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Skincare

A consistent, evidence-based skincare routine is the foundation of healthy skin and of any result from treatment. Medical-grade products carry active ingredients at the concentrations that have been studied, and prescription strengths are available after a consultation.

Your practitioner
Skincare treatment tray prepared in a Waterfront treatment room

Contents

Why medical-grade skincare?

The skin acts as an effective barrier, preventing many ingredients applied to its surface from reaching the deeper layers where they are needed.

Medical-grade skincare products are formulated to maximise the stability, penetration and effectiveness of active ingredients, helping them reach the epidermis and upper dermis where they exert their biological effects.

Using products with clinically proven ingredients and appropriate delivery systems offers the greatest opportunity for improving skin health over time

Evidence-based ingredients

There are thousands of skincare products available, but only a relatively small number of ingredients have consistently demonstrated clinical benefit in well-designed scientific studies.

The cornerstone ingredients recommended by dermatologists and aesthetic physicians include:

  • Retinoids
  • Vitamin C
  • Broad-spectrum sunscreen

Together, these ingredients form the foundation of an effective long-term skincare programme.

 

Retinoids

Retinoids are derivatives of vitamin A and are among the most extensively researched topical treatments in dermatology. They have proven benefits in the management of photoageing, acne and pigmentation, and are widely regarded as the gold standard topical treatment for improving skin quality.

Regular use of retinoids may help to:

  • Improve skin texture
  • Reduce fine lines and wrinkles
  • Improve uneven pigmentation
  • Increase epidermal cell turnover
  • Improve acne
  • Promote healthier, more even-looking skin

Retinoids require gradual introduction, as temporary dryness, peeling and irritation are common during the first few weeks of treatment.

The retinoid ladder

Retinoids vary considerably in their potency. In general, stronger retinoids produce greater clinical effects but may also be associated with increased irritation.

The progression is often described as the retinoid ladder:

  • Retinyl esters – the mildest form, commonly found in cosmetic skincare products.
  • Retinol – effective for improving skin quality with good tolerability for many patients.
  • Retinal (retinaldehyde) – more potent than retinol and increasingly used in medical-grade skincare.
  • Prescription retinoids, including tretinoin – the most extensively studied and clinically effective topical retinoids.

Patients are usually introduced gradually to retinoid therapy, with strength and frequency adjusted according to skin tolerance

Tretinoin

Tretinoin (all-trans retinoic acid) is the active form of vitamin A and remains the most extensively studied topical treatment for photoageing.

Unlike cosmetic retinoids, tretinoin does not require conversion within the skin before becoming active.

Clinical studies have demonstrated improvements in:

  • Fine lines and wrinkles
  • Uneven skin pigmentation
  • Skin texture
  • Sun-damaged skin
  • Acne

Because tretinoin is a prescription-only medicine in the UK, it should only be used following assessment by an appropriately qualified medical practitioner.

Patients commencing tretinoin are carefully monitored and provided with guidance regarding gradual introduction and management of temporary skin irritation.

 

Vitamin C

Vitamin C is a powerful antioxidant that helps protect the skin against oxidative stress caused by ultraviolet radiation and environmental pollution.

Evidence suggests that appropriately formulated vitamin C serums may help to:

  • Improve skin brightness
  • Reduce the appearance of pigmentation
  • Support collagen production
  • Protect against environmental free-radical damage
  • Complement daily sun protection

The effectiveness of vitamin C depends upon the formulation, concentration and stability of the product. Not all vitamin C products are equivalent, and many formulations lose activity rapidly if they are unstable.

Broad-spectrum Sunscreen

Daily sunscreen is the single most important skincare product for maintaining healthy skin and preventing premature skin ageing.

Ultraviolet (UV) radiation contributes significantly to:

  • Wrinkle formation
  • Pigmentation
  • Loss of skin elasticity
  • Sunspots
  • Skin cancer

Daily use of a broad-spectrum sunscreen helps protect against both UVA and UVB radiation.

We recommend:

  • SPF 30 or SPF 50
  • Broad-spectrum UVA and UVB protection
  • Daily application throughout the year, regardless of weather conditions

Sunscreen is particularly important for patients using retinoids, vitamin C and following aesthetic procedures such as microneedling, chemical peels or laser treatments.

Prescription skincare at Waterfront

Some of the most effective skincare ingredients are prescription only. Prescription skincare is prescribed by Dr Katy Nassar or Mr Ben Aldridge after a consultation, and made up by Klira in a personalised formulation built around a prescription-strength retinoid.

A consultation comes first, to confirm the treatment is suitable for you. Treatment usually starts at a low strength, with clear instructions on how to build up use while your skin adapts. Tretinoin should not be used during pregnancy or breastfeeding, and should not be applied to the eyelid skin; keep a fingernail-width gap above the lower lid.

You can read more in our article on the difference between tretinoin and retinol.

