harmful for Skin

1. Smoking: This is one of the biggest villains when it comes to skin
health. Smoking increases the formation of free radicals, which not
only damages your collagen but also elastin, which decreases skin
elasticity, causing premature wrinkles and telangiectasia
(prominence of blood vessels). So, if you want good skin, avoid
smoking! Plus, it’s no longer cool to do so in most cultures!

2. Environmental factors: Air pollution plays havoc on skin.

Airborne particles can aggravate inflammation, causing elastin and
collagen to degenerate, leading to early signs of ageing. There have
been comparative studies showing decreased dark spots and
wrinkles in people staying in rural areas when compared to urban
areas.* This is directly linked to pollution. So I plead with everyone
reading the book to be mindful of the environment and take even
the smallest steps to better our air quality. Some things could be not
bursting crackers, choosing to walk shorter distances instead of
driving and educating our children about pollution.
Other skin stressors are prolonged exposure to wind, cold and
dry air, exposure to the sun between 11 a.m. and 4 p.m., and
running the air-conditioner and heater for many hours.

3. Stress and lack of sleep: Whenever I look at my two newborns,

I’m in admiration of their soft, plump, ‘googly-woogly’ skin. Other
than not being exposed to any of the stressors above, they also
sleep for about sixteen to eighteen hours a day. Sleep is crucial for
optimum health—both for the mind and the body. Sleep deprivation
increases production of cortisol, a stress hormone, which is linked
to inflammation and skin irritation. A sound sleep, on the other
hand, promotes the release of growth hormones, which increases
collagen production. No wonder it’s called ‘beauty sleep’. Throw in
some meditation and light yoga for a few minutes before sleeping,
and this amps up serotonin (happy hormone) levels in your skin,
making it glow!
 4. Dairy products: Dairy is a complicated food group. Some people
love it while others (who are lactose-intolerant) cannot consume it
because their bodies react adversely to the properties in dairy. There
have been many studies that have shown that people who consume
a lot of dairy products are more likely to develop acne.* So, if you
are acne-prone, I would ask you to decrease or stop your dairy
consumption until your acne problem is resolved. If you are unsure
how your skin reacts to dairy, note down if you develop a zit every
time you consume a glass of milk.

5. Medicines: Some medications might be necessary for your system,

but remember that they can also cause dry skin. Some of them
include retinoids, lipid-lowering drugs or statins, diuretics, which
are commonly used to manage blood pressure, and even
antihistamines. So, if you are on any of the above drugs and facing
constant itching, you know the culprit.

Supplements or Nutraceuticals

Even though I firmly believe in eating less from a box and more from the
earth, there are several supplements that I highly recommend because they
are particularly beneficial to skin and specific conditions.
These nutritional supplements are called nutraceuticals. The word was
coined by Dr Stephen DeFelice in 1989 and derived from the words
‘nutrition’ and ‘pharmaceutical’. According to him, nutraceuticals could be
defined as ‘a food (or a part of it) that provides medical or health benefits,
including the prevention and/or treatment of a disease’.* So these nutritional
supplements can be used to delay the ageing process, improve health and
enhance the structure and function of the body.
Nowadays, supplements have garnered a lot of attention and are of
interest to many because of their nutritional benefits. However, there is also
an overflow of supplements in the market, so much so that it can be very
confusing for the consumer. I have met so many patients who have turned
self-doctors and have had a history of self-medicating with supplements
because the packaging was attractive or the Instagram influencer they
follow vouched for it. And this self-medication is not just limited to
multivitamins and minerals but also extends to Ayurvedic formulations.
Well, is self-medication bad? As a doctor, my answer is a resounding ‘yes’.
When it comes to any kind of medication—be it prescription or
supplements—it’s always safest to get advice from trained professionals.
Will self-medication lead to side-effects? Yes, if you consume them for a
long period of time. To be on the safer side, always stick to a three-month
limit.
My friend, Max Kushnir, an expert in quantified nutrition from Sova
Health, a precision nutrition platform that simplifies healthy living through
personalized nutrition, helped me collate the information below. According
to him, here are some of the best supplements for skin health. But do
remember that it’s always best to consult your doctor before consuming
them, especially if you have pre-existing conditions.

1. Collagen: Collagen is the scaffolding that holds the skin firmly in

place. As we age and are exposed to adverse environmental
conditions such as UV rays and pollution, this collagen degrades,
leading to the appearance of fine lines and wrinkles. Today, there
are many types of collagen powders, capsules and creams in the
market. It seems to be the latest fad in supplements. But are
collagen supplements really effective?

In the past, I did not believe in the effects of collagen supplements,

as they did not have significant results, but many of my elderly
patients who had tried collagen supplements told me they
experienced relief from knee pain. Hence, collagen molecules
benefit both the body and the skin. Even though its results are not
visible to the eye, it will delay signs of ageing.*
 Who should use it: People with mature or sagging skin. It can be
beneficial for dry skin type, and dehydrated and mature skin
condition. Remember that any oral supplement is effective only till
it is used. Once its intake is stopped, the results start to decline.
Natural sources: Chicken, seafood, egg whites and citrus fruits.

2. Glutathione: This is now considered the magic supplement—the

road to glass skin. But you need to be aware of its effects, so you
can make an informed decision before you include this supplement
in your diet.
Glutathione was originally used to treat liver abnormalities but
has also shown benefits in protection from viral infections and in
treating diabetic complications. But, recently, there has been the
sudden trend of using this ingredient in skin lightening, in topical,
oral and intravenous forms. Considered a wonder drug by many
physicians, glutathione is a powerful active that is used to brighten
skin.
Glutathione is an antioxidant that is naturally present in our
bodies. However, it decreases with age. There have been a few
studies that show the efficacy of oral glutathione supplements in
temporary skin brightening; their safety profile is good too.*
However, safety and the results of intravenous administration are
still questionable, as even if given twice weekly for ten to twelve
sessions, it gives temporary results at a very high cost. The
intravenous administration of glutathione is popular in the aesthetic
industry because it gives far superior results than oral supplements.
It makes skin glow and evens out skin tone in just a few sessions.
But remember that no treatment gives permanent results for skin
brightening. Results stay only until the sessions are on and you
maintain regular follow-ups.

Who should use it: Those with uneven skin tone, and pigmented
and mature skin.
 Natural sources: Glutathione is naturally produced in the body, so
there is an ambiguity about whether nutrition can increase
glutathione status. However, there are certain glutathione
precursors and co-factors that can enhance glutathione status in the
body. They include green leafy vegetables, food rich in lean
protein, green tea, fish and walnuts.*

3. Vitamin C: During COVID-19, many of my patients and even

some of my relatives noticed an improvement in their skin texture
and condition. At first, I thought it was because they were staying
home and were less exposed to environmental stressors. But then I
realized that the common factor that tied all my patients was the
intake of vitamin C, which they were consuming to improve their
immunity.
Not only does vitamin C boost immunity, it also supports skin
structure and function. It is a potent antioxidant, which protects our
skin from the harmful effects of pollution and UV rays. When
consumed regularly, it brings a youthful glow to skin, as it
promotes collagen synthesis, decreases pigmentation and evens out
skin tone. It is especially effective when combined with vitamin E,
especially in cases of sunburn.

