Sleep Lines – Why Sleeping May Cause Wrinkles ?

If you've been subscribing to the notion that a girl needs her beauty sleep, you may want to reconsider. Apparently, visits to slumberland may cause wrinkles.

A friend of mine often complained about the lines on his lower eyelids that appeared like an eye bag despite religiously getting eight hours of sleep every night. On closer examination, there are triagular shaped creases on both his lower eye lids which are not typical of a true eye bag, tear trough or eye bulge. A photo taken when he was lying on his side suggested the root cause of his “eye bag” - they are actually sleep lines.

My friend lying on his side, with his lower eyelid skin cramped by the pillow. The opposite lower eyelid showed similar permanent creases due to his face being plastered into the pillow night after night.

Sleep lines tell the story of your restful nap. However, resting your face on the pillow in the same way every night for years on end may lead to wrinkles known as “sleep lines”. Eventually, these lines no longer disappear when the head is not resting on the pillow and becomes permanently etched on the skin surface.

In 1987, Dr. Samuel J. Stegman described “Sleep Creases”. His study noted that sleep lines are accentuated by pillow contact.

Sleep lines are sometimes single but are usually characterized by 2 to 3 parallel lines in the same area of the face, such as the temples, forehead, around the eyes and mouth. Sleeping on your side can also cause the skin to wrinkle in the laugh lines and chest.

Photo source : Intima

A crinkly clevage begins to be a problem for many women as they pass 40.

How to Treat Sleep Lines ?

Unfortunately, once sleep lines become permanent, treatment options are limited. Subcision, dermal fillers and laser skin resurfacing may help but results are variable.

A wacky way to prevent decolletage wrinkles – an adhesive silicone pad purports to smooth the clevage by just applying the pad at bedtime. But does it work ?

Prevention is the Key

Try sleeping on you back. Although getting used to a new sleeping position might needed some time and discipline, it is the cheapest and most effective way to smooth out sleep lines for both face and chest. People who sleep on their backs do not develop these wrinkles since their skin does not lie crumpled against the pillow.

If you are unable to sleep on your back, use silk pillow cases. Silk is a smoother material than cotton and allows your skin to glide through the surface smoothly.

Facts and Misconceptions About Botox - Part 2

This is the second part of the article - Facts and Misconceptions about Botox. Please click here to read the first part.

3) Will My Friends Know I Did Botox ?

Yes and No. In skilled hands, Botox will not make you look as if you’ve “had work done”. A telltale sign of Botox that has been badly done is that you can look “Spocked”, as in Mr. Spock, a fictional character from Star Trek. That is why it is important to seek treatment from an experienced doctor.

Photo source : Virgin media

Mr. Spock-like eyebrows are also known as the "Mephisto sign" - elevation of the lateral eye brows, at rest and at maximum frown. This should be avoided as it leads to either a weird or evil look.

4) Does Botox Have Any Side Effects ?

Every drug has side effects, and Botox is no exception. Luckily, they tend to be short-lived and mostly resolve spontaneously. Common side effects include droopiness of the eyelid or eyebrow, discomfort or pain at the injection site and bruising. Rarely, eye problems such as double vision, allergic reaction and facial asymmetry might occur.

5) Will I Look Worse Than What I Originally Was After the Botox Effects Wear Off ?

If you choose not to continue Botox treatment, the wrinkles or muscle bulk will gradually return to the same way they looked before treatment (and not worse than before). Botox does not affect the normal aging process.

Patients often get used to looking at the “Botox-enhanced” version of themselves. After the treatment effect wears off, they might think that they “look worse” when it really is their original wrinkles returning.

6) Botox Is Expensive

This is not necessarily true but prices vary widely. In my clinical practice, Botox is priced from a few hundred ringgit onwards, depending on the indication. Common factors that determine the cost of the Botox procedure are : brand of Botulinum Toxin (either Botox® Cosmetic, Dysport™ or others) and total units of Botulinum Toxin administered.

For Botox procedures, the quality of the results always depends on the injector. Choosing a good doctor is the key.

Facts and Misconceptions About Botox - Part 1

Botox is probably one of the most popular cosmetic treatment but often the most misunderstood. Botox inspires both confusion and admiration but is it right for you ? The information here helps to clarify some of the common misconceptions related to Botox.

What Can Botox Do ?

