Its All About the C's

Its the start of spring and we are entering the second quarter of the year. Busy schedules and a lot of hard work for most of us due to the current economic slow down that is happening worldwide. In the hustle and bustle of keeping up with the rat race, it is really important to keep our health intact to meet up with our expectations. So for the next couple of weeks, I will be explaining about vitamins, minerals and supplements required for the body to function better. 

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Let's start with the big C. Vitamin C is a very important nutrient for our body. Humans are the only mammals in the world that does not produce their own vitamin C. Other animals produce C's internally and it plays a major role in their immune system and survival. Because of this, we need to consume vitamin C's on a regular basis to keep our stores up.

In humans, the benefits of vitamin C has been established more and more. It is involved in the formation of certain proteins to make skin, bones, cartilage and blood vessels. It is also useful in wound healing and formation of scar tissue, repair and maintenance of bones, cartilage and teeth, and it also aids iron absorption. 

It also plays a strong role in aiding the immune system and helps alleviate colds, flus and otehr viral illnesses. Historically, it was used to avoid scurvy but nowadays, this problem is relatively rare due to reduced long sea travels. It is also used to maintain gum health, treatment of acne, treatment of bronchitis, H. pylori bacter related stomach ulcers, control of HIV, treat tuberculosis, dysentry, skin infections and help in curing infections of the bladder and prostate.

Recent studies also shown the benefits of Vitamin C in relation to brain functions. It helps reduce depression, Alzheimer's disease, reduce physical and mental stress, improve concentration, improve ADHD and reduce fatigue. It has also shown in a study recently that it reduces heart rate during exercise and reduces the perception of fatigue and exertion. 

Latest studies also show that it aids in heart disease and diabetes by improving endothelial functions and reducing inflammation thus improving the outcome. However, you will need to take more than 500mg daily in order to see the benefits. With improved endothelial functions, there is a reduced risk of artherosclerotic disease which is involved in stroke and heart disease. 

Other benefits of Vitamin include improves glaucoma, prevent cataracts, prevent gall bladder disease, relieves constipation, improves dental caries, improves Lyme disease, helps with heat stroke, hay fever, asthma, cyctic fibrosis, infertility, chronic fatigue syndrome, autism, collagen disorders, arthritis and bursitis, back pain and disc swellings and improves osteoporosis.

High doses of vitamin c has also been used in alternative cancer treatments and as adjuncts to chemotherapy to reduce chemotoxic effects and has shown to improve patient outcomes. It is also an anti-aging supplement that helps reduce signs on aging, whether applied topically, consumed or given IV.

The next popular question that I normally get is how to take the vitamin. Well, for skin problems, the best is to apply topically. If you can get a 'medical grade' vitamin C more than 20% concentration it would definitely benefit your skin by reducing wrinkles after 6 weeks of diligient bidaily application of serum. If you notice I purposely highlighted medical grade, because a lot of cosmetic skin care claim to have more than 20% vitamin C inside their products but in actual fact, when you test them most don't even hit 10%. Sometimes, they put 20% concentration prior to manufacturing and after processing, the vitamin C being a water soluble vitamin, the percentage reduces. If you want to try a good medical grade Vitamin C serum, we do carry a few brands.

The next easiest method is to consume orally. However, most people do not realize that the gut can only absorb 600mg of Vitamin C per 4-6 hours and this also depends on how good your digestive system is. Most Malaysians have really bad digestive system due to diets high in fats and carbohydrate and lack of fiber. We also have a lot of irritable bowel syndromes and leaky gut syndromes which causes poor absorption in the gut. Now with our hair profiler system, we can screen for leaky gut syndrome and improve your gut health with just a simple test. The other issue with concuming orally is the form of vitamin C that you are consuming. Some believe L-ascorbate is the best form to take, the clinical data on it is scarce. And at the end of the day, how much vitamin C can the body actually absorb in a day? Maybe 2 grams. However, really high doses of vitamin C taken orally can cause nausea, diarhoea and abdominal discomfort.

Some medical practitioners advocate intravenous vitamin C in high doses for immune curve shifting. This is to avoid gut wastage of the C's and deliver accurate high doses. The idea has been used for many years in treating people with cancer and severe immune problems and now some are advocating as an anti-aging regime. Personally, I did try 10gms of vitamin C over 30 minutes with a combination of glutathione 600mg, ALA and B Complexes. The infusion was a little bit uncomfortable despite being diluted with normal saline, and I felt stiff in the arm during the infusion process. Immediate effect for me was actually lethargy but I noticed improvements in my skin tone, pigmentation and feel. Immune wise, I guess I improved, because my sinuses improved without needing antibiotics. However, one off therapy wouldn't be sufficient and usually you will need a course to achieve a good concentration. Being water soluble, the vitamin gets excreted out by 3-7 days. However, the high dose concentration for a few hours is what gives the body that extra boost to jumpstart the immune system.

Regardless, if you are unsure or planning to start high dose vitamin C regimes, please consult a medical practitioner that is well verse in the indications, contra indications and side effects. There are some contra indications to the use of high dose vitamin C that you will need to discuss with your doctor to ensure it is safe for you.

For more information please email us at drmmclinic@gmail.com or call us at 03-21106608 or send a msg to 0123301585.