Who should use it: Everyone, especially those with pigmented skin
condition.
Natural sources: Citrus fruits such as lemon, and papaya,
strawberries, blackberries, broccoli and green leafy vegetables.

4. ;Vitamin E: I have talked about this vitamin in great detail in the

chapter on active ingredients (see p. 130). Vitamin E is a naturally
occurring fat-soluble antioxidant that protects our skin from the
adverse effects of oxidative damage, including photoageing, which
can have long-term effects on skin, such as redness, skin thickening
and the early development of wrinkles. This vitamin works best
 when taken along with vitamin C to enhance the degree of
photoprotection.

Who should use it: Everyone, especially those with dry skin type
and pigmented skin condition.
Natural sources: Spinach, nuts, olive oil, sunflower oil, seeds, corn,
soya and meat.

5. B complex vitamins: All vitamins from the B group are important

for maintaining healthy skin, especially vitamin B12, since it is
essential for cell division. Our skin is the fastest renewing organ in
our body. Billions of dead skin cells are shed and created every day.
Having enough vitamin B complex ensures healthy skin in many
ways. Vitamin B1 (thiamine) decreases stress-related breakouts;
vitamin B2 (riboflavin) increases cell turnover, healthy collagen
and renewed skin; and vitamin B3 (niacin) is extremely beneficial
for skin. Niacinamide, a derivative of niacin, is used in various
skincare products as a skin-brightening and anti-ageing ingredient.
Pantothenic acid (vitamin B5) is a humectant, hydrating skin
ingredient and keeps skin soft, smooth and healthy. Biotin (vitamin
B7) is the most commonly used supplement for hair, but it is also
great for dry skin and brittle nails. Vitamin B12 (cobalamine) is an
important vitamin for keeping skin healthy; its deficiency can lead
to hyperpigmentation and hair loss.

Who should use it: Everyone, all skin types and conditions. Great
for people going through hair loss.
Natural sources: Milk, cheese, eggs, fish, meat and green leafy
vegetables.

6. Iron: When I was pregnant and feeding my kids, iron was one of
the most vital supplements advised by my gynaecologist. As a
vegetarian, I struggle with iron intake, because most sources are
usually of the non-vegetarian kind. Iron deficiency is one of the
 most important findings in Indian women, especially when they are
pregnant. Iron deficiency may cause anaemia—a condition where
there are not enough red blood cells to carry oxygen around the
body. When cells producing skin (and hair) don’t get enough
oxygen, their ability to produce healthy skin is depleted. People
with iron deficiency often display dull, dry skin, enhanced under-
eye dark circles and brittle hair; some may even be experiencing
hair loss. However, supplementing iron to people without iron
deficiency is not recommended and has no effect on improving skin
appearance.

When to use: Only after laboratory reports of decreased

haemoglobin and serum ferritin for dull, dry skin and hair loss.
Natural sources: Shellfish, spinach, dates, legumes, pumpkin seeds,
quinoa and meat.

7. Omega 3 and 6 fatty acids: So many patients come to me with

concerns of dull, dry and dehydrated skin. My answer to most of
these queries is usually an omega fatty acid supplement, which is
amazing when it comes to restoring skin vitality and bringing back
lustre to hair. Omega 3 and 6 are also present in rich quantities in
their natural sources and can easily be incorporated in your diet,
whether you are a vegetarian or a non-vegetarian. Therapeutically,
they also help ameliorate itchy skin conditions, photoageing, skin
wounds and hyperpigmentation.*

Who should use: People with dull, dry, dehydrated and itchy skin.
Dry and lacklustre hair can be revived with regular use.
Natural sources: Salmon, anchovies, walnuts, flaxseeds, soya bean
and tofu.

8. Ceramosides: Marketed commonly as oral moisturizers, this is

another great ingredient for dull, dry and dehydrated skin.
Ceramides play an important role in maintaining the health of the
 skin barrier. Reduced ceramide content in the body can increase
skin dryness and the early onset of wrinkles. Oral supplementation
of ceramides restores the skin’s ceramide content, repairs the skin
barrier and makes skin look more hydrated, plump, youthful and
glowing.*

Who should use: People with dull, dehydrated and itchy skin. Even
those with normal skin can have this to get the effect of glass-like
skin.
Natural sources: Eggs, dairy, sweet potato, corn and brown rice.

9. 𝞫-carotene (or beta carotene): This is a type of pigment that is

found in certain plants. Our body uses it to produce vitamin A—a
potent antioxidant that protects our skin from harmful UV radiation
and free radical damage, delaying the signs of ageing. This nutrient
acts as a crutch and has a supporting role to other supplements.

Who should use: Should be used as an antioxidant to get that glow

and delay signs of ageing. Beneficial for all skin types, especially
pigmented skin condition.
Natural sources: Carrots, sweet potatoes, green leafy vegetables,
apricot and cantaloupe.

My Favourite Supplements for Skin

1. Skinglo Collagen drink (collagen)

2. Tab Berkowits Radiate (glutathione)
3. Tab Celin 500 (vitamin C)
4. Cap Evion 400 (vitamin E)
5. Cap Becosules (B complex vitamins)
6. Tab Ferium Xt (iron)
7. Cap HH Omega (omega fatty acids)
8. Cap Skinfay (ceramosides)
 9. Cap Antoxid HC (beta carotene)
(Note: The above supplements are not a medical prescription. The above-mentioned names
have been recommended by the author based on her personal experience.)
 15
QUICK-FIX RECIPES: TREATMENTS AT THE
CLINIC

There are many instances in life when you find yourself at the centre stage.
For some people, such as television anchors and actors, it is part of their
daily lives, while for others, these moments are few but when they do
arrive, are moments to cherish. Even though I strongly believe that good
skin is the result of consistency, habit and time, there are certain cheat
sheets that can enhance your skin in a second. And these treatments are
what can come to your aid if you need a quick-fix for your moment in the
sun. After all, your skin must glow, whether you are on camera or off, and
when life says, ‘Lights, camera, action!’
Any quick-fix skin solution must always be done at a professional skin
clinic. A clinic can offer you diverse treatments, from making your skin
radiate and clearing acne and marks to zapping away wrinkles; some even
nourish dry skin, making it soft and supple. At Berkowits, we have created
an entire product range based on these wants—Clear, Nourish, Radiate,
Renew and Protect.
Being a chain of clinics, we at Berkowits see hundreds of patients across
the country. I have access to thousands of patient diaries and experiences,
and while each comes from an individual, personal standpoint, many of the
treatments they require are similar. That said, no two treatments are exactly
the same, because each patient comes with a unique physiological need. At
Berkowits, we classify all treatments under the following categories, which
makes it easy for us to curate a treatment for every individual.

1. Clear
• Chemical peels
• Intense Pulse Light (IPL)
• Non-Ablative laser
• Dermaroller
• Platelet Rich Plasma (PRP)

2. Nourish
• Chemical peels
• Hydrafacials
• Mesotherapy
• Skin boosters (dermal fillers)

3. Radiate
• Microdermabrasion
• Photofacial
• Chemical peels
• Mesotherapy
• PRP
• Laser

4. Renew
• Dermal fillers
• Botox
• Threadlift
• Mesotherapy
• PRP
• Laser
 5. Protect
• Mesotherapy
• Sunscreen

Now, let’s look at some of these in detail.

