The importance of continual skin care cannot be stressed enough. There
are many different types of skin care products and you will find that
you prefer some more than others. The trick to skin care is to find
products that agree with your skin and continue to use them on a
regular basis. On and off skin care does not maintain your skin
adequately and the signs of aging and sun damage will become apparent
more quickly. There are a multitude of products such as Clinique,
Clarence, Revlon, Verativa, Environ, Dermalogica and Neostrata to name
but a few. The choice depends on the compatibility with your skin and
accessibility to the products.
In essence skin care can be broken up into two major interconnected
1. Prevention of accelerated aging and
2. Care for skin.
Prevention of accelerated aging and sun-damage to skin generally
revolves around being well informed about what is harmful to your skin.
Avoiding these harmful factors will help in keeping your skin youthful.
Factors which may be harmful to your skin include:
- Sun exposure:
UV radiation results in collagen damage in your skin as well as
decreasing the elasticity of the skin. This makes the skin thinner and
more susceptible to damage. In addition, UV radiation is carcinogenic
which means that it can cause skin cancers.
Protection from the sun is very important and you should be aware of
this at all times. The use of sunscreens, hats and protective clothing
is vital and you should even apply make-up that has some form of sun
protection in it.
Smoking also decreases the amount of eleastic fibers in your skin
resulting in a poor quality skin.
This is easily prevented by stopping smoking.
- Oxygen free radicals
Oxygen free radicals result from and may mediate the effects of UV
Prevention of this involves sun protection which we have already
mentioned. In addition, antioxidants such as vitamins A, C, and E act
as free radical scavengers. Topical and systemic administration of
these vitamins have a photo-protective effect but I advise you to use
these as prescribed by a doctor.
- In addition to barrier protection and
antioxidant treatments, the following lifestyle changes are beneficial:
o selection of a healthy diet with
adequate fluid intake for hydration
o regular exercise
o proper rest and relaxation
o minimal alcohol ingestion
o refraining from smoking
Care for Skin
It is vital to care for your skin every day. Once you have found a
product that agrees with your skin you should be diligent and have a
routine that you follow every day. There are hundreds of creams and
ointments that claim to keep your skin youthful and it is easy to get
confused. I will try and simplify this for you.
I feel that every home treatment program should consist of at least the
- facial cleanser
- skin exfoliants
- stimulating agents
- moisturizing agents
- protective and preventive agents
In the evening.
- Facial cleansers are important to keep
the pores clean and prevent the build-up of bacteria which may cause
- Products to exfoliate and stimulate the
skin are used in the evening as you are at home and not exposed to the
sun. Alpha-hydroxy acids (AHAs) and poly-hydroxy acids (PHAs) are found
in products used to exfoliate and smooth the skin. Examples of
alpha-hydroxy-acids are glycolic acid and lactic acid. These are often
combined with a moisturizer.
- Abrasive scrubs are mechanical
exfoliants designed to remove small skin scales with a sponge or
- Stimulating agents (such as Prevage)
and skin renewers can also be used in the evening which help the cells
regenerate and replenish themselves.
In the morning:
- These products are oriented towards
prevention and protection. Topical and systemic antioxidant containing
preparations result in free radical scavenging and reduction of the
photoaging process. It is also vital to consider creams that have sun
- Moisturization increases the water
content of the skin and protects injured or exposed skin from harmful
or annoying stimuli. If the skin is poorly hydrated, it is more
susceptible to harmful factors and it cannot protect itself as well. In
addition, the skin lacks its fullness and tends to sag and wrinkle more
if it not well hydrated.
injections are excellent alternatives as well as adjuncts to
surgical facial rejuvenation. Areas on the face which have deep
wrinkles could be filled with a filler and thereby mask the appearance
of the wrinkle. Areas that are often filled include the lips,
nasolabial folds, marionette lines, and the frown lines. In addition,
fillers can be used to augment certain areas on the face which can be
used for both aesthetic as well as reconstructive purposes.
There are many different types of fillers and they all have their
benefits and pitfalls. Filler injections could either be permanent or
My preference to permanent fillers is using your own fat taken from the
abdomen or thigh. This fat is then refined and injected into areas
which require filling. The benefit of using your own tissue is that
there will be no complications regarding rejection. Unfortunately, some
of the fat that gets injected does not survive and will be taken up by
the body. Although this is not harmful, it may mean that the procedure
needs to be repeated to “touch-up” certain areas. This procedure can be
done in the office but it is mostly performed in theatre as an adjunct
to a facelift.
I do not use any permanent fillers other than fat because I feel that
the possible complications outweigh the benefits.
There are many types of non-permanent fillers such as Restylane and
Juvederm. Although these products can be derived from other substances,
the ones that I prefer are made of hyaluronic acid. This substance is
ubiquitous in our bodies and therefore it has very few complications
once it is injected. There are several types of Restylane fillers which
can be used to fill in deep and superficial wrinkles on the face such
as the nasolabial folds, marionette lines, and the frown lines. In
addition, the lips can be augmented giving them a fuller and more
attractive appearance. The beauty of using this technique is that it is
an office based procedure with very little time required off work.