F1 Fever...... Sepang International Circuit 2013

Its F1 weekend following Spring Collection Fashion Week Launch. Usually I am not really a fan of F1 racing because I personally do not like crowded areas. But this year, I was given a seat at the Grand Stand, so hopefully it will not be as bad. Despite my lack of lustre, I do find myself pretty excited. I guess the F1 fever has started to infect my brain.

The Sepang International Circuit was designed by a German designer, Herman Tike and was officiated by our 4rth Prime Minister Tun Dr Mahathir Mohamad on 7 March 1999. It held its first Motor GP in April 1999, and the first Formula 1 Petronas Malaysian Grand Prix in October 1999. So far the best lap was done by Williams-BMW team, JuanPablo Montoya in 2004 with a lap time of 1:34.223. 

This year, the top drivers are Kimi Raikonnen, Fernando Alfonso, Sebastian Vettel, Fellipe Massa, Lewis Hamilton, Mark Weber and a few new names. During practice runs Vettel showed best time but Kimi is still int he lead with 25 points. 

It would be a really interesting race to see who finally grabs the title for F1 this year. My only concern now is how tanned I'll be sitting in the middle of Sepang Circuit (Despite the grandstand podium mall and such). Having a Fitzpatrick's type 4 skin makes it easier to tan even with protection. Personally I like being tan but not too tan. As it is now, my arms are 3 shades darker from my hidden areas because I have been out a lot. On top of gluthatione supplements and high doses of vitamin C, sun protective agents are my number one friends.

Oh yes, I have the full range Heliocare in my bag for this outing. Heliocare is so far to me the best sunblock for this weather. It is oil free gel based lotions with a slight tint give you ample protection, but does not appear white on the skin as some other sunblocks do. It is less greasy and it has a nice citrusy smell (although not everybody would like it).  The sunblock has both UVA and UVB protection, and comes in 3 strength - 30, 50 and 90. I prefer 50 SPF due to its consistency and non-stick properties. SPF 90 is thicker and has some antibacterial properties but it is a tad greasier and sometimes it does clog up my pores a bit more. There is also a Compact oil-free Heliocare foundation powder for those who prefer compact powder form. It does give a good coverage as a foundation, but after awhile, you may need to top up a bit. Indoors, the compact would stay for at least 4 hours. The new product launched last year was the oral capsules. The oral capsules are a very strong anti-oxidant that helps to reduce UVA / UVB absorption by the skin. It is purely from vegetal source, and has been shown to help reduce severity of burns from sun or other light sources. It does not cause lightening of the skin, but rather helps maintain your tone. However, if you will be out in the sun like me today, you will still require topical sunblock protection. It is recommended that if you are indoors to reapply sunblock on your skin every 4 hours and if outdoors, every 2 hours.

All these products can be found in my clinic. The price ranges from RM 120 - RM 190(oral sunblock 6 tablets) which I feel is pretty affordable for clinical grade sunblock. Okie peeps, its another 2 hours till the start of the first race, time to get ready. See you at the race track.... :)

For more information about the products, feel free to call/text Faceworks Clinic at 03-21440080/014-2233268 or email to info@faceworks-clinic.com / faceworksclinic@gmail.com.

Miss Universe 2012 is Miss China....

I think my blog roll have collected some cobwebs since I have been super busy with a million and one things to do on a day to day basis. From patients to management issues, to children and bffs jumping off the plan for an unplanned holidays and the so many events after fasting month, oh yes, I have my plate pretty full. 

Anyways, last couple of months Miss Universe World pageant came to an end with Miss China crowned as the Miss Universe World for 2012. She also won the Miss talent award and she is actually the 2nd person from China to win such a title in the whole 61 events in the past. Congratulations to Miss China.

Personally I love watching Miss Universe pageants. I caught the last bit of it recently as they were crowning Miss China. Its a show full of glitz and glamour and not to forget the pretty girls. Looking at each of the girls features, you can see similar traits that signifies beauty - flawless skin and symmetry. Although for these beauty queens it is actually loads of make-up to get the flawless effect. But proper skincare and supplements can also help you achieve that effect. When dealing in the aesthetics world, we need to have a good eye for beauty, and what better way to train yourself than watching and appreciating beauties.

Coming back to Miss China, she is definitely beautiful and talented. But perhaps the more attention is that she is Asian, and yes the Asian look is becoming more appealing to a lot of people. (think K-Pop). Semi slanted big eyes, with dark hair and eye brows, yellow tinged skin, full lips and a high nose. Despite Asians typically having a flatter nose bridge, the advancement of fillers have made it possible for Asian's to have a higher nose bridge thus enhances the look. Skin fairness is often sought by most Asians - seriously I am wondering why Asians are so obsessed in being fair? Hence so many supplements claiming to help improve skin tones and fairness are being sold like hot cakes. My personally opinion on it - I'm cool about it as long as it does not cause any harm. Some skin bleaching products were taken off market due to risk of cancer and other more harmful conditions. Some of the beauty supplements have unknown ingredients so a proper evaluation of their safety is impossible.

Skin fairness depends on a few factors. The first is of course genetics. You cannot expect to be Korean fair if your family comes from a line of dark tanned people. Nor would you get Caucasian pink skin if you were a pure Asian. Some may argue about this, but unless you are an albino, you would be as tan as your parents were. The second factor is of course sun exposure. You cannot expect to be fairer is you are exposed to the sun most of the time. The sun in the equator tend to be most consistent and thus people near the equator tend to be tanner than those living in the Arctic. Vitamin C supplements, glutathione etc are just temporary measures. As long as you take the supplement you can maintain the skin tone. Pretty expensive investment for something unnatural perhaps. But everyone's perception of beauty is different, hence why we hear the proverb beauty lies in the eye of the beholder. So what do you think is beautiful?

