Q: I shouldn't wear any moisturiser, right? A: Understandably, many clients with combination skin are under the impression that they should avoid putting anything moisturising onto their faces to avoid breakout risk, so their skin is often very dehydrated and malnourished at their initial appointment. One post-menopausal client in particular was avoiding skincare and sunscreen altogether when I first met her for fear of causing spots, and her skin was very flaky and thin – I am slowly re-educating her now! People often don't realise that it is hormonal activity – raised Testosterone in particular - which causes T-Zone sebum levels to increase, and so I always look at clients holistically when treating.

Q: Is a combination skin a mix of oily and dry skin, or rather a mix of oily and dehydrated skin? Or can it be both? A: Dry skin is a genetically predetermined skin type which may worsen as we pass through the ageing process due to epidermal and dermal thinning, environmental factors such as UV damage and hormonal changes. Those with dry skin tend to have brittle hair and nails, plus skin will have minimal pore visibility. In combination types, dryness tends to occur over the U-zone (cheeks and / or chin). Dehydration tends to occur as a result of exposure to extrinsic factors such as heating, pollution, menopause, smoking, diet and very hot, dry climates, so in effect an area of combination skin can be both dry and dehydrated at the same time. Dryness can be managed, dehydration can be cured. One study provided evidence that skin sebum production alters with seasonal changes in those with combination skin types; unsurprisingly, summer was shown to be the highest sebum‐secreting season with winter encouraging dehydraytion and dryness in the U-Zone of subjects.

Q: Is combination skin as common as acne? A: Personally I would say more of my clients have combination compared to acne vulgaris skin type, but they often don’t realise that they have combination, believing that they have acne and meaning their skin is not being managed in the best possible way. A rise in acne, in my opinion, could be due to dietary and lifestyle factors such as heightened stress levels, sugar and saturated fat consumption globally.

Q: What is the right type of cleanser, moisturiser and SPF for combination skin, in terms of ingredients and texture?

A: I always encourage nourishment as baseline for combination skin types –antioxidants are great for reducing redness, protecting skin and helping to balance skin health, and there is evidence to show that Niacinamide (Vitamin B3) is particularly beneficial in balancing sebum production on both dry and oily areas of the face. The chosen cleanser should be light, unscented and easily absorbed; I like Green People’s Neutral Cleanser and Makeup Remover. A good niacinamide-rich serum will boost skin health; I like 100% Pure Serums for this, and Emma Coleman Daily Sunscreen SPF50 is super light, so won’t clog and gives lots of protection. For night time, try Emma Coleman Natural Healing Night Balm – it contains anti-inflammatories and nourishing Vitamins A and E to help heal and maintain moisture levels as you sleep.

Q: Should I use a mild acid product, such as salicylic?

A: Daily Salicylic acid might cause irritation, so I usually recommend this be used on alternate days with a balm cleanser in between. Polyhydroxy Acids provide a gentler approach to exfoliation; Zelens PHA + Bio Peel Resurfacing Facial Pads are quick and easy to use

Q: What kind of foundation would you recommend for combination skin in order to keep problems as bay, and what kind would you warn against? Are mineral powder foundations perhaps best? A: Foundations need to be light but also hydrating; I prefer mineral or natural foundations for skins prone to sebum imbalance, and would recommend Nui cosmetics liquid foundation as it gives coverage without the oil. I also regularly recommend All Earth Mineral Cosmetics to combination skin clients, as they offer sample sizes. Tip: Buy some plain squalane oil and blend a tiny bit with your foundation before applying to hydrate your skin without greasiness and prevent makeup flaking.

Q: In terms of mattifying powders, are there ingredients that you rate to balance oily skin?

A: Yes! Extracts of the Mint and menthol families help to prevent formation of blemish-causing bacteria on skin’s surface