In my first week working here, I sat in on an appointment I have not been able to put down since.
The woman was 62. She pushed both sleeves back and rested her arms on the table between us.
Dark marks the whole way from her wrists to her elbows. A few had gone yellow at the edges. One looked like it had arrived that morning.
On the back of her left hand there was a small tear, where a plaster had come off the day before and taken a layer of skin with it.
She had been raising this with her doctor for three years.
He had done the sensible things. He had asked what she was taking and checked she was not on anything that thins the blood. He had sent her for blood tests.
They came back normal. He told her that was good news, and he was right, and it was.
Then he looked at her arms. He told her to carry on with the arnica. He told her to cover up when she was gardening. He told her to watch out for hard edges.
And he told her to make another appointment for six months’ time.
She had done every bit of that, for three years, and her arms had only got worse.
The last thing he said to her was that it came with age.
I have spent 22 years on skin that marks and tears from almost nothing. Seventeen of those in Geneva.
In all that time I have never once sent a woman home with that sentence and nothing else.
What I sat through was not care. It was the shape of care with nothing inside it.
And it was not a one-off. It was not one doctor having a bad morning.
By the end of my first month, I had watched that same appointment play out over and over.
Women in their fifties, sixties and seventies. The same marks. The same tests coming back clear. The same sleeves. And the same four words to finish with.
It’s your age.
Let me put something to you directly.
How many of you have been sent for tests, been told everything was normal, and gone home with arms that had not changed at all?
How many of you have been handed those same four words?
How many of you took that answer home while some part of you quietly refused to believe it?
That part of you was not being difficult. It was right.
Why this still makes me angry
Where I trained, skin that has thinned to the point of marking from ordinary contact does not get filed under cosmetic.
It gets looked at early, and worked on, before it becomes harder to shift.
Here is the comparison I keep coming back to.
Nobody would sit a woman down, tell her the bones in her arm were thinning, and leave it at mind the stairs.
They would do something about the thinning itself. They would take it seriously.
But when it is the skin over those same bones, she goes home with a follow-up in six months.
The mark is not the trouble.
It is the notice.
It is telling you the skin itself has been getting thinner, quietly, for years.
And everything she has ever been offered is busy with the mark she has already got. Not one of those things has ever been pointed at the skin that let it happen.
“Handing a woman arnica for this is like handing someone with thinning bones a leaflet about stairs. You are tidying up after the problem. You are nowhere near the thing causing it.”
— Elise Renner, Skin Specialist, 22 years
What your doctor was never taught to look for
This is what I explain to every woman who sits in front of me, in plain words, so that nobody can wave her off again.
The bruise is not the problem. The bruise is what the problem looks like.
Skin has padding under it. Think of a layer of foam sitting between the outside world and the small vessels underneath. You bump the cupboard, the foam takes it, and nothing shows.
That foam wears away as you get older, and the skin over it gets thinner at the same time. So those small vessels end up sitting right near the surface with almost nothing over them.
Now when you bump the cupboard it goes straight through to them. They give way, there is nothing to hold it in, and that is your bruise.
That is all it is.
Which explains the things nobody has ever answered for you.
Why it does not hurt. There is barely anything happening. A cupboard door is a cupboard door.
Why the mark is so much bigger than whatever caused it. There is nothing under there to contain it, so it spreads.
And why every test came back normal. None of this is in your blood. It never was. They were testing properly and finding nothing, because they were looking in the wrong place.
If you were told a good deal of it is sun you got thirty or forty years ago, that is true as well. Sun is one of the things that thinned the skin in the first place. But it did not leave anything behind in your arm. It left you with skin that is thin today, and today is the part you can do something about.
That is all a bruise like this is. Not clumsiness. A cushion that has quietly gone.
A fitted sheet. A rose cane. A small hand holding on. A cupboard door you have walked past a thousand times.
What meant nothing at 40 now goes straight through, because there is no longer anything sitting between it and the vessels underneath.
The question that made the room go quiet
In my second month, I put something to my colleagues during a case discussion.
If the skin itself is what has thinned, why is every single thing we hand these women pointed at the mark?
Nobody spoke for a moment.
Nobody had much of an answer either.
Not because the people in that room were careless. They were not.
Easy bruising gets taught as something cosmetic that comes with getting older. Something to be managed. Not something with a cause you go after.
So arnica gets suggested, because it is the one name everybody knows. And arnica does its job properly. It works on the mark that has already appeared.
It was never meant to do anything beyond that. Nobody ever claimed it was.
