Cooltech Fat Freezing Technology

Dr Lalloo Blog February 2020

CoolTech is the latest most advanced fat freezing technology on the market, improving on older systems like CoolSculpt which has been around for over ten years.  CoolTech treats larger areas more effectively, removing up to 50% more fat than older technologies in one treatment.  A 30% reduction in the area treated is not uncommon.

CoolTech works by rapidly and painlessly cooling body fat causing the fat cells to die.

Treatment times are reduced and patient comfort is increased, compared to older technologies.

Fat treated is permanently removed over a six-week period after treatment.  Unlike older systems there is little bruising or swelling and no pain.

The key to success is the cooling technology which allows for larger areas to be treated using a single or double handpiece per side.

Treating large areas at one time with one handpiece is part of the reason it is so successful.  Many combinations are possible, two areas per session are possible, using either a double handpiece or two handpieces, for example the entire lower abdomen ‘Mum Tum’ can be treated using the double handpiece, as can the upper tummy. It is possible to have the upper or lower tummy treated individually, or both sides at one time but not all together.

CoolTech has both straight and curved handpieces which makes it very versatile for a variety of areas, such as: –

 ‘Muffin Top’ both sides (fat close to the belt line, both hips), thighs inner and outer, saddle bags, (inner and outer), ‘Bra Strap’ fat areas around the bra strap area, flabby knees and bingo wings. Two handpieces are used for all treatments.

Chin Fat: There is a separate small hand piece which treats the area under the chin.

Treatments last approximately 70 minutes. During the treatment patients are lying down, able to read a book or use a phone. 

Subject to maintaining a sensible diet and lifestyle the results should be permanent.  Weight gain or hormonal changes may affect the results long term. Suitable for both women and men.

Prices from €450 per treatment

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What is Cellulite & how to minimise the effects ?

Cellulite is a chronic degenerative process in the superficial subcutaneous adipose tissue and it alters the texture of the skin. It affects almost 90 percent of women and it is mostly visible on their thighs and buttocks, stomachs and arms. Cellulite is often genetic and starts in adolescence and becomes worse with age. Women have a higher risk of developing cellulite as their connective tissue and fat cells are arranged differently compared to men. Cellulite responds to female hormones and so is worse in women.

The main characteristic lesions caused by cellulite are: orange peel skin, which is widespread, irregular bumpy skin that alters the whole area affected by the process and the singular introverted lesions caused by retracting fibres that vary in shape number and appearance. The ‘hill and valley’ appearance of cellulite is treated by smoothing out the dimples and reducing the fat in the area with lipotherapy (fat reducing injections) at a later date giving a smoother slimmer appearance to the skin and body. We use deoxycholic acid to dissolve pockets of unwanted fat (Aqualyx / Kybella).

It’s important to specify that cellulite is not just fat. Fat insulates the body and cushions the organs, nerves, and muscles while supplying your muscles with useable energy. Cellulite occurs in certain areas on the body, such as the thighs, buttocks and abdomen. You don’t have to be overweight to have cellulite. The skin in the area where there are dimples is pulled down by tight fibres in the fat causing a puckered look, these are the fibres that are released with Celluerase treatment to make the skin return to a smoother texture.

 

 

Here are 5 ways you can minimise the effects of cellulite:

  • Drink plenty of water to flush toxins out of your body
  • Exercise regularly and include movements such as squats, step-ups, and lunges in your exercising programme
  • Include fruits, vegetables and lean proteins in your diet with moderate carbohydrate intake
  • Quit smoking. Smoking can weaken the skin due to the constriction of capillaries and damage the connective tissue that causes the dimpling effect of cellulite.
  • De-stress. Take a yoga class. Stress can cause muscles to seize up with tension while also causing the connective tissue that covers that muscle to seize up. Tension also blocks the tissue, preventing proper waste elimination and purification.

 

There are four stages of cellulite development to be aware of:

  • Grade 0: No cellulite present
  • Grade 1: Smooth skin while standing, bumps and dimples appear while sitting
  • Grade 2: Orange peel visible while sitting or standing
  • Grade 3: Orange peel appearance visible while sitting or standing with deep raised and depressed areas
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Ask The Doctor! When Should I Start Having Botox?

Ask the doctor

Reader:

Hi Doctor Lalloo.

I was wondering if you could tell me Botox. Is it safe and when would be the ideal time to start having the procedure?