Medical Aesthetics for age groups......

I went to Penang two weeks ago and enjoyed beautiful sun rises and sunsets on the beach, despite some haze but the ambiance was wonderful. The only thing was the lack of internet access in my room which made it less convenient to update my blog. Still, I did get nice writing ideas which I would like to share.

Today's entry is about medical aesthetic procedures for age based groups. It is just a simple suggestion of things you can get done based on your age to improve how you look. As I always tell my patients, it is always better to do something than nothing because by doing something, there will be some change in your end result. I would also include a rough budget of how much the procedures will pinch you just as a guide.

Early 20s (18-25)

Usually at this age group, you will not have much aging issues. However, acne control and skin tone problems are very common because in this age group, you will still have some hormonal imbalance and is more active outside. Acne treatments would include chemical peeling, extractions, hormone pills or even retinoid A to clean up the skin and control sebum production. The usual skincare would range from acidic wash to exfoliators and gel based products to cope with the active sebum productions. You need to treat acne, because if you don't, you may end up with scars. Medically, we do have oral medications to help control sebum and a change of habits is usually advised. Smoking, late nights, low personal hygiene, stress and food selection does influence worsening of acne. Treatment for acne will depend on severity. Usually doctors would charge between RM 200-RM 1000 per treatment depending on what is involved in the treatment. Skin care can range between RM 300-RM 1000 for a full range depending on brand. Some doctors will use IPL or long pulse lasers to reduce sebum production and reduce P. agnes bacteria that is abundant in acne prone skin. To even out skin tone, I normally would recommend regular skin peeling and religious use of sunblock. Laser peels are also an option but if you have acne issues, there is a high chance of acne breakouts post procedure due to heat stress.

Besides acne and skin tone, this would be a good age to fix asymmetry of the face or to augment. The skin is young, hence fillers will sit in better. But because of the young age, I normally would only recommend doing hyaluronic acid fillers (Juvederm, Teosyal, Restylane) which are non permanent because it is easier to change the look when you've decided and because as you age, a lot of your face fat pads disappear so putting a permanent structure there may look awkward after a couple of years. For face shaping, you can slim down your face with a simple injection of botulinum toxin A (Botox/Dysport). You can read more about this in my previous entry on face shaping. (http://faceworksclinic.blogspot.com/2012/03/face-shaping-it-only-takes-5-minutes.html) Filler prices would range between RM 1400 - RM 2000 per syringe depending on type and how long the filler lasts. 

Late 20s- 30s (26-35)

This is usually when a person is most prime in their life. Biologically for most people, the hormones have settled and you start losing the baby face and your face becomes more defined. The early signs of aging start appearing such as wrinkles on your forehead, frown lines, crows feet and some loss of volume especially at the malar area. (cheeks) Pigmentation problems start occurring and the skin texture becomes drier. Botulinum toxin A can help with dynamic wrinkles. Fillers can help with the slight loss of volume and also to define the face to make it more attractive. Regular peeling can help with the skin texture but a definite skin care range change need to be considered. For pigmentation, using hydroquinone will help to reduce the pigmentation substantially but requires constant use. Lasers can help to reduce pigmentation and improve the skin texture but if proper sunblock used religiously is not applied, there is a high recurrence rate and may even worsen the pigmentation. This is also the point where I would normally suggest to add serum vitamin C into the skin regime as a maintenance and preventive program to help with texture and pigments. Supplements and vitamins are also important at this point to keep the skin glowing healthy. 

Another issue would be the body contour change, where most people find that certain areas are not as attractive as before. For this, I would recommend body contouring programs using medical grade radiofrequency machines (http://faceworksclinic.blogspot.com/2012/02/radiofrequency-tightening-rf.html) , or other medical grade body contouring machines to help. For some people, they prefer mesotherapy injections to reduce fats n certain parts but this requires recurrent treatment of specific area and so may add up to be costly. Regular exercise helps, and target specific exercises are more warranted.

Late 30s to 40s (36- 45 years old)

Most people are more stable at this age but due to the aging process, coupled with stress of work and family and other responsibilities can cause you to look older than you really are. For the face, At this age, most people would start complaining of more pronounced wrinkles on the forehead, frown lines and crows feet. There would be a more marked loss of volume in the malar and lower face, especially around the mouth and the folds by the side of the nose looks more prominent. The skin texture is still good, but pigmentation is more seen if nothing has been done before. Sagging of the cheeks is felt, although not extremely obvious and causes a lot of concerns in some people. Fillers and botulinum toxin A are a good investment for non-invasive treatment to treat lines, wrinkles and volume loss. Some would consider lip fillers because the upper lip has started to thin out more and you lose that youthful look. (Check out http://faceworksclinic.blogspot.com/2012/05/sexy-lips-in-15-minutes.html) Regular chemical peeling and face tightening with radiofrequency devices or lasers would help improve overall skin texture and turgor. At this point, you should also consider having a retin-A or derivatives cream supplement to the face to help with fine wrinkles. 

