What is the difference between a hydrator and a moisturiser?

Water plays a central role in making sure your skin stays healthy, smooth and radiant, so it only makes sense that every skin care aisle is lined with products that promise to hydrate and moisturize skin. But what many of us may not realize is that although they are often used interchangeably, moisturising and hydration are not exactly the same thing. While both are key in providing skin with much-needed nourishment, knowing the difference will help you make the best choice when targeting your skin’s specific needs.

Difference between hydrating and moisturizing

Moisturizers and hydrators both address the importance of making sure the skin is getting all the water it needs to fight dryness and dehydration, premature signs of aging and environmental damage. The difference, however, lies mostly in how they go about achieving these results.

Hydration refers to the water content within the cells that leads them to swell and be plump and bouncy, thus reflecting light well. If water flows out of the cells and the cells are dehydrated, they become shrivelled and the skin gets a lacklustre look.  When you use a hydrator, you’re infusing your cells with water and improving your skin’s ability to absorb moisture and nutrients.

On the other hand, moisturising is about trapping and sealing in moisture to build the skin’s protective barrier, prevent water loss and keep the skin soft and smooth.

How do you know if you need a hydrator, moisturiser or both?

If your skin tends to be on the dry side, it’s easy to assume that a healthy dose of moisturizer is all it takes to restore its plump appearance and youthful glow. While this may be true at times, it’s also possible that your skin may not, in fact, be dry but dehydrated. And if the latter is true, then a hydrator is what you need to get the job done.

To know if your skin is dry or dehydrated, it’s important to take note of your skin’s condition. The skin has a natural lipid barrier that protects itself from damage and water loss. If you’re prone to having dry, flaky skin, it’s a tell-tale sign that it’s not producing enough lipid cells to form a protective barrier, making it unable to lock in moisture. And that’s where moisturizers come in.

A moisturiser’s job is to reduce the amount of water that evaporates off of the skin to minimise water loss. They lock in and seal in moisture.  Moisturising is particularly helpful for skin that is dry and peeling or flaking after undergoing a chemical peel.

Meanwhile, if you’re dealing with a dull and lacklustre complexion with fine lines and wrinkles becoming more noticeable, your skin may be battling dehydration. Dehydrated skin means the cells are parched and starved of water. When this happens, they are not plump and volumised and are shrivelled collectively. People can have hydrated but dry skin or dehydrated but moisturized skin. Ideally, we want hydrated, bouncy, swollen cells that have topical moisture locked into them,

When dehydrated, the skin will feel dry even if you have used a good moisturiser. In today’s life, environmental damage (which includes UVA, blue light, electro-magnetic radiation and air pollution) most people have dehydrated skins.

Do you have to choose between a hydrator and a moisturiser?

Drinking plenty of water is a good way to hydrate your skin, but those with dehydrated skin must supplement with a topical hydrator that binds and draws water into the cells.

In today’s environment it is necessary to both hydrate and moisturise the skin. Luckily for us there are modern dermoceutial products available that contain active ingredients that protect the skin’s lipid barrier to lock in moisture, and increase the moisture between cells and within cells.

Also make sure that the product you select is easily absorbed and applied, is hypoallergenic and have nourishing ingredients to counter the signs of aging and fight free radical damage. For best results product should be applied mornings (before sunscreen) and at night. “

More about eye puffiness, bags under the eyes and dark eye circles

Most men and women experience unwanted puffiness or so-called bags under their eyes at some point in their lives. It can be stubborn and difficult to get rid of, but it’s not impossible to conquer, if you understand the cause of the problem.

In the natural ageing process the tissue structures and muscles that support the area under the eye weaken, and as a result the skin starts to sag. The fat that is usually located below the eye moves lower down and the area may also accumulate fluid. In some cases, this is completely out of our control, and in others, lifestyle factors may cause or contribute to the problem.

What can cause or worsen puffiness and bags under the eyes?

  • Family genes – genes play a major role and could be the cause of yours.
  • Lack of sleep – though lack of sleep doesn’t cause puffiness, it can make it worse.
  • Fluid retention – largely due to too much salt or alcohol in your diet, when the body retains water, it may cause puffiness in the face and around the eye area.
  • Allergies – if you suffer from allergies like hay fever, you may find your puffiness is worse when your allergies are worse due to a build-up of fluid in your sinuses and around the eyes.
  • Smoking – causes puffiness by irritating the eyes (even if you are not the one smoking).
  • E-ageing – is caused by exposure to electro-magnetic radiation (cell phones signals, radio and TV waves, Wi-Fi, wireless connections etc) and high energy visible / blue light (digital screens, computer screens, laptops, TVs, smart phones etc). We literally swim in in a sea of these waves 24 hours a day.

