12.3.17

Uncovering The Dark Secrets Behind Panda Eyes


Dark circles around eyes, Dr. Shazia Ali
You sleep 8 hours a night and still suffer from Raccoon eyes – you are not alone, dark circles can be genetic. Though most people associate them with fatigue, but lack of sleep and hours on electronic screens are not the only reason dark circles exist around your eyes. These murky halos underlining the eyes can also be shadows cast by puffy eyelids. Loss of fat under the lower eyelid can also causes deep hollows that develop as a normal part of aging.

Let’s Dig Deeper Most common causes leading to dark circles include:
  • Allergies like dermatitis leading to skin irritation with frequent rubbing or scratching of the eyes or sinusitis leading to engorged blood vessels and heme (iron) deposits under the skin.
  • Fatigue in the form of too much time staring at electronic screens and late nights.
  • Heredity has its part to play here too, as Panda eyes run in families.
  • Pigmented Skin Type which presents itself as a common concern in people prone to irregular pigmentation patches on different parts of the body especially Middle Eastern, blacks and Asians.
  • Excessive sun exposure prompting melanin production can lead to exaggerated pigment deposits under the sensitive eye areas.
  • Aging leading to loss of fat and skin thinning in the delicate area around the eyes is the most common cause in people above 35 years of age.
You Are In A Hurry — Let’s Decipher The Easy Way Out For A Quick Fix
Camoflauge + treatment for dark cirles around eyes
The right concealer can do just that — hide dark circles. While choosing the concealer it is important to know the color palette to conceal. If the circles under your eyes are bluish, use a peach-colored concealer, not one that's white or gray. Avoid scented products and those containing salicylic or glycolic acid, which can irritate delicate eye tissue, making redness and swelling worse. Covering up the nebulous shadows using makeup concealers coupled with dark circle preventing cosmeceuticals gives you dual benefit — camouflage as well as treatment (I recommend Isispharma’s Light eyes or DDF’s Erayse Eye Gel). 
Auriga’s Cernor Coverstick and XO kit has also got you covered real well when it comes to 2-in-1 action. The moisturizer-enriched coverstick covers up pigmentation while protecting the delicate skin around the eyes. Couple it with Cernor XO kit containing vitamin K oxide, vitamin C, phytic acid, rutin sulfate, ferulic acid and helenalin tiglate and you have treatment as well as camouflage all taken care of.

Make A Real Difference - Treatments
Treatment of dark circles around eyes
Peels: Chemical or laser peels can help remove the extra melanin deposits in the skin. When coupled with skin lightening and tightening home skincare deliver beautiful results in a short span of time.
Lasers: Pulse dye or Nd-Yag lasers that help treat the exaggerated blood vessels under the skin because of heredity or life style are extremely useful in eradicating dark circles on long term basis.
Injectables: Low G prime hyaluronic acid injections done strategically can give instantly glorious results. The shadows are also wiped away partially as the deep groove under the eye gets filled-up. The filler spread under the skin like an invisible layer lifting and supporting the damaged skin and masking engorged blood vessels (red, blue or green tint) or heme deposition (brown color) under the skin.
PRP: Platlet Rich Plasma drawn from your our own blood holds the power to heal and regenerate the delicate area around the eyes.

Banish ‘Em For Good - Long Term Solutions & Prevention
Once you have ruled out all medical reasons for pigmentation around your peepers and sought treatment to erase them the next big task is to stop them from coming back. Here’re some of my tried and tested suggestions:
Sleep Well: Sleepless nights cause blood vessels to engorge around the eye area leading to excessive leakage. Iron in the blood collects under the thin skin and once oxidized leaves dark stains. Lack of sleep also makes you paler and more hollow-eyed, so shadows and circles you already have appear more obvious.
banish dark circles life tips
Use Extra Pillows: Sleeping with your head elevated prevents fluid accumulation around during night. Puffiness and dark circles develop as a result that.
Healthy Eating: One life mantra you can always count on is: the healthier you eat, the better your skin is going to look. For dark circles, you need a healthy dose of Vitamin C, Vitamin E, Vitamin K, iron and folic acid. So gorge on healthy does of citrus fruits, berries, green leafy veggies, nuts, whole grains, avocado, seafood, beef, cheese, green tea etc. and do away with processed and greasy foods.
Cold Therapy: Chilled teaspoons or cucumber slices help reduce dilated blood vessels hence preventing dark circles from reappearing. Cold slices of potato or refrigerated used teabags work equally well.
Sunscreen: People prone to skin pigmentations should avoid sun. Excessive melanin production can also be controlled with religious use of sunscreens and dark UVA & B protective glasses.
Keep Sinusitis Under Check: Rinsing your sinuses with a saltwater solution or over-the-counter saline spray can help relieve nasal congestion. To make your own sinusitis check concoction mix 1/4 teaspoon sea salt with 2 cups warm water and flush away allergies and resulting dark circles.
Cosmeceuticals: Hundreds of skin creams that claim to reduce or prevent under-eye circles crowd drugstore shelves. When looking for eye-creams look for active ingredients like: Vitamin A, C, K, and caffeine. I recommend: Dermaceutic K Ceutic, Cernor XO Kit, SkinCeuticals A.G.E. Eye Complex and Comfort Zone Sublime Eye cream.
Cream to cure dark circles by Dr. Shazia Ali
 

