A chat with Prof. Greg Goodman on Excessive Sweating

It is estimated that about 3% of people suffer from a condition called hyperhidrosis, where they sweat much more than they need to — having implications on their quality of life.

We sat down with DIV director and head dermatologist Professor Greg Goodman to discuss options and treatment for excessive sweating.

Q: What exactly is deemed “excessive” when talking about sweating? 

GG: People who suffer from excessive sweating are a different group to those who have normal sweating. Their levels are significantly above the population. There is a scale called the IHHS scale, which defines people into 4 groups, with 3&4 being sweating that interferes with daily activity. People take extraordinary measures for this type of sweating, including only wearing certain types of clothing, utilising air blowers in restaurants and cafés, putting paper towel under their armpits and avoiding shaking hands with people.

Q: Are there any Medical conditions that cause hyperhidrosis?

GG: Yes. Diabetes, menopause, thyroid disease and anxiety can all induce sweating. This is slightly different to focal hyperhidrosis, the more typical problematic and common sweating that we are discussing here. Sweating, if it comes on later in life can be a sign of internal malignancy or autoimmune disease and needs to be investigated. However, most hyperhidrosis common forms occur either in late childhood and early adolescence and are consistent through adult life.

Interested in finding out more? Give our clinic a call during business hours on (03) 9826 4966 - remember, we’re closing between 23/12 and 5/1!)

Why is collagen so important?

‘Collagen’ has become one of those buzzwords that marketers have used increasingly to promote products and treatments across the dermatology and skin care product fields. But what is it and what does it do?

Let’s break it down

Collagen naturally occurs throughout the body and is made up of amino acids.  In fact, it is the main structural component that determines how well our bodies retain their shape and firmness as we age – it actually makes up around 30% of the body’s total protein.

So that’s the basic science - what about the cosmetic benefits? 

Collagen plays a huge role in the way our skin looks and feels, providing firmness and shape and assisting in giving a youthful appearance and ‘glow’. Collagen rests under the surface layer of the skin where it forms a scaffolding that, combined with elastin, helps the surface layer retain its structure and accommodate movement without wrinkling. 

Like all bodily systems, collagen production slows down over time. Not only does the body make less of it as we age, but what does remain becomes weaker due to lack of support. As a result, it begins to break down, which can result in a variety of changes including wrinkles and sagging skin.

A lot of topical skincare products claim to contain collagen to help with skin appearance and health – is that true?

When topically applied in a cream or serum, collagen molecules are simply too large to penetrate the skin's surface, meaning you unfortunately can’t boost levels in the skin this way.

So can we increase or at least maintain our body’s collagen levels in other ways?

The good news is that there are numerous treatments available to assist in increasing the density of and strengthening your collagen layer. You may have heard of such treatments as Ultraformer III, Venus Viva or microneedling – as everyone is different and consequently have different needs, your practitioner will be best able to advise on which of these or else other treatment options will work best for you.

The take-home message? collagen structure and production contributes a great deal to your skin texture, look and feel. Boosting your collagen levels can be a great way to maintain or rejuvenate your skin.

Let’s talk about - Ultraformer III

Ultraformer (also known as High Intensity Focused Ultrasound) is one of our most popular treatment requests at DIV. It promotes collagen production and renewal in the deep layers of the skin to resolve the appearance of wrinkles, sagginess and pigmentation.

How does it work?

The Ultraformer III machine uses ultrasound technology to tauten and lift loose or drooping skin, decrease the appearance of lines and wrinkles and improve the shape of the areas such as the jawline.

The machine utilises precision micro-focused and macro-focused High-Intensity Focused Ultrasound (HIFU) energy to instantly contract collagen fibres and induce a process known as neocollagenesis. This promotes long-term collagen production for a natural, lifted look without the downtime.  

Hang on, why do I need collagen?

Collagen is what preserves our skin’s youthful strength and elasticity. From our mid to late twenties, our skin starts to produce 1% less collagen each year, and even less so in the years leading up to menopause. Less collagen can lead to skin laxity and wrinkles.

What does it treat?

The Ultraformer III can be used to treat a wide variety of areas. The most popular treated areas however tend to be the neck, jawline, cheeks, nasolabial folds and eye area.

