Healthy skin: what a dermatologist actually recommends

Healthy skin comes down to a handful of habits, not expensive pots of cream: protect yourself from the sun, don’t strip your skin by over-washing, keep it moisturised, eat sensibly, sleep enough and don’t smoke. We pulled together the main points a consultant dermatologist made on a recent podcast, so you know what actually matters. No brands, no hype, just what your skin really needs.

The basics of healthy skin

Your skin is your largest organ and your first line of defence. It keeps bacteria and viruses out, regulates your temperature, lets you feel, and makes vitamin D. You don’t keep it healthy with one miracle product, but with a few steady habits:

• Protect against the sun. Sunlight is the single biggest factor you can control, for both ageing and skin cancer.
• Wash gently. Showering once a day is plenty. Twice a day tends to dry your skin out.
• Lock in moisture. If your skin is dry or older, a richer, oil-based moisturiser helps.
• Mind your diet. Sugar, and dairy where acne is involved, can affect the skin.
• Sleep enough. Too little sleep raises cortisol, which shows up in your skin.
• Don’t smoke. Smoking is one of the outside factors that ages skin faster.

Sun protection: the most important thing you can do

This is where the dermatologist was firmest: sunlight does the most damage. Two types of UV reach your skin. UVA goes deep and drives ageing; UVB stays nearer the surface and does the burning and tanning. UVA even passes through glass, so you still catch it behind the wheel or sitting by a window.

You don’t need to burn to be harmed. Sun on your skin always means UV damage to your DNA, even without any redness. And a tan isn’t protection: that pigment is your body’s natural umbrella, but the damage is already done by the time you’ve put it up.

The advice is simple: cover up, use sunscreen and stay out of the strong midday sun. Through the brighter half of the year, roughly spring to early autumn, it’s worth applying sunscreen before you head out, even for something as ordinary as the weekly shop. Cloud cover doesn’t block nearly as much as people assume.

Cleansing and moisturising without wrecking your skin

Plenty of people assume that washing more often and more thoroughly is better. For your skin, it’s the opposite. Water and soap rinse away your natural oils, and that dries the skin out.

• Not too often. Once a day is genuinely the maximum. The dermatologist called twice-a-day showering pointless for your skin.
• Go easy on soap. Soap is drying. An oil-based option, like a shower oil, actually puts a little oil back.
• Add oil back if your skin is dry. Older, thinner skin holds moisture less well and needs help sooner.

Healthy young skin can take a lot. But as you get older it becomes thinner and drier, itches more easily, and washing gently starts to matter more.

Diet and sleep: what reaches your skin from the inside

Dermatologists used to say diet had nothing to do with skin. They’ve walked that back. What looks reasonably clear now:

• Sugar. With a condition like psoriasis, cutting back on sugar may in theory help.
• Dairy and acne. Two or more portions of dairy a day are linked with more acne. It seems tied to lactose and a high-protein diet, which is worth noting for people who train and eat that way.

Exactly how each food works isn’t fully mapped out yet. But that diet has some influence is now well established.

Sleep counts too. Too little sleep raises your cortisol and insulin, and that stress shows in your skin quality. The same stress pathway explains why conditions like eczema often flare up during busy, stressful spells.

Skin ageing: what’s really going on

Part of skin ageing is simply your genes: your skin type sets a lot of it. Fair skin with blue eyes tends to age faster than darker skin, and there’s little you can do about that.

The outside factors you can influence. UV is the biggest, followed by smoking, stress and diet. What happens is that your skin loses elasticity and makes less collagen, so wrinkles form more easily. At the same time your bone structure shrinks a little, so skin drapes over it more. And UV causes DNA damage that leads to spots and marks.

Worth knowing: expensive anti-wrinkle creams do little for wrinkles. The ingredient that genuinely works, a prescription-strength vitamin A acid (retinoic acid), isn’t sold over the counter. The milder derivative in ordinary creams does nothing for wrinkles. What do dermatologists reach for themselves? Sunscreen. A good one costs a few pounds, which makes it the best-value skincare going.

Moles: how to spot a suspicious one

Skin cancer is common, and cases of melanoma, the dangerous type, are still rising. Most melanomas are superficial and treatable by removing them, especially if you catch them early. That’s why keeping an eye out yourself matters so much.

Dermatologists use the ABCDE rule. For checking yourself at home, it comes down to this:

• A – Asymmetry: one half of the mole doesn’t match the other.
• B – Border: ragged or irregular edges.
• C – Colour: more than one colour, or a blue, white or unusual shade.
• D – Diameter: larger than about a pencil rubber, or growing.
• E – Evolving: a change in shape, colour or thickness, or bleeding or itching on its own.

The heart of her message: things that change are the ones to watch. Change isn’t always cancer, but it’s the signal to get it looked at. Her tip for noticing change is to make a habit of it: every few months, take a moment to look over your moles and photograph them, so you can compare later. If a spot hasn’t changed after a few months, you can be reasonably reassured.

When to see your GP or a dermatologist

Get a spot or mole checked if it:

• changes in shape, colour or thickness;
• bleeds or itches on its own for no clear reason;
• looks clearly different from all your other spots (the odd one out);
• simply gives you a nagging feeling that something’s off.

A dermatologist uses a magnifier called a dermatoscope to look deeper into the skin and judge whether something needs removing. They’d rather take one off too many than too few, so don’t feel awkward about getting something checked.

Also see your GP if a skin problem is affecting your life: persistent itching, poor sleep because of your skin, or bad eczema. There’s no routine check for healthy skin, but for anything you’re unsure about, the rule is to get it looked at rather than wait and see.