Category: Beauty

Laser Your Way To Perfect Skin

April 27, 2022 Return

WORDS HANNAH MAY-LEE WONG

Can you believe that zapping your skin with laser beams can vaporize some of your deepest insecurities? This technology has come a long way in the aesthetic industry. Laser therapy for the skin can be used to resurface acne scars, remove freckles and tattoos, lessen wrinkles and more.

HOW DOES IT WORK?

There are different types of lasers out there. Each laser machine emits lasers at a specific wavelength. By tweaking the wavelength of the laser, we can treat different skin conditions.

We use carefully chosen wavelengths, pulse durations, and energy strength to target an area and minimize injury to the surrounding healthy skin. Generally, lasers can be used to improve acne scars, reduce pigmentation, wrinkles, blood capillaries, remove tattoos and rejuvenate the skin.

Laser machines work by emitting light of a single wavelength that is absorbed by target chromophores. In the beauty industry, lasers target chromophores (target cells) such as tattoo pigments, melanin, haemoglobin and water. What happens is that certain light waves would target broken capillaries and vessels, while others target dark spots and pigments. When light energy is absorbed by these targets, the vessels or pigments would break down and get swept away by white blood cells or macrophages in the body. In other words, after being zapped by lasers, these imperfections will disappear or fade.

Some lasers are used for rejuvenation. In these cases, the energy from the laser is absorbed deep within the skin and creates a “controlled injury”. This process would stimulate the inner layers of the skin to produce more collagen. As a result, fine lines would appear less visible and the skin would look firmer.

“By tweaking the wavelength of the laser, we can treat different skin conditions.”

However, this is not a one-size- fits-all kind of treatment. The intensity of each laser therapy depends on what the patient hopes to target, skin type, the age of the skin and the gender of the patient. For example, the skin of a 60-year-old gentleman would be thicker and rougher compared to that of a 20-year-old lady. Hence, the settings of the machine used during each treatment needs to be carefully tuned by the doctor to achieve the best possible results.

With more technological innovation, newer machines now provide faster results, are safer for use and have less risk of complications.

WHAT ARE ABLATIVE AND NON-ABLATIVE LASERS?

By definition, “ablation” means to surgically remove. Ablative lasers work like sandpaper — they “sand away” or “resurface” the top layer of your skin and they may cause peeling. With non- ablative lasers, the top part of your skin remains unharmed, because the wavelength and energy used penetrates deeper into the skin and stimulates collagen production. Non-ablative lasers do not cause any injury to the top layer of your skin.

MUST ALL LASER PROCEDURES BE DONE BY A DOCTOR?

Yes. In Malaysia, laser procedures for the skin are supposed to be done by doctors who are trained and certified to use laser machines. These doctors need to obtain a Letter of Credentialing & Privileging (LCP) from the Ministry of Health before being allowed to practise. This is to ensure patient safety. Improper use of lasers may cause burns to the skin and even damage to the eyes.

ARE THERE CERTAIN GROUPS OF PEOPLE WHO CAN’T GO FOR LASERS?

Pregnant or breastfeeding mothers are advised not to go for lasers. Also, those who have recent sunburn would have to wait for a couple of days for the skin to heal before going for laser therapy.

WHAT IS THE PROCESS LIKE?

The patient would first have to come for a consultation session. The doctor would discuss the patient’s expectations and explain the possible risks and complications. Once the patient is fully informed, treatment can be started.

Before the doctor performs the laser procedure, a nurse would wash the patient’s face to remove impurities and apply numbing cream. It takes 30 to 45 minutes for the numbing cream to set in. After that, the doctor performs the laser procedure, which typically lasts for 20 to 30 minutes. Once that is completed, the nurse would wash the patient’s face, do a post-laser care regime and apply a cooling mask to soothe the treated skin.