I don’t want that ‘frozen face’ look!

Dr Lalloo: 

Here’s how to do it right at 20, 30, and 40.

Firstly there are different rules for different decades.

Anti-wrinkle injections used to be a procedure reserved for Beverly Hills housewives, but now this treatment, hailed for its minimal invasiveness and drastic results, is very commonplace. And these days, 20- and 30-somethings are depending on the injections to treat and prevent lines and wrinkles.

Now that the procedure is less controversial, I’m starting to see young women view it as a preventative measure instead of a means to treat skin that’s already showing signs of aging.

If that’s the case, when should you get started, and what should you know before going under the needle?

For Starters, Here’s How Botulinum Toxin A Works

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Botulinum Toxin A is an FDA-approved drug made up of botulinum toxins that, when injected into the correct facial muscles, temporarily blocks local nerve impulses that trigger contractions. This softens wrinkles and prevents even more lines from forming. As the skin ages, it loses its elasticity and collagen breaks down, so constant muscle and skin contractions can create more permanent creases.

While you can technically get anti-wrinkle injections at any age under a doctor’s supervision, the FDA has only approved it for those ages 18 to 65.

How you face changes in your 20’s, 30’s, and 40s’  and what you should know about getting anti-wrinkle injections

In your 20s:

To prevent wrinkles, some doctors may recommend using Anti-Wrinkle Injections as early as your mid-to-late twenties to reduce facial muscle over-expression, a totally genetic thing.

Botox

Many women don’t have wrinkles in this decade, and wearing SPF daily can help keep skin line-free. If you’re considering using Anti-Wrinkle Injections in the future, think of your twenties as a training wheel period: It can actually help you train your facial muscles not to move as much to prevent future skin wrinkling.

Just remember, Anti-Wrinkle Injections will affect the way your facial muscles move in general. This means it might feel funny when you try to make a particular expression. Don’t want that frozen face? Your doctor can use a smaller amount of the botulinum toxin and also inject it more superficially, so it doesn’t go as deep into the skin I avoid the frozen effect, which happens when too much is used. Most women I see in their 20’s are more looking for a refreshing treatment to look less tired and perhaps lift the eyebrows into a more seductive shape.

In your 30s:

botox

This is the decade when you normally start noticing somefine lines developing between your brows and around your eye area. “Botulinum Toxin will soften and even erase many of the finer lines around this age, as long as you continue keeping up with this regimen every 4-6 months or so.

If you’re only getting the procedure to look wrinkle-free for a particular event- your wedding, let’s say—or simply as a feel-good booster every now and then, you can space it out to every six to nine months to save yourself the cost of an appointment.

In your 40s:

At this age, your skin is thinning more rapidly, meaning wrinkles are far more obvious. If you’ve not yet used Botox, your muscles have been contracting for a long time and you might have a few static wrinkles.

Lines are more likely to have become etched in your skin even when you’re not moving the muscles underneath—not just dynamic ones that form only when you move your facial muscles.MTIzMDQ5NjY0NTAxMTU1MzQw

There’s also some mid-face volume loss (aka sagging) at this age, which Anti-Wrinkle Injections can help with, but your skin may not be perfectly smooth afterwards because of the changes in its quality and resilience.

Again, you’ll want to keep up injections approximately every 4-6 months and perhaps consider fillers to replace the lost fat and help lift the middle of the face and hollowed front of the face under the eyes.

The bottom line:

You don’t need Anti-Wrinkle Injections. Wrinkles are a part of the natural aging process, after all. But if it’s something that interests you, discuss it with your doctor, I recommend only ever having them done in a doctors office, I find it amazing that people think nothing of going to a salon to have this done to ‘save money’, would you bring a new born for their vaccines to a salon? Of course you wouldn’t you’d be terrified of doing that, but for some unknown reason Irish women don’t see it this way. Talk to your Doctor, in their registered office so that you can come up with a treatment plan that won’t leave your face looking stiff as a board…

Remember you get what you pay for too.

Hope that helps!

Dr Lalloo FRCS(Ed) MICGP

Doctor Lalloo 1

Please note that Dr Lalloo’s opinions are based on the information given to him. You should always consult your GP if you have concerns. This does not constitute a doctor patient relationship. MCRN No 019510

To submit a question to Dr Lalloo in the strictest confidence, please email info@sosueme.ie and include ‘Ask The Doctor’ in the subject line.