What about dark circles?

Bags and puffiness around the eye area are often accompanied by dark eye circles but may also occur on their own. The biggest cause for this is sleep deprivation. When you don’t sleep enough, your skin becomes dull and pale, allowing the dark tissue and blood vessels beneath your skin to show. They may also occur naturally when you age, as the skin becomes thinner and the fat and collagen around the eye area decreases. Allergies, dehydration, overexposure to the sun, genetics and e-ageing also play a role. Dark circles can also be due to pigmentation that forms around the orbital area, this is normally due to genetics.

How to address the problem?

  • Lifestyle changes that may help improve appearance and alleviate the swelling.
  • Giving up smoking and cutting back on salt and alcohol may help.
  • Drink more water.
  • Get more sleep.
  • Invest in a good dermoceutical eye cream or gel. Identify the main cause you would like to address and then look for the specific characteristics when choosing a product:
    • Always – A formulation suitable for the delicate skin around the eyes which absorbs easily and well
    • A formulation that is anti-ageing
    • A formulation that specifically combats e-ageing
    • A formulation that treats the microcirculatory system around the eyes
    • A formulation that treats hyperpigmentation
    • A formulation that hydrates the eye area throughout all the levels of the skin
  • Remember to apply the product very gently, and not to stretch the skin.

 

What is hyperpigmentation?

Hyperpigmentation of the skin manifests itself in the different ways:

  • Freckles in areas where the skin is exposed to the sun’s radiation
  • Cloasma (pregnancy mask) which is caused by hormonal factors together with exposure to the sun’s radiation
  • Hypermelanosis which results from skin irritations or inflammations after surgery or a chemical peel
  • Age spots (senile lentigo) usually on the face, hands, neck and chest and which are also stimulated by the sun’s radiation
  • Brown marks on the face or hands resulting from ageing, endocrine system disorders or malnutrition
  • Lentigines which are small pigmented spots that are inherited
  • Sunspots (solar lentigo)

A rich combination of active ingredients to combat all five levels of melanin production:

  • Nanopeptide-1, a bio-mimicking peptide that prevents the synthesis of tyrosinase which reduces the amount of melanin is produced
  • Diacetyl boldine, a powerful antioxidant that keeps tyrosinase from becoming active
  • Alpha arbutin which effectively inhibits tyrosinase from turning into its active form
  • Encapsulated Vitamin C, an antioxidant that ensures better absorption of the product, restricts the production of new melanin and inhibits the oxidisation of melanin
  • Sucrose laurate that inhibits the number of melanosomes that move to the surface of the skin
  • Pea extract which protects collagen and elastin and stops melanosomes from maturing
  • Niacinamide (Vitamin B3) that slows down the transfers of melanosomes to the surface of the skin

The Coverderm Luminous Supreme range successfully treat these conditions and are available countrywide at selected Dis-Chem Pharmacies, various independent pharmacies, and salons, as well as online at www.coverderm.co.za / www.dischem.co.za .

Would you like to cover that tattoo for a special occasion?

Use Coverderm Camouflage Classic

You will need the following Coverderm products:

  • Luminous Exfolia
  • Camouflage Removing Cream (waterproof make-up remover)
  • Camouflage Extra Care Lotion # 1 or # 2 (toner)
  • Camouflage Skin Protector (make-up base / primer)
  • Camouflage Classic
    • # 0 for Light skin
    • # 10 for Indian skin
    • # 13 for Dark skins
  • Camouflage Finishing Powder
  • Camouflage Classic which matches your skin tone

The evening before you want to cover the tattoo exfoliate with Luminous Exfolia:

When you are covering the tattoo:

