Patient Journey Guide

Which is why we know everyone’s Secret Skincare journey will also, be different.

The important thing to know about your Secret Skincare journey is that the products you are using are not the same as the day and night moisturisers you might find on regular retail shelves.

Like all the best kept secrets, we’re not so easy to find…

…for a good reason. Our products utilise the power and strength of prescription ingredients available to you after completing our e-consultation process and only with approval by our doctors.

Prescription skincare requires a prescription for a reason. The products need to be used with care. The methods by which you use your skincare may therefore be different than what you’re used to. This document was made to guide you through this journey…

The power of prescription ingredients sounds great right? Who wouldn’t want to take the most effective and scientifically proven approach to skincare? But what does this really mean for you…

If you haven’t used skincare of a similar strength before, or if your skin happens to be delicate or even in an “unhealthy” condition to begin with, your skin will need some time to adjust.

The idea is to create healthy skin, functioning in optimal condition. When your skin is in optimal condition it does not overproduce oil and cause breakouts, nor does it overproduce melanin and cause pigmentation. It does not lose collagen and elastin which causes wrinkles, sagging and premature aging. Skin behaving in a healthy manner will also maintain its structure to help prevent any future damage to the skin.

The initial adjusting period on the road to this healthy skin can induce a number of side effects that may feel a little alarming at first – especially without knowing what is happening to your skin.

So… what is happening to your skin?

It’s a process called “retinisation”.

To put a somewhat complex process very simply: this is where your skin adapts to the new rapid rate at which its cells are turning over. Cell turnover is the term used to describe the constant shedding of dead skin cells and subsequent replacement with younger cells. As we age, this process slows down -consequentially meaning dead, damaged or unhealthy cells will stick around for longer. Healthy skin in optimal condition will turnover at a rate of approximately 28 days.

This increased cell turnover is a result of the ingredient in your Night Cream called “Tretinoin”. To learn more about tretinoin, refer to The Secret Skincare Ingredients Glossary.

We call it a skincare “journey” for a reason. While some may expect their journey to look like this:

The reality is, it will often look like this:

Your skincare journey won’t always be linear. We know how before and afters can look; as though one day the patient suffered from a severe skin condition and within a few weeks, the severe skin condition was simply replaced with a clear, glowing complexion. What you don't see is that the patient actually experienced a period of redness and peeling while their skin adjusted to the prescription ingredients they were using to achieve said clear, glowing complexion. You don't hear about the period of internal stress the patient went through that caused skin sensitivity and meant they had to take a step back from their active skincare to allow their skin to settle. You don't know about the plateau the patients' results took a few months in, and how they had to make alterations to their regime as a result. As much as we expect it to be, a skincare journey is never linear. Your skin is constantly evolving throughout its life. It is constantly changing its structure and functions as we start to age and as we expose ourselves to different external aggressors. With so many different factors contributing to the state of our skin, there will be times where you feel like you're not progressing, or even sliding backwards.

It's frustrating, but inevitable, and somewhat unavoidable. The good news though, is that it is manageable.

Which is where we step in.

We like to call “retinisation” the “adjusting phase”, because, well, it just sounds a lot nicer than “retinisation” and it’s also a reminder that it is only temporary. Generally speaking, the adjusting phase will last one skin cycle (for most people, this is around 4 – 6 weeks, but this can change depending on your current rate of skin cell-turnover). In the same way we can’t run a marathon without training and building up endurance first, our skin will need to adjust to the new rapid rate of cell turnover the tretinoin is encouraging.

When training for a marathon, you won’t always be out of breath and clutching at a stitch in your side. With more training, you become fitter, and as time goes on you will be able to run further and faster. The same can be said for your skin; it won’t always be red and flaky. It is training to become healthier and more resilient.

Now you know what is happening to your skin, you should know how it looks on the skin. If you’re experiencing any of the following, do not stress. It is a completely normal part of your journey to a healthier complexion.

• Redness and flaking
• Dryness and tightness
• Purging
• Darkening pigment

You may notice the surface layer of your skin starting to peel or flake. Dead, dry or damaged skin cells need to be removed to make way for the healthier, new cells coming through. As a result, these excess skin cells will start to “flake” away. The new cells can also induce a reddish appearance to the skin. This can be due to the initial irritation that retinisation can cause and from the younger, delicate cells coming through that tend to be pinkish in appearance.

