Showing posts with label Fraxel. Show all posts
Showing posts with label Fraxel. Show all posts
Which Kind Of Under-Eye Circles Do You Have?
Dark circles are a common beauty problem, but not all under-eye circles are created equal. The color of your dark circles can help you decide what kind of treatment is most effective for your condition.
Is Skincare Enough? The Truth About Skin Care and Aging
The amount of skin care products available on the market is staggering, with existing brands releasing new ranges all the time, and new brands coming on to the market everyday. They are marketed for acne-prone, mature age, pigmented, oily, sensitive, combination skin, in too many varieties to count, each marketing a special ingredient or function. I know that when my wife visits the cosmetics and skin care counters, I'd better get a comfortable place to sit because it will be a long wait as she goes through her many options!
As an aesthetic practitioner, skin care is my expertise, so it is not unusual that I am asked this question: If I take care of my skin and have a good skin care regimen, am I doing enough for my skin to help it age well?
As an aesthetic practitioner, skin care is my expertise, so it is not unusual that I am asked this question: If I take care of my skin and have a good skin care regimen, am I doing enough for my skin to help it age well?
Collagen Supplements - Do They Really Work? What Does?
I've had many patients come to me and say they take excellent care of their skin,with a regimen that includes regular beautician visits, expensive skincare and that latest must-have - collagen supplements. Usually available in a drink, and costing up to USD100 per bottle, these supplements are not cheap, but come with a lot of promises for prolonged beauty and general health.
The body naturally produces the collagen that it needs, but this production is gradually disrupted as part of the natural aging process. Women produce less collagen than men, and this collagen is lost at a rate of about 1% per year. This means that a woman has naturally lost almost half of the collagen from her skin by the age of 50.
Collagen is also greatly affected by environmental stresses such as sun exposure, nutrition, skin damage, and exposure to toxins such as pollutants, cigarette smoke and recreational drugs. With decreased collagen, the skin loses its natural elasticity and firmness, and fine lines, wrinkles and sagging appear.
Poor collagen levels also affect the bones, and this picture (right) shows how collagen loss affects facial shape in extreme age degeneration.
Collagen supplements claim to offer a range of benefits, including
So many companies have jumped on the collagen bandwagon that it is very hard for consumers to realise that there is actually no scientific proof that collagen supplements have any effects on skin health and appearance at all. There is no guarantee that drinking collagen drinks would be any more effective than any source of protein such as meat, cheese, eggs or beans at restoring the collagen in your skin.
So if you can't get collagen through a drink, what about collagen in skin care products? Most collagen molecules applied to the skin in lotion, cream or gel forms are far too large to be absorbed into the dermis - they merely lie on the surface and get washed or rubbed off. There are some companies that are selling micronized collagen which are meant to be small enough to be absorbed into the skin, but it is unlikely these micro molecules would be in any form useable by skin cells. It is also highly likely that any collagen that actually manages to penetrate the skin would be challenged by the body's immune system as a foreign body. They would either cause an allergic reaction or simply be destroyed by the white blood cells before they manage to be of any benefit to the skin whatsoever.
Reduce collagen degradation
To ensure sufficient collagen in the skin, first prevent loss of the collagen that you already have. If you are not already on a proper sun care regimen, that should be your first priority. Studies have shown that sun protection is one of the most important ways in which you can combat aging. Cigarette smoke, like sun exposure, has also been shown to greatly degenerate collagen, and there is also evidence that improper and insufficient sleep has a negative effect on skin health. Read more about tips for choosing a good sunscreen in this previous post.
A nutritious diet
Eating the right foods and getting good sources of antioxidants from fruits and vegetables is very important for collagen production. Brightly coloured produce such as tomatoes, grapefruit and watermelon contain the powerful antioxidant lycopene, which helps prevent collagen degeneration. Fruits such as oranges, strawberries and red peppers also contain Vitamin C, something that is key for the optimum condition of the skin. Vegetables such as broccoli, leafy greens and cauliflower provide our skin with glucosinolates, which fight the free radicals that attack our collagen. Also key to skin health is the omega-3 fatty acid known as eicosapentanoic acid or EPA, which has anti-oxidative and anti-inflammatory effects to help protect and heal the skin. Omega-3 is readily available from food sources such as oily fish and spirulina. Avoid starchy foods and sugary substances; this helps
reduce inflammation which interferes with the body's natural collagen production processes.
