Source:

https://www.straitstimes.com/life/ozhean-zoey-medical-aesthetic-clinic-collagen-banking-treatment-skinbooster-injectables-10therma-ultherapy?utm_source=ron&utm_medium=dc-banner-lb&utm_campaign=apx85146_595176

A survey in 2019 indicated that 30-35% of Singaporean women between the age range of 35-44 are concerned about wrinkles and sagging skin. The younger population, those in their 20s have also been presenting an increased interest in anti-ageing initiatives to best preserve their youth. With the added popularity of collagen banking, we often receive multiple queries on the broad range of collagen injectables offered at Ozhean Zoey Medical and Aesthetic Clinic. A recurring pattern we have identified is patients with decision fatigue and confusion about the right collagen stimulator for them. Thus, this article will bring you the clarity you seek.

Understanding the mechanism of collagen in your body

In our previous articles, we have determined: 

• The human body is limited with collagen supply, which once lost, cannot be recovered.
• Pollution, stress, sun exposure, and toxin from substances such as cigarette smoke will expedite collagen loss.
• The human body loses an estimated 1% of collagen every year after the age of 20. 

Collagen creams will not improve your collagen production, they may serve as a protective barrier at most. Additionally, there is no definitive conclusion that consuming collagen supplements will improve collagen production at the dermal level. When compared to our scientifically-curated injectables solution, these alternatives may be significantly slower in achieving the results you seek or may completely falter. 

It is important to note that one injectable is not superior to the other. When approaching our team of experts we will evaluate various aspects of your life before proposing a treatment. What may be suitable for one patient, will not necessarily be the right solution for you. This is why consultation is arguably the most important aspect of our service at Ozhean Zoey Medical and Aesthetic Clinic. 

The overarching goal of injectables stimulate collagen growth in your skin. The methodology of how they work varies but ultimately the aim is to catalyse the activity of fibroblasts, cannibalise free radicals, and improve the metabolic activity of cells.

Factors affecting the decision of selecting a collagen stimulator

There are a few variables to weigh in when deciding which collagen injectable is best suited for you. 

Below are some factors of consideration: 

• Inflammatory health problems 

Conditions such as obesity, endometriosis, inflammatory arthritis, and diabetes cause high levels of inflammation in the body. Patients with inflammatory health problems have high collagen turnover. In these health situations, you may consider opting for collagen injectables that have anti-inflammatory properties such as Rejuran. Additionally, Rejuran can also be used with other treatments, particularly in cases where post-inflammatory hyperpigmentation (PIH) is persistent. 

• Low levels of oestrogen 

Your oestrogen levels directly impact collagen production in your body. It also explains why menopausal women look more aged than women of reproductive age. Lower estrogen in younger women may be due to various health conditions such as autoimmune disease, conditions impacting pituitary glands and hypothalamic amenorrhea. If patients are diagnosed with one of these health conditions, injectibles such as Zoey Skin may go a long way in preserving your youth. This concoction of Rejuran, Hyaluronic Acid, and Butolinum will halt the formation of wrinkles, encourage healing and reparation in your skin, and aid in hydration support.

• Lifestyle factors 

Sometimes, lifestyle factors can be the primary cause of rapid skin ageing. These may include poor sleep quality and behaviours such as smoking and excess alcohol consumption. These may be especially true for patients with unpredictable work hours and frequent exposure to high-stress environments. Symptoms include dull skin, persistent scars, and an overall change in complexion. If you believe your skin health has been impacted by lifestyle factors, Nucleofill may be the best solution for you. Nucleofill also comes with the added advantage of different concentrations, so you can opt for the strength that matches the severity of your skin condition. 

• Genetic disposition to collagen loss 

“I do not smoke, I eat a healthy diet, and have no health issues, why is my skin ageing so rapidly?”. If you are taken aback by sudden signs of ageing in your skin, it is possible that you are just genetically predisposed to collagen loss. Studies have also found that some races are more predisposed to skin ageing than others. When dealing with genetic predisposition, you may attempt the prevention route with Profhilo especially if signs of presentation of ageing are new. However, if signs of ageing such as wrinkles and fine lines have formed over a long period of time, you may decide between Liquid PCL or BTX (botulinum) to significantly reduce signs of ageing and add volume to your facial structure. 

• Targeted skin issues 

Sometimes previous skin conditions such as cystic acne may be the cause of the aged appearance of your skin instead of direct loss of collagen. In these situations, Juvelook would be an appropriate solution to manage the aged appearance of your skin. Another targeted skin issue is deep wrinkles forming at thicker skin areas of the face such as the temples and neck. In these particular conditions, Lenisna would be the more appropriate solution for these areas.

As you may have comprehended by now, each injectable has its’ own strength with the capability to address whichever main concerns you might have. It is important to note that this is merely a surface-level guide to making a decision. Upon consultation, your doctor will be able to identify the exact cause of an ageing appearance (whether it is one or more factors) and prescribe the best treatment solution. At Ozhean Zoey Medical and Aesthetic Clinic, we strive in making sure treatments are inclusive and comprehensive for patients from all walks of life. 

If you have any questions or concerns, drop us a message or book a consultation. We will be happy to address any other inquiries or doubts you may have.

Prevention is always better than cure, and this rings especially true in aesthetics today. This is why aestheticians and patients worldwide are uttering a new buzzword: Collagen banking.

As you might imagine, collagen banking is about saving the exhaustible collagen in our skin, and preventing the collagen loss that inevitably occurs with age. Collagen banking is also known as prejuvenation.

In the past, many would wait till they saw their first wrinkle before looking at ways to rejuvenate the skin. But as a result of the widespread proliferation of skincare knowledge and advancing technology, younger individuals in their 20s and 30s are now just as serious as older clients about protecting their youthful glow.

In other words: Collagen banking is no longer only for the middle-aged.

If you’re a young individual who would like to maintain a healthy, refreshed, and natural complexion for longer, prejuvenation is your answer. Read on to find out about what collagen banking is, and the treatments available for you.

What is collagen banking?

While the focus has long been on staving off ageing, we are now becoming more interested in maintaining youth.

Prejuvenation, or collagen banking, is different from rejuvenation in that the former means “to prevent the loss of youth”, while the latter means “to make young again”[1].

Prejuvenation involves a series of thoughtfully planned steps that are meant to impede the loss of collagen, and prevent the symptoms associated with aged skin, such as fine lines, wrinkles, and brown spots.

Most importantly, collagen banking is meant to be started early on in life. The sooner one begins, the less damage they will have incurred; it is more effective to prevent rather than treat the signs of ageing.

Why is collagen banking important?

Firstly, we all have finite amounts of collagen in our bodies, and largely, once lost, it cannot be recovered[2].

With time, and external stressors such as pollution, stress, sun exposure, and toxins, our bodies ability to produce collagen starts to deplete in adulthood. Upon hitting the age of 20, a person will start to produce about 1%[3] less collagen in their skin each year thereafter. Therefore, investing in your skin while it’s healthy is crucial.

The effects of collagen loss are incremental – as soon as their 30s or 40s, people finally start to notice obvious signs of ageing in the form of wrinkles, saggy skin, dryness, and an overall loss of vitality in their faces.

How is collagen banking carried out?

Prejuvenation can be carried out in ways both big and small:

• UV protection
  Having proper protection from the sun is one of the easiest, most inexpensive methods of prejuvenation. Regular use of sunscreens will not only protect your skin from skin cancer, but will also help prevent fine wrinkles, sun-induced brown spots, and loss of collagen.
• The use of retinoids
  Retinoids are an effective topical agent when it comes to stimulating collagen, preventing wrinkles, retaining skin hydration, and more[4].
  