The doctor may prescribe some medication to help with the discomfort and inflammation. The patient is usually given some skincare to take home too. Patients are required to protect their skin with sunscreen, daily. Overexposure to the sun after the laser treatment to remove pigmentation may result in the treated skin turning darker.

DOES IT HURT?

It depends on the patient’s pain tolerance and what treatment the patient goes for. If the patient receives more intense treatments like tattoo removal, birth mark removal or vascular lesion reduction, light sedation or local anaesthesia may be given. Generally, ablative laser treatments are slightly more painful, and they also require local anaesthesia or sedation.

Non-ablative lasers tend to hurt less. Don’t worry, numbing cream is usually applied before these procedures to reduce the pain sensation, so it will be tolerable. The sensation is akin to being snapped by a rubber band.

ANY DOWNTIME INVOLVED? FOR HOW LONG?

Again, it depends on what you get treated for. If you do laser treatment for rejuvenation or lessening wrinkles (milder treatments), your face would only appear pinkish for a day. If you go for lasers to remove or reduce the appearance of a scar (a stronger treatment with the use of higher energy lasers), it takes up to a week to recover. In those cases, your face would appear red for some time, followed by some peeling of the skin which normally occurs after day five of treatment.

HOW MANY SESSIONS DOES A PERSON NEED TO SEE RESULTS?

This is very subjective and it depends on which treatment you opt for. Most of the time, if you’re looking to treat pigmentation issues like solar lentigo (darkened patches of skin due to exposure to the sun), bulky skin lesions like seborrheic keratosis or treatment to brighten up the skin, results sometimes can be seen after just one session.

However, for treatment of melasma (patches of brown on the skin), it will be more challenging and would take around six or more sessions to get good results.

HOW LONG DO THE RESULTS LAST?

It depends. The rule of thumb is that the more you take care of yourself, the longer the results last. If you don’t smoke, sleep early, have a healthy diet and drink lots of water, the results remain for a long time.

Also, if you go for laser therapy to remove hyperpigmentation, you’ll need to protect your skin from the sun diligently because exposure to the sun may cause the pigmentation to reappear.

WHAT ARE THE POSSIBLE RISKS AND COMPLICATIONS WE SHOULD KNOW ABOUT?

Lasers are at large, safe for use. However, in inexperienced hands the risk of complication would be much higher. Complications can include damage to the eyes, burns on the skin and pigmentation becoming darker or very much lighter (post-inflammatory hyper/ hypopigmentation). During tattoo removal, if the power of the laser is set too strong, the person might develop blisters, which may lead to infection.

Remember, always get your treatment from a licensed doctor to minimize your risk of complications. Your health and safety are of utmost importance and this should not be compromised. While we all want flawless skin, we need to remind ourselves that the procedures we go for should be done safely and with minimal risk. HT

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Need A Lift?

April 27, 2022 Return

WORDS HANNAH MAY-LEE WONG

Dr William Hoo

Medical Director

Botulinum toxin injections and dermal fillers may seem similar, but they are two very different things. Although they are both injectable cosmetic treatments performed by aesthetic physicians, that’s pretty much where their similarities end. An expert in the field answers some frequently asked questions and tells us all we need to know about these two popular non-invasive procedures.

BOTULINUM TOXIN

Tell us about the Botulinum toxin.

Botulinum toxin (BTX) is a type of protein produced by the bacterium Clostridium botulinum. There are many different types and brand names of BTX that are registered as medication and are approved by the Ministry of Health (MOH).

In the medical field, BTX can be used to treat chronic migraines, muscle spasms (e.g. in children with cerebral palsy or in stroke patients who have lost control of their muscle movement), hyperhidrosis (excessive sweating) and more. In the medical aesthetic industry however, BTX is mainly used to reduce wrinkles.

How is it used in the beauty industry?

BTX can be used to reduce dynamic wrinkles, which are wrinkles caused by repeated muscle movement associated with facial expressions, e.g. squinting, frowning and smiling. Common areas for injection are the glabella (frown lines), crow’s feet and forehead lines.

