How to know when to see dermatologist, not social media

We asked over 100 London women where they sought advice, and the results were not surprising. There is a gap between seeking and solving skin issues. When to see a dermatologist is clearly confusing.

Women aren’t passively uninformed; 41% aspire to see a dermatologist, 72% are wearing SPF daily, and they’re actively engaged.

Yet, 24% still don’t think their skin problem is “serious enough” to warrant professional help, and 30% don’t know where to start even when they’re ready to act. Women are now self-diagnosing, self-filtering, and self-dismissing before they ever reach a professional. 

This rings true with what we see in clinic. Our dermatologists at No. 23 regularly see people who have “tried everything”, applied many miracle creams and still nothing works – they have an expensive shelf of products but little results, or worse, inflammation.

We’re not here to say don’t use creams  – we get it, we know there is an element of self-care and ritual amongst all these things. But we do urge you to seek proper advice if you want to clear skin issues and achieve the best long-term, healthy results.

There are a few skin concerns that need medical support:

Persistent or cystic breakouts/acne

If your skin is consistently breaking out, despite good habits and following at-home advice such as eating well, drinking fluid, washing your skin with benzoyl peroxide, and using non-comodegenic products, then it’s time to see a dermatologist to find out the underlying causes and prescribe you a treatment plan that will get your skin clear for good. The same goes for cystic acne – this is very difficult to clear without medical support plus, it can scar – so the sooner you get support the better.

Pigmentation

It may be that pigmentation doesn’t bother you – but if it does, over-the-counter products may slightly lighten it for a period of time, and adding a retinol to your routine can help (not for pregnancy or breastfeeding). However, first you need to understand what type of pigmentation you have – is it melasma and hormonally related (need to see a dermatologist), sun spots (broken up with laser), or post inflammatory pigmentation (combination of both)?

Rosacea/redness

Rosacea often goes undiagnosed for a long period of time. It can flare up and is sensitive to changes in routine, weather, food, and products on the skin. It may be rosacea if you have persistent red flushing of the skin, lots of broken capillaries on your skin, and/or red pustules – commonly across the cheeks.

Treatment involves lifestyle factors, such as avoiding spicy food and red wine, but often further support is required in the form of prescription medications and BBL laser treatment – which can be genuinely lifechanging. Trying a lot of skincare on rosacea may not work, and we often see that it exaccerbates it.

Changes in moles

Very important. If you notice any change in size, shape, colour or any new moles then it is important to get them checked. This is definitely when to see a dermatologist.

Overall skin changes related to hormones or ageing

Your skin is constantly changing, and over time this causes intrinsic and extrinsic ageing. We love a few lines, but want them on healthy, fresh and dewy skin. 

Extrinsic ageing (and perhaps the most obvious) is related to UV exposure; wearing good sun protection and clothing is essential to reduce this photoageing. Nutrition plays a part – a nutritional study showed resilience to photoageing was associated with a higher intake of vegetables, olive oil, fish, and legumes such as chicpeas, beans, peas, and lentils, and a lower intake of margarine, sugar and dairy products. Menopause, immune conditions, and smoking all impact the appearance of the skin.

Our advice is to stick to what works. If you have concerns about sun exposure, then get a mole check because the prevelance of skin cancer is increasing. The evidence is reasonable for:

• Retinols and Vitamin A (albeit you may need a prescription for stronger versions in the UK)
• Azelic Acid
• Niacinamide
• And of course SPF is a must.

We get it, the marketing is confusing. We recently did an event where our dermatologists debunked some of the myths around collagen, LED masks, and Biotin etc – see the summary here. 

When to see a dermatologist

Better still, come and chat to a specialist about your skin ageing concerns – we offer a complimentary consultation for rejuventation services so you get the right answers when you need them. For anything medical, you need to book a dermatology consultation to ensure you have proper medical treatment.

Skin is personal — but for too long, the expertise around it hasn’t been. I spent 15 years in private dermatology watching brilliant, beauty-savvy people navigate a system that offered appointments without answers. My research confirmed it: 80% of people are seeing changes in their skin, yet most have no idea what to do next. We’re changing that — with access to the UK’s top dermatologists and the kind of clear, honest guidance that replaces guesswork with confidence.

Reach out with your skin questions – hello@23skin.co.uk and 02039411815.

Helen

CoFounder
No. 23 Skin

hc@23skin.co.uk

02039411815

NB: the advice in this postis for information only. For specific medical advice on when to see a dermatologist, please see your doctor or one of our dermatologists.