About Philippa

Dr Philippa McCaffery is a Cosmetic Physician, practicing in Edgecliff, Sydney. Her practice focuses on patients affected by Acne, Acne Scarring, Pigmentation, Sun Damage and premature Ageing. Dr McCaffery graduated from Sydney University Medical School in 1980. Following several years as a hospital resident, she undertook a Masters in Public Health in 1984 and spent the next fourteen years managing large hospitals in both the Public and Private health sectors in Sydney. She returned to clinical practice in 1998 and took over the CACI Clinic in Edgecliff in Sydney in 1999. The CACI Clinic had pioneered laser hair removal in Australia in 1995 and was one of the first Cosmetic Medicine Clinics in Sydney. Dr McCaffery’s interest in Womens Health and in particular, Polycystic Ovarian Syndrome (the commonest cause of Adult Acne in females) expanded the Clinic’s service profile to include skin correction programmes for Acne, Sun Damage, Pigmentation, Facial veins and Scarring. Dr McCaffery has trained with a number of the world’s leading innovative Dermatologists including Dr Zein Obagi in California USA and Dr Philippe Simonin in Geneva Switzerland. Dr McCaffery formulated Clearskincare skincare creams in 2000 – 2002, designed Clearskincare’s “Easy Squeeze” in 2003, Clearskincare’s Skin Roller range in 2004 and Clearskincare’s Skin Peels in 2008 Dr McCaffery is a keen researcher and is always testing and refining her treatment programmes to deliver the best possible results for her patients.

Jessica Rowe’s Adult Acne

Jessica Rowe

Jessica Rowe has posted a lengthy article about her own history of Acne as both a teenager and an adult. I had the pleasure of meeting Jessica on the show Studio 10, whilst discussing the problem of adult acne in women and she is such a gorgeous woman and so happy to share her own experience with adult acne. Here is a sample of it;

I remember reading in Dolly magazine that the way to hide your pimples was by turning them into beauty spots with a black kohl pencil. That might work if you had just one or two spots, but I looked very odd with my face covered in twenty black ‘beauty spots’.

No wonder I never got kissed by any of the cool boys!

Clearly using eyeliner as a cover up wasn’t working, so Mum took me to a dermatologist who prescribed me oral antibiotics as well as antibiotic lotion of varying strengths for a few years. Nothing worked, so I ended up taking a number of courses of Roaccutane. A super heavy duty drug that had been marketed as being the ‘cure’ for acne. ( I do believe it stopped my skin from scarring)

Finally by the age of nineteen I had clear skin. My reprieve was short lived, with my cystic acne coming back with a vengeance when I was 21. Still another course of Roaccutane and it still wasn’t enough. My skin specialist sent me to an endocrinologist who diagnosed me with Polycystic Ovarian Syndrome (basically my body produces too much male hormones and the side affects for me included acne and later problems falling pregnant- but that is a whole other story!)

The so called cure for my acne was hormone treatment and then later I went on the contraceptive pill. That has been enough to keep my skin behaving most of the time. However since turning forty I have been introduced to the joys of yet more acne!

Why? And I know it’s not just me and my decades long problematic skin. Acne is an all too common problem for many women once we approach premenopause and menopause.

If you would like to read her whole article visit her blog CrapHousewife

Interesting New American Survey about the impact of Acne on young adult women

A new survey, conducted by an Online Dermatology service called Curology, provides some insight into the challenges women face when dealing with acne and highlights how far women of all ages are willing to go to achieve clear skin. The survey was conducted online with Google Consumer Surveys among 1,001 women, between the ages of 18-44, who have suffered from acne, blackheads or clogged pores at some point in their lives.

Here are the key findings of Curology’s survey.

Suffering from unwanted acne, blackheads or clogged pores can be challenging for women of all ages. In many cases, social situations can exacerbate the emotional toll acne takes and brings unwanted commentary.
● A staggering 52% of women 18-24 have had a significant other or family member comment on their acne, blackheads, or clogged pores in a negative way.
● Almost 15% (14.8%) of women between the ages of 18-24 are likely or very likely to cancel plans or a date because of a breakout.
● Of the women who said they were likely to cancel plans or a date because of a breakout, 26% of them would ALSO be willing to be celibate for six months in order to have clear skin.

