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热玛吉治疗

什么是热玛吉治疗？

热玛吉是一种非侵入性却能达到让皮肤紧致和提升治疗。

它采用独特的专利射频技术（RF），加热我们的皮肤深层，刺激皮肤产生新的胶原蛋白。

热玛吉可以做什么？

通过热玛吉治疗产生的新胶原蛋白可以有效地提升和收紧面部皮肤。它还可以减少毛孔、皱纹和眼睛周围、面部和颈部的松弛皮肤。

哪些人适合接受热玛吉治疗？

热玛吉适合所有希望延缓皮肤老化迹象的男性和女性，从年轻人到中年人。

胶原蛋白的再生有助于减缓皮肤的老化过程，并提供全面的皮肤嫩化、提升和紧致效果。

需要多长时间才能看到效果？

大约需要2-3个月才能看到效果。热玛吉的效果通常是渐进式的，并在未来6-12个月内继续改善。

效果能持续多久？

热玛吉的效果通常持续12个月。您可以通过每年重复进行治疗，以保持您的青春容颜。

如果我在午休时间做？有停工期吗？

停工期为极少，甚至零。

热玛吉安全吗？

热玛吉FLX有着先进的技术和智能冷冻系统，是一种非常安全的治疗。

这确保了在整个治疗过程中自动检查热度并进行相应调整，以确保病人的安全，同时提供最大的效果。

超声刀还是热玛吉？

在超声刀和热玛吉的完美配合下，能在延缓您的皮肤和脸部老化过程方面获得非常理想的效果，并能在不同方面使您受益。

这些治疗只能由医生进行。请咨询医生以确定哪种治疗最适合您。

S AESTHETICS SINGAPORE为您提供的热玛吉治疗

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新加坡非手术眼袋和黑眼圈去除概述

非手术眼袋和黑眼圈去除

许多人被眼袋和黑眼圈困扰，这让他们看起来很累或比实际年龄更老，但想到手术和全身麻醉，许多人就不敢寻求治疗。然而，许多人都不知道，眼袋可以在不动刀的情况下治疗。

眼袋的成因有哪些？

要正确有效地治疗眼袋，我们首先要了解导致眼袋和黑眼圈出现的确切原因。

导致眼睛周围区域出现疲劳和衰老的各种因素包括:

  1. 脂肪、眼睛下方韧带周围的皮肤下垂，
  2. 脸颊上的骨质流失，
  3. 由于皮肤松弛和眼睛周围肌肉的过度活动，眼睛周围出现细纹和皱纹，
  4. 上眼皮下垂，
  5. 眼睛周围的色素沉淀或静脉充血，
  6. 眼睛周围的肌肉突出导致出现阴影，以及
  7. 眼部周围皮肤变薄

这些因素单独或结合在一起，会导致眼睛疲惫、苍老和不美观。

如何在不进行手术的情况下移除眼袋？

为了有效地处理一个多因素的问题，我们必须考虑多方面的方法。这适用于眼袋/黑眼圈的非手术治疗和手术治疗。

对于去除眼袋和黑眼圈以恢复眼部活力的非手术治疗，可采用的治疗方法包括:

填充剂

在眼睛周围注射填充物是一种快速且有效的方法，从而达到改善眼袋和眼周阴影的外观。通过正确填充物的选择和注射技术，将填充物放置在脸颊、太阳穴和眼下区域，可以立即提升和恢复看似疲劳的眼睛。

肉毒杆菌素

一般来说，肉毒杆菌素对眼睛周围的治疗主要针对以下两个问题：

  • 眼睛周围的皱纹，
  • 下垂的眉毛

该疗主要针对减少眼部周围的细纹和皱纹，并抬高眉毛，使眼睛周围的外观看起来更年轻。

多核苷酸和玻尿酸注射液- 水光针，婴儿针，婴儿针-i（眼睛）

在眼部周围注射水光针和/或婴儿针可有效地补给水分并同时刺激胶原蛋白的产生。这一点很重要，因为眼睛周围的皮肤比面部其他部位薄且老化更快。

从长远来看，通过改善眼睛周围皮肤的质量和健康状况，有利于延缓皮肤的过早衰老，同时为明亮的眼睛提供水分。

镭射

如今有许多激光技术已被采用于治疗各种皮肤问题。

医学上有3种主要的激光技术可用于治疗眼睛周围的区域。

I.) 皮秒镭射
色素激光(如皮秒激光)可用于治疗眼下区域的色素沉淀，以淡化黑眼圈。皮秒激光还可以改善皮肤纹理，收紧眼睛周围的皮肤.通过这种治疗，疲劳的眼睛和细纹的外观可以得到缓解。

