5 Things You Can Do to Have Healthy Skin in the COVID-19 Circuit Breaker

5 Things You Can Do to Have Healthy Skin in the COVID-19 Circuit Breaker

The recent COVID-19 Circuit Breaker means that a lot of us have now either brought our work home, or are on a period of extended leave. It also means that we are now not able to go for our routine facials and skin treatments. 

How can we keep our skins looking healthy and not look like we aged a decade when we complete this month-long social segregation?

Below we share five things we can do to keep our skins supple and healthy in this period. 

1. Hydration

Now that we are stuck at home, whether working or not, “having no time” is no longer an excuse for skipping or forgetting that all important H2O that we too often have no time for. Water is one of the most important liquid to drink as it acts as a transporter and is also an important substrate in many of our body processes.

For our skin, water keeps it hydrated and youthful looking by filling and plumping up the hyaluronic acid molecules bounded within the collagen fibres in our skin. It can also improve complexion and early fine line and dull skin.

It can also help weight loss by replacing our modern day calorific rich drinks such as sodas, sweetened coffees etc. 

2. Balanced Diets

Being asked to stay at home does not mean we can relax on our diets. In fact, it may be a good time to assess our diets and ask ourselves if we are eating as healthy as we ought to be. With the decreased energy expenditure now that we are not commuting daily to work, or for those of us who have a job scope that is more physically active, now that our days are more sedentary, it is important that we try to cut out as much as possible refined and processed foods.

Swap a meal for a healthy salad, or do that home cookout instead of reaching over to your phone for the next takeout meal. These will allow us to incorporate into our diets more antioxidant-rich foods that have been proven to push back ageing while removing the refined, processed and sugary ones that are now known to add years onto our skin and health. 

3. Exercise

Now that we have time to plan our day out, including an exercise session at least 3 times a week can help not just our health, but also our skin. Exercise is great for the body and mind, and can also do wonders for our complexion.

Sweating can help flush out toxins from our pores. Do be aware to wash after a session, as leaving sweat, dirt and sebum on your skin can cause breakouts and sensitivity. By working out, we can also maintain healthy levels of the stress hormone cortisol and help stimulate collagen production to keep our skin firm and supple.

Improving muscle tone can also make our skin look firmer and reduce the appearance of cellulite. There is also the post-workout glow which happens when our skin receives a good dose of oxygenated blood and our skin starts producing its natural oils. 

4. Get Sufficient Rest and Sleep

One of the things most of us loathe on a workday is needing to sleep late and wake up early. There is now little excuse to deprive our bodies of its much-needed sleep. Benefits of sleep for skin include fewer wrinkles, less sagging, rejuvenated colour, fewer acne blemishes and less inflammation. The reasons for these are many, but some of them are because the skin repairs itself at night.

During this overnight process, our skin builds collagen, elastin and hyaluronic acid, all of it responsible for our skin’s plumpness, translucency and elasticity. Getting sufficient sleep also boosts our immune system and reduces the stress hormone cortisol which then reduces our propensity to developing acne and inflammation.

Increased blood flow during sleep into our facial area also helps remove free radicals and pollutants accumulated throughout the day and helps repair any damage incurred and restore our complexions to a radiant colourful glow.

5. Overhauling Our Skincare Regimen

Now that we are deprived of our weekly/fortnightly facials, we need a skincare regimen that can continue to target our active skin issues whilst protecting us against oxidative stressors and ageing. How do we go about this? 

a) Select your skincare products based on your skin type and lifestyle, e.g. cleansers should not only suit your skin type, but also be sufficient in removing the type and amount of makeup that you use, or in removing any type of occupational exposures. Foaming liquids are generally suitable for people with oily or acne-prone skin, whilst micellar water are more suitable for individuals with normal skin. Mature skin may require cleansers that are more moisturizing such as a melting balm or cream-based cleanser.

b) Gone are the days of toners being an alcohol-based product used for drying up oily skin and removing any leftover dirt after cleansing. In the modern day regimen, toners are a good way to add in specific ingredients that you may not have in your other products. These can be alpha and beta hydroxy acids, hyaluronic acids, vitamins or even simple things such as rose water. They should be done after cleansing, before putting on anything else.

c. Serums are powerful skin allies which we can use to address specific issues, such as pigmentation, dark spots or wrinkles. These are usually applied after your toners but before moisturizers. Some ingredients to look out for are hyaluronic acid to seal in moisture, vitamin C to brighten dull skin and decrease dark spots, retinol, vitamin B3 and peptides for anti-ageing.

d. Moisturizers should like cleansers, be selected based on your skin type and lifestyle. Everyone needs moisture but the texture of your moisturizer will differ based on your skin type. What a moisturizer should provide however is to protect your skin from environmental aggressors and replenish moisture levels.

e. Protecting your skin with a sunscreen. It goes without saying that sunscreen is hands down the most crucial skincare product. Daily and consistent use of sunscreen helps to prevent the development of fine lines and wrinkles, textural imperfections and changes in the appearance of pores over time.

With these, we hope that you are now better equipped to deal with the different set of challenges that the COVID-19 Circuit Breaker throws our skin. Let us all be consistent, and take good care of our health, well-being and skin during this difficult period. 

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10 Hydroquinone Alternatives

Hydroquinone is one of the most famous whitening agents. It is most studied to date, and very effective. However, it does have some serious side effects, can be irritating to skin and has been heavily restricted in some countries. 

Today, we look at some of the other whitening agents on the market, how they work and what side effects they have. 

HOW DO SKIN WHITENING AGENTS WORK?