In today’s digital age, when photos are constantly shared, the pressure of having clear and photo-ready skin is very real. Women of all ages are willing to subject themselves to other burdens to avoid a very public breakout.
● Almost 60% (58.6%) of women said they’d rather have their period than a breakout on their wedding day.
● 40% (39.9%) of women admitted to editing a picture to cover a blemish before posting on social media. For women aged 18-24, the number goes up to 52.6%.
Acne and the Workplace
Women who suffer from acne, blackheads or clogged pores also struggle with nerves and feelings of anxiety in the workplace.
● 36.6% of women admitted to feeling nervous or anxious going into a job interview or big presentation because of their acne. The nerves increase even more for younger women, with 40.6% of women 18-24 admitting the same feelings of anxiety.
● 52.4% of women who have had someone close to them comment on their acne in a negative way also admitted to having felt nervous or anxious going into a big presentation or job interview.
● Almost 10% (8.7%) of women said they would be willing to take a pay cut for six months in order to have clear skin. Younger women age 18-24 would go even further, with 11.5% willing to take a pay cut for clear skin.
● Of women 18-34 who said they would be willing to take a pay cut for six months in order to have clear skin, 57.9% would be willing to pay $100/month for 10 years ($12k) to guarantee their skin would be cleared of any acne, blackheads or clogged pores for life.
● 20.5% of women would be willing to pay $100/month for 10 years ($12K) to guarantee their skin would be cleared of any acne, blackheads or clogged pores for life. That number jumps to 26.4% for women 18-24.

The unfavorable emotional and physical toll of acne can be severe for many, so it’s no surprise that women are willing to go to great lengths to make sure their skin is blemish free. What’s surprising is JUST how far.
● More than ⅓ of women (35.7%) would be willing to gain 10 pounds, take a pay cut or be celibate for six months in order to have clear skin. When looking at women between the 18-24, that percentage rises to nearly 44% (43.6%).
● 10.6% of women said they would be willing to gain ten pounds in order to have clear skin.
● 24.2% of women would be willing to be celibate for six months in order to have clear skin.
Adult Acne, as I have written about many times, is a far bigger problem for women than men. Adult Acne in women tends to be more chronic and more treatment resistant. My own experience treating 100s of women with adult acne over the years, is that it can be an insidiously debilitating condition, which takes a quiet but persistent toll on emotional well being.

There are a number of Online Dermatology services in the USA, which offer an Online prescription service for the cost of a visit to the GP in this country.  Access to doctors in the USA is very costly and out of reach for many young Americans who suffer from Acne. Unfortunately, whilst this service is a great step up from no access to medical care for Acne, prescription medicines, other than Isotretinoin, do not offer a long term solution for Acne, and as discussed previously, even Isotretinoin has a 40% relapse rate for females who take a course.

That is why finding SGA and bringing it to my clients has been such a wonderfully satisfying process for me. We have been performing SGA for over 5 years now and a recent survey of our therapists returned an almost universal expression of their enthusiasm and satisfaction with performing SGA for their clients and the outstanding results they were able to achieve for them.

My focus over the next few years is to teach as many therapists and clinicians as possible to perform SGA, both in Australia and all around the world.

Keira Knightly has Chronic Adult Acne

The beautiful star has often spoken of her body hang-ups in interviews, particularly her skinny frame and her chronic adult acne. Indeed, her acne has caused her to loathe having her photograph taken, particularly by the paparazzi. She explains, “I’m not comfortable being photographed when I’m being myself. I believe the Aborigines say that every photo takes away a bit of your soul. It’s very odd but I think there’s some truth in that.”
The actress also reveals that she dislikes her looks and relies on make-up artists to make her look good. She said: “I look in the mirror and go, “Oh no! More spots, more acne!” she adds, “I’ve been saved many times at film premieres by wonderful make-up artists who make my skin look much better than it is. That’s all part of the make-believe world of cinema.”
Knightley admits that her adult acne has left her with low self-esteem, although being a sex symbol has helped her to come to terms with her body. She said: “My film career has boosted my self-esteem. I’m self-conscious and I’ve always tried to dress down. I don’t even like wearing make-up but I have to because of my acne.”

Clearly she needs SGA, I just have to work out how to contact her!


Keira Knightley

Acne as a Fashion Accessory

In one of the more bizarre fashion statements ever, Malasyian designer Moto Guo sent his models down the Mens Fashion week runway in Milan last week, with pimples on their faces, not covered up with tons of make up, but highlighted as a fashion accessory.


Apparently the designer wanted to remind people its okay to be human. Reaction to Guo’s   fashion statement has been mixed, with some commentators applauding his efforts to normalise taboo skin conditions like acne, others saying, trying to make acne “cool” trivialises a condition that causes many of those who have it significant emotional trauma.