• Neuromodulators like Botox
  It is not uncommon to see patients in their early 20s with deep and prominent forehead wrinkles and frown lines. Neuromodulators such as Botox help relax the muscles that form lines and wrinkles on the face. The early use of Botox not only helps treat current wrinkles, but can help prevent the progression of them.

  At Ozhean Zoey Aesthetics, we include the use of buffered saline in our Botox treatments – this helps dilute botox solution and consequently reduces the pain and discomfort that comes with the injection.

• Collagen stimulators like Juvelook
  Collagen loss is often combated by using HA fillers which are composed of naturally occurring sugar molecules. The use of hyaluronic acid fillers can help stimulate[5] the production of your skin’s collagen. When it comes to fillers, selecting the right type of filler and being treated by a skilled injector are paramount.

  In Korea, dermatologists now prefer collagen stimulator treatments like Juvelook over traditional HA fillers like Rejuran, largely due to its longer lasting results.

This highly viscoelastic gel improves skin by:

• Stimulating dermal fibroblasts and the deeper layers of the skin.
• Acting as a scavenger of unstable molecules that damage skin (free radicals).
• Promoting the metabolic activity of cells to restore youthfulness.
• Producing new collagen in the skin for a natural lift and volumisation.

Fun fact: Nucleofill is derived from biocompatible salmon DNA which offers the skin a younger, healthier appearance.

What is Juvelook?

Juvelook is a collagen skinbooster that contains two very important ingredients for anti-aging – HA and PDLA.

As a hybrid filler, it offers the immediate filling effect of HA and the long-term collagen stimulation of PDLA, which is found in other collagen biostimulators like Sculptra.

• HA (Hyaluronic Acid) fills in wrinkles and fine lines by retaining moisture; voluminising effects can be seen immediately.
• PDLA (Poly D-Lactic Acid) stimulates natural collagen growth over a period of six months, provides the skin with extra support, and prevents HA from migrating.

Juvelook is prized for its patented ultrafine PDLA and HA molecule technology, which enables intense collagen production stimulation and offers extremely natural-looking results.

Juvelook also:

• Helps improve acne scars.
• Improves enlarged skin pores.
• Lifts the face without too much volume or puffiness.
• Hugely improves overall skin texture, thinness, and wrinkles.
• Diminishes the risk of bumps and HA migration.
• Does not induce acne outbreaks like some energy device treatments.
• Can be injected superficially, unlike Sculptra, which must be injected deeply as it can easily cause bumps and granulomas otherwise.

The anti-ageing effects of Juvelook can last for around two years, which is significantly longer than the effects of other fillers like Profhilo, Lidocaine, and Salmon DNA.

Juvelook vs Sculptra

	JUVELOOK (PDLLA)	SCULPTRA (PLLA)
Structure	Outside - Round form Inside - Network structure	Outside - Cristal(sharp) Inside - Tightly packed structure
Degree of lactic acid secretion	Mid	Strong
Strength	Smooth	Stiff
Target Area	Sub-Q Dermis	Sub-Q
Target Treatment	Volume augmentation Skin rejuvenation	Volume augmentation

How about thread lifts? Do I still need it?

A thread lift is a procedure whereby temporary sutures are used to produce a distinct and visible skin lift. Instead of removing a client's loose facial skin surgically, skin is instead stitched up and suspended. As such, threadlifts are a great option for those who would like to look more youthful without going through surgery.

While a thread lift yields stronger results out of all the skin lifting treatments available (it is, after all, the closest non-surgical alternative to a facelift), it does come with more pain and invasiveness than an injectable such as Juvelook.

If you’re in your 20s to 30s and would like to protect the collagen in your skin, my suggestion is to opt for Juvelook first. Juvelook can delay the need for a threadlift for many years, and is a more feasible step to take.

When the time for a threadlift comes, OZ threadlifts will work just fine. They are:

• Very strong
• Ultrasound-molded
• Extremely resistant to pressure and last significantly longer

If you have any questions, I’m more than happy to answer them. Feel free to drop me a message.

References 

1. Hogan, S. R., Zachary, C. B., & Arndt, K. A. (2021). Prejuvenation: Definition of the Term and Evolution of the Concept. Dermatologic Surgery, 47(6), 871–872. https://doi.org/10.1097/dss.0000000000002929
2. Kothapalli, C. R., & Ramamurthi, A. (2010). Induced elastin regeneration by chronically activated smooth muscle cells for targeted aneurysm repair. Acta Biomaterialia, 6(1), 170–178. https://doi.org/10.1016/j.actbio.2009.06.006
3. Why does skin wrinkle with age? What is the best way to slow or prevent this process? (n.d.). Scientific American. https://www.scientificamerican.com/article/why-does-skin-wrinkle-wit/#:~:text=After%20the%20age%20of%2020
4. ‌Zasada, M., & Budzisz, E. (2019). Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments. Advances in Dermatology and Allergology, 36(4), 392–397. https://doi.org/10.5114/ada.2019.87443
5. Wang, F., Garza, L. A., Kang, S., Varani, J., Orringer, J. S., Fisher, G. J., & Voorhees, J. J. (2007). In Vivo Stimulation of De Novo Collagen Production Caused by Cross-linked Hyaluronic Acid Dermal Filler Injections in Photodamaged Human Skin. Archives of Dermatology, 143(2). https://doi.org/10.1001/archderm.143.2.155

A recent American survey1 reported that millennials aged 25-35 are more worried about ageing than their mothers and grandmothers, with the average individual starting an anti-ageing regime as early as 26 years old. 

The same sentiment applies for those in Singapore. 

The earlier need to stave off signs of ageing is thought to be attributed to how millennials place utmost importance on looking good – social media and pop culture now demands everyday individuals to look good from all angles. And while this information isn’t groundbreaking per se, it shows us that our approach to ageing, as with body image, has changed drastically from one generation to the next.

Read: Why muscle building treatments don’t work 

But are you tackling ageing correctly, or worse, wasting money? In this article, we’ll address the common mistakes that both young and mature clients make when it comes to anti ageing treatments, and talk about the solutions available in Singapore today.

Botox, fillers, threadlifts: How you’re getting anti ageing wrong

Fact is, almost every aesthetic treatment can be considered an anti-ageing treatment, as the overall goal of such treatments is mostly to look better and younger. And while a naturally lifted face or enhanced jawline —think botox, threadlifts, HIFU— might contribute to a more youthful look, congruent treatments must be done to improve skin from within.

As aged skin is often a result of poor skin quality and loss of collagen due to factors such as age, smoking, and lifestyles, anti ageing treatments often begin with inducing collagen production and maintaining that. One cannot simply threadlift their way to revitalised youth.

Dare I also say by starting on collagen biostimulation treatments early, you can prevent the need for treatments like botox and fillers in future.

What treatments should I choose to reverse ageing?

Many individuals tend to opt for skinboosters or HA fillers first, as one of the most obvious signs of youthful skin is glowy, hydrated complexion. But let’s not forget beyond a pristine facade, volume and elasticity also play a huge role in a youthful visage. 

When someone looks older than they wish to due to volume depletion, I nudge them toward collagen biostimulators instead. This is because HA fillers can add volume to certain parts of the face only to a certain point; adding more might result in overfilling. 