II.) 飛梭镭射(清晰+明亮)
这是一种点阵式镭射治疗反式，其技术能渗入皮肤表层并形成多个微热区，以达到去除眼下区域的皮肤不需要的色素以及刺激胶原蛋白产生，能使真皮层变厚，从而使眼下区域的皮肤变得紧致。

III.) 血管镭射
血管镭射可有效治疗由眼下静脉充血引起的黑眼圈

超声刀(微聚焦音波或超声波紧肤拉皮)

微聚焦音波或超声波紧肤拉皮是一种使用声学透镜将超声波束集中到皮肤深层的医疗技术，它能有效地刺激新的胶原蛋白从而来收紧皮肤。对于眼部治疗，它有助于抬高眉毛，让眼睛看起来更有活力，收紧眼下区域的皮肤，减少眼部衰老迹象。

磁性多极射频(RF)治疗

射频(RF)是一种非常有效的眼部治疗方法，可改善血液循环并收紧眼部周围皮肤。这有助于减
少眼下区域的浮肿和肿胀，并减少黑眼圈的出现。

非手术摘除眼袋是否比手术摘除更好？

在去除眼袋方面，手术摘除仍然是黄金标准，而且效果比非手术摘除方案更持久。

然而，手术摘除也有它的缺点，如需要麻醉，更严重的并发症，它是不可逆转的，而且不能纠正面部其他体积的损失。

对于那些可能需要更多时间考虑他们的选择的人来说，非手术摘除是一个很好的桥梁，对于那些可能不确定眼袋摘除是否一定适合他们的人，以及那些可能还没有准备好进行永久性整容的人来说。

哪种治疗方法适合用于治疗我的眼袋？

每个人的眼袋和黑眼圈都是不同的，为了确定最合适的非手术治疗，有必要对眼睛进行彻底评估，同时需要与病人深入讨论手术的预期效果、风险或副作用以及预计的恢复时间。通常情况下，定制的治疗计划会比标准的现成套餐产生更好的效果。

效果能持续多久？眼袋摘除是永久性的吗？

对于非手术眼袋摘除术，其效果持续时间通常取决于所进行的治疗种类以及治疗后对皮肤的保养和维护。非手术治疗可能会给你的眼睛周围的外观提供一些持久的改善，而有些则需要定期的维护治疗。通常情况下，主治医生会和病人讨论这个问题，并给予建议。

非手术眼袋摘除治疗是否有停工期/恢复期？

同样，由于治疗可能是多方面的，并有可能使用多个模式，非手术眼袋摘除的停工/恢复时间可能从没有到大约一个星期不等。与手术摘除眼袋的停工期/恢复时间相比，这通常要短得多，也更容易接受。

如何在新加坡找到最适合眼袋治疗的医生？

给予那些考虑非手术摘除眼袋的患者的提示是，找一个能提供全面的激光和治疗方案的医生或诊所。

“一个多因素的问题将需要用一个多层面的方法来处理。”

眼部再生是一个多因素问题，通常需要全面治疗才能达到最佳效果。

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黄褐斑: 如何不治疗黄褐斑

Melasma

“医生，你能用更强的激光打掉我的色素吗，” – 如何不治疗黄褐斑。

在过去的两年里，“皮秒”或“皮秒激光”已经成为色素沉着治疗邻域中最常听到的流行语之一，导致患有“色素问题”的患者到美容诊所询问有关“皮秒激光”的疗程已变得非常普遍。