Proper skin care
The right skin care helps regulate the optimum skin condition so that it is protected from extreme stresses. What works? Regular exfoliation with a gentle exfoliator scrub, or with alphahydroxy acids (AHAs) can help to 'exercise' the skin, and ensure healthy cell renewal. Skin care products that have been proven to help combat aging include products that have antioxidant properties, examples of which include green tea extracts, coffeeberry and DHEA. Try products with retinol, a Vitamin A derivative, sometimes known as Retin-A, which works to both stop collagen degradation from the effects of UV exposure while boosting collagen production.
Collagen Stimulating Dermal Fillers
Hyaluronic acid, a natural water-binding component of the skin, helps to stimulate collagen production by surrounding fibroblasts - the skin cells that produce collagen - with plenty of water. As the skin ages, this important component of the skin also suffers a decline.
Researchers at the University of Michigan medical school found that Restylane injections (Restylane's key component is hyaluronic acid) not only stimulated the fibroblasts around them to increase collagen output, but also seemed to be protective of the existing collagen in the area as well. The two top hyaluronic acid dermal filler brands are Restylane and Juvederm, and they work by immediately filling the area to plump out lines and wrinkles. The effects of the filler are enhanced by the collagen stimulation, so patients tend to need repeat sessions less frequently.
Just like hyaluronic acid, poly-L-lactic acid or PLLA, has been shown to stimulate collagen growth. PLLA is a major component in Sculptra dermal fillers, which are injected deep into the dermal layer in a three-session treatment program which lasts up to two years. Sculptra has been proven to correct both collagen loss and fat atrophy, and is also FDA approved for AIDS patients who have severe cheek lipoatrophy (fat loss).
Radiesse, which has calcium hydroxylapatite as its collagen stimulating active ingredient, is another dermal filler that works very effectively in restoring volume in patients with deep lines or sagging skin. The effects of the collagen stimulation allows the volumising effect of Radiesse to last for about 12 months or more.
Laser and RF collagen stimulation
Collagen production slows with the aging process, but where the skin is injured, collagen production is increased as part of the skin healing process. Aesthetic equipment such as carbon dioxide and Fraxel lasers, and radiofrequency modalities such as Thermage and Ultherapy all work by subjecting the skin to controlled damage, so that collagen renewal can be stimulated. All of these methods work very well to tighten the skin and improve its appearance, although lasers are designed to stimulate regrowth on the surface and epidermal (top layer) areas, and radiofrequency skin tightening works in the deeper dermal areas for greater wrinkle and line rejuvenation.
- Cosmetic Medicine, MD
Dr. Liow Tiong Sin is an aesthetic practitioner who practices in Kuala Lumpur and Melaka, Malaysia. He has more than 12 years of expertise with non-surgical cosmetic treatments, and conducts training courses for other doctors from all around Asia. To connect with Dr. Liow, Like Cosmedmd's Facebook page. medical centre website or drop him an email at cosmedmd@gmail.com
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| Old or young? The difference is collagen |
Collagen - is it really so important?
Collagen is a natural protein component of the skin that acts like a scaffold and the main building block for cells, tissues and organs. About a third of the protein content in your body is made up of collagen, which is found in the bones, muscles, and tissues of the organs. Collagen, keratin and elastin give the skin its strength, elasticity and structure.The body naturally produces the collagen that it needs, but this production is gradually disrupted as part of the natural aging process. Women produce less collagen than men, and this collagen is lost at a rate of about 1% per year. This means that a woman has naturally lost almost half of the collagen from her skin by the age of 50.
Collagen is also greatly affected by environmental stresses such as sun exposure, nutrition, skin damage, and exposure to toxins such as pollutants, cigarette smoke and recreational drugs. With decreased collagen, the skin loses its natural elasticity and firmness, and fine lines, wrinkles and sagging appear.
Poor collagen levels also affect the bones, and this picture (right) shows how collagen loss affects facial shape in extreme age degeneration.
Here's to your youth - anti-aging drinks claim to deliver beauty in a bottle, but do they really work?
- reducing wrinkles
- reversing age of skin
- tighter skin
- plumps up skin
- improves skin elasticity
So many companies have jumped on the collagen bandwagon that it is very hard for consumers to realise that there is actually no scientific proof that collagen supplements have any effects on skin health and appearance at all. There is no guarantee that drinking collagen drinks would be any more effective than any source of protein such as meat, cheese, eggs or beans at restoring the collagen in your skin.
