FAQ - Romrawin Skin Body Rejuvenation Clinic

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Romrawin IN TOUCH
Vol. 1 Jan - Mar 2008
"Best BODY"
*Only Thai version available

FAQ: Frequently Asked Questions

For some of your questions, we may have answers for you here.

Read Dr.Thanisorn's ariticles published
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Section: Lifestyle> Beauty



	Will putting toothpaste on acne help clear it up?
	Using toothpaste will dry and irritate the skin. There are many more effective products available to improve your acne. Invest in a gentle cleanser (soap-free and pH-balanced). Avoid cleansers with emollient if you have oily skin.


	I am breaking out in spots and have a special event in a few days - what do I do?
	First, do not pick or squeeze or otherwise manipulate your acne! Next, visit a dermatologist. Here are some of the things he or she can do to assist. - Injections : The dermatologist can provide anti-inflammatory injections that will flatten out the acne with almost immediate results. - Laser treatment : Over the past few years, there have been several reports of success in treating acne using lasers - either alone or in conjunction with phototherapy. Improvement is usually obvious within one or two days.


	How do you choose the right sunscreen to stay sun-safe this summer?
	There are some important decisions to be made. First, you need different sunscreens for different activities. For everyday use, you might use a hydrating chemical sunscreen. For the beach, you should look for a water-resistant formula. Keep in mind that the chemical sunscreen helps absorb the sun's rays, while the latter totally blocks the rays. Second, different skin types call for different types of sunscreen. Make sure your sunscreen is hypoallergenic if you have sensitive skin, but use oil-free if you have acne-prone skin. Third, choose a sunscreen that has an SPF of 15 or more with broad-spectrum protection, which means that sunscreen contains benzophenones, titanium dioxide, zinc oxide or avobenzone. This will protect you from both ultraviolet A and ultraviolet B light. Regardless of skin type, activity and SPF rating, the main factor is how often you use the product. Whether cream, lotion, gel or wax stick, you should select a sunscreen you're comfortable with, so that you can use it regularly.


	Is it true that sunscreens take 20 minutes to start working?
	The sunscreen works right away, but it's better to apply it 20 to 30 minutes before you step outside to give the active ingredients time to be absorbed into your skin or dry.


	What else can I do to beat the sun?
	I actually put sunscreen at the bottom of the list. The other smart things to do include looking for a clump of trees so that you get maximum shade, and covering up with a hat, wrap-around sunglasses, long pants and a long-sleeved shirt. Then comes the sunscreen. If you followed my other advice, you probably only need a little sunscreen on your face!


	Hi. I'm going out to the beach during the holidays. Is there a safe way I can get a suntan?
	No. The only known safe way to tan is with self-tanners - creams or lotions that you can apply to the skin to give it a golden glow without any of the damage from sun exposure. Tanning occurs when the sun's ultraviolet rays penetrate the skin's outer layer, which causes the skin to produce more melanin (the brown colour in skin) as a response to injury. Though tanning booths will often say that they offer safe tanning, you should be wary of such claims. Self-tanning creams, however, are safe. They work by staining only the outer dead layer of skin cells, leaving the living tissue beneath unharmed.


	How can I reduce large pores on my face?
	Pores are the passageways for oil to be released. They are barely visible on normal and drier skin, but people with oily skin tend to have larger, more noticeable pores. There are a few treatments you can try to minimise their appearance. Microdermabrasion is ideal. It removes the dead skin cells that clog the pores. The treatment, done at skin clinics, can stimulate collagen production, which is essential for healthy-looking skin. Double Matrix is another non-ablative laser treatment that's effective in treating enlarged pores. It also treats wrinkles, and the best thing is that it stimulates long-term collagen and rebuilds elastin.


	Can you tell us a little about Thermage and how it works?
	Thermage tightens and contours the skin, improves skin texture and minimises pore size. The Thermage procedure offers dermatologists and patients a non-invasive facelift and body contouring option without the downtime and recovery period associated with invasive cosmetic procedures such as conventional face-lift surgery and liposuction. All the Thermage procedures use a unique radio-frequency technology for controlled heating of tissue that is backed by years of clinical research. The device was cleared by the FDA in 2002. Thermage's deep-heating, produced by radio waves, contracts patients' existing collagen and stimulates new collagen growth. The end result is tighter and firmer skin. Patients benefit from a single treatment and results can be subtle to dramatic depending on the individual patient. Unlike lasers, Thermage works on all skin types and tones. Its immediate results are visible and continue to improve for up to six months.


	Is it better to use a conditioning shampoo or a separate shampoo and conditioner?
	This is an excellent question because facing the plethora of haircare products on the market can be bewildering. The answer depends on your hair type. If you have curly and relaxed hair, both a conditioning shampoo and a separate conditioner should be used because the hair requires concentrated conditioning to reduce friction between the hair shafts. But if you have straight and fine hair, the use of a conditioning shampoo and a conditioner will leave the hair limp and difficult to style. As a general rule, the curlier the hair, the more conditioning required; the straighter the hair, the less conditioning.