没有一成不变的标准

然而，并非所有的色素问题都是相同的。

在我最近的一次门诊中，一名患者前来就诊，以解决其面部色素沉着的烦恼。几个月前，她在另一家诊所接受了“皮秒”疗程，并被告知她的色素将在一个疗程内清除。

然而，令她失望的是，色素不但没有消失反而变得更深，整个治疗过后她看起来更糟。她等了几个月，希望色素会消退，但却没什么起色。

她问是否可以用更强的皮秒激光来治疗她的色素。然而，我建议她使用色素淡化霜，而不是选择更强烈的激光。

你可能会问，为什么？显然某些波长的皮秒激光的确能色素性疾病起到很好的治疗作用，但是，面部或身体任何部位的色素可由多种因素引起，而一成不变的做法肯定不是正确的方法。

黄褐斑

MELASMA

根据她的情况，诊断为黄褐斑。黄褐斑是一种色素沉着过度的疾病，其病因被认为是紫外线照射、遗传和黄褐斑激素因素之间的相互作用。

它通常以对称的斑点状棕色斑块呈现在脸颊上，尽管该症状也会体现于额头、太阳穴、鼻梁、上唇和下颚线。女性相比较更容易患上这种疾病，一般在30岁左右发病。

黄褐斑也可能在怀孕期间或之后发病。增加黄褐斑发生几率的其他因素也可能是患者有过度日晒的经历、家族遗传、因使用激素替代疗法或口服避孕药而导致女性荷尔蒙增加、甲状腺疾病和睾丸素水平低下等等。

虽然不是危及生命的疾病，但对受其影响的人来说，可能会造成非常严重的毁容，并对生活质量产生不利影响。

黄褐斑无法治愈，但可以治疗。

难道色素激光不是治疗色素沉着的方法吗？

自钕雅铬镭射激光器问世以来，色素激光器已成为治疗晒斑、雀斑等色素性疾病最有效的工具之一，也成为美容医生或皮肤科医生临床上最宝贵的工具之一。

色素激光器引用了发色团的物理理论从光中导出能量。治疗过程中,皮肤中的色素将会充当发色团，并从特定波长的激光中吸收能量。这些色素随后由于激光的光声和光热效产生选择性碎裂，随后被我们的免疫系统摄取和排除。

现在，这疗程适用于大多数色素沉着的相关疾病，甚至对其他外源性色素如纹身也会有效。然而，为什么黄褐斑如此难以治疗？那它到底是对黄褐斑有效，但几乎马上就会复发，还是根本没有反应？

黄褐斑是一种由敏感的黑色素细胞过度分泌黑色素的疾病。

为了了解原因，我们必须首先了解黄褐斑是如何形成的。我之前提到，黄褐斑是紫外线照射、遗传和黄褐斑激素因素之间的相互作用。

然而，黄褐斑与由紫外线或炎症引起的皮肤色素沉着不一样。通过分子途径研究 ，研究人员认为，与正常人相比，黄褐斑患者的某些受体在黑色素生成和黑色素体转移上有着明显的活跃和上调，从而导致黄褐斑的持续性的色素沉着。

这意味着黄褐斑患者的色素生成细胞非常敏感和过度刺激，因此当被能够刺激黑色素生成的因素触发时，将导致更多色素生成并沉积到皮肤中。

到底要不要进行激光治疗

出于上述原因，面部色素的治疗必须从合理的医疗方法开始。在开始任何治疗之前，必须做出正确的诊断。

雀斑、晒斑、炎症后色素沉着等色素性疾病都可以通过激光治疗轻松解决。
另一方面，黄褐斑需要用更全面的方法来治疗。由于这种情况是基于色素生成细胞的上调和敏感所引起的，因此治疗应从治疗其根本原因开始，即尽可能减少色素生成的所有风险因素。

这将包括对荷尔蒙因素的治疗，如审查患者的药物中是否存在任何可改变荷尔蒙水平的药物，如口服避孕药或荷尔蒙替代疗法；使用广谱防晒霜进行防晒等。

治疗还应该包括治疗色素的外用药膏。氢醌色素霜仍然是治疗黄褐斑的标准方法，尽管近年来，人们对长期使用这种药物的担忧增加了，而且还使用了效果较差的替代品，如含有熊果苷、杜鹃花酸和抗坏血酸、烟酰胺曲酸的药膏。

