Skin Q&A: Dr Rhonda Meys

Hi, I'm Doctor Rhonda Meys, Consultant Dermatologist, and I work here at The McIndoe Centre. You may have heard about Mohs surgery for skin cancer, but what is Mohs surgery? So Mohs surgery is the gold standard of surgery for skin cancer. It has the lowest risk of recurrence and normally we use it for basal cell cancers on the face. It's a specialized technique where the tumor is excised by the Mohs surgeon with a small margin. It's then taken to a special laboratory on-site where we cut and stain it with frozen sections and look very carefully to see that the tumor is completely excised. This highly specialised technique is available here at The McIndoe Centre. Giving the right sun protection advice is a very important part of my work as a Consultant Dermatologist. As you can tell, I was born in Australia and I grew up knowing how important sun protection is. In The UK, some people assume that you don't need to use sun protection because there's less sunshine, but this is not necessarily the case. UV A rays are present all year round, can pass through glass and often contribute significantly to skin ageing and to the degeneration of skin cancers. UVB is the more burning wavelength and is much more prevalent during the sunnier months. Now, around five blistering sunburns before the age of 20 can increase your risk of getting melanoma almost twice. Cumulative sun exposure over many years can also generate other skin cancers like squamous cell cancers and basal cell cancers. So good sun protection has two main benefits. The first is it reduces skin aging and the second is it reduces the generation of skin cancers. I always advise using a sunscreen that has a combination of mineral and chemical filters. The best sunscreens are those that are classed as being broad spectrum. I look for sunscreens with a very high UVA protection, which is indicated by the PA plus plus plus rating, as well as UVB protection, which is indicated by the SPF of 50 or greater. I usually recommend one of the French brands that have a very good broad spectrum filter, as well as some homegrown brands that have encapsulated SPF filters. The key is also knowing how much to apply and how to apply it. There is the two finger rule where we apply two finger lengths of sunscreen for the face and neck. Now this is about a teaspoon, four or five mills. Many people don't apply enough and therefore they don't get their full SPF. Another tip is to apply SPF with the fingertips rather than the palms because that means more of the product gets on the face where you need it. Layering can also help to get the correct amounts onto the skin and it's important to reapply every couple of hours, particularly if you're outdoors, sweating or it's hot. The most important principle is to find a sunscreen that my patient likes and they can use it every single day. So when people talk about anti aging, they think about Botox, filler and surgery. But as a Consultant Dermatologist, there's other things that I utilise, particularly skincare to help reduce the signs of aging. The first principle is sun protection because prevention means that then we can reduce the signs of aging before they occur. The second principle is looking at introducing a topical retinoid as this makes the skin look youthful by increasing cell turnover and also boosting collagen production. And finally, I recommend other ingredients such as peptides and antioxidants that can be used in a sustainable daily skincare routine that can help make the skin look more youthful.