The Harley Medical Group


Common lifestyle factors such as sun damage, weight loss, smoking and sleep deprivation are all known to accelerate ageing, affecting different areas of the face.

Our Consultant Dermatologist, Dr. Justine Hextall, reveals how you can use letters of the alphabet as an easy guide to target your anti-ageing treatments.

Five key letters of the alphabet act as a template for the areas of the face that require treatment dependent on lifestyle factors such as sun exposure, smoking, weight loss and lack of sleep.

For example, sun-induced ageing causes forehead and cheek pigmentation, under-eye wrinkling and a general downward sagging of the face. This particular formation reflects the letter M on the face, indicating that these are the areas that need to be treated in order to reverse the signs of ageing.

Dr Justine Hextall explains how certain lifestyle factors age specific areas of the face and what treatments she recommends to combat the tell-tale signs.



  • Lines around the mouth
  • Loss of volume in the nasolabial lines
  • Dark under-eye circles

Smoking does an enormous amount of damage to the skin, both at the skins surface causing fine lines and thread veins and deeper down it causes damage to collagen and elastin triggering the skin to sag. Some of the changes are very predictable including lines around the mouth and loss of volume in the nasolabial lines that run from mouth to chin. It also can also cause dark circles and skin pigmentary changes.

So what can be done? My first advice overwhelmingly is to stop smoking. This is one of the most important steps you can take to protect not only your skin but more importantly your general health. Once you have taken this step there’s a lot that can be done to start to restore skin health.

Micro-needling is excellent for tackling skin tone, wrinkles and loss of volume. A minimum of three treatments, six weeks apart will make an enormous difference and start to give you back that glow. To tackle the loss of volume around the nose and mouth I would suggest a dermal filler, hyaluronic acid that is naturally present in our skin. This will restore volume but also acts as a humectant, attracting water to skin leaving it plumped and hydrated. I find skin boosters work brilliantly for smokers skin. Which in effect injects small amounts of hyaluronic acid into the deeper layers of the skin, subtly restoring volume, whilst hydrating the skin to leave it looking fresh and youthful.

KEY TREATMENT: Dermaroller / Micro-needling

The Genuine Dermaroller™ Therapy™ provides advanced micro-medical skin-needling, a treatment that stimulates the skin to regenerate and repair itself naturally and safely, creating smoother, brighter, healthy skin. It works by penetrating the dermis layer and closing rapidly, enabling the skin to recover quickly - often in the same day. New collagen is formed, new skin cells are generated and blood supply is enhanced which works to reduce the appearance of acne scarring, providing you with a natural and long lasting enhancement.

Letter H: Sleep-Deprived ageing 


  • Dark circles
  • Hollow cheeks

We all know how much better we look after a good night’s sleep. Sleep is a vital time for skin to regenerate. Lack of sleep leads to dark circles, not only that skin often becomes dull, dry and often more sensitive. This isn’t an illusion; skin really does regenerate at night. This is why I love night creams and serums full of anti-oxidants that can support this process and protect against the damage caused my UV, stress and pollution we face on a daily basis.

So what can be done? Firstly, make time in the evenings for a good skin care regime. Remove make-up and the dirt and pollution that settles on our skin during the day. This is very important as we know pollution in particular can causes permanent skin changes such as wrinkles and age spots.
Apply a cream / oil or serum that preferably has anti-oxidants to help mitigate against the free radical damage that shows as a result of lack of sleep and stress and also as above pollution and UV exposure.

To help regenerate skin as before IPL laser, micro-needling and peels will help. Loss of facial volume again can be helped with dermal fillers, ask your expert about recommended treatments.

KEY TREATMENT: Medical Microdermabrasion

Microdermabrasion is a non-surgical method of skin rejuvenation using mechanical skin exfoliation. Tiny, sterile particles are used to exfoliate the top layer of skin, which improves its tone and texture whilst enhancing the absorption of moisturiser. The results are instant so you can leave this treatment right up until the day before a big event. Your skin will be left with a healthy glow that lasts for hours.



