A skin programme: what happens between appointments

In-clinic treatment does things daily care cannot: it reaches depths topicals do not, and it creates the controlled injury that prompts remodelling. It happens a few times a year.

Daily care does something different. It maintains barrier function, supplies the ingredients with evidence behind them consistently, and prevents the damage that undoes the treatments. It happens twice a day, every day.

When people report that a course did not work, the reason is frequently that nothing changed between the appointments, and often that unprotected sun exposure continued throughout. The appointments were not the problem.

Give a new active twelve weeks before judging it, and change one thing at a time. Introducing three products together means learning nothing about any of them, and if irritation occurs you cannot tell which caused it.

Photograph your skin in the same light, at the same angle, once a month. Day-to-day perception of your own face is unreliable, and monthly photographs are the only honest comparison you will have.

Be sceptical of claims that a topical does what a procedure does. Claims of lifting, dissolving fat or permanently removing pigment from a bottle do not hold up, and the Federal Trade Commission has published guidance on exactly this kind of health claim. A good product improves the skin's condition; it does not replace a treatment.

Price is not a proxy for evidence. Some of the best-supported ingredients are inexpensive, and some very costly products are built mostly around packaging and fragrance.

The usual order is barrier first, then sunscreen daily, then one evidence-backed active introduced slowly, then in-clinic treatment once the skin is tolerating all of that. Starting with the procedure and adding the home care later is the common sequence and the less effective one.

Before certain treatments, we may ask for weeks of specific preparation, particularly where pigmentation is a risk. That preparation is part of the treatment, not a retail upsell, and skipping it changes the odds of the result.

We will tell you which parts of a routine we think are doing work and which are not. If something you are already using is fine, we will say so rather than replacing it.