Klira skincare bottles and boxes in several colours

What skincare can and can’t do

Good skincare is the foundation of any result and the only thing that stops further sun damage. It improves the surface of the skin slowly; it cannot undo decades of sun or replace treatment.

It can

  • Soften fine lines and improve uneven pigmentation and texture over three to six months of consistent use, with prescription-strength retinoids the best studied.
  • Reduce acne and keep pores clearer.
  • Protect against further sun damage, which drives most visible ageing and most skin cancers, with daily broad-spectrum sunscreen.
  • Support and prolong the results of injectable and skin treatments.

It can’t

  • Reverse sun damage or remove deep wrinkles. Even prescription retinoids are licensed to soften fine lines as part of a routine, not to repair sun-damaged skin or deep lines.
  • Replace treatment. Volume loss, sagging and scars need injectables, microneedling or surgery; skincare improves the surface.
  • Work quickly. Skin turnover takes about a month, and most people need 8 to 12 weeks to see a change.
  • Be started at full strength. Retinoids irritate at first. Starting low and building up is normal, and some people never tolerate the strongest forms.
  • Keep working once you stop. Benefits fade over months when regular use stops. Sun protection is for life.

Your practitioner will tell you at your consultation which of these apply to you.

Our aesthetic practitioner

Skincare at Waterfront is advised by our aesthetic practitioner and dentist, Dr Katy Nassar.

Dr Katy Nassar

Dentist and aesthetic practitioner

GDC-registered dentistMSc Skin Ageing and Aesthetic Medicine

Risks, and how often they happen

Skincare carries fewer risks than injections, but active ingredients are not risk-free. Here they are in three groups, with how often they happen where the evidence allows. Your practitioner will go through them with you.

Expected Almost everyone, and they settle

  • Dryness, peeling and redness in the first few weeks of a retinoid, settling as the skin adapts.
  • Stinging on application, especially with vitamin C or after exfoliating.
  • Increased sun sensitivity, which is why daily sunscreen is part of the routine.

Uncommon Some patients, and some need further treatment

  • Irritation that needs a break from the retinoid or a short course of a mild steroid cream before restarting at a lower strength.
    About 1 in 3tretinoin 0.02% trials, any severity
  • Irritation severe enough to need a steroid cream prescribed by your practitioner.
    Under 1 in 10tretinoin 0.02% trials; under 1 in 100 with the base cream alone
  • Stopping altogether because of side effects despite adjusting strength and frequency.
    About 1 in 25tretinoin 0.02% trials
  • Contact allergy to an ingredient, such as a fragrance, preservative or sunscreen filter, showing as an itchy rash.
    Uncommon

Rare but serious

  • Darker or lighter patches after irritation, more likely in darker skin and with sun exposure.
    Rare
  • A severe allergic reaction to a product.
    Very rare

For the long term

  • Benefits need continued use. A retinoid is a long-term habit, usually at a maintenance strength once the skin has adapted.
  • Pregnancy and breastfeeding. Retinoids are stopped if you are planning a pregnancy, pregnant or breastfeeding. Tell us if that changes.
  • Sunscreen every day. The NHS advises SPF 30 or higher with at least 4-star UVA protection, reapplied through the day when outdoors.
  • Prescriptions are reviewed, so that strength and frequency match how your skin is coping.
Where these figures come from

Figures are drawn from the prescribing information for prescription retinoids and from NHS guidance, and your own risk may be higher or lower. More from the NHS on sunscreen and sun safety.

Frequently asked questions about skincare

What is the difference between medical-grade and shop-bought skincare?
Medical-grade products are formulated so that proven concentrations of active ingredients reach the layers of skin where they work. Some high-street products contain the same ingredient names at lower concentrations, so results differ.
Do I need a consultation first?
For prescription items such as tretinoin, yes. A consultation confirms the treatment is suitable for your skin and medical history, and you leave with a plan for how to introduce it.
How long before I see results?
Skin renewal takes time. Most people need 8 to 12 weeks of consistent use to see meaningful change, with further improvement over the following months.
Can I use retinoids around my eyes?
Not on the eyelids. The skin there is too thin and easily irritated. Keep a fingernail-width gap above the lower lid.
Which sunscreen should I use?
A broad-spectrum SPF 30 or 50, worn daily, including in winter.

Written by

Dr Katy Nassar, dentist with a special interest in facial aesthetics

Dr. Katy Nassar, BDS, GDC 80528, is an Aesthetic Practitioner at Waterfront Private Hospital in Edinburgh. She graduated from the University of Glasgow Dental School in 2002 and worked in general dental practice for fifteen years before moving into facial aesthetics. In 2022, she completed a Master’s degree in Skin Ageing & Aesthetic Medicine at Manchester University, which she was awarded with distinction. Katy is dedicated to expanding the range of non-surgical procedures offered at Waterfront Private Hospital.