An Interview With Acne Expert Justine Kluk

How did you get into skincare and dermatology? 

I’ve always been interested in skincare - my grandmother planted the seed as she used to spend a lot of time doing her skincare routine and applying makeup - she was always complimented on how youthful her skin looked. My own particular interest in skincare and dermatology came off the back of developing acne myself at the age of 12. I went to see several GPs and eventually saw a Dermatologist who finally took me seriously, trying various treatments until eventually one of them worked. The relief I felt from having someone treat my acne seriously and taking the time to get it under control made me feel well cared for and seen. This experience inspired me to study Dermatology.  

When and how long did you study for and what did it entail?

I completed my five-year medical degree at the University of Birmingham Medical School. After qualifying as a doctor, I did two years of basic medical and surgical training which involved long day and night shifts working in the hospital, and on-call shifts over the weekends dealing with very sick patients.

During that time I did placements in intensive care, sexual health, vascular and bowel surgery, respiratory medicine, gastroenterology, nephrology and more. Working in all of those different specialities gave me a good grounding in internal medicine before I went on to study Dermatology.

I then spent a further four years specialising in Dermatology!  This involved working in lots of different Dermatology departments to get a feel of the variety of cases that Dermatologists might encounter. Some focused on skin allergies, others on skin surgery, pediatric dermatology, skin cancer and inflammatory skin disorders like eczema, acne, and psoriasis - it’s necessary for a Dermatologist during their training to rotate through various different departments so that they can get experience in all of the different facets of the field.

After my four years of specialist training, I took an exam to achieve the Specialist Certificate in Dermatology. This is equivalent to “board certification” in the USA and shows that a Dermatology trainee has acquired the requisite knowledge and skills during their training so they can go on to become an accredited Consultant Dermatologist. 

After becoming a Consultant, I decided to train further in the field of skin cancer. I competed successfully for a fellowship at St. John's Institute of Dermatology, which is a prestigious world-recognised centre for research and training in skin disease. Having completed the fellowship, I went on to work as a Consultant Dermatologist in the NHS for several years before setting up my own private dermatology clinic in Harley Street in 2016. My area of specialist expertise is acne management, however, Dermatologists like myself treat a wide breadth of different skin concerns across all ages.

Our skin clinic has grown over the years. We are now a team of four Consultant Dermatologists, a plastic surgeon and laser expert who treats acne scarring, a psychologist who specialises in psycho dermatology - the science connecting mental health and emotional wellbeing with skin health - and a consultant gynaecologist. Acne is common in males and females during adolescence and early adulthood, however becomes much more prevalent in females than males after the mid-twenties due to our hormones.

Why has acne treatment been your specialism? 

I started to have acne when I was 12. I actually still have acne and take treatment for it at the age of 41! Thankfully I have the right tools to keep it under control nowadays. Acne is

visible and can be physically and emotionally challenging. I have a great amount of empathy for other people dealing with it, having lived with the condition myself for almost 30 years of my life. This is what makes me really passionate about helping others who are struggling.

Having a visible skin condition can invite unwanted comments about your appearance and well-meaning, but useless advice. The really tricky thing with acne for many people is the onset during the teenage years when your body is already undergoing enormous physical changes due to hormone shifts, you’re developing your social identity and navigating personal relationships. It's during this time that we’re often at our most vulnerable about body image. 

90% of us will develop acne in our teenage years - some mild, some severe. My main goal is to ensure that whilst going through this transition, we empower people to manage the skin difficulties commonly faced. Sometimes this will be self-management e.g. having an appropriate skin routine to follow and knowing about some of the lifestyle factors that can make acne better or worse. Sometimes it will mean involving a doctor for a discussion about prescriptions.

What are some of the most common concerns patients come to seek help for?

The most common is acne, which is our clinic’s area of specialist expertise. Because of our multidisciplinary set-up - with a psychologist, plastic surgeon, gynaecologist and four dermatologists - we can take a really well-rounded approach to optimising skin health. 

We also have many patients with other skin concerns like rosacea and facial hyperpigmentation (e.g. melasma), and some with inflammatory skin conditions like eczema and psoriasis. We can give anti-ageing skin health advice, perform mole checks, and treat sun damage.

What has changed within skincare over the years?

