These days, there's so much information about skin care out there that the consumer has become the expert. Beauty fanatics know their retinol from their vitamin C, their AHAs from their PHAs, and their hyaluronic acid from their salicylic. But even so, it can still be hard to cut through the white noise and distinguish fact from fiction, especially when so many brands are built on reviews and Instagram likes. The ability to look past the usual PR trappings and have an open conversation with skin-care shoppers is a good thing (usually), but sometimes a dermatologist's science-backed advice is the only way to get to the crux of a skin issue.
That's exactly what led dermatologist Dr. Anjali Mahto, one of the United Kingdom's leading practitioners, to publish a book called The Skincare Bible. "One thing that has really struck me with the advent of social media over the last five to 10 years is that there is so much conflicting information for those wanting advice about their skin from both a medical and beauty point of view," Dr. Mahto explains. "More and more, people are turning to the internet as their first port of call for information, and one thing I was noticing in my clinics as a result of this was the amount of time, effort, and money being wasted by people on products that weren’t going to work. The Skincare Bible was an opportunity to provide quality information grounded in science, based on my role as a consultant dermatologist."
Her book (appropriately described as "Your No-Nonsense Guide To Great Skin") covers everything from finding your ideal everyday routine to how to tackle specific concerns like acne, rosacea, dark spots, and under-eye circles. It's a thorough but easy-to-read guide that's relevant to anyone of any age who's interested in skin care. Between answering specific questions (like whether there are any circumstances where a blood test could be useful for acne) and providing step-by-step regimens under "The Lazy Girl's Guide to Anti-Aging Skin Care," there's nothing Mahto doesn't cover.
Ahead of the book's launch, we asked the consultant, writer, and dermatologist about our biggest skin-care misconceptions, her clients' most common concerns, and if there's really a different between professional treatments and the kind you can pull off at home.
How did you end up working in skin care?
"I struggled a lot with my own skin as a teenager, and my first dip into skin care was probably similar to a lot of other people. I spent hours browsing [drugstore aisles], looking for a miracle face wash and spot treatments for my cystic acne. After most of my teenage years with my skin getting worse, not better, I eventually went on Accutane, which at the time literally changed my life. My skin was spot-free for the first time as a teenager, just before I went to university.
I studied medicine and also got a degree in pharmacology from Cardiff University [in Wales], and knew fairly early on that I was interested in dermatology. My acne came back over the years and I also suffered with a number of other skin issues, and specializing in skin seemed like an obvious thing to do. I found that I understood it not just from a medical perspective but also from the point of view of a patient. Having to take medicines or use creams and the significant impact that had on my daily routine, as well as my visible skin conditions affecting how I felt when I looked in the mirror, all led to my career choice.
I qualified in 2004 before deciding to apply to specialize in dermatology. I got a position in London and have now been a consultant for over five years."
How has the skin-care industry changed since you first started out?
"There are a number of things that are very different from my days as a teenager in the early 1990s. The sheer volume of products on the market is the biggest one — I remember just having Clean & Clear and Clearasil for my spots! Trends have changed, too — skin-care routines have become so much more complicated and multistep, but I remain skeptical that we need to layer so many products onto our skin. We have become much more aware of the importance of sunscreen use for preventing premature skin aging, and there's been a drive towards skin care labeled 'natural' or 'organic' as wellness has gained popularity – again, not something I think is necessarily a good thing. It leads to the misconception that these products are somehow safer or better than synthetic ones."
Skin care has become more democratic and consumer-friendly. As a trained professional, what's your view on this?
"The beauty industry needs to sell, so it benefits to be more consumer-friendly. Using influencers to promote or sell a new face cream or beauty product is the new normal, but we need to remember that often money exchanges hands for this. One of the problems this leads to is [the difficulty of] getting genuine, evidence-based advice. Most beauty products overstate or oversell the benefits they can provide."
What's the biggest misconception people have about skin care?
"There is an idea that skin-care needs to be complicated or expensive to be genuinely worthwhile. This crops up over and over again, talking to patients, family, friends, and acquaintances. It doesn't. Cheaper products can work just as well as expensive ones, and we don't need to be using complex routines in the morning or evening."
What's the biggest skin-care concern your clients come to you with?
"The top reasons I see patients are for acne, pigmentation, facial redness, and prevention of skin aging. These are all incredibly common problems faced by nearly all of us at different stages in our life, and often require the right skin care combined with medical prescriptions, and occasionally laser or injectable treatments. Being able to see one individual that can provide all of these things rather than chopping and changing practitioners is much better for the patient and treatment of their skin. It means I have a relationship of trust with my patients and continuity of their care."
In your opinion, can at-home skin care ever be as good as professional treatments?
"For those people that don’t have any specific skin problems and are blessed with 'normal' skin, most basic home skin care such as moisturizers will be adequate. However, if there is a problem with the skin, then home skin care as a general rule will work for mild concerns but will never be as effective as clinic-based treatments. The same goes for those interested in reducing skin aging; at-home skin care is not as good as professional treatments. The simplest reason for this is that clinic-based treatments are stronger than what can be sold to the general public. I see people on a daily basis in my clinic that have spent a fortune on skin care which simply is not going to work despite what the packaging says."
What are you most excited about in skin care right now?
"More brands offering products that contain active ingredients at good concentrations with a very reasonable price point. I’m not going to use any trendy buzzwords surrounding skin care as I suspect that is all they will be: trends and fads that will come and go. Sunscreen and retinol, though, aren't going anywhere."
What does the future of skin care look like?
"The way things are going, I think we'll continue to see an explosion of more and more new 'pseudoscience' products — growth factors, stem cells, microbiome manipulation, DNA testing. While the science behind these sounds plausible and exciting, we need to turn to the actual medical evidence at hand and seek the advice of a good cosmetic scientist to really prove they work. Ingredients in a lab test tube in isolation do not necessarily act in the same way when applied to human skin in the context of a cream or serum. I think we should always maintain a healthy dose of skepticism."