Dr Shammi Theesan is a highly experienced Melbourne-based dermatologist, who recently founded ODE Dermatology, a brand new clinic in Fitzroy. Dr Shammi is passionate about transformative dermatology care that combines medicine and wellness.
Throughout her career, she has striven to place herself at the cutting edge of her specialism. Her interest lies in not just fixing the skin, but enhancing it.
In this session of Mamamia's The Skin Summit, Dr Shammi Theesan speaks to Mamamia's Head of Content, Holly Wainwright, about aging without needs and the best Botox-free options available for our faces.
What is actually happening to our faces as we get older?
Dr Shammi Theesan: It's remodelling, it's changing. The skeletal aspect of our faces is kind of shrinking down. That's why you get gels more, because our mandible (where our jawline is) kind of shrinks down. You've got laxity of the skin, you don't produce as much collagen and elastin.
Women after menopause lose a good 30 per cent of their collagen - and then you've got that two per cent decline every year after that. So when you put that in the mix together, with ageing on every level, you know, from the muscles to the bones to the skin, and then you get that cumulative sun damage over time that also gives you a bit of a textural or a pigmentation issue or an impact skin barrier.
That also gives you a bit of a textural or a pigmentation issue or an impact skin barrier.
What's one important thing that women should change about their skincare as they age?
Dr Shammi Theesan: I think the one thing you could do is probably get your gut health right.
To be honest, if I had to choose just one thing - because I love sleep, I love the right skincare, and to exercise and eat a plant-based diet. But if I had to choose one thing, I think it would have to be gut health.
Your gut is one of the largest immune organs in your body. So when that is happy, you really have better skin, better hair, better mental health.
So I actually say pare it back and work from inside out, which is sometimes tricky as a dermatologist, but I love doing both. So your skin talks to your overall wellness and your gut health and your brain health, but your gut is basically a mirror image of your skin.
What do I mean by that? Less sugar, less dairy, less gluten, look at inflammatory foods and look at reducing them. So if you've got a tendency to have more redness or rosacea or pigmentation, you really want to hone in on that dietary element of probiotics.
I take a teaspoon of artichoke powder - artichokes and asparagus are really good for your gut health, because they feed the good bacteria in your gut, which then makes your skin so much happier.
What products and ingredients do we need to look for to tackle wrinkles and fine lines?
Dr Shammi Theesan: I'm not going to choose between my favourite vitamins but you really want to have your Vitamin A, B and C.
So your vitamin A is in the retinol family and that is probably the gold standard for wrinkles and anti-ageing because it truly plumps up your collagen. It helps with skin renewal. It's a great multitasker. So that's your retinol and the cosmeceutical industry has caught on. You know they have good, highly effective products now for that retinol element at night.
The trick with retinol though is to introduce it gently. So use a pea size amount, a couple of times a week at night, you don't really want to get that retinal dermatitis or retinoid dermatitis but their skin peels and gets irritated because that level of inflammation actually is counterproductive.
So using a very low level and gradually building up that strength, or the frequency is the way to go.
Now that we're on it, maybe I do have a favourite vitamin - it has to be Vitamin B3. It is a massive multitasker. It will be anti-acne, it'll be anti-oil production, it helps with pigmentation and it actually helps increase the production of ceramide. So ceramide is little lipids or glue between your skin cells, and it's a key ingredient in that production.
So when you've got more ceramide, you're going to look fresher, more luminous. It's excellent for your immunity in your skin cells. So it's actually protective against sun damage and skin cancers as well. Vitamin D3 is very important.
We know vitamin A gets applied at night, whereas vitamin C is in the morning. But when and what kind of products am I most likely to use my vitamin B with and where does it fit?
Dr Shammi Theesan: It's a great multitasker. You can use it morning or night. I would use it in the morning, that way you've got immune regulation of your skin.
Vitamin B is not really an irritant, it works very well with retinol. It also works very well with vitamin C too.
It all depends on how that formulation is conjugated. It's important to note that you just can't pick a random vitamin D3 or a random vitamin C.
I think it's worth seeing a professional to work out what state of vitamin C you need it in. Ask these questions:
- What do I need?
- Do I need a lactic acid in conjunction with it?
- How do I introduce my retinol?
- Which brand should I use?
