M: Mai Davis, host
T: Dr Tamara Griffiths, Consultant Dermatologist

M: Hello my name is Mai Davis and welcome to the Health and Beauty Show. Now we live in a world which is obsessed with beauty and especially youth. We’re bombarded with all this information about the latest anti-aging treatments from cosmetic creams, over-the-counter creams at one end to non-cosmetic treatments like Botox through to of course full face-lifts and cosmetic surgery. With the current rash of programmes on the television they’re everywhere you look – Extreme Makeover, the Swan, 10 Years Younger – it seems we have a huge appetite for looking younger. Now a new report out today by the company Restylane aims to shed light on some of these treatments available, what we’re looking for, how we want to look and how far we’re willing to go to achieve that look. Joining me is Dr Tamara Griffiths who is a consultant dermatologist in Manchester. Just quickly this report from the company Restylane, it features products that are safe, that are natural, because many people are worried about unnatural and unsafe things aren’t they?

T: Absolutely I think these procedures have become extremely popular because they do give excellent results but also are very low risk so certainly many of these minimally invasive procedures such as hyaluronic acid like Restylane fill the gap between topical anti-ageing creams and full-blown plastic surgery so it’s a middle ground

M: Let’s have a look at some pictures from the Restylane website, they’re before and after pictures if you like and you can talk us through them and tell us what has happened in these slides

T: Ok

M: Let’s have a look at the first one – we’ve got a picture of – what are we seeing here, ok it’s the lips we’ve got lips that appear to be full of lines?

T: Yes these are what we call smoker’s lines or lipstick lines that occur around the mouth and do age the face in addition to the nasal labial lines and the lines –

M: So which lines, these are the lines that go from the mouth to the chin?

T: Between the nose to the corner of the mouth and then the corner of the mouth down, so these are all lines and shadows that can create a much older appearance and tend to give away a person’s age

M: Ok and how to people get those lines because I’ve heard them called smoker’s lines –

T: Yes yes

M: The ones around the lips, but it doesn’t – it’s not just smokers who get them?

T: Well smoking certainly can cause premature ageing or damage to the skin but really the changes that occur in the skin that we associate with looking old are actually due to cumulative sun exposure, so it’s really photo damage over one’s lifetime. But in addition these lines are a result of loss of subcutaneous facial fat, so in our youth the face is full and plump and evenly balanced, you can think of a child or a teenager but sadly as we get older the fullness of the face diminishes, the fat pads shrink down, the skin doesn’t spring back quite so well and we get these hills and valleys, of shadows and light

M: Ok so in the second picture, obviously we can see that those lines have been evened out slightly, so it’s going back to a more youthful look. What’s in this stuff though, because people watching this might think hang on I’m having stuff injected into my face, is it safe? What’s in it?

T: Well hyaluronic acid is a product that occurs naturally in our bodies and in our skin, so it is a natural product. It’s a clear, colourless gel that really attracts water, plumps up the skin and restores this youthful volume that we discussed. Restylane has a very long and strong safety track record, it’s a product that’s been around for over 10 years

M: Ok if you want to ask Tamara a question all you have to do is go to the bottom of the screen to the box, put in your name, where you’re from, your question and we’ll try and get through as many questions as we can. Before we come to the questions Tamara, what kind of people come for these kinds of treatments, is there an age they start at, or an ideal age?

T: Well I wouldn’t necessarily say there’s an ideal age, I look upon embarking on these cosmetic treatments, it’s a bit like a step ladder, so on the first rung we have creams, anti-ageing creams, certainly photo-protection, sun protection, the next rung are these minimally invasive procedures and then higher up are the cosmetic surgery, procedures where people go under the knife. The changes become more drastic as one climbs the ladder and I think for the first rung it’s never too early or never too late to start broad spectrum photo protection, that is really the take-home message that prevention is better than cure, but if you’re kind of a little bit older, or already have some photo damage and other changes associated with ageing such as loss of volume, then you might need to go up to the next rung. However it’s completely a personal decision whether one wants to start climbing the ladder and how far one wants to climb up the ladder – it’s a very personal choice

M: Is it mostly women who do this or is it men and women?

