Artemis Hospital - Gurgaon

Hello friends. 

I am doctor Monica Bambroo. I am the dermatologist. Today I am going to tell you about one of the very important aspects of skincare and that is anti-ageing. Lot of us wonder how aging happens, what are the reasons why we age and why this ageing differs from one person to another. So, there are many factors why our skin ages but we start aging at a very young age. Usually, the early signs of aging start in our 20s and then by 30s we notice certain changes and in 40s the changes become more pronounced, as we age further into 50s and 60s we see overt signs of aging.

So, what are these early signs of aging which we can recognise because prevention is always better than cure? We can divide the face into 3 parts: we have the upper face, the middle face and the lower face. In the upper face, we often see the frown lines, we see the forehead lines, in the middle we see the crow's feet, we see the sagging of our cheeks, the laugh lines, the marionette lines, the pre jaw, we see that the definition of a jawline has changed; so all these things basically constitute our facial aging. So, facial aging as I told you starts in the 20s and as Indians, we see the first signs of aging is tear trough. The tear trough is a small groove present under the eye which makes us look very tired. So, when most people come to me they do not say that they are looking aged but most of their concerns are we are looking very tired even when we are fresh and sometimes we are looking very angry and we are not angry actually but people say kya hua why are you so angry.

Sometimes people say that our facial shape has changed, we used to look a little slimmer, thinner but now we feel that the face is looking much broader and heavier. Sometimes people complain that they feel a lot of sagginess in the face. So sometimes you have people coming with certain emotional attributes which basically represent a form of aging like being angry, having an angry look on the face or having a very sad look or tired look on the face and sometimes they come with sagging and feel saggy, broadness of the face or probably some people also come with definite opinions like I want removal of my frown lines or crow's feet or nasal line.

So how do we handle this? So anti aging bracket has 4 arms: the first arm is home care. Homecare means what we should do at home. So, in Indian skin or in Asian skin or in brown skin most important factor is pigmentation. So we get a lot of pigmentation as we age, we don't realise it but by the time we are in our 40s we see that we are having some brown spots, sunspots, photodamage, some kind of darkish brown spots which we called as TPMs, we can have savoury keratosis so these can be handled and one of the primary things we have to do is sunscreen. Photo aging, that is Sun related aging is responsible for 60% of our aging and chronological aging that is what happens because of the age is because of the 40%. So, if you use a good brand of sunscreen, if you use a good protective cover of sunscreen we are able to protect ourselves from 60% of the aging. Not that the sunscreen is 100% protective, but yes of course we prevent the damage a lot. Second important thing is the products that we use so early on, we have to start with certain peptides or protein-based creams, we have to start with certain retinol or Vitamin A based creams, we can also use AHA that is alpha hydroxy acids or BHA based creams which will help in mild exfoliation and improving the skin. So this is the first part which is your skin care, what we do at home. Second part is a heat or laser based treatment. In this, we have a huge galaxy of things but remember early aging is best to treat with these kinds of heat-based devices or lasers or RF-based devices or ultrasound based devices which we are using nowadays so all this help like hypho, we know about hypho, we know about monopolar, bipolar RF so these are the devices that can be used mostly between 30 to 50 years of age. If the aging is too pronounced, these heat based devices give very subtle results.

Third important thing is injectables so a lot of people question are they safe, should we go ahead with them, what, how will they help us, whether we'll have to repeat them or not. Yes, so first thing is that injectables basically target the basic cause of aging. So, for example, if our muscle is very hyperactive and we are always frowning botox relaxes botulinum toxin which is Botox relaxes our muscles, relaxes our frown muscles and it so we do not frown all the time, our lines relax. If we are going for the forehead line, our lines relax. If we are doing for the crow's feet, our lines relax. So, we do not see these lines. So, Botox or Botulinum toxin stays in our, helps us to remove the lines for 3-6 months so we repeat them every 3-6 months and we this means we can do them twice a year and if we do early we will be preventing a lot of wrinkles from coming. The second important thing is fillers.

What is the difference between fillers and Botox is that in fillers we are basically targeting the static wrinkles. Static wrinkles are those which will stay even when we don't make a facial expression like our laugh lines or marionette lines so these are the lines which stay even when we don't make a facial expression. So, these are the lines where we require fillers. Dynamic wrinkles are those which come when we make a facial expression like we raise our eyebrows, we frown, we smile; so these are the wrinkles which come when we are making facial expression but sometimes botox can also be used for certain specific areas like we can use it for masseter. Sometimes people have very broad jaw, so here we can use Botox to slim down the jawline. Sometimes we use it for too much of the activity of the platysma which pulls our skin down so that is known as Nefertiti neft. So, again we can do Botox for that. As far as fillers are concerned nowadays why the aging is happening because our fat is becoming shrinking and it is shifting so there is a shrinking of the fat, shifting of the fat downwards, so when we try and put the fillers we are trying to restore the volume and then we refine the shape and that is where the fillers help. Many times we see that the cheek is coming down, the cheek is sagging, so how can we bring back the cheek. We can do it by putting in a little bit of filler, restoring the volume and refining the contours so that a person so once you lift this, the jaw, the marionette line, the nasal everything lifts, so we look at the cause of those lines and work on those areas. The mostly the fillers which we use in our country they are hyaluronic acid fillers. Hyaluronic acid is a gel and it is the part of the skin, our skin is also made of hyaluronic acid. It's something like natural substances so when you put it in your skin it does not feel like a foreign body.