Treatment recommendations:

• Enzyme Exfoliation to lift excess skin from the surface
  Enzymes are very gentle exfoliants that break down the “glue” that bonds dead skin cells together. Without this, the dead skin will gently slough away for a smooth, polished surface. You may use Enzyme exfoliation 1 - 2 times a week. We advise against using other forms of exfoliation such as chemical or physical as this is likely to be too harsh or abrasive for the skin. 
• Starting slow
  Gradually introducing your skin to your night cream will help to build tolerance to the active ingredients. The doctors have outlined instructions for usage on your Personalised Treatment Plan based on the details in your consultation. Generally speaking, most patients will start using the night creams on alternating nights to begin with, until their skin can tolerate nightly applications.
• Adjusting usage
  You may need to make adjustments to your usage throughout your journey. As we mentioned earlier, the ever-changing nature of your skin coupled with the different lifestyle factors we expose our skin to will contribute to the condition of your skin at any given moment. It’s important to be guided by your own intuition. If your skin is feeling particularly sensitive one day for whatever reason, instead of powering through, it might be better to take a little step back. Let your skin calm down, and slowly build that tolerance back up.
• Protect the baby cells from lifestyle aggressors (SPF, Day Elixir)
  Baby skin cells are smooth, soft and clear. This also means they tend to be delicate in nature. We need to be sure we are protecting and maintaining the health of these cells from harsh external aggressors. The two main culprits being the sun and free radicals. Utilise SPF 50+ protection daily and strengthen the cells with antioxidant ingredients, as found in your Day Brightening Elixir. 
• Utilise an oil for added hydration
  Flaking is often an indication of a lack of oil in the skin. Take a few drops of a lightweight oil, warm it up in your palms, and gently pat it over your Day Elixir to lock in extra moisture throughout the day. You may also use an oil on any night you aren't applying your night cream. Our favourite tip for smooth, flawless makeup - mix a drop of oil in with your foundation. The extra hydration will stop your makeup from cracking for a longer lasting base while also disguising any flaky skin.

You may experience initial drying affects to the skin while using our Night Cream range. This is because the natural oil produced by the skin can decrease which affects your skin’s ability to retain moisture. as a result of the skin adjusting to the tretinoin. As the skin loses both oil and water, the skin can initially dry out and its cells on the topmost surface die and begin to peel away.

Treatment recommendations:

• Boost your skins water levels and skin barrier function with a serum
  Your skin may need that extra bit of hydration and strengthening as it learns to keep up with the new rapid rate at which your skin is turning over. Using a Hyaluronic or B5 Serum underneath your Day Brightening Elixir or on any night you aren’t applying your Night Cream will give your skin that extra drink of water to relieve any feelings of tightness.
• Pick the right supporting products
  Make sure any additional products you are using alongside your Secret Skincare are not drying it out further and acting to nourish the skin. Cleansers tend to be the culprit for this – avoid stripping cleansers such as foams and gels and instead use oil or cream-based cleansers.
• Avoid lifestyle triggers
  Things like excessive exposure to hot air, cold air, long showers, the sun and even your daily caffeine fix could be contributing to the dry state of your skin! Keep these in mind when battling to regain control of your skin’s moisture levels. Minimising any of these lifestyle triggers can help significantly.

We promise this is not as terrifying as it sounds or at first seems. For those who aren't familiar with the word, purging in the realm of skincare is usually in reference to the skin reacting to an increase in cell turnover.

Skin functioning in optimal condition will have a cell turnover of around 21 days. It encourages clearer, smoother baby cells to the surface of the skin to improve the texture and tone of your complexion.

While doing this, it is inevitably bringing forward all that is lying dormant in the lower layers to the skin. The skins recovery process is expedited, and everything is pushed to the surface – including excess sebum from the lower layers of the skin. 

This excess sebum is the perpetrator behind your breakouts. It is being pushed to the surface resulting in what we have come to know as "purging". A sudden bout of breakouts can seem like cause for panic, but rest assured, these breakouts were going to find their way to the surface eventually. The Vitamin A has simply sped this process along. The good news is that even though it happens all at once, after you have cleared everything away breakouts will substantially decrease in frequency for clearer and healthier skin.

Purging will usually last one skin cycle (generally 4 – 6 weeks). The breakouts that arise will often appear and disappear faster than a “normal” breakout.

Treatment recommendations:

• Acne spot treatment
  If you are using the Cellular Repair Night Cream and experiencing purging, speed up the life-cycle of your breakout by expediting your skins recovery process and removing acne-causing bacteria from the skin. You should apply the Acne Spot Treatment to any active breakouts and your Night Cream over the remainder of your complexion.
• HydraFacial
  A HydraFacial is a facial treatment using a patented device to deliver exfoliation, cleansing, extraction, and hydration to the face. This system uses a vortex swirling action to deliver hydration and to remove dead skin, dirt, debris, and impurities while cleaning and soothing your skin. Make sure you cease use of your Night Cream 5 days prior and post to your treatment, and to always disclose the ingredients you are using to your skin therapist.
• Adjust your usage
  Breakouts might also be a sign that you’re using too much or going too hard, too fast. Sometimes dialling back on the usage of your night cream can help the skin to settle and ultimately adjust at a rate better suited for your individual skin.
• Persistence
  The best (and possibly the most frustrating) remedy for purging is persistence. It’s important to be consistent, or you’ll find your skin never really adjusts to its new rapid rate of cell turnover. Unfortunately, it can be one of those things that gets worse before it gets better – but believe us when we say, it is well worth the journey.

Darkening of pigment may initially occur in some patients as a result of two contributing factors.

