AESTHETICS medicine encompasses non-invasive treatments that do not involve surgery and aim to improve or correct the appearance of patients. Less intensive than cosmetic surgery, aesthetics medicine procedures are carried out by doctors to give natural and reversible results. Depending on your areas of concern, different techniques may be employed in combination to produce the best results - there is no "cookie-cutter" approach to your skincare needs.

Our skin has three layers:

The epidermis, the outermost layer of skin, provides a waterproof barrier to protect our body from germs and harmful UV rays. Its bottom-most layer makes new skin cells, and these skin cells travel up to the top layer and flake off, about a month after they form. It also gives you your skin colour, due to the presence of special cells called melanocytes, which produce the pigment melanin.

The dermis, the middle layer, contains tough connective tissue, blood vessels, hair follicles, and sweat glands.

The hypodermis, the innermost layer, is made of fat and connective tissue.

Ageing happens in every layer of the skin. Changes within the skin's layers show themselves on the surface as signs of ageing.

In the epidermis, a slower cell turnover and reduction in lipid production on the skin's surface means rough and dry skin as we age. Our skin is less efficient at repairing itself from harmful infections and UV rays. This causes pigmentation problems, like sunspots.

In the dermis, from the age of 25, there is a 1 per cent annual decrease in collagen, one of the "building blocks" of the skin. Elastin also decreases as we age. Hence, the structure of the skin is compromised, and wrinkles and saggy skin start to appear.

In the deeper layers, the hypodermis, the changes to the size and number of fat cells leads to deep wrinkles and hollow cheeks.

Skin ageing manifests by:

Fine lines and wrinkles: The first noticeable sign of ageing from 25 onwards are fine lines and wrinkles, especially around your eyes. Your dermis, the second layer of your skin, contains the collagen and elastic fibres that keep young skin plump, taut and wrinkle-free. The amount of collagen and elastic fibres in your dermis dwindles as the years roll on. As a result, your skin becomes less elastic, sags and you start to see the tell-tale signs of wrinkles.

Open pores and sagging skin: Ageing causes your skin to lose its elasticity, which stretches your pores and make them look larger. The accumulation of excess oil, dead skin cells and dirt trapped inside your pores also enhances their appearance. Hormonal changes such as pregnancy, menstruation and puberty can also enlarge your pores.

Dry and dull skin: Your epidermis forms the outer layer of your skin - a physical barrier from the external environment. On average, your body will produce an entirely new epidermis about every 60 days. Cells on the surface of your skin rub and flake off, continuously being replaced with new ones from below.

As you get older, it takes longer for your epidermis to renew itself, hence, more dead skin cells accumulate on the top layer of our skin. This diffuses light away and produces a dull skin tone. In addition, as we age, oil production slows down and this makes our skin dry - we soon lose that "Korean glass-skin effect".

Hyperpigmentation

Melanocytes located in the epidermis produce pigment called melanin. Hyperpigmentation is caused by an overproduction of melanin in patches of the skin.

This overproduction is triggered by a variety of factors, including sun exposure, genetic factors, age, hormonal influences, and skin injuries or inflammation.

Common types of hyperpigmentation encountered in our population are:

Melasma: Melasma is a common skin problem among Asians. Women are far more likely than men to get melasma, especially during pregnancy. They present as brown to gray-brown patches, usually on the face. Most people get it on their cheeks, nose bridge, forehead, chin, and above their upper lip. It also can appear on other parts of the body that are exposed to sunlight, such as the forearms and neck.

Solar lentigo: Solar lentigo, also known as age spots, are non-cancerous lesions that occur on the sun-exposed areas of the body. These flat lesions usually have well-defined borders, are dark in colour, and have an irregular shape. The backs of hands and face are common areas.

The lesions tend to increase in number with age, making them common among the middle age and older population. Age spots occur in 50 per cent of women and 20 per cent of men over the age of 50, due to stimulation from UV rays.

Post-inflammatory hyperpigmentation (PIH): It is temporary pigmentation that follows injury, for example, a cut to the skin, or inflammation of the skin, for example, acne or eczema. PIH can occur in anyone, but is more common in darker-skinned individuals, in whom the colour tends to be more intense and persist for a longer period than in lighter skin.

Freckles: Freckles are common, especially among fairer-skinned individuals. They start early on in life, even in childhood, and are due to your genetic makeup and sun exposure.

Dull skin, enlarged pores, pigmentation - How can they be corrected?

Avoid sun exposure: Sun exposure is the main cause of ageing. Choose a sunscreen with "broad spectrum" protection, meaning that it protects against both UVA and UVB rays. UVA rays also contribute to skin cancer and premature aging, UVB rays are the main cause of sunburn and skin cancers.

Ensure your sunscreen has a SPF30 or higher. Physical sunscreen, those that contain zinc oxide or titanium dioxide, provide better sun protection compared to chemical sunscreens, and are less likely to clog pores and cause pimples.

Protect your eyes with sunglasses and cover up with a wide-brimmed hat or an umbrella. Limit your direct exposure to the sun, especially between 10am and 4pm, when UV rays are strongest. Avoid tanning beds, which can cause serious long-term skin damage and contribute to skin cancer.

Lightening creams: Abnormal accumulation of melanin results in hyperpigmentation. Lightening creams contain ingredients to reduce the production of melanin. Powerful lightening creams are available through a prescription from a doctor, while milder ingredients do not require a prescription.

Hydroquinone is a major ingredient in lightening creams. However, frequent adverse reactions experienced by patients, such as skin irritation and inflammation, have prompted research into other agents. Several alternatives such as tranexamic acid, and 4-n-butyl resorcinol, arbutin and kojic acid have been developed.

Lasers: There are many different lasers in the market, for many different types of indications. The property of the laser, which determines what it is used for, is the specific wavelength it emits. Different structures in the skin will absorb light energy at different wavelengths. Therefore, in pigmentation treatments, we can deliver light energy at the correct wavelength to heat up the pigmentation, while sparing the other nearby structures that absorb different wavelengths.

The pigmentation absorbs the light energy and is broken up into small fragments and eventually is cleared from the skin.

My personal favourite protocol is to use two very effective lasers for pigmentation treatment, via a Rejuvenation Laser protocol.

The Nd:YAG laser emits wavelengths of 1064nm and 532nm. It is a gentle cleansing machine that helps to remove surface dirt and oil, cleanse your skin, dry up pimples, build collagen and is very effective to break up pigmentation into small fragments.

The yellow laser, made in Germany, emits a wavelength of 577nm. It helps with improving radiance, giving you radiant skin, reducing redness and effectively vaporising pigmentation.

The Rejuvenation Laser is non-ablative, gentle and has no downtime.

Combined with a potent post-procedure serum, it synergistically enhances the anti-ageing effect of the laser protocol. The serum employs proteins secreted by umbilical cord-lining stem cells to produce collagen, restore healthy skin function and treat symptoms of ageing.

This series is produced in collaboration with The Aesthetics Medical Clinic

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Aesthetic treatments can help you maintain your youthful glow - The Business Times

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