当然，激光在黄褐斑的治疗中并不是没有作用。明智地使用激光和酸性换肤可以作为治疗黄褐斑的良好辅助手段。如果使用得当，它们可以加快色斑的淡化速度；并且当进行对外用药膏反应不佳的顽固性黄褐斑治疗中，激光和酸性换肤仍然具有强力的作用。

黄褐斑是可以成功被治疗的

黄褐斑是一种复杂且具有挑战性的疾病，治疗的过程中需要时间、耐心和毅力。医生采取合理和全面的医疗方法，病人勤奋地应用和使用规定的治疗方法，同时保持着适当生活方式，如远离阳光，避免使用刺激性化妆品，种种因素都是为了能在治疗黄褐斑中，实现明显的改善和保持良好肤色的关键。它可能无法治愈，但肯定可以得到良好的治疗。

如果你也受黄褐斑的困扰，请咨询您的医生，以便可以尽早处理。

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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 wide accepted 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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Melasma: How NOT to treat melasma

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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Ultraviolet Radiation

Ultraviolet radiation

Ultraviolet rays / Ultraviolet radiation. Why do we need to protect ourselves against it?

We often get asked to put on sunscreen before going out in the sun. Why is it so important? 

What are ultraviolet rays?

Our bodies are exposed to many forms of radiation on the electromagnetic spectrum on a daily basis. These can be radio waves, microwaves, visible light, X-rays, Gamma radiation, infra-red and ultraviolet (UV) rays.

UV falls in the portion of the electromagnetic spectrum between X-rays and visible light: The shorter the wavelength, the higher the energy; ie. UV has higher energy than visible light.

Conversely, when it comes to penetration, the longer the wavelength, the deeper the penetration. 

The most common UV radiation is sunlight, which produces mainly 3 types of UV, namely:   

UV-A

UV-A has the longest wavelength of the three types of UV radiation we get from the sun. It penetrates deep into the deeper layer of our skin (the dermis). 

UV-B

UV-B has a wavelength between UV-A and UV-C. Some of this is absorbed by the Earth’s ozone layer as it passes through the atmosphere. As it has a short wavelength, it reaches only the outer layer of our skin (the epidermis). 

UV-C

UV-C has the shortest wavelength, all of this is absorbed by the Earth’s ozone layer as it passes through the atmosphere. 

We also get UV from other sources like tanning booths, mercury vapour lighting, halogen, fluorescent and incandescent lights and some types of lasers. 

What harm can UV do?

UV exposure has its benefits. UV-B specifically helps the body produce vitamin D and have also been used in the medical setting to treat certain skin conditions. 

However, excessive exposure to UV radiation can result in chronic harmful effects. These include photokeratitis (inflammation of the surface of the eye due to UV exposure), photoaging/ accelerating ageing of the skin, micro-DNA damage and mutations that increase the risk of and cause skin cancers, sunburn.

Does my exposure to UV change depending on where I am or what I am doing?

Many factors determine how much UV exposure you get. These include: 

Geography and Altitude

The equator receives the strongest UV rays as the sun is directly over the equator and UV travels a shorter distance of atmosphere to reach our skin. The ozone layer in the equator is also naturally thinner so less UV is absorbed compared to higher up in the northern and southern hemispheres. 

Having said that, there are certain terrains that can increase UV exposure due to their reflective properties, such as snow, sand, pavement and water. 

Higher land also receives more UV than lower land because there is less atmosphere. 

Timing (Time of the year/ day)

The sun’s angle in relation to Earth varies with the season. During the equinoxes, the sun rests directly above the equator, whilst the solstice is when the Sun reaches its most northerly or southerly excursion relative to the equator. Hence why the northern and southern hemispheres receive more UV during their respective summer months and conversely receive less in their winter months. 

Image from National Environment Agency (Singapore)

Weather

This serves as a reminder that UV rays are present even on a cloudy day and it can still cause long term damage to skin and eyes. Hence, it is important to continue protecting yourself with sunscreen even if it is a cloudy day. 