- Should it be in a creamy base? Or should it be in a serum?
There's no one answer for mature skin because you might have a bit more dryness, you might have a bit more rosacea. You might have a tendency towards eczema. So how you actually introduce new skin products, or what base you put the retinol in, or the vitamin C, it all matters.
Is it too late to start a skincare routine when you're older?
Dr Shammi Theesan: No. That is why I love treating all ages because the skin is one of the best regenerative properties of our whole body so we can improve our skin.
It might be a bit slow as you get older, but you've got that potential to reawaken your stem cells, which are at the bottom of your skin layer.
So no, and it's only going to get worse if you don't do anything. You can't reverse ageing completely, but you can mitigate it radically with the right intervention of the right skincare. But skincare has to be homework that you do every day.
Is an eye cream essential? Should we be treating our neck and decolletage differently to our face? How do we have the best kind of skin without undergoing invasive procedures?
Dr Shammi Theesan: Your skin doesn't just stop at your chin. It's all over and all of the skin ages. In fact, your neck and your chest age a bit faster because that part of the skin doesn't have the same amount of sebaceous area so the oil glands are not as active.
So I actually think a simple tip to follow, instead of buying separate creams, is to just stretch out your routine.
Why stop at your chin? Just pat it down all the way to your neck. The only time you've got to be a bit careful is when it comes to using retinol - your chest and your neck might be a bit more sensitive.
To combat this, I recommend the following:
- Dilute it with your moisturiser, so you weaken the retinol yourself.
- Use it less often.
- Use a smaller amount.
For eye creams, I'd actually recommend using all your serums - your vitamin C, your vitamin B and your retinol. Kind of extend it all the way around the periorbital area with the knot in the corner of your eye.
If it doesn't irritate you, you don't need an eye cream. But if you get some redness or itchiness, then I would invest in a separate retinol eye cream that's just got an attenuated strength.
If you don't want to contest your eyes as much, go for one that isn't as heavy. If you have specific eye issues or eye area issues, or specifically pigmentation, you might want to look into a product with liquorice extract.
If you've got puffiness, you might want to use something with some caffeine in it. And the other thing why an eye cream sometimes is important is if you've got more wrinkles, more laxity, more pigmentation under the eye, you might want to use an eye cream that's got some SPF in it.
When you say pigmentation under the eye, do you mean dark circles?
Dr Shammi Theesan: It can be but there's a broad terminology for dark circles. There's venous congestion sometimes when you've got a lot of intrusion of your vessels underneath the skin that can kind of give you that bluish hue. Prominent eyebars can also give you some shadows under your skin, but also just volume loss in the area can present as hollows that look a bit darker.
In terms of non-invasive treatments for your face, how do you start knowing what really is going to work for you?
Dr Shammi Theesan: I'm biased, but I think the right dermatologist would know exactly what you need. But a lot of dermatologists specialise in different areas. So if you want, you can find someone who is an aesthetic specialist or who's going to look at your skin holistically from a prescription and laser treatment. There's even an ultrasound energy treatment of filler if you have to do Botox, but either way - we can kind of do it all. We don't have one tool to fix a condition we can give you a myriad of options.
What's a good go-to skin routine?
Dr Shammi Theesan: Use a gentle cleanser at night, and then use a lactic acid moisturiser or a serum. Afterwards is when you put on retinol. In the mornings, splash a bit of lukewarm water, and pat your skin dry - DO NOT rub it dry with a towel. Then use a drop of your Vitamin B serum and tap it in. Then you use a drop of your Vitamin C. Then lock it in with moisturiser.
Wait 30 seconds, apply your moisturiser and then you can apply your makeup!
Is it too late to start on a sunscreen if you've been a bit slack?
Dr Shammi Theesan: No, because sunscreen is not just about skin, it's about cancer prevention. It's about your collagen loss. It's about your pigmentation. It's about worsening your rosacea. So no, never too late.
Did you miss The Skin Summit presented by Mamamia? Get on-demand access to the best skin experts in the world. Whether you love nerding out over a 12-step skincare routine or still use a bar of soap, the summit is the secret to the best skin of your life. Streaming directly to your couch. Catch up on-demand here.
You can follow Dr Shammi Theesan on Instagram or her dermatology practice ODE Dermatology on Instagram.
Feature Image: Mamamia.