Collagen biostimulators achieve their anti-ageing goals by directly regenerating collagen in your skin and imparting more substance and shape. For example, Ellansé works to quickly replace lost volume, whilst more robust fillers like Sculptra gradually add fullness to gaunt areas of one’s face.

Both are great, but allow me to introduce two new innovative biostimulator treatments, Nucleofill and Gouri.

Nucleofill and Gouri: The future of anti-ageing treatments?

Nucleofill was formulated in Italy, whilst Gouri was created by a Korean company that specialises in biopolymer (natural polymers produced by our cells) technology. Both treatments are aimed at improving collagen production in the skin, and are low risk and suitable for all skin types.

Nucleofill

As the newest technology in biostimulation, Nucleofill is a polynucleotide-based injectable gel specifically designed for natural face shaping and remodelling. 

This highly viscoelastic gel improves skin by:

• Stimulating dermal fibroblasts and the deeper layers of the skin.
• Acting as a scavenger of unstable molecules that damage skin (free radicals).
• Promoting the metabolic activity of cells to restore youthfulness.
• Producing new collagen in the skin for a natural lift and volumisation.

Fun fact: Nucleofill is derived from biocompatible salmon DNA which offers the skin a younger, healthier appearance.

Gouri

Gouri is a 100% liquid type PCL injectable from Korea.

Gouri is used for long term skin firming, tightening and distinct wrinkle reduction. 

Here’s why Gouri is an excellent anti-ageing solution:

• Unlike other fillers which offer revitalising effects on localised partspart only, Gouri spreads naturally to regenerate collagen throughout the entire face.
• Unlike other existing fillers in the market, Gouri is fully liquid, has no microparticles, homogenously solubilises in water, and presents significantly lower risk.
• As a biodegradable polymer, Gouri naturally degrades due to hydrolysis.
• Compared to HA fillers, it has a more long-lasting cosmetic performance.

Comparing Nucleofill and Gouri treatments

	Nucleofill	Gouri
What it is	An innovative biotechnology that contains polynucleotides which stimulate the skin and ensure long-lasting skin hydration and firming.	A solubilised active and biodegradable polymer injectable that enables collegenesis and rejuvenation without the use of microparticles.
Composition	Gel 2.5% polynucleotides, with pH values of 6.8 to 7.5, and viscosity of 48 to 65 Pa*s.	Fully liquid. 21% PCL, or only PCL.
How long does it take for results to show?	Roughly 10 to 20 minutes following treatment.	Clients normally see their first visual results within 1 to 2 weeks following treatment.
Longevity of results	Results are long-term and last at least 6 months.	Results vary from person to person. As PCL is a high molecular material, the body usually takes 6 to 12 months to degrade it.
Risks involved	There are no serious side effects, making Nucleofill an effective and safe treatment for all skin types1.	Excluding extremely rare cases, the PCL-based filler presents disruptively low risk2 compared to other fillers.
Recommended protocol	After 3 sessions, additional treatments in 15 to 30 day intervals are recommended for continuous, long-lasting, and effective results.	After 3 sessions, an additional 1 to 2 treatments administered in intervals of 4 weeks, or 3 to 6 months are recommended for optimal results.

Why should I consider Nucleofill and Gouri?

Due to the natures of Nucleofill and Gouri, the risk of overfilling, or pillow face syndrome is significantly lowered. These two treatments also present little to no risk, and are known to be consistently long-lasting treatments with a gradual anti-aging effect.

As such, individuals who undergo either Nucleofill or Gouri can expect to experience the following breakthroughs with their skin:

• Increased skin elasticity
• Intensely hydrated layers of skin
• Revitalised skin tone and texture
• Reinvigorated collagen production
• Skin lifting and youthful volumisation
• Repair of skin tissue and damaged cells
• Significant reduction of fine lines and wrinkles

When combined, they address aging issues on different layers of the face and therefore completely rejuvenate the face.

Can I combine Nucleofill and Gouri with other treatments?

While Nucleofill and Gouri can be compatible with other mesotherapy products, we recommend waiting at least a month before and after undergoing other treatments like HA fillers and other cross-linked materials. 

With Gouri, you can apply non-crosslinked skin boosters or Botoxs. However, do not mix any other products with GOURI. Overall, we would also suggest against mixing Gouri with other products.

Furthermore, as patients usually see long-lasting results and are satisfied with what they see, it’s unlikely that they’ll need supplementary treatments, unless they have specific concerns like acne scars or pigmentation.

When it comes to maintaining your youth, don’t wait till it’s too late. Prevent, not cure! 

Let my team help you restore your youth and stop ageing in its tracks.

About Dr. Park Ji-Youn

Dr. Park Ji-Youn is the founder and managing director of the Ozhean group. As a board certified dermatologist, she has published more than 30 scientific papers on dermatology, and is the creator of Ozhean’s SKIN FIT program, which was conceived in 2015, and continues to successfully retain 80% of its original customers.

References 

1. https://www.newbeauty.com/millennials-reportedly-worry-more-about-aging-than-their-moms-or-grandmothers/
2. Park, K. Y., Seok, J., Rho, N. K., Kim, B. J., & Kim, M. N. (2016). Long-chain polynucleotide filler for skin rejuvenation: efficacy and complications in five patients. Dermatologic therapy, 29(1), 37–40. https://doi.org/10.1111/dth.12299
3. Lin, S. L., & Christen, M. O. (2020). Polycaprolactone-based dermal filler complications: A retrospective study of 1111 treatments. Journal of cosmetic dermatology, 19(8), 1907–1914. https://doi.org/10.1111/jocd.13518 

Touted by Vogue as a top beauty trend for 2022, skinimalism is a spartan approach that involves stripping back skincare and make-up routines in order to let one’s real skin shine. This can be done in a number of ways, such as reducing the number of skincare products you use or simply packing less foundation onto the skin.

As a result, patients are now seeking low-maintenance treatments that carry more longevity. Likewise, the aesthetic industry’s focus has also shifted from restoring the look of one’s skin to improving skin health from deep within.

Think treatments that allow your body to slow down the ageing process naturally through collagen biostimulation. 

In this article, we’ll talk about the treatments you should be looking at, especially in light of anti-ageing, skin safety, and looking your best from within – all aboard the skinimalism bus!

What is biostimulation, and how does it achieve skinimalism?

Biostimulation¹ is an injective therapy that’s aimed at boosting the anabolic functions of dermal fibroblasts to obtain skin improvement. 

Sounds confusing? Don’t worry. Let’s break it down:

• Anabolism: Our anabolic functions work to free and capture energy in our body.
• Dermal fibroblasts: While they might sound like weapons from Star Wars, dermal fibroblasts are cells within the dermis that generate connective tissue and allow the skin to recover from injury.
• Dermis: Skin comes in 3 layers. The dermis is the layer of skin above the subcutaneous layer and beneath epidermis.

When we speak of collagen biostimulators, they can be explained simply as non-invasive treatments that work to stimulate your own collagen production, correcting signs of ageing such as loss of elasticity. 

As such, biostimulation offers individuals a quick, safe, and effective way of achieving youthful, firmer skin. This is where Nucleofill comes in.

The Nucleofill difference

As one of the newest technologies in biostimulation, Nucleofill is a polynucleotide-based injectable gel that is specifically designed to revive dull and tired skin.