Whitening agents in the market work in a number of different ways, some in more than one way. But most will generally slow down the production of melanin, which is what gives our skin it’s colour and tone.

The agents available on the market generally work by acting on the first step of melanin synthesis – the conversion of tyrosine into DOPA and dopaquinone by an enzyme called tyrosinase. They work by either:

  • Acting as a mimic of tyrosine – essentially keeping tyrosinase too busy to produce as much melanin as before (hydroquinone, mequinol, azelaic acid, arbutin, licorice extract) 
  • Blocking off important copper ions in tyrosinase and thus preventing the enzyme from working (kojic acid) 

There are also other ingredients that can reverse or slow down hyperpigmentation using other pathways: 

  • Slowing down production of the tyrosinase enzyme (N-acetylglucosamine)
  • Reversing the reaction that tyrosinase does (ascorbic acid/Vitamin C)
  • Slowing down maturation of melanosomes (arbutin and derivatives)
  • Preventing melanin from travelling from melanocytes to skin cells (soy, niacinamide, retinoids)
  • Dispersing pigments (licorice extract)
  • Increasing skin turnover, meaning less pigments to go around (alpha and beta hydroxy acids, retinoids) 

There are also other ingredients that can reverse or slow down hyperpigmentation using other pathways:

In general, side effects are less of a concern for less effective ingredients, but combining different agents may result in a more potent product without too much irritation. 

Below, we investigate the agents individually: 

1. Mequinol

Mequinol is the main alternative prescription alternative to hydroquinone. It is not entirely clear how mequinol works, but it seems similar to hydroquinone in that it mimics tyrosine and decreases tyrosinase’s ability to produce melanin. It comes in concentrations of 2% and sometimes in combination with 0.01% tretinoin and ascorbic acid to enhance penetration.

It is supposed to be less irritating than hydroquinone but can sometimes cause temporary postinflammatory hyperpigmentation (PIH). Rarely, it can lead to reversible depigmentation. 

2. Retinoids

Retinoids are Vitamin A analogues used for treating many conditions such as acne, sun damage as well as acting as a penetration enhancer for other treatments. Examples are: tretinoin, adapalene, tazarotene, isotretinoin (prescription) and retinol (non-prescription).

Retinoids are thought to work in multiple pathways to reduce pigmentation, including increased skin turnover, interruption of melanin transfer to skin cells, reduced tyrosinase production in skin and dispersal of melanin. Retinoids are commonly used in combination with other treatments for hyperpigmentation as on their own, they can take several months to achieve results.

In general, the more effective a retinoid is, the more irritating its side effects. Common side effects include redness, dryness and peeling. PIH is also a risk, especially in darker skin. 

3. Azelaic Acid

Azelaic acid is another common alternative to hydroquinone. It is produced by a fungus which sometimes infects humans and causes light patches of skin. It is slightly milder than hydroquinone but in combination with retinoids, can come close to the effects of hydroquinone.

Azelaic acid works by interfering with tyrosinase activity as a tyrosine mimic, and suppresses and kills abnormal melanocytes. It is known for its lack of side effects, which are mild stinging and redness. 

4. Arbutin

Arbutin is sometimes also known as the “natural hydroquinone”. Its chemical structure is very similar to hydroquinone. It is found in extracts of bearberry leaves and to a lesser extent in cranberry and blueberry leaves.

It works in our bodies by slowly turning into hydroquinone and acting as a tyrosine mimic to slow down production of melanin. It also interferes with maturation of melanosomes. Results from studies on its efficacy are mixed.

The most common formulation is 5% although there are higher formulations. Higher concentrations of arbutin increase the risks of PIH. 

5. Kojic Acid

Kojic acid is produced by bacteria in the fermentation of rice in the manufacture of Sake.

A derivative of kojic acid, kojyl-APPA has also been investigated on its whitening effect and improved skin penetration. It works by binding to copper in tyrosinase, preventing the enzyme from performing its role in the production of melanin.

It is often combined with hydroquinone, retinoids, glycolic acid, emblica extract or corticosteroid. It is very irritating and is a potential allergen. Preparations typically include steroids to reduce the chances of a reaction. 

6. Licorice Extract

Licorice extract is extracted from the root of the licorice plant (Glycyrrhiza glabra) and is widely used as a whitening ingredient in cosmetics. It contains a number of antioxidants and anti-inflammatory chemicals. Its main effects are through two whitening components, glabridin and liquirtin.

Glabridin protects skin from UV-B induced pigmentation whilst also acting on tyrosinase to slow down melanin production. Liquirtin disperses melanin. Licorice extracts are mild and have few side effects, likely due to its anti-infammatory and anti-irritant ingredients. 

7. Ascorbic Acid (Vitamin C)

Vitamin C is an ingredient in many skincare products. It is a potent antioxidant, but is very unstable and is usually combined with other ingredients.

Vitamin C works by turning dopaquinone back into L-DOPA, undoing the reaction that tyrosinase does. It is less irritating than hydroquinone and has an excellent safety profile. 

8. N-Acetylglucosamine

N-acetylglucosamine is a sugar found abundantly in nature and is a precursor of hyaluronic acid. It works by slowing down the production of tyrosinase, which is a crucial enzyme in the synthesis of melanin.

It has been found to improve pigmentation at 2% in clinical studies and is often used in conjunction with niacinamide. It can cause mild to moderate skin irritation occasionally. 

9. Niacinamide

Niacinamide is also known as nicotinamide and Vitamin B3. It is an antioxidant but unlike vitamin C, it is very stable. It works by inhibiting the transfer of pigments to skin cells. 2-5% is the typical concentration and has been found to be effective in reducing hyperpigmentation in several studies. Some skin irritation can occur. 