Ultraformer III is also commonly requested for other areas of the body such as the abdomen and upper arms. Further, many women look to the Ultraformer to help minimise the effects of pregnancy by getting abdominal tightening treatments.

What are the main benefits?

• No Downtime: Unlike many procedures there are few following treatment.

• Targeted: The Ultraformer III is incredibly precise so can treat areas that are delicate (the eyes) or areas difficult to target (neck and jawline).

• Immediate Results: The heat generated by the ultrasound pulsations has an immediately noticeable skin tightening effect.

• Ongoing Results: An increase in collagen will occur gradually over 3-6 months following the initial treatment.

• Natural Results: By naturally stimulating your body’s own collagen production the results look entirely natural.

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Call div to discuss ultraformer III and how it can help you on (03) 9826 4966

Four Skin Myths Busted by the DIV Dermatologists

People sure do believe some crazy things about their skin - from the good old toothpaste on the pimple trick to believing pore size changes with temperature; some are old housewives tales while others have been propagated by magazine beauty 'hacks'. 

Let’s break it down

MYTH 1 - You can boost the collagen in your skin with a collagen-containing cream or serum

“Collagen is a protein found in the deep layers of the skin that make it elastic, supple and plump. Unfortunately when topically applied, collagen molecules are too large to penetrate the skin's surface, meaning you can’t boost levels in the skin with a cream.” 

“Collagen in your skin naturally weakens and unravels with age, however there are things to avoid that can cause further damage like sugar, the sun, smoking, pollution and stress.”

- Dr Katherine Armour, Dermatologist 

So is there anything you can do to increase the collagen in your skin?
Collagen-stimulating treatments like Pelleve, Venus Viva, Fraxel and skin needling are your best options.

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MYTH 2 - Toothpaste is an effective way to treat a pimple

"Chances are you've heard this at least once in your life but toothpaste is definitely meant for teeth and not skin! While it may be helpful in drying out a pimple, the fluoride in toothpaste can damage your skin, over-drying it, and even causing burning which can leave obvious red marks long after the pimple has gone.”

- Dr Lee Mei Yap, Dermatologist 

If you find that your skin is acne-prone, perhaps consider a visit to your dermatologist. Otherwise, a consistent, medical-based skincare routine should keep your skin clear enough to avoid toothpaste!

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MYTH 3 - Toning is an important step in your daily skin routine

While they are part of many skin care ranges, toners and astringents should be avoided by almost all skin types. This is especially the case for those with dry skin, as they strip the skin of all oils, both good and bad.

“Toners often contain harsh astringent chemicals that remove the remnants of the cleanser but simultaneously strip the oils from the skin completely and unnecessarily after the cleanser has removed what it can.”

“Depending on the ingredients, toners can even be too drying for those with oily complexions.” 

- Associate Professor Greg Goodman, Dermatologist 

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MYTH 4 - Blackheads are a buildup of dirt in the pores

"Despite sometimes looking like little grains of dirt, blackheads are not caused by dirt on the skin. They are actually a build-up of oil and shed skin cells that become trapped in the follicle on the way to the skin’s surface. This plug of dead cells and oil is called a comedone, another type of comedone is a whitehead. Blackheads get their colour because this plug contains dislodged melanin which are the cells that give our skin colour." 

- Associate Professor Greg Goodman, Dermatologist 

If you're prone to getting blackheads, there are many treatment options to clear the congestion and reduce the appearance of pores.

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A professional skin evaluation bridges the gap between beauty and science in addition to helping educate patients on the best ways to care for their particular skin. Not to mention, it helps a patient avoid any detrimental or ineffective myths!

DIV is still open for all medical dermatology concerns five days per week.  Note that we are not currently offering some treatments - for more information, call us on (03) 9826 4966 or send an email at dermatology@div.net.au

Three ways to treat under eye puffiness and dark circles

I’m well-rested. So why do I look so tired?

