A little more kindness, A little less judgement!

It has been a few months since my last blog post. The past few months have been extremely intense with work and home matters (yes…mainly the kids) which I chose to focus on first. In the meantime, I have thought about several Health & Beauty topics that I would like to write about. Yes! Regularly updating my blog will definitely be one of my 2018 resolutions, but before I start writing about those topics, I would like to share a good quote that we could all use as we embrace this coming new year.

(FYI aside from medicine, I enjoy reading story books, inspirational books or autobiography books by successful people in the world. I find that it helps keep me motivated, have an open-mind and allows me to also share with everyone any useful information I am able to gain from it)

kindnessquote

Cosmetic Dermatology / Aesthetic Medicine has been around for quite some time now, but back then it was a hush-hush and not-talked about. In the recent years, with the boom of Selfies and Social Media, issues surrounding Self-Image is more openly talked about and suitable treatments available are also more openly discussed. However, in my experience and observation, I find that many people still have strong judgements on others wanting to do cosmetic procedures. Perhaps it is the fact that we are on this side of the world, people are more reserved and shy to discuss self-image issues.

I have treated both men and women of different religion and cultures, young and old, different socioeconomic status and the one common goal they all have is to ‘be healthier, look better and feel better’.

We do not know what others are truly going through in their lives and sometimes subtle improvements may give that boost of confidence and self-esteem which may affect their mental health and overall daily life. I have found that some people have very valid reasons for seeking such treatments. It could be about having extra confidence to handle a newly appointed job promotion, or women gaining body-confidence post-childbirth, or even regaining self-esteem post-emotionally/physically abusive relationship. Everyone has their own stories & reasons for undergoing such procedures. Just a little advice… when considering such procedures, ‘Do it for YOURSELF’ & not for someone else.

So let’s embrace the new year with a little more kindness & a little less judgement!

[Disclaimer: As medical practitioners, each new patient seen during consultation will be assessed thoroughly to ensure patients do not have underlying untreated mental health issues such as Body Dysmorphic Disorder before undergoing any type of cosmetic-related procedures]

Acne: Focus on Five 

We all have encountered a sudden outburst of acne at some point in our lives. Whether it was puberty, pregnancy or the few pimples that appear just before monthly menstruation.

The 3 main reasons how and why acne happen:

  1. Sebaceous Gland Hyperactivity

Sebum is continuously produced by the sebaceous glands and secreted to the skin surface through the hair follicle pore. This is controlled hormonally. Active acne is seen during puberty due to the increase in androgen which promotes sebum production. For women, the sebaceous gland activity also increases post ovulation due to the surge in Luteinizing Hormones, and this explains the acne breakouts just before menstruation.

  1. Keratinocytes Clumping

In acne patient, the keratinocytes (cell in the top skin layer) tends to stick together and block the pore, creating open comedones ‘blackhead’ or closed comedones ‘whitehead’. This clogged pore is a great nutritional source for bacteria.

  1. Impact of Bacteria

Propionibacterium acnes – commonly found on the surface of the skin in an adult face with or without acne. The increase in sebum production and keratinocytes clumping leads to an increase in P. acnes around the hair follicle.

acnepic2

The 5 essential steps of  acne management are:

  1. Exfoliation – Normalize Keratinization

The first step to control acne is to prevent the exfoliated keratinocytes from clumping together. Retinoids are great to achieve this. Many dermatologists prescribe some form of retinoids as part of ‘Acne Care Management’ due to the ability to eradicate existing comedones and prevent new ones.

  1. Reduce Bacteria

Depending on the severity of the acne, anti-bacterial medications such as Topical Clindamycin and Oral Tetracycline / Doxycycline are commonly used in the treatment of acne.

Benzoyl Peroxide can also eliminate bacteria, however by generating reactive oxygen species in the sebaceous follicle causing free radical formation, this may lead to accelerated aging of the skin therefore it should be used sparingly.

  1. Remove Pore-Clogging Material

AHAs and BHAs (Salicylic Acid) are used to loosen the keratinocytes, therefore ‘unclogging’ the pores. This is usually done in clinics and known as ‘chemical peel treatment’. 

  1. Manage Inflammation

Anti-inflammatory products such as Salicylic Acid helps soothe active acne. For severe cystic type acne, the physician may even suggest intralesional steroids in order to prevent scarring.

  1. Decrease Sebum Production

It is also recommended to have hormone profile test done, as many women who suffer from persistent acne turns out to have Polycystic Ovarian Syndrome, and by managing the excess testosterone with anti-androgen oral treatment, drastic improvement can be seen even after 1 month of this hormonal stabilization treatment.