By stimulating deeper layers and dermal fibroblasts of our skin, this highly viscoelastic gel effectively improves the quality of skin by:

• Acting as a scavenger against free radicals (unstable molecules that damage skin)
• Promoting the metabolic activity of cells to restore and maintain youthful functionality
• Producing new collagen in the skin for a natural tissue lift and skin volumisation

As such, clients who’ve undergone Nucleofill treatment can expect to experience these long-lasting results:

• Increased skin elasticity
• Intensely hydrated layers of skin
• Revitalised skin tone and texture
• Reinvigorated cell function and activity
• Lifting and anti-ageing outcomes
• Repair of skin tissue and damaged cells
• Immense protection and recovery of the skin
• Deep bio-remodelling and lifting effects

Additionally, Nucleofill, which was formulated in Italy, is well-known for its safety: Not only is it derived from bio-compatible salmon DNA which offers the skin a younger, healthier appearance, it is also suitable for all skin types.

At Ozhean Zoey, we utilise a safe 5-point injection technique to target our clients’ key tissues for optimal biostimulation and collagen production. 

How are fillers different from biostimulators?

While dermal fillers work to boost hyaluronic acid levels to enhance and volumise skin, biostimulators boost the collagen levels in the skin to improve its long-term tone, texture, and overall health.

For example, hyaluronic acid (HA) fillers plump skin because hyaluronic acid attracts water, which immediately hydrates the skin. But while HA has been known to boost collagen in the skin, it is not nearly as effective as biostimulators.

Here are some other ways that Nucleofill differs from other treatments available today:

Treatment	Nucleofill	HA fillers	Ellansé	Sculptra
What it is	Nucleofill is an innovative biotechnology that contains polynucleotides  which stimulate the skin.	Hyaluronic acid (HA) is a substance that’s  found in our skin. HA fillers help attract water to voluminise the skin.	As a non-HA filler, it contains Poly-Caprolactone (PCL) microspheres suspended in a gel-carrier made up of Carboxymethycellulose (CMC).	Sculptra contains poly-L-lactic acid (PLLA), which is a biocompatible synthetic that stimulates collagen production.
Results	- Youthful look - Vibrant complexion - Natural filling - Face lifting - Face shaping - Improved tone, texture and elasticity - Skin improvement is significant and notable	- HA is hydrophilic (tends to mix with, dissolve in, or be wetted by water), and while it helps to plump skin, may also cause puffiness after filling.	- Volumising and Collagen-stimulating effects - Skin improvement is significant and notable	- Natural shaping - Face lifting
Length of results	Results are long-term and last at least 6 months. Treatment needs to be repeated thrice, and every 15 to 30 days to be continuous, long-lasting, and effective.	Results last anywhere between 9 to 24 months.	Results can be long-lasting, but it is difficult to predict final outcomes. Initially, results may also decline before increasing.	Results are long-lasting, as with Nucleofill. Some prefer Sculptra over Ellanse as the results are gradual and more discreet.
Treatment cost in Singapore	Low (compared to Ellanse)	Medium (depending on volume)	High	High
Potential side effects	There are no serious side effects, making Nucleofilll an effective and safe treatment for all skin types2.	The most common adverse effects include tenderness, bruising, and swelling. These side effects typically resolve naturally within 2 weeks.	Like HA fillers, side effects of Ellansé include bruising and tenderness3.	While extremely rare, side effects can include granulomas, scarring and discolouration, nodules, and lumps.

Should I undergo Nucleofill biostimulator treatment?

If you’re looking to regenerate your skin tissues and skin from within, and are looking for more than a quick glow up, Nucleofill is an effective solution for correcting fine lines, wrinkles, and loss of elasticity. I especially recommend it for mature individuals who wish to regain their collagen levels and youthfulness.

Additionally, Nucleofill is an effective solution for anyone who suffers from:

• Asphyxial skin
• Dehydrated skin
• Stretch marks
• Scars and wounds
• Loose skin and/or poor circulation
• Skin that has been damaged by oxidative stress

If you’re already on a low maintenance anti-ageing regime, Nucleofill would be the perfect complement. 

Remember, skin health is a cornerstone of one’s beauty – you’re never too young to start on an anti-ageing routine! 

About Dr. Park Ji-Youn

Dr. Park Ji-Youn is the founder and managing director of the Ozhean group. As a board certified dermatologist, she has published more than 30 scientific papers on dermatology, and is the creator of Ozhean’s SKIN FIT program, which was conceived in 2015, and continues to successfully retain 80% of its original customers.

References 

1. Avantaggiato, A., Martinelli, M., Palmieri, A., Pascali, M., Bertuzzi, G., & Carinci, F. (2015). HYALURONIC ACID: THE USE OF ITS PRECURSOR IN SKIN BIO-STIMULATION. Journal of biological regulators and homeostatic agents, 29(3), 647–654.
2. Park, K. Y., Seok, J., Rho, N. K., Kim, B. J., & Kim, M. N. (2016). Long-chain polynucleotide filler for skin rejuvenation: efficacy and complications in five patients. Dermatologic therapy, 29(1), 37–40. https://doi.org/10.1111/dth.12299
3. de Melo, F., Nicolau, P., Piovano, L., Lin, S. L., Baptista-Fernandes, T., King, M. I., Camporese, A., Hong, K., Khattar, M. M., & Christen, M. O. (2017). Recommendations for volume augmentation and rejuvenation of the face and hands with the new generation polycaprolactone-based collagen stimulator (Ellansé®). Clinical, cosmetic and investigational dermatology, 10, 431–440. https://doi.org/10.2147/CCID.S145195

Goodness knows there are countless slimming treatments and supplements available today in Singapore, and while we all know that variety is the spice of life, I’m afraid that our current industry –great clinics and practitioners notwithstanding– is also home to many questionable characters and technologies.

In September 2016¹, an 85-year-old woman settled a lawsuit against a popular slimming centre, in which she sought a full refund and damages over a $400,000 weight-loss package. On top of being ineffective, her treatment had caused her diarrhoea, a skin rash, and pus discharge. 

Just last year, a woman was justly jailed² for cheating victims of over $630,000 worth of beauty packages.  

It’s hardly rocket science: Many slimming treatments and crash diets offered today are scams, and even if they seem to produce initial results, often, weight loss is only temporary and will bounce back.

One of the reasons for this is that too many “professionals” are not upfront about what type of weight is lost in their “guaranteed” results. What clients really want is fat loss, as water loss is hardly permanent, and muscle loss can actually be detrimental to health in the long term.

The cold, hard, truth: Losing weight is hard work

The truth is that losing weight is hard work, and requires a multi-pronged approach. I’ve said this before to my dearest clients, and I will say this again: Diet, lifestyle, exercise, and proper fat removal treatments are all crucial in achieving the body you desire.

I know how hard it is for many to commit to the time and effort required to lose weight consistently. One aspect of eating well for a better body is to be aware of the amount of calories you’re putting in your body. And this is not an easy task – as studies³ go, even healthcare professionals get their calorie counts terribly wrong.

With the above said, weight loss can be an uplifting and life changing journey, if you’re willing to embark on it. As a health and beauty professional, I always remind my clients that the work starts with them FIRST. Fat removal treatments are not the be-all and end-all of achieving the body you desire – but they can be an integral part of the process for sure.

After weight loss, the body might look worse

We can’t spot-reduce fat, so even after dropping some overall body fat, some people may find that certain areas such as their belly, armpit, or thighs remain largely unchanged. Worse still, others who have achieved significant progress losing large amounts of body fat might become skinny fat and left with excess skin. 

You also want to make sure you’re losing fat and not weight just for the sake of it – weight loss from water weight does not count! 

Read to find out the difference between fat loss vs weight loss. 

