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Dr Justine Hextall MBBS FRCP

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Dr Justine Hextall MBBS FRCP

Consultant Dermatologist | Rosacea, Acne and Skin Cancer specialist | Rejuvenation Treatments

31/03/2026

I have thought about this for a long time . I have been concerned about ( mostly ) young women spending increasing amounts of money in an attempt to ‘ prejuvenate’ the skin. The idea that lines and wrinkles can be prevented for example with e.g.neuromodulators and/ or fillers at an age before they’re established. I am struck by how many women I see in their twenties asking me if they should be having these treatments to stop themselves ageing more than their peers . It wasn’t until my daughter who I would have had low on my list of potential ‘ prejuvenators’ asked for Botulinum toxin treatment that I realised how widespread this practice was. I am a big fan of Tweakments and use them myself but the question is when to start? What outcome can you expect ? And can in some cases early treatments in fact age a youthful face? I believe completely in choice and understand why these treatments are being considered . I just think we need an honest conversation about risk and true benefit … and remember protecting your skin from external aggressors such as UV and pollution with SPF and anti- oxidants and maintaining a calm hydrated skin barrier is probably a perfectly adequate approach in your twenties … Also facial ‘ ageing ‘ is complex and involves mechanisms beyond just surface skin changes . Also crucially beauty is unique worry less about future ageing, an evolving face is something to celebrate. 🎉 🥳👏 thank you and for interviewing me.

19/03/2026

I was hot wired to achieve from a young age … academic girls school.. you can do anything I heard over and over … the problem came not in my twenties… medicine bring it on, tough on- call I just got bigger than it . The wall came in my thirties . What do you mean you can’t intellectualise parenting ? What do you mean I might have to slow down to accommodate children? How? Tell me how to do that? Sometimes I wish I could start again …..Knowing that it’s okay to stop and breathe , step sideways for a bit, sit and stare with that tiny hand in mine . If you’re a young parent I know how hard this is, there are no answers and we need to ensure that institutions recognise this difficult period and support young parents . All I would say is don’t feel bad about giving family time the focus it needs, it’s precious and fleeting❤️❤️

05/03/2026

Sometimes we are asked to have a quick look at a photo of a rash as I was this morning . The history was sudden onset of a widespread rash that had developed 7 days after a course of antibiotics for a throat infection with a history of EB virus . He had been seen and given oral steroids for a presumptive drug reaction . It was getting worse could I give a quick opinion? I was swayed by the history and thought the diagnosis was probably true, you can also get such a rash with reactivation of EB virus treated with Amoxicillin. Lots of explanations, job done right? Mm I wasn’t sure, could he drop in at the end of clinic, he was my colleague’s partner it’s tempting to give a quick ‘ corridor diagnosis ‘ but these can go wrong . I am glad I did . As you can see the diagnosis quickly changed once I saw him and saw my diagnostic clues. Increasingly with pressure on dermatology departments we asked to make diagnoses from photographs … I understand why but always worry by not seeing the patient and fully examining them we may miss things . In this case I probably would have made the wrong diagnosis.

27/02/2026

Sometimes it’s just the simple things that will literally transform your skin . In my view the most important step in any skin care regime is the cleanser and when you use it ….. here is the advice I give to my patients. Follow for more dermatologist tips …

12/02/2026

If I was to teach one think after 25 years in dermatology…. CHECK THE SKIN. So many times a patient presents with one issue, I examine them and lo and behold …. There’s the melanoma . People have come for micro needling , skin tag removal, facial sun damage treatment and even advice about a skin care regime … and we have spotted this serious skin cancer . Remove a melanoma at the in situ stage we’re talking 99% 5 year survival . I wish we saw all melanomas at this stage… but if we don’t look we won’t find ..

10/02/2026

A physician colleague asked me to see this young woman… He was treating her for joint issues and fatigue . She had received repeated courses of Isotretinoin …. but her skin would flare as soon as it was stopped . I felt there were significant gut- skin issues and that this wasn’t a straightforward acne case . I focused on gut health and set out to tackle her complex skin issues … no further Isotretinoin just repairing skin care and topical prescriptions. A year later her skin is glowing 🤩 confidence restored and she has a sustainable solution … I am very interested in both the gut and skin microbiome, we have so much to learn but emerging data is so interesting. I feel ‘ acne’ is often a default diagnosis for more complex skin issues often with crossover diagnoses. Finally as I always teach … healthy skin also comes from within .