Chemical Peels

What Is It?

Also known as chemical exfoliation, in this procedure, chemical solutions

are applied to the skin in a controlled manner, causing controlled tissue
destruction. The procedure involves cleansing of an area to be treated and
application of a suitable chemical-peel solution for a certain period of time.
The treatment’s end point is neutralization of the peel, followed by cleaning
of the area and application of sunscreen.
There are various types of peels, such as AHA peels (which include
glycolic acid, lactic acid, mandelic acid and phytic acid), BHA peels
(salicylic acid), tretinoin peels, TCA peels, and azelaic acid, kojic acid,
arginine, ferulic acid, black acetic acid and phenol peels. According to your
concern, the doctor decides the strength, type and duration of the
application of the chemical peel.

Who Is It for?

Everyone can benefit from some kind of chemical peel. The many chemical
formulations target many problem areas such as acne, acne scars, dark
spots, fine lines and signs of ageing; it is also used to give skin a healthy
glow.

Duration of Treatment
Chemical peels are usually called ‘lunch time’ procedures, as the entire
process may take only fifteen to twenty minutes. The procedure is usually
repeated after a duration of fourteen to twenty-one days, and a minimum of
four to six sessions are required for the desired result. I strongly recommend
patients not to do peels at home, as it can cause burns and make your skin
excessively dry and sensitive. I usually ask my patients to undergo a
combination treatment with other procedures to get maximum benefit.
Post chemical peel, home care is necessary for at least three to seven
days. However, do not be scared of this post-treatment care—it’s just a few
simple precautions. Remember to use a gentle face wash, and apply a
moisturizing cream and a sunscreen before you step out in the sun. That’s
it! You can even apply make-up the same day if a mild peel is used.
However, I advise patients to wait a day, unless it’s a hydrating peel.

Microdermabrasion (MDA)

What Is It?

MDA involves mechanical exfoliation, which gently removes dead skin

cells from the most superficial layer of skin. This procedure is most
commonly done for the face, but can also be done on the chest, hands, back,
neck and other areas of the body. It is also commonly known as body
polishing.
The MDA technique works through a controlled graduated vacuum. It
uses aluminium oxide crystals to gently ablate the skin. Aluminium oxide is
one of the most popular crystals used in the MDA machine because they are
the hardest-known material—second only to diamonds—which makes them
strong enough to be blasted on the skin’s surface without fragmentation.
Also, they have a rough, jagged surface, which makes them excellent for
exfoliating the top layer of the skin.

Who Is It for?
Do you have a dull skin tone, uneven complexion, large pores, comedones
and mild dark spots? If yes, you may want to consider microdermabrasion.

Duration of Treatment

Around twenty to forty minutes. You can expect smooth and fresh skin in
just one session, but a course of at least four sessions leads to a more
youthful appearance. There can be slight redness and swelling after the
procedure, which lasts only for one to two hours. You must apply sunscreen
and a moisturizing cream post treatment.

Hydrafacial

What Is It?

This treatment is similar to MDA but the main difference is that, here,
exfoliation is done through a spiral tip instead of aluminium oxide crystals.
Simultaneously, we can also apply various antioxidant and hydrating
serums to get you soft, supple skin.

Who Is It for?

The ability to moisturize the skin differentiates a hydrafacial from other

forms of skin-rejuvenating treatments. After only a few sessions of
treatment, you will not only notice better facial tone and texture but also
better quality of skin and visible skin refinement. It is best for those with
dry, dull and dehydrated skin.

Duration of Treatment

Hydrafacial sessions last for about thirty minutes and, because it is a

hydrating facial, patients can return to their normal work and activities
immediately. They just need to make sure they take at least four sessions for
the desired result. Post-care moisturization and application of sunscreen is a
must.

IPL/Photofacial

What Is It?

This is one of my favourite treatments, because it not only pampers the skin
on the superficial layer, but also penetrates into the deeper layers. IPL photo
rejuvenation is more effective than other skin-rejuvenation technologies
because of the high frequency and intensity of the light used. It brings an
immediate glow to the skin, prevents impending signs of ageing and delays
the formation of wrinkles by increasing blood flow and enhancing elastin
and collagen stimulation.

Who Is It for?

People who have large pores, freckles, wrinkles, blotchy, sun-damaged or

discoloured skin, can benefit the most from an IPL photofacial. In fact, IPL
has various filters, which can be used to treat acne and even vascular
lesions. It can even be used to simply get a beautiful glow on the skin and
make it glass-like!

Duration of Treatment

At our clinics, we make sure to pamper the patient for at least an hour with
this treatment. As this procedure involves no downtime, it is a convenient
option for people with busy schedules. I’m sure you’ll fall in love with it
after just one session.

Q-Switched ND:YAG Laser/Carbon Facial

What Is It?
This laser is a triple-purpose machine. In this procedure, a beam of light is
absorbed by melanin and other coloured pigments in the skin, causing the
melanosome or tattoo ink to fragment into smaller pigment particles that are
removed by the body’s immune system. It is not a painful treatment, but a
numbing cream may be applied before the procedure. It most commonly
feels like a rubber band snapping against your skin. Also popularly known
as a carbon facial, this laser treatment is excellent to bring out an even skin
tone.

Who Is It for?

Those who want to correct uneven skin tone, fade dark spots and reduce
hyperpigmentation, and those looking for tattoo removal. Dark spots
include freckles, melasma, acanthosis nigricans, lichen planus pigmentosus,
post-inflammatory hyperpigmentation and even birth marks.

Duration of Treatment

Depends on the area treated. Ideal results are achieved in four to eight
sessions, at least two to three weeks apart. There may be a little swelling
immediately after the treatment, but it will subside in a few days.

Botox

What Is It?

Mirror, mirror on the wall, can you tell my age after all? Everyone wishes
to be ageless and timeless. If I had to put my money on a treatment that
would erase any signs of ageing and wrinkles in a jiffy, it would be Botox.
Botox is a very popular treatment overseas. However, I have come across
many Indians who are still wary of this wonderful treatment. The most
commonly asked questions are: Will I have a frozen look after the
treatment?; Will I start looking artificial?; Will my wrinkles get worse when
the Botox wears off?; Will I become dependent on the treatment?; Will my
muscles get paralysed after treatment?; Is the treatment very painful?
The answer to all the above questions is no! Botox is a purified protein
solution, which only temporarily blocks nerve signals to muscles, and hence
relaxes the muscles and prevents their formation. Injecting Botox is an art,
so always go to an experienced physician who is an expert at anti-ageing
treatments.

Who Is It for?

This therapy is approved by the USFDA to treat horizontal forehead lines,

frown lines (vertical lines between the brows), crow’s feet (lines around the
eyes) and excessive sweating of the underarms. But that’s not all—apart
from the aesthetic indications, it has also been approved for various medical
treatments, such as correction of migraine headaches, easing of muscle
aches, improving bladder control and even correcting twitching of eyelids.
It can also be used for eyebrow shaping, bunny lines on the nose, gummy
smiles, lip lines, inverted corners of the lips, dimpled chins, platysmal
bands on the neck and face slimming.