27.2.17

Become The Queen Of Self Grooming — Dr. Shazia Decodes Braun Beauty Tools For The New Brides


Skincare and grooming for brides Dr. Shazia Ali
New year, new starts and now we also have the wedding season in the air. Ladies I know when it comes to getting married, you feel a lot of pressure to look prim, proper and positively radiant. This entails hair-free body as well as flawless healthy skin — with or without makeup. And when you do decide to glam up a little and put on some makeup you want to dazzle the world like a glamazon fit to rock the cover of any beauty magazine. Can you do all that without multiple visits to beauty saloons and skincare clinics? Off course you can! By incorporating Braun Beauty Portfolio in your daily life you can take charge of your skincare and grooming needs without breaking your bank plus save on pesky trips between beauty parlors and skin spas. How Braun can help you shine bright like a diamond? Lets find out.

Beauty Grooming Starts With Smooth & Hairless Face / Body:
You can’t look feminine and polished with hair sprouting out of your arms, legs and face. So first things first lets fix that. Braun believes in lavishing a modern-day girl with choices: for long term hair removal you can pick Braun Silk-épil 9 SkinSpa or if you’re interested in permanent hair reduction you can choose Braun Silk-expert IPL.


Braun Silk Epil Skinspa
This is one beauty tool that you can rely on explicitly and constantly to deliver long-lasting salon-smooth hair-free skin. I believe today’s modern woman deserves professional hair removal results at home plus a gold standard of experience when she indulges in self-grooming using her beauty tools. The Braun Silk-épil 9 SkinSpa gives you just that plus much more now. Innovation Alert Recently a NEW Deep Massage pad attachment has been added to the existing skin removal system that can help revitalize the skin. This massage pad adapts to the body’s contours and helps improve skin appearance by stimulating blood circulation. Better circulation in the skin means more oxygen and nutrients reaching the skin. Hence the skin looks more healthy and radiant. The dual combination of the massage applicators and exfoliation pads results in glowing skin and salon worthy results.

Braun Silk Expert IPL
If you are looking for permanent hair removal experience from the comfort of your home, then choose Braun Silk-expert. It literally gives you the best experience your money could ever buy. The Braun Silk-expert IPL is the only IPL device in the market that comes with SensoAdaptTM technology. This technology continuously reads your unique skin tone and adapts the light intensity accordingly, avoiding any chance of getting side effects like burns or hyper-pigmentation. To make at home IPL treatments even more accessible, Braun is adding the Silk-expert 3 to its IPL family, which will make IPL treatments even more affordable.

Braun Facespa
With this one beauty gadget and its multiple interchangeable applicators you can experience quality deep cleansing, exfoliation, revitalization as well as facial hair-removal in one go. By learning how to use Braun FaceSpa to your best advantage you can master smoother, and revitalized skin. Recently Braun has unveiled an exciting new upgrade to the skincare routine with the NEW FaceSpa. Featuring the same superior facial epilating and cleansing brush heads, the 3-in1 facial system now comes complete with a Skin Vitalizing pad that can deliver smoother and revitalized skin in as little as three treatments. The revitalizing pad features easy to clean, non-absorbing silicon tips, that smartly adapt to skin contours and stimulate skin with hundreds of micro-vibrations. With the optional range of brushes, this 3-in-1 facial system allows you to experience up to six different treatments in one device now.

The NEW & Improved Braun Beauty Routine For The New Brides
All new brides-to-be rejoice, as Barun has you covered when it comes to your beauty and grooming needs. Now you can remove unwanted hair as well as deep cleanse, exfoliate and revitalize your skin with Braun all by yourself from the privacy of your own bedroom in three easy to follow steps.

Smoother Skin In Three Days
Braun Beauty Tools
Braun FaceSpa beauty set empowers you daily to cleanse and exfoliate like a professional. You can use normal or sensitive skin cleansing brushes according to your skin-type to thoroughly clean your skin. The soft bristles of the cleansing brush reach deep into the pores and crevasses of your skin delivering six times better cleansing than manual face washing.

