Skin Concerns

Your acne is likely hormonal if it clusters along the chin and jawline, flares predictably before your period and produces cyst-like, painful spots rather than surface blackheads.

The underlying cause of hormonal acne is androgen sensitivity. Most women with hormonal acne have skin that reacts to normal testosterone levels, which is why standard spot treatments rarely work. They address the surface, not the trigger. Hormonal acne can also return after Roaccutane and often doesn’t respond fully to topicals or antibiotics alone. Triggers include coming off the pill, perimenopause, stress and conditions like PCOS.

At Thames Skin Clinic, Dr Anna Hemming is experienced in identifying and treating acne in Twickenham with a hormonal root cause. If your acne is accompanied by irregular periods or excess hair growth, we factor this into your plan from your very first consultation.

For hormonal and PCOS-related acne, a combination of AviClear, medical-grade skincare and targeted in-clinic treatments can deliver lasting improvement even when other approaches have failed.

Yes. Adults can get acne in their 30s and 40s, and it is extremely common, with around 15 to 20% of adults aged between 25 and 40 experiencing it. There is a higher rate in women due to hormonal fluctuations.

Teen acne is mainly driven by puberty and tends to appear across the T-zone, forehead, nose and chin. Adult acne is often seen on the lower part of the face, particularly along the jawline, chin and neck, and spots are often inflamed and cystic. Acne breakouts in adults are influenced by stress, lifestyle, skincare habits and hormonal shifts.

Yes. Roaccutane is an oral acne treatment often used for cystic acne. The best alternative is AviClear, an FDA-approved laser treatment that uses laser energy to suppress oil production. The main benefit of AviClear is that this treatment has no prescriptions, blood tests or systemic side effects. AviClear< is our Roaccutane alternative because it is:

• FDA‑cleared 1726 nm laser targeting sebaceous glands.
• Requires a typical 3 sessions, 4–6 weeks apart, with improvement maintained for 2+ years.
• No blood tests, prescriptions or systemic side effects.

AviClear delivers longer-lasting results than Roaccutane as improvements are maintained for over two years.

Yes. At Thames Skin, treating both active acne and acne scarring within one personalised plan is exactly how we work. Active acne and scarring are different stages of the same problem.

Active acne needs to be controlled first because ongoing breakouts can create new scars while older ones are being treated. Once active acne is stabilised, we can begin scar treatments.

For active acne, Thames Skin offers AviClear, ZO Skin Health active acne plans, HydraRadiance and Obagi Blue Peel Radiance. For scarring and redness left by spots, we offer acne scar laser and microneedling in Twickenham. This includes Secret RF Microneedling, Cutera Excel V+, Laser Genesis and medical chemical peels.

All of our acne treatments in Twickenham and South West London are customised to your skin health.

Sensitive skin reacts when the barrier is disrupted, then settles. Redness caused by rosacea has a pattern. It is persistent redness across the cheeks and nose, flushing that takes longer to resolve each time and often visible thread veins. If your redness is becoming more constant rather than occasional, rosacea is the more likely explanation. A proper skin assessment is the only way to be certain because treating rosacea as sensitivity isn’t effective.

Yes. Visible thread veins and persistent redness don’t respond to skincare alone – but they respond well to vascular lasers. At Thames Skin, we use the Cutera Excel V+, a medically regulated laser that targets the blood vessels causing redness without damaging surrounding skin. A course of three sessions, spaced one month apart, produces a significant visible reduction in most patients, with Laser Genesis used for ongoing maintenance.

Yes. This is exactly the type of rosacea Thames Skin sees most. Highly reactive rosacea needs a different starting point: a desensitisation phase that calms the inflammatory response and rebuilds the skin barrier before any active treatment begins. This typically involves plant-derived exosomes, a gentle HydraFacial and a structured ZO Skin Health plan.

Yes. Hormonal changes during perimenopause and menopause are one of the most common triggers for rosacea onset or worsening in women over 45. Oestrogen decline affects the skin’s vascular tone and barrier function, making blood vessels more reactive and the skin more susceptible to flushing. At Thames Skin, we factor hormonal context into every rosacea consultation we have at our Twickenham-based skin clinic. This is particularly important for patients who’ve noticed symptoms developing alongside other menopausal changes.

Anti-wrinkle injections will not make you look frozen if they are administered by a qualified medical professional. At Thames Skin Clinic in Twickenham, anti-wrinkle injections are always administered conservatively and after thorough discussion about how much movement you want to retain. The goal is lines that are softened, not a face that’s stopped moving. Dr Anna has been described as ‘a goddess with a needle’ specifically because her results are consistently natural.

There isn’t one right age to start anti-ageing treatments but earlier is genuinely more effective. Preventative anti-ageing treatments in the late 20s and 30s focus on maintaining collagen, hydration and skin barrier health. Profhilo and medical-grade skincare plans with retinol at this stage give the skin a foundation that slows visible ageing measurably. A consultation with our skin experts at Thames Skin Clinic in Twickenham can help you address any specific skin concerns you have right now.