No one here is at fault as a person. It is what got left out of the teaching.
But the women carrying the cost of that are entitled to know it happened.
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What actually works on the skin itself
Working on skin that has thinned takes three things, and they need to be in the same jar.
Not one. Not two.
Leave one out and you are only ever doing part of the job.
- Arnica. It works on the marks you already have and helps the colour go faster than it would on its own. Useful, and it is where nearly everyone begins.
- Vitamin K. For the fine vessels sitting near the surface, the ones that give way at almost nothing and show through so readily once the skin has gone thin.
- Ceramides and peptides. The one that counts. These work on the thin skin itself, so week by week it feels thicker, firmer and stronger. And skin with some strength back in it stops marking from the things that used to mark it.
The first two work on a bruise you have already got. The third one works on the skin itself, so you stop getting them in the first place.
All three. Together. Every day.
And there is one more thing I want to say without dressing it up.
Hardly anything on the shelf contains that third one.
Go and look for yourself. Arnica on its own. Vitamin K on its own. Occasionally both in one tube, which looks like progress and is not.
The part that works on the skin itself is the costly one. So it gets left out, arnica goes on the front of the box, and the tube sells perfectly well.
Two things aimed at what has already happened. Nothing at all aimed at the reason it keeps happening.
That is not one poor product. That is very nearly the whole aisle.
The one I recommend
You will have seen the name by now, so let me tell you why it is the one I point women at.
When I moved here I went through what was actually available to British women. Arnica by itself, mostly. Some of it arnica with something added for the look of the mark. Almost nothing working on the thin skin underneath.
Skinergy was the only one with all three in it. That is the whole of why I recommend it.
Skinergy Advanced Relief Cream
- Arnica — works on the marks already there, so the colour clears faster than it would alone.
- Vitamin K — for the fine vessels near the surface that show through so readily on skin gone thin.
- Ceramides and peptides — the part that counts. Works on the thin skin itself, so over the weeks it feels thicker, firmer and stronger, and marks less easily.
- Morning and night — arms and hands, or anywhere the skin has gone thin.
- 90-day money-back guarantee — if nothing has shifted, they return every penny.
I recommend it because of what is in the jar, and because it is the only thing I have found here that does all three at once rather than one.
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What I have seen in the women using it
Age 58
Two years of arnica every day. Sleeves all summer. By the sixth week her daughter asked her what she had changed. She had not mentioned to anybody that she was trying anything.
Age 64
Gave up the garden three years ago because of the state it left her arms in. By week eight she sent me a photograph from her own flower bed. Kneeling in the soil, sleeves up.
Age 71
Had not worn anything sleeveless since her sixties. She wore a summer dress to her granddaughter’s wedding and told me afterwards that not one person mentioned her arms, which was precisely the point.
What to expect, and when
None of this happens overnight, and anything telling you otherwise is not being straight with you.
- The first week or twoMost women notice how the skin feels before they notice anything they can see. Less papery. Less dry and fragile under the fingers. That is the first sign the thin skin is being worked on.
- After thatThe marks already there begin clearing faster than you have got used to.
- Over the weeks that followUsed morning and night, the skin carries on feeling stronger, and new marks turn up less often from the small knocks that used to be more than enough.
Not days. Not a miracle. A direction.
Thin skin does not hold where it is
I want to be straight about this, because it is the one reason not to sit on it.
Left alone, thin skin does not stay as it is. It goes on thinning, quietly, the way it has been doing for years already.
Nothing about that is frightening. It is simply why the small knocks that mark you now were not marking you five years ago.
Two ways this goes
You carry on as you have been. Keep being careful. Keep reaching for the sleeves. The skin goes on thinning, and next summer looks like the last one.
Or you start on the cause tonight. Twice a day, on your own arms, for ninety days. If your skin is no stronger and the marks keep coming exactly as they did, one email and you have every penny back.
You have been careful for long enough.
Careful was never going to be enough, because it never once went near the reason.
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There is nothing wrong with you.
What has failed you is advice that made your carefulness the subject, when your carefulness was never the problem.
Your skin was once sturdy enough for your own life. It can be closer to that again.
The skin itself is where that starts.
This article reflects the personal perspective presented by the author. Individual results may vary and are not guaranteed. Skinergy Advanced Relief Cream is a cosmetic skincare product, not a medicine, and is not intended to diagnose, treat, cure or prevent any disease or medical condition. If you have concerns about your skin or your health, please speak to your doctor or pharmacist. This is an advertisement for Skinergy Advanced Relief Cream. The personal account is written for advertising purposes.