For the body, you can still opt for body contouring and tightening programs but the expectations should be more realistic. There will be improvement although subtle, and you may need to consider options of skin lifts and fat grafts to get a more marked improvement. Weight control can be achieved by modifying the diet and exercise and I do suggest most everybody above 36 with BMI more than 25 to go on HCG diet (http://faceworksclinic.blogspot.com/2012/03/hcg-diet-my-experience.html) to not only lose the excess weight and reduce body fat percentage but also to retrain yourself to a much more healthy diet and lifestyle. If done properly, you will be able to maintain your weight and enjoy a better life. It also helps increase personal health consciousness as only organic and non-processed meats are allowed during the diet.

After 46 (46 to 65 or more)

At this age, the skin texture is more wrinkled and you will need more moisturizers to help maintain suppleness. Laser resurfacing treatments are a good investment as it helps to improve your skin texture and tightens it as well. Radiofrequency device tightening of the face is another method to help improve sagginess. At this point, fillers are used for volumnization, and a lot of fillers would be needed to have a good effect. (At least 3 syringes per sitting usually). Semi permanent fillers (Aquamid) can be considered for structures like lips and cheek. Mesotherapy treatment with PRPs (http://faceworksclinic.blogspot.com/2011_02_01_archive.html) or non-cross link hyaluronic acid fillers (Dermaqueen, Restylane Vital, Juverderm Hydrate, Teosyal Redensity) is also an option to increase hydration of the dermis layer. Skin peeling is still a good way to maintain the skin. Surgical options would be fat graft to the face and face lifts. Vitamin E  and hyaluronic acid topical creams can help maintain hydration as dryness is always a problem. 

After 46, a lot of our natural hormones start to decline. Because of this, we will have vague tired symptoms that we cannot explain. Another thing that you should consider is to undergo anti-aging consultation and the use of bioidentical hormones to help supplement the decline of hormones. The blood test are expensive (a complete test would cost around +/- RM 1000). The hormone supplements are in cream form. Please be sure to go to a proper anti-aging doctor (trained) because not all doctors are trained properly.

This is just a rough guide of procedures you can do at the certain age. However, the current environment pollution, poor diet and nutrition, work stress and health problems can always make you look aged more than you really are. A proper consultation can help give you a good idea of the possible intervention to help make you maintain a healthy and youthful you. But one thing for sure, you need to start taking care of yourself early, to stay younger longer.

Any enquiries please email to info@faceworksclinic.com or call 03-21440080 and book an appointment to see me.

Tried & Tested Part 2

I have been trying out so many products lately, and now I think I need to rest my face for a bit. But before that let me share my experience with these products.

1. Infracyte Wrinkle Resist Complex Serum.

Infracyte is a brand from USA which is pretty new. I like the bottle a lot because it reminds me of a posh perfume. The wrinkle resist serum has 99% hyaluronic acid for better hydration. It also contains alpha-oligohexylpeptide that is an ingredient that acts on the neuromuscular end plate to give an action similar to botox but temporary. It takes around 2 minutes to completely absorb the product on your skin. It is moisturizing and not oily hence making it suitable for oily and combination skins as well. For very dry skin, you would still need to put on extra moisturizer at night but for day wear it's pretty cool. Post treatments, I find it very effective and gives the skin a cool feel. Each bottle costs around RM 328++ and can last you up to a month if used daily.

2. KISS Dermablend Vitamin C Milky Cleanser

I have been selling KISS in my clinic for the past 1 and a half years, and one of the questions I get is about the make-up remover. Although KISS is purely mineral and you can just wash with water ( a lot of water that is) some prefer to have a make-up remover for a cleaner face. So finally KISS came out with their own Mineral Make Up cleanser called the KISS Dermablend Vitamin C Milky Cleanser, which not only cleans mineral but also other dirt on the face as well. It has a very unique apple smell and you just need a little bit to lather on your whole face and it feels so clean afterwards. It is gentle on most skins and few of my friends have tried it without having any complications. With its active ingredient being Magnesium Ascorbyl Phosphate, it allows better penetration of Vitamin C into the skin which also helps to hydrate and is a potent anti-oxidant to the skin giving it a clearer and more luminous glow. It is sold at RM 190 per bottle of 200ml which can last up to 3 months or more. So if you like wearing make-up and thinking of getting a good cleanser, this is one you should have.

3. KISS Dermablend Swiss Apple Extract

Having a good cleanser is incomplete if you do not have the moisturizer to go with it. So KISS came up with their own Dermablend Swiss Apple Extract. This is a specially formulated moisturizer containing extracts from swiss apple stem cells that helps to keep skin supple and moist by the direct effect of the extracts to the skin. So not only you will have clean skin, now you can preserve its youthfulness with this moisturizer, before applying on your Mineral Make-UP. It is a very interesting moisturizer that absorbs quickly and has a nice peach scent to it. Because of its liposomal properties, you may feel that it is slightly oily but after absorption, it makes the skin feels so soft and moist. I would recommend this for people with more mature skin without much problems for maintenance purposes. Each 50ml tub cost only RM 380 and can last over a month with twice daily usage.