10. Cysteamine

Cysteamine is a new kid on the block when it comes to pigments. It is a chemical compound that can be biosynthesized in mammals (this includes humans) by degradation of co-enzyme A. It was conventionally used as a treatment for cystinosis.

Recently, ScientisPharma had compounded it into a 5% cream for treatment of hyperpigmentation and to lighten skin overall. Cysteamine is a metabolite of L-cysteine which inhibits melanin synthesis. The ways it is thought to work through includes inhibition of tyrosinase and peroxidase, scavenging of dopaquinone, chelation of iron and copper ions and increasing intracellular glutathione.

Randomized controlled trials have confirmed the efficacy of cysteamine cream in treatment of epidermal melasma, a hyperpigmentation disorder. Side effects are generally mild, with temporary heating up or burning sensation and redness that is typically short-lived. 

In Conclusion

That is 10 alternatives to hydroquinone for hyperpigmentary disorders, all with different modes of action. If you are wary of hydroquinone, or your skin cannot handle it, there are still plenty of options for treatment of hyperpigmentation. Feel free to speak to your doctor if you have concerns with hydroquinone or if there is pigmentation on your face that you are concerned about. 

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Profhilo vs Skinboosters vs Rejuran

This is one of the most commonly asked questions by patients when it comes to skin injectables. If you happen to not know any of the treatments on the title, you can refer to one of our posts here: 

Why did we compare these treatments? 

These 3 treatments are similar in a few ways, and to the layperson, it is also these similarities that confuse us to think that they are the same:

  1. They are all injectable treatments, usually delivered in the form of multiple injections on the skin of the face either manually or with an injector. 
  2. They improve ageing skin which typically is plagued with dryness, fine lines, and laxity. 
  3. They do not change the shape of our faces. 
  4. Profhilo and Skinboosters both contain hyaluronic acid (HA) like dermal fillers, but due to structural differences, they do not add to volume in the face. 

So, which treatment is the best? 

Well, there is no right answer to this question. Profhilo is not better than skin boosters and vice versa, and the same applies to Rejuran. The right question to ask rather is: 

“Which is the best treatment for me?”

All 3 treatments have their own special qualities and have been proven to be effective in their respective domains, giving significant results if done properly. More importantly, it is imperative and essential that the treatment that is chosen is best suited to target the patient’s unique skin needs and concerns. These concerns could be skin laxity, dryness, skin texture, pore size, scars, uneven skin tone or even all of them. 

Below, we will first look at some basic differences between these 3 products: 

InjectableHA contentPain ScoreFrequencyEffects
Profhilo64mg/syringe2ml
per syringe		2/102 sessions,
1 month apart		Hydration
Plumps skin
Improves skin quality
Reduces skin laxity
Modest lifting effect
Skinboosters15-20mg/syringe1ml/syringe4/103-4 sessions,
1 month apart		Hydration
Skin brightening
Rejuran Healer0mg2ml/syringe6/103-4 sessions,
1 month apart		Improve skin quality
Minimal hydrating effect

So, who will benefit from which treatment?

Skinboosters

What are skinboosters and who will benefit most from Skinboosters?

Skinboosters are colloquially known as injectable moisturizers. It is a treatment that is based on multiple micro-injections of free hyaluronic acid into the skin to increase the hydration level in the skin. HA is a water-binding molecule that is able to hold up to 10,000 times its own weight in water. Common brands include Restylane Vital Lite and Teosyal Redensity I. 

Patients who primarily want to improve skin dryness as well as want some glow and radiance to their complexion will benefit most from skinboosters.

A course of skin booster treatment involves 3 sessions one month apart to achieve long-lasting radiance. Downtime is typically 3-5 days due to the many injection points and depth of injection, typically as small injection marks, although bruising is also a possibility. Skin boosters can be administered via manual hand injections by your doctor or using an injector, or a mixture of both. 

Rejuran

What is Rejuran and who will benefit most from Rejuran?

Rejuran is an injectable based on polynucleotide derived from Salmon DNA from Korea. Its main benefits are creating skin healing and collagen synthesis. 

Patients who have acne scars, open pores, sensitive skin, uneven skin tone as well as redness stand to benefit most from Rejuran injections. 

Rejuran injections also require a minimum of 3 sessions, one month apart. Due to the superficial nature of the injections – it is placed in the superficial layer (basement membrane) of the skin, patients get “mosquitoes bites-like bumps” immediately after treatment that typically take 24-48 hours to subside. Injection marks may remain for up to 3 days, but bruising is exceedingly rare. 

Profhilo

What is Profhilo and who will benefit most from Profhilo? 

Profhilo is an injectable based on both high molecular weight and low molecular weight HA which had been treated with just thermal reaction to form hybrid cooperative complexes. It works by multilevel dynamic remodelling, and hence in addition to skin hydration, it also stimulates collagen production and improves skin laxity. 

Patients with ageing skin that is affected by both dryness, laxity and loss of elasticity with early sagging will benefit most from Profhilo treatment. 

Profhilo requires 2 sessions one month apart due to the presence of cooperative hybrid complexes which renders it more resistant to hyaluronidase breakdown. 

Profhilo also has the advantage of requiring only 5 injection points on each side of the face using the Bio-Aesthetic Points (BAP) technique which means the treatment only causes minimal downtime in the form of swelling over the injection points that usually subside within the day. In all 3 treatments, Profhilo has the least downtime due to this. 