The 5 steps mentioned are mainly for prevention of future eruptions, therefore optimal results will only be seen between 6-8 weeks from commencement of treatment.

“Patience is not the ability to wait, but the ability to keep a good attitude while waiting”

So…stay positive, ensure good compliance to the recommended treatment plan and that clear radiant skin will be yours again in due time!

IMG_6679

IMAGE ABOVE IS MY ACTUAL PATIENT. KINDLY DO NOT DISTRIBUTE IMAGES WITHOUT WRITTEN PERSMISSION. THANK YOU.

References:

Baumann, L. (2009). Cosmetic Dermatology: Principles and Practice. McGrawHill,  pp121-125.

 

 

 

Double Celebration

Last Saturday – 12th August 2017, was a memorable day indeed.

I turned 21 (yeah…I wish) and celebrated the official opening of our second branch in Kuala Lumpur.

We started in December 2014 in Kelana Jaya. It was not any special reason we chose our first outlet to be in Kelana Jaya but it was more of the convenience of working nearby home and where my kids go to school. I grew up in Kelana Jaya too, so it felt very much ‘at home’ for me.

Over the years, we have many patients who live in the heart of the city (Kuala Lumpur) and have travelled so diligently for their treatments. I truly appreciate the support they have given us despite having to battle through horrible traffic at times. I guess it is alright for some face treatments which needs once a month travel, but since we also do a lot of body contouring treatments which involves weekly visits, the distance may disrupt the programme and I am always concern about how this would affect them obtaining their optimal results.

By early 2016, we had many requests to open a branch in the city itself. I was unsure about this at first, and after visiting many places, I still didn’t feel I quite found THE place.

It was December 2016, my family and I went for dinner at BLVD, in Platinum Park. After dinner, my ‘forever-hungry’ kids wanted to get some snacks from the convenience store which was at the building next door. We walked outside and saw the beautiful view of Petronas Twin Tower. It was almost sunset, the skyline was beautiful, kids were happily running around and that was when I saw ALAINN KUALA LUMPUR right there!

It was love at first sight.

Fast forward half a year later and here we are in the heart of the city, and very thankful to have such amazing support from our Kuala Lumpur clients. We had a simple and intimate Opening Ceremony and a truly meaningful birthday celebration this year!

A blessed 12th August indeed!

@alainn_kualalumpur

ES_7007

 

ES_7241

ES_7276

ES_7290

ES_7369

 

 

 

Embracing Those Tiger Stripes?

Not too long ago, the famous model Chrissy Teigen showed off the side of her body that we don’t usually see in magazines. She shared a revealing shot of her stretch marks on Instagram and that caught the attention of many women who then also posted their #stretchies picture in support of that bold move.

chrissyteigan

Yes, stretch marks are common and do occur even in supermodels. 90% of the population has 1 or more stretch mark somewhere on their body. It is not a disease, but usually an aesthetic concern of many women. As a mother myself, who has ‘earned her stripes’ (three times to be specific), I am extra passionate about this topic!

Stretch marks, also known as striae, are defined as “linear dermal scars accompanied by epidermal atrophy’

Striae – skin that is subjected to continuous and progressive stretching; increased stress is placed on the connective tissue due to increased size of the various parts of the body. Skin distension may lead to excessive mast cell degranulation with subsequent damage of collagen and elastin. 1

The onset of stretch marks can often be seen during puberty (growth spurts), pregnancy or a rapid weight gain.

New stretch marks are usually pink (striae rubra). Over time usually after six months, the pink colour fades and turns to white (striae alba) – an old stretch mark which becomes permanent.

What is interesting is the fact, that striae are also related to an excess of certain hormones, namely cortisol.

This can be seen when people with no stretch marks commence steroid therapy and they then develop new stretch marks even if their weight doesn’t change. Similarly, as seen in Cushing’s syndrome.

So how do we manage stretch marks?

Prevention is better than cure

With stretch marks, prevention is best but early interventions would yield satisfactory results too.

The current medical devices that can be used for external treatments are:

  1. Pulsed-Dye Laser
  • Best for newly formed stretch marks because it aims to correct, and improve the blood vessels responsible for circulating oxygenated blood supply to the location of stretch marks.
  1. Fractional Non-ablative Laser
  • Helps stimulate coagulation in the dermal connective tissue which is effective in old stretch marks. Treatments are done every 6 to 8 weeks. After 4-5 sessions, texture of stretch marks is remarkably improved by 50%.
  1. Microdermabrasion
  • Improves skin texture and hyperpigmentation and encouragement of new epidermal layer. Since microdermabrasion affects mainly the epidermis, improvements are minimal.
  1. Skin Tightening Device – Radiofrequency
  • Radiofrequency devices deeply heat the target soft connective tissues, resulting in stimulation of collagen and elastin, which leads to increase in skin tightening.
  1. Acoustic Wave Therapy 
  • By mechanically stretching and relaxing and the released energy of acoustic waves initiates physiological processes.