Duration of Treatment

The best thing about this treatment is that very fine needles are used to
inject the solution in your muscle, and it takes only a few minutes to
perform this procedure. So with very minor discomfort, you not only enjoy
a wrinkle-free face but also improved texture of skin and a shining glow. It
takes only three to seven days to show its full effect and the results diminish
after four to six months. The results improve with regular sessions.

Dermal Fillers

What Is It?
A patient once came to me for a treatment that would make her look at least
five years younger. I suggested dermal fillers. At the end of the treatment,
she was a convert. ‘OMG,’ she said. ‘If I start doing this when I’m thirty,
how will I look when I turn forty?’ ‘The same!’ I replied. That’s the
wonderful truth about this treatment.
The good news is that dermal fillers are composed of hyaluronic acid—a
substance naturally present in our body. It is present in our skin in large
amounts and its main function is to retain water and keep our tissues
lubricated and moist. Hydrated skin diminishes the appearance of wrinkles,
and that is one of the main reasons we turn to dermal fillers. As we age, our
hyaluronic acid reserves decrease, which leads to sagging skin and the
formation of wrinkles. So just as we take vitamin D supplements when we
are deficient, dermal fillers are like supplements for the skin.
Do not confuse Botox with fillers. Botox is used to treat dynamic
wrinkles or lines that form on expression, whereas fillers work on static
lines or hollows. They both are commonly done together and, in symbiosis,
can lift the face beautifully—popularly known as a liquid facelift.

Who Is It for?

This is a quick-fix that can instantly shape your forehead, fill under-eye
hollows, transform your nose, sculpt your cheeks, elongate your chin,
plump up your lips and contour your jawline within a few minutes, without
the need for any surgical intervention. With age, our bones get thinner,
overlying fat pads slide down and the levels of hyaluronic acid diminish,
making our face hollows more prominent and saggier. Dermal fillers help
with these issues.

Duration of Treatment

This procedure is done with very small, fine sterile needles. I always tell my
patients that if they have ever got eyebrow threading done, fillers will be
less painful and more satisfying. Because we perform the procedure with
needles, I always suggest that my patients keep a gap of at least seven days
between the procedure and any major event, as there are slight chances of
swelling and mild bruising. It gives instant results and the effect lasts for
about nine to eighteen months, depending on the area treated and the
amount of filler used. Whenever I do this treatment, I feel like a magician
with a magic wand in my hand. If you don’t like the results, the filler can be
easily dissolved by a solution called hyaluronidase.

Face Platelet-Rich Plasma (PRP): A Natural Treatment at Aesthetic

Clinics

What is it?

Popularly known as the ‘vampire facial’, PRP is an effective treatment for

facial rejuvenation. In this treatment, a patient’s own plasma is taken and
injected into the required area, which increases blood flow to the skin and
stimulates collagen and elastin production. On activation, the platelets in
the plasma release several growth factors that stimulate collagen and
peptide formation. This brings a good glow to the face.

This procedure is done by drawing about 10–15 ml blood from the arm. The
plasma is then prepared in a centrifuge machine and injected into the
concerned areas of the face, neck, hands and décolletage. A numbing cream
is applied on the area to be treated and the plasma is injected with very tiny
30-gauge needles, which cause minimal pain. If you can tolerate the
discomfort of threading, you’ll manage a PRP. The biggest advantage of
this treatment is that because this is an autologous treatment, where the
patient’s own blood is taken to prepare plasma, there is no risk of any
allergic reaction and any side-effects. If you are looking for a natural
treatment at an aesthetic clinic, this is the treatment to go for.

Who Is It for?
Improves skin texture, helps in decreasing the signs of ageing—that is,
reducing wrinkles, plumping up sagging skin and even diminishing acne
scars. It’s also a popular treatment for hair loss.

Duration of Treatment

The entire procedure takes about forty-five to sixty minutes. Mild swelling
and bruising may be seen after the procedure, but that goes away in a few
days. At least three sessions are a must to see the desired results and this
procedure works perfectly well symbiotically with other procedures. PRP is
also a very popular treatment for hair loss. However, it must be combined
with medical therapy to give significant results.

Microneedling Dermaroller

What Is It?

Microneedling is an FDA-approved skin-rejuvenation treatment, which is a

breakthrough in many aspects. In this treatment, a hand-held rolling
instrument containing 192 needles is used. The size of these needles can
vary from 0.25–2 mm. After applying a numbing cream, this instrument is
rolled on the skin, creating multiple puncture wounds on it. This stimulates
blood circulation, sends signals to our body to start the process of wound
healing and collagen production.
Never perform this procedure at home, because the skin thickness varies
in every individual, according to race, ethnicity and age. Only get
microneedling done at a clinic by a trained therapist.

Who Is It for?

Dermaroller can be used in the treatment of acne scars, dilated open pores,
aged skin with wrinkles, stretch marks and hair loss. Another benefit is that
it creates multiple open channels on your skin, through which we can infuse
various skin-brightening and anti-ageing solutions to add to the benefits.

Duration of Treatment

The procedure takes around fifteen to twenty minutes, and a minimum of

six sessions are required to deliver desired results. Proper post-treatment
care must be followed, or it can cause post-procedure pigmentation on the
skin. In my experience, people who self-treat with a dermaroller at home
often overlook the precautions and have a higher chance of developing side-
effects.

Mesotherapy

What Is It?

Like chemical peels, mesotherapy can correct and treat multiple concerns
on your face by working on the superficial layer of the skin. This treatment
works on the deeper layers of the skin, which can give you long-lasting and
effective results. Like any other injectable treatment, a numbing cream is
applied before the procedure and tiny 30-gauge needles are used to deliver
the solution.

Who Is It for?

There are a variety of mesotherapy cocktails available in the market that

can help clear your acne scars, nourish dry skin, treat a dull look, fix uneven
skin tone and renew ageing skin. The beauty of this treatment is that we can
even protect your skin from the harmful effects of the sun and pollution by
infusing antioxidant solutions. The doctor will choose the right ingredients
and formulate the therapy according to the patient’s needs.

Duration of Treatment
At least four to six sessions are required to deliver adequate results and the
patient will start to see improvement after the third session. It’s only a ten-
minute session.

Radiofrequency Cautery

What Is It?

This treatment is used to correct various dermatological conditions. Done

under anaesthesia, this procedure uses high-frequency energy waves to
cauterize skin lesions and simultaneously coagulate the tissue to avoid any
skin bleeding. It is easy to perform and gives instant results.

Who Is It for?

Radiofrequency is a commonly used treatment for the removal of skin tags,

warts, calluses, freckles, moles, milia, seborrhoeic keratosis and even
dermatosis papulosa nigra (DPN).

Duration of Treatment

A scab may form after treatment, which falls off within seven days. It takes
about fifteen to twenty minutes to perform the treatment. Usually, a single
session is enough. However, a repeat session may be given after seven to
ten days if the lesions persist.