The active ingredient, Hydroquinone, can cause pigment to darken at first. Essentially, Hydroquinone is a skin lightening agent that works on a cellular level to halt the production of melanocytes, which are the skin’s pigment cells. Hydroquinone uses a double-sided approach to decrease melanocyte production while speeding up cellular breakdown, working to lighten the skin while preventing future damage. You can read more about Hydroquinone in The Secret Skincare Ingredient’s Glossary.

This means that Hydroquinone does not actually remove pigment from the skin, it simply reduces the production. As melanocytes die off, they can start to accumulate on the skin, similar to any other dead skin cell. These cells are more pigmented, thus meaning the accumulation of them at the surface may temporarily make the skin appear darker.

The second way in which pigment may appear darker is through “deep pigmentation”. What we mean when we refer to deep pigment is pigmentation that may not have necessarily been visible to the eye to begin with as it sits in the dermal layer of the skin. The skin is made up of layers, split by the Epidermis and the Dermis. The Epidermis is the top layer while the Dermis sits deeper underneath. Excess melanin caused by hyperpigmentation can be found within both layers. The depth of the excess melanin depends on the specific cause and it can be hard to know how deep the hyperpigmentation really is. See below for a general guide to the depth of different pigment types.

The rapid rate at which your skins cells are turning over may result in bringing pigmentation that was happily sitting out of sight in the Dermis, to the surface. We know it can be a worrying sight but trust us when we say, this would have come about eventually - whether in a few months or a few years. Patients who see lightning-fast results most likely had their pigmentation sitting in the epidermis, so don’t be discouraged if your friend who is also using The Secret had her pigment disappear in a week and yours just hasn’t budged yet. Ever heard the saying, sometimes things have to get worse before they can get better? The good news is, you are getting a head start on the issue and a little bit of patience and persistence is going to pay off. The methods we use are tried and true, it may just take a little bit longer for you.

Treatment recommendations:

• Utilising a regime
  We like to recommend your Night Cream to be used alongside our Day Brightening Elixir. Not only will utilising both a medical-grade night and day cream accelerate your results, they each support the outcome of the other by offsetting their side effects. In the case of deep pigmentation or darkening pigment, using the Day Brightening Elixir will add an extra 3 brightening ingredients into your regime to help break down pigment even faster.
• Consistency
  You’ve heard the saying “consistency is key” for a reason. It’s another frustrating answer to hear. The good news is, you are getting a head start on the issue and a little bit of patience, persistence and consistency is going to pay off.
• Skin analysis
  There is technology available at certain skin clinics that will reveal the condition of the underlying layers of your skin. You are able to see for yourself any pigment that may be lying dormant underneath. This will give you a better insight into your skin and understanding into the level of your pigmentation. 
• Diligent SPF 50+ application
  Daily and diligent SPF 50+ application is essential while using prescription ingredients such as tretinoin and hydroquinone, which can both cause the skin to become photosensitive. By skipping your sunscreen, you are negating any of the benefits these two ingredients bring to the skin and opening up your skin to issues of further pigmentation. The key to utilising these ingredients all lies in sunscreen.

This is a topic we are very passionate about, especially as an Australian company. Australia experiences some of the highest levels of UV radiation in the world because we are close to the equator and have many clear, blue-sky days. We are a nation of sun-worshipers which increases the burden of sun smart skin protection.

Retinoids and hydroquinone can cause the skin to become photosensitive. Does this mean you should avoid them completely? No! It does however mean you need to be a little more savvy with how you use them. Some people choose to restrict their usage to winter only, but these ingredients can benefit the skin throughout the entire year. Retinoids in particular will help to repair the damage that the sun induces on the skin such as the breakdown of collagen and the overproduction of melanin that causes pigmentation.

Hydroquinone will also inhibit melanin production to help prevent and fade pigment. You would waste an entire half a year of skin benefits if you were to restrict such important ingredients to winter only. The key to utilising these ingredients all year round lies in sunscreen. If you are diligent in wearing a SPF 50+ every day and are not overexposing your skin to the sun (which is essential anyway if you are serious about looking after your skin) you are fine to use them.

We also encourage patients to be guided by their intuition. If you know you are going to be in the sun for prolonged periods of time where SPF application won’t be as strict (beach days and sunny holidays are major culprits) you should consider decreasing applications of your night cream to alternating nights and using your Day Brightening Elixir to pick up the slack. The Day Brightening Elixir contains powerful brightening and preventative benefits. 

Your skin will start to acclimate to its new behaviours and this is where you can expect to see results.

When the skin has adjusted to the new rate at which its cells are turning over you will start to see the benefits of increased cell turnover. You’re on the other side now – where clear, glowing skin is the new normal.

We understand the adjusting process can be enough cause to stress and think your skincare isn’t working. With a little understanding of the skin and its behaviours, we hope it makes it a little easier for you to push past this. Remember; It’s not magic. It’s Science. The results speak for themselves.

We are with you on this journey every step of the way. The Secret Skincare has a team of skin specialists trained to guide you to results. While your patient journey guide is here for advice, please also feel free to reach out to us via email at info@thesecretskincare.com.au or give us a call on 0444 555 261 at any time.