The types of treatment that are suitable may differ from person to person depending on genetic, hormones and ethnicity.  The likelihood of Asians getting PIH (post-inflammatory hyperpigmentation) with aggressive fractional laser settings must be taken into consideration when choosing the right treatment.

New treatment tools, clinical studies, and multi-approach protocols are introduced every so often. Many physicians have tried a combination of PRP (Platelet-rich-plasma) or Sculptra (Poly-L-lactic-acid) injections, and hormone analysis as part of their treatment regime. I have definitely used those mentioned combinations before in treating stretch marks and happy to see good results.

I am always looking forward to discovering new methods to battle with this #stretchies, because as much as women can readily embrace their newly earned tiger stripes, they also love that bikini-beach-body-ready for sure!

2016-06-22-PHOTO-00000130

JUNE 2016 – INTERNATIONAL THAI COSDERM CONGRESS ON AESTHETIC MEDICINE . (6TH ITCAM BANGKOK)
PRESENTATION ON STRETCH MARKS : REVIEW AND UPDATE ON TREATMENTS

Resources:

1.Sheu HM, Yu HS, Chang CH. Mast cell degranulation and elastolysis in the early stage of striae distensae.J Cutan Pathol. 1991 Dec. 18(6):410-6.

 

Crystal Tomato Skin Supplement

I was asked to write an article for MIMS Hong Kong on Crystal Tomato® supplements and I would like to share some of the information in this blog.

Asian skin by nature has an increased amount of melanin, and the cells that produce melanin tend to be more sensitive to any type of inflammation or injury. Therefore, the incidence of pigmentary conditions such as melasma, solar lentigos and PIH (Post-inflammatory Hyperpigmentation) are much higher in this part of the world.

The usual treatments include a combination of topical skin lightening agents, light-based device, and prescription-based oral medications.

In the recent years, there have been several oral supplements developed to help people treat skin pigmentation and help prevent further UV damage.

Crystal Tomato® is a type of food supplement which has been scientifically proven to reduce pigmentation and have overall skin brightening benefits. It consists of a unique breed of non-genetically modified white tomatoes and also an amino acid L-Cysteine which helps to boost the liver’s production of Glutathione.

The main benefits and mechanism of action:

  1. It inhibits melanin synthesis and reduces the existing melanin

Crystal Tomato® alters the metabolic processes of melanocytes to turn dark pigmentation (eumelanin) into light pigmentation (pheomelanin).

melaninpathway

  1. It acts as a natural sunscreen and gives protection against UVA/UVB damage

These carotenoids lack any visible colour and they absorb light in the ultra-violet range which makes them ideal for offering protection against UVA/B damage from within.

  1. It has an anti-oxidant and an anti-inflammatory effect

Crystal Tomato® carotenoids can block free radicals from the UV rays. Hence, they act as anti-oxidants to protect against free radical damage by environmental aggressors.

The patients I see in clinic with skin pigmentation such as melasma or solar lentigo find that by consuming this supplement, their pigmentation becomes much lighter after the second month of consumption. It has also benefited patients with post-acne PIH to help lighten the pigmented scar faster.

It is recommended to consume 1 caplet a day continuously for the first three months to see the full effects. Visible radiance and lightening of the pigmentation can be seen from 2-3 months of consumption, however, some patients have also reported lightening effects as early as 3 weeks.

One of the main reasons people are more confident in consuming Crystal Tomato® is because it is 100% made of natural food supplement. To ensure the safety of a supplement, it should be reversible and does not cause long term effects. When the consumption of the Crystal Tomato® supplement is stopped, the brightening effects will also slowly diminish and revert to original form.

I have been recommending Crystal Tomato® as part of Pigmentation Treatment Regime for the past few years and glad to see that results have been consistent and my patients are happy with the noticeable difference too.

In Malaysia, Crystal Tomato® supplements are sold only in clinics. It is registered and approved by  Ministry of Health and every box comes with a hologram sticker and registration number. Just be mindful when purchasing, as there are many counterfeit “Crystal Tomato” supplements out there!

CT-box-imposed-2