Lasers

What Is It?

There are many lasers available in the market, which have their own
mechanism of action and method to treat a problem area. They can be long-
pulsed or Q-switched, depending on the time taken to pass the beam, and
could be non-ablative or ablative, based on if they work on intact skin or
burn off a portion of the skin. All you need to know is that these are very
effective treatments that do not involve needles. So if you have a phobia of
needles, this should be your go-to treatment. They usually work at the level
of the dermis, giving you a long-lasting result.

Who Is It for?

This clears acne scars, gives you an instant glow, corrects

hyperpigmentation and renews ageing skin by decreasing fine lines and
wrinkles. The most popular laser is for hair reduction—and I swear by that
treatment. For more information on laser hair reduction, you can visit my
YouTube channel and see detailed videos on it. Lasers also work on fat
reduction, body slimming and correcting stretch marks.

Duration of Treatment

Make sure you take at least four to six sessions to get the desired outcome
and do follow the post-care instructions after every treatment mentioned
below.

General Post-Care Instructions after Skin Aesthetic Treatments

All the above treatments are extremely effective and give long-lasting
results. However, to avoid any side-effect, make sure you follow these post-
procedure instructions.

What Not to Do

Do not use any make-up for at least twenty-four hours.

Don’t use any medicated ointment or night cream for at least three
days before and after the treatments.
Avoid gymming for forty-eight hours.
 Do not use any heat treatments such as steam, sauna and hot
showers for seven days.
Avoid swimming for seven days.
Do not use any bleach or similar products on the treated area for
seven days before and after the treatment.
Avoid facials or scrubs for at least seven days.

What to Do

Use a gentle cleanser at least three days after the procedure.

Use a moisturizing cream or healing cream at least two to three
times a day post procedure for the next three to five days.
Sunscreen application post treatment is a must even if at home. It
should become part of your daily routine.
Aloe vera gel or ice may be applied to soothe skin if necessary
afterwards.

Patient Diaries

Case 1

Nitara, a twenty-seven-year-old girl, graduated from IIM and got a job in

the IT sector. Her long working hours made it difficult for her to fit in a
skincare routine. In the months leading up to her wedding, she wanted
glowing skin. She has dry skin type, under-eye hollows from long hours on
her laptop, and thin lips.
Now let’s break down Nitara’s case. Nitara wanted to renew her look by
correcting her under-eye hollows and adding a little plumpness to her lips.
She has dry skin type, for which she would have to take nourishing skin
treatments to make her skin soft and supple. In the six months leading up to
her wedding, she wanted her skin to glow.
The treatment for Nitara is like solving a puzzle. Just use the key I have
mentioned above. The treatments that she should opt for are chemical peels,
hydrafacials, mesotherapy or skin boosters to nourish her skin,
microdermabrasion, photofacial or other medical facials to make her skin
radiant, dermal fillers to correct her under-eye hollows, plump up her lips
and renew her face. Using a sunscreen to protect her skin is mandatory,
whether she goes for treatment or not. If you also find yourself having the
same concerns as Nitara, and you don’t want to go for any treatment,
simply use the products. They will have slow, steady and limited results, but
will tackle your concerns if used consistently.

Case 2

Chaitra is a nineteen-year-old girl who’s just graduated and moved to

Chennai to begin studying medicine. Seeing new acne lesions on her face
has become a routine affair for her. She has been suffering from this for the
past five years and has followed various home remedies. She has even
visited multiple doctors for treatment. But because she frequently changed
her doctors, her acne was never treated properly. She also had a habit of
picking at her acne, which led to scars/pits on her face. Now, a change of
environment and food, coupled with exam stress, is taking a toll on her
skin. The many pus-filled lesions have depleted her confidence to such an
extent that she hates stepping out of her room.
Let’s have a look at Chaitra’s case in detail and understand what she
could have done to treat her acne sooner.
The main reason Chaitra’s acne didn’t get treated effectively was because
she changed doctors frequently. Acne treatment takes time and requires
patience to show effects. It is imperative to follow the doctor’s instructions
and have faith in the process. Secondly, picking on acne is detrimental to
recovery. It leaves behind pits and scars that cannot be treated effectively by
any medical therapy. And, most importantly, one should not depend on
home remedies to treat acne. Take professional help to clear it—that’s the
fastest and most effective way to get rid of it.
Chaitra’s main concern was to clear her acne and acne scars. Medical
therapy would be the first line of treatment for her acne, but it can be
coupled with clinic treatments to give faster results. Treatments with
maximum benefits are chemical peels, such as salicylic peel, sali-mandelic
peels, and azelaic acid and phenol peels. Even an IPL treatment can be a
good option for treating acne. However, in my experience, chemical peels
are better and more effective.
There is no effective medical therapy to treat acne scars. Retinoid creams
are an option but usually give limited results. I have treated multiple cases
of acne scars, and the most effective treatment for it is a combination of
microneedling dermaroller, non-ablative laser treatment and PRP. At least
four to six sessions of these treatments are required to clear acne scars by
60–70 per cent. The use of sunscreen is a must for post medications and
procedures.
 16
HOW TO READ A PRODUCT LABEL LIKE A
PRO

A Louis Vuitton and a Hidesign bag are both made of leather. Yet the price
difference is a world apart. It’s up to you, the consumer, to choose the price
point. A Hidesign bag is a really good-value leather bag. It’s the same for
skincare. Expensive does not necessarily mean good. Not all that glitters is
gold. Especially when it comes to skincare products. In fact, especially with
skincare products, what’s inside a bottle or jar counts more than the
packaging. But there’s a catch. How do you really know if the product you
want to buy will deliver all that it claims to? After all, you do want value
for every buck you spend.
The best way to know if a product is worth your money is to be able to
understand the ingredients it contains. You already know what active
ingredients you need to look out for that work best for your skin type and
skin condition. Now let’s learn how to read a product label, so you are
guaranteed those ingredients for what you are paying.

The Elements of a Product Label

Even though the outer packaging of every product seems different, the story
behind every label is rather similar. Every product that is legitimate needs to
follow the FDA guidelines and state the following:*

1. Brand name and product name

2. Description of the product/product type
3. List of ingredients
4. Net quantity of the product
5. Contact details of manufacturer

For example, in the picture, the brand name of the product is ‘Berkowits’
and the product name is ‘Nourish’. The product type is a conditioning
shampoo. The net quantity of the product is 1 litre. The details of the
manufacturer are mentioned on the right hand side of the label (behind the
bottle). It is extremely important to know the quantity of the product before
you pay the bill, so check whether it’s giving you value for money.
Now, other than the information above, it is vital to understand the list of
ingredients and the meaning of the symbols on every product.

What Is an INCI List?