UV Index

The UV index (UVI) is a rating scale used throughout the world to indicate the amount of skin damaging UV reaching the Earth’s surface. 

On 19 Feb 2018 in Singapore between 1pm to 3pm, UV Index indicated “Extreme”
Source

In Singapore, the National Environment Agency reports the UVI. It is measured at the Changi Meteorological Station and is reported hourly from 7am to 7pm.

Protective measures should be taken if out in the sun, especially during the peak hours of 11am to 3pm. 

What can I do to protect against UV?

  • Sunscreen 
  • UV protective umbrella and seek shade
  • Sunglasses that block UV-A and UV-B rays 
  • Wear a broad-brimmed hat


*DisclaimerInformation provided in this article is for reference and educational purposes only. It does not replace actual medical advice and consultation with your doctor.

Also See: Pico Laser Singapore, Mole Removal Singapore

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Help! My selfie looks better than me?

As social media becomes an increasingly larger part of our social lives, be it group photos taken at events, or selfies that we post onto our own profiles, we are also increasingly pressured to look the way we have portrayed our digital avatars. 

PHOTO EDITING, SELFIES AND BEAUTY APPS

Photo editing used to be available to only the highest echelons of society, mainly in the form of airbrushed pictures and videos seen in the media.

The advent of beauty and social apps such as Meitu, Instagram and Snapchat in recent years have vastly changed this. Now, every social class in society who has access to a smartphone has the ability to use the various facial filters and editing options to edit their photos and make adjustments to facial features to control the image they portray online. This has redefined the perception of beauty and has allowed us to enhance and beautify our facial and body features in a few clicks and swipe. It has allowed us to take control of our public face in the virtual realm. As a result, wide ranges of “selfies” have since populated the vast social media, ranging from minor edits to completely unnatural looking photos such as the infamous “snake man” from China.

FAKE PIC?

However, despite the now-common phenomenon of photo editing, the advent of these tools has also fuelled new insecurities, such as “what if people noticed?”, “oh, that must have been an edited picture”, “he does not look like that in real life” etc. Also, there is often a fear of not putting your best foot forward – for example, not getting a job or not getting the second date for not looking like the photo in your CV or profile. These have as a result fuelled both insecurities as well as aspirations to look more like our digital images or avatars. 

In the last decade or so, the once-taboo topic of having aesthetic procedures done is now increasingly becoming more mainstream and better accepted socially. Indeed, the acceptance of cosmetic and facial plastic surgery has increased and it is an increasingly common sight to see people discussing what they had done at dinner events, or even overhear discussions about trips to foreign countries for aesthetic and plastic surgical procedures. It is also more common for people to turn up in aesthetic and plastic surgery clinics requesting to look like their app-edited selfies. 

JUST VAIN OR “SNAPCHAT DYSMORPHIA” AT PLAY?

The phenomenon, as it becomes more common, is also attracting more discussions and opinions. Singaporean media TODAY published an opinion recently discussing how doctors in aesthetic and plastic surgery clinics are getting an increasing number of patients requesting to look more like their app-edited selfies, and the concern of how much mental health issues such as body dysmorphia disorder and low self-esteem is at play when it comes to wanting to improve one’s looks.

Rightly so, aesthetic treatments will not treat a fundamental psychological problem and patients who truly have body dysmorphia disorder will not attain satisfaction from aesthetic treatments and in fact may go down a slippery slope of repeatedly seeking enhancements without ever getting satisfaction. 

CAN I LOOK LIKE MY SELFIE?

The desire to enhance one’s look is not new. Selfie-editing apps, however, have now brought the idea of editing how one looks to the masses. After seeing enhanced versions of themselves, people want to be able to control how some of their facial features look. Of course, most people will only want minor improvements, such as a smoother complexion, sharper-looking features, removing their eye bags or dark circles, a more lifted face. Realistic requests and expectations are usually achievable although people also have to be prepared to accept some deviation from their desired results occasionally. 