Ozhean Zoey’s fat loss treatments help get rid of problem areas  

In summary, you want to lose weight the smart way – through dropping your body fat levels, and if you’re feeling it, some fat removal treatments or skin tightening technology (think stretchmarks and cellulite removal) could help complete your dream body.  

Ozhean Zoey’s fat freezing technology aids clients in achieving the bodies they want via non-invasive fat removal treatments that are scientifically backed⁴:

In 2012, Cryolipolysis received FDA clearance for love handles, abdomen, and thighs. The efficiency of the treatment method on fat reduction without physical damage to surrounding tissue has been clinically proven. The procedure is effective in reducing adipose tissue, and also offers high patient satisfaction. Here are some of its other benefits:

• It is suitable for all ages
• It is painless and non-invasive
• There is no downtime required
• There is no risk of infection
• Damaged fat cells are flushed out permanently
• Blood vessels, nerves, and muscles are not affected
• Multiple areas can be treated in a single session

Apart from Cryolipolysis, we also utilise treatments such as Agnes Fat Melt and Shockwave, Vacuum & Multipolar Radiofrequency to tighten, rejuvenate, and firm treated skin, giving our clients an even leaner and sculpted look after their fat removal treatments.

Struggling with cellulite? Here’s why losing more weight isn’t the solution. 

While the full flushing out of treated fat cells may take up to six months, the odds of fat cells returning after treatment are slim to zero. Patients are strictly advised to maintain a healthy diet and lifestyle to support their fat removal treatment.

The journey might be hard, but it is so worth it. And with the right knowledge, mindset, and help, it is 100% achievable. If you’re just getting started, contact us today for the guidance that you need. We look forward to helping you succeed at achieving your dream body!

About Dr. Park Ji-Youn

Dr. Park Ji-Youn is the founder and managing director of the Ozhean group. As a board certified dermatologist, she has published more than 30 scientific papers on dermatology, and is the creator of Ozhean’s SKIN FIT program, which was conceived in 2015, and continues to successfully retain 80% of its original customers.

It’s been 20 years since Singaporean actress Andrea De Cruz’s furore with slimming pills, which left her with liver failure and almost death. You’d think that consumers today would be wary of products that promise quick and immediate fixes, but it seems not – many are still falling for countless weight loss scams that promise to speed up your metabolism and more, as confirmed by CNA¹. 

One of these products even claims to be "15 times more effective” on stubborn fat, with "results guaranteed within one to five days". 

To a professional, these claims are obviously nonsensical. 

Even outside of consumables, the “get slim fast” scam pervading Singapore today has made its way through other facets, such as slimming massages, body wraps, steam treatments and vibrating belts alike. 

All these treatments promise instant results, but the only real thing they have in common is that they help lose water, which unlike fat, is promptly regained. If you’re losing weight at a rapid pace without being on a hypocaloric diet, it’s very likely that you’re losing water weight instead of achieving actual weight loss, which comes from losing fat. 

Want to lose fat and slim down for the long-term? Here’s the lowdown on what to look out for. 

The difference between fat loss and water loss

The human body is made up of about 60%² water. Even fat cells contain roughly 10% water; suffice to say, water and hydration levels can greatly affect our body weight. 

When your body undergoes a state of dehydration (through activities like alcohol consumption, sweating, water fasts), your tissues, fat and intestines easily lose water. Hence, it is not uncommon to experience a drop in weight, a smaller waist circumference and even smaller fat bulges. 

Fun fact: did you know you can easily lose two pints’ worth of water just from 15-20 minutes in the sauna? 

That’s a whole lot of water weight – and something many slimming centres take advantage of to produce “instant weight loss” and “instant slimming effects”. But this weight loss is gained back the minute you replenish your body with hydration, and can take as fast as 45 minutes³. 

The bottom line: Rapid weight loss and slimming effects from slimming treatments that cause dehydration are only temporary and not meant to be permanent. The only real way to lose fat is through a caloric deficit. 

Fat loss the real way

A calorie deficit occurs when you consume fewer calories than your body burns. 

How big of a deficit over a consistent period of time will determine how fast you lose weight; but in general a deficit of 200-500 calories is enough to accumulate steady fat loss without feeling hungry and lethargic all the time. 

All literature and clinical studies have proven that a caloric deficit is the only way to achieve meaningful long term weight loss. When trying to lose weight, you should always focus on fat loss or losing visceral fat (fat located within the gut and intestinal organs). This significantly influences the body to look more attractive and healthier. 

Do fat loss aesthetic treatments work? 

Fat removal treatments focus on the removal or destruction of fat cells thus causing a reduction of fat or fat loss in the treated area. 

Yes, diet will have a big impact on the overall success of your slimming journey – but fat removal treatments can assist and even accelerate this process, provided the client is strict with their diet and exercise regime. 

For example, this 2012 study⁴ which evaluated long term fat loss in liposuction shows while the number of fat cells remained stable and low at treated areas, they actually increased in other areas of the body. In other words, fat redistribution is possible especially if current dietary and activity habits continue. 

So the gist is: Have your diet and exercise habits in place, and they will greatly enhance the aesthetic results of your fat loss treatments. 

Types of fat loss treatments in Singapore

Our team deliberately chooses fat removal treatments that are centred around clinic research and medically proven results. Let us help you achieve and maintain your desired body!

About Dr. Park Ji-Youn

Dr. Park Ji-Youn is the founder and managing director of the Ozhean group. As a board certified dermatologist, she has published more than 30 scientific papers on dermatology, and is the creator of Ozhean’s SKIN FIT program, which was conceived in 2015, and continues to successfully retain 80% of its original customers.

References

1. https://www.channelnewsasia.com/singapore/hsa-weight-loss-banned-substance-sibutramine-flash-slim-280751
2. https://www.medicalnewstoday.com/articles/what-percentage-of-the-human-body-is-water#percentage-chart 
3. https://www.drinkhydrant.com/blogs/news/how-long-does-it-take-to-recover-from-dehydration 
4. Benatti, F., Solis, M., Artioli, G., Montag, E., Painelli, V., Saito, F., Baptista, L., Costa, L. A., Neves, R., Seelaender, M., Ferriolli, E., Pfrimer, K., Lima, F., Roschel, H., Gualano, B., & Lancha, A., Jr (2012). Liposuction induces a compensatory increase of visceral fat which is effectively counteracted by physical activity: a randomized trial. The Journal of clinical endocrinology and metabolism, 97(7), 2388–2395. https://doi.org/10.1210/jc.2012-1012

In 2019, the K-beauty trend¹ that reigned supreme was glass skin. The main goal of glass skin is simple but crazily unattainable: Look so radiant and dewy that your skin becomes almost reflective, or mirror-like.

That all changed in 2020, when the simpler trend of cream skin took over, and the focus shifted from radiant and dewy to soft and supple. The cream skin trend also pared down the complicated steps of glass skin skincare, which is a big reason why it gained such wild popularity in Singapore and the rest of the world.

But whether it’s glass skin or cream skin, Korean skincare trends continue to revolve around the same thing: Attain the perfect, poreless, porcelain skin that Korean actresses seem to have. As a Korean aesthetic clinic, we can vouch for the fact that skin whitening remains one of the top goals amongst our clients.

How are skin bleaching and skin whitening different?

Before I move on, I’d like to stress that skin bleaching is different from skin whitening. While the former involves severe changes in skin tone and colour, skin whitening, especially in the context of Korean beauty standards, speaks to perfecting to the overall texture and health of skin, and is designed to help women achieve bright and luminous skin, no matter their place on the Fitzpatrick scale.