An INCI (International Nomenclature for Cosmetic Ingredients) list is
simply the ingredients mentioned on the back of the product in their
chemical and Latin forms. For example, the chemical name for water is
aqua.
Below are some INCI list names of common ingredients:

Aqua: water
Caprylic/capric triglyceride: liquid fraction of coconut oil
Glycerine: humectant
Cetearyl alcohol: emulsifier
Sodium stearoyl lactylate: solubilizer, emulsifier
Sucrose stearate: emulsifier
Aloe barbadensis leaf juice powder: aloe vera
Tocopherol: vitamin E
Xanthan gum: naturally derived thickener
Parfum: fragrance
Linalool: fragrance component/allergen
Hexyl cinnamal: fragrance component/allergen

Some preservatives commonly used for natural cosmetics and skincare

products:
Benzyl alcohol, dehydroacetic acid, potassium sorbate, sodium benzoate.
You can find the complete list of preservatives and perfume agents on the
INCI decoder website (www.incidecoder.com).

How to Read an INCI List

I consider this step the most important when making a purchase. A majority
of skincare products mention their key/active ingredients in the front. This
adds to the appeal of the product. However, before being impressed, do not
forget to check the complete ingredient list at the back and the order in
which they are listed.
The most important thing to note is that the ingredients mentioned first are
present in the highest quantities and the ones mentioned at the end are
present in the lowest. For example, in the picture on the previous page,
vitamin C is highest quantity, followed by citric acid, then sodium
hyaluronate. And allantoin is the least.
So, if you are in the market for a vitamin C product to tackle
pigmentation, vitamin C must be mentioned in the top five ingredients for
the product to be effective. Just ignore what the packaging says. The INCI
list is what matters.
The only exception to this rule is retinol, which is usually present in low
percentages: 0.25–0.5 per cent. However, vitamins, peptides and most other
actives should be more than 1 per cent and high up the list.
But do keep in mind that although an INCI list is a good way to judge a
product, companies don’t always list all their ingredients. Luxury
companies tend to leave out certain ingredients to avoid being copied by
others.

Organic Ingredients
In India, organic products have always been successful, because we have an
inherent instinct to believe in traditional home remedies. So it is only
natural that when we see a product listed as ‘organic’ or ‘natural’, we think
it is amazing and without any side-effects. I am not against organic products
but when a product claims it is organic, make sure it is!
The truth is that a product can claim it is organic due to the presence of
organic almond oil as an ingredient. However, if the quantity of this organic
oil is just 1 per cent, such a small amount would hardly be of any benefit.
Also, it could be that except for the organic almond oil, the other
ingredients are not organic. But since they have the word ‘organic’ printed
prominently on the label, it makes the consumer think that the entire
product is organic. This is a false claim. Ensure that you check and confirm
the organic label at the back of the product. Legitimate organic brands are
Ecocert Cosmos-certified. Check out the symbols from pp. 281–283 to
understand what they mean.

Alcohols in Skincare: Should You Use Them?

First, by alcohol, I don’t mean a glass of wine! We are talking about

alcohols in skincare—one of the most controversial ingredients out there.
You don’t need to abandon a product just because it has the word ‘alcohol’
in it. Just make sure it’s one of the good guys.
Let’s look at the main alcohols in skincare and their uses, and then
determine if they are as bad as people make them out to be. Alcohols in
skincare can be divided into three categories:*

1. The good alcohols: Cetyl alcohol and cetearyl alcohol are fatty
alcohols that not only act as emollients but also have emulsifying
properties that help water and oil blend together. These alcohols are
actually good for dry and sensitive skin because they are non-
drying, non-irritating and give your skin a soft feel.
2. Preservative alcohols: Benzyl alcohol is an aromatic alcohol used
as the fragrance component in many cosmetic products. It also has
 a role as a preservative, solvent and viscosity-decreasing agent.*
They are usually the last ingredients on an INCI list and are not
irritating. However, people with sensitive skin should watch out for
this one, as it may cause them trouble.
3. The bad guys: Isopropyl alcohol and denatured alcohol (alcohol
denat or SD alcohol) are the main culprits that have given alcohols
such a bad name. These are usually found in strong, astringent
toners, which can be very drying to skin. Even though not everyone
has an adverse reaction to these alcohols, if you have even the
slightest skin sensitivity, I’d recommend staying away from these.
Also, if you’ve started using a new product and it’s causing a bad
reaction, check the INCI list for this ingredient.

Parabens in Skincare: Are They Safe to Use?

In the past decade, all hell has broken loose about parabens in skincare
products. Every day I get asked by my patients if the parabens in their
skincare is harming their skin, because people actually believe that parabens
are toxic. This is a classic case of scare-tactic marketing. The truth is that
there is no definite scientific literature that says parabens are harmful for
us.*† The studies that were used to bring the adverse effects of parabens into
the limelight were small and not empirical. So much so that the use of
parabens in skincare products has been approved by the FDA,‡ the
American Academy and also the British Academy of Dermatology.
It’s really unfortunate that parabens have got such a bad name, because
they are considered an ideal preservative ingredient. They prevent the
spread of mould and bacterial growth. So don’t be worried if your product
doesn’t say ‘paraben-free’ on the label—just give it a go!

Ingredients to Look for and Those to Avoid in Skincare Products

There are various ingredients that are ideal for your skin type and some that
are an absolute no-no. To go back to the list of active ingredients suitable
for each skin type and condition, go to Chapter 6 (see p. 133) to refresh
your memory. Here’s an ingredient checklist for all skin types and
conditions.

Sensitive Skin Checklist

Things to look for:

• Camomile extract
• Aloe vera
• Ceramides
• Hyaluronic acid
• Lactic acid in low percentages

Things to avoid:
• Sulphates, such as sodium lauryl sulphate and sodium laureth sulphate
• Fragrances (parfum)
• Essential oils, such as Melaleuca alternifolia (tea tree) leaf oil, Citrus
medica limonum (lemon) oil
• Retinol (form of retinoids)
• High percentage of acids

Oily to Combination Skin Checklist

Things to look for:

• Salicylic acid
• Green tea extract
• Azelaic acid
• Vitamin C
• Retinol
• Hyaluronic acid
• Glycolic acid
Things to avoid:
• Occlusive emollients such as mineral oils (petrolatum or paraffinum
liquidum)
• Alcohols such as isopropyl alcohol and denatured alcohol
• Harsh scrubs

Dry Skin Type and Dehydrated Skin Checklist

Things to look for:

• Vitamin E
• Hyaluronic acid
• Squalene
• Shea butter
• Ceramides
• If your skin is dehydrated, also look for glycerine and aloe vera

Things to avoid:
• Sulphates
• Retinoids
• AHAs (except lactic acid)
• BHAs
• Willow bark extract (the natural version of salicylic acid)
• Alcohol
• Fragrances

Pigmentation Checklist

Things to look for:

• Kojic acid
• Arbutin
 • Vitamin C
• Niacinamide
• Liquorice
• Retinol
• Mandelic acid
• Azelaic acid
• Glutathione
• Glycolic acid

Things to avoid:
• Steroids (only as advised by a doctor)
• Hydroquinone (only as advised by a doctor)

Mature Skin Checklist

Things to look for:

• Retinol
• Bakuchiol
• Ceramides
• Copper tripeptide
• Hyaluronic acid
• AHAs
• Peptides
• Coenzyme Q10

Things to avoid:
• Fragrances
• Sulphates (such as sodium lauryl sulphate and ammonium lauryl
sulphates)
• Alcohols
What Do Symbols Mean?