A popular procedure in Asia is using BTX for face reshaping—for example, reshaping a square face to a more feminine oval face via size reduction of the masseter muscle. With special injection techniques, BTX can also be used for face lifting.

BTX can help reduce the appearance of a “gummy smile”—a smile that shows gum excessively. This is done by weakening the muscles that strongly pulls up the upper lip. For men, many get BTX injections at the frown lines to get a more approachable, refreshing and “less angry” look.

Does it hurt?

The needles used for BTX injections are very fine. Additionally, the doctor may apply ice packs or numbing cream beforehand, so that you may only feel minimal discomfort during the injection.

However, after the treatment, you might feel a bit heavy in the injected muscle area. BTX works by blocking nerve signals in the muscles where it was injected. As a result, the injected muscle would be temporarily relaxed or “asleep”. Extra effort is needed to move the affected muscle, so that area might feel heavy. Don’t worry, the sensation only lasts about 1 to 2 weeks, and then you’ll adapt to it.

“BTX can be used to reduce dynamic wrinkles, which are wrinkles caused by repeated muscle movement”

What is the after-care like?

There will be a needle injection mark at the injected site, therefore the goal is to prevent contamination and infection in the area. After treatment, avoid swimming and going for sauna sessions or massages. Don’t drink excessive amounts of alcohol, as alcohol causes vasodilation (the dilation of blood vessels). Avoid going for laser or facial treatments for about 3 days.

How long do the effects last?

The effects of BTX lasts around 3 to 6 months.

What are the risks and possible complications?

The toxin effect of BTX may spread. If BTX is injected over the forehead, there is a small chance that the toxin may spread downwards and cause the eyelids to droop (ptosis) or cause the patient to have double vision. There are medications available to treat this if it happens.

Some patients may experience headaches after treatment. BTX can also cause breathing difficulty or difficulty in pronouncing certain words when it is injected around the mouth area.

If the doctor injects unequal doses on the left and right side of the face, it may cause asymmetry, which can become obvious when a person is making expressions. Not to worry, you may go back to your doctor to correct the asymmetry; these effects are temporary and can be reversed after a period of time.

Who should NOT get this treatment?

Pregnant women, those who are allergic or those who have had adverse reactions to BTX before.

Can it become addictive?

BTX in itself is not addictive, but people can get addicted to the beauty effects of BTX. The communication between the patient and the doctor is very important. The doctor needs to know when to advise the patient to stop, as too much BTX may make facial features and expressions to become unnatural (stiff or mask-like).

DERMAL FILLERS

What are fillers and how are they different from BTX injections?

Fillers are substances used to restore volume loss, whereas BTX is used to weaken the muscles that cause wrinkles. They are entirely different.

There are different types of fillers: hyaluronic acid fillers, synthetic fillers (e.g. calcium hydroxylapatite, silicone, etc.) and autologous fillers (i.e. fat transfer) which is a method of using fats from other parts of the body for reinjecting over the face. Hyaluronic acid fillers tend to be a popular choice in the aesthetic industry because it is the only type of filler which has an antidote, called hyaluronidase. If anything goes wrong during the treatment, it can be reversed quickly by the antidote.

Where in the face are fillers typically injected?

Previously, fillers were mainly used to restore volume, especially in the sunken under-eye area and in the lips. Nowadays, we use fillers for much more than that; fillers can be used to correct certain features on the face.

As we age, our features tend to sag and look tired. Many women experience volume loss in the under-eye area. The corners of the mouth and the lateral canthus of the eyes also tend to point downwards as a person gets older, which may make a woman look angry or sad all the time. Fillers can be used to plump up and restore volume in these areas, and it will overall result in the woman looking refreshed, and more feminine and youthful.