T: I would say it’s mostly women but certainly we are seeing more men in the clinic, approximately 10% of my patients are men and I think as these treatments become more accessible and widely accepted men also see the benefits

M: 10% is quite high actually, I thought you were going to say less, so it’s obviously becoming more popular with men?

T: It is becoming more popular and men particularly have trouble, very heavy muscles in the upper face which can make them look cross. A lot of patients say “I’m not being vain I just don’t like people telling me why are you so grumpy, or what’s the matter?” so it’s giving a softer, fresher look

M: It must be quite difficult for people to find the right practitioner to do the treatments, it must be very bewildering for them – how do they do that?

T: I think it is very confusing for people and we all hear snippets from the media, friends that may have tried this, that or the other but I would like to emphasize that these procedures like hyaluronic acid, interdermal fillers such as Restylane and Botox Botulinum toxin injections are very low risk, but no medical procedure is zero risk so patients have to be very well-informed in terms of the benefits and the risks, the pitfalls, and they have to understand who the person is injecting, what are that person’s qualifications, are they a consultant dermatologist, consultant plastic surgeon, cosmetic doctor, aesthetic nurse – what are the premises like, are they professional, do they feel pressurized, is it a hard sell situation, which people should really shy away from. Vulnerable people are often targeted so I think a common sense approach is best and you really need to find the balance

M: So check the qualifications, check that the person is qualified to do these treatments

T: Absolutely. And a good doctor / patient relationship is key for a successful outcome. Realistic patient expectations

M: Can we really do anything to halt the ageing process – or halt looking older?

T: Absolutely I think to say we can stop ageing is not a realistic comment but what these procedures do is try to recreate a youthful appearance and certainly prevention again is key with photo protection and good skincare

M: So that’s a good sunscreen?

T: Absolutely, broad spectrum photo-protection, SPF 15 or higher, that’s for UVB protection. 3-4 * out of the 5 * UVA protection rating system and use enough of it, use it on a regular basis –

M: And use it all year round?

T: I usually say 3 seasons out of the 4, particularly up in Manchester where I am, but that photo protection regime is only part of the whole programme which is try not to get a tan, avoid tanning beds, sun protective clothing, and if you like colour, get a little fake tan, that’s a much safer option

M: That’s very good advice. Well let’s start, we’ve got some questions coming through now –

T: Ok

M: Let’s have a look at the first one, it’s from Sally from Preston. Sally wants to know, she says “hi Tamara” –

T: Hello

M: “I’m quite keen to give my appearance a bit of a boost but I’m a bit confused about the treatments I should opt for” – a lot of people seem quite confused

T: Absolutely

M: “I’m not keen on Botox” she says “after negative publicity, but I am keen to work on my crows feet and lines around my lips, can you give me some advice? Many thanks.”

T: Sure well I would agree with you wholeheartedly that it can be very confusing and if you’re thinking about embarking upon these procedures you really need to have a proper consultation with a qualified practitioner, whether it’s a consultant cosmetic nurse, doctor or whatever, and that person needs to look at your face individually to determine what treatment would have the most impact for you, whether it be treating the crows feet or plumping up your lips or even recreating a more youthful facial shape which sometimes people don’t understand, and it takes someone whose experienced or an expert to advise on what are the best treatments, but I would also like to reassure you that these treatments are safe, don’t be scared of them. There’s no such thing as bad Botox, only bad Botox injectors that really can give us an undesirable effect

M: Ok Gina, I don’t know where she’s from, she hasn’t said, but Gina wants to know “when should I start using eye cream, I’m only 22 and have no wrinkles yet” – lucky you is all I can say to you