When I first started working in dermatology, most people who came to see me didn't have a clue how to form a skincare routine and which products might be useful for which skin condition. The internet and social media have increased access to information about skincare products. Whilst there are many positives to this, there is also a LOT of misinformation. Whereas doctors are trained to recognise and distinguish good health-related information from bad, members of the public may not always find it easy to separate fact from opinion or pseudoscience. Self-management without expert guidance can sometimes be based on entirely wrong information as a result. For some, this means their skin doesn't get any better. For others, products used may actually cause harm.

We see this in the clinic when people arrive desperate for help after trying on their own to combine too many different - and sometimes inappropriate - skincare products,  just because they've read somewhere that a particular ingredient is good for acne-prone skin. For example, they may have seen that products containing salicylic acid, retinoids, benzoyl peroxide or niacinamide are great for acne so try to use several of these at the same time. They end up with red, sore, flaky, peeling skin, tightness, sensitivity, more spots and an unhappy skin barrier.

Taking advice from non-expert influencers is also a concern. We have to be mindful that content or recommendations may be sponsored or products gifted. Some people are very clear about declaring this so you can take this into consideration when you make a decision

to purchase a product. Some are not. So, if your favourite content creator recommends a particular product, ask yourself if you think they really believe in that product (e.g. is it a longstanding partnership over many years) or is this a flash in the pan and simply a good short-term commercial opportunity? If in doubt, it’s always worth talking through any online advice that sounds unusual or unexpected with an expert - your GP, an aesthetician like at < renude.co >or a dermatologist. 

Going forward, we really do need to ensure that it’s easier and faster for people to access experts so those in need can speak to someone with knowledge and experience without delay. A service such as

 Renude.co connects people with skin concerns and questions to an aesthetician for personalised recommendations tailored to their individual needs. 

In our dermatology practice, we are trying to make life easier for those who do need to see a doctor by offering online appointments as well as in-person consultations. We also have a free online guide about the role of the skin barrier, skin microbiome and gut-skin connection in acne that people can sign up to receive now at drjustinekluk.com/guide - and we are developing further online resources to give people access to evidence-based, scientifically verified information direct from the Dermatology clinic. Hopefully, this empowers more people with the right knowledge so they can make better-informed skincare decisions. 

What are your thoughts on the explosion of celebrity skincare brands?

I don't have anything against celebrity brands, as such. Celebrities will often pay very reputable cosmetic chemists to formulate their products. My bigger concern is the market. It is saturated and overwhelming. We really don't benefit from having thousands of cleansers, moisturisers and sunscreen options. Decision-making becomes impossible, and we can succumb to FOMO resulting in ineffective and unnecessarily expensive purchases. It’s also, more often than not, the marketing we’re falling for rather than the product. We are told each product is unique and different from the rest, when in actual fact there are very few true game-changers that come onto the market. 

How did you get involved with Renude? 

Cate and Pippa (Renude Co-Founders) reached out to me during one of the Covid lockdowns and told me about the ambitions they had for Renude. They were developing an AI platform to support skin experts in making even more effective, personalised skin care recommendations

for buyers.  They knew they wanted to involve a Dermatologist (which is clearly sensible as the most highly trained medical experts in skin health and disease!). I loved the idea, given the marketing hype and confusion I have already described. Even more appealing to me was the ability to help shape the technology they planned to create - building and training computer programs to recognise common skin conditions and to make more and more precise, tailored skincare recommendations over time. I find the machine learning capability fascinating.

There is a lot of noise and hyperbole within the skincare industry about artificial intelligence so with their science backgrounds Cate (data scientist) and Pippa (cosmetic scientist) were both extremely credible. I am really excited about the future at Renude. Being part of the team and helping build the AI is fun and very different to my normal day job! 

 What is it like to be on the Renude Advisory Board and what does this entail? 

It’s very exciting to be part of a start-up, particularly one that combines skincare, one of my big passions in life, and cutting-edge technology.  I support Cate with training the AI to recognise various skin conditions by sharing how I go about this in real life. I also help to write and edit blogs and social media content to educate people about skincare. I provide expert quotes to the media and support in mentoring Renude aestheticians. 

Many patients who end up seeing me in the clinic have experimented with skincare products that were not suitable or helpful for their skin or didn’t give the results they were after. There are only so many trained aestheticians and dermatologists available to help iron out these issues. I really see the potential of the platform we’re building at Renude to help people at scale as we move forward.