Fillers are often used together with other non-surgical techniques such
as botox and chemical peels to give a more complete rejuvenation.
I feel that there is a large gain from these fillers as they provide a
youthful appearance with very few side effects. It is quick and easy
and it will make you feel more confident and boost your self esteem.
Chemical peels (chemexfoliation) create a controlled injury to the skin
which allows it to heal with a better quality. There are many
types of chemical peels such as glycolic acid peels, phenol peels and
trichloracetic acid peels.
I feel that a facial peel should be controllable and must be tailored
to your needs. Phenol peels for example give a result which is not
dependant on the time of application and therefore the result cannot be
tailored to individual needs. On the other hand, the glycolic acid skin
renewal peel is considered to be one of the safer and more controlled
facial peels. It is by nature a “lighter” peel but this is not to say
that results will not be noticed. More accurately, the glycolic acid
peel helps maintain the quality of the skin and keeps it well
conditioned. Different concentrations exist which can be used depending
on the desired result which will be discussed with you.
The chemical peel is done as an office procedure and the recovery time
is roughly 2 days. The skin may peel slightly but not always and this
is dependent on the concentration that is used. Immediately after the
peel, the skin becomes red for approximately 24-48 hours. During this
time, this skin should be kept well hydrated with a non-allergenic
moisturizer or Vaseline. The skin may feel tight for a few days.
The best results are obtained from several lighter peels roughly 4
weeks apart so that the skin is gradually rejuvenated and not
traumatized. During this period, it is a good idea to use good facial
products to assist the process of facial rejuvenation. I will discuss
this with you.
The complications of such a peel include:
• Fever blister (herpes) reactivation
• Hypopigmentation (skin lightening)
• Hyperpigmentation (skin darkening in
These complications are very rare and do not often occur if lighter
peels are done more often.
Botox is derived from Botulinum toxin which comes from the bacteria
Clostridium Botulinum. The toxin has been denatured to a degree that is
completely harmless but still has an effect on muscle fibers. Once
botox is injected into a muscle it paralyses that muscle but it does
not have any systemic effects. It was originally used for squinting of
the eyes where botox was injected into the affected muscle thereby
paralyzing it and correcting the squint. It has however found its niche
in the cosmetic field to get rid of facial wrinkles. Wrinkles are
formed by the function of the underlying facial muscles pulling on the
skin. This is commonly seen in the forehead, frown lines and crows feet
(laugh lines). If the underlying muscle is paralyzed, it cannot pull
the skin together and the wrinkles will disappear with time.
Botox injections are done with a very small needle and are relatively
painless. Once the injection is done, the muscle will be paralyzed in
two to three days. The wrinkles will not disappear immediately but they
will start to fade with time. Botox injections last about three to six
months and then the muscle function will start to return. Once the
muscle function begins to return, further botox injections are required
to maintain the result.
It is important to use botox correctly to avoid paralyzing adjacent
muscles. This could result in a droopy eyelid. In addition, one can be
allergic to an ingredient in the botox injection but this is very rare.
I feel that the aim is to provide a more youthful appearance without
losing facial expressions completely.
Botox is widely used and it is very successful in removing wrinkles and
helping to rejuvenate the face to a fresher and younger look.
PELLEVE SKIN TIGHTENING
is a revolutionary non-surgical procedure to safely treat facial
wrinkles with virtually no pain and little downtime. Using advanced
radiowave technology, the Pellevé system precisely heats the deep
layers of the skin without damaging the epidermis, or top layer. The
heat causes the collagen in the skin to contract and tighten. After
treatment, the skin begins to produce new collagen, which improves skin
firmness. The result is a naturally refreshed appearance.
Unlike some other skin tightening systems, Pellevé doesn’t require
anesthesia or skin cooling. Patients can expect to feel a deep warming
sensation each time the handpiece touches the area being treated.
Because the skin is not numb, the patient can describe the depth of the
feeling to the doctor, which helps to ensure the best possible results.
They can also return to home or work immediately. Side effects may
include mild discomfort during the procedure within the treatment area.
Mild swelling and redness may also occur and typically go away within 2
to 24 hours after treatment.
Pellevé can be used to treat the skin on the face, including the eye
area. Many people start to see results after just one treatment, with
lasting improvement in skin tightness and tone for up to six months.
Because a full facial treatment takes only about an hour with little,
if any, recovery time, Pellevé fits easily into busy schedules.
In addition to the face, Pellevé can be used to rejuvenate the skin of
the hands and other areas of the body. The treatment can be combined
with other non-invasive procedures such as Botox and fillers depending
on the patient’s need.
The Pellevé machine is multifunctional and it can also ablate small
vessels on the face and legs. This treatment is also painless with very
good results. For the best results, it’s important to choose a doctor
who is experienced in administering Pellevé.