Why are skin whitening products known to be dangerous, and do they really bleach your skin? 

While the demand for skin whitening (or bleaching) remains strong, the procedures and products involved, however, have earned bad reputations due to cases of highly dangerous and unregulated skincare products and services being available in worldwide markets.

Some skin whitening or bleaching products have been found to be closely linked² to health problems such as kidney failure, blood poisoning and cancer³. It is for this reason that many countries, such as Australia, Japan, and Singapore, have banned the use of toxic bleaching agents in skincare products (thank goodness!)

On that note, are there products out there that are safe to use for skin whitening? Let’s take a closer look. 

What works and what doesn’t? 

While research states that using intravenous glutathione (whitening drips) to lighten skin brings countless adverse effects⁴, including the toxic harming of the nervous system, kidney and liver failure, and Stevens Johnson syndrome, there are those who still choose to do it, whether it’s out of ignorance or stubbornness.

Oral whitening supplements are yet another solution, and consist of options such as oral carotenoids (aka. the crystal tomato), glutathione, melatonin, Polypodium leucotomos hydrophilic extract, procyanidin, and tranexamic acid. Initial findings for the treatment of hyperpigmentation seem promising, and such oral treatments do appear safe for now.

However, the plain truth is, even dermatologists are behind when it comes to understanding the properties, risks, and efficacy of treatments and products in the market today.

The Ozhean Zoey way of skin whitening for brighter, radiant skin 

At Ozhean Zoey, we use a combination of safe and effective treatments to help our clients achieve the skin they dream of. Here are a few examples of the help that we offer:

I personally really like the De:H Brightening Ampoule: This topical whitening product contains Sea Buckthorn, and Vitamins C and E, which are excellent antioxidants (hello, anti-aging effects!) It also contains VHTN complex, which is an active whitening formula that:

• Reduces and prevents melanin pigmentation
• Repairs damaged basement membrane of the skin
• Reduces dark spots
• Improves skin texture
• Reduces skin inflammation
• Helps eliminate the occurrence of acne

Topical glutathione (Not intravenous whitening drips)

Topical glutathione is safe⁵ to use, and combined with LDM electrophoresis mode, is best applied after Secret RF for the reduction of pigmentation, and enhancement of melasma whitening effects.

Curas Laser

The Curas Laser in long pulse mode helps target hyperpigmentation in the deeper layers of the skin.

Proyellow Laser

This laser treatment targets both superficial melanin in the epidermis, and haemoglobin. It reduces blood vessels so as to lessen skin redness and achieve overall brightening of the skin. The Proyellow Laser is great for achieving the aforementioned glass skin effect. Many of our clients love how their skin just glows after treatment!

Pico Laser (With Pico Toning)

The Pico Laser targets superficial pigments better with a photoacoustic effect, and is a risk-free treatment that lessens fine lines and wrinkles, reduces pigmentation and scarring, boosts collagen production and tightens the skin, and can even remove tattoos.

Secret RF

If you’re looking to improve the thickness of your skin, and would like to create a healthy and deep skin environment, Secret RF is a great choice as it significantly enhances the efficacies of lasers when attempting to whiten the skin.

LDM Treatments

LDM treatment uses dual-frequency ultrasound to deliver waves of energy to the connective tissue of the skin. This does an amazing bunch of things, like improve skin health, decrease inflammation and redness, and offer the healthy, glowy skin that everyone hankers after.

Apart from the above methods, we also have a lineup of other whitening treatments that specifically target melanin and haemoglobin. 

These treatments effectively deal with melanin hyperpigmentation, and also efficiently decreases redness in the skin, which enhances skin whitening effects. Best part? Our treatments are suitable for even the most sensitive parts of the body.

Glass skin is not just for K-pop stars - you can achieve it too with the right treatment method and with a doctor who understands your skin type. Let 2022 be the year of clear skin! 

About Dr. Park Ji-Youn

Dr. Park Ji-Youn is the founder and managing director of the Ozhean group. As a board certified dermatologist, she has published more than 30 scientific papers on dermatology, and is the creator of Ozhean’s SKIN FIT program, which was conceived in 2015, and continues to successfully retain 80% of its original customers.

References

1. https://www.refinery29.com/en-us/2019/12/9067590/cream-skin-korean-beauty-trend
2. https://news.abs-cbn.com/lifestyle/05/31/11/glutathione-injections-could-kill-fda-warns 
3. McGregor D. (2007). Hydroquinone: an evaluation of the human risks from its carcinogenic and mutagenic properties. Critical reviews in toxicology, 37(10), 887–914. https://doi.org/10.1080/10408440701638970
4. Juhasz, M., & Levin, M. K. (2018). The role of systemic treatments for skin lightening. Journal of cosmetic dermatology, 17(6), 1144–1157. https://doi.org/10.1111/jocd.12747
5. Watanabe, F., Hashizume, E., Chan, G. P., & Kamimura, A. (2014). Skin-whitening and skin-condition-improving effects of topical oxidized glutathione: a double-blind and placebo-controlled clinical trial in healthy women. Clinical, cosmetic and investigational dermatology, 7, 267–274. https://doi.org/10.2147/CCID.S68424

Koreans are widely thought of to be slim and fit, thanks to the advent of picture-perfect K-pop celebs like BTS, Exo, Jun Ji-Hyun, BLACKPINK, and countless others. The truth of this general notion has caused many of my clients to curiously ask me, “Is there a secret Korean weight loss diet I should know about?”

After all, it’s not just glammed up idols who are slim and svelte: Statistics¹ show that among the top 10 slimmest countries in the world, Japan and South Korea, which rank at #7 and #9 respectively, are the only two developed nations on that list. Additionally, less than 5% of the South Korean and Japanese population are overweight. 

In my opinion, the simple secret to weight loss is a calorie-deficit diet, and sufficient exercise. The science is simple: Weight loss is all about whether you burn more calories than you take in.

But sometimes, even with the most disciplined of regimens, some of my clients find it near impossible to shed impossibly stubborn fat - think those nagging love handles and double chins. This is where slimming treatments come in—but as a complementary remedy, and not as a be-all and end-all solution.

What are the best fat removal treatments in Singapore?

With the endless myriad of slimming treatment options available today, which one would work best on you? Let’s look at a few of them:

At Ozhean Zoey, our top pick is FreezeMax. Here’s why.

FreezeMax is our proprietary slimming program designed to help our clients achieve maximal fat loss.

How so?

Well, fat loss is firstly a time consuming process that requires trial and error; it takes some experimenting to find out what really works for you. We’ve eliminated this tedious process by narrowing down 4 treatments (Cristal Pro, Radiofrequency, Agnes Melt, Kybella Injections) that’s been clinically proven to work. They each come with their unique selling points, but work synergistically to produce the best results. For example, with Cristal Pro you can reduce up to 30% of fat cells - but sometimes fat loss results in saggy skin so that’s where the skin tightening effects of radiofrequency comes in. 

Second, at Ozhean, we prioritise patient safety over anything else. 

There are many slimming centres out there that claim to yield immediate results - this is not only dangerous but highly unrealistic. As a doctor, I can assure you that any immediate results are usually due to water loss and not actual fat loss. You should always make sure the procedure is clinically backed with a high success rate and safety profile. 

After years of research with my team at Ozhean, I’m proud to say that our FreezeMax program: 

• Is painless
• Carries no risks of infection
• Permanently flushes damaged fat cells out of your body
• Does not affect your blood vessels, nerves, and muscles
• Can treat multiple parts of the body in one session
• Is suitable for clients of all ages

If you would like to have a more informative chat about our slimming program with one of the friendly professionals in our team, feel free to contact us.