Exfoliation brush can be used to removed dead skin and reveal a more fresh skin. If you have oily and normal skin you can use exfoliation applicators daily or every other day. If you have dry or sensitive skin indulge in exfoliation every 7-15 days.

With the new Skin Vitalizing pad, you can reveal clearer, smoother skin in under a week. Best time to add this massage step is while you’re doing your evening skincare routine. When used in combination with your daily moisturizer or anti-aging skincare serums skin vitalizing pad enhances the efficacy of your skincare products.

To finish off your beauty ritual the beauty sponge applicator can be used to apply your skincare serums and creams on daily basis. This applicator enhances the absorption of your daily skincare giving you more bang-for-your-buck. For a more professional makeup experience you can also use the beauty sponge applicator to apply your skin foundation, as it delivers natural looking results with no caking or tire-marks.

Massage Your Way To Firm And Toned Skin
The NEW Silk-épil 9 SkinSpa now comes with a Deep Massage pad attachment
If you’re new to epilation, use your Silk-épil 9 to remove unwanted hair once a week for the first month. After this, repeat once every 2-4 weeks. The NEW Silk-épil 9 SkinSpa now comes with a Deep Massage pad attachment that can be used once a week to boost circulation and reveal radiant skin. You can use it independently from the epilator head both, in or out of the shower. If you use it with a massage-oil you can enjoy a relaxing shower experience. After your shower you can also use it with a cellulite or skin firming cream to tighten and tone your skin.

Permanent Visible Hair Removal With IPL
Dr. Shazia Ali
Most ladies these days want permanent hair reduction, so they can enjoy freedom in life wearing whatever whenever without thinking “are my arms and legs hair-free?” After shaving, use your Braun Silk-expert IPL on a weekly basis for visibly permanent hair removal over time. Try using the Gentle mode on any sensitive areas such as underarms and the bikini line.

To compliment your Braun set of Beauty tools the only thing you need additionally is a confident dazzling smile and with that in place, now you are all set and ready to face life and your commitments with smooth, beautiful and glowing skin day-in and day-out.

19.2.17

Looking At Beauty Through The Eyes Of A Dermatologist


Dr. Shazia Ali
Why certain faces attract envious glances, possess the invisible power to turn heads, and invoke a certain chemistry of attraction with human visual cortex? More importantly, what qualities make such faces so special that they can unintentionally become the focus of any lens; ogled and admired by all eyes that happen to gaze upon them? Can we measure attractiveness and recreate it and if the answer is yes, can we impart it onto the faces that genetically lack it? Questions, catechism and more queries — Aesthetic medicine has been on a quest for forever and more to find out answers to questions like these. 

Is beauty divine and bestowed by God only or can mortal hands recreate them?
Beauty might be divine in origin but if we can set benchmarks and quantify it — once that is done that we can attempt to recreate it. Actually plastic surgeons and aesthetic doctors have been carving beautiful visages out of ordinary faces for years now. Ancient Greeks believed beauty lies in the mathematical proportions of a face, rather than just being in the eye of the beholder. 

Golden Proportions of beauty

Lets follow this train of thought and see where it leads us.

 What defines a beautiful face? — Looking from the perspectives of poets, painters and sculptures a unique set of pretty features arranged in a certain mathematical proportion to one another creates a fascinating face. The individual features that invoke beauty include: a smooth convex forehead, a symmetrical set of big eyes highlighted by arched brows, small nose, voluptuous lips, dainty chin, high cheek bones and a chiseled jaw-line, Being a dermatologist I’d add perfectly flawless and radiant skin to this mix and we have perennial beauty at our hands.

Looking At Facial Features:
Research linking beauty to evolutionary psychology has shown that attractiveness perception comes from how our brain perceives information in general coupled with adaptations for mate choice because attractive traits signal important aspects of mate quality, such as health and fertility.

From an evolutionary standpoint, fuller faces indicate heart health and immunity to infections. So, to some degree, we are programmed to be more attracted to certain faces over others. Sexual dimorphism, a fancy term for sex-specific traits, is one of the major factors in determining what we find beautiful. The more feminine a woman’s features are, the more attractive she’s perceived to be through a male set of eyes. For women, things like large eyes, a small nose and fuller lips are generally found to be more attractive since they are considered to enhance facial femininity.

Take home message at this point is: if you don’t look like Angelina Jolie it doesn’t mean you’re out of luck. It’s important to note that it’s less about your specific features than it is about the overall face. In other words, as long as your features collectively feminize your face (even if you have a larger nose or thinner lips, for instance), you’re still considered pretty in a male visual cortex. If high cheekbones contribute to greater femininity, then the total look would be perceived to be attractive. Not necessarily just the high cheekbones on their own.

The overall face and the proportion of features compared to each other give a face an attractive advantage over others. Aesthetic doctors use this fact, while they remodel faces using surgical or non-surgical treatments.

