Understanding your skin

13 January 2023

The key to a glowing, radiant complexion is great skin health. And if you know me or have kindly been following along on socials, you’ll know that skin health is my passion. 

We all have unique skin types, which means we all have different skin needs. So instead of blindly following social media skincare trends, I implore you to understand your skin type first. Once you know what you’re working with, you can tailor your skincare accordingly. Always remember: Skincare isn’t one size fits all.

Having said that, it can be tricky to understand your own skin type. If you’re unsure, start by asking yourself these three questions:

  1. How does my skin look?  
    Look at your skin – makeup free – in good natural lighting. What catches your eye? Perhaps you notice blemishes, pigmentation, or redness? Remember not to sweat the small stuff. Pores, wrinkles, and freckles are all normal. But should you wish to treat them, it is entirely up to you.
  2. How does my skin feel? 
    Healthy skin should feel smooth and even. Or is your skin rough, bumpy, flaky or even oily? 
  3. How does my skin behave? 
    Healthy skin should be robust. Whilst we can all be sensitive at times, does your skin react frequently? For example, does it sting or burn with a number of products? Does your skin break out? And what are the triggers that cause this?

Go through these steps and then come up with 1 or 2 specific skin goals. It may be that you’re happy with the look, feel, and behaviour of your skin, but you want to maintain that. Remember, skin is the largest organ of the body – we need to look after it carefully. 

Read on for a deep dive into some of the most common skin conditions that I see and treat in my clinic.



Acne is an extremely common disorder affecting nearly 85% of people during their lifetimes. 

It is an inflammatory condition of the oil producing (sebaceous) glands, which involves changes in oil production and disruption of the skin’s microbiome.

There are a number of factors that can make some people more prone to acne than others. To start, having a family member with acne – particularly severe acne – can increase your chances. It also often occurs around times of hormonal changes. These include puberty, hormonal disorders such as polycystic ovaries, and hormonal medication, i.e. the morning after pill, contraceptive pills, and HRT. Certain lifestyle factors such as diet and skincare may make things worse, but are not usually the cause of the condition. 

Acne can present in lots of different ways: small red bumps (papules); yellowheads (pustules); blackheads (open comedones); and flesh coloured bumps (closed comedones). Severe acne can present as very large cysts which are much more likely to scar. 

The condition is entirely treatable, and management for mild changes start with over the counter products such as cleansers, salicylic acid, niacinamide, and benzoyl peroxide. More severe changes are very likely to require medical creams and even tablets. It’s important to treat acne effectively and as early as possible to reduce the risk of scarring. 


Rosacea presents as a combination of one or more red, sensitive bumps on the face.  

It often happens later in life than acne and usually (although not always) starts in the early-to-mid 30s. Most people who suffer from Rosacea are genetically predisposed and factors such as UV exposure, smoking, and alcohol can exacerbate the condition further. 

While people often treat the bumps of Rosacea in a similar way to acne, Rosacea actually requires very different treatment. Skincare must be very gentle and soothing, and medical creams and tablets may be required to calm down the bumps, flaking, and sensitivity. 

    Eczema is a dry, itchy, red, flaky skin condition. Also known as Dermatitis, Eczema presents itself in different forms:
    Atopic Eczema often goes alongside conditions such as hayfever, asthma, and food allergies. It can start at any age, but frequently begins in the first 2 years of life. Children are more likely to suffer from this condition, with 1 in 5 kids in the UK currently having it. It frequently presents in creases of the arms and legs, and can also appear on the face. Atopic Eczema is a combination of three things: sensitive skin with a weakened barrier; an overactive immune system in the skin; and changes in the skin’s microbiome. Treatment concentrates on first helping to restore the skin barrier – reducing inflammation with medicated creams or tablets – and then balancing the microbiome of the skin. 
    Irritant Contact Dermatitis is a condition caused by the use of harsh chemicals. It can be triggered by repeated hand washing or the skin coming into contact with cleaning products. 
    Allergic Contact Dermatitis occurs as an allergy to a substance coming into contact with the skin. Examples include nickel in belts or jewellery, and fragrance within skincare. 
    Seborrheic Dermatitis is a type of eczema that occurs on the scalp, face, and chest. It causes flaking in the scalp, around the corners of the nose, and the eyebrows. It’s actually the basis for many people’s dandruff. This condition is caused by an abnormal skin sensitivity to a yeast known as Malassezia and is often more of a problem in oily skin. Treatments involve anti-yeast creams and shampoos, as well as moisturisers to help with the dryness and flaking. 

Psoriasis is a chronic inflammatory skin condition which presents as areas of red skin with a silvery scale – commonly occurring over elbows, knees and scalp. It can sometimes affect nails and even joints, and is thought to run in families. Mild psoriasis may be controlled with moisturisers and coal tar shampoo. However, more extensive cases are likely to require medicated creams, light therapy, and even tablets and injections. 


Pigmentation (or hyperpigmentation) is the excess production of the brown pigment – melanin – within the skin. It can result from a number of causes and whilst each individual cause will have specific treatment, there are some ingredients which can help across the board. High-factor sun protection is essential, as melanin production is stimulated by UV exposure. Niacinamide, vitamin C, retinoids, and azelaic acid can all help, too. 


Sunspots (or solar lentigines) are flat brown patches which occur commonly on the face and the back of the hands, as a result of sun damage. They are different from freckles, which appear in childhood and are genetically determined. Laser treatment can be helpful to reduce or eliminate the spots.


Melasma is a pigmentary disorder resulting in symmetrical, brownish patches of pigmentation on the face – often over the forehead, cheeks, and upper lips. It is caused by an overproduction of melanin by the pigment cells melanocytes. Melasma is frequently related to hormonal changes due to pregnancy or the oral contraceptive pill, and is exacerbated by the sun. While it may improve after pregnancy, it sometimes still requires medical treatment. Today, we treat Melasma with a combination of creams and tablets, while more resistant cases may require chemical peels or even laser treatment. 


Sometimes, pigmentation can occur after trauma to the skin. This is particularly common in darker skin tones and can result from blemishes, eczema patches, or even cuts. PIH will fade, but this may take a significant amount of time. Preventing the cause of the PIH, where possible, is often the most useful intervention. 

Thanks for reading,

Dr Emma xx

Follow me – @dremwedgeworth – on Instagram and TikTok for more healthy skin tips and advice.