Below is a summary table comparing the 3 products 


ProfhiloSkinboosterRejuran
IngredientsH-HA & L-HAFree HAsPolynucleotides
BenefitsHydration
Multilevel bio-remodelling
Collagen+Elastin production		HydrationRadianceSkin barrier rejuvenationSkin repairCollagen production
TargetAgeing skin with laxity and early saggingDry skinSensitive skin, open pores, acne scars, uneven skin tone, redness
Age group30-50yo for anti-ageingSagging thinned skin20yo above with dry, dehydrated dull skin20yo above with problematic, acne or sensitive skin
Administration BAP techniques – 5 injections per sideMultiple manual microinjections with hand or injectorMultiple manual microinjections with hand or injector
Treatment Regime2 sessions, 4 weeks apart3-4 sessions 1 month apart3-4 sessions 1 month apart
Duration of efficacy6-9 months6 months6 months
DowntimeMinimal downtime – mild swelling on injection pointsInjection marks 3-5 days with risk of bruisingInsect bite like swelling for 24-48 hours, injection marks 2-3 days
Treatment areasFace, neck, décolletage, arms, handsFace, neck, décolletage, handsFace, neck, hands
Combination with other treatmentsYesYesYes
Pain Score+++++++++
Price$$$$$$$

So, which treatment is right for you? 

This really depends on your skin concern and what you are looking to achieve with treatment. There is no “one size fits all” solution in aesthetic practice and it is always advisable to speak in detail with your doctor about what you want to achieve. 

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SAC Teleconsult

Teleconsult

Get your skin and aesthetic concerns checked from wherever you are!

In light of the COVID-19 social distancing measures, we are offering SAC Teleconsult. This SAC Teleconsult service allows our current and potential clients to connect with our aestheticians and doctors during clinic operating hours for non-urgent consults.

After assessment and consultation, we will be able to advise you on the next steps, and can even deliver medications straight to your doorstep if required.

Skin concerns we can address during teleconsult:

  1. Acne
  2. Skin Ageing
  3. Pigmentation
  4. Body contouring
  5. Skin Health
  6. Body contouring
  7. Dark circles
  8. Face slimming

How Does SAC Teleconsult Work?

*Our Whatsapp Video Consultation is not an official medical consult. A video consultation does not replace an actual in-clinic medical advice and consultation with our doctors.

Step 1: Set-up an Appointment

Arrange for a SAC teleconsult appointment during our business hours (see below)*

a. Click here to message us on our website
b. WhatsApp us at +6590207234
c. Call us on +6562350338
d. Send us an email at hello@saestheticsclinic.com

If you require any in-person appointments, we will be able to arrange this for you.

*Contact us during these hours for an appointment
Monday – Sunday: 10am – 9pm

Sunday & Public Holidays: Closed

Step 2:

Our doctors and aestheticians will give you a call back at the appointed time. After the consultation has completed, we will email or WhatsApp you a customized treatment plan.

What are the Fees?

(Only Medication & Delivery Charges)

A) No Charges for SAC Teleconsult.

B) Medication charges: As per usual in-clinic charges.

C) Delivery charges:
– From S$10.70 Singapore Mainland* (*Except restricted areas, Alps Ave and Mandai)
– A S$5.40 surcharge applies for Sentosa deliveries

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7 Nutrients To Keep Your Skin Looking Healthy

7 nutrients to keep your skin looking healthy

Our skin requires a good balance of nutrients to perform its main functions well: protecting our bodies from the rough environment we face. To keep our skin looking, working and feeling good, we need to look after it well, from both inside and outside.

We discuss the 7 nutrients which are important in keeping our skin healthy.

1. Healthy Fats 

Healthy fats are essential for maintaining the ‘glow’ in our skin. Too little fat in our diet and make our complexions look wrinkled and dull. 

Essential fatty acids are fat that our bodies cannot produce and the only way we can get these are from a balanced diet. Omega-3 fatty acids work to nourish our skin and are important in maintaining the radiance and softness of our complexions. 

Omega-6 fatty acids on the other hand are the building blocks of cell membranes which help us maintain healthy and hydrated skin and prevent skin dryness.

Focus on monounsaturated and polyunsaturated fats from plant sources such as nuts, seeds, avocados and from fatty fish. These help our skin stay moist, firm and supple.

2. Protein

Dietary protein is broken down by our digestive systems into building blocks called amino acids. These are then reused in our bodies to make proteins such as keratin, collagen, elastin that forms the structures of our skin. They also help slough off old skin. 

Certain amino acids also act in our bodies as antioxidants that protect our skin from ultraviolet (UV) rays as well as free radicals caused by exposure to certain foods, medications or even alcohol and cigarette smoke. 

3. Vitamin A
Vitamin A is one of the most important vitamins when it comes to our skin. Both the upper epidermal and lower dermal layers of skin need vitamin A. It prevents sun damage by interrupting the process that breaks down collagen. It is also an antioxidant and gives your skin some protection. It also helps the functions of oil glands around our hair follicles work and may help cuts and scrapes heal. Skin, deficient of vitamin A may get itchy, bumpy and dry.

4. Vitamin C
Vitamin C is one of the essential compounds that helps collagen hold its shape. It is also a powerful antioxidant that protects us from free radicals and lowers our risks of getting skin cancer. Insufficient intake of vitamin C can lead to easy bruising, bleeding gums and even slow healing wounds. 

5. Vitamin E
Vitamin E is an antioxidant as well as an anti-inflammatory. To top that off, it can also absorb energy from UV rays which damages skin and can lead to wrinkles, sagging and increase the risks of skin cancer. It also works in tandem with vitamin C to strengthen cell walls.