The perceptions of beauty also differ from one cultural to another and also across timelines (old time period to modern times). Like these days among Caucasians model-skinny or angular faces are considered ideal. While in Asian and Arab cultures more fuller and contoured faces are considered attractive, which used to be popular in older times in Caucasian societies as depicted by renaissance literature and art.
East vs West Beauty Standards

A study done at St. Andrews University few years back showed that facial adiposity, or the perception of weight in the face, was actually rated as more attractive to men. From an evolutionary standpoint, fuller faces indicate agreeable cardiovascular health and immunity to other infections. Good health equals healthy babies. At least that may have been our ancestors’ unconscious reasoning. Symmetry and average-ness are also equally important when it comes to perceptions of beauty. Believe it or not, being average is cool. Both appear to indicate high variations in individual proteins, which lead to fewer birth defects in offspring.

Cognitive researchers Dr. Kang Lee and Dr. Pam Pallett published a study in 2010 that attempted at explaining the key factors that determine how attractive a woman’s face may appear to others. According to their research the distance between a woman’s eyes and the distance between her eyes and her mouth holds the key to her attractiveness. They also suggested in the study that keys to attractiveness include facial ratio, alluring features, symmetry and average-ness.

Facial Symmetry is considered beautiful because it rules out a history of poor developmental stability early on —for example, a major illness or a nutrition deficiency (which could lead to asymmetrical features). Evolutionary psychologists believe humans have evolved to find healthy facial features attractive, and symmetrical facial features are a good indication of health. Anti aging research has shown that as we grow older the asymmetry of the face becomes exaggerated, hence asymmetry is linked with aging and fading beauty.

Facial Features Average-ness Another reason you might be considered attractive is because you’re familiar. In a study at Brandeis University, there was a higher rate of agreement among close friends, siblings and spouses on what they considered attractive among strangers, suggesting that attractiveness has a strong social component, too. People who have already formed romantic relationships idealize their partner’s facial features, so they actually perceive them to be more physically attractive than other people would. These days movies and media also have a strong influence on what we perceive as beautiful. Like in certain societies big lips are considered a mark of beauty, while in other cultures high cheek-bones and chiseled jaw-line is considered more beautiful compared to a more chubby and rounded face.

Aging & Beauty
Aging changes in face
As we age all layers of our face under go changes. Skin looses collagen and elastin, which makes face look tired, dehydrated and wrinkled. Fat compartments under the skin begin to loose volume. These changes happen much earlier in the mobile areas of face like mid-cheeks and under the eye area compared to the sides of the face. As a result face does not age uniformly, mid-face volume loss leads to deep smile lines, drooping of corners of mouth and hanging jowls. Bones, which provide the solid foundation for all soft tissue layers of our face, also loose volume over time. Maximum change is seen in the glabellar (forehead), maxillary (center of face and upper lip area), lateral projection of zygoma (cheeks) and mandible (jawline) areas due to bone loss with aging. More bone loss in certain regions of face contributes to the further asymmetry of face as we age. When we gaze upon a young face our attention is drawn to eyes and lips, which is hallmarked as the triangle of youth. In contrast when we inspect an older face, our attention is caught by the drooping jawline and hollowing of mid-face, which looks like as if the triangle of youth has been inverted.
Inverted triangle of youth

Aesthetic Treatments: Working in partnership with an aesthetic doctor you can restore, as well as enhance the golden proportions and symmetry of face with injectable soft tissue implants and neurotoxins. No facial treatment can be deliver aesthetically pleasant results if the person doing the treatment does noy understand the basics of Beauty and youthfulness. So while selecting your doctor you have to remember — Can any doctor inject beauty into your face? Answer is not really, only aesthetically inclined doctors that study beauty and understand the golden proportions of a beautiful face can artistically elevate an ordinary face into a much sought after beauty.

Looking At Skin:
A luminous, unblemished complexion is a strong factor to contribute towards attractiveness. Studies suggest there are mainly two reasons for that: Flawless skin indicates good health and youth. Smooth and relatively hairless skin indicates low levels of androgens and high estrogen. Both indicate fertility. What’s more, skin free of acne and other dermatological issues is perceived to carry healthy genes (hence, greater chances of producing healthy babies). A study published in the journal of European academy of dermatology and venereology in 2007, suggested that the skin topography indicates youth and color distribution indicates health of a person. Hence these two factors make skin look attractive and alluring — so get on the good side of your dermatologist.

Aesthetic Treatments: Injectable soft tissue fillers or fat can be used to bring proportion back to face compensating the loss of volume with age or to recreate the genetically blessed proportions of beauty.