	Hi, I'm 54 years old and have puffy eye bags. What can I do about them? I don't want to undergo surgery.
	Treating eye bags and reducing the puffiness with medical devices such as Thermage and ReFirme may help. Thermage is today's effective "lift" treatment for all sagging areas - under eyes, face, legs, thighs - even buttocks. In the eye area, results can be dramatic as it will reduce "hooding", improve texture and tone, and smooth and soften fine lines. Thermage is a safe, effective and unique radio frequency technology for eyelid rejuvenation. The other device, the ReFirme Skin Tightening Procedure, is also proving to be a popular alternative for patients with skin laxity. It combines bi-polar radio frequency with diode lasers. ReFirme is a non-invasive treatment with FDA approval for painless skin tightening via wrinkle treatment.


	What sort of treatments work best for slimming?
	There are a number of non – invasive treatments for slimming, many of which can bring very dramatic results over time without going under the knife. For example, SmartLipo Laser, Mesotherapy which is the popular injectable treatment, Thermage which uses radio frequency to tighten and sculpt skin tissue, making it a recommended treatment for both Body Shaping and skin smoothing. Last but not least is Vaser or LipoSelection which uses ultrasonic vibrations to break down fat deposits. I’d say, recently, combining Vaser technology with Thermage allows us to remove fat and tighten the skin efficiently in very little time, and either Vaser or Thermage is typically performed in a single session. However, every individual patient represent a unique circumstance, and every physician has his or her own opinions and methods for helping patients reach their goals. There is no fixed recipe, it might take a single treatment or a combination of different approaches to get the job done as well as to satisfy the patients.


	Are many people looking for non – invasive treatments now instead of surgery? What do you offer here?
	Yes, we’re seeing that non – invasive type treatments that offer patients less downtime are increasing in popularity. The goal is to have a nice, natural – looking outcome – you don’t want to look like you’ve had surgery. The trend toward non – invasive cosmetic procedures has allowed more patients to get the look they want without having to turn their busy lifestyles upside down. We offer general dermatology services as well as laser and other advanced technologies for treating wrinkles, laxity, acne, acne scars, blood vessels, skin discoloration, hair removal, cellulite reduction, body contouring and so on.


	What are the most popular treatments for face today?
	The most popular treatments performed on both male and female patients are Botox, followed by Thermage, fillers and Fraxel.


	I've heard that the most recent non-ablative technology is the Body Shaping by Thermage. Can you tell me more about this and explain the term "non-ablative" device?
	A non-ablative device is one that does not break or cause visible damage to the skin. That means there's no downtime. There are non-ablative devices used for skin tightening and body contouring such as Thermage. The Thermage procedure uses patented radio-frequency technology to create a precisely controlled zone of heating in the lower part of skin and the underlying tissue. At the same time, the outer part of skin is protected with continual cooling. The latest advance in Thermage technology is the Thermage Deep Contour tip, which is specifically designed for body sculpting. The new tip delivers a tightening effect more deeply into the thicker dermal layer of the body skin, not only tightening and remodelling collagen, but also eliminating unwanted superficial fat. The results are: - Tightening and lifting of knees and buttocks; - Circumferential reductions around the waistline, thighs, hips and arms; - Flatter and smoother skin on the tummy and legs. The benefits of the Body Shaping by Thermage procedure are that it is relatively quick, with treatment duration of approximately one to two hours. There is no downtime and no scarring. Changes can be seen immediately, and progressive improvements are seen up to six months following treatment. However, the results are less than those seen with surgical intervention.


	My legs look great, but because I have a significant bulge on the inside of each knee, I don't wear skirts. Is there anyway of treating this?
	A perfect solution to your problem is Thermage Deep Contouring. The new Thermage tip is designed to deep contour abdomens, arms, thighs, buttocks and knees. In your case, it will get rid of the bulges, tighten and firm the texture of your knee skin in a single treatment without surgery, injections or downtime. Results are seen immediately with even more improvement in six months. And they can last up to one year. With the Thermage treatment, you'll be comfortable and confident and ready to show off your great legs.


	How should I treat a sunburn?
	First-degree burns are red and will usually heal (after some peeling) within a few days. The pain can be treated with cool baths. Applying a non-irritating moisturiser may make you more comfortable. Aspirin or Ibuprofen taken early in the development of a sunburn may help to speed recovery, as a result of these medications anti-inflammatory properties. Second-degree sunburns should be considered a medical emergency if a large area is affected. If a sunburn is severe, it may be accompanied by headaches, chills or fever, and medical attention should be sought right away. Be sure to protect your skin from the sun while it heals, as repeated burns are associated with a greater risk of skin cancer.