So if you can't get collagen through a drink, what about collagen in skin care products? Most collagen molecules applied to the skin in lotion, cream or gel forms are far too large to be absorbed into the dermis - they merely lie on the surface and get washed or rubbed off. There are some companies that are selling micronized collagen which are meant to be small enough to be absorbed into the skin, but it is unlikely these micro molecules would be in any form useable by skin cells. It is also highly likely that any collagen that actually manages to penetrate the skin would be challenged by the body's immune system as a foreign body. They would either cause an allergic reaction or simply be destroyed by the white blood cells before they manage to be of any benefit to the skin whatsoever.
What really works?
The abundance of collagen supplements on the market tells us that many people are genuinely concerned about their skin health. So, based on the best dermatological and anti-aging expert advice, what can be done to ensure we show up at our 20-year school reunions with our best faces forward?Reduce collagen degradation
To ensure sufficient collagen in the skin, first prevent loss of the collagen that you already have. If you are not already on a proper sun care regimen, that should be your first priority. Studies have shown that sun protection is one of the most important ways in which you can combat aging. Cigarette smoke, like sun exposure, has also been shown to greatly degenerate collagen, and there is also evidence that improper and insufficient sleep has a negative effect on skin health. Read more about tips for choosing a good sunscreen in this previous post.
A nutritious diet
Eating the right foods and getting good sources of antioxidants from fruits and vegetables is very important for collagen production. Brightly coloured produce such as tomatoes, grapefruit and watermelon contain the powerful antioxidant lycopene, which helps prevent collagen degeneration. Fruits such as oranges, strawberries and red peppers also contain Vitamin C, something that is key for the optimum condition of the skin. Vegetables such as broccoli, leafy greens and cauliflower provide our skin with glucosinolates, which fight the free radicals that attack our collagen. Also key to skin health is the omega-3 fatty acid known as eicosapentanoic acid or EPA, which has anti-oxidative and anti-inflammatory effects to help protect and heal the skin. Omega-3 is readily available from food sources such as oily fish and spirulina. Avoid starchy foods and sugary substances; this helps
reduce inflammation which interferes with the body's natural collagen production processes.
Proper skin care
The right skin care helps regulate the optimum skin condition so that it is protected from extreme stresses. What works? Regular exfoliation with a gentle exfoliator scrub, or with alphahydroxy acids (AHAs) can help to 'exercise' the skin, and ensure healthy cell renewal. Skin care products that have been proven to help combat aging include products that have antioxidant properties, examples of which include green tea extracts, coffeeberry and DHEA. Try products with retinol, a Vitamin A derivative, sometimes known as Retin-A, which works to both stop collagen degradation from the effects of UV exposure while boosting collagen production.
Collagen Stimulating Dermal Fillers
Hyaluronic acid, a natural water-binding component of the skin, helps to stimulate collagen production by surrounding fibroblasts - the skin cells that produce collagen - with plenty of water. As the skin ages, this important component of the skin also suffers a decline.
Researchers at the University of Michigan medical school found that Restylane injections (Restylane's key component is hyaluronic acid) not only stimulated the fibroblasts around them to increase collagen output, but also seemed to be protective of the existing collagen in the area as well. The two top hyaluronic acid dermal filler brands are Restylane and Juvederm, and they work by immediately filling the area to plump out lines and wrinkles. The effects of the filler are enhanced by the collagen stimulation, so patients tend to need repeat sessions less frequently.
Just like hyaluronic acid, poly-L-lactic acid or PLLA, has been shown to stimulate collagen growth. PLLA is a major component in Sculptra dermal fillers, which are injected deep into the dermal layer in a three-session treatment program which lasts up to two years. Sculptra has been proven to correct both collagen loss and fat atrophy, and is also FDA approved for AIDS patients who have severe cheek lipoatrophy (fat loss).
Radiesse, which has calcium hydroxylapatite as its collagen stimulating active ingredient, is another dermal filler that works very effectively in restoring volume in patients with deep lines or sagging skin. The effects of the collagen stimulation allows the volumising effect of Radiesse to last for about 12 months or more.
Laser and RF collagen stimulation
Collagen production slows with the aging process, but where the skin is injured, collagen production is increased as part of the skin healing process. Aesthetic equipment such as carbon dioxide and Fraxel lasers, and radiofrequency modalities such as Thermage and Ultherapy all work by subjecting the skin to controlled damage, so that collagen renewal can be stimulated. All of these methods work very well to tighten the skin and improve its appearance, although lasers are designed to stimulate regrowth on the surface and epidermal (top layer) areas, and radiofrequency skin tightening works in the deeper dermal areas for greater wrinkle and line rejuvenation.