By working on your skin with a dermatologist you can achieve clear, healthy and youthfully radiant skin. Treatments that stimulate production of new, non-fragmented collagen provide substantial improvement to the appearance and health of aged skin. These treatments along with improving the skin hydration with non-crosslinked hyaluronic acid can elevate skin from being ordinary to full of life radiant.

13.2.17

Smile You Got Dimples


dimple surgery, dr. shazia ali
A smile empowered with dimples can add attraction and cuteness to any face that’s why dimples have always been seen as symbols of beauty. It seems silver screen and media world has also been cast under the spell of dimples by just looking at how many celebs have dimples.

Dimples can adorn a face boosting up the appeal of the cheeks or chin, although the chin dimples are more rare than cheeks. Beauty decoded by science shows that dimples are inherited as an irregular autosomal dominant trait. Which in layman’s terms means: if both your parents have dimples you have a great probability of inheriting them, but this does not guarantee that you will get these cute facial dents for sure.  
Fun Science fact: Genetic research places the cleft chin dimple on chromosome 5 and cheek dimples on chromosome 16, with a variable penetrance.

Looking At The Anatomy Of Dimples
Structurally speaking dimples are a facial muscle deformity. Where as the chin dimple is a result of an underlying bony defect. Both happen to be envious and popular deformities that are requested by many cosmetic surgery patients.

There are two different theories that attempt to explain how cheek dimples form. First one states that theses cute divots form as a result of shorter muscles around the mouth. The second and more popular theory describes dimples as a defect in the facial muscle going by the brilliant name of Zygomaticus Major. This large muscle covers the side of the cheeks, and dimples are believed to form when there is a divide in this muscle; which is normally all in one piece. The skin in the region of the double or bifid Zygomaticus Major muscle is inserted onto the inferior bundle of the muscle fibers. Smiling makes the overlying skin draw inward and the dimple grows deeper, thereby making it more visible.

Dimples can be transient or permanent, depending on the cause or factor responsible for their occurrence. Excessive fat deposition, which disappears with the aging process, some times causes transient dimples. The stretching or lengthening of muscles during aging process can also lead to gradual obliteration of this facial feature. This explains why some dimples are more common and conspicuous in younger age groups.

Dimple Surgery
Dimples can be created surgically as a minor procedure done under local anesthesia. Most of the techniques, if not all, involve adherence of the buccinator muscles of the face to the dermis of the skin. This can be achieved with sutures inserted through the skin or by an open technique that is performed through the mouth, which has added bonus of avoiding any surface scarring. Like natural dimples, dimples created surgically typically appear with smiling, although surgically created dimples may be visible most of the time depending on the surgical technique used. The dimple may be present even without smiling for the first several days, or even weeks, after surgery; eventually, the surgically created dimple will most likely be present with smiling as scar develops between the inner skin and the buccinator muscle

Positioning Of The Dimples
Dimple surgery, Dr. shazia ali
While surgically creating a dimple, the ideal location should be the area where a less obvious faint dimple is present with smiling; thus the pre-existing dimple is made more prominent. If one cheek has a dimple, the ideal location for the other dimple can be marked at the corresponding site that would create symmetry of the face.
If a pre-existing dimple is not present, the ideal location reported by Boo-Chai is: the intersection between a horizontal line from the corner of the mouth and a vertical line from the lateral canthus of the eye. Some doctors choose a point 1.5 to 2 cm superior to a point bisecting an angle formed by the projection of the lateral commissure of lips and the lateral canthus of eye. Another landmark to correctly position the dimple can be established by asking the patient to create a negative suction and suck the cheeks inside. The site of the maximum depression can be the marked site of the dimple. The marking should be migrated slightly laterally if pulsation of Facial artery is palpable at the marked point to avoid hematoma.  The final position to do surgery is usually chosen by the patient based on preference and keeping in mind the vector of smile.

Technique
Surgical techniques can be categorized into 2 major categories, namely blind coring and open approach.

The patient’s face and mouth are prepared, and local anesthesia is administered, along the marked area. Hypodermic needles are then passed through the marked point into the buccal mucosa. A soft tissue trephine bur connected to a latch-type handpiece or a punch biopsy needle is used to punch the buccal mucosa while the opposite hand pushes the buccal mucosa inward and supports this area externally. The soft tissue cylindrical fragment (consisting of the mucosa, a small portion of the buccinator muscle, and a part of the Bichat fat pad) is removed with scissors, and the skin is kept intact. Alternatively you could incise the mucosa and under direct vision excise a small part of muscle and fat. The advantage of open approach is the depth and size of dimple can be adjusted based on the amount of fat present. For more depth of dimple more fat can be excised and a larger defect in muscle should be created.