Common areas for filler injections are over the cheeks; under the eyes; at the temples; on the chin and on the lips. Some people who are allergic to BTX can opt for fillers too, as fillers can limit muscle movement and reduce the appearance of wrinkles—we call this myomodulation. Lastly, fillers can also be used to reduce the appearance of acne scars.

How long do the effects last?

Some fillers produce effects, which last around 6 to 9 months, while others for up to 24 months. It all depends on the brand, the method of preparation and the concentration of fillers used.

It’s worth noting that if you get fillers for the second or third time, the amount of fillers needed will be less than before, and the effects will probably last longer. This is because when fillers are injected into an area, it stimulates collagen production.

What are the risks?

The skill of the medical professional performing this treatment is a very important factor. Sometimes, fillers can cause asymmetry if the dose injected is not equal on both sides. Filler injections can cause lumps and bumps in the skin if the level of injection is too superficial. Sometimes, after getting fillers, some people might have redness, rashes, bruising or swelling over the treated area.

The more serious complications arise when the fillers are accidentally injected into a blood vessel—it can cause skin necrosis (cell death) or blindness.

The probability of risk also depends on the type of fillers being injected. Fillers are riskier if injected on the central area of the face—there are more blood vessels connected to the eyes, brain and nerves in the central area of the face. Hyaluronic acid fillers are more popular because it has an antidote to reverse the adverse effects, in case anything goes wrong.

It is highly advisable to consult a trained and certified medical professional from a reputable clinic, which uses good quality products. Regulation by the MOH requires the doctor to have a license to perform these procedures, and the clinic must also have an aesthetics treatment license. Lastly, all products used must be registered and approved by the MOH. HT

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Oral Piercing: A New Fad in Body Piercing

April 25, 2022 Return

WORDS DR ANDREW CHAN KIENG HOCK

Consultant Oral Surgeon

Private Dental Practice Klang, Selangor.

Body piercing, including oral piercing, is a form of body art or self-expression with similarities to body tattooing. By definition, body piercing is the practice of puncturing or cutting a part of the human body, in which jewelry or implants can then be inserted. They are often physically visible but sometimes hidden, such as in the case of charm needles (susuk), which are embedded subdermally on the face. In this article, Dr Andrew Chan Kieng Hock discusses some of the more common side- effects due directly to oral piercings and steps that can be taken to minimize them.

The History of Body Piercing

Ample historical records indicated that this practice has been common since ancient times and is practiced by both sexes. The hardware can be metallic or non-metallic objects such as stainless steel, niobium, titanium, gold alloy, silver, bone, ivory, stone, horn or even synthetic materials like PMMA (polymethyl methacrylate) and PTFE (polytetrafluoroethylene).

The reasons for practicing body piercing are numerous. They include religious or spiritual aspects; to conform to a certain popular or tribal culture; for aesthetic value or body adornment; self-expression in making a fashion statement; eccentric lifestyle choices, and even for sexual pleasure.

The most common sites for body piercing are the ear lobes and the noses. Even though in this age of modernity the practice is rampant, some countries—including several states in the US as well as certain European countries—prohibit or ban such practices until the person is at least 16 or 18 years of age; otherwise, parental consent is required. Most state schools, churches, or corporate companies do not allow their members to openly exhibit or display their body piercings due to dress code violation.

Contrary to popular belief, any form of piercing including in the oral cavity is an invasive and risky surgical procedure. Dentists are seeing more and more cases of oral piercings which went wrong, resulting in serious complications.