Yes, wrinkles around the mouth and cheeks can be improved, but the approach matters. Nasolabial folds and marionette lines are largely driven by volume loss in the fat pads beneath the cheeks rather than by the skin surface itself. Treating them with surface filler alone often creates an overfilled appearance.

The more effective approach is to restore volume at the right depth, lifting the structural foundation so the lines soften naturally. At Thames Skin Clinic, we use Profhilo Structura and carefully placed dermal fillers to do this without altering the character of your face. Dr Anna played a key role in Profhilo Structura’s UK study programme, making Thames Skin Clinic one of the most experienced practices with this treatment in the country.

The best treatment for forehead wrinkles in your 30s is small amounts of anti-wrinkle injections to target dynamic wrinkles. We often combine this with a medical-grade skincare plan and microneedling to support collagen production and maintain skin quality.

In your 50s, forehead wrinkle treatment shifts towards restoration and addressing deeper, static wrinkles alongside volume loss. The best options for forehead lines at this stage include anti-wrinkle injections, Profhilo Structura and CO₂ laser for skin tightening.

Yes, combining injectables and skin treatments is where the best results come from. Injectables and skin treatments work at different levels. Anti-wrinkle injections address muscle movement, fillers restore structural volume, and skin treatments like Profhilo, Secret PRO and medical-grade skincare improve the quality of the skin itself. Used together in the right sequence, they complement each other.

Melasma can be significantly improved and kept controlled, but it requires ongoing management. Treatments can suppress melanin production and remove existing pigment, while daily broad-spectrum SPF prevents restimulation. For melasma treatment at Thames Skin Clinic, we combine the ZO Skin Health brightening plan with a series of chemical peels and with laser therapies where appropriate.

Yes, laser treatment is safe for darker skin tones with the right assessment and the right technology. Laser pigmentation treatment on darker skin tones requires a practitioner who understands Fitzpatrick skin typing and selects wavelengths and settings accordingly. At Thames Skin Clinic, we assess skin tone before every laser treatment in Twickenham. Our Excel V+ laser uses two clinically proven wavelengths with smart sapphire cooling, which allows safe treatment across a wide range of skin types. If a laser isn’t appropriate for your skin tone or pigmentation type, we’ll tell you and recommend what is.

To fade dark marks left behind by acne, first, if any active acne or inflammation is still present, that needs to be treated first. Treating this type of pigmentation while acne is still active risks worsening pigmentation. Once settled, a combination of topical brightening agents (retinol and brightening serums), gentle chemical peels and, in some cases, lasers can progressively fade existing marks. At Thames Skin Clinic, we treat both active acne and post-acne pigmentation as part of one plan.

Pigmentation can be treated in the summer, but higher UV levels increase the risk of worsening existing pigmentation. If you do proceed during the summer months, daily use of a high-factor SPF is essential, and it should be reapplied more than once throughout the day.

Winter is the ideal time to treat pigmentation. Reduced UV exposure means treatments are less likely to trigger further discolouration. The lower sun intensity allows for more intensive procedures, such as lasers, chemical peels and microneedling, to work more effectively.

The best treatment depends on the cause of your concern, your skin type, your medical history and your treatment goals. Many skin concerns look similar on the surface but have different underlying causes. This is why we recommend a consultation before deciding on treatment.

Yes. Many patients have more than one concern, such as acne with pigmentation, rosacea with sensitivity, or wrinkles with skin laxity. Your treatment plan may be designed to address several concerns in a careful sequence.

In many cases, preparing the skin with medical-grade skincare can improve skin health, reduce sensitivity and support better treatment outcomes. This is particularly important for concerns such as pigmentation, melasma, acne, rosacea and barrier weakness.

Some skin concerns can be significantly improved, but many require ongoing management. Acne, rosacea and pigmentation can be influenced by genetics, hormones, inflammation, sun exposure and lifestyle factors. The aim is to control symptoms, improve skin health and reduce flare-ups or recurrence.

This depends on the concern being treated and the type of treatment recommended. Some treatments may give visible improvement within weeks, while concerns such as acne, pigmentation, scarring, rosacea and collagen loss often require a longer treatment plan with maintenance.

Many treatments can be safely used on darker skin tones when they are selected and performed correctly. At Thames Skin Clinic, your skin type, pigmentation risk and medical history are assessed before treatment. Some lasers, skincare ingredients or resurfacing treatments may need to be adapted to reduce the risk of post-inflammatory pigmentation.

Pigmentation is a broad term for areas of increased colour in the skin. It may be caused by sun damage, inflammation, acne marks, hormonal changes or ageing. Melasma is a specific type of pigmentation that is often hormonally influenced and can be triggered or worsened by sun exposure, heat and inflammation. Melasma usually requires careful long-term management.

Yes. A consultation allows us to assess your skin properly, identify the likely cause of your concern and recommend the safest and most effective treatment plan. This helps avoid unsuitable treatments and ensures your plan is personalised to your skin.