Botox is administered to treat dynamic wrinkles - wrinkles that occur only when we use our facial muscles to form expressions, such as crow's feet and forehead frown lines. Botox does not alter existing static wrinkles - wrinkles and folds that are present even at rest, such as laugh lines. But Botox does play a role in preventing static wrinkles (Please refer to a separate article which further elaborates on this topic). Other indications for Botox includes facial reshaping, reducing excessive sweating, neck rejuvenation and many more.

Photo source : Allergan

Unretouched photos of paid models taken at maximum frown before treatment with Botox and taken at maximum frown after treatment with Botox at indicated time points. Botox is FDA approved to treat frown lines between the eyebrows - the glabellar lines.

Limitations of Botox

Botox is not permanent. Results only last about 4 to 6 months for wrinkle elimination.

Botox Facts and Misconceptions :

Photo source : Allure

Still wondering if Botox is the right choice for you ? Read on to find out more regarding this "miracle" wrinkle eraser. 

1) Botox is a Toxin. Isn't That Dangerous ?

Yes, Botox is purified Botulinum Toxin type A produced by the bacteria Clostridium botulinum. But because the dose and volume used in aesthetics is so small, Botox is incapable of spreading to other parts of the body, and is extremely safe.

Photo source : David Cook

Botox is safe when administered at the correct dosage by a properly trained doctor.

2) Will I Look “Frozen” After Botox ?

Botox will not radically change your facial appearance. The muscle activity is temporarily reduced by Botox, so you can still frown or smile without the wrinkles. Some patients do report that their facial expressions become less intense after Botox but at the same time, they also looked more pleasant, relaxed and refreshed.

It is important to communicate your expectations to the doctor before the procedure - whether you prefer to retain some mobility of the treated muscles. An experienced doctor will have the knowledge to administer just enough Botox to relax the targeted muscles and not make the patient appear "frozen".

To be continued in the next article : Facts and Misconceptions About Botox - Part 2

Understanding Acne : Part 1 - Why Do We Get Acne ?

Acne is a disorder of the sebaceous gland (a gland that secretes sebum or oily substance to lubricate the skin). Acne develops when the opening of the gland becomes clogged with sebum and dead skin cells.

Photo source : National Institutes of Health
Schematic view of a sebaceous gland. The gland is found in greatest abundance on the face, upper chest and back - where outbreaks of acne commonly occurs.

Possible causes and factors linked to acne :

1) Hormones

Puberty causes hormone levels to rise, especially testosterone. A hormonal surge signals sebaceous glands to produce more sebum.

 Being a teenager is hard enough, and having acne just makes it worse. Puberty causes elevated levels of male hormone resulting in greasy skin and pimples.

2) Bacteria

Propionibacterium acnes (P. acnes) is a bacteria that inhabits the skin and uses sebum as a source of nutrient. P. acnes promotes inflammation, causing pustules and papules.

3) Genetics

Acne tends to run in families. Studies suggest that if both parents had acne, 3 out of 4 of their children will have acne. If only one parent had acne, then 1 out of 4 children will have acne.

4) Make-up or Skin Care Products

Oil based make-up, moisturizers and even hair care products may block pores and cause acne.

 Photo source : Allure

 For acne prone skin : It may sound obvious, but what you need is an oil-free lotion or gel, instead of a cream.

  

5) Contact with garments 

Pressure from helmets, chin straps, collars, suspenders can aggravate acne.

6) Stress

Stress does not cause acne but can aggravate acne in predisposed individuals. Stress causes an increased level of cortisol (a hormone released by the adrenal gland), which stimulates the sebaceous glands to produce sebum.

7) Diseases

Acne may be a symptom of an underlying illness such as Polycystic Ovarian Syndrome. Women with this condition also suffer from menstrual disturbances, infertility, excess hair growth and weight gain.

8) Medication

Certain medicines, such as steroids and phenytoin (a drug to treat seizures) can cause acne as a side effect.

The prescription medication Dilantin (Phenytoin)

9) Diet

Chocolate and fried foods are often blamed for causing acne. While these foods may not be good for overall health, there is little evidence that they cause acne. Although some recent studies have implicated dairy products in aggravating acne, these findings are still not well established.