Doctor Lalloo 2

About Dr Lalloo:

Dr Lalloo is qualified from the Royal College of Surgeons in Dublin, and has a fellowship in surgery from the Royal College of Surgeons Edinburgh. He is a fully qualified GP with an interest in skin surgery and dermatology. His registered qualifications with the Irish Medical Council are MBBCh, FRCS Edinburgh, MICGP. Dr Lalloo is on the specialist register with the Irish Medical Council.

Dr. Lalloo is a recognised expert in medical aesthetics having established Cosmedics Clinic in 2002 when medical aesthetics was in its infancy in Ireland. He is a member of the British College of Aesthetic Medicine and on the committee of the Primary Care Surgical Association.

– See more at: http://sosueme.ie/lifestyle/ask-the-doctor-when-should-i-start-having-botox/#sthash.qMQxzthn.dpuf

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ASK THE DOCTOR – I have suffered with boils on my inner legs and under my armpit……

Question: I’m nearly 24 and since about the age of 12, I have suffered with boils on my inner legs and under my armpit, sometimes even on my bikini line.

I have gone to my doctor and they have given me antibiotics and creams but nothing seems to help. They leave purple scars too. Is there anything I can do to help or get rid of these?

It’s such a nightmare. They really do put my self-esteem down.

Thanks x

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Dr Lalloo: 

Hi! My heart goes out to you. To me it very much sound like a condition called Hidradenitis Suppurotiva but I have not examined you.

This is a condition characterised by recurrent boils and abscess formation in the skin of arm pits / groin, under the breasts and pubic region (areas where we have what are called Apocrine Glands in our skin that is the sweaty areas), it is not however due to disease of the sweat glands as the name implies. Typically there are lots of scars from old cysts and sinuses or tracts between the lesions, which are pus filled. It is also known as Acne Inversa

Who gets it?

  • Hidradenitis usually starts at puberty, and is most active between the ages of 20 and 40 years, and in women, can resolve at menopause. It is 3 times more common in females than in males.
  • Other family members with hidradenitis suppurativa
  • Obesity and insulin resistance/metabolic syndrome
  • Cigarette smoking
  • Follicular occlusion disorders: acne conglobata, dissecting cellulitis, pilonidal sinus
  • Inflammatory bowel disease (Crohn disease)
  • Rare autoinflammatory syndromes associated with abnormalities of PSTPIP1 gene

hidradenitis

What causes it?

Hidradenitis suppurativa is an autoinflammatory disorder. Although the exact cause is not yet understood, contributing factors include:

  • Friction from clothing and body folds
  • Aberrant immune response to commensal bacteria
  • Follicular occlusion
  • Release of pro-inflammatory cytokines
  • Inflammation causing rupture of the follicular wall and destroying apocrine glands and ducts
  • Secondary bacterial infection

What is the treatment for hidradenitis suppurativa?

  • General measures
  •  Weight loss; follow low-glycaemic, low-dairy diet
  •  Smoking cessation: this can lead to improvement within a few months
  • Loose fitting clothing
  • Daily unfragranced antiperspirants
  • If prone to secondary infection, wash with antiseptics or take bleach baths
  • Apply hydrogen peroxide solution or medical grade honey to reduce mal-odor
  • Apply simple dressings to draining sinuses
  • Analgesics, such as paracetamol, for pain control.

Hidradenitis-suppurativa

Medical management of hidradenitis suppurativa

Medical management of hidradenitis suppurativa is difficult. Treatment is required long term. I usually start with antibiotics and a contraceptive pill and can go from there to injecting the pustules all the way to removing the diseased skin. There are multiple ways to treat this depending on the patient, but we have no cure at the moment unfortunately, other than complete excision of the diseased skin, which can be very challenging, even then it is not a guarantee.

I hope this information helps you and remember you are not on your own, I have seen hundreds of patient’s with this condition and many have gone on to live normal healthy lives.

As you can see, I have included some very mild pictures, I have lots more that are way, way more awful looking, but these are at the very mild end of the spectrum as I don’t want to shock or upset anybody either.

I hope you find your answer and the best of luck

Dr. Mukesh Lalloo FRCS(Ed) MICGP

Please note that Dr Lalloo’s opinions are based on the information given to him. You should always consult your GP if you have concerns. This does not constitute a doctor patient relationship. MCRN No 019510

To submit a question to Dr Lalloo in the strictest confidence, please email info@sosueme.ie and include ‘Ask The Doctor’ in the subject line.