T: Great. Well it’s a perfect time to start a good photo-protection programme, so eye cream, specifically may not be necessary, these are good emollients and the skin around the eyes tends to be thinner and can get dehydrated resulting in fine lines and wrinkles, but at your age, at 22 again prevention is the key, broad spectrum photo-protection – avoid tanning parlours and sunbeds and stop smoking because - if you do smoke – because smoking is also associated with premature ageing of the skin

M: I suppose when you are 22 and you’ve got no lines it’s easy to think “oh that’s later on in life” but it’s important to start straight away

T: Absolutely because the damage done is delayed, so if you’re careful now – particularly if you’re fair-skinned, if you’re careful now you will reap the benefits later

M: There you go Gina. Constantina asks “I’ve read so much about trout pouts –

T: Oh dear

M: “Will lip enhancements make me look ridiculous?” We’ve seen so many celebrities haven’t we in the glossy magazines with terribly enhanced lips, and I know it’s called the bee-stung look but some of them look dreadful

T: Well I – you highlight a very important point that when we’re talking about facial rejuvenation – balance, proportion and symmetry are key so we’ve all seen 50 year old women who have the lips of a 20 year old but the rest of their face still looks 50 and it’s completely unconvincing. We know that our patients want a natural, refreshed look, they don’t want to look weird or artificial, so there are numerous procedures – the hyaluronic Restylin injections which can give a fantastic result, but again -

M: So it’s not the product is it, it’s how it’s used? It’s not the treatment it’s whose doing it will depend on what you look like?

T: It’s whose doing it and everybody’s perception of what is pleasing and what isn’t is very individual, but I would say there are some fillers that are higher risk, some semi-permanent and permanent fillers are higher risk resulting in negative allergic reactions, that sort of thing so in my personal practice I stick to the temporary fillers like the hyaluronic acids

M: And with the permanent ones if you don’t like it you’re stuck with it?

T: Absolutely when we talk about cosmetic procedures less is more. It’s always better to start off slowly, do a little bit if you like it you can always add to it, and the thing about the temporary fillers is they do wear off after about 9 months but if you really don’t like the look it’s not permanent

M: You don’t have to keep it!

T: No that’s right

M: Lucy wants to know “is there a real difference between day and night creams?” Or is it just good packaging?

T: Well night creams tend to be heavier because during the day people don’t tend to like more greasy ointments and they might have a more hydrating effect but part of that is to do with the marketing and finding a niche

M: And of course I suppose you don’t need an SPF in a night cream?

T: You don’t need SPF in a night cream no, unless you – I can’t think of a situation where -

M: Well you might do, it depends whether you sleep outdoors during the day! Phillipa wants to know “what are the most effective natural ingredients on the market?”

T: It’s difficult to say, I think if you’re talking about topical agents or creams, topical retinoids which are derivatives of vitamin A are the most effective anti-ageing creams -

M: You see a lot on commercials now they’re always talking about these retinoids

T: Yes absolutely, so the first key point we need to make is when we’re talking about anti-ageing creams they’re not targeting old skin, they’re targeting photo-damaged skin because -

M: Sun damaged?

T: It’s sun damage that gives us the wrinkles, the coarse texture, the sallowness and the blotchy colour, red spots and brown spots, so anti-ageing creams really target photo-damage and the topical retinoids have been shown in extremely robust scientific studies to repair damage done to the deeper layer of the skin caused by cumulative sun exposure, so the retinoids are really the products that are most effective in terms of rejuvenating photo-damaged skin. Private prescription products of course are more effective than over-the-counter products but can also be slightly more irritating so -

M: So you have to choose a good practitioner again?

T: You have to find a balance

M: Heather wants to know – oh we’re back to the lips again – “I’ve a really thin top lip” – so this isn’t an anti-ageing thing, she doesn’t like the way she looks. She says “it’s not very attractive, what can be done?”

T: So this is the distinction between rejuvenating and improving appearance, and certainly the injectable fillers can be very effective in recreating a prettier mouth, a more youthful mouth

M: So that picture we saw earlier of the lady with the lines round her lips, would it be the same kind of treatment, the same kind of products but used differently – is that right?