All products that are made in Europe and the US have these symbols
printed on the packaging by law. Below are some of the most commonly
seen symbols. Just remember that you won’t find them on a majority of
products manufactured in India.

PIC 1, 2:

PIC 3:

PIC 4, 5, 6:
PIC 7:

PIC 8:
PIC 9:

PIC 10, 11:

1. This symbol signifies the period after opening. The product must be
consumed within thirty-six months after it has been opened
(according to the timeline mentioned on the jar).
2. This symbol means its best-before date. The product must be
consumed within the date mentioned, regardless of when it was
opened.
3. Recyclable: This symbol means that the package of the product can
be recycled.
4. 5, 6. These symbols mean that the products are cruelty-free.
7. This symbol means that the product is Organic/Natural. USDA
organic: United States standard for organic products.
8. Cosmebio: This symbol is the French standard for natural and/or
organic cosmetics.
9. EcoCert: France-based international standard for organic foods and
cosmetics.
10, 11. These symbols are the logos and a sort of certification given to a
product by an external official organization, which means that the
product has met certain quality standards. Sometimes, some brands
also create their own logos, which are not official. These are
marketing strategies, and there is no way of confirming the product’s
genuineness.
 *
Laura Shin, ‘Inside The Booming Korean Skincare Market’, Fast
Company, https://www.fastcompany.com/3038283/why-korean-skincare-is-
booming
*
‘South Korea Cosmetics Market Outlook 2017-2030’, Goldstein Market
Intelligence, https://www.goldsteinresearch.com/report/korean-cosmetics-
market-report-south-korea-industry-analysis
*
Amanda Montell, ‘“I Had an Anti­-Aging Routine at 11”: The Backstory
of Korean Beauty’, Byrdie, 16 March 2020,
https://www.byrdie.com/korean-beauty-2016
 *
Wilfredo Lopez-Ojeda, Amarendra Pandey, Mandy Alhajj and Amanda
M. Oakley, ‘Anatomy, Skin (Integument)’, StatPearls, 20 November 2020,
https://www.ncbi.nlm.nih.gov/books/NBK441980/
*
‘How to Control Oily Skin’, American Academy of Dermatology,
https://www.aad.org/public/everyday-care/skin-care-basics/dry/oily-skin
*
Eve Merinville, Cyril Messaraa, Carla O’Connor, Gemma Grennan and
Alain Mavon, ‘What Makes Indian Women Look Older—An Exploratory
Study on Facial Skin Features’, Cosmetics, 1 January 2018,
https://www.mdpi.com/2079-9284/5/1/3
 *
Anne Harwood, Ali Nassereddin and Karthik Krishnamurthy,
‘Moisturizers’, StatPearls, 2 June 2020,
https://www.ncbi.nlm.nih.gov/books/NBK545171/
*
Anisha Sethi, Tejinder Kaur, S.K. Malhotra and M.L. Gambhir,
‘Moisturizers: The Slippery Road’, Indian Journal of Dermatology, May–
June 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4885180/
*
Anisha Sethi, Tejinder Kaur, S.K. Malhotra and M.L. Gambhir,
‘Moisturizers: The Slippery Road’, Indian Journal of Dermatology, May–
June 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4885180/
 *
‘Definition of Active Pharmaceutical Ingredient’, World Health
Organization, July 2011, https://www.who.int/medicines/areas/
quality_safety/quality_assurance/DefinitionAPI-QAS11-426Rev1-
08082011.pdf
*
Rong Kong, Yilei Cui, Gary J. Fisher, Xiaojuan Wang, Yinbei Chen,
Louise M. Schneider and Gopa Majmudar, ‘A comparative study of the
effects of retinol and retinoic acid on histological, molecular, and clinical
properties of human skin’, Journal of Cosmetic Dermatology, 18 November
2015, https://onlinelibrary.wiley.com/doi/full/10.1111/jocd.12193
*
E.A. Duell, S. Kang and J.J. Voorhees, ‘Unoccluded retinol penetrates
human skin in vivo more effectively than unoccluded retinyl palmitate or
retinoic acid’, The Journal of Investigative Dermatology, September 1997,
https://pubmed.ncbi.nlm.nih.gov/9284094/
*
‘Tretinoin Superstar’, INCI Decoder,
https://incidecoder.com/ingredients/tretinoin
*
Caroline Hirons, Skincare: The Ultimate No-Nonsense Guide,
HarperCollins, Kindle edition, 2020, p. 52.
*
R.K. Chaudhuri and K. Bojanowski, ‘Bakuchiol: A Retinol-like
Functional Compound Revealed by Gene Expression Profiling and
Clinically Proven to Have Anti-aging Effects’, International Journal of
Cosmetic Science, June 2014, https://pubmed.ncbi.nlm.nih.gov/24471735/
*
Silke Karin Schagen, ‘Topical Peptide Treatments with Effective Anti-
Aging Results’, Cosmetics, 22 May 2017, https://www.mdpi.com/2079-
9284/4/2/16/htm
*
Chedli Ellijimi et al, ‘Helix aspersa maxima mucus exhibits
antimelanogenic and antitumoral effects against melanoma cells’,
Biomedicine & Pharmacotherapy, 22 March 2018,
https://pubmed.ncbi.nlm.nih.gov/29635896/
*
‘Alpha Hydroxy Acids’, US Food and Drug Administration,
https://www.fda.gov/cosmetics/cosmetic-ingredients/alpha-hydroxy-acids
*
Walter P. Smith PhD, ‘Epidermal and dermal effects of topical lactic
acid’, Journal of the American Academy of Dermatology, September 1996,
https://www.sciencedirect.com/science/article/abs/pii/S0190962296906027
*
Joachim W. Fluhr and Klaus Degitz, ‘Antibiotics, azelaic acid and
benzoyl peroxide in topical acne therapy’, Journal of German Society of
Dermatology, March 2010, https://pubmed.ncbi.nlm.nih.gov/20482689/
 *
Pumori Saokar Telang, ‘Vitamin C in dermatology’, Indian
Dermatology Online Journal, April–June 2013,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673383/
*
Jacquelyn Levin and Saira B. Momin, ‘How Much Do We Really Know
About Our Favorite Cosmeceutical Ingredients?’, The Journal of Clinical
and Aesthetic Dermatology, February 2010,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921764/
*
Sidharth Sonthalia and Rashmi Sarkar, ‘Glutathione for skin lightning:
an update’, Pigment International, June 2017,
http://www.pigmentinternational.com/article.asp?issn=2349-
5847;year=2017;volume=4;issue=1;spage=3;epage=6;aulast=Sonthalia
*
Mohammad Abid Keen and Iffat Hassan, ‘Vitamin E in dermatology’,
Indian Dermatology Online Journal, July–August 2016,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976416/
*
Se-Kwon Kim and Fatih Karadeniz, ‘Biological importance and
applications of squalene and squalane’, Advances in Food and Nutrition
Research, 2012, https://pubmed.ncbi.nlm.nih.gov/22361190/
 *
Maryam Moosavi, ‘Bentonite Clay as a Natural Remedy: A Brief
Review’, Iranian Journal of Public Health, September 2017,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5632318/
*
Larissa Meier, Rainer Stange, Andreas Michalsen and Bernhard
Uehleke, ‘Clay jojoba oil facial mask for lesioned skin and mild acne--
results of a prospective, observational pilot study’, Forschende
Komplementärmedizin, 19 April 2012,
https://pubmed.ncbi.nlm.nih.gov/22585103/
†
Basim Abu-Jdayil and Hazim A. Mohameed, ‘A facial mask comprising
Dead Sea mud’, Journal of Cosmetic Science, November–December 2006,
https://pubmed.ncbi.nlm.nih.gov/17256074/
*
M.V.R. Velasco et al, ‘Short-term clinical of peel-off facial mask
moisturizers’, International Journal of Cosmetic Science, August 2014,
https://pubmed.ncbi.nlm.nih.gov/24750029/
 *
Amita H. Sutaria, Sadia Masood and Joel Schlessinger, ‘Acne Vulgaris’,
StatPearls, 8 August 2020,
https://www.ncbi.nlm.nih.gov/books/NBK459173/
*
David A. Whiting, ‘Acne’, Western Journal of Medicine, December
1979, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1271924/?page=2
*
J. Ayer and N. Burrows, ‘Acne: more than skin deep’, Postgraduate
Medical Journal, August 2006,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585707/
*
Richard M. Rubenstein and Sarah A. Malerich, ‘Malassezia
(pityrosporum) folliculitis’, The Journal of Clinical and Aesthetic
Dermatology, March 2014, https://pubmed.ncbi.nlm.nih.gov/24688625/
*
Edileia Bagatin et al, ‘Adult female acne: a guide to clinical practice’,
Anais Brasileiros de Dermatologia, January–February 2019,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360964/
†
‘Adult Acne’, American Academy of Dermatology,
https://www.aad.org/public/diseases/acne/really-acne/adult-acne
*
José Bellver et al, ‘Polycystic ovary syndrome throughout a woman’s
life’, Journal of Assisted Reproduction and Genetics, January 2018,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758469/
*
Patricio P. Gallardo Avila and Magda D. Mendez, ‘Milia’, StatPearls, 1
October 2020, https://www.ncbi.nlm.nih.gov/books/NBK560481/
*
Manas Ranjan Puhan and Bharati Sahu, ‘Pseudofolliculitis Corporis: A
New Entity Diagnosed by Dermoscopy’, International Journal of
Trichology, January-March 2015,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4387696/
 *
S. Rahrovan, F. Fanian, P. Mehryan, P. Humbert and A. Firooz, ‘Male
versus female skin: What dermatologists and cosmeticians should know’,
International Journal of Women’s Dermatology, September 2018,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116811/
*
Ibid
†
Ibid
 *
According to the CDC (Centers for Disease Control and Prevention),
more than one drink per day (which is one glass of wine, 500 ml beer, 50 ml
of alcohol of 40 per cent strength, or 1.5 pegs) can be harmful for your
health (https://www.cdc.gov/alcohol/faqs.htm)
*
Lefebvre M.A., Pham D.M., Boussouira B., Bernard D., Camus C. and
Nguyen Q.L., ‘Evaluation of the impact of urban pollution on the quality of
skin: a multicentre study in Mexico’, International Journal of Cosmetic
Science, 18 March 2015, https://europepmc.org/article/med/25655908
*
Christian R. Juhl et al, ‘Dairy Intake and Acne Vulgaris: A Systematic
Review and Meta-Analysis of 78,529 Children, Adolescents, and Young
Adults’, Nutrients, August 2018,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6115795/
*
Baby Chauhan, Gopal Kumar, Nazia Kalam and Shahid H. Ansari,
‘Current concepts and prospects of herbal nutraceutical: A review’, Journal
of Advanced Pharmaceutical Technology & Research, January–March
2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3645360/
*
David L. Vollmer, Virginia A. West and Edwin D. Lephart, ‘Enhancing
Skin Health: By Oral Administration of Natural Compounds and Minerals
with Implications to the Dermal Microbiome’, International Journal of
Molecular Sciences, October 2018,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213755/
*
Sidharth Sonthalia and Rashmi Sarkar, ‘Glutathione for skin lightning
[sic]: an update’, Pigment International, June 2017,
http://www.pigmentinternational.com/article.asp?issn=2349-
5847;year=2017;volume=4;issue=1;spage=3;epage=6;aulast=Sonthalia
*
Deanna M. Minich and Benjamin I. Brown, ‘A Review of Dietary
(Phyto)Nutrients for Glutathione Support’, Nutrients, September 2019,
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 *
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 Acknowledgements