– See more at: http://sosueme.ie/lifestyle/ask-the-doctor-2/#sthash.YgzAUWtm.dpuf

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ASK THE DOCTOR – Acne is a scourge for many… my latest post.

Question: “For as long as I can remember, I have suffered with such bad skin. Lots of girls my age (29) complain about spots or blemishes which annoys me as I suffer with near enough boils on my face. They come up like lumps, feel like bruises and nothing I do gets rid of them. I cleanse, tone and moisture my face daily so my skin is extra clean so it’s not from dirty pores. 

My wedding is coming up, and I just don’t know what I can do anymore. No amount of make up covers them, and I don’t want to go into my thirties looking like a teenager with spots, or boils in fact. 

Right now, I have 5 on my face and 4 on my neck, and they’re not only unsightly, but sore too. I’ve also been on the pill for 10 years and wonder if this is contributing to it?”

2Dr Mukesh: 

I sympathise with you as this is a common enough problem found in men and women, it is unsightly and quite painful physically.

The simple truth is that there is no regime of skin care that you can do that will stop it. If I am correct without having actually examined your skin and taken a proper medical history it sounds very much like Acne Conglobate or Cystic Acne.

Acne Conglobata is a type of acne that leads to cysts under the skin which are painful and inflamed. It can affect the face and other parts of the body such as the neck and back or chest.

There is hope though, you need to go to your GP and ask to be referred to a Dermatologist as the treatment of choice is Roaccutane plus or minus long term antibiotics. Sometimes I will even inject the cysts with a special steroid that makes them shrivel up quickly and lessens the scarring left when the cysts burn out.

Sometimes changing your pill to one which has Cyproterone Acetate in it can help too, but as you said you’ve always had bad skin. I would just get on with getting to a doctor who specialises in skin now as your wedding is close and time is not on your side unfortunately.

The official advice is summarized below:

What is acne conglobata? Acne conglobata is an uncommon and unpleasant form of nodulocystic acne in which there are interconnecting abscesses and sinuses (channels under the skin). These result in unsightly hypertrophic (thick) and atrophic (thin) scars. There are groups of large macrocomedones and cysts that are filled with smelly pus.

Acne conglobata is occasionally associated with: Other disorders associated with follicular occlusion, particularly hidradenitis suppurativa, a condition in which similar boil-like lesions and scars occur in the armpits, groins and under the breasts.

Nodulocystic acne may very rarely be a manifestation of a genetic disorder, PAPA syndrome.

What is the treatment for nodulocystic acne? Treatment of nodulocystic acne can be challenging and may require a combination of medicines. Topical treatment is usually ineffective.

The recommended treatment for nodulocystic acne is isotretinoin (Roaccutane), which should be commenced early to prevent scarring. The treatment is required for at least five months, and further courses are sometimes necessary.

Patients with acne conglobata often need additional treatments, such as:

  • Oral antibiotics
  • Intralesional steroids
  • Systemic steroids
  • Hormonal therapy in women

Thanks,

Dr. Mukesh Lalloo FRCS(Ed) MICGP

Please note that Dr Lalloo’s opinions are based on the information given to him. You should always consult your GP if you have concerns. This does not constitute a doctor patient relationship. MCRN No 019510

To submit a question to Dr Mukesh in the strictest confidence, please email info@sosueme.ie and include ‘Ask The Doctor’ in the subject line.

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About Dr Lalloo:

Dr Lalloo is qualified from the Royal College of Surgeons in Dublin, and has a fellowship in surgery from the Royal College of Surgeons Edinburgh. He is a fully qualified GP with an interest in skin surgery and dermatology. His registered qualifications with the Irish Medical Council are MBBCh, FRCS Edinburgh, MICGP. Dr Lalloo is on the specialist register with the Irish Medical Council.

Dr. Lalloo is a recognised expert in medical aesthetics having establishedCosmedics Clinic in 2002 when medical aesthetics was in its infancy in Ireland. He is a member of the British College of Aesthetic Medicine and on the committee of the Primary Care Surgical Association.