4. Phiderma vitamin C and retinoid A capsules.

 

These are pretty cool treatment options for those who like serums. Phiderma is a well-known clinical skincare producer from America. These serums are a great investment for busy people who travel a lot since they are placed in single used capsules and come in 50's in one tub. There are 2 main capsules. One is retinol complex that gives the same benefit as retin A creams but with reduced side effects. They created the serums with microsponge technology which allows better absorption of the serums into the skin. The Cerum vitamin C is a favourite of mine, since it comes in separate capsules leads to better hygiene and no risk of oxidization of the vitamin C which occurs in serums in bottles over time. This in turn guarantees better efficacy of the serum to work compared to other serums in bottles due to this non-oxidation factor. Applying the Cerum on your face will give an instant softness of the skin. For those who use both, normally the Cerum is used in the morning after cleaning the face and before moisturizer or sunblock and the retinol complex is used at night. With 50 capsules in each bottle allows almost 2 months supply of serum at affordable prices of RM 300 for the Cerum, and RM 320 for the Retinol Complex.

Tried and tested........... (Part 1)

I have been super busy with so many things that sometimes I wonder what is it that is making me so busy to begin with. Well, one of the things I was up to was actually testing out supplements and products to see how good they are. So here are a list of things I have been trying and the outcome.

1. Tiox-C Glutathione and Vitamin Capsule tablets.

At first when I saw this product I was skeptical. Oral glutathione and vitamin C? But since it was provided in gelatin capsules, it would survive the acidic PH of the stomach. I took some for the clinic and some of my patients tried it out. I gave a box to my sister, and she took 10 capsules a day at different intervals. (The recommended was 2 capsules daily). In one week she was fairer than me by at least 2 shades. Anotehr patient took 4 tablets a day, and she was fairer after 2 weeks, despite spending some time in the sun over that weekend. Besides the fairness, my patients also commented on the brightness of the skin and healthier glow. So I decided to try it out, so I am currently on my 2 week and I think I am a tan lighter compared to usual. This product is from Japan but packed in Malaysia. The bovine gelatin capsules are from Pakistan, and has a Halal certification. Other benefits of this product is that it is a good anti-oxidant and was actually promoted as a supplement for detox. One box comes with 90 tablets with 150mg of vitamin C and 150mg of glutathione in each one. The price for a box is around RM 328/= which is pretty good since you have 90 tablets to take. So instead of going for vitamin C injections, you can take orally for cheaper with results. You can get this product in my clinic.

2. Linurase Serum from Phiderma

This is a new product in town called Linurase. As the name entails it is designed to erase wrinkles and lines. Fine ones that is. I have tried this product for about more than 2 weeks everyday twice daily application without fail and this is what I think about it. First of all, the product is in a serum form. It absorbs quickly within 2 minutes. Initially I had a little bit of a tingling from using this product but after a few days it felt better. After a few minutes, I do notice my wrinkles improving, even the dynamic ones. They claim to be better than botox or BTA, but after 2 weeks, I'd say that they are competitive, but you need to apply daily to get the best effect. Once you stop, the muscle action will return and expressive wrinkles will come back again. Nevertheless, it is a good alternative for people who have needle phobia or not keen to get BTA/botox done yet. Daily usage of this serum actually stalled some of the wrinkles on my forehead, until I stopped a few days ago to try out another product. The lines came back after a few days. After reading more about the active ingredient, you need to use it consistently for more than 30 days to have a lasting effect. It contains Acetyl Hexapeptide-8 which acts on the same acetyle choline receptors as bta/botox thus blocking muscle actions. Other ingredients are Hyaluronic acid, anti-oxidants and seaweed biopeptide extracts. If you are interested with this serum, you can contact my clinic and we will order for you. It is selling at RM 300/bottle which may well last up to 3 months.

3. Double X from Nutrilite

Previously being on stem cell supplements and later HCG diet has actually turned me into a pretty health freak where I am seriously into organics and reducing artificial colourings, flavours and sugar based foods. But stem cell supplements are expensive, and it would be not so ideal for people of the working class to take on a monthly basis. So I scoured the internet for solutions and I came across this particular brand of multivitamins. Nutrilite actually has the largest organic farm in the states, and has passed accreditation for few years already. (4 or more) My major turn off was the fact that it was sold under Amway which is a multi-level company. However, being a curious and caring doctor, I decided to search for it anyway and give my opinion on it. I have been taking this vitamin for almost a month now and for what it is, it is super affordable. (RM 150 per box of 62 X 3 tablets for non Amway members). What I felt after taking these vitamins is that my energy level came up again, despite my super busy schedule. I looked less tired and these changes started perhaps after a few days after taking them twice daily and after a week I felt healthier. What I really like about it is the fact that they divide 2 separate doses in a day which is actually what is recommended by all Nutritionists and dieticians since 3 years ago. The reason for this is that the gut has a saturation level for all nutrients so if you were to take too high a dose at a time, you will only absorb as much as the saturated level allows thus wasting the vitamin. Another good thing is that they separate vitamins from minerals which allows accurate concentrations to be achieved since in processing a lot of the minerals get binded by the vitamins - e.g. sodium to vitamin c - ascorbate and others. They even added a third component which is more of a traditional preparation but known to have good benefits like cranberry extracts, apple extracts, etc as anti-oxidants to complete the multivitamin. The only thing is, you cannot take this on a completely empty stomach since when I tried, there was some reflux felt, so I'd recommend some food before taking them, but definitely not on a full stomach. Another downside would be having to swallow 3 hard tablets which I know there are some people who do not like popping pills. But otherwise, this is certainly a keeper to maintain on a daily basis for good health. Personally I do not sell this, but if you are interested to get some you can contact my clinic and we will get you in touch with my friend Ed.

These are but a few of the other things I've been testing. I welcome any feedback or comments.