Nobody can make out that you have put something in your skin and after sometime when it integrates with the skin you cannot feel it anywhere in your skin. It can be done as an office procedure, you can come and get it done and usually these are painless because a numbing cream is applied before you do them and the one thing that you have to plan that sometimes they can be a little bit of bruising but that's a minor thing and usually it is settled in few days and normally should see that you are getting your fillers done from somebody who has already doing fillers because the technique of fillers is very important to give you the appropriate results. So, what I can conclude is that even for people with early aging if you do these procedures before we are trying to prevent lot of wrinkles, lot of lines, lot of sagging, we are trying to prevent those from happening and it's basically anti-aging today is not about it's about aging gracefully.

Of course, it's about aging gracefully but that doesn't mean that you don't have to have interventions. These small interventions try and balance your face. They give symmetry and shape to the face which sometimes distorts because of aging. If the face looks asymmetrical or distorted or you feel it's too saggy that looks out of balance. There was a study in which people looked at their own self and felt that they don't look good when they were aging and then when they were injected with fillers they looked they felt they looked more natural. So, if you want to do something about our aging, the fillers and Botox is the answer and they do make us look very natural and most people cannot make out that we have done something. Only thing is that people will say that you are looking good, you are looking better, you are looking much fresher, you look much happier, cheerful, you don't look that tired, you look fresh but they will not be able to make out that you have got a lot, a little or few interventions done on your face. So, therefore what I would suggest is if you ever feel that there are certain expressions you want to change which do not, some expressions which you want to change, which you don't like about your face: the answer lies with using some of these anti-aging techniques and making you look the best you that you can be.

Thank you.

Hi,

I am Dr. Monica Bambroo, Dermatologist. Today I will talk about hair fall. Hair fall has emotional overturns. We all are worried about it. And who is not involved with hair fall. We have kids, elder, middle age, the young female, after pregnancy, so hair fall is like a universal thing. But many times people ask is this the hair fall is normal. Or is it a serious problem, should I seek help from an expert. So, I am going to answer these queries. So, one thing we have to is all hair fall abnormal. Some hair fall are natural. If we lose 40-100 hair on a non-shampoo day, consider it normal. And on head wash day, you can lose 100-400 hair. So, this is a normal phenomenon. There is a lot of conditioners which can lead to hair fall. So, primarily divide hair fall into 2 basic categories. One is non-scarring alopecia which means you are losing hair but you have every chance of getting back your hair. Which means if you lose your hair, you can get them back. Hair growth will be there. Alopecia is fortunately very rare. Most patients we see non-scarring alopecia.

Now, non-scarring alopecia can further be divided into those categories who have patterned alopecia. Patients lose hair in a particular pattern. In this, we have 2 pattern hair loss. Male pattern and female pattern. Male pattern is very common like common baldness, androgenetic alopecia that we see. Here we have patients who have a frontal recession, hairline going back and texture thinning. We see that entire hair from the front scalp is gone. That is common baldness that we see in men. In females, also we have this kind of baldness but here we have a widening of the parting. Pattern alopecia runs in family or sometimes we get hair fall without any family history or without any apparent cause. This time we realize that we are losing hair. There can be hair thinning. We actually see a lot of hair fall on the floor, pillow, while having a bath. There are certain conditions which can lead to hair fall. You can have it after a high-grade fever or viral, dengue, post-pregnancy also it can happen. It can also be related to some medicines. Hair fall can also happen because of various deficiency.

Our food habits have been changed and lifestyle also. Deficiency of vitamin-B12, D. A lot of people are there who have normal hemoglobin but they have a non-anemic iron deficiency. Hair is made of very important protein which is called keratin. If protein intake is not proper, we can lose hair. Now the question is whom should we consult when we have hair fall. The dermatologist is best for this kind of consultation. They are well worse with hair condition. So, the best trichologist is a dermatologist. First, we need to see the cause of hair fall. We should know the cause only then we can do the treatment. If pattern alopecia is there, medicines can be given. We have to look at the cause if it is because of certain deficiency. A lot of people ask, are there any procedure which can be done. PRP can be done in which a patient's own blood is taken.

And then the platelets are injected to the scalp. This also strengthen the hair growth. Mesotherapy can also be done for hair fall. If hair loss has reached beyond the stage, hair transplant can be done. Transplants from the good clinic are very successful. Patients are very happy after transplant. So, don't worry if you have hair fall. Consult a Dr early. If you go beyond the stage where not much can be done, then the hair cannot be regained back. So, the key is to diagnose it early and then go ahead with the treatment. I am sure you will get a very good result.

Thank You.

Lybrate | Dr. Monica Bambroo speaks on IMPORTANCE OF TREATING ACNE EARLY