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Did you get your hair done ?

kelly b
beforeafter
Sitting having coffee with some of the girls after our usual friday morning music class with our kids I announced I had to leave early. “Ooh, doing anything nice?”, they asked. “Nice?..Well if you think getting a load of needles inserted into your face to freeze it nice then yes, I’m doing something nice. Queue the puzzled looks. I was having botox done. Nice may not be the best word to use when having this procedure done but the results are nice, beautiful even.
“Why are you getting botox done, you don’t need it?”. This I’ve heard off pretty much everybody whom I’ve told I was getting botox. It dawned on me that maybe they just didn’t understand botox. Most of the girls couldn’t understand why I would want to get it done. I’m young(ish), mid thirties and not terribly aged yet, ‘yet’ being the operative word. So I set about explaining why I would want to get botox.
Firstly let me explain, botox is not a reversal procedure. It will not turn back the clock on already ingrained facial lines and wrinkles. It is a pause button. It delays the ageing process and so by doing it now I can prevent my face from becoming more wrinkled than it already is. While it does not plump out lines present at rest on the face it can help to smooth them out a bit.
A few puzzled faces still looked back at me in the cafe, some nodded in agreement some maintained I didn’t need it but each to their own and all that. So I left saying I’d be back to prove myself right next Friday with a fresher face.
I’ll admit this is not my first encounter with botox, I’d had it done last year and was pleased with my results. For some reason though this time I was a little bit more nervous. I think it was the fear of pain. I was so nervous the first time I got it done my whole body was tense which made the supposedly painless procedure quite painful. I can still hear the noise of my skin popping when the needle was inserted, I’m not sure that noise will never leave my memory.
This time however I was going to a different clinic and seeing a different Dr. A Dr. I’d wanted to see for a very long time now. I’d heard nothing but great things about Dr. Lalloo and I’d seen his ‘work’ on a few faces and knew that I was going to be in the best hands possible.
Battling the M50 traffic on a very wet and stormy Friday afternoon I arrived at the Primary Care Centre in Blanchardstown. Dr. Lalloo’s clinic, Cosmedics, was located on the second floor, so up I went, waiting a minute or two before Dr. Lalloo appeared. If I’m being honest I greeted him with a false bravado. I may have been smiling on the outside but honestly my heart was about to jump out  of my chest. Should I make my excuses, say I felt unwell? Maybe the girls were right, I really didn’t need botox, I could just head home…but my feet kept on following him.
He took me through to one of the therapy rooms and began asking the important ‘WH’ questions, “Why did I want botox?”, “Where did I want it?”, “Did I understand the process?”. He examined my face explaining where I might benefit from the toxin, he also pointed out where I might benefit from a filler. “Filler??!!!”. Oh god this is not something I signed up for. Surely I don’t need fillers? Do I?. Facing the mirror Dr. Lalloo showed me where there had been some hallowing under my eyes. I admit I had noticed this myself over the last year or so. I wasn’t sure though whether it was just from tiredness and kids or from gaining and losing weight over the course of my pregnancies. It wasn’t something that really bothered me, but now that it had been pointed out to me and I was getting the opportunity to do something about it maybe I should.
Again let me explain the filler Dr. Lalloo was suggesting was for under my eyes. The dark hallows that most of us get as we get older. I had done a little research on this before, I knew that it filled the area called your tear trough. It could plump up the skin reducing the hallowness and therefore reverse the signs of ageing by a couple of years.
After a further twenty minutes of explaining the the pro’s and of course the possible con’s of both procedures I decided to go for it. Despite my earlier hesitations I really wanted the botox, my laughter lines had really started to become more noticeable and the lines on my forehead were beginning to become a permanent fixture as were my 11 lines or Glabella, the frown lines between the brows. The filler I was a little more apprehensive about. Would it be painful? Would I end up looking like I had something done to my face. I really didn’t want to change my appearance, I’m happy enough with it, I just wanted to freshen myself up a bit. Dr. Lalloo assured me that I would look no different than I do now except maybe a few years younger. He told me that by filling the tear trough my cheekbones would be slightly raised, in turn lifting the naso-labial lines (those lines from your nose to the corners of your mouth) which would instantly give me the appearance of a more youthful face. I was sold. I also knew that any work that was going to be done on my face would in time fade so if I was unhappy with anything it wouldn’t be permanent. Probably not the best argument for getting it done but it made me more comfortable going ahead with it.