  1. Clean skin with Camouflage Removing Cream and allow to dry completely
  2. Wet a cotton round with Camouflage Extra Care Lotion #1 (normal, dry-sensitive) or #2 (oily) and wipe all over, and around the tattoo
  3. Always apply a thin layer of Camouflage Skin Protector on the tattoo and the area around it
  4. Between your fingers or on the back of your hand warm a small amount of the Camouflage Classic (#0, #10 or #13) to body temperature
  5. Cover the tattoo and the area around it with a thin layer of the Classic
  6. Press Camouflage Finishing Powder onto the skin on the tattoo and the area around it
  7. Wait 30 seconds and brush of the excess, this will make the make-up last longer
  8. On the back of the hand, warm the Classic (that matches your skin tone) to body temperature
  9. Apply thin layers until the tattoo and the area around it is complete covered
  10. Blend with skin around the area of the tattoo
  11. Press Finishing Powder onto the skin
  12. Wait 30 seconds and brush of excess, this will make your make-up last longer
  13. Dab extra Classic on areas of the tattoo that need additional cover and blend into area around it
  14. Press Finishing Powder onto the skin
  15. Wait 30 seconds and brush of excess
  16. Each evening, clean skin properly with Removing Cream
  17. If your cover comes off, you are using too much product, or you are applying incorrectly

 

Lespedeza capitata leaf / stem extract – a powerful active

The human circadian rhythm regulates certain patterns in the body

The body is regulated by a 24-hour biological clock, or global circadian rhythm, which controls physiological behaviour and metabolism, synthesizes molecules and hormones, and regulates appetite and sleep patterns. When the circadian rhythm is desynchronized or is under too much stress, cells do not function effectively.

What can disrupt this cycle and what is the result?

 The circadian clock can be disrupted by everything from stress and jetlag to electro-magnetic radiation and high energy visible light including blue light emissions from electronic devices, all of which are a part of modern living. The increasing use of digital devices show no signs of abating and the demands of the working environment means extended or unusual working hours, so we are exposed to them 24 X 7.

All the stressors lead to the deregulation of the circadian rhythm and is especially harsh on the skin which shows visible signs of fatigue. Skin fatigue is, for example, characterised by an unhealthy, tired and dull complexion, uneven skin tone and puffiness and dark circles around the eye area.

What is lespedeza capitata leaf / stem extract and what does it do?

It is a plant extract that naturally emulates the cells’ ability to resynchronize and regulate rhythm-dependent biological functions such as skin hydration and detoxification. These significantly reduce skin fatigue, improving complexion, skin tone and eye circles and puffiness.

Coverderm Peptumax range contains lespedeza capitata leaf / stem extract

Together with some other very powerful ingredients, the newly reformulated Coverderm Peptumax treatment range contains lespedeza capitate leaf / stem extract. This treatment range consists of a serum, an eye cream and a day/night cream.

Lespedeza capitate leaf / stem extract is totally plant-based and natural, and it is not tested on animals.

Sequence in your skin care regime matters

According to experts the sequence and the timing of when you apply skin care products is incredibly important. When you apply them at the right time and the right sequence it ensures that your skin receives the full benefits of each product. If applied incorrectly you will not see the best results. Also remember that:

1. Treatment products are much more effective on a properly cleansed, exfoliated, toned and moisturised skin. Your make-up will also last longer.
2. Your skin may need different treatments or care at different times depending on:
⦁ The season
⦁ Your activities
⦁ Internal factors such as ageing, hormonal changes, stress, dietary habits etc.
⦁ External factors such as wind and sun, air conditioning and heating, pollution, electronic pollution, chemical peeling etc.
You may therefor need to adapt the products you use during the year or over time

Evening regime:

Step one: Cleanse

Cleanse thoroughly especially if you use waterproof or water-resistant make-up products or sun protection. Coverderm Camouflage Removing Cream is a gentle deep cleanser that is suitable for the eye area, it moisturises and soothes, is soap free and does not stimulate sebum production

Step two: Exfoliate

Exfoliate gently without irritating or damaging your skin. Coverderm Luminous Exfolia contains perfectly round joboba microspheres that do not damage the skin. It also treats hyperpigmentation and uneven skin tone and is healing and soothing.
⦁ Normal and dry skin: 2-3 times per week
Oily skin: 1-2 times per week

Step three: Tone

Tone to make sure that you remove any residue left on the skin. Coverderm Camouflage Extra Care Lotion #1 (normal and dry sensitive skin) and #2 (combination and oily acneic skin) is pH balanced and alcohol free. It also moisturises, is anti-ageing and helps regenerate the skin.