6. Zinc
The outer epidermal layer of our skin has five times more zinc than the dermal layer, and for important reasons. Zinc helps our skin heal after an injury. It also plays an important role in the lifespan of cells, in keeping the cell walls stable and in the process of cell division and differentiation. Zinc also protects the skin from UV harm and acts as an antioxidant. When we lack zinc, our skin can look like eczema but the itchy rash will not get better despite moisturisers and steroid creams.

7. Selenium
This is an essential mineral that helps some antioxidants in their role protecting our skin from UV. Deficiency of this mineral has been linked to an increased risk of skin cancer. 
These essential beauty nutrients can mostly be obtained from a balanced diet. Some foods that pack more of one of these goodness as a “many-in-one” include:
– Fatty fish (salmon, tuna, sardines): protein, omega-3, selenium
– Eggs: protein, vitamins A and E, selenium, zinc
– Leafy dark greens (kale, spinach): vitamins A, C, E; omega-3, protein, selenium (in spinach)
– Legumes (lentils, chickpeas): protein, zinc
– Avocados: healthy fats, vitamin C and E
– Extra virgin olive oil: healthy fats, vitamin E

Adjusting your diet to include some of these into your daily foods can help improve and brighten up your complexion while making sure the largest organ in your body stays healthy!

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Sunscreen – What’s Inside?

Sunscreen

With such a wide range of sun protection products in the market, choosing one that works for your skin can be difficult and confusing. 

What do we look at and how do we choose the best sunscreen for our skin?

Sunscreen helps to shield our skin from ultraviolet (UV) rays in 2 ways: 

  • By scattering UV, reflecting it away from us
  • By absorbing UV before it reaches our skin 

There was a time when SPF was the main hype but research has since gone further than that. 

We now know that the 2 main types of UV coming into contact with our skin are: 

  1. UV-A: does not cause sunburn but penetrates deeply into skin and causes wrinkles and photoageing. Also increases the risk of skin cancers
  2. UV-B: burns our skin, reaches only the epidermis, causes skin cancer.  

Let’s dissect the main labels on a sunscreen bottles and what do they mean. 

1. SPF

This is probably the most widely recognized label on a sunscreen bottle, with numbers going ever higher, ranging from 4 to 100+. What does it mean though?

SPF stands for Sun Protection Factor. It is a measure the fraction of UV-B reaching the skin. For example, SPF 15 means that 1⁄15 of UV-B will reach the skin, assuming that the sunscreen is applied evenly at a dosage of 2mg/cm2. Thus, if a person normally burns in 10 minutes under the sun, it would theoretically take him/her 150 minutes to burn with an SPF 15 sunscreen. 

However, it is also important to note that sunscreens with higher SPF do not last or remain effective any longer than lower SPF sunscreens, and the general rule of thumb would be to reapply every 2 hours. The scale of SPF is also not linear. 

Image result for SPF scale

Hence, a high SPF does not mean stronger protection. SPF is only a rating for UV-B, and there are other things to look out for, such as UV-A protection, water or sweat resistance that we will discuss further.

2. UV-A protection

There is not a universal rating system for UV-A protection, which leads to even more confusion. 

Below, we will discuss the main UV-A protection ratings used. 

PPD (Persistent pigment darkening)

Originally developed in Japan, this is the method employed by manufacturers such asL’Oréal.

This method uses UV-A to cause persistent darkening or tanning of the skin. In example, a sunscreen with a PPD rating of 10 should allow a person 10 times as much UV-A exposure as would be without protection. 

PA system

In Asia, a common system used is the PA (Protection Grade of UVA) system. This system is basd on the PPD reaction and is now widely adopted on labels of sunscreen. 

PA+ corresponds to UVA protection factor 2-4; PA++ 4-8, PA+++ >8 and PA++++ >15. 

3. Active ingredients

As discussed earlier, sunscreens absorb or refract UV to protect our skins. Typically, a sunscreen will contain at last one if not more types of active ingredients, which can be either chemical or mineral in nature. The important thing here is to look for a sunscreen with broad spectrum sun protection. 

Two of the most common mineral ingredients are titanium dioxide and zinc oxide. They protect the skin by reflecting, scattering and absorbing UV rays. 

Organic compounds on the other hand works mostly by absorbing UV rays although some of them do scatter and reflect a fraction of UV. Ingredients such as these include benzophenones (oxybenzone), avobenzone (Parsol 1789), ecamsule (Mexoryl SX), salicylates, sulisobenzone, etc. 

4. Water resistance

Another important factor when looking at sunscreens. Choosing the right sunscreen for the activity you will be doing is imperative to ensure its efficacy. However, before doing that, we need to first understand some of the labelling related to water resistance. 

“Water resistant” sunscreen is defined by the FDA as sunscreens with an SPF level that stays effective after 40 minutes in water. Similarly, “very water resistance” – 80 minutes. 

5. Mode of application 

These days, sunscreens come in a variety of preparations, examples of which include sprays, balms, gels, creams, powders etc. One of the important factors to look at when selecting a preparation is how it blends in with your own lifestyle. For example, a powdered or spray sunscreen may be suitable for ladies who have make up on, whilst a water resistant cream sunscreen may be more suitable for the outdoors. It should not be the case that one has only one type of sunscreen for all occasions. 

6. Carrier ingredients

The other important factor when looking at sunscreen is carrier ingredients. Increasingly, we are seeing cosmeceutical manufacturers moving into the sunscreen industry, and there are now a myriad of choices of sunscreens that have multiple other ingredients such as anti-oxidants, vitamins, moisturisers that not only protect your skin against the sun, but nourishes as it does so. For daily use, selecting one that acts as your moisturiser may be suitable for people constantly on the go, but of course, for people with sensitive skin, more attention will have to be paid to the ingredients included in these sunscreens. 