- Cosmetic Medicine, MD
Dr. Liow Tiong Sin is an aesthetic practitioner who practices in Kuala Lumpur and Melaka, Malaysia. He has more than 12 years of expertise with non-surgical cosmetic treatments, and conducts training courses for other doctors from all around Asia. To connect with Dr. Liow, Like Cosmedmd's Facebook page. medical centre website or drop him an email at cosmedmd@gmail.com
How To Age Like A Celebrity And Look 30 Forever
There are some lucky people who never seem to face the ravages of time. Celebrities like Madonna, Tina Turner and Demi Moore are some examples, and despite being over 50, they manage look better than people 20 years their junior.
Aging is a process that is greatly affected by genes, environment, sleep habits and diet to name just a few factors, but since this is a cosmetic medicine blog, and my patients come to me to reverse the effects of time rather than prevent them, let's examine exactly how a face ages.
As the face ages, it undergoes significant and visibly identifiable changes. It begins with weathering of the skin, and changes to the texture, transluscence and variance in skin colour in the mid twenties. By the mid thirties, furrows and lines are visible in forehead and near the eyes. Loss of fat from the temples and upper cheeks may show by the age of forty, and the undereye area is one tell-tale sign of aging as the skin begins to sag and pouch. The neckline is also an age giveaway as it becomes loose and baggy during the fifties. By the sixties, the skin is noticeably lined and very loose and saggy as the cheek fat atrophies.
Lipoatrophy, the loss of fat in the underlying facial structures means the facial skin begins to sag, the cheeks become sunken and gaunt, facial shadows become more pronounced and lips become flatter and thinner, jowls appear on the sides of the face, and the neckline is visibly looser.
The Fix: Thread lifting, fillers, Thermage
Thread lifting for jowls and sunken cheeks
Fillers for deep lines and for plumping cheeks, lips and sunken areas
Thermage for overall facial rejuvenation and collagen remodelling
2. Skin texture and pigmentation
Environmental effects such as sun exposure and air pollution, as well as hormonal changes and effects of diet all play a part in the appearance of the skin as we age. The skin also gets thinner and fine lines appear, while melanin deposits and surface damage all contribute to obscure the glow of healthy, young skin.
The Fix: Skin resurfacing
3. Wrinkles and lines
Wrinkles appear in forehead, eye, cheek and around the mouth, as a result of the loss of fat and also due to constant muscle movements.
The fix: Botulinum-A injections
There are many exciting techniques for holding back the ravages of time, and ensuring you look your best, even into your 50s and 60s. These treatments are best used in combination, for a natural look that is purely you, but just younger, brighter and refreshed, so you too, can look and feel like a star, no matter your age.
Cosmetic Medicine, MD
Dr. Liow Tiong Sin is an aesthetic practitioner who practices in Kuala Lumpur and Melaka, Malaysia. He has more than 12 years of expertise with non-surgical cosmetic treatments, and conducts training courses for other doctors from all around Asia. To connect with Dr. Liow, Like Cosmedmd's Facebook page. medical centre website or email.
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| Christy Brinkley will celebrate her 58th birthday this year, but her looks remain forever 30. |
Aging is a process that is greatly affected by genes, environment, sleep habits and diet to name just a few factors, but since this is a cosmetic medicine blog, and my patients come to me to reverse the effects of time rather than prevent them, let's examine exactly how a face ages.
 |
As the face ages, it undergoes significant and visibly identifiable changes |
As the face ages, it undergoes significant and visibly identifiable changes. It begins with weathering of the skin, and changes to the texture, transluscence and variance in skin colour in the mid twenties. By the mid thirties, furrows and lines are visible in forehead and near the eyes. Loss of fat from the temples and upper cheeks may show by the age of forty, and the undereye area is one tell-tale sign of aging as the skin begins to sag and pouch. The neckline is also an age giveaway as it becomes loose and baggy during the fifties. By the sixties, the skin is noticeably lined and very loose and saggy as the cheek fat atrophies.
How to Turn Back The Clock
1. Loss of volumeLipoatrophy, the loss of fat in the underlying facial structures means the facial skin begins to sag, the cheeks become sunken and gaunt, facial shadows become more pronounced and lips become flatter and thinner, jowls appear on the sides of the face, and the neckline is visibly looser.