There is a common misconception among many people that dark circles or puffiness under the eye are the result of sleepless nights, stress or a little too much partying (pre-COVID, of course). There are three primary causes for under-eye issues -

• genetics affecting the underlying structure

• age-related volume loss resulting in under-eye hollowing

• dark pigmentation under the eye

• a combination of the three

The good news is, there are ways to treat this

-Let’s break it down

 1. Eye serums with Peptides 

Eye serums are tricky. We find that they are either highly effective or not at all - it depends entirely on the ingredients. 

The best advice is to ensure that the company you are purchasing from is medical-based and that they are using adequate concentrations of active ingredients. Active ingredients such as peptides and plant stem cells bring about cellular change in the dermis. 

Talk to your dermatologist or skincare professional about what will work best for you. 

 2. Pigment fading skin serums 

In some cases, the under-eye area is pigmented in addition to being sunken. Once again, medically active skincare is your best friend.  These serums contain tyrosinase inhibitors, vitamin C and peptides. Licorice root extract is also a powerful brightener of the skin.

 3. Laser treatments 

Lasers treatments work by emitting one wavelength, a single small part of the light spectrum, which targets a specific colour in the skin. The target absorbs the light energy from the laser and converts it to heat.  This result is lighter and brighter coloured skin, with less pigmentation and visible redness. 

So, let's sort it out

During the Stage 4 Lockdown in metropolitan Melbourne, DIV is unfortunately not offering Cosmetic Dermatology.

We can however offer Online Dermatology Consultations to assess the undereye area and recommend the best approach for helping you moving forward. In addition, our sister company Script Skincare is offering phone consultations with our Dermal Therapists, with free delivery of their broad range of medically active skincare. 

The good news is that DIV is still open five days per week and can be reached on (03) 9826 4966 or else by email at dermatology@div.net.au

Physical Or Chemical Sunscreen, Which Is Better For Preventing Melasma?

It’s one of the most challenging conditions to treat, hyperpigmentation (the over production of melanin resulting in darkened areas of the skin), and unfortunately, happens to be one of the most common. Thanks to our outdoor lifestyle and its link to UV exposure, many Australians suffer from pigmentation that typically presents on the face, neck and décolletage. Pigmentation conditions can affect us from our teen years but usually become more noticeable and persistent as we age. There are many causes - hormonal influences (such as taking the pill or embarking on HRT), genetics, inflammation, heat and or injury to the skin can all cause hyperpigmentation. Its important to understand the ways in which you can reduce your risk, the simplest of which, is choosing the right sunscreen.

Melasma is an inflammatory disorder that typically appears in symmetrical blotchy hyper-pigmented patches on the face - usually the cheeks, bridge of the nose, forehead, chin and upper lip. Exacerbated by sun exposure, hormonal changes, genetics or general skin irritation, it is extremely common and notoriously difficult to treat due to its recurring nature.

Given the strong link between melasma flare ups and UV exposure, sufferers must be adept at the application and reapplication of a sunscreen. In a flooded market that offers both physical and chemical variations, it can be hard to find one that’s right for you. The first step is to under-stand the difference between both physical and chemical sunscreens and what they offer. At the very least, we recommend daily application of a broad-spectrum SPF 30+.

SO, WHAT IS THE DIFFERENCE BETWEEN PHYSICAL AND CHEMICAL SUNSCREENS?

Physical sunscreens sit on the surface of the skin creating a barrier or shield and reflects the UV rays, which is why they’re often referred to as physical blockers. They do this via mineral filters, the most common of which are titanium dioxide and zinc oxide. Unlike their chemical counter-parts, they don’t penetrate through the surface of the skin. Chemical sunscreens contain active sun filters that penetrate the skin and absorb the UV rays to prevent them from causing damage. In short, physical sunscreen = reflect. Chemical sunscreen = absorb.

WHICH IS BETTER FOR MELASMA SUFFERERS?

Melasma sufferers should opt for a physical sunscreen. This is due to its ability to prevent heat within the skin, unlike chemical sunscreens that can increase the skins temperature when absorbing UV rays. Zinc is also a powerful anti-inflammatory ingredient. Recent studies have shown that the efficacy of physical sunscreens can be taken one step further by including iron oxides. Iron oxides offer the added protection against all light wavelengths, including blue light.

If you are investing in treatment for your pigmentation, it is important to support this with at home skincare. We suggest discussing sunscreen options with your practitioner for the best out-come.