Dimple surgery, Dr. Shazia Ali

Defect closure is performed by placing a non-absorbable or absorbable suture through the cheek mucosa, muscle, and Bichat fat pad on 1 side of the defect; then through the dermis layer of the skin; and finally through the Bichat fat pad, the buccinator muscle, and the mucosa on the other side of the defect. The knot is tied and tension adjusted based on the depth of dimple required. The patient is advised to maintain good oral hygiene with chlorhexidine mouth wash and oral antibiotics. Analgesics are prescribed to keep the patient comfortable and pain free. Suture removal is done in non-absorbable sutures at 10-14 days.

dimple surgery, Dr. shazia Ali

Potential Complications Of Dimple Surgery
·      Sudden disappearance of the dimple,
·      Asymmetry,
·      Foreign body reaction,
·      Bleeding, and
·      Injury to a nerve (buccal branch of the facial nerve)
·      Injury to the salivary gland duct (Stensen duct)
All these potential side effects can present themselves during the surgery, but in experienced hands the chance of them happening is not very common.

Tips & Tricks To Improve Surgical Outcomes
·      The non-excision suture techniques do not provide long lasting results. Removing the part of the muscle and fat delivers more long lasting and
·      Location of dimple must be chosen based on vector of smile. Blindly following the intersection of oral commissure and lateral canthus may place dimples too inferiorly.
·      For bulky cheeks choosing an open approach with excision of adequate amount of fat to create a deeper dimple rather than a core excision and single stitch delivers better results.
·      Prolene sutures for muscle to dermis approximation causes long lasting results but increase chances of foreign body reaction and infection. Alternatively Polydiaxone suture can be used and mucosa closed with catgut.
·      Always explain to the patient that the dimple will be exaggerated in first few weeks and will be present even at rest and over time only on animation.

There you have it the nitty gritty and the surgical journey through the whole process of creation of cuteness factor called: dimples. Happy Valentines Day!!

16.1.17

Unwrap Your Gift Of Revitalized Skin - Braun Face Spa



Happy New Year ladies! A clear, smooth, and glowing complexion is always at the top of every woman’s beauty wish list. Modern day girls want to look beautiful naturally they don’t want to hide behind make up in everyday life be it at the gym, on the beach, at school or in the office. Having perfect skin lends you the edge to get ready in the morning quicker and your skin looks great with minimum effort. To impart you with the savvy of healthy, luminous and revitalized skin and make 2017 a memorable year vis-à-vis your skincare, Braun has launched its latest addition to the Face spa – the unique and new revitalizing pad attachment.

Its time you updated your daily skincare beauty routine and found out how to maintain flawless skin 24/7 all year round.

Say Hello To Your Very Own Sleek & Compact Beauty Wand – Braun FaceSpa
Braun Dr Shazia Ali

As you all know Braun’s FaceSpa is the world’s first 3-in-1 facial epilator and cleansing brush system. It comes complete with a set of beauty brushes to cleanse, and exfoliate plus a Beauty Sponge to apply skincare or makeup smoothly.
Braun Dr. Shazia Ali

What’s new in 2017? – Braun Face Spa has an additional and NEW Skin Vitalizing pad.

Now this powerful six-in-one beauty tool can offer you everything you need to remove unwanted hair, cleanse, exfoliate and vitalize your skin. The system works with specialized brushes, so you can exfoliate, get sensitive cleansing, or apply makeup like a professional. You can restore your skin’s flawless radiance anytime, anywhere, with this device.

How To Use Braun Face Spa For Best Effects?

Braun can help you master your beauty regime with these efficient range of beauty tools that fit seamlessly into one device and your life and help save you those valuable minutes!
Braun Dr. Shazia Ali

Always Start With A Clean Skin: Within the optional range of cleansing brushes you can choose Facial Cleansing Brush or Sensitive Skin Brush to deep cleanse your skin on daily basis. These brushes help cleanse the skin and remove impurities much more thoroughly compared to when washing with hands or a wash-cloth. The gently oscillating bristles of the cleansing brushes reach into hard to reach areas and pores to effectively removes dead skin, sebum or daily built up of impurities that make the complexion dull making your skin look lifeless and unhealthy.

Exfoliate And Radiate: Once the skin is clean and primed for exfoliation you can use the Exfoliation Brush attachment to remove dead skin and debris from skin to reveal a more fresh and radiant complexion. The trick with exfoliation is never to over do it. If you have oily skin use it once daily or alternate day. If you have normal to dry skin use it two to three times per week. And if you have sensitive skin, exfoliate once ever 7-15 days.

Smoother Skin In Three Days: With the new Skin Vitalizing pad you can get smoother and revitalized skin in as little as under a week. The pad comprises of easy to clean, non-absorbing silicon tips, that adapt to skin contours and stimulate skin with hundreds of micro-vibrations. This massaging action helps restore skin circulation and improves skin radiance and vitality.