I believe highlighting acne as a real problem, even in this somewhat unusual way, is a good thing. Acne is the commonest health problem experienced by young adult women and men and young adult women in particular are four times more likely to suffer from chronic treatment resistant acne.

We all need to speak about this more, so that those with acne don’t feel isolated and alone in their struggle to get clear skin. Everyday I receive a dozen photographs of young adult women and men with acne who come to our Clinics for help. I am so pleased that we now have a solution to offer them.


Adult Acne – “Like an Epidemic”

Below is a story from the Telegraph London I have republished.  Adult Acne has been on the rise for a number of years now, but rarely gets the attention that such a common and distressing condition deserves. I have been on a mission for some time now to raise awareness of this condition, which is 4-5 times more common in adult women than men and much more treatment resistant.

SGA ( Sebaceous Gland Ablation ) has been a godsend for our clients with Adult Acne and breakouts over the past four years and it is my goal for 2016, that everyone in Australia and New Zealand who has Adult Acne, will hear about SGA and find a permanent solution for their Acne and enjoy clear skin.

Wish me luck!

Vicky Eldridge breezed through her teenage years and twenties without so much as a blotch or blemish. But two years ago, aged 34, the unthinkable happened; she began to be plagued by spots.

“They started on my chin and came up around that time of the month, then lasted longer and longer until they were there all the time,” says Eldridge, now 36, who lives in Chelsea. “Dating was out of the question; I wouldn’t want to meet anyone with my face looking like that.”

“I tried everything to cover them up. Before then, I had always taken my nice, smooth skin for granted. I was miserable, embarrassed and self-conscious. I would apologise to friends in advance about it – if my skin was bad, I would even stay in. Dating was out of the question; I wouldn’t want to meet anyone with my face looking like that. I grew depressed, low and very emotional.”

As the editor of a beauty magazine and someone who prided herself on knowing how to look good, her shame was all the more marked; at worst, Eldridge would call in sick when she had a particularly “horrific” breakout.

And as extreme as her case sounds, Eldridge is just one of an increasing number of people in Western countries affected by adult acne, an affliction doctors and dermatologists agree is on the rise, largely due to an increase in stress and poor diet.

Dr Stefanie Williams, medical director of Eudelo (European Dermatology London), does not mince her words on the subject. “It is like an epidemic. We have so many sufferers [in this country]. It is important to acknowledge that it is a skin disease. It is not normal and not a right of passage.”

Indeed, a study of 92 private dermatology clinics last year found a 200 per cent rise in the number of adults seeking specialist acne treatment. A quarter of those who visit their doctor have skin problems – from acne to psoriasis or eczema – and women are five times more likely than men to be affected by late-life acne, due to fluctuating hormones during pregnancy, the menstrual cycle and changing methods of contraception (the pill, coil or patches) – Cameron Diaz and Victoria Beckham have, notably, suffered.

Acne is caused by the over-production of oil from sebaceous glands, usually driven by changes in hormone levels, leading to blocked and inflamed pores.

Low-level changes in stress have long been linked to problematic skin as the hormone cortisol contributes to breakouts. Dr Nick Lowe, a consultant dermatologist believes it is this stress that is fueling the rise, especially in women who are working full-time while simultaneously raising families. “There are so many triggers; perceived shortness of time, general instability in lots of parts of the world, women being pressured at both work and home.”

Eldridge agrees mounting stress was integral to the onset of her acne. “Skin is a reflection of what is going on in the inside and I was burning the candle at both ends. I was working long hours, partying and not sleeping enough. It was definitely a contributing factor.”

As well as causing physical scars, the emotional impact of poor skin can reverberate through relationships, work and home life. The British Skin Foundation found that 95 per cent of acne sufferers say it impacts their daily lives and 63 per cent experience lower self-confidence.

Vicky managed her acne with treatments and a strict diet
Vicky managed her acne with treatments and a strict diet 

Vicky switched to a diet with an emphasis on healthy eating and fresh vegetables. After committing to giving up alcohol and avoiding dairy and sugar, where possible, she finally saw an improvement in her skin.

After three months, her cystic acne subsided and a prescription vitamin A cream saw off the rest of her breakouts.

Now Eldridge is spot-free, 10 months sober and has been known to leave the house without make-up for the first time in years.

“It was a long slog and there was no one quick fix,” she says. “Making the dietary changes certainly had a dramatic impact and then the cream finished it off. I know it will need maintenance but my face looks amazing now and there is no scarring.”

Republished from The Telegraph London


Diet and Acne

University of Osnabrück researcher Bodo Melnik has published more evidence linking diet to the development of acne.