  • Forehead and cheek pigmentation
  • Under–eye wrinkling
  • Sagging

When we are chronically exposed to UV we get skin changes that we associate with ageing. In my view a lot of this skin change is preventable with the daily application of a high factor sun cream. The effects of sun include damage to the pigment producing cells our melanocytes which causes both increased pigmentation and loss of pigmentation giving us that uneven skin tone that we associate with sun-ageing. There is also an upregulation of the enzyme MMP-1 that breaks down collagen - our skin’s scaffolding. This leads to wrinkles and a loss of firmness we associate with youth.

So what can be done? Uneven skin tone and pigmentation can be tackled with a variety of methods including skin peels, micro-needling and laser treatment. I recommend this treatment at the end of summer. Remember however even though the sun is less intense in autumn, UVA levels are still significant and will continue to damage skin, so don’t forget your daily SPF even throughout those dark winter months.

KEY TREATMENT:  Rejuvenating Pumpkin Resurfacer

Our Rejuvenating Pumpkin Resurfacer contains 40% pumpkin pulp and orange stem cells which, when combined with other ingredients, promotes collagen and elastin production, reducing fine lines, wrinkles and sun damage. Addresses the early signs of aging while providing an intensive level of exfoliation and resurfacing.

Letter U: Weight-induced ageing 


  • Double chin
  • Puffy cheeks
  • Rounded face

As we age there’s a natural redistribution of fat, which often results in a changing face shape with loss of fat in mid-cheeks, which we tend to associate with loss of youth. However if we put on weight as we age, it unfortunately tends to settle in all the wrong places. This can give rise to heavy features and form what is described as a double chin. Excessive weight gain can often cause puffiness at the top of the cheeks and a rounded jawline.

So what can be done? There are no substitutes here for a healthy diet and exercise. Cutting out alcohol can make a huge difference especially when it comes to facial changes. With excessive alcohol we often see facial redness and visible thread veins. These can be tackled with for example the intense pulse light (IPL) laser which will also boost collagen and tackle an uneven skin tone. To tighten skin, radio-frequency and micro-needling work well. There are also treatments increasingly used to remove unwanted fat such as The Harley Medical Group’s i-Lipo Xcell for underneath the chin.

KEY TREATMENT: Laser Liposuction 

i-Lipo Xcell is a revolutionary treatment and referred to as the non-invasive alternative to liposuction. Promising a minimum of a 2cm reduction, i-Lipo Xcell can be performed on any part of the body but is particularly useful for reducing fat in stubborn areas such as the chin! Combining Low Level Laser Therapy (LLLT), vacuum massage and radio frequency to reduce fat in targeted areas of the body, the three-pronged treatment works by emptying fat cells, aiding the body’s lymphatic drainage system to move the fat cell contents for use and tightening the skin.



  • Loss of volume
  • Hollow Cheeks
  • Heavier Jawline

As we age we start to have a redistribution of facial fat. This explains the changing facial shape we associate with loss of youth. Loss of mid-face fat is a common complaint especially in those who have recently lost weight. Ironically despite this volume loss, the lower face can start to appear heavier, often forming slackened skin around the jawline, commonly known as jowls.

So what can be done? Mid–face dermal fillers can make a real difference here, restoring that youthful volume. It is interesting how small amounts of filler in the right area of the cheeks can bring back that youthful shape. There are several ways to tackle jowls. Some practitioners seek to remove the underlying fat. Others focus on stimulating new collagen with laser treatments such as radiofrequency treatment and micro-needling.

KEY TREATMENT: Dermal Fillers

Dermal fillers are used to fill out the crevices in the skin caused by lines and wrinkles and to create volume and fullness. Most commonly used to increase the fullness of lips and to fill out lines around the mouth and crow’s feet around the eyes. The suppleness and tone of the skin are instantly restored, with lines and wrinkles visibly reduced from the first treatment.

Do you have any questions about Justine’s alphabet skincare? Ask us today on Facebook.

Posted July 18, 2020
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