With the myriad of choices in the market, consumers are definitely spoilt for choices, but knowing what one is buying, and choosing the right product for your skin type and lifestyle is very important. With this, we are hoping that consumers are able to choose their sunscreens better for healthier and more youthful looking skin. 

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An Overview on Non-surgical Eye Bag and Dark Circles removal in Singapore

Many people are bothered by eye bags and dark circles that make them look tired or older than their age, but the thought of surgery and general anaesthesia deter many from seeking treatment. Unknown to many however, eye bags can be treated without going under the knife. 

What are the causes of eye bags?

To treat eye bags correctly and effectively, we first have to look at the exact reason causing the appearance of the eye bags and dark circles. 

Various factors that can contribute to the appearance of fatigue and age in the area around the eyes include:

  1. Sagging of fat, skin around the ligaments under the eye, 
  2. Resorption of bones in the cheek, 
  3. Appearance of fine lines and wrinkles around the eyes due to lax skin and over activity of muscles around the eyes,
  4. Drooping of the upper eye lids,
  5. Pigmentation or venous congestion around the eye 
  6. Prominence of the muscle surrounding the eye leading to shadowing, as well as 
  7. Thinning of the skin around the eye. 

These, singularly or in combination lead to tired, old and unattractive looking eyes. 

How can eye bags be removed with no surgery?

A multifactorial problem will need to be treated with a multi-faceted approach. This applies to both non-surgical and surgical treatments of eye bags/ dark circles. 

For non-surgical treatment of eye bag removal, dark circle removal to rejuvenate the eye area, treatments that may be used include: 

Fillers

Filler injection around the eye is a quick and effective way to improve the appearance of eye bags and shadowing around the eye. With the correct choice of fillers and injection techniques, fillers placed around the cheeks, temples and under eye area can immediately lift and rejuvenate tired looking eyes. 

Botox

Botox treatment around the eye typically targets 2 main issues around the eyes: 

a. wrinkles around the eyes,
b. droopy brows

The treatment is aimed at reducing fine lines and wrinkles around the eye as well as lifting the eyebrows to provide a younger looking appearance around the eyes. 

Polynucleotide and hyaluronic acid injections – Skin boosters, Rejuran, Rejuran i (eye). 

Rejuran and/or skin booster injections around the eye can be used to improve hydration and simultaneously stimulate collagen production. This is important as the skin around the eyes is thin and ages quicker than the other parts of the face.
By improving the quality and health of skin around the eye, we may delay premature ageing of the skin in the long run while providing hydration for brighter looking eyes. 

Lasers

There are many lasers that have been used to treat multiple skin problems.
Specific to the eyes, 3 main lasers can be used to treat the area around the eyes:
i. PICO laser
Pigment lasers such as PICO laser can be used to treat pigmentation in the under eye area, to lighten the appearance of dark circles. PICO laser can also improve the skin texture and tighten the skin around the eyes to reduce fine lines and the appearance of tired eyes.
ii . Fractional lasers (clear+brilliant)
These lasers are fractional ablative lasers that penetrate the skin superficially to create multiple microthermal zones which help the skin in the under eye area purge unwanted pigments as well as stimulate collagen production which can thicken the dermis giving rise to tightening and firming of the skin in the under eye area
iii. Vascular lasers
Vascular lasers are useful in treating dark circles that are due to venous congestion underneath the eye bags

Ultherapy (Microfocused Ultrasound or HIFU)

Microfocused ultrasound or high intensity focused ultrasound is a medical technology that uses an acoustic lens to concentrate beams of ultrasound into deeper layers of skin to stimulate new collagen for skin tightening. Treatment around the eyes can help in brow lifting for more energetic looking eyes, and to tighten skin in the under eye area, to reduce the signs of ageing around the eyes. 

Magnetic multipolar radiofrequency (RF) treatment

Radiofrequency (RF) is a very useful treatment around the eyes to improve blood circulation, as well as tighten the skin around the eyes.  This helps to reduce the puffiness and swelling in the under eye area, as well as reduce the appearance of dark circles. 

Is non-surgical eye bag removal better than surgery?

Surgery remains the gold standard in terms of eye bag removal and results are more permanent than non-surgical options.

However, surgery also has its downsides, such as the need for anaesthesia, more serious complications, it is irreversible and will not correct other volume loss in the face.

Non-surgical options are a good bridge for people who may want more time in considering their options, for people who may not be sure if eye bag removal will necessarily be suitable for them, as well as those who may not be ready for a permanent look. 

Which treatment is suitable for treatment of my eye bags?

No eye bag or dark circle is the same. Decision on the most suitable form of non-surgical treatment will require careful assessment of the eyes, as well as an in-depth discussion with the patient regarding the desired outcome, risks or side effects of the procedure, as well as the projected downtime. A treatment plan customized to the patient will usually yield a much better result than standard off the rack treatment packages. 

How long do the effects last? Is the eye bag removal permanent?

With non-surgical eye bag removal, the duration that effects last typically depends on the treatment undertaken as well as upkeep and maintenance of the skin after treatment. Certain benefits obtained from non-surgical treatment may confer a lasting benefit to the appearance around the eyes, whilst some will require regular maintenance treatments. This will usually be discussed by the treating physician with the patient. 

Is there any downtime/ recovery time from non surgical eye bag removal treatments?