Step four: Apply serum

It is best to apply serums at night, as this is the time that the skin and body does most of its repairing, restoring and regenerating. Coverderm has a number of serums you can choose from depending on the skin condition you want to treat:
⦁ Maxydrat Serum (hydration)
⦁ Peptumax Serum (anti-ageing incl e-ageing)
⦁ Luminous Supreme Serum (hyperpigmentation)
Vanish Serum (facial redness and dark eye circles)

Step five: Apply eye cream

Eye creams must be applied both in the evening and in the morning. Coverderm has a number of eye creams you can choose from depending on the skin condition you want to treat:
⦁ Maxydrat Yeux (hydration)
⦁ Peptumax Yeux (anti-ageing incl e-ageing)
⦁ Luminous Supreme Yeux (hyperpigmentation)
Vanish Yeux (facial redness and dark eye circles)

Step six: Moisturise

You must moisturise both in the evening and in the morning. Coverderm has a number of night and day/night creams you can choose from depending on the skin condition you want to treat:
⦁ Maxydrat Visage – dry, normal or oily (hydration)
⦁ Peptumax Visage (anti-ageing incl e-ageing)
⦁ Luminous Supreme Tri-Activ (hyperpigmentation)
⦁ Vanish Night (facial redness and dark eye circles)
Camouflage Skin Basics

Morning regime:

Step one: Cleanse

Cleanse thoroughly especially if you use waterproof or water-resistant make-up products or sun protection. Coverderm Camouflage Removing Cream is a gentle deep cleanser that is suitable for the eye area, it moisturises and soothes, is soap free and does not stimulate sebum production

Step two: Tone

Tone to make sure that you remove any residue left on the skin. Coverderm Camouflage Extra Care Lotion #1 (normal and dry sensitive skin) and #2 (combination and oily acneic skin) is pH balanced and alcohol free. It also moisturises, is anti-ageing and helps regenerate the skin.

Step three: Apply eye cream

Eye creams must be applied both in the evening and in the morning. Coverderm has a number of eye creams you can choose from depending on the skin condition you want to treat:
⦁ Maxydrat Yeux (hydration)
⦁ Peptumax Yeux (anti-ageing incl e-ageing)
⦁ Luminous Supreme Yeux (hyperpigmentation)
⦁ Vanish Yeux (facial redness and dark eye circles)
⦁ Camouflage Skin Basics

Step four: Moisturise

You must moisturise both in the evening and in the morning. Coverderm has a number of night and day/night creams you can choose from depending on the skin condition you want to treat:
⦁ Maxydrat Visage – dry, normal or oily (hydration)
⦁ Peptumax Visage (anti-ageing incl e-ageing)
⦁ Luminous Supreme SPF 15 (hyperpigmentation)
Vanish Day (facial redness and dark eye circles)

Step five: Apply sun protection

Make-up and moisturisers do not always provide enough protection against the full spectrum of radiation. It is advised that you apply an effective sunblock or sunscreen after your moisturiser and before your make-up. The product should protect against UVA, UVB, High Energy Visible Light (incl Blue Light) and IR. It should also be long-lasting and waterproof. You can choose from the following Coverderm products:
⦁ Filteray Face SPF 40, 60 or 80
⦁ Filteray Face plus SPF 50+

Step six: Apply make-up base or primer

Before you start to apply your make-up, it is advisable to apply a make-up base or primer. You can apply a thinner layer of make-up, your make-up spreads more evenly and smoothly, and it then lasts longer and looks more natural. Coverderm Camouflage Skin Protector has a very light fine texture, it protects against environmental damage and it moisturises and soothes. It is also hypoallergenic, non-comedogenic and long-lasting

You are now ready to apply your make-up !!!!

Glycogen – an amazing active ingredient

Your skin is a living organism

Your skin is doing some amazing things for you, day and night, 24/7! It protects you from the everyday effects of the environment like UV damage and pollution, repairs damage caused by these effects (as well as all those cuts and scrapes), and moderates which substances (and how much) can enter or leave your body to maintain an optimal balance.  Your skin is a living organism, and it requires energy to fuel all these important functions.

Where does your skin get this energy from?

It turns out that energy is stored in your skin the same way it’s stored throughout the rest of your body – in carbohydrate molecules. The amazing active ingredient glycogen is made up of many glucose (sugar) molecules, packed together so that they can be stored efficiently in cells as carbohydrate molecules. These are then used as an energy source.

