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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

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 …..

23/01/2026

When we remove skin cancers, we have to make sure we excise with good margins … this can create problems especially in areas where the anatomy is tricky i.e. above the eye . Iconic as the unilateral eyebrow lift was for Roger Moore … trust me no one wants it imposed upon them after surgery….. Here’s a step by step guide to avoid it when operating above the eye .…

20/01/2026

We are currently studying polymorphic light eruption . What is this ? A skin rash that often appears around 48 hrs after sun exposure . Winter skin seeing early sunshine in spring is often vulnerable to this condition . Treatment is variable including topical and oral steroids and even UV light treatment amongst others . We are looking at a different approach that does not use steroids or UV. Interested ? Give us a ring 01903 882917 for further details. If you are a skin specialist/ dermatologist and have patients please get in touch too. Looking forward to starting in the next month . Justine 🙏

01/01/2026

Firstly so important to point out these are the highlights … the good moments. That is life though, the tough days and sometimes weeks , deep sadness with the loss of precious family and friends… then the glimmers, sometimes where you least expect them. Hang on to the glimmers🤩, they matter . For me I can see I have taken so many photos of our kitchen table with food , wine and family and friends… always my happiest moments . The sea and the Arundel lido .. again places of solace. My work is important and I am so lucky to work with the best team my TSC family that I spend more time with than my own, thank goodness I love them all ❤️. Special highlights were receiving the Medical Advocate of the year from CeraVe and officially launching the pharmacy training scheme I developed with L’Oréal Dermatological beauty for Boots .. a really amazing moment . Also being invited back to St John’s Institute to teach in an acne masterclass and being invited by to celebrate their 50th birthday in Paris 💙I notice here how much creativity matters to me. I loved our Moth - inspired live story telling and of course our 3 rd play The Camden Climax written with my brilliant friend , we did it!! Interviewing the amazing about her fantastic new book Alive for the Arundel literary Festival. We also opened the Ann Sutton Studio named after .artist who lived and worked there 1980- 2024 a fitting tribute to an inspiration and wonderful artist. We want this to become an arts hub and have already hosted plays, story slams and a chamber concert with the - what a privilege! Finally celebrating 25 years of marriage to Sebastian, hard to believe. The best lessons of last year have been simple though … slow down , look around you, really be present, be grateful and sleep… everything feels better after a good night’s sleep. Wishing everyone a healthy and peaceful 2026 ❤️❤️

09/12/2025

I saw this patient in clinic . I will walk you through the step to step guide when making a skin cancer diagnosis .
Clinically this is typical of a basal cell carcinoma . They tend not to spread beyond the skin . The complication is they can spread under the skin, extensively in some cases . As this is in a facial site we want to remove but preserve the anatomy and minimise scarring . I am suspicious that this might be a more infiltrative version …. So plan to biopsy in a couple of areas to get a clearer a look at what we’re dealing with before planning further surgery …

08/12/2025

We realise that triggers and successful treatments for adult acne may differ from those with typical teenage acne . We find skin is often more sensitive and we frequently see crossover conditions such as acne and rosacea and or acne and perioral dermatitis. Here we started my settling the skin barrier, look how inflamed the skin is in the first photo compared to after. We used skincare and prescriptions to create a calmer and more robust skin barrier . We added a topical retinoid to treat the acne . We often combine in clinic LED AND light peels. We start a combination of good skincare , topical prescriptions and calming in clinic treatments to settle the skin. We try to avoid antibiotic use unless warranted, and then we make sure we have an exit strategy and maintain gut health . The pictures speak for themselves . Follow for more consultant dermatologist skin advice .

05/12/2025

I have a demanding job. I have busy clinics filled with skin cancer, rosacea , acne and eczema and facial treatments . This is an extremely busy time of year as everyone understandably wants to be ‘ ready for Christmas ‘. This might mean having that skin cancer treated or rosacea settled . I try to make sure everyone is seen. Increasingly that first hour of my day is becoming more important . If I feel good I perform so much better. This has become one of my non- negotiable parts of the day . What are yours ? Follow for more advice on skin and wellbeing.… 😊 #

28/11/2025

Thank you and Tracy Achonwa .t.e.a for asking me to contribute to this fantastic and incredibly comprehensive article on a guide to facial serums . My take home messages were:

🌟don’t underestimate the power of a hydrating serum to brighten and protect skin
🌟There are many clever peptides that can help pe*******on of ingredients, suppress enzymes that damage collagen , boost collagen and elastin and soften fine lines lines and wrinkles amongst other roles of these clever products.
🌟when using active serums that may dry or irritate skin always balance with calming hydrating skin products. My favourite balance / repair approach . Be careful about combining , changing pH may reduce efficacy of some peptides for example
🌟 Multi- weight hyaluronic acid can be more effective allowing more effective hydration . My absolute favourite is La Roche Posay’s Hyalu B5 hyaluronic acid.
I was in great company! Read valuable insights by and Dr Hank Hassan cofounder of Hue.

27/11/2025

Since developing our ROSACEA RESET ™️ ( we have run a study since 2018) we have seen incredible results, crucially avoiding antibiotics and targeting all of the areas driving rosacea skin. We want to create a sustainable solution that targets the skin- brain- gut axis. We see rosacea as driven by a series of taps 🚰 that once switched off can slowly reset the skin …..we’re looking for long term results 🤩

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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