Again, as treatment may be multi-faceted and use a myriad of modalities, the downtime/ recovery time from non-surgical eye bag removal may vary from none to about a week. This is generally much shorter and more acceptable compared to downtime from surgical eye bag removal. 

How do I find the most suitable doctor for eye bag treatment in Singapore?

The one important take-home message for patients considering non-surgical eye bag removal is to find a doctor or clinic that can offer a comprehensive range of lasers and treatments. 

“A multifactorial problem will need to be treated with a multi-faceted approach.”

Eye rejuvenation is a multifactorial problem and will generally require a full range of treatment to achieve the best results. 

Eye Rejuvenation treatment requires professional assessment, proper treatment planning and customization of treatment based on individual needs. 

If you wish to improve your eye bags/ dark circles, visit us at S Aesthetics Clinic to speak to our doctors.

Tags: Botox Singapore, Eye Bag Removal Singapore

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Rejuran Healer Singapore

Why is REJURAN® so Hot?

Simple response to this is because it functions….and it doesn’t cost an arm or a leg to perform the treatment; the treatment isn’t expensive. Additionally, it doesn’t cost legs and both arms unlike any lasers to supply the treatment, in order to get the results.

Another reason why it’s so popular is because in Asia, there’s such a significant emphasis on attaining”flawless-looking” skin. Having a healthy skin is a vital building block for success and social standing.

What is it?

REJURAN® Healer or generally called”REJURAN®”,”PN (polynucleotides) treatment”,”PDRN treatment” or “infant skin injections”, is currently the MUST-HAVE treatment if you’re dreaming about getting flawless skin. REJURAN ® healer is suitable for achieving a wide variety of beauty results. Its “secret weapon” is PNs (polynucleotides) and PDRNs (Polydeoxyribonucleotides), extracted from salmon DNA.

How does this work?

OK, so this is where it gets quite technical…

As stated previously, REJURAN ® comprises PDRNs and PNs. There is a molecule composed of more or 13 nucleotide monomers.

What’s nucla nucleotidecleotide; it is the basic component of DNA.

What’s DNA made of?
• DNA is a polymer of repeating sub-units.

REJURAN ® is able to stimulate cell regeneration for younger and newer skin in addition to skin hydration and regeneration of critical skin compounds.

How secure is REJURAN® Treatment?

The treatment is secure.

In the history of REJURAN ® treatments, we haven’t seen or heard of anyone who develops negative responses to it. It doesn’t trigger negative immune responses nor does it cause irreversible or intolerable side effects. Additionally it is developed in a very sterile state and it is bio-compatible with human cells.

Tag: rejuran healer

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Melasma: How NOT to treat melasma

‘Doctor, can you hit my pigments with a stronger laser?’ –  How NOT to treat melasma. 

‘Pico’ or Pico Laser has in the last 2 years became one of the most commonly heard buzzwords in the treatment of pigmentation, so much that it has become very common for patients turning up at aesthetic clinics requesting for ‘picolaser’ for their ‘pigment problems’.

NO ONE SIZE FITS ALL

However, NOT all pigment problems are the same.

In one of my recent clinic sessions, a patient came in for a consultation to address her facial pigmentation. She had gone for a ‘pico’ session in another clinic a few months ago and was told that her pigments will be cleared in one session.

To her dismay, however, the pigment had become darker and she looked worse after the treatment. She waited a few months hoping that it will lighten out, but it did not.

She asked if she can have stronger pico laser to treat her pigments. I had however started her on a pigment lightening cream instead of hitting her harder with the laser.

Why you may ask. Indeed, picosecond lasers of certain wavelengths are useful in treating pigmentary disorders, however, pigments on the face or anywhere on the body can be caused by a myriad of conditions, and a one-size-fits-all approach is certainly not the way to go.

MELASMA

MELASMA

In her situation, the diagnosis of melasma was made. Melasma is a disorder of hyperpigmentation of which aetiology is thought to be an interplay between UV exposure, genetic and hormonal factors.

It typically appears as symmetrical, blotchy brown patches over the cheeks, although the forehead, temples, nasal bridge, upper lips, and jawline are also known to be affected. The condition affects women more than men and commonly appears in the mid-30s.

It can also develop during or after a pregnancy. Other factors increasing the chance of melasma include a history of excessive sun exposure, family history, increased female hormones either by being on hormone replacement therapy or oral contraceptive pills, thyroid disease and low testosterone amongst others.

Also Read: What Harm Can Ultraviolet Radiation Do

Although not a life-threatening condition, it can be very disfiguring for people affected by the condition and has a deleterious impact on the quality of life.

Melasma has NO CURE, but it can be treated.

IS PIGMENT LASER NOT A TREATMENT FOR PIGMENTATION?

Pigment lasers have since the days of Q-switched lasers become one of the most effective tools in the treatment of pigmentary disorders such as sunspots, freckles and have become one of the most invaluable tools in the clinic of an aesthetic physician or dermatologist.

Pigment lasers use the physics theory of chromophores attracting energy from light. Pigments in the skin act as a chromophore and absorb the energy from certain wavelengths of lasers. These pigments are then selectively fragmented due to photoacoustic and photothermal effects from the lasers and are subsequently ingested and cleared by our immune systems.

Now, this works for most pigments, and will even work for other exogenous pigments such as tattoos. However, why is melasma so difficult to treat? It either responds only to return with a vengeance almost immediately after or just does not respond at all?

MELASMA IS A DISEASE OF OVERPRODUCTION OF MELANIN PIGMENTS BY SENSITIZED MELANOCYTES

To understand why we have to first understand how melasma happens. I mentioned earlier that melasma is an interplay between UV exposure, genetic and hormonal factors.