As far as oral healthcare providers are concerned, oral piercings irrespective of site or materials are not harmless but often come with some side-effects, which most owners are ignorant about. These complications, which have been reported in scientific journals as well as personally encountered by practicing dentists, include:

Speech, swallowing, and chewing impairment
Tooth fracture and chipping as well as damage to fillings and dental prosthetics due to the knocking effect from the jewelry
Gingival trauma and recession
Profuse bleeding especially in the tongue region as the organ is highly vascularized (blood vessels)
Pain
Loss of taste
Risk of blood-borne infections such as HIV, hepatitis B and C, and tetanus due to contaminated equipment
Increased salivary flow resulting in uncontrolled drooling
Numbness due to nerve damage
Infection at the pierced site which in rare cases can lead to septicaemia and bacteria endocarditis. This is because the mouth is home to numerous microorganisms
Swelling which can compromise or obstruct the airway
Interference when taking X-ray
Foreign body reaction leading to keloid scarring
Allergic reactions to the material especially metal alloy with nickel elements.

What role can a dentist play?

If patients intend to perform oral piercing but have yet to do so, they must be advised against it by explaining all the possible side-effects. Nonetheless, in the event they insist on proceeding with the piercing, they should be advised to get the procedure done by a professional or trained body piercer in a piercing studio, which is kept in a clean and hygienic condition at all times, since it is an invasive and risky surgical procedure. The American Dental Association (ADA) lists very helpful guidelines to patients who have existing oral piercings.

List of guidelines from the American Dental Association (ADA) regarding oral piercings:

Contact a dentist or physician immediately if there are any signs of infection such as swelling, pain, fever, chills, shaking, or a red- streaked appearance around the site of the piercing.
Keep the piercing site clean and free of any matter that may collect on the jewelry by using a mouth rinse after every meal.
Try to avoid clicking the jewelry against teeth and avoid putting pressure on the piercing.
Be gentle and aware of the jewelry’s movement when talking and chewing.
Check the tightness of the jewelry periodically with clean hands. This can help prevent from swallowing or choking if the jewelry becomes dislodged.
When taking part in sports, remove the jewelry and protect the mouth with a mouthguard.
See a dentist regularly and remember to brush twice a day and floss daily.

Dentists need to stress to owners of piercings that they need to maintain good oral hygiene and keep up with their dental check-ups regularly. Oral piercings seem to be on an increasing trend as dentists encounter not only more but also younger patients with various forms of oral piercings. This type of body art is associated with real complications, which dentists should themselves be familiar with, so that they in turn can educate patients professionally and appropriately on this issue.

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References:

1. ADA. Guidelines on oral piercing. Retrieved from https://www.ada.org/en/member-center/oral-health-topics/oral- piercing.

2. Levin, L., et al. (2005). Oral and dental complications of intra-oral piercing. Dent Traumatol.;21(6):341–343. 3. De Moor, R.J., et al. (2005). Dental and oral complications of lip and tongue piercings. Br Dent J.;199(8):506–509.

Luscious Lips For The Holidays

April 25, 2022 Return

WORDS HANNAH MAY-LEE WONG

The skin on our lips is typically thinner and drier than other parts of the face. Follow these tips to show your lips some extra TLC.

Ahh the lips. We all know what the ideal set of lips should be: smooth, plump, soft and supple. It’s especially desirable for our lips to remain in pristine condition during the holiday season. I mean, how else would we rock a bold lippie for that year-end party? But all too often, our expectations fall short when we wake up to (yet again) find dry, cracked lips. Worst of all, no lipstick can hide dull, crusty lips! Don’t worry, this is quite a common problem among men and women alike.

If you really want luscious lips, sometimes, you’ve got to work for it. Here’s how:

1. KNOW YOUR INGREDIENTS

If you’ve got dry, sensitive lips, try paying more attention to the ingredients in your lip products the next time you go shopping. Choose products that are fragrance free and hypoallergenic.”

According to the American Academy of Dermatology, those with chapped lips should avoid the following ingredients in their lip products:

Camphor
Eucalyptus
Flavouring such as cinnamon, citrus, mint, and peppermint that can be especially irritating to dry, chapped lips
Fragrance
Lanolin
Menthol
Octinoxate or oxybenzone
Phenol (or phenyl)
Propyl gallate
Salicylic acid.