Once all the consent forms were read and signed it was show time. ‘Before’ pictures were taken so I could compare the results once he was finished. I lay back in the chair where Dr. Lalloo began firstly with the botox. I shouldn’t really be calling it botox. Botox is a brand name like hoover is to vacuum. Instead Dr. Lalloo used a toxin called Dysport. Kinda like the Dyson vacuum of toxins. Enough with the vacuum metaphors, the toxin he was using like everything that he uses is the best out there, FDA approved and most importantly totally safe (well as safe as a toxin can be).
He started on my forehead, explaining exactly why he was inserting the toxin where he was and the reasoning behind it. It all made perfect sense to me then and I really was listening but for the life of me now I can’t remember exactly what he said and so don’t want to bore anyone with the finite details. Let’s just say he really knows what he is doing. I felt little or no pain. This was my biggest worry about getting it done, and here I was feeling relaxed and excited now to be getting it done. I think what helped though was his manner. Every time he inserted one of the needles he said “Good for you”. And I thought, ‘yeah, good for me, thanks Doc, I’m coping with this really well.’
Forehead done and onto the filler. He had said that this may be a little uncomfortable. He used the word sting actually. But again a “Good for you” from him and it was done. I couldn’t believe it. That was it? Honestly, no pain, not really, just a little pinch. I couldn’t wait to look in the mirror. The big reveal!! Oh, I look like me. Just a slightly better me, younger maybe, definitely. A pre kids me I think. Happy days.
After photos were taken, we went to his office to take a look at the pictures so I could compare the results. We both looked at the before and after pics and both struggled to pin point the exact reason why the girl on the right looked better than the girl on the left. The changes were so sublet yet striking. My eyes looked less tired, my smile brighter and cheekbones just a little fuller but I really couldn’t point to a specific change in my face. I just looked great, well for me that is.
The real test would be if my husband could tell the difference. Dr. Lalloo did explain that while the fillers are instant the botox/toxin can take up to two weeks to really settle in with results lasting up to five to six months. Usually first time botoxer’s can see the results last up to four months but would need a top up after that. As it was my second time getting it the results should last slightly longer.
I left the clinic feeling grateful. Grateful for the opportunity to have this treatment done, grateful to Dr. Lalloo for putting me at ease while still being reassuringly professional and grateful that all went well.
I couldn’t wait to get home and show off my face. Would anyone notice? I was hoping that they did, as in they thought I looked well, not as in, omg do you get your face done? A week on and thankfully its been the latter. Everyone has commented on how fresh I look, asking whether I’d had my hair done or changed my makeup. While some knew I’d had this done others didn’t and it was their comments that I was really interested in.
Would I recommend it? A big yes. I had drinks with a girlfriend the other night who didn’t know I’d had it done who said I was looking well. I excitedly told her what I’d had done, I think I may have sowed a little botox seed in her head.
While I would definitely recommend having this procedure done to anyone who has thought about it but just hasn’t made up their mind, I think it’s important to point out that you should really do your homework. Make sure you research the different types of toxins out there. Only go to a registered doctor. The toxin used is powerful and should only be administered by a trained professional. Know that not every doctor is going to yield the same result. Look for someone who has a strong aesthetic history, who understands the intricate dimensions of the face and the effects of beauty on the face. Ask people who’ve had it done are they happy with their results. And run a mile when you see salons offering too good to be true knock down prices on botox. It’s just that, too good to be true. Quality should be at the forefront of your mind when having any chemical inserted into your body.
I had the Dysport toxin inserted into three areas of my face. My forehead, my 11 lines and my laughter lines ,the cost of this was €425.00 with the cheek filler costing €350. Not cheap I know but Dr. Lalloo did not charge me extra for his time and so offered me the toxin and filler at a reduced rate of €650.00. This price I know is defiantly not the cheapest on the market but as I said before spend your money wisely. I knew I was in the best of hands with Dr. Lalloo, I’d done my homework and was more than happy to have him carry out the procedures knowing that the quality of the product he used was the best on the market. His knowledge and precision can also not be measured monetarily.
I am now happy with the face that looks back at me in the mirror. Don’t get me wrong I wasn’t unhappy before just a little weary of the forever tired face staring back. I’m glad I did something about it and hopefully this helps anyone who may be thinking of getting it done themselves.
Posted by Kellie B Beautiful at 08:37
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WEEK 1 – ASK THE DOCTOR