The amount of energy your skin stores reduces as you get older

The amount of energy your skin stores decreases as you age, so that over time there is less energy available to the cells to perform everything they need to do to maintain youthful looking skin: Cellular renewal slows down and the rate at which the skin can produce components that impact structure and suppleness, like hyaluronic acid, elastin and collagen, begin to decline.

Electronic pollution speeds up the ageing process

The ageing process is also speeded up by the sea of electronic pollution we live in in today’s life, that is electro-magnetic radiation and high energy visible light including blue light (emmited by cell phones, wi-fi, computers etc). Some of these are visible and others are not. This is known as e-ageing and has now been identified as one of the four main causes of deep and medium wrinkles and fine lines (the other three being natural ageing, photo-ageing and expression lines). And, because you are exposed to electronic pollution 24 hours a day, protection against the ravaging effects are critical.

What glycogen does for your skin

When glycogen, which is identical to carbohydrates already found in your body, is applied topically, it gives your skin an extra boost of energy to keep working at its best. It naturally reenergises and fuels the skin.

There is glycogen in the new Coverderm Peptumax range

Together with some other very powerful ingredients, the newly reformulated Coverderm Peptumax treatment range contains glycogen.

This range consists of a serum, an eye cream, a day/night cream, a make-up, a concealer and a compact powder. Apart from the new ingredients the make-up products also all have an SPF 50+ which protects against high energy visible light including blue light.

Importantly the glycogen used in Coverderm Peptumax is totally plant-based, natural and not derived from, or tested on animals.

 

Not all skins react the same way during pregnancy

There are lucky women who experience the best skin of their lives during pregnancy. They literally glow from within, but there are others who battle with skin conditions associated with hormonal changes. So, not every pregnant woman will experience the same skin conditions.

1. Call it what you will, pregnancy mask, melasma, chloasma, the bottom line is that hyper pigmentation during pregnancy is very common. A woman’s body produces more hormones during pregnancy, and this may result in darkened blotchy spots on the forehead, upper lip, nose, chin and cheeks. These blotchy spots may completely disappear after giving birth, but for some it does not and requires further attention to prevent and treat.

⦁ Good news! The Coverderm Luminous hyperpigmentation range is safe to use during pregnancy and is clinically proven to significantly reduce blemishes.

2. Other hormonal skin changes might include acne and a dehydration. During the first trimester of pregnancy acne and breakouts are fairly common as this is when the body’s hormone levels start to increase. This increases the skin’s oil production and may lead to acne, clogged pores and blackheads. As the skin stretches and tightens to accommodate the growing belly it loses elasticity and moisture.

⦁ To give your skin a fighting chance it is important to:

⦁ Drink plenty of water during pregnancy to hydrate your skin from the inside out, but more than likely this will not be enough
⦁ Use cleansers, toners and make-ups that moisturise your skin, are gentle and do not clog pores so make sure the products you use adhere to this
⦁ Hydrate the skin on your face with the Coverderm Maxydrat range which hydrates throughout all levels of the skin

3. A third important aspect to remember is that your skin is extra sensitive to radiation during this time and this encourages the development of hyperpigmentation. Always apply good sun protection products on your face and body. And remember that high energy visible and blue light, as well as electro-magnetic radiation are emitted from electronic devices 24 hours a day, so especially you face needs protection all day long. Make sure the face product you choose provides this kind of protection.

Dr Raboobee, president of the Vitiligo Society of South Africa

Dr Raboobee, president of the Vitiligo Society of South Africa, has coordinated efforts in three major cities in South Africa to host Vitiligo Day meetings. Dr Raboobee’s interest in vitiligo began when he noticed the dismal fear in patients given a diagnosis of vitiligo, many thinking that they were going to turn all white in a few weeks. He realised that there was very little known about vitiligo and that many patients thought that nothing could be done about their condition. The condition evoked strong negative psychological effects on sufferers. He felt there was a massive need to create awareness in the country as few patients knew about the dramatic effects one achieved with Excimer laser and phototherapy and many were unaware of topical, systemic and surgical possibilities.