T: Yes used in a different patient for a different purpose so it’s not to smooth out the wrinkles but again to increase volume and to create a more attractive, pretty mouth

M: Is there a risk if you’re going from somebody like Heather whose got a very thin top lip, that she’s going to look trout-poutish, just because she’s had a little bit of work done?

T: Well I think whenever you have an injection in the lips there’s bound to be quite a lot of swelling because the lip tissue is very vascular, there’s a lot of blood vessels and it’s very delicate, so she will have some over-compensation right afterwards which might make her feel a little bit panicked, but the practitioner, the person injecting should be able to inject appropriately. But patients I’ve had who have thin lips do have to get used to having fuller lips a little bit, it takes a little bit of an adjustment

M: Ok. Rachel from Liverpool wants to know, she says “hi my mum keeps banging on about sorting her wrinkles out but hasn’t done anything about it yet. Thought I could go some way to helping her as a Christmas present. I’ve seen people having injections on TV programmes that fill in wrinkles – is this really possible and how safe is it? I want to look into booking something for her, is there somewhere I can go which lists experts in my area that carry out this sort of procedure?” Well there’s a couple of questions there, first of all filling wrinkles, is it possible and is it safe?

T: Yes the interdermal fillers such as the hyaluronic acid products are extremely safe if used appropriately. Restylane has the longest track record in terms of these hyaluronic-type fillers, but again it’s the practitioner, it’s the realistic patient expectations, and then on the flip side the Botulinum toxin injections can work in combination with the fillers for a very effective, good balance in terms of upper face and lower face

M: Ok and what was the other – the other question was where can she go to find a list of reputable practitioners, because obviously that’s a worry especially if she’s buying the treatment for somebody else

T: Of course, well this is a key point again to reiterate, these are safe procedures and effective if used in the correct hands but there’s no risk that – there’s no procedure that’s zero risk. There are numerous websites available, the British Association of Dermatologists website, Association of Aesthetic Plastic Surgeon’s website, Cosmetic Doctor website, British Cosmetic Dermatology Group Website and the Department of Health has a very neutral website which people can access, and I also think word of mouth is very helpful. Your general practitioner, your doctor might be able to advise you, or you might have a friend or know someone who has had a very positive experience, but the key is the patient, or the person having the treatment has to have realistic expectations and I think particularly you may need to be a little bit careful if you’re buying these procedures for another person, the motivation for having these procedures really needs to be examined and making sure the patient is doing it for the right reasons

M: Ok. If you’ve got any questions for Dr Tamara Griffiths on the Restylin report or anything else on anti-ageing, just go to the bottom of the screen, look in the box, put your name, where you’re from and the question and we’ll try and answer them before the end of the show. Tamara we’ve got another question from Lucy, she wants to know “do you think there’s too much pressure on the young to look older?”

T: It’s a difficult question to answer, I’m usually coming at a different perspective

M: It’s usually the other way round isn’t it?

T: So I think that’s a difficult question to answer. I think children probably are growing up quicker nowadays

M: There’s a lot of pressure on people to look a certain way. I don’t know whether it’s necessarily older, but you open a magazine and you’ve got to get the look, which possibly to a teenager, they might want to look 18 or 19 when they’re actually 13. There’s probably a lot of pressure on them

T: There’s probably peer group pressure to fit in and conform. It is a difficult area, the concept of beauty and youth and looking good is not a modern phenomena, the ancients in classical times, Romans used to – women used to apply vermilion to their lips and coal to their eyes to accentuate certain features. Cleopatra bathed in ass’s milk to appear more youthful and to have an even skin tone and Victorian women had ribs surgically removed to create a more attractive female shape so -

M: And we think we’re extreme now?

