纹身后悔了？可以做些什么。

大家去纹身有很多原因，可能是文化、个人、一时兴起的决定，或者仅仅是因为他们喜欢一个设计。随着纹身变得越来越主流，而且有这么多纹身店提供纹身服务，纹身已经变得越来越受欢迎。

正如大家去纹身有着许多原因一样，大家也可能因为种种原因想要去除身上的纹身，可能是由于后悔，画工欠佳，纹身褪色，甚至是由于工作需要。当然，虽然纹身是永久性的，但这只是在一定程度上。它们是可以被去除的，但至于是否可以完全去除，这在很大程度上取决于纹身的情况。

我们如何才能去除纹身？

多年来，人们采用了各种技术来去除纹身，这些技术包括使用皮肤颜色的纹身，也叫作遮盖纹身，手术切除，以及激光去除。一般来说，专家们都认为，激光去除可能是最成功的去除纹身的方法。

现在，激光去除纹身一般使用钕雅铬(Q-Switched)镭射或较新的皮秒镭射(Picolaser)。这些激光器以一个强大的脉冲发出能量，随后能量会击碎您皮肤内的墨水，将其溶解。钕雅铬镭射和皮秒镭射在皮肤上的工作方式也有细微差别。对于钕雅铬镭射，来自激光器的能量脉冲会加热您皮肤中的墨水，使其破碎（光热效应）。而对于较新的皮秒镭射，它不依靠热能，而是通过快速传递能量（万亿分之一秒），使纹身墨水中的微小色素颗粒振动和破碎，而不会烧伤周围组织，不仅疗效更高，清除更快，而且由于减少了对正常皮肤结构的损害，治疗更安全。

哪些纹身是最好去除的？

对于纹身，它们越久，就越容易去除。此外，业余的 “粘和戳 “纹身也更容易去除。移除的难易程度也取决于颜色，通常情况下，黑色、深蓝色、绿色和棕色等深色纹身较容易移除，而彩色纹身则较难移除，因为它们通常需要用不同的激光器和波长进行治疗才有效。此外，纹身的颜色与您的皮肤越接近，就越难去除。

激光去除纹身的最佳人选通常是那些皮肤较白但有深色纹身的人。由于有副作用的风险，皮肤颜色较深的人，原有的皮肤疾病如瘢痕疙瘩（蟹足腫）、湿疹，可能会导致在清除上更加复杂。

激光去除纹身是怎样的？

在新加坡，激光去除纹身一般可由皮肤科医生或在美容诊所进行。通常使用麻痹药膏来麻痹有纹身的皮肤区域，然后将激光照射到皮肤的色素部分。治疗的感觉通常就像有人在您的皮肤上扣了一个橡皮筋，然后在治疗区域有一种热和刺痛的感觉。治疗后，皮肤可能会出血、起水泡和肿胀，因此必须认真做好术后护理，如涂抹抗菌药膏、定期更换伤口包扎、避免阳光和户外活动。这个过程要重复多次，通常每隔6至8周进行一次，直到您对您的纹身消退的程度感到满意。

激光去除纹身有风险吗？

老式的钕雅铬镭射存在更高的风险。可能的风险包括疤痕、在治疗区域出现永久性白斑以及周围区域的皮肤变黑。若使用较新的皮秒镭射，发生这些情况的可能性会减少，但仍然不是零。因此，为了减少疤痕的风险，在伤口愈合之前，不要挑剔该区域，尽量避免阳光照射，并遵循医生的指示和建议。

如果激光不能完全去除纹身怎么办？

如果激光无法去除您的纹身，那么唯一万无一失的方法就是进行手术切除，也叫作纹身切除。通过手术切掉有纹身的皮肤，然后将剩余的皮肤缝合起来。这将留下疤痕，通常适用于小型纹身。

底线

纹身是一种常见但永久性的身体装饰。首先在纹身之前必须仔细考虑，因为去除纹身是一个比拥有纹身本身更漫长和艰巨的过程。当然，对于那些不再想要纹身的人来说，有不同的方法可以去除它。