For more information or if you would like to try out these products you can contact my clinic at 03-21440080 or email to info@faceworksclinic.com.

Spring Promotions.....

New Service from Faceworks.... Milk Peel

We are proud to introduce our latest peel from Dermaceutics - Milk Peel. Milk Peel is a much stronger peel than the classic glycolic peel of 20% because it combines 50% glycolic with 10% lactic acid + salicylic acid making it penetrate deeper but with less pain. In combination with our whitening Intense C serum, you can see how it instantly lightens superficial pigmentation and even the deeper ones. Look closely at the picture and you will also notice an improvement in texture and reduction of fine wrinkles and this is just immediately after. Some people may experience some redness which normally subsides within the day. As for peeling? Well, some may have some peeling which I describe like having dry glue on your face and peeling it off, otherwise most are fine. The trick to a better lasting results is applying lots and lots of moisturizers and serums immediately after and up to a week since the penetration of products will be superb during this period. Oh.... And do not forget sunblock as it is a must. This short procedure only takes 40 minutes to complete with the given results.

Feel your skin dull and non-radiant, starting to see those big pores and fine wrinkles forming, No time to take off from your busy schedule?? This is definitely the right peel for you. Don't settle for any peel, Choose MILK PEEL - the immediate solution with minimal downtime.

To know more or to book appointment, do call us at 03-21440080 or email to info@faceworksclinic.com

Mirror, mirror on the wall.... who's the fairest of them all....?

I have come across a lot of patients who wanted fairness and even to the point of luminant skin. Being an aesthetic physician in Asia this is not uncommon. The Asian's model for beauty is to have fair flawless skin like the Japanese, and Korean counterparts. So I've decided to give my two cents on it, based on the things that I have read and researched.

Before I start explaining on the products that claims to make a person fairer, first we need to understand the difference in skin types and tans which determines how fair or tan you will be and the factors that lead to a more exaggerated tanning. There are 6 skin types based on Fitzpatrick's Skin Colour Classifications ranging from type 1-Type 6. For Asians, Type 1 are the extremely fair Scandanavians with blue eyes and yellow hair, type 2-3 are mainly Caucasians some are the Japanese and Korean Asians and for people like us, living at the equator would likely have type 4-5 skin type. Type 6 are the African origins or dark Indians. This genetic predisposition to skin colour depends on the distribution of melanin at the basal layer of the epidermis (skin). The environment also plays a role, whereas, where there is a overstimulation of the melanin - leads to more tanner skin. The most common cause is exposure to UVA/UVB sunlight. What it means in simple tense is that, even if we were to exclude environmental factors, our genetic built up will be the limitation to the fairness that we can achieve despite any treatment. I usually tell my patients that if you want to be fair, you can only achieve fairness as much as your non sun exposed areas and not more than that unless you bleach yourself.

According to most of the clinical studies that I have come across, topical Vitamin C in high concentrations does lead to a brightening of the skin because of its anti-oxidant effects and skin healing properties which allows better new skin formations. However, a lot of the creams/serums in the market have problems in delivering the vitamin C into the skin effectively leading to reduced efficacy. (Check out blog entry What's Up with Vitamin C -  http://faceworksclinic.blogspot.com/2011_04_01_archive.html ) The better ones are more expensive and prices range from a few hundred for a bottle. Furthermore, you need to use it on a more consistent basis in order to achieve lasting results. 

Similarly, there are some bleaching agents such as hydroquinone (HQ) - which is still the gold standard for treating pigmentary problems. However, long term use of hydroquinone will lead to a condition called onochronosis which is a bluish discolouration of the skin at the area of usage. Onochronosis is really difficult to treat and require multiple laser treatments to reduce the appearance. This was the main reason why there is a lot of bad press and reports on HQ. A lot of beautician products use HQ in the creams to get fast results as fast as 1-2 weeks but in long run causes damage to the skin. The FDA approval for concentration of HQ in skin products is only 4%. I know some beautician products that use up to 8% HQ and is sold over the counter with no restriction. Therefore, if you plan to use HQ to treat your pigmentation issues, please make sure you are under a follow-up by a doctor who actually know what they are prescribing.

Then we come to the non-HQ bleaching agents such as kojic acid, arbutin, mendelic acids etc. The most common nowadays are the kojics and arbutins. In high topical concentrations, you can see an instant lightening of pigments. However, if you are using a topical cream, containing these products, you will only see results after perhaps 4-6 weeks, in contrast to HQ where you see improvement in 2-4 weeks. Because these bleaching agents are taken from natural sources, you can actually use them up to whenever you feel like it without much side effects. However, I have noticed that after 6-9 months, some patients feel that the bleaching ingredient does not give any additional effects and sometimes I shift them back on HQ. Although this may appear to be the miracle product for avoiding and brightening up pigmentation, some people are allergic to these products and develop rash and itchiness. I see this more common with kojic acid preparations.

