Skin health sits at the intersection of everything I do, internal physiology, topical science, and the specific active ingredients that actually change what’s happening at a cellular level. My background in phytochemistry gives me a detailed working knowledge of what the actives are in the products you’re already using, whether your products are doing what the label claims, not just what sounds good in marketing.
Skin issues take a toll that goes well beyond the skin itself. Many people I see have built their whole routine around covering up, long cleansing rituals, makeup applied to hide rather than enhance, clothes chosen to conceal rather than to wear. Some avoid the beach, swimming, anything that means exposing their skin to other people. Many have already spent a real amount of money on topical treatments that did little to help. And for a lot of people it goes further than that, turning down invitations, pulling back from friends, staying home rather than risk being seen. If any of this sounds familiar, this isn’t an overreaction to something “just cosmetic”, the impact on how you live and how you feel is real, and it’s exactly why I don’t treat skin health as separate from the rest of you.
As a skin health naturopath in London, I check whether your skin barrier can actually tolerate a routine before layering on more actives.I use and recommend a lot of Japanese and Korean skincare in my own life and in my practice. In my view, formulation quality and price relative to what you’re actually getting is frequently better than most products made in Europe, and it’s a specific area of interest and expertise I bring to how I advise patients on their skincare routines, alongside the internal, root cause side of naturopathic practice.
Skin issues take a toll that goes well beyond the skin itself. Many people I see have built their whole routine around covering up, long cleansing rituals, makeup applied to hide rather than enhance, clothes chosen to conceal rather than to wear. Some avoid the beach, swimming, anything that means exposing their skin to other people. Many have already spent a real amount of money on topical treatments that did little to help. And for a lot of people it goes further than that, turning down invitations, pulling back from friends, staying home rather than risk being seen. If any of this sounds familiar, this isn’t an overreaction to something ‘just cosmetic’, the impact on how you live and how you feel is real, and it’s exactly why I don’t treat skin health as separate from the rest of you.
Barrier restoration comes first
Almost every skin concern on this page gets worse, or fails to improve, when the skin barrier itself is compromised, and almost every routine I see arrives at my clinic with too many actives and not enough attention paid to the barrier underneath them. Before layering on treatments for pigmentation, acne or ageing, I look at whether the barrier can actually tolerate what’s being asked of it. A barrier that’s stripped, over-exfoliated or chronically inflamed will absorb actives unpredictably, react instead of respond, and undo the benefit of whatever expensive serum sits on top of it.
This is a running thread through rosacea, post-procedure recovery and acne for example, which are all barrier conditions as much as anything else, and I treat them that way rather than reaching straight for actives.
Hyperpigmentation
Hyperpigmentation is driven by UV exposure, inflammation from acne or trauma, and is more common in skin of colour. Sun protection is the single most evidence-backed intervention available, more important than any active ingredient you could add on top of it but what is the best sunscreen suitable for you? Beyond that, azelaic acid, vitamin C, niacinamide, topical tranexamic acid, arbutin and retinoids for cell turnover all have evidence behind them. A compromised barrier makes these actives harder to tolerate and slower to work, which is why I check barrier function before building a pigmentation protocol, not after. I also look at the formulations patient bring to me so I can establish if their products will actually have a meaningful impact. There are other factors which can cause hyperpigmentation, including nutrient deficiencies and chemical sensitivities, driven by histamine overload, which are also addressed through internal work. Some skincare procedures and treatments are unsuitable for people who are prone to hyperpigmentation so it’s worth understanding your risk factors and Fitzpatrick skin type to see what works for you and this is also something I help my patients with.
Melasma
Melasma has its own distinct drivers, hormonal shifts from pregnancy, the contraceptive pill or HRT, UV and visible light exposure, and genetic predisposition. Visible light, not just UV, which is why tinted sunscreen containing iron oxides has trial evidence of outperforming plain sunscreen for melasma specifically.
What you can and can’t use is more relevant here than in most skin conditions, since some active ingredients that help other forms of pigmentation can worsen melasma or irritate skin already prone to it. Topical tranexamic acid has growing evidence for melasma specifically, but sits with prescribers rather than being something to self-select.
Rosacea
Rosacea has several subtypes, erythematotelangiectatic, papulopustular, phymatous, and ocular, triggered by heat, UV, alcohol, spicy food and exercise. This is the clearest example on this page of barrier dysfunction being central rather than incidental, gentle skincare and barrier repair matter more here than active ingredients do, and reaching for actives before the barrier is stable is one of the most common mistakes I see.
Demodex mite overgrowth has an established association with the papulopustular subtype specifically. Gut dysbiosis, including SIBO and fungal overgrowth, also shows a consistent association with rosacea, and treating it produces improvement in some patients, a gut-skin connection, not a stretch.
Acne
Acne is driven by androgens and hormonal shifts, particularly adult female jawline acne, alongside C. acnes, hyperkeratinisation, sebum production and inflammation. Dairy, particularly skim milk, and high glycaemic load diets have moderate to good observational evidence linking them to severity, one of the stronger diet-skin links in the research. The gut microbiome’s link to acne is real and often misunderstood by dermatologists.
On the topical side, retinoids are often first line, with benzoyl peroxide, azelaic acid, salicylic acid and niacinamide all carrying evidence. All of these are also barrier-disrupting at the concentrations that work, which is exactly why so many acne routines fail, they treat the acne and destroy the barrier at the same time, then wonder why the skin won’t calm down. Barrier support has to run alongside acne actives, not follow behind them once things have already gone wrong.
Post-procedure recovery
The priority after any procedure is barrier repair, full stop. Ceramide-dominant moisturisers, avoiding retinoids and acids until the skin has re-epithelialised, and strict sun avoidance. Growth factor topicals are a specific exception to my usual caution about penetration. On intact skin, most growth factor molecules are too large to meaningfully cross the stratum corneum, which is why I’m generally sceptical of growth factor serums as a category. Post-procedure, with the barrier genuinely disrupted, that objection doesn’t fully apply, and there’s trial evidence specifically in this context, including a reduction in post-inflammatory pigmentation after laser treatment, so I treat post-procedure use differently to on-label, everyday use.
Anti-ageing support
Sunscreen is, again, the single most evidence-backed anti-ageing intervention that exists, before any serum or device. Retinaldehyde has a stronger biochemical case than retinol, it requires fewer conversion steps to reach active retinoic acid in the skin, though large long-term head-to-head clinical trials comparing outcomes are still limited. Vitamin C earns its place as both an antioxidant and a cofactor for collagen synthesis. Peptides are the one area worth being honest about a gap, the evidence for skin peptides is markedly weaker than the marketing around them suggests. And barrier function declines with age regardless of what actives you’re using, so ageing skin often needs more barrier support, not less, even while it’s also asking for more active ingredients.
How I read skincare ingredients and claims
Part of what I bring to this is knowing how to actually read a product rather than trust its marketing. Active concentration is judged from where an ingredient sits on the INCI list, not from what the front of the bottle claims. Brand-commissioned studies and lab certifications are real, but they aren’t equivalent to independent peer-reviewed evidence, and conflating the two is one of the most common ways people get misled. Claims like “clinically proven” or “twice as fast” very often rest on a single mechanistic or in-vitro study, not a head-to-head clinical trial, and I’ll always tell you which one you’re actually looking at.
If this sounds like where you are, apply for a 15 minute consultation and let’s work out the best way forward for your skin.