However, melasma is a condition is not the same as skin hyperpigmentation that is induced by UV or inflammation. Through molecular pathway studies, it is now believed that people affected by melasma have increased expression and upregulation of certain receptors involved in the stimulation of melanogenesis and melanosome transfer compared to normal individuals resulting in persistent hyperpigmentation in melasmic lesions.

This essentially means that pigment-producing cells in people with melasma are sensitized and hyper-stimulated, thus when triggered by factors which can stimulate melanin production, will result in even more pigments being produced and deposited into the skin.

LASER OR NO LASER?

For the above reasons, treatment of facial pigments must start with a sound medical approach. The correct diagnosis must be made before embarking on any treatment.

Pigmentary conditions such as freckles, sun spots, post-inflammatory hyperpigmentation can be easily treated with lasers.

Melasma, on the other hand, needs to be treated with a more holistic approach. As the condition is due to upregulation and sensitization of pigment-producing cells, treatment starts with treating the root cause of it, by reducing all risk factors for pigment production as much as possible.

This will include treating hormonal factors such as reviewing a patient’s medications for any medications that can alter hormonal levels such as oral contraceptive pills or hormone replacement therapy; sun protection with broad-spectrum sunscreens.

Treatment should also include topical creams for pigments. The pigment cream hydroquinone is still the standard treatment of melasma although, in the recent years, concerns have grown regarding long term use of the medication and alternatives which work to a lesser degree such as creams containing arbutin, azeleic and ascorbic acids, niacinamide kojic acid have also been used.

Now, that does not mean that laser has no role in the treatment of melasma. Judicious use of lasers and acid peels can act as good adjuncts in the treatment of melasma. When used correctly, they can speed up the lightening of pigments; and in recalcitrant melasma which responds poorly to topical creams, lasers and peels still have a strong role to play.

MELASMA CAN BE TREATED SUCCESSFULLY

Melasma is a complex and challenging condition to treat and requires both times, patience and persistence. A sound and holistic medical approach by the doctor, and diligence on the part of the patients applying and using the prescribed treatments while maintaining lifestyle factors such as staying away from the sun, avoiding irritative cosmetics are crucial to achieving visible improvement and maintaining good complexion in the treatment of melasma. It may not be curable, but it certainly can be treated well.

If you are indeed suffering from melasma, speak to your doctor so that it can be addressed early.

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Battling Hair Loss in Singapore

You are not alone. Here is how to deal with hair loss
Perhaps you have noticed that the baffling number of baldness centers in Singapore? Yup, hair fall here’s a thing that is true. And while stress, hormones, diet, health or hereditary conditions might be the cause, we also hear complains (particularly from our expat friends) that there is simply something in the Singapore water which makes crowning glories excessively shed. While we are no hair specialists, there could be some truth to this: the local water is processed and filtered, with tap water containing an average of 2.45 mg per litre of chlorine. Other reasons cited are the shift in climate (humidity does no favours), in addition to city pollution. Ahead, we have the scoop on how to handle baldness in Singapore…

Use a chlorine-filtering shower head
Fact of the day: Your body absorbs around eight glasses of water with each shower. Showering in chlorine strips away the protective bum, which coats your hair, resulting in hair and breakage fall. The best course of action is a shower head that is chlorine-filtering to prevent this. VitaC’s one-size-fits-all showerhead filters 99.9% chlorine and chloramines in each shower to decrease hairfall and damage. These are simple to install, and are available in forms such as misty shower and shower rain. Shop VitaC showerheads in Sonaki Singapore online.

…or shower in cool water
Yes, it requires an additional step, but using boiled water is believed to assist chlorine and other processed minerals evaporate. Showering in hot water is thought to harm the scalp, resulting in narrowing of follicles decreasing of strands, and resulting in hair thinning and loss. Since it is not gentler on your hair you are better off taking a shower in cooler water — it’s gentler on your skin.

Let us discuss your diet…and vitamins
You know what they say: too much of a good thing is a bad thing. Just as we love living in this food heaven, the access to hawker food may have been one fast spiral diet of grease, sodium, MSG and sugar. These not only damage your body but your mane; ingesting a lot of such foods may lead to clogging up your pores and resulting in a decrease in hair follicle size.

Daily shedding of hair might be ordinary — you lose 100 to 150 strands of hair per day; it’s normal, however if you see your hair out more than normal then it’s time to seek help. Besides altering your diet, consider taking vitamin supplements — the ones recommended for hair growth include Biotin, Niacin (Vitamin B3) and Vitamin C, and minerals for hair loss like Zinc and Iron.

Use the Perfect shampoo
Before you grab the hair loss shampoo off the shelves, get to know your hair. When it comes to treating your hair, your health, genes, hair history and response to Singapore’s climate and water need to be taken into consideration. Be ready for a little trial and error…but , arm yourself with the correct knowledge.

Also, know the components that make up your shampoo. These may include ketoconaketoconazolet that improves hair density and dimensions, caffeine biotin to fortify and saw palmetto. Understand that shampoos are by no means a miracle hair growth solution; they do remain after all on hair only temporarily. They merely emphasize the improvement of scalp and hair health and baldness problems.

Engage a hair loss expert
If your hair is severely shedding, the hair physician is your best friend. A tricologist can do a check on your medical history and conduct scalp examinations to reach the root of the issue. What triggers baldness may be drugs, imbalanced hormones or nourishment and a tricologist can guide you in the right tonics or remedies.

Tag: hair loss treatment singapore, hair loss singapore

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