There are some products in the market which claims oral intake can help lighten up the skin. Some offer vitamin C in high doses of 1000-2000mg daily, others claim glutathione up to 5000mg daily oral intake. Although these may appear appealing, the high concentrations may not benefit in view that the gut can only absorb as much and overconsuming of vitamin C can lead to orange discolouration of skin, gut disturbances, etc. There are some products in the market which contain melanin blockers and acts at the cellular level of melanin production. I found one product interesting called White Beaute. It is an oral supplement that acts as a melanin blocker. I have seen some of my patients who improved in skin tone when taking this product after 3-6 months. The only thing with oral supplements, it takes longer to see the results compared to other methods, and that may be the reason some people prefer not to try it out. I have also tried out oral sunblocks such as Heliocare Oral Sunblock Pynocare - I find that it does give a fair results for about 3 months but prolonged use did not appear to benefit much in terms of skin brightening. But I did notice that I got less sunburnt compared to prior being on the product and you need to take it 2 weeks prior to any sun vacations to get the best results. My consultant consumed this product only 1 week before a beach holiday and she still got burnt, so perhaps the other general precautions such as hat, umbrella,shades and topical sunblock and sunscreen should be applied despite using the product.

Now we go to the injections. The most common injections for whitening sold are the Vitamin C's and Glutathione injections. Personally, I've never tried since I'm pretty happy with my tan, but maybe for research purposes, I would subject myself to this trial in the future. However, I do have girl friends who swear that it really does work. It works fast, but you need a maintenance program to keep yourself fair and you still have to avoid direct sun exposures. Furthermore, in view that you are trying to get the anti-oxidant benefits and the glutathione overdose side effect, you need to understand that there are factors that will cause these injections to not work. Basically, oxidative stressors.

There are many different processes and substances that chronically damage cells and contribute to oxidative stress including:

• Toxic chemical compounds and pollutants in your body
• Hydrogenated fats
• All kinds of pollution , including air, water, and food
• Oils that have been heated to very high temperatures
• Cigarette smoke, directly inhaled or secondhand
• Dehydration
• Too much sugar
• Too much animal protein in your diet
• Geophysical stress like living near power lines or waste dumps
• Microbial imbalance, including bacterial, fungal and viral infections
• Preservatives in your food
• Drugs (over the counter and prescription)
• Artificial food colorings and flavorings
• Plastics
• Chemical cleaning supplies
• Chlorinated water that you drink, shower in or swim in
• Alcohol
• Pesticides in your food
• Radiation exposure
• Psychological and emotional stress

Which is why in smokers, sometimes the whole course does not work. Another issue is gaining a good IV access and being careful enough to not shoot the products too fast because it will cause damage to the vein endothelium. And the most problematic part would be the commitment to come to the clinic according to the recommended intervals. If you skip 1 even, it may not work. I have come across a few alternative studies which links the usage of Vitamin C extreme high does as a cytotoxic agent to treat cancer cells. Therefore, injections for whitening using vitamin C and glutathione although some say may not benefit the person much, I do believe would help reduce oxidative damage that causes aging and is not just an expensive urine. But whether you are willing to fork out for a treatment that you may or not become fair from, its up to the person's personal choice. I would rather the person comes to a proper doctor in a clinic who understand the benefits and complication rather than shoot it up in a beauty saloon or a hotel room by some unlicensed person. Its always better to be safe than sorry. 

So maybe one day we will find a way to lighten up skin even from darker skin subtypes. But is fairness really that important? Perhaps, since we have all been brainwashed since we were really young- remember snow white? Mirror, mirror on the wall........ who's the fairest of them all? My belief is beauty is not just skin deep, it comes from within.

For more enquiries please email to info@faceworksclinic.com or call +603-21440080 for an appointment.

What's up with Vitamin C?

I have been asked about this question a couple of times, so I've decided to write about it in my blog. A lot of people wanted to know whether Vitamin C actually works.

After going through a few papers and a few professional opinions, this is what I have managed to gather:

Benefits of Vitamin C

1. Reduces fine wrinkles around eyes and mouth.
2. Improve skin hydration.
3. Improve pigmentation appearance and age spots.
4. Improves wound healing through fibroblast stimulation nad migration.
5. Increases capacity of fibroblasts to repair potentially mutagenic DNA lesions.
6. Prevents scurvy.
7. Potent anti-oxidant that protects skin from UVA oxygen radicals.

However bear in mind that:

1. Ascorbic acid or vitamin C is pretty unstable and oxidizes easier when exposed to air.

Because of this, most vitamin C preparations have a pretty short shelf life and usually will change colour after a few months if stabilizing agents are not added in. An oxidized form of vitamin C is sometimes more harmful to skin and may cause sensitivity. An easy tip to keep it stabilize is to keep the bottle sealed tight, away from sunlight and chilled in the fridge.

2. Vitamin C is a water soluble vitamin whereas the skin is protected by water by our keratinized layer.

Because of this, you need to be very careful when selecting vitamin C creams or gels to ensure that absorption can occur. Look for products which are lipophilic as it will absorb better into the deeper layers of the skin.

3. Topical Vitamin C has shown to have more benefits towards skin health compared to other methods, although oral vitamin C of 1000 mg daily is sufficient to maintain good health and good skin. Never exceed 2000mg daily as this will lead to vitamin C toxicity which gives you an orange discolouration of the skin, and some have reported renal side effects.

So what would I recommend for a good topical vitamin C?

Obagi has just launched its new range of Vitamin C + Hydroquinone 4% for whitening effect. So far I have been using this serum for the past 1 month and have noticed a significant increase in radiance. Recently, they launched another product which replaces the hydroquinone with Arbutin instead, thus making long term usage possible. Although I do admit these serum are not exactly cheap, but one bottle would last you a good 3 months with the benefits of vitamin C and enhanced whitening. There are also topical vitamin C ranges from 5%-20% for those who are looking for only vitamin C.