Instead, opt for products that contain these ingredients to help heal cracked lips. Dermatologists recommend choosing lip products that have one or more of the following ingredients:

Castor seed oil
Ceramides
Dimethicone
Hemp seed oil
Mineral oil
Petrolatum
Shea butter
Sun-protective ingredients, such as titanium oxide or zinc oxide
White petroleum jelly

Pro tip: If you apply a product on your lips that starts burning, tingling, stinging or causing you discomfort, these signs don’t point to the product working its magic on your lips. Quite the opposite—it most likely means that the product you are using is irritating your lips, so it is best to stop using that product immediately.

2. MOISTURIZE DAY AND NIGHT

A good lip balm contains nourishing emollients to help form a barrier that protects your lips. If you’ve got dry lips, it’s a good idea to apply lip balm, a moisturizing lipstick or other types of lip moisturizer throughout the day and before bed. Thick ointments such as white petroleum jelly is good for cracked lips—ointments are more effective in locking in moisture than waxes or oils.

Pro tip: A popular Korean product making waves in the beauty scene is the overnight lip mask. These are deeply hydrating and are meant to be put on just before bed so that your lips stay hydrated until the next morning.

3. GET OUT OF THE BAD HABIT OFLICKING OR BITING YOUR LIPS

When your lips are dry, you may be tempted to wet them with saliva. But this often worsens the problem. When saliva evaporates, your lips can become drier. If you need a quick moisture boost, use a lip balm. Biting your lips would also irritate your lips and prevent them from healing.

4. YOUR LIPS NEED SUN PROTECTION TOO

The sun can burn dry and chapped lips, which could lead to cold sores. Protect your lips from the UV rays by using lip balm that has SPF30 or higher. Lip balms that have sun protection typically contain titanium oxide or zinc oxide as ingredients. Don’t forget to reapply every 2 hours.

5. STAY HYDRATED

Drink plenty of water to keep your skin hydrated from within. It’s good for your overall health too.

6. REMOVE MAKEUP AT THE END OF EVERY DAY

Your skin needs time to breathe too. Washing your face and removing makeup thoroughly at the end of every day is an essential step for smooth, healthy skin. If you wear long-lasting/waterproof lipstick, remove your makeup with an oil-based makeup remover to get rid of all traces of makeup.

7. USE A LIP SCRUB

Exfoliating or using a lip scrub can help slough away dead skin cells when necessary. It is recommended to only do this once or twice a week. You can probably find a ready-made lip scrub from your nearby pharmacy or beauty store, but you can also easily make your own at home (check out the recipe below!). Note: If you have sensitive skin, injuries on your lips or severely chapped lips, refrain from exfoliating.

8. KNOW WHEN TO SEEK HELP

Most of the time, dry or chapped lips can heal itself within 2 to 3 weeks. However, peeling lips could also be a sign of an allergic reaction to lipstick, toothpaste, food or certain medication. If the issue persists, it’s best to consult a dermatologist.

9. ALWAYS A GOOD TIME FOR LIPSTICK

On top of providing colour, the right lipstick adds a layer of protection and much-needed moisture to dull lips. There are all kinds of options of lip products to choose from, the trick is to pick what best suits your lifestyle. If you go outdoors a lot, get a lipstick or lip moisturizer with SPF for sun protection. If you’ve got dry lips, avoid wearing matte lipsticks. Instead, choose a lip gloss or moisturizing lipstick that is rich in nourishing and emollient ingredients (such as shea butter or cocoa butter).

You can also add a layer of moisturizing lip balm under your usual lipstick for longer-lasting hydration on your lips. HT

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References: 1. American Academy of Dermatology. 7 Dermatologists’ Tips For Healing Dry, Chapped Lips. Retrieved from: https://www.aad.org/skin-care-basics/heal-dry-chapped-lips 2. Stylecraze. Care for Your Lips. Retrieved from: https://www.stylecraze.com/articles/care-for-your-lips/#gref