WHAT CAN BE DONE

With aesthetic and plastic surgery procedures receiving more acceptance, the million dollar question is now whether achieving one’s desired look is possible. 

There are a host of treatments to address particular concerns, and when used in combination, they can generally achieve the ‘wants’, albeit minor deviation from the desired results occasionally. 

Patients who want a clearer complexion may undergo treatments to improve skin texture and tone such as light based therapies the likes of Intense Pulsed Light (IPL) treatments and lasers, chemical peels, rejuvenation injections such as Rejuran and skin boosters as well as botox and fillers to lighten the appearance of wrinkles. People with acne scars may consider lasers, peels and injection based treatments such as Rejuran S to lighten and ameliorate the scars over time. 


Read More: Look Refreshed with Restylane Skinbooster

To alter facial features however, a combination of skin tightening treatments, contouring treatments, fillers, thread lifts, botox, or even the more invasive plastic surgery may be used to enhance features such as a higher nose bridge, more defined jaw, slimmer face, higher cheekbones, or even fuller lips; and to reduce the appearance of undesirable features such as a double chin, sagging jowls, deep smile or laugh lines, frown lines, crow’s feet etc. By enhancing the aesthetically pleasing features and reducing the appearance of undesirable features, aesthetic doctors can often rejuvenate and freshen up one’s appearance.

One other common concern is tired eyes. Although most people put this down to having insufficient sleep, the factors causing this is much more complex than that. Tired looking eyes is usually due to a combination of pigmentation in the under eye area, lax skin around the eye, venous congestion as well as herniation of the fat pad under the eye that becomes worse with age. To achieve the ‘eye bag’ function that face editing apps achieve, a combination of treatments including light based therapies such as lasers, fillers and polynucleotide injections, chemical peels, topical skin care as well as addressing age related volume loss in the cheek area, are typically employed to rejuvenate the eyes. 

Read more: Rejuran i – Everything You Need to Know

As evident from above, there are many options and ways of dealing with particular aesthetic concerns. However, the perception of beauty and facial features varies greatly, not only between cultures, but also between individuals. This is also the reason why customization and tailoring a personalized treatment plan to each individual is so important. 

THE PRICE OF BEAUTY

All these however come at a price. In an ideal world, everyone will want every treatment that can keep them looking like they were in their 20s. However, as with any procedures, there will be a cost to it. The cost of cosmetic procedures have always been perceived to be high and only accessible to the highest echelons of society. 

In Singapore, the growing aesthetic market has attracted the attention of multiple stakeholders. Over the past decade, the number of aesthetic providers have been steadily increasing. With the increased numbers of providers, costs have been on a downward trend over the past decade. Average prices for procedures have fallen over the years and consumers are having an increasing number of choices in terms of providers as well as treatment options. 

Despite this however, misled by the outdated perception that procedures in medical clinics are costly, some people have unwittingly attended unscrupulous beauty parlours that provide aesthetic procedures illegally, sometimes with dire consequences such as infections, blindness, skin necrosis, disfiguring scars etc. 

There are also people who travel abroad to countries like Thailand or South Korea for cosmetic surgical procedures. While people often get satisfactory results, cosmetic surgeons and practitioners in Singapore are often left to manage complications or revisions from botched surgery overseas. 

WHERE DO I START?

Everyone has a different motivation in wanting to improve their appearance. The first and foremost important question to answer is if that motivation is warranted and valid. Beyond that, other things such as invasive vs. non-invasive procedures, expectations, desired results also make important considerations. Although reading up from validated websites is also a good way to start, readers will have to be cautious of the source, quality and truth of the information they obtain, as every individual responds differently to treatments and there is a lot of misleading half-truths on the world wide web. Having friends who have done it first-hand to speak to will also be helpful and the final step will be to speak to one or even two trusted doctor to understand the procedures, the possible outcomes, risks and treatment plan to definitively address the aesthetic concern before embarking onto the journey of looking like your selfie. 

See also: rejuran, rejuran healer


*DisclaimerInformation provided in this article is for reference and educational purposes only. It does not replace actual medical advice and consultation with your doctor.

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Face Lift Singapore

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