Understanding Acne : Part 2 – Acne Treatment Tips

When treating acne, it is easy to make mistakes or even make the acne worse, despite the best intentions. It could be what you are not doing right that is preventing you from seeing clearer skin. These do’s and don’ts can help you get the best results from your acne treatment.

The ultimate acne "treatment" - Photoshop, apply once and results are immediate. Unfortunately in reality, acne is annoyingly persistent. Acne lesions heal slowly, and when one begins to resolve, others seem to crop up.

1. Be Consistent With The Treatment and Do Not Give Up Too Soon

Despite many claims made by advertisements, acne does not clear up overnight! It may take up to six weeks to see improvement. Acne treatment is most effective when they are consistently used over a period of time. Not sticking to a regimen delays any potential improvements.

2. No Picking or Squeezing !

While you are waiting for treatment to work, it can be tempting to pick on the acne hoping to get rid of it. Acne picking prolongs healing time and increases the risk of scarring.

 Photo source : Adam Gault

Resists pimple popping. If done improperly, you could turn a blemish into a full blown crisis.

3. Follow Product Instructions
 

Over usage of topical medication can cause skin irritation. On the other hand, spot treatment fails to prevent breakouts. It is recommended to apply acne medication to the entire acne prone area, not just the blemishes.

4.  Maintenance Treatment

Many people make the mistake of stopping anti-acne treatment once they see clear skin. It is best to taper medication usage by using it less and less. To keep skin free from blemishes, do continue to apply topical acne medication even after the acne is under control.

5. Do Not Skip Moisturizer and Protect with Sunscreen

Even acne prone skin needs to be hydrated. The key is to apply an oil-free moisturizer. Some anti-acne products contain Alpha Hydroxy Acids (AHAs) that may cause the skin to be more vulnerable to ultraviolet rays. Choose a non-greasy sunscreen to protect against sun damage.
 

 Image source : Flickr

Lotions or gels are often a good choice because they feel non-greasy on acne prone skin.
 

6. Avoid Harsh Cleansers and Scrubs

Harsh cleansers and scrubbing your skin will not clear acne. They tend to irritate the skin and may worsen the acne.

 

7. Seek Early Treatment From A Doctor

Severe acne can lead to irreversible scarring if left untreated. It is time to make a clinic appointment if the acne starts taking a toll on self-esteem or if over-the-counter medications do not clear the skin. Prescription medication such as antibiotics or isotretinoin can effectively control moderate to severe acne.

Understanding Acne : Part 3 - Adult Acne

Who would have guessed that actress Salma Hayek's flawless face was once plagued by acne. In a recent interview with Lucky magazine, she revealed that she had acne at 25 and the acne was so bad that it sent her into a depression - “I couldn’t leave the house. I’d wake up in the morning and lie there and touch my face before I got up, just to prepare myself to look in the mirror!”.

 Adult acne is a common problem. Actress Salma Hayek was once plagued by adult acne in her twenties.

We used to think that our “bad skin” days will be over once we hit adulthood. However, according to the American Academy of Dermatology, almost 50 per cent of adults suffer from acne at some point in their adult life. Currently, the average age of those being treated for adult acne is about 30 and females are more likely to develop adult acne compared to males.

What is the Difference Between Teenage and Adult Acne?

Teenage acne mostly involve blackheads and whiteheads on the T-zones and cheeks. Adult acne typically affects the lower face - jawline and neck, sometimes presenting in the form of painful cysts and nodules. Scarring is more likely as the lesions are larger in adult acne (cystic, nodular lesions) and the skin becoming less resilient with age.

 Adult acne mainly affects the lower half of the face

What Causes Adult Acne ?

Although the exact cause is not well documented, several factors are associated with adult-onset acne. Experts agree that hormonal fluctuations play a key role in adult acne. Pimples tend to flare up during menstruation and menopause. In addition, adult women are more likely to wear make-up and use richer anti-aging creams that may clog pores. Lastly, stress is also an aggravating factor for the modern adult working woman to develop acne. 

Treatment of Adult Acne

Adult acne can be treated with anti-acne skincare, topical and oral medication. Many over- the-counter acne products are formulated to treat teenage acne with underlying greasy skin. As adult skin is generally less oily, care should be taken to avoid harsh cleansers or topical acne lotions that may dry up or irritate the skin. Do consult a doctor for treatment of adult acne to avoid unwanted side effects such as scarring.