What can I do at home to supplement my slimming treatments?

As mentioned earlier, slimming treatments should complement your fat loss efforts. The ideal patient is someone who already has a sound diet and exercise regime. 

Here are some scientifically-backed tips my patients in Korea and Singapore have found to help them accelerate and/or maintain results: 

• Consistently track your diet and exercise. If you want to lose weight, you need to be tracking what you eat, and logging down your physical activities. A study² confirms that health tracking is associated with weight loss.
• Mindful eating. Eating mindfully is proven³ to help break highly ingrained patterns, decrease emotional reactivity, increase distress tolerance, and build self-acceptance in individuals. 
• Cut back on sugar and refined carbohydrates. Consuming food and drink with high levels of sugar is famously linked to obesity. Choose fibre-rich foods instead.
• Get good rest at night. Quality sleep positively affects the regulation of hormones in your body that help control your appetite. Consistently getting less than 5-6 hours of sleep at night is linked to increased risk of obesity⁴. 
• Manage your stress, or stress will manage you. Stress triggers hormones such as cortisol and adrenaline, which initially decreases your appetite. However, in constant stress, cortisol ends up remaining in the bloodstream for much longer, and could lead to an eventual increase in appetite.

If you would like to explore a proven and effective way of dealing with stubborn fat, feel free to visit our clinic or book an appointment. Our team would be honoured to help you on your journey toward achieving your dream body.

About Dr. Park Ji Youn

Dr. Park Ji Youn is the founder and managing director of the Ozhean group. As a board certified dermatologist, she has published more than 30 scientific papers on dermatology, and is the creator of Ozhean’s SKIN FIT program, which was conceived in 2015, and continues to successfully retain 80% of its original customers.

References

1. https://www.worldatlas.com/articles/which-are-the-thinnest-countries-in-the-world.html
2. Pourzanjani, A., Quisel, T., & Foschini, L. (2016). Adherent Use of Digital Health Trackers Is Associated with Weight Loss. PloS one, 11(4), e0152504. https://doi.org/10.1371/journal.pone.0152504
3. Mason, A. E., Epel, E. S., Aschbacher, K., Lustig, R. H., Acree, M., Kristeller, J., Cohn, M., Dallman, M., Moran, P. J., Bacchetti, P., Laraia, B., Hecht, F. M., & Daubenmier, J. (2016). Reduced reward-driven eating accounts for the impact of a mindfulness-based diet and exercise intervention on weight loss: Data from the SHINE randomized controlled trial. Appetite, 100, 86–93. https://doi.org/10.1016/j.appet.2016.02.009
4. Xiao, Q., Arem, H., Moore, S. C., Hollenbeck, A. R., & Matthews, C. E. (2013). A large prospective investigation of sleep duration, weight change, and obesity in the NIH-AARP Diet and Health Study cohort. American journal of epidemiology, 178(11), 1600–1610. https://doi.org/10.1093/aje/kwt180 

If you do a quick Google search, you’ll quickly understand just how many services and products are offered today when it comes to melasma. Dig a little further online, and you’ll also realise that there is a severe lack of knowledge when it comes to treating different types of melasma on different skin tones. The biggest problem melasma patients face is not a lack of treatment options, but a huge shortage of guidance and knowledge.

This is why even with a host of affordable options, melasma patients struggle to find treatment options that actually work long term, do not cause a rebound, and do not worsen the condition of their skin. And let’s not even get started about the fact that some professionals themselves are almost nearly clueless about the true efficacies of the technology they are using on their clients.

Be careful about the types of melasma treatments you pick, as they could make your condition worse.

How should we really treat melasma?

The principles I adhere to for treating pigmentation also apply to melasma, and because this condition is so delicate and tricky, I employ the use of Secret RF microneedling on top of laser treatment. While microneedling is still a relatively new method in pigmentation treatment, several clinical studies¹ have already demonstrated the efficacies of microneedling combined with laser toning when it comes to treating recalcitrant melasma. 

In addition, radiofrequency microneedling is very safe and effective, and can be used repeatedly in combination with laser treatments to treat individuals with darker skin. 

However, Secret RF alone is not enough to effectively treat melasma - later in this article I’ll detail how Secret RF and lasers work synergistically to tackle this condition. 

Why Secret RF works for melasma

Dermatologists have postulated that melasma is associated with thinning skin, and this is where Secret RF truly shines: Microneedling has added benefits of thickening the skin and improving its collagen content, leading to a reduction of fine lines, skin tightening, and distinct rejuvenation effects².  It also improves acne, acne scars, axillary hyperhidrosis (sweaty armpits), and even cellulite³.

In other words, Secret RF brings distinct anti-aging results to the skin when used with lasers to treat melasma. Various studies show that microneedling, combined with laser toning, show distinctly more pronounced and sustained pigmentation improvement in patients. 

As Secret RF triggers collagen and elastin production, our patients often find themselves delighted that apart from healing their melasma, they’ve developed tighter, healthier skin, and a significantly more youthful appearance. And the best part about it is that with the use of numbing creams, there is little to no pain involved for my clients.

A combination of lasers + Secret RF effectively treats melasma

How exactly do these lasers work together with Secret RF to treat melasma?

The importance of finding a melasma treatment approach that works

In many practices, quality pre-procedure discussions are not always available to clients, and this deeply saddens me, as factors such as ethnicity, skin tone and more are all crucial components that your dermatologist needs to understand before using any form of treatment on you. 

After all, melasma treatments only work if your dermatologist actually understands what your skin needs, and fully knows the technology they are using on your skin.

This is why at Ozhean Zoey, we take painstaking measures to make sure that our clients’ laser programs are customised in the way that best suits their condition, skin age, skin thickness, and more. 

If you’re looking for an effective melasma treatment that boasts almost zero downtime, is suitable for all skin types, and obliterates the worry and risk of side effects such as post-inflammatory hyperpigmentation, you want to explore the benefits of Secret RF combined with Pico Laser treatments. It only takes 1-3 Secret RF and Pico Laser treatment sessions to see significant improvements in your skin. 

Let me help you with your melasma - please don’t hesitate to contact me if you have any questions!

About Dr. Park Ji-Youn

Dr. Park Ji-Youn is the founder and managing director of the Ozhean group. As a board certified dermatologist, she has published more than 30 scientific papers on dermatology, and is the creator of Ozhean’s SKIN FIT program, which was conceived in 2015, and continues to successfully retain 80% of its original customers.

References

1. Lima E. (2015). Microneedling in facial recalcitrant melasma: report of a series of 22 cases. Anais brasileiros de dermatologia, 90(6), 919–921. https://doi.org/10.1590/abd1806-4841.20154748
2. Seo, K. Y., Kim, D. H., Lee, S. E., Yoon, M. S., & Lee, H. J. (2013). Skin rejuvenation by microneedle fractional radiofrequency and a human stem cell conditioned medium in Asian skin: a randomized controlled investigator blinded split-face study. Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology, 15(1), 25–33. https://doi.org/10.3109/14764172.2012.748201 (Retraction published J Cosmet Laser Ther. 2020 Jul 3;22(4-5):215)
3. Tan, M. G., Jo, C. E., Chapas, A., Khetarpal, S., & Dover, J. S. (2021). Radiofrequency Microneedling: A Comprehensive and Critical Review. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 47(6), 755–761. https://doi.org/10.1097/DSS.0000000000002972

Of the many conditions that skincare professionals encounter today, one of the most prevalent and mysterious is Melasma. Just ask Charlie’s Angels actress Drew Barrymore – the 46-year-old starlet isn’t shy about her “crazy level 10 Melasma”, and once likened her condition to having “dirt all over my face.”