T: Yes so it’s just – these treatments are more accessible now, they’re safer, people are more accepting of them and we are a reasonably affluent society with disposable income, so with the power of media everybody wants to have it done whereas in the past it was probably only a very select few who could afford the luxury

M: Rose wants to know “are there any ingredients that I should stay clear of in creams whilst pregnant?”

T: Well pregnancy is a very sensitive issue and any doctor would recommend that if you’re pregnant you need to be careful about anything you certainly ingest and topical products, although the dangers of absorption with applying something topically is probably much less than ingesting, but I would say obviously stick to over-the–counter creams, if your doctor prescribes something then he or she would be responsible for determining whether it is or isn’t safe in pregnancy, but -

M: Presumably with some of the more invasive treatments like non-cosmetic, anything that involves a needle, being pregnant - not a good idea

T: The non-invasive procedures would be – pregnancy would be a contra-indication, yes

M: You wouldn’t?

T: I would definitely steer clear of those things

M: Ok. Luke wants to know “do you think there is ever a time where plastic surgery is ok?”

T: Absolutely, if you’re in the medical profession and you’ve seen severe facial deformities, trauma patients, car accident victims – these are extreme cases and plastic surgery is definitely indicated in those cases, but I think the lay people get a little confused with what is plastic surgery – plastic surgery for cosmetic reasons and -

M: What’s the difference between plastic and cosmetic surgery then?

T: Well plastic surgery’s an umbrella term to reconstructive surgery where cosmetic surgery is more specifically to improve appearance but not necessarily to restore function. But we know that people can be very upset about how they look and if they have certain characteristics that they really don’t like, psychology studies tell us that they have avoidance behavior, they’re more shy, they aren’t as successful in their work and those sort of things, so these are issues that do have important implications on quality of life. In any medical situation we have to balance the risk and benefit, and if the benefit is great, then the patient or person may be able to take more risk if the benefit is minimal, then the risks one is willing to take again would have to be proportional

M: Ok. Lexy wants to know “is it true that splashing your face with ice cold water makes make-up stay on for longer?” Are you a make-up expert?

T: I would say I’m not familiar with that treatment. I think if you put your make-up in the fridge and you apply it it’s colder it would probably emulsify or melt in a slower way, but I don’t much know -

M: I would have thought you need quite a warm face to make the make-up look better actually

T: It might not flow so well but

M: We were talking just now about Luke was asking about cosmetic surgery and is it ok – do you think that this growth of the kind of middle ground if you like, the non-cosmetic stuff that you specialize in, is that stopping people for going for plastic surgery because they don’t need to go that far?

T: Yes I think the lines are blurring – invasive plastic surgery is becoming less invasive with a general anesthetic often isn’t required and some of the procedures are more temporary but I think the lines are becoming blurred and I think certainly these minimally invasive procedures can cause postponement where people would need to go to the third rung of the ladder like I was talking about later, because these minimally invasive procedures can hold people for much longer and are a much lower risk

M: Ok. We’ve got another make-up question now

T: Ok

M: Lisa wants to know “is it dangerous to sleep with eye make-up on?”

T: Well it’s mainly a hygiene thing if you have your eye make-up on it’s – potentially it could get infected so – dangerous is a relative term but I would certainly encourage patients to utilize proper hygiene and remove their make-up before going to bed

M: I mean presumably it’s just good for your skin anyway to just look after it better and to take the make-up off?

T: Yes there are hygiene issues

M: If you don’t look after your face and you do tend to leave make-up on and not remove it and not use good creams, is your skin going to age significantly faster than somebody whose got a good skincare regime?

T: Right, I wouldn’t say doing those things would make your skin age prematurely the real issue with ageing in the skin is sun protection so when you say using a good regime, if you’re using a good photo-protection regime your skin will suffer less photo damage compared with someone who doesn’t protect their skin from the sun, but certainly creams that are effective don’t have to be expensive

M: That’s very interesting to know. Lee wants to know that “is it true that using soap on your face dries it out?”