The Fix: Thread lifting, fillers, Thermage
Thread lifting for jowls and sunken cheeks
Fillers for deep lines and for plumping cheeks, lips and sunken areas
Thermage for overall facial rejuvenation and collagen remodelling
2. Skin texture and pigmentation
Environmental effects such as sun exposure and air pollution, as well as hormonal changes and effects of diet all play a part in the appearance of the skin as we age. The skin also gets thinner and fine lines appear, while melanin deposits and surface damage all contribute to obscure the glow of healthy, young skin.
The Fix: Skin resurfacing
3. Wrinkles and lines
Wrinkles appear in forehead, eye, cheek and around the mouth, as a result of the loss of fat and also due to constant muscle movements.
The fix: Botulinum-A injections
There are many exciting techniques for holding back the ravages of time, and ensuring you look your best, even into your 50s and 60s. These treatments are best used in combination, for a natural look that is purely you, but just younger, brighter and refreshed, so you too, can look and feel like a star, no matter your age.
Cosmetic Medicine, MD
Dr. Liow Tiong Sin is an aesthetic practitioner who practices in Kuala Lumpur and Melaka, Malaysia. He has more than 12 years of expertise with non-surgical cosmetic treatments, and conducts training courses for other doctors from all around Asia. To connect with Dr. Liow, Like Cosmedmd's Facebook page. medical centre website or email.
Understanding Melasma
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| Melasma |
What is melasma?
Melasma typically occurs in three patterns: centro-facial - occurring on the forehead, cheeks, upper lip, nose and chin areas, malar - occurring on the upper cheek areas and mandibular - which is specific to the jaw line and sides of the cheek.
Melasma differs from freckles in that freckles are generally spread over wide areas of the face and occur as small, darkened spots of various sizes. Melasma that occurs in the epiderrmis (top layers of skin) responds better to treatment than dermal melasma.
As melasma can build up very gradually over a number of years, proper diagnosis and treatment may not be sought until the melasma is at a very advanced or pronounced stage. Early stages of the condition may be only visible with the use of a Wood's lamp or computerised facial analysis system.
Treatment of melasma
Melasma treatment can be very difficult, as the pigmentation can be worsened with the wrong care. Physicians may choose to explore different options as different patients respond to different types of treatment. Epidermal melasma is the easiest to treat, with dermal melasma often recurring very rapidly after cessation of treatment. Hence, identification of melasma type can be a very important factor in Here are some clinically-tested treatments for melasma that are the best available on the Asian market at the moment.
Tri-Luma
Tri-Luma is an FDA-approved treatment for melasma. It is a topical cream treatment for melasma that is well-tolerated and works well for most patients. It is a combination of hydroquinone - a lightening agent, Tretinoin - vitamin A derivative, and fluocinolone - an anti-inflammatory agent, and can be very effective if properly used.The cream is applied to the affected areas once daily, and is effective within 6 - 8 weeks of use.
Cosmelan
Cosmelan is a facial mask treatment that works on facial pigmentation by inhibiting tyrosinase, an enzyme in the melanin formation process. The mask is applied by a doctor, and it is left on for a set number of hours depending on each patient's requirements. Peeling of the skin occurs on the second day of treatment, and usually resolves within the next few days to leave the skin clearer, smoother and more refined.The treatment is combined with a topical skin treatment that the patient applies at home.
Fraxel
The Fraxel Re:store DUAL laser is the only laser that is FDA approved for the treatment of melasma. The treatment for melasma differs from that of other conditions, so it is important that the proper settings for melasma are used when Fraxel is given. In certain cases, the wrong Fraxel settings can result in a worsening of the melasma. Patients may be given a topical treatment such as Tri-Luma for pre- or post-treatment care. Treatments are typically given monthly for a three to four month period, and a few days' downtime as the skin darkens and peels is normal after every treatment.
IPL
IPL or Intense Pulsed Light is a very commonly found therapy that even beauty salons are offering today. While there are many horror stories of botched treatments and intensification of melasma pigmentation after such treatments, studies have shown that melasma can be very effectively treated with the right settings and protocol on an IPL machine. Li, et al. showed in a 2008 study conducted at the China Medical University in Shenyang, China, that 69 out of 89 Chinese women suffering from melasma, obtained a 51% to 100% improvement in their condition after a total of four IPL treatments in 3 week intervals.
Melasma can be successfully treated, but improvement usually takes time and repeated treatments,and may require a combination of different modalities for full effectiveness. Proper sun care, with sun avoidance, usage of hats or covers or high SPF sunscreen is a very important factor for successful resolution of the problem. In many cases, unless exposure to the sun or to hormonal factors can be minimised, melasma will recur after the prescribed treatment.
CosMed, MD
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