Dr Jeanine B. Downie
Private Dermatology practice focused on medical and cosmetic dermatology, laser, dermatologic surgery and skin cancer.
Behind The Woman
About your career and the people who inspired you:
When I was 4 years old, I already knew that I wanted to become a doctor. I was inspired throughout my
childhood by my grandfather who was a Dentist and by my mother who is a Pediatrician. Both of them
continue to be a source of inspiration. My mother still practices part-time now even though she is in her
80s. There is a real passion for Medicine running in the family which has been all along a source of
inspiration and fulfillment for me.
My own journey as a kid suffering from eczema and a teenager with a “wicked” acne certainly influenced
me to study Dermatology because people were extremely judgmental about the way I looked. So
both my acne and my straight A’s in high school led me to college then graduate school when I received
my Masters in Biology with the concentration in Reproductive Endocrinology. Next was medical school,
Internship in Pediatrics and finally Dermatology. I never looked back, I just love Dermatology.
|Have you noticed a rise in the prevalence of Adult Acne in your patient population?
Acne is one of the world’s most common skin disorders, and its prevalence among adults is on the rise. Around 85% of people aged between 16 and 241 are affected by acne and rates of adult acne have also increased in recent years2. This is definitely more than a trend. I have come to notice in my own practice a growing demand for acne management in adult patients, especially among my female 30+ patient population.
Air pollution and acne. Is there a link?
Acne may be triggered or worsened by a variety of factors including hormone fluctuations, smoking, drinking alcohol, genetic predisposition and stress. Recently, another likely environmental cause of acne has come to light, and that’s air pollution. Air pollution is an unavoidable aspect of modern life, particularly for people living in cities and industrial areas. Several studies have identified a link between airborne pollutants ( such as particulate matter, volatile organic compounds, ozone, nitrogen dioxide and Sulphur dioxide) and the rising prevalence of skin problems among adults3.
What does Air Pollution do to the skin?
Airborne pollutants but also dust, dirt and grime can also accumulate on the skin throughout the day, clogging pores and increasing the likelihood of acne breakouts. Harmful air pollutants are known to increase oxidative stress when they come into contact with the skin, severely disrupting its natural functions4. This can lead to elevated sebum levels (which causes greasy skin), increased inflammation and a disrupted microbiome; the perfect combination for cultivating pustules and blackheads. To add insult to injury, these pollutants don’t just cause breakouts, but can even accelerate skin aging.
Additionally, UV exposure has an additive effect with airborne pollutants and ozone (O3). UV irradiation is known to compromise the skin barrier and O3 seems to heighten this phenomenon by disturbing stratum corneum lipid constituents that are known to be critical determinants of the barrier function. UV exposure and O3 have also been found to have an additive effect on antioxidant depletion ( vitamin E)5,6.
So, how can you protect your skin from the harmful effects of air pollution?
Airborne pollutants are inescapable for most people, so controlling and preventing adult acne often depends also on a good skincare routine. To reduce the impact of pollution on your skin and control acne outbreaks, I recommend to my patients to take the following 4 steps skincare routine for clear, healthy skin:
Cleanse every day
Physically removing the layer of grime that builds up on your skin is a crucial first step in tackling pollution related acne. Cleanse your skin twice a day (in the morning and at night) to prevent a build up of dirt and excess sebum, which can clog your pores and lead to outbreaks. If you wear make up this is especially important – pollutant particles can cling to foundation and are held close to the skin, so sleeping in your makeup is sure to exacerbate acne. Use only oil-free make-up products.
The downside to all that cleansing is that it can strip your skin of its natural oils, leaving it dry, inflamed and acne prone. Make sure to rehydrate your skin after each wash with a facial moisturizer, preferably with added sun protection.
Use an antioxidant serum
Air pollution is known to put the skin under oxidative stress, which can trigger acne outbreaks and accelerate aging. You can combat this effect by applying a night serum enriched with antioxidants (such as vitamins C and E). These help to prevent the formation of free radicals, which damage cells and can cause premature aging.
Sun protection everyday
Sun protection is critical and needs to be apply EVERY SINGLE DAY. Sunscreen must be used and reapplied every day, rain or shine, January through December regardless of ethnicity. It must be an SPF30 or above.
Anything that you recommend in particular to your darker skin patients?
I recommend to my darker skin tone patients to put on sunscreen SPF 30 everyday and re-apply during the day, just like everyone else. Dark skin is not and should not be excused from proper skin protection.
Are there any promising new products or technologies on the Horizon in this field?
When it comes to skin protection and defense against environmental assaults, there are some new innovative “superscreen” products: 100% mineral-based sunscreen formulated with DNA repairsomes ® and Vitamin E to help prevent actinic damage and some rejuvenating sunscreen, infused with antioxidant complex to enable protection against IR-A and help rejuvenate the skin.
What is your definition of healthy skin?
My definition of Healthy Skin is even skin tone, a decrease of fine lines and wrinkles and no skin cancers.
What is your secret to Healthy Beautiful Skin?
I use sunscreen with an SPF of 30 every day. Rain or Shine, January through December myself! I like new “superscreen” product containing antioxidants for additional protection against IR-A. For skin rejuvenation, in the morning I prefer serums containing either a mix of growth factors or a blend of proprietary glycosaminoglycan analogues. At night, I use a serum chock full of growth factors every night before bed because it gently builds collagen without the use of retinoids. I use additionally at night, either a serum containing Melatonin, Backuchiol and Vitamin C or a clarifying Rx-serum with Vitamin C and Hydroquinone. My final daily touch is the use Brush-on Sunscreen that can be used alone or over make-up to give a sheer, natural-looking coverage and SPF in one simple, on-the-go application.
I drink 12-15 eight ounce glasses of water daily. I do not smoke, do not drink coffee or drink alcohol. I exercise seven days a week and do a combination of cardio, weights, Spinning, pushups, sit-ups and core work. I try to get enough sleep-that is the one area I need to work on!!
1. Aad.org. (2019). Skin conditions by the numbers. [online] Available at: https://www.aad.org/media/stats-numbers [Accessed 28 Nov. 2019].
2. Albuquerque, R., Rocha, M., Bagatin, E., Tufik, S. and Andersen, M. (2014). Could adult female acne be associated with modern life?. Archives of Dermatological Research, 306(8), pp.683-688.
3. Krutmann, J., Moyal, D., Liu, W., Kandahari, S., Lee, G., Noppakun, N., Xiang, L. and Seité, S. (2017). Pollution and acne: is there a link?. Clinical, Cosmetic and Investigational Dermatology, Volume 10, pp.199-204.
4. Dréno, B., Bettoli, V., Araviiskaia, E., Sanchez Viera, M. and Bouloc, A. (2018). The influence of exposome on acne. Journal of the European Academy of Dermatology and Venereology, 32(5), pp.812-819.
5. Valacchi G, Sticozzi C, Pecorelli A, Cervallati F, Cervellati C, Maioli E: Cutaneous responses to environmental stressors. Ann N Y Acad Sci. 2012;1271:75-81.
6. Pillai S, Oresajo C, Hayward J. Ultraviolet radiation and skin aging: roles of reactive oxygen species, inflammation and protease activation, and strategies for prevention of inflammation-induced matrix degradation- a review. Int J Cosmet Sci. 2005;27(1):17-34.