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脂肪冷冻与脂肪燃烧：哪个更好？

Fat Freezing - Cryolipolysis SAC

脂肪冻结

我们经常都会遇到一个人，他一直在节食和定期锻炼，但就是无法摆脱几处顽固的多余脂肪。曾经唯一的能解决的办法是吸脂，直到过去几年，脂肪分解疗法在医疗美容市场上的出现改变了这种情况。它们成为去除多余脂肪的新趋势，而且原因很简单–非侵入性、低风险、最少或没有停机时间。

在过去的十年中，市场上出现了许多不同的通过永久减脂来塑身的技术。两种最好的塑身技术是射频和冷冻溶脂（冷诱导脂肪细胞死亡）。

这导致了人们在考虑接受身体塑形治疗时的一个共同难题–哪种方法更好？

首先，他们是如何运作的

这两种类型的治疗实际上是非常相似的，但同时又是截然相反的。它们都是通过杀死脂肪细胞来发挥作用的，我们的身体随后通过淋巴系统和肝脏将其消除。然而，将它们区分开来的最大区别是温度：射频通过加热脂肪细胞来摧毁它们，而冷冻溶脂则通过冷冻它们来运作。

之所能选择以这两种治疗方法用于脂肪细胞上，是因为脂肪细胞中不含很多水份，使它们对这些治疗方法很敏感。

那么，哪一个更好呢？

这是一个很难做出的决定。每种治疗方法都有自己的优势和适合性，这取决于你所追求的结果。

冷冻溶脂术可以很好地治疗脂肪袋，但它可能很难均匀地减少脂肪。另一方面，射频可以治疗大面积的脂肪，并且在治疗均匀脂肪的人时效果更佳。射频还能触发身体的自然愈合反应，刺激胶原蛋白的产生，所以当有松弛的皮肤时，它是一种很好的治疗。

哪个是最快的？

使用射频技术，通常在4-8次治疗后才能看到最佳效果，而对于冷冻溶脂术，每个区域需要大约2-3次治疗。最大的效果通常是在治疗后2-3个月。

疼痛和风险？

这两种治疗方法都是非侵入性的，而且没有停工期。治疗后的典型影响是轻微发红和肿胀。对于冷冻溶脂和射频治疗来说，都有可能出现皮肤烧伤的奇怪情况。这通常是由于使用了不安全的机器，或者如果从业人员不达标。为了避免这种情况，请确保你做足功课。

总结

脂肪冷冻(冷冻溶脂术) 射频技术(脂肪燃烧)
优点 有利于治疗顽固性脂肪口袋

每个区域在1至3个疗程内就能见效

可以治疗更深层的脂肪

治疗后的区域脂肪量减少达到15-25%。

 有利于治疗均匀的脂肪

舒适

较短的疗程（20-30分钟）

皮肤紧致
弊端 每次治疗需要至少一个小时

治疗一两天后有可能出现不适和酸痛的感觉

 明显效果可能需要多次疗程

有些机器可能会让您感到非常热

我可以合并治疗吗？

你当然可以!结合以上治疗的病人能看到更好的效果。这是因为脂肪冷冻对治疗脂肪袋有着明显的作用，而脂肪袋通常在深层处最常见，而射频技术更擅长针对均匀的脂肪，而这些脂肪往往是浅层的性质。射频技术也可以起到治疗皮肤的作用，并在消去脂肪体积后收紧你的皮肤。然而，请注意，加热和冷冻治疗不应该在同一天进行。

在你做出最后决定之前…

请您… 检查您的医生所使用的设备品牌。不是所有的冷冻或射频机器都是一样的。有许多仿制的冷冻溶脂机需要提高警惕，因为并非所有的机器都得到了美国食品和药物管理局的批准。挑选去哪里接受治疗已经很困难了，挑选设备的血统甚至会更困难。切记别被价格牵着鼻子走。

请不要…把身体塑形手术当成减肥治疗。这些治疗方法更多的是转移运动和节食都无法撼动的顽固脂肪，特别是下腹部、臀部上方及腰两侧的脂肪、腹部和大腿。在为这些治疗所做的大多数临床研究中，患者能看到的是英寸数的减少，而不是体重的减轻。如果你想减少的是你的体重，而不仅仅是英寸，您可能还需要食欲抑制剂治疗，如Saxenda（减肥针），或传统的饮食和运动。 

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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

tattoo removal

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 a good 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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