09/02/2026

Rosacea doesn’t appear overnight … slowly the inflammatory taps switch on . It’s our job to switch them off … if you want a sustainable solution . This patient after several courses of treatment including antibiotics was eventually told she couldn’t be helped . She would have to live with her skin … like so many likely a clinical path with multiple intermittent courses of antibiotics. When she came to us we quietly switched off the drivers for this condition . No more oral antibiotics just our Rosacea Reset ™️ approach . We gave topical prescription medications with our specific skin- brain-gut support . We did give some laser eventually, but only after we regained some control of this inflammatory skin condition . As you can see 8 months later her skin is glowing and clear and as she describes it ‘ it feels like different skin’ . We’re not looking for a quick fix we want a lasting solution at Tarrant Street Clinic . Follow for more skin solutions. 🤩

05/02/2026

This patient had seen many practitioners who had given different prescriptions and skin care to treat her rapidly progressive pigmentation … nothing improved, in fact it was getting worse. She even had microdermabrasion…. Until she called our clinic and made an appointment. The first thing I did was to start from the beginning … in medical terms take an old-fashioned history. It became clear that she had started a new vitamin C active around 9 months previously at exactly the time that she had noticed some skin irritation, Since then her skin had been burning and itching. This vitamin C was her only new product and she had continued it alongside all the treatments that had been prescribed for her hyperpigmentation. I looked at the ingredients, I felt the most likely culprit was limonene. I suspected this was causing a photosensitive reaction that was causing the reticulate pigmentation . What did I do?
Step1: Stop the cream immediately 🚦.
Step 2: Prescribe an anti-inflammatory prescription cream and skin care regime that was going to reduce the inflammation and calm and hydrate the skin. We couldn’t proceed until the inflammatory process was switched. 🧴
Step 3: Protect the skin from UV , sun avoidance behaviours, hats and an excellent SPF 50 regularly apply! ☀️
Step 4:Once the skin symptoms of itching and burning stopped I noticed already the pigmentation was subtly reduced.
Step 5: Cautiously introduce a pigment suppressing prescription treatment… slowly we started to see progress..within weeks the skin was significantly improved and we never had to do any in-clinic treatments, just prescription cream and patience….
Take Home : Take a history, try and elucidate a cause and stop the offending drug/ topical. Reduce the inflammation driving pigmentation, and only then tackle the pigmentation WITH CAUTION ⛔️. Remember that pigmentation can get worse if you attempt in-clinic treatments such as a peel or laser … make every attempt to switch off the inflammatory and pigmentation processes first… I hope that helps!

04/02/2026

On World Cancer Day I want to emphasise the IMPORTANCE of a full skin examination . We pick up so many often subtle malignant melanomas … a serious skin cancer. We need to pick up melanoma as early as possible …. So we always need to be looking for it . I published a paper showing 17.5%. of our melanomas over a two year period were picked up entirely incidentally . Early pick up is essential always get checked !

02/02/2026

In a world where it seems not having tweakments in your twenties is just not trying and likely to result in ‘premature ageing’ … as a dermatologist I would like to offer some balance …….
I cannot over emphasise the importance of good skin care, giving the best possible protection from external aggressors such as UV and pollution. Look for antioxidants and a really effective SPF daily . Make sure your skin barrier is as robust as possible and wear protective clothing, hats and sunglasses in strong sunshine . Eat a balanced diet promoting a healthy gut microbiome. Sleep well and exercise . If you do all of these steps in your twenties and thirties …. You are ahead of the game . But do you really need to be having expensive in - clinic treatments such as neuromodulators ?? I’m not sure. Your day to day practices will definitely have the biggest influence on your skin health, and is probably more than enough in your twenties and even thirties……. These are just my opinion, but I hope it might help to bring some clarity and balance. over50andfabulous

01/02/2026

I am surprised how much some young people spend on preventative ‘ Tweakments ‘ in their twenties . In my view not only are most unwarranted, I fear they may sometimes have the opposite effect . The radiance of youth is hard to recreate … and some treatments actually detract from it. Neuroscience can help to explain it . As a rule I advise young people to just protect their skin from external aggressors that we know over time will ‘ age ‘ skin such as UV and pollution . I highly recommend antioxidants and a good broad spectrum SPF . I also think we underestimate the importance of protecting the skin barrier our first line of defence . Financially times are hard, especially for young people. Consider carefully what benefit a treatment will really will bring . Prevention may be far more straightforward and less expensive than you think …..

Address

40A Tarrant Street
Arundel
BN189

Opening Hours

Monday	9am - 5pm
Tuesday	9am - 5pm
Wednesday	9am - 5pm
Thursday	9am - 5pm
Friday	9am - 5pm
Saturday	10am - 2pm

Website

http://www.justinehextall.co.uk/

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