Sounds like an exaggeration, but for many patients with this condition, it isn’t really. People¹ with melasma can refuse to leave home, ruminate ceaselessly about their melasma, and feel inferior to others due to their skin condition. It is therefore not uncommon to hear of individuals feeling depressed, frustrated, and ashamed. 

Melasma, which often presents as brownish patches on the cheeks, can appear on other parts of the face, jaw and neck as well, and is brought about by a mixture of genetic, hormonal, and environmental factors. Melasma is very common among Asians, and tends to affect women more than men.

And here’s the kicker: Melasma is a chronic condition that is incurable. But it can be managed — provided you undergo the correct treatments that improve and not worsen your condition. 

In this article, allow me to explain why melasma is so difficult to treat, the limitations of pigmentation treatments in Singapore, and why some lasers can worsen your melasma. 

The causes of melasma

The crux of the condition involves your skin’s pigment-producing cells, a.k.a² Melanocytes, becoming overactive and producing way too much melanin. While we don’t have a complete understanding of what exactly makes these cells start behaving in this way, there is strong evidence that the following triggers melasma or pigmentation in general:

• Sun or UV exposure: Melasma is influenced by UV rays, just like sunspots. Those who have melasma may notice that their dark spots appeared or worsened after a period of sun exposure. 
• Hormonal changes: This can occur in the form of hormonal imbalances, pregnancy, or the use of oral contraceptives. Pregnancy is famously notorious for causing flare ups of melasma – so much so that the condition has been christened ‘the mask of pregnancy’.
• Other causes: Family history of melasma, hormone replacement therapy, thyroid disease, low testosterone levels, and more.

For some melasma sufferers, the normal rebalancing of hormones after pregnancy can cause ensuing dark spots to fade on its own. This is what we call transient melasma. Unfortunately, for most others, melasma is frustratingly persistent.

Classifications of melasma

Why do some melasma sufferers successfully treat their skin with sunscreen and topical creams, while others struggle hopelessly even with the use of Pico lasers and other costly treatments? Let’s find out:

	Epidermal melasma	Dermal melasma	Mixed melasma	Vascular melasma	Melasma islands	Mottled melasma
What is it?	This means that the pigment (melanin) is in the more superficial layers of the skin called the epidermis.	With Dermal melasma, the pigment is in the deeper layers of the skin, the dermis.	As a combination of epidermis and dermal melasma, mixed melasma is the most difficult to treat. It occurs with other pigmentation issues like nevus and lentigines.	Vascular melasma’s calling card is vascular proliferation, or increased vascularity.	This type of melasma occurs near the eyes.	This melasma pattern might be due to previous over-lasering resulting in white patches and spots.
Treat- ment	As this type of melasma is superficial, it usually clears with the regular use of topical creams, sun avoidance, and other similar  treatments.	An effective combination of superficial treatments such as topical creams and sunscreen, plus Secret RF and microneedling are needed.	While you may get promising results from a chemical peel, they tend to be short-lived. Different laser protocols are needed for various mixed melasma conditions.	Antivascular pigmentation treatment with the Curas Laser, and vascular treatment with the Proyellow Laser works best for positive outcomes.	This type of melasma can be hard to manage. It is best treated with Picomax and Secret RF.	Non-aggressive laser treatment is needed to avoid hypopigmented spots. Aggressive laser energy will only worsen any white spots.  Tranexamic acid oral treatment and microneedling with Secret RF will yield good results.

Why is melasma so difficult to treat? 

Laser treatment could worsen melasma

Recurrence rates after successful treatments are reportedly high³, and for more severe cases, chemical peels, IPL therapy, laser treatments and the like tend to offer variable, lackluster, and gloomily short term results. 

What many are unaware of is that pigment laser treatment is also known to worsen melasma and produce a risk⁴ of post-inflammatory hyper or hypopigmentation (PIH). The heat from such technology tends to make melasma worse, and can trigger the formation of even more pigment in the weeks following treatment. 

The Q-switched laser: friend or foe?

Some of you might be familiar with Q-switched lasers. These lasers became commercially available in the 90s, and have since grown to be wildly popular in Singapore. Prior to this, dermatologists only used lasers for treating the skin surface, which is why the Q-switch laser is so special: It selectively targets and treats pigmentation within the skin.

While these lasers have successfully helped treat pigmentation disorders such as freckles, solar lentigines, and ABNOM, it is not reliably effective when it comes to managing melasma. Q-switch lasers help break down melanosomes at the bottom of the epidermis, which contain melanin, and does so without any redness, bruising, or downtime.

However, the Q-switch laser does not successfully confront any of the root causes of melasma, which means that melanocytes in the epidermis are still producing lots of melanin, and that frequent relapses, or even a worsening of conditions, is bound to happen.

And while the repetition and quantity of treatments varies across the differing technologies, Q-switched lasers require the greatest number of treatment applications for good results.

Melasma requires a multi-pronged approach

One key point to consider is that while laser treatments can accelerate the removal of melasma-related hyperpigmentation, they are far from cures. The most effective management of difficult melasma cases often includes a combination of technologies and therapies.

As melasma is aggravated by hormones, it’s also not uncommon for dermatologists and gynecologists to work hand in hand to help patients transition to a low-dose pill, or if possible, wean them off the pill entirely. 

Melasma is triggered by uncontrollable factors like the sun

Singapore’s never-ending summer is brutally unrelenting, which is why a broad-spectrum sunscreen with a high SPF needs to be a regular part of your skincare regimen. It’s also a good idea to wear a hat with a wide-enough brim that’ll protect melasma hot spots like your nose and cheeks. 

While less challenging conditions can be managed with the consistent use of broad spectrum sunscreens, medicated creams, and staying out of the sun, such methods only bring about an initial clearance of the condition, and have zero to little effects for sufferers of more severe cases of melasma. 

Limitations of current melasma treatments in Singapore 

To summarise, here are some common melasma treatments available in Singapore today: 

• Chemical facial peels: This process removes discolored patches and melanin, whilst promoting new skin growth. Chemical facial peels, however, present a risk of post-inflammatory hyperpigmentation, and cannot be used to treat melasma that affects the deeper dermis.
  
• Lasers: With lasers, a focused beam of light energy is used to heat and destroy pigment in the skin. However, there is a risk of rebound pigmentation. Recurrences are high even with low-energy laser treatments.
• Microneedling: Punctures are made in the epidermis to allow the ingredients in topical creams to penetrate into deeper layers of the skin, where your blood vessels and pigment cells are located. While microneedling has developed exponentially over the years and shows much potential, the use of microneedling on its own is not yet proven to drastically improve melasma.

The inefficacy and variability of these treatments is the reason why Ozhean Zoey utilises a combination of Secret RF and Pico Laser to effectively treat melasma. I will speak about this approach in a separate article.

References 

1. https://clearifirx.com/blog/melasma-treatments 
2. https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/melanocyte 
3. https://www.nsc.com.sg/Patient-Guide/Health-Library/Types%2520of%2520Skin%2520Conditions/Pages/Melasma.aspx
4. Trivedi, M. K., Yang, F. C., & Cho, B. K. (2017). A review of laser and light therapy in melasma. International journal of women's dermatology, 3(1), 11–20. https://doi.org/10.1016/j.ijwd.2017.01.004