Question: 

“I am just gone 30 and have started to notice some small changes in my face and body recently. I am getting some skin colour bumps on my eye lids (one on each inner eyelid so far) and am not sure why. Should I exfoliate more or will these just continue to form? I know it’s a silly question but I want to prevent more as much as possible.

I also have an extremely red face when I wash it and even when I come out of he shower. Should I use cooling lotions after I shower or wash my face? I have a pale complexion so you can see my red veins under my skin unfortunately but the redness and sometimes slight irritation is getting worse. I am using Lancôme pearl face wash and Olay moisturiser. I have just recently started to use Nivea night cream on my face which I feel is helping.

One more problem I have had for years now is irritated red skin on my upper arms on the outside after I shower. I’ve started using shower cream for sensitive skin but that doesn’t seem to help. Any suggestions?”

so 2

Dr Mukesh:

Dear reader, thanks for your list of questions, I hope I can answer them for you in a way that makes sense but is not too boring.

With regard to the first part of your question, you have a condition of your eyelid skin called Primary Milia. Usually they are found around the eyelids and cheeks. They are caused by the formation of tiny white cysts in small areas under the surface of the skin, usually the eyelids or cheeks.  Typically any product that is greasy can block one of your pores and lead to Milia. Avoiding these products and using and regular good cleansing may be preventative.

There is no cream or way to remove them. These tiny cysts have a thin almost translucent skin covering which is usually opened, de-roofed, with the tip of a needle allowing the contents to be removed. A simple and often painless doctor’s office procedure.

Below is a picture of one under the microscope that I removed today in fact from a young woman in her late twenties.

dermosc0731

You also say that you can see red veins under the skin but the redness and sometimes slight irritation is getting worse. I could be wrong, but to my mind, it sounds like you are suffering from Rosacea. Rosacea is an allergic condition of the skin on the face and nose.

It is found in people who have a very low grade allergy to a mite that we all carry on our skin called the Demodex mite. This little guy is the cause of misery for thousands of Celtic men and women in particular and the chronic low grade allergic reaction causes dry sensitive skin, which can produce some spots, even though it is dry and eventually the low grade chronic allergy shows itself in the second and third decades as increasingly sensitive skin with the appearance of superficial capillaries that lead to increased redness.

The condition can be controlled by reducing the numbers of the mites with topical antibiotics, but not cured. Laser treatments help too, but only if they are done the right way.

They can help kill the mites and so reduce the allergy in the skin and I usually find I can clear the red veins in one to two treatments. I also give six months of a particular antibiotic cream and tell people not to keep swapping creams in the hope of finding a cure, just stick to a range that suits you and that you can tolerate, nothing you can DO will cure it I am afraid.

Under the microscope the skin can look like this:
dermosc0163With regard to the third part of your question (‘One more problem I have had for years now is irritated red skin on my upper arms on the outside after I shower. I’ve started using shower cream for sensitive skin but that doesn’t seem to help’)

I have no doubt that what you have is called Keratosis Pilaris.

There’s no cure for Keratosis Pilaris, but you may be able to improve the rash by using soap-free cleansers, moisturising and gently exfoliating (removing dead skin cells from the surface of the skin). Urea based creams help along with cool showers.

There’s no real need to see your GP unless the condition is causing you concern. It usually improves as you get older and sometimes disappears completely in late adulthood.

Keratosis Pilaris most commonly affects the back of the upper arms, and sometimes the buttocks and front of the thighs.

The patches of affected skin will be covered in tiny spiky bumps, which may be white, red or skin-coloured. This spotting looks like “chicken skin” or permanent goose pimples, and the skin feels rough, like sandpaper. In some people, the skin itches and there may be pinkness around the bumps.

Keratosis Pilaris isn’t contagious. The skin tends to improve in summer and get worse during winter months or dry conditions.

Keratosis-pilaris_342x198_ARCWJA

It is is very common, affecting up to one in three people in Ireland and the UK. It can affect people of all ages, but it’s particularly common in children and adolescents, females, people with eczema or a condition called ichthyosis (thick, dry scaly skin), people of Celtic origin

The condition typically starts during childhood, and gets worse in adolescence, around puberty.

Keratosis Pilaris sometimes improves after puberty, and may even disappear in later adulthood, although many adults still have the condition in their 40s and 50s. It’s uncommon in elderly people.

Keratosis Pilaris runs in families and is inherited from your parents. If one parent has the condition, there’s a one in two chance that any children they have will also inherit it.