Last But Not The Least Protect & Moisturize Your Skin: Braun Face Spa should be used in combination with your daily moisturizer, such as OlayRegenerist Micro-Sculpting Cream or any other skincare and anti-aging products you use on daily basis. In fact the Beauty Sponge applicator can help with better absorption and application of your daily skincare creams or serums.

Incorporating this four-step regimen into your evening skincare routine daily will help you to cleanse, exfoliate and stimulate your skin cells effectively like a skincare-pro revealing smooth, radiant and healthy skin.

15.12.16

The Journey Of Botox — From Injections To Creams


Dr. Shazia Ali
Botox has proven its success in combating dynamic wrinkles and has acquired a star status among anti-aging treatments during the past 25 years. Originally approved for the treatment of eye muscle disorders like blepharospasm and strabismus, Botox over the years has become an increasingly popular cosmetic procedure. According to the American Society of Plastic Surgeons (ASPS), botox (BoNTA) injections were the single most popular minimally invasive cosmetic procedure performed in the United States in 2015. The ASPS report found that 7.3 million injections were given in 2015, showing 3% rise from the year prior.

The Not So Glam Side Of Botox
Although cosmetic BoNTA has demonstrated strong efficacy and good safety profile, but adverse events do occur from time to tome. Misplaced injections, unique anatomy of patients and novice doctors doing the treatment can lead to unwanted effects in non-target areas. Looking at the literature reviews side effects like eyelid and brow ptosis and partial lip ptosis have been reported after injection of BoNTA into the upper face and periocular areas, respectively. Few reported cases of injection into the pretarsal portion of the orbicularis oculi muscle have resulted in dry eyes. There have also been reported complications involving pupillary reactions and light sensitivity in some cases.

Additionally limitations of using injections include pain, erythema, swelling, bruising, tenderness, and potential infection from needle use.

The patient’s medical regimen is in selected cases potentially affected by being advised to avoid aspirin, nonsteroidal antiinflammatory drugs, and vitamin E before injection to reduce the risk of bleeding and bruising. Bruising is of particular concern in the lateral canthus and orbicularis oculi region, where the blood vessels are superficial and the skin is thin.

Next Step In Evolution

Research conducted among consumers has shown that many consumers are needle averse and would prefer a more noninvasive alternative that would provide the same benefits as BoNTA injections. The survey showed that in US alone 11 million people are potential target demographic for BoNTA treatments, but less than 10 percent have actually received treatment. Providing an alternative non-injectable option to current injections holds the potential to expand the market considerably.
Dr. Shazia ali
The target consumer market can be organized into the following three categories:
1) Past users of BoNTA injections who would like a less painful, and cheaper option
2) Consumers with no past history of injections because of the expense and/or pain associated with them and
3) Consumers currently undergoing regular injections who would welcome a more comfortable way to maintain each treatment

A safe, targeted alternative in the form of topical BoNTA makes an attractive option.

Nanoparticle Technology & BoNTA Cream

Nanotechnology allows the potential to deliver molecules into the skin, which ordinarily do not penetrate the superficial corneal layer. This ability to enhance penetration of active ingredients offers many benefits. In the last decade two companies, Transdermal Corp., Birmingham, Michigan, and Revance Therapeutics, Newark, California, have made good progress on topical delivery of BoNTA sharing their clinical trials.

CosmeTox 
Dr. Shazia Ali

Transdermal Corp. was formed in August 2008, since then it has developed an FDA-approved topical BoNTA cream based on commercially viable ionic nano-particle technology (InParT™). This technology consists of micelles (surfactants and protein solubilizers), coated with lipid molecules that entrap the active component with no changes in chemical composition - the particles are one to ten nanometers in size; smaller than skin pores.

This transdermal noninvasive drug delivery technique preserves the bioactivity of molecules without denaturing them. The cream (CosmeTox) contains BoNTA and is intended for the softening of facial rhytides as well as reduction in hyperhidrotic (excessive sweating) conditions. Active ingredients in the cream allow for greater toxin stability at room temperature for extended periods of time.

How Does It Work?
Topical BoNTA allows for deeper delivery of the active molecules into the skin in order to encourage the same effect of injected BoNTA — inhibiting the release of Acetylcholine and blocking neuromuscular transmission. The stabilized toxin cream is applied topically onto the skin and dosed by the quantity of cream applied. Using nanospheres and absorption enhancers, the toxin is delivered into the skin without any known skin damage or systemic toxicity. The cream also behaves in a similar fashion as an injectable in that when it is applied, it stays local for targeted delivery.

