The Backstory

One of the things I love about dermatology is that it’s right in front of you. The patient is there telling you a story and all the clues are right there. You just have to look and then piece the pattern together. From a young age that desire to be able to see things and solve a problem quickly is always something I’ve really liked and therefore dermatology is quite a good field to get into. I love every single aspect of it. I’m fascinated. I feel like I’m never off duty because I just spot things everywhere. Excuse the pun.

The thing that first sparked my interest was that I’m from Northern Ireland and I was injured in a bomb when I was about 16. It was actually also the day that I first met my husband, but I was 16 and we went to the hospital and the doctor who was fixing my leg said, “You’re very interested in all of this”. I said, “Yeah, I just love it. How is the skin going to heal?” And he was describing it all to me and he said, “Would you like to put a stitch in?” And I said that I’d love to”. So he showed me how to do that and then I had to have all these special dressings on the leg and just spent my time watching how this leg was being fixed. And that is where I got this fascination about the skin.

It’s really satisfying helping people. It’s not just about skin, it’s also about the entire change it can have on a patient. And it’s so frustrating sometimes to hear as a doctor as well as a dermatologist say, “Oh, that’s just a bit of eczema or that’s just a lipoma or a cyst.” It’s never really just that. It might not be going to kill that person, but if they can’t have the relationships that they want to, can’t get the jobs that they want to, can’t look people in the eye because of it, all of those things really impacts someone’s life if they’re not able to get on top of it.

What I spend most of my time on is UV skin damage. I treat skin cancers and all of the issues with skin cancers, but aside from that I’m really focused on skin ageing because the vast majority of what happens to our skin as we age, well nearly all of it, is to do with UV. So my real area is trying to not only fix and repair but also educate on how to prevent.

People are definitely getting better when it comes to SPF. Once you get to your thirties for example, that is typically when you really start to see the first effects of fine lines, brown spots and maybe redness as a consequence of sun damage. And at that point people will typically realise that they do need to put SPF on every day.

But we can’t really ever get away from the fact that in our society being tanned is regarded as something that looks attractive. Who that influences most is teenagers and those in their early twenties where they don’t see the damage that they’re doing until 10 years later. So that’s the message that still needs to be pushed a little bit more. But there are now very wearable SPFs that people want to wear, so I think this overlap where SPF has now become part of our beauty routines will make people use it more.

If you want to look three forever then you should start wearing SPF from childhood! We don’t typically recommend babies wearing sunscreen, you should just keep them out of the sun altogether. But from the age of around about one to one and a half onwards – when they’re moving around – is when you want to really try and avoid burning.

Before the age of 16, two or three episodes of burning in children with fairer skin types increases their risk in the future of getting skin cancer by about 60 to 70%. It’s a lot. In the UK’s climate, for children who have very fair skin types, so those ones who have type one, which means maybe red hair, white skin, freckle very, very easily – starting to get them to wear a daily sunscreen every single day, probably from about the age of 12, is a reasonable thing to do. In fact, I do that with my own daughters, one whom has red hair freckles, green eyes, the other has dark hair, dark eyes, but it’s getting in the habit of putting that on every single day from about that age. And it doesn’t have to be all over, it’s just the face and a little bit on the neck and hands.

Not all is lost even if you are older and haven’t been wearing SPF. A lot of sun damage is actually reversible or if not totally reversible, but treatable with the right treatment. At a younger age it’s about educating people about SPF and then when people are a bit older, it’s also about the other types of treatments that you can do just to get the skin health back. And then from a cosmetic side, we can use all of this knowledge to make people’s skin much better and essentially slightly reverse age the skin with the kind of topical medicines that we know how to use.

During lockdown I ended up having to do a lot of my consultations via video where you can’t properly examine someone’s skin. However, I realised that there are questions that will help you to understand someone’s skin without being there in person. After Covid, when we were able to see patients in real life, we could then test this and say, did these questions really work? And the answer was yes, it did, and it worked very, very successfully.

What we then realised was that people do not have a skin type. It just doesn’t exist. The idea that somebody has oily skin and you’ve got oily skin forever is not the case. You might well have oily skin, but what are your melanocytes doing? What is the collagen doing and what about fibroblasts? Are they making the collagen? And what’s the skin barrier doing? So it’s not just one factor that people need to understand about their skin. It’s multifactorial, and it all mixes in together.