T: Soap can act as an irritant and water can actually even act as an irritant in people who have -

M: Really?

T: Very sensitive skin, water will hit the skin then when the water evaporates can also take moisture from it so yes soap and water can dry the face out but if you have normal skin you apply a moisturizer then that’s not a problem, it’s only people who are susceptible to dry skin and eczema who have diminished barrier function where they can’t retain moisture quite so well who might be a little bit more careful about using a soap which could act as an irritant

M: Are some soaps more aggressive or more irritating than others?

T: Yes soaps that lather a lot, that cause a lot – real foamy lather – can be more irritating in susceptible individuals and people who tend to have sensitive skin. Those type of people will do better with a ph balanced creamy cleanser as opposed to a very foamy soap but again these are people who - sensitive skin types - might have to be a little bit more careful. But I wouldn’t say soap is the enemy

M: I suppose even men have to worry about -

T: Absolutely

M: Putting too much shaving foam for instance, is that like a soap or is that like a moisturizer?

T: Well shaving foam is more like a soap but can act as an irritant so men do need to be careful and of course men have the issue with razor bumps and ingrown hairs and those types of issues

M: If you’ve just joined us, this is Dr Tamara Griffiths and we’re talking about all the range of anti-ageing treatments that are on the market at the moment. We’re very confused by them, many of us, so Tamara is here to try and sort through them all and answer your questions about what works and what doesn’t. If you’ve got any questions go to the bottom of your screen, put in your name, where you’re from and your question and we’ll try and get it answered for you from Tamara before the end of the show. We’ve got a question from Layla Tamara, she wants to know “do anti-wrinkle creams actually work?”

T: That’s a difficult question, there’s a huge spectrum and there’s so many creams on the market even the experts can get confused, but again I will say the robust scientific data supports topical retinoids, specifically retinoic acid, some of the other creams may have potential, but proved to a scientific standard in peer review journals is perhaps lacking, although many creams may have potential but in terms of scientific proof it’s the topical retinoids that we tend to accept as being the most effective

M: Ok, Mario wants to know “a lot of dermal fillers contain something called hyaluronic acid, we mentioned this at the beginning of the show

T: Yes

M: She wants to know what is it, so shall we go over that again, what’s in it?

T: Yes that’s fine, I think it’s a bit of a scary name to the lay person because acid doesn’t conjure up very nice images, but hyaluronic acid or hyaluronic gel is a clear, colourless substance that’s naturally occurring in our bodies and in our skin so it’s a natural substance, and when we re-inject it into the deeper layers of the skin we’re replenishing something that goes away or diminishes naturally with time and again it’s not just the skin that we’re talking about with interdermal fillers, it’s replacing volume, filling in the valleys – we get hills and valleys with age, it’s filling in the valleys to give a more youthful facial shape

M: With something your body already makes

T: That’s correct

M: So as you said the word acid conjures up horrible images -

T: Yes

M: People have heard of other kinds of fillers like collagen that’s derived from certain animals -

T: Of course

M: Some with permanent things in them

T: Yes

M: But hyaluronic acid ones have nothing else in them, is that right?

T: Well there are different combinations – some of the semi-permanent fillers contain hyaluronic acid plus other agents but in my personal practice I stick with the temporary fillers because the side effect profile is much better, the risk for allergic reaction, lumpiness and untoward side effects is much less with the temporary hyaluronic acid fillers

M: Ok. Heather wants to know “is it true pollution damages your skin?” We’ve been talking about photo damage and sun damage, I mean if you live somewhere – if you live in London or a big city pollution’s a big issue -

T: Yes

M: Isn’t it?