A study was conducted in 2008 to test the efficacy of this topical BoNTA cream (CosmeTox) on facial wrinkles. The study involved 4 to 7 weeks of treatment with 12 weeks of follow-up evaluation. Within the first two weeks of treatment, the BoNTA group reported subjective improvements in their appearance, including less wrinkling, but also noticed a fading of dark circles under their eyes as well as a hyperpigmentation reduction in treatment areas. The active ingredient cream was compared to a placebo on 40 female subjects. The active ingredient cream contained a concentration of 2U/mL BT and the vehicle control contained no BT. They were assessed by Facial Line Outcomes and Self Perception of Age questionnaires. The Facial Lines Outcome scores were improved and maintained for the duration of the study period of almost three months. The Self Perception of Age was also reduced in the majority of subjects. At Week 4, more than 85 percent of the BoNTA cream group rated their wrinkles as improved by at least 75 percent.

RT001
RT001 Botulinum Toxin Type A Topical Gel Revance Therapeutics, Inc., Newark, CA contains an albumin-free 150-kDa BoNTA and a novel peptide that enables transcutaneous delivery of the BoNTA.  RT001 raised a lot of hopes with successful Phase 2 trials.

Two efficacy scales — the Global Assessment of Lateral Canthal Line Severity and the Patient Severity Assessment — have been used in phase 2 research to quantify the degree of muscle rest achieved (the primary end point). To be categorized at the most stringent level of efficacy, it was necessary for physicians and patients to record a crow’s feet severity reduction of at least 2 points in their respective rating systems.
Dr. Shazia Ali

Investigators with a 90-patient study enrolled participants at 3 sites, and randomized them to active treatment or placebo for a single treatment of RT001. A reduction in severity of 1 point was demonstrated in 89% of the RT001 group and 28% in the control group (P < .0001). A reduction of at least 2 points was demonstrated in 44% of the RT001 group and in 0% of the control group (P < .0001).

RT001

Phase 3 Trial – REALISE 1
The Phase 3 trial was a randomized, double-blind, parallel-group, placebo-controlled study to evaluate the safety and efficacy of DaxibotulinumtoxinA Topical Gel (RT001) for the treatment of moderate to severe lateral canthal lines.  A total of 450 adult patients were enrolled at seven sites in the United States and were randomized 1:1 to a single treatment of either RT001 or placebo topical gel applied to lateral canthal lines on both sides of the face using Revance’s proprietary applicator.
In a press release Dan Browne, President and Chief Executive Officer at Revance announced that, “We are disappointed with the results of the REALISE 1 trial. The data was unambiguous, and we do not plan to continue development of RT001 topical for crow’s feet. Based on these results, we have also decided not to pursue the current clinical development plan for RT001 in axillary hyperhidrosis.  We are grateful to all the patients and investigators for their participation in the REALISE 1 trial.” As of today the development of tropical botox RT001 has been shelved by Revance after non satisfactory Phase 3 trial  and long acting  DaxibotulinumtoxinA for Injection (RT002) has entered phase 3 trials.”

The Future

Delivery Of Botox Using Iontophoresis
Dr. Shazia Ali
Iontophoresis is a drug delivery system that uses a small external electric current to deliver water-soluble, charged drugs into the skin. A  case report published in the British Journal of Dermatology has shown that iontophoresis might enhance botox uptake by the sweatglands while treating cases of palmer hyperhidrosis.

Delivery Of Topical Botox Enhanced by Fractional CO2 Laser:
As previous studies have demonstrated that topical surface application of BoNT A has negligible cutaneous bioavailability and is not effective in treating wrinkles. A new study was designed to determine the effect of BoNT a solution applied topically on the skin surface immediately after ablative fractional CO2 laser treatment. There was a clinically significant greater degree of improvement in wrinkles after treatment with CO2 laser, on the topically applied BoNT A side. Also, the difference between the 2 treatment types (laser followed by topical BoNT A vs laser followed by saline) at 1 week and at 1 month was statistically significant.

Another study evaluated the synergistic efficacy and safety of combined topical application of Botulinum Toxin Type A (BTX-A) with fractional CO2 laser for facial rejuvenation. Twenty female subjects were included for this split-face comparative study. One side of each subject's cheek was treated with fractional CO2 plus saline solution, and the other side was treated with fractional CO2 laser plus topical application of BTX-A. Patients received one session of treatment and evaluations were done at baseline, one, four, and twelve weeks after treatment. BTX-A combined with fractional CO2 laser sides showed higher physician's global assessment score, subject satisfaction score, roughness, skin hydration, and skin elasticity compared to that of fractional CO2 plus saline solution side at 12 weeks after treatment.

Considering the non chemoimmobilization effects of botox and its role in anti scaring and rejuvenation it will remain a potential area of research. The newer non-invasive delivery modes of Botox will be explored further in the future.