The Vitiligo Society of South Africa was established in 2008 to provide exactly this type of awareness and support to patients with vitiligo. The Society maintains a website which is kept up to date with latest treatments and discoveries in the field of vitiligo. An annual World Vitiligo Day meeting is held in various parts of the country, Newsletters are distributed. Dr Raboobee is also part of the International Vitiligo Working Group and has contributed book chapters and articles in peer reviewed journals. He has recruited several vitiligo researchers to South Africa to teach local dermatologists the latest surgical techniques in the field.

Dr Raboobee insists that without the support of his team – secretary, treasurer, co-opted members and dermatologists in other cities, the degree of awareness of vitiligo that the VSSA has achieved would not have been possible. Dr Raboobee appeared on two health talk shows on SABC 2 to discuss the subject of vitiligo and has also taken awareness campaigns to schools. A poster on vitiligo designed by him has been translated into 4 languages already and more are on the way.

Dr Noufal Raboobee
Dermatologist
President: Vitiligo Society of South Africa
T: +27 31 265 1505
W: www.drnraboobee.com
A: Suite 292, Westville Hospital, 7 Spine Road, Westville, 3630, South Africa

Coverderm Peptumax e-ageing treatment range is specially formulated to protect the skin against damage caused by HEV and EMR

We live in a sea of electronic pollution, so we need to protect our skins 24 by 7

During the day we are exposed to the full spectrum of the sun’s radiation, and we have learned how important it is to wear sunscreens and sun blocks during the day and when we are outside. However, in the modern world we are not only exposed to radiation during daylight hours. We are also exposed to:

  • High Energy Visible Light (HEV) including Blue Light and
  • Electro Magnetic Radiation (EMR)

These are emitted throughout the day and night, making us live inside a sea of pollution 24 hours a day.

Newly formulated Coverderm Peptumax e-ageing treatment products

The new Coverderm Peptumax e-ageing treatment range is specially formulated to protect the skin against damage caused by HEV and EMR. The sensitive area around the eyes is especially vulnerable to this kind of damage and the Peptumax treatment range includes an eye cream to address this. Read some more about HEV and EMR below.

High Energy Visible Light and Blue Light is visible to the eye and is emitted by for example:

  • Digital screens
  • Computer screens
  • Laptops
  • TVs
  • Smart or cell phones
  • Tablets
  • LED lighting
  • Fluorescent lighting

What does HEV and Blue Light do to your skin?

  • High Energy Visible and Blue Light penetrates the skin deeper than both UVA and UVB rays. It induces significant amounts of oxidative stress, weakens the epidermal barrier, enhances hyperpigmentation and damages the extracellular matrix.
  • The oxidative stress leads to, for example, microcirculatory slow down, dark eye circles, bags under the eyes and a dull complexion.
  • The damage to the extracellular matrix creates a situation where UVA, UVB and IR rays can cause damage more easily.
  • It also leads to e-ageing, one of the four main causes of wrinkles and fine lines.

Electro Magnetic Radiation (EMR) is not visible to the eye, and is emitted by for example:

  • Cell phone signals
  • Radio and TV towers
  • Wi-Fi
  • Microwave ovens
  • Wireless connections, i.e.:
  • bluetooth devices
  • computers
  • headphones
  • cordless phones
  • doorbells
  • baby monitors
  • gaming equipment

What does EMR do to your skin?

  • It leads to the excessive production of cell-damaging free radicals
  • It weakens the skin’s own defence mechanism
  • It causes DNA damage which leads to the death of skin cells
  • It causes oxidative stress, weakens the epidermal barrier, enhances hyperpigmentation and damages the extracellular matrix.
  • Oxidative stress leads to, for example, microcirculatory slow down, dark eye circles, bags under the eyes and a dull complexion.
  • The damage to the extracellular matrix creates a situation where UVA, UVB and IR rays can cause damage more easily.
  • It also leads to e-ageing, one of the four main causes of wrinkles and fine lines.
  • Because EMR is emitted throughout the day and night, you must protect your skin 24 hours a day.

More about skin conditions that result from oxidative stress that is cause by both HEV and EMR

  • Chronic inflammation
  • Intensified cutaneous fatigue which leads to skin rashes and itching
  • Microcirculation slow down
  • Dark eye circles or eye bags
  • Decrease of skin cohesion
  • Skin regeneration slowdown
  • Hyperpigmentation
  • Dull complexion
  • Excessive wrinkling