T: There is more evidence to suggest that pollution can act as an anti-oxidant, can act as an oxidant to cause or hasten damage caused in the skin, similar to photo ageing, it just works alongside photo ageing, but again this is a very kind of a newish area and we can’t quantify exactly how much pollution effects the skin but there is some research to suggest that antioxidant preparations may counter balance some of those effects but really the take home message is photo protection because we know that -

M: That’s the big factor

T: The major negative impact on making our skin look old

M: Ok, Feralith wants to know “I’ve really prominent veins showing through on the back of my hands, I don’t want surgery, is there any non-surgical treatment that can tackle this problem?” First signs of ageing of course on the hands and the neck

T: Yes people always focus on the face but the neck and the backs of the hands are an area that can also give away a person’s age. The hands are particularly susceptible because they’re exposed all year round. People might think about wearing a hat or suncream on the face but they tend to be less persistent about protection on the hands which is an area that’s chronically exposed so we can get brown spots -

M: And the skin on the hands gets very thin in older people doesn’t it?

T: The skin gets thin and the veins show so there’s lots of different things we can do to minimize the age spots which are really photo damaged spots, and then again hyaluronic acid injections to replenish the lost volume in the skin on the hands -

M: So you can actually inject into the back of the hands?

T: Yes

M: And that plumps the whole hand up and makes it look -

T: It rehydrates the thin skin to give a more youthful appearance but it’s very temporary effect

M: Ok. Jo wants to know “do wraps actually work or are they just a short term fix?” I’m not exactly sure what she means there, I think -

T: Yes it’s a little bit of a vague question, she might be referring to body wraps with certain substances – wrapping anything on the skin will potentially enhance penetration but again it would depend what’s under the wrap and the procedure, but I think that’s more of a luxury experience type situation

M: It’s a kind of a spa treatment rather than -

T: It’s more of a luxury experience -

M: Yes. Do you find a lot of people come for treatments thinking that they are a nice treatment and maybe come in and have a shock when they’re a bit more invasive?

T: Well I think the type of treatments they expect from a consultant dermatologist would be sort of not really the beauty-type treatments but more the medical treatments and just to reiterate the minimally invasive procedures are very low risk and can have fantastic, effective, natural results but they’re not zero risk and a patient needs to have realistic expectations and a long consultation to discuss what the potential benefits but then on the other hand what the potential pitfalls are, so they’re fully aware of the situation

M: Ok

T: It’s not something to take on lightly, I don’t want to trivialize these procedures

M: Ok. Very very quick question, Deidre wants to know “what should I look for in a sunscreen, I want something that is light and non-greasy for my face?”

T: Well this is a really important question, when we talk about sunscreens everybody’s heard about SPF which is sun protection factor and that will protect the skin against UVB irradiation so you want to choose an SPF of 15 or higher, but equally as important you want UVA protection, it’s the UVA irradiation from the sun that actually penetrates deeper and causes the wrinkles and the abnormalities in the skin texture so to prevent premature ageing and photo damage you want UVA protection as well which is a 5 star rating in this country, so I recommend 3-4 stars and SPF 15 or higher, but the other pitfall with sun protection, sun creams is people don’t tend to use enough and they don’t tend to reapply it often enough, particularly in the summer -

M: You can’t just put it on – say you’re not sunbathing or swimming on the beach and you’re just going out to work -

T: I think if it’s mid-summer -

M: People just put it on once don’t they?

T: I think if it’s mid-summer you do need to think about re-applying it

M: How many times perhaps?

T: Usually every several hours, again it depends – people who have darker skin have more natural protection from the sun so might be – can be a little bit more relaxed because there’s also the issue of Vitamin D, we need Vitamin D for multiple health reasons and people who have a darker complexion are not as efficient at getting vitamin D through the sun -

M: But if you’re me you need lots of sunscreen so somebody fair-skinned like me -

T: A fair Celtic complexion like you – certainly an aggressive sun protection programme would be to your benefit

M: Tamara you’ve given us some fantastic advice on the Health and Beauty show. If you want any more information you can go to the Restylane website, it’s restylane.co.uk/consumer. Dr Tamara Griffiths thank you very much for joining us -

T: Thank you

M: That’s it from the Health and Beauty show, we’ll see you next time, thanks for joining us, bye bye