Melnik calls into question the pivotal role of androgens in acne development, calling insulin-like growth factor 1 (IGF-1) the main culprit. He supports his argument with the fact that while androgen levels remain high after puberty, IGF-1 levels drop off about the same time acne usually does.

Or at least, they should. The problem is that our Western diet, high in saturated fats, dairy and refined carbohydrates, can exacerbate and sustain IGF-1 levels such that acne comes on stronger and lasts longer than it should, even into adulthood. Melnik cites several populations that eat paleo-style diets who also happen to be acne free.

The irony is that while most of us grew up being told that a poor diet causes acne, scientists have spent the past decade or so refuting this. While the old wives tales weren’t exactly on the mark (I recall fatty foods and chocolate as being no-nos),they weren’t entirely wrong either. Rather than specific foods, dairy and foods high in saturated and/or trans fats should be avoided in general. Instead, the paleo-style diet recommended by Melnik includes lots of vegetables and low-glycemic fruits with plenty of fish, rich in anti-inflammatory fatty acids. Reservatrol, a compound found in wines also helps, but then again that’s not particularly helpful for acne sufferers not old enough to drink.

So for now, it does make sense for anyone with acne to cut out dairy and fatty foods, which is good for the waistline as well as your skin.

Pete Evans


If you want to learn more about the Paleo diet, chef Pete Evans is a great advocate and his website is https://www.thepaleoway.com.

Em Ford You Tube video

Em Ford has made a very powerful You Tube video in which she shows her skin un made up and the  nasty comments she received on Social Media about it, then she applies make up and displays both the positive and negative responses she received once her acne was covered up. The video has attracted 1.5 million responses and is very courageous, given that Em is a beautiful girl, with or without her make up.

Adult acne is very common in young adult women and is often treatment resistant. It is also a hidden problem as women with adult acne become very skilled at disguising it with make up.

My heart goes out to her and every other person who is plagued by breakouts and I feel very honoured to be able to help with this huge problem every day.


Sebaceous Hyperplasia

My post today is about Sebaceous Hyperplasia, a condition seen more commonly in middle age but it can affect young adults as well. It is a benign condition ( meaning it does not create any harm ) but it can be a significant cosmetic problem for some people. Each lesion appears on the surface of the skin as a lump, as each lesion is a sebaceous gland that has grown out onto the skin. In the centre of each lump is a pore, which is generally enlarged.

The biggest problem with Sebaceous Hyperplasia is that nobody treats it ( which I still find extraordinary ) and if you do find some one who does, the chances are they will over treat the lesions with a laser. Over the years I have had clients who have gone to multiple doctors only to be told there is nothing that can be done.

Well the good news is, there is something that can be done. Sebaceous Hyperplasia is very readily treatable with gentle diathermy ( a heat and seal treatment ) and provided the treatment is down very gently, the cosmetic result is very good.

Gentle Diathermy for Sebaceous Hyperplasia will be available at all my Clearskincare Clinics in the coming weeks.

Sebaceous hyperplasia 1

Sebaceous Hyperplasia

Best SGA Result

A big part of my job now is supervising more than 150 therapists around Australia and NZ who perform SGA. Every day I look at tens of photos of clients with Acne in all its guises. I particularly enjoy when therapists send me before and after photos of the success they had in treating a client with Acne. They are always as thrilled with the results as the client and have a tremendous sense of fulfilment. And sometimes a set of before and afters come to me that are so extraordinary I am as thrilled as them. So today I am sharing one such client with you all. OL came to us three months ago with severe breakouts and today he is well on his way to control following two SGA treatments, two peels and two LED light treatments as well as his home care, including Stieva A. The redness that he still has will fade over the next 6 to 9 months and in 12 months, his Acne will just be an unpleasant memory.OL before

OL after

OL before 1

OL after 1

OL before 2

OL after 2

More Great Results from SGA

This month will mark 3 years since I found SGA during a trip to a conference in Asia. I am constantly amazed at how few patients are referred to me by our Clinics, because SGA is not working for them. So far this year I have helped with 2 or 3 whose acne has not settled with 6 – 10 SGA treatments. Given we are treating thousands of patients with acne and breakouts, this is pretty remarkable. I have spent most of this year working out how to take SGA to the world as there are so many people who have chronic treatment resistant acne. I am hoping to launch a new website in the New Year which will offer online consultations, advice on where in-Clinic SGA is available and home based treatment in some countries.

In the meantime, here are a few more examples of the great results we are achieving with SGA.