Keratosis Pilaris occurs when too much keratin builds up in the skin’s hair follicles. Keratin is a protein found in the tough outer layer of skin, which causes the surface of the skin to thicken (hence the name “Keratosis”). The excess keratin blocks the hair follicles with plugs of hard, rough skin. The tiny plugs widen the pores, giving the skin a spotty appearance.

It’s often associated with other dry skin conditions. There’s little that can be done to treat keratosis pilaris, and it often gets better on its own without treatment.

However, if it’s bothering you, the following measures may help improve your rash:

Use non-soap cleansers rather than soap – ordinary soap may dry your skin out and make the condition worse.

Moisturise your skin when it’s dry –your GP or pharmacist can recommend a suitable cream. However, moisturisers and emollients only reduce the dryness of your skin and won’t cure the rash. Creams containing salicylic acid, lactic acid or urea are thought to be the most effective.

Gently rub the skin with an exfoliating foam pad or pumice stone to exfoliate the rough skin – be careful not to scrub too hard and rub off layers of skin.

Take lukewarm showers rather than hot baths.

I hope this helps.

Dr. Mukesh Lalloo FRCS(Ed) MICGP

Please note that Dr Lalloo’s opinions are based on the information given to him. You should always consult your GP if you have concerns. This does not constitute a doctor patient relationship. MCRN No 019510

To submit a question to Dr Mukesh in the strictest confidence, please email info@sosueme.ie and include ‘Ask The Doctor’ in the subject line.

About Dr Lalloo:

dr lalloo

Dr Lalloo is qualified from the Royal College of Surgeons in Dublin, and has a fellowship in surgery from the Royal College of Surgeons Edinburgh. He is a fully qualified GP with an interest in skin surgery and dermatology. His registered qualifications with the Irish Medical Council are MBBCh, FRCS Edinburgh, MICGP. Dr Lalloo is on the specialist register with the Irish Medical Council.

Dr. Lalloo is a recognised expert in medical aesthetics having established Cosmedics Clinic in 2002 when medical aesthetics was in its infancy in Ireland. He is a member of the British College of Aesthetic Medicine and on the committee of the Primary Care Surgical Association.

– Read more at So Sue Me

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NEW! ASK THE DOCTOR

From next week onwards we will be starting a new Q&A series called, ‘Ask The Doctor in association with Suzanne Jackson, one of Ireland’s leading fashion & beauty bloggers.Whatever your question relates to, whether it be anxiety, sun damage, treatments, etc. you can email it in confidence to info@sosueme.ie making sure to include ‘Ask The Doctor’ in the subject line, and each week, Dr Mukesh will select one to answer on SoSueMe.
Your name will not be featured on the blog so please don’t worry about anonymity.

so 2

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Lifestyle and Youthful Looks

D.A. Gunn; J.L. Dick; D. van Heemst; C.E.M. Griffiths; C.C. Tomlin; P.G. Murray; T.W. Griffiths; S. Ogden; A.E. Mayes; R.G.J. Westendorp; P.E. Slagboom; A.J.M. de Craen

The British Journal of Dermatology. 2015;172(5):1338-1345.

Abstract and Introduction

Abstract

Background Lifestyle has been proven to have a dramatic effect on the risk of age-related diseases. The association of lifestyle and facial ageing has been less well studied.

Objectives To identify lifestyle factors that associate with perceived facial age in white north European men and women.

Methods Lifestyle, facial wrinkling and perceived facial age were studied in two cross-sectional studies consisting of 318 Dutch men and 329 women aged 45–75 years who were part of the Leiden Longevity Study, and 162 English women aged 45–75 years who were nonsmokers.

Results In Dutch men, smoking, having skin that went red in the sun, being outside in the sun most of the summer, sunbed use, wearing false teeth and not flossing teeth were all significantly associated (P < 0·05) with a total 9·3-year higher perceived facial age in a multivariate model adjusting for chronological age. In Dutch women, smoking, sunbathing, sunbed use, few remaining teeth and a low body mass index (BMI) were associated with a total 10·9-year higher perceived facial age. In English women, cleaning teeth only once a day, wearing false teeth, irregular skin moisturization and having skin that went red in the sun were associated with a total 9·1-year higher perceived facial age. Smoking and sunbed use were associated more strongly with wrinkling in women than in men. BMI, sun exposure and skincare were associated predominantly with perceived facial age via wrinkling, whereas oral care was associated via other facial features.

Conclusions Although associative in nature, these results support the notion that lifestyle factors can have long-term beneficial effects on youthful looks.

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