Instead of skin types, we created twelve skin sizes. The idea with skin sizes was to really simplify all of the workings in our head into a number so that once you have your number, you’re like, “okay, that’s my number”. So for example, I’m a skin size one. That means my skin is oilier than the general population. It also means I’m prone to pigmentation. It also means my skin barrier is not very good and I need a bit of extra help with that. And it also means my collagen needs a bit of support and boosting, and I need to protect it as well. Now, you’re never going to remember all of that, but you will go, I’m a skin size one and that’s dead easy. And that then guides you to the right kind of SPF, cleanser or moisturiser for your skin.

With KLIRA, it’s all about simplifying it and giving people one product. If you’re taking all of these dynamic aspects of the skin into consideration, when you then come up with a formulation for someone, they’re much more likely to tolerate it. When I’m preparing the formulation that you get, it’s taking all of your skin tendencies and issues into consideration and everything is put into one product, everything. It’s not, “do this in the morning, do this at night, do this in the middle of the day”. Everything that you’ll need is at the right dose in one product that your overall skin size really likes, so you can actually use it.

Your skin size tends to stay the same throughout your life because it is actually dictated by your genetics.  Your melanocytes and oil glands will behave in a certain way because they’re your melanocytes and oil glands. So it’s really down to your genetics, which is fixed. Environmental exposure can of course cause changes, as can taking medications like the oral contraceptive pill, or whether you become pregnant or just age and go from puberty to postmenopausal. So that environmental aspect can change, but your genetics really don’t. So actually most people’s skin sizes do not change. Your skin can get much better and you can have the most perfect skin ever, but actually if you weren’t following the right regime or you weren’t following the right environmental advice then you would have a tendency to fall back into the issues that you might’ve suffered from based on that particular skin size. However, where your skin size can change is really related to what the collagen level is in your skin and how you can help to improve that. So some people might change from say a two to a three, but you’ll always be flipping between these ones rather than having a completely different skin size altogether.

The result is that everybody has a slightly different KLIRA blend, it is completely prescriptive skincare made for you. But I’ll give you some of the overall medications as well as the glorious treatments that are within it. So within skincare, we all want to have stuff that feels nice and looks nice. And that’s why over the counter nighttime creams are filled with really gorgeous ingredients that hydrate the skin and make the skin glowy. So things like hyaluronic acid, different types of ceramides, all of these things feel nice and make the skin immediately or the next day look hydrated and nice. Then there are ingredients that can make a big difference and actually change the skin, not just seemingly improve it a little bit. That’s temporary. This is active change to the skin. And some of those ingredients include things like Ivermectin which is great for rosacea, acne and dermatitis and Tretinoin, which is between 20-100 times more effective than Retinol. This makes it a phenomenal ingredient for the skin, but it has to be at the right dose. From about 0.05, you’re really seeing a meaningful difference in how the skin looks and feels and the texture of the skin as well as reversing fine lines and wrinkles.

Tretinoin can be hard for people to tolerate but the key is that it has to be used in the right base and the right supporting routine, like a really simple cleanser and a simple boring moisturiser and a simple boring SPF is generally all that most people need. Complicating it with peels and AHA and active masks,  will cause a problem with Tretinoin. So it’s not just about the drug, it’s about the dose and it’s about the grade and how it’s mixed in with the formulas.

As always with a business, the idea is the easy part. Having been a specialist and worked in this area for so long, I understand what people want and I could see that something like KLIRA wasn’t out there. I could see that you can buy whatever kind of cream you want over the counter and there are other prescription brands making creams and things, but there wasn’t anything that was really trying to be somebody’s dermatologist in their pockets, but in a way that is going to be exciting and joyful to use. I’m so lucky, my dermatology team is, I mean it’s immense. We’ve worked together for 15 years. We work in the NHS together. We work on the TV shows together. We work in private practice together. We’ve got a wonderful, amazing team all working on this.