For more information, contact us at info@faceworksclinic.com or call 03-21440080.

Faceworks Clinic Products

Its about time I posted the newer products available in myclinic. After trying out a number of them, I finally rested my convictions on these products, which I find does give results at an affordable price.

1. Obagi Nuderm System.

This is one of the most impressive sets I've ever come across. The Nuderm System is a 6 step care which is targeted at changing the skin environment to reduce acne break-outs, reduce pigmentation and also tackle fine wrinkles. Its active ingredients contains Hydroquinone 4% (which is the recommended % to treat pigmentation problems) and in combination with retin-A is the complete solution for acne with post-inflammatory hyperpigmentation and melasma which are the 2 major concerns in facial skin health. It is a prescribed skincare and would require physician monitoring but the results can be seen as early as 2 weeks after initiating the product. The product is used in small quantities and a travel set can last up to 3 months.

2. Obagi C treatment System.

This is a skincare range for people who have mild pigmentation or have flawless skin that they wish to maintain and add more luminance to the skin. Vitamin C being a potent anti-oxidant has shown benefits in skin brightening and evens out of skin tone. It comes in 2 forms of preparations, i.e. with Hydroquinone 4% or just Arbutin. The product is light and non-greasy, absorbs into the skin almost immediately.

3. Obagi Vitamin C serum 15% and 20%

The Vitamin C serum from Obagi is one of the most stable vitamin C compounds in the world. Multiple studies done has shown that over time, the Obagi Vitamin C does not get oxidized as fast as other brands. In terms of its solution, it is highly absorbable and has that nice orange scent. it comes in concentrations as high as 20% and for those vitamin C serum lovers would love this as an adjunct to your current skincare regimes.

4. Obagi Clenziderm for Acne.

Clenziderm is a range produced to treat acne in younger people and those who are not keen to be using hydroquinone or retin-A preparations. The active ingredient is salicylic acid and liquid benzyl peroxide for elimination of P. acnes bacteria which is the cause of pustular acne breakouts. Some may say why liquified benzyl peroxide and not your normal Oxy - well, in view of its form you get evenly distributed lotion with better penetration into the pores. Results can be seen as soon as 2 weeks of usage. The pack lasts up to 4 months.

5. Obagi Elastiderm Eye treatment.



Elastiderm eye treatment from Obagi comes in two forms, the eye gel and the eye cream. Both are made for different types of skin and the main function is to treat under eye fine wrinkles and increase elasticity around the eyes. It has been proven to increase elasticity by 46% in 9 weeks and visibly reduce fine wrinkles around the eyes in 9 weeks. As aging occurs, the elasticity around the eyes are compromised thus giving rise to fine wrinkles and thining of the skin around the eyes.

6. Obagi Elastiderm Decolletage.

Now we have a system to maintain that sexy neck and decolletage area. Obagi Elastiderm Decolletage offers a system to help keep the decolletage area supple and even out the skin tone in the neck area to give you a more youthful bust to flaunt. It is good for sun damaged bust areas as it contains hydroquinone 4% or arbutin to help reduce pigmentation. It also tackles fine lines and wrinkles around the bust area and returns some of the elasticity. Results can be seen as early as 4 weeks.

7. Under EyeBryten for severe dark eye circles and puffiness.



Under EyeBryten could be the solution to your dark eye circles and puffiness. The active compound is called Haloxyl and is recognized as the accepted treatment for undereye discolouration. It works better when combined with regular chemical peels which can also be done in the clinic. One package of 30 mls lasts up to 2 months based on twice daily usage.

8. Skintech Vitamin E cream.

Most people would agree that when you peel your face with laser, IPLs or chemicals, the most common side effect is dryness of the skin. Skintech Vitamin E cream is a wonderful adjunct for people with flaking skin due to treatment. Its a definite keeper for your late night mousterizer after retin-A creams or other treatments and it helps reduce flaking post chemical peel and dryness post laser. Its a moisturizer that can suit most skin types, and most would agree that the texture of your skin in the morning after an overnight application feels wonderful.

9. PK24 Natural 24 hours Feminine Tightening Creme.



This is a weird addition to my range of products but since I do consult cases for vaginoplasty and hymenoplasty, why not. PK 24 is only sold in USA and Malaysia. It is made out of natural ingredients and acts as a feminine tightener. The viscous gel-like substance acts within 5 minutes of application and lasts up to 24 hours. It is recommended for sexually active women after childbirth or those who just want to enhance what they already have.

10. Heliocare SPF 50 Gel sunblock.

Personally I love this sunblock. Its gel based and its tinted so it does not clog up my pores and I don't get that chalk like appearance with other sunblocks. It has a nice scent of oranges and it absorbs swiftly into the skin. I would recommend this for daily use, although for sporting activities, it may not last long enough on the face when you sweat.

11. Foltene Hair treatment system for men and women.



Foltene is a hair care range from Europe. Its a system that consists of a shampoo, a conditioner and treatment ampules. Its good for people who are having problems with hair fall or some scattered baldness patterns, and early balding. The whole set is for a months use and it is recommended to be used for 6 months at least, although there are some reports of results as fast as 2 weeks. It is made out of plant base products and has separate systems for men and women.
For more info check out http://www.foltene.eu .

For enquiries about these products, feel free to email us at info@faceworksclinic.com or call 03-21440080.