Writing a book is one of the most rewarding yet challenging experiences,

and this adventure will be forever etched in my life.
I owe this book to both my mothers and my fathers. One made sure I
built a strong foundation and the other showed me the light to build my
future.
Dad, you have always been my guide, teacher and support whenever I
felt lost. Thank you for instilling in me the confidence to attempt to write a
book.
Mom, you are a superwoman! You have been the biggest inspiration in
my life, which has always encouraged me to work tirelessly and be a
working woman and homemaker at the same time.
A big hug of gratitude to my father-in-law for always being so
supportive. Your intelligence, spontaneity, hard-working nature and charm
astound me. You have been one of my biggest role models. And my mother-
in-law, for being the most non-typical ‘saas’—for being extremely flexible
and attending to all my cravings during pregnancy.
Dr Alia Rizvi—you have been my biggest teacher. Your presence in my
life is invaluable.
My entire team at Berkowits. All of you have been wonderful. A sincere
thanks to Arpit, for giving me the space and the time to write my dream and
cooperating with me during my times of absence, when I had to meet
deadlines.
Thank you, Anubhav, my brother, for being the bright elder brother and
for always setting such a high benchmark, whose footsteps I have followed
in. And a big hug to Tanvi and Kanupriya, my sister-in-law, for adding fun
and creativity to our lives.
 Thank you Apeksha, Vidhi, Simar, Pihu and all my lovely friends for
being just a phone call away, and to all my friends, family and well-wishers.
This book would not have been possible without your blessings.
My heartfelt thanks to my commissioning editor, Radhika Marwah, for
believing in me and letting me pen down my ideas to shape this beautiful
book. When you gave me the green light, I pinched myself because it was
too good to be true. My editors, Trisha Bora and Ujjaini Dasgupta—your
suggestions and inputs have been indispensable.
This book would not have come into existence without my followers and
patients, who have always showered me with love and trust. Thank you so,
so much, from the bottom of my heart, for supporting me—it means the
world to me.
Thank you, COVID-19, for giving me ample time to write this book. You
shall never be forgotten.
Last but not the least, my adorable family. Anantika and Anaahita—
thank you for being such wonderful cooperative children while I was
writing this book. You are the two little angels in my life who will always
inspire me to give everything my best. And my husband. You are my guide,
my friend, my emotional support and my family. You have always been the
biggest motivator and source of strength. You are the wings that have
helped me fly high and I will always pray we spread our wings in this
universe together.
 THE BEGINNING

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This collection published 2021

Copyright © Dr Anupriya Goel 2021
The moral right of the author has been asserted
This digital edition published in 2021.
e-ISBN: 978-9-39114-959-8
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