We wanted to make something that was going to be as sustainable as possible. So that in itself was a challenge, you have lots of hoops that you have to jump through in order to say comfortably, this is a sustainable product. It brought a lot of hurdles, but was one thing that we wanted to do to try to minimise the waste within the beauty industry. How can we try and help? It became one of our measures of success.

Because some of what we do uses medicines, it’s very difficult to advertise what it can do for your skin because you’ll be breaching the advertising standards. You’re not allowed to advertise that you have drugs within your products. And that’s right. I mean, it’s not right to advertise drugs to people. It’s completely wrong. And so we were so conscious given all of our positions in what we do in medicine, that we didn’t want to overstep any of these boundaries.

But the irony is that companies can make a cream and say that that cream can do XY and Z and legally that is allowed, even if that cream doesn’t do any of those things. But conversely you can’t make a cream that has a drug in it that is scientifically proven to do a job and advertise that. That’s a very weird fact about the laws and regulations of skincare. But we obviously want to make sure that we comply with it exactly. We set ourselves up as a dermatology service, we’re not there just dispensing prescription drugs. That’s not who we are at all. And that’s why we turn away people, and that’s why we’re more expensive because we have luxury things within our products as well as this established dermatology team behind us. So that’s probably the biggest challenge of all I would say, really, because we want to also then let as many people know about this as possible so that they’re not wasting money on all the products out there that doesn’t work.

I would ultimately love to see KLIRA be where people go whenever they’re looking to see what they should be doing for their skin. I’d like it to be seen as the ultimate trusted professional skin treatment skincare line. Where people think “I’ve got a skin problem and KLIRA are dermatology doctors and nurses at the top of their game. They can fix this for me.” And so I’d like people to know it, have confidence in it, and be able to buy it from us around the world.

The Advice

The Kit

My Secret Weapon: So for my skin, if I’ve been out the night before or not had enough sleep, then it’s typically because it just doesn’t have enough moisture in it or the skin barrier doesn’t have enough moisture. So typically I will do my oil cleanse and rub it with my fingers to get any of the excess dry skin away. And then I’ll just put an extra thick layer of my moisturising cream on. So I really like the Cetaphil Rich night cream. I’ll just put extra layer of that on, probably let it dry and then even put it on again. That’s my secret really.

Biggest Indulgence: It would be the SkinCeuticals antioxidants. If I want to use a vitamin C that I know is going to be effective and do the job, then I’m only going to use them. It’s got the best evidence to support it. So that’s the one. I use the Silymarin CF Vitamin C.

Signature Scent: I have two, they’re both from Le Labo and I love Another 13 and Santal 33. They’re beautiful.

Red Carpet Transformer: I’ve had to do a few photo shoots recently, and one of them was with this amazing photographer but it was a makeup free shoot, so my skin had to be like tip-top. Again, it’s a bit boring, but I would say that to get the skin as smooth as possible, it is about the preparation beforehand. And so using Tretinoin, which is a really good effective exfoliant, for about six weeks will just give such a glow to the skin. So that is a definite, that must happen. And then there are also little tips and tricks that you can do with moisturisers beforehand. So you can do a layering of hyaluronic acid and then a thick emollient on the top of that to plump up the skin for the actual day. It’s a bit like what a HydraFacial does, but you can just do it yourself.

The Experts

Nails: I am diligent with where I go for nails because I just think that they’re amazing and it’s something that I love to do as well with my girls, and we really like it. So we go to Camden Nails and Beauty on Parkway in Camden. It’s so good. That’s where I get my pedicures done as well. And I’ve diligently gone there for probably about the last eight or nine years. I’ve tried different ones, but just nothing can beat them there. Yeah, they’re amazing

Massages: It’s just hard to find the time. But when I do go, I go to the Triyoga in Camden.

Eyelashes And Brows: I don’t do my eyebrows, no. But I’ll have eyelash extensions put on and actually Anushka, who is my, I’m going to say practise manager, but she literally runs my life. We actually met because she was my eyelash technician. So when we first met, I was looking for a new medical secretary and she was doing some medical secretary things as well and I said, would you consider coming to work for me? And she said, oh my gosh, yes. So we’ve now been together and she’s been instrumental in the success of KLIRA actually, but she still finds the time to do my eyelashes for me.

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