Dr. Uliana Gout
Harley Street- LONDON, UK
Non-surgical Aesthetic Medicine Doctor
Dr Uliana Gout is the founder of London Aesthetic Medicine Clinic in the heart of world renowned Harley Street, London. She is the President of the British College of Aesthetic Medicine (BCAM) representing 400 clinicians with a 20 year heritage. Dr Gout is the Scientific Director of FACE Congress (UK’s longest running Congress). She also sits on the Board of the International Peeling Society (IPS). Amongst other roles, she is also Course Director of the Aesthetic Medicine World Congress (AMWC) catering for 10,000 international delegates. Dr Gout’s passion is to raise standards in Aesthetic Medicine across the globe. Today, she tells us about the importance of Double Cleansing to protect and maintain optimum skin health.
Behind The Woman
About your career and the people who inspired you:
I am hugely passionate about Aesthetic Medicine and very proud of our how innovative and fast paced our sector is. My key goal is to pioneer evidence-based medicine by collaborating closely with pharma, societies, colleagues and the consumer press. Furthermore, I love the fact that as a community we are a fun & very lively group of like-minded experts. This makes everyday work seem less like work and more a collaborative and cohesive effort to progress our specialty & educate the wider public on what we do.
My inspiration comes from my family (I have a long standing family heritage in medicine) and my peers. I love to communicate and share ideas and hence really enjoy my work within the conference arena. Furthermore, when I started over 10 years ago I was particularly drawn to the research & education part of Aesthetic Medicine- it’s so welcoming to doctors who wish to explore these areas- which is amazing.
How important is cleansing in maintaining Skin Health?
Cleansing is a crucial and supremely important part of maintaining optimal skin health! And interesting enough it is a part of the skincare routine which is often poorly or completely underperformed! I see a lot of patients who still wash their face with any old soap or just water. And then another cohort who over-cleanse, which in turn causes further skin issues ie dryness, sensitivity etc. The most interesting and latest finding in our specialty is the appreciation of the importance of pollution management with cleansing. We now know that pollution does not simply sit on the surface of the skin but penetrates the skin. In turn it causes pigmentation, wrinkles and rashes.
Can you tell me more about the concept of Double Cleansing? Marketing and / or Science?
Yes of course- it is super simple and simply needs a good routine. It simply means cleansing the face once and then washing off, followed immediately after with a second cleanse and wash-off.
How does it work concretely? What are the 2 steps in Double Cleansing?
This process gives two major benefits to the technique, the first cleanse achieves the removal of any surface makeup, dirt, oil, and the second cleanse then allows for a deeper cleanse and exfoliation of the stratum corneum. When using exfoliant cleansers i.e beta or alpha hydroxy acids cleansers we also allow for a more optimal penetration of other ingredients ie antioxidants, retinoids, depigmenters etc. Hence, double cleansing allows for better outcomes of other ingredients! A common approach to double cleansing also involved the use of an oil-based cleanser or a micellar water for the first cleanse to remove surface makeup, oil build-up and pollutants that have accumulated on the skin during the course of the day. This is then followed by a stronger cleanser ie alpha/beta hydroxyacids to achieve further exfoliation, tighten the pores and bring back the radiance.
Do you any specific recommendation when it comes to Sensitive Skin?
In the case of sensitive skin, I encourage my patients to be less aggressive with their exfoliating cleansers. Gentle gel or foaming cleansers containing moisturising agents e.g. urea, xylitol as well as anti-inflammatory and anti-bacterial agents are great options. Another example is micellar water cleansers but I do ask my patients to use soft cloths/pads to apply the cleanser and the best option of course if using hands to apply and wash off. The less mechanical stress the better. Micellar water is excellent at removing water-soluble cosmetics as it contains very mild cleansing agents that do not disrupt the skin barrier and do not need to be rinsed off with water (5).
FACT: Some interesting research has shown that washing the skin with hard water is associated with an increased risk of atopic dermatitis (3). It can exacerbate skin sensitivity especially with the rubbing of the skin associated with cleansing (4).
Isn’t water gentle to the skin?
The physiological pH of the skin is acidic ranging from 4.5 to 5 whereas pure water has a pH of 7, which is a neutral pH and not an acidic one. As such, it is better to favour the use of products that do respect the physiological pH of the skin such as facial and body cleansers and avoid soaps (which have an alkaline pH) (4) (6).
Anything else that you recommend to perfect Double Cleansing ?
Good moisturization is essential to complete the double cleansing routine-one of my favourite ingredients is hyaluronic acid preparations. Also remember to apply daily SPF 30 + broad spectrum and the trick is a good volume ( 2 finger-lengths worth every day).
PERSPECTIVES ON SKINHEALTH
Do you think that the Covid situation has had an influence on consumers’ cleansing habits?
Covid has both disrupted facial skincare routines (e.g. either too tired, or too stressed to do it properly) and made hand washing an obsessive habit. As such, we have seen a rise in skin complaints such as congestion, dilated pores, spots and blemishes due to poor cleansing routines. ‘Maskne’ as a global phenomenon has also exacerbated the lack of proper cleansing. Hence we are seeing a rise in patients seeking proper advice and help on how to get the skin back to a healthy, radiant, congestion-free state more than ever before.
What is your definition of Healthy Skin?
Skin which is diagnosed by a medical specialist, and maintained and cared for in a strategic and medically-focused way.
Your secret to Healthy, Beautiful Skin?
See a doctor and get a proper consultation and examination so we can tailor the treatments for you!
Self diagnosis and self medication is common- but let’s not forget skin is our largest organ and it deserved medical care!
1. Dréno, B., Bettoli, V., Araviiskaia, E., Sanchez Viera, M. and Bouloc, A. The influence of exposome on acne. Journal of the European Academy of dermatology and venerology. 2018, Vol. 32(5), pp.812-819.
2. Schikowski, T and Hüls, A. Air Pollution and Skin Aging. Current Environmental Health Reports. 2020, Vol. 7, pp.58-64.
3. Danby, SG., Brown, K., Wigley, AM., Chittock, J., Pyae, PK., Carsten, F., Cork, MJ. The Effect of Water Hardness on Surfactant Deposition after Washing and Subsequent Skin Irritation in Atopic Dermatitis Patients and Healthy Control Subjects. Journal of Investigative Dermatology. 2018, Vol. 138, pp.68-77.
4. Hosokawa, K., Taima, H., Kikuchi., M., Tsuda, H., Numano, K., Takagi., Y. Rubbing the skin when removing makeup cosmetics is a major factor that worsens skin conditions in atopic dermatitis patients. Journal of Cosmetic Dermatology. 2020, Vol. 00, 1-8.
5. Draelos, ZD. The science behind skin care: Cleansers. Journal of Cosmetic Dermatology. 2018, Vol. 17, 8-14.
6. Edwence A., Rumsby P., Dunby S., Cork MJ., Williams H. A Review of Skin Irritation and Tap Water Quality. Swindon, UK: WRc. 2011.
7. Cacciapuoti, S., Luciano, MA., Megna, M., Annunziata, MC., Napolitano, M., Patruno, C., Scala, E., Colicchio, R., Pagliuca, C., Salvatore, P and Fabbrocini, G. The Role of Thermal Water in Chronic Skin Diseases Management: A Review of the Literature. Journal of Clinical Medicine . 2020, Vol. 9, 30-47.