	Hi. I'm going out to the beach during the holidays. Is there a safe way I can get a suntan?
	No. The only known safe way to tan is with self-tanners - creams or lotions that you can apply to the skin to give it a golden glow without any of the damage from sun exposure. Tanning occurs when the sun's ultraviolet rays penetrate the skin's outer layer, which causes the skin to produce more melanin (the brown colour in skin) as a response to injury. Though tanning booths will often say that they offer safe tanning, you should be wary of such claims. Self-tanning creams, however, are safe. They work by staining only the outer dead layer of skin cells, leaving the living tissue beneath unharmed.


	What is the best way to protect against skin cancer?
	Sun protection in the form of broad-spectrum sunscreens, wearing a broad-brimmed hat and clothes, using a parasol and staying out of the sun at certain times of the day are all factors that will help protect against skin cancer. Try to avoid long periods of time in the sun, and avoid exposing your skin as much as possible between the hours of 10am and 4pm. If you have to go to the pool or the beach, wear a waterproof or sweat-proof sunscreen with an SPF of 30 or higher and reapply it every two hours. It's safer if you swim early in the morning or late in the afternoon and carefully limit your time in the midday sun, when rays are strongest and most capable of causing sunburn and damage.


	hello, i wanted to get a consultation for a possible smartlipo procedure done on my stomach and thighs. I was wondering the estimate cost of these multiple procedures,and how far in advance you had to book an appointment. Thank you for your time, i look forward to hearing from you.
	SmartLipo or laser liposuction is an innovate technique for minimal invasive liposculpture treatment in a less traumatic manner compared to traditional techniques. No surgery is involved because laser energy liquefies fat rather than suctioning. Thus, the recovery times of SmartLipo / Laserlipolysis are much faster. Patients can resume work after two days, while it is advisable to avoid vigorous activity for 1 – 2 weeks. The cost of SmartLipo Abdomen + Waist 65,000 Baht Abdomen 45,000 Baht Thighs ( outer side ) 45,000 Baht Thighs ( inner side ) 35,000 Baht If you would like to make an appointment please call 0-2625-6886 Time : 8.00 AM - 6.00 PM everyday PS. Please make an appointment one more week


	I have read your article about new treatment for people whose have too much sweat. I would like to know more advise from you before I make decision. I think you know very well about "Hyperhydrosis" which the nerve too sensitive and make me more sweating than others this really annoyed me because I work with an internation firm and have to meet many people , shake hand is unavoidable. i am very nervous and feel uncomfortable when they want to shake hand with me.
	Thank you very much for your intrested about our clinic and if you want to consult you can come to visit us and don't worry about the price. Because docter will dicision case by case. And if you want more about our discribtion you can search web site "www.romrawin.com" or you can contact Call Center 02-6557511-3


	I'm in my late 30s. Recently my skin has become very dry, especially on my hands and legs. I drink a lot of water and eat healthily, but signs of ageing and spots are emerging. Is there anything I can do to promote good skin and delay ageing?
	Your problem is dry skin and sunspots. For dry skin, a care regime including a good moisturiser, emollient and gentle soap or mild cleanser is helpful. Warning: hot showers strip natural oils from your skin. You should spend no more than 10 minutes in the shower and keep the water temperature below 32 degrees Celsius. Pre-menopausal and menopausal women can have dry skin. This usually starts for most women in their 40s, but can also begin for some in their 30s. Generally, for anti-ageing I would recommend a healthy diet including antioxidants, suitable exercise, a suitable skin-care regime based on skin type and, of course, sun protection. This can be supplemented by a proper aesthetic treatment, such as mesotherapy, botulinum toxin (botox) injections or rejuvenation lasering.


	I heard about Matrix technology from Ellen Barkin on a "Face to Face" feature. It said crow's feet could be diminished by a little botox, in conjunction with Matrix lasering. Can you tell me more about this?
	Matrix is a new technology for the treatment of wrinkles, acne scars, pores, promoting skin tightening and better texture. A combination of fractional diode laser and bipolar radio frequency delivers focused energy with deep penetration into the skin. This creates multiple micro thermal bands of heat, while leaving the outer skin and surrounding tissues intact. The surrounding tissue works to promote quicker healing, which means no patient downtime. The advantage of Matrix technology in creating deep dermal heating is that it causes both collagen shrinkage and the stimulation of new collagen. Both are significant and efficient factors in wrinkle reduction, skin tightening and improvement in tone and texture. Matrix is very effective for wrinkles around the eyes, nose and acne scars, and even superficial blood vessels on the face.


	My wife is interested in your treatments. We have visited your clinic in Patong and would like to take some treatments. My wife is interest in: 1. Remove dark brown spots in her hands 2. Loss weight (please explain about your SlimFast treatrment) 3. She wants to eliminate fat zones on her lower back and the contour of her waist and legs. I read about two treatments that could do it: Thermafirm and Carboxy therapy. Give me further details about them. As I'm out of Phuket now, please send me your comments and treatment prices as soon as possible to this email so that we could make an appointment at your branch in Patong beach. My wife is there in Patong and we would like to start with the treatments whenever possible.
	How is carboxytherapy performed? It is non surgical method. Carbon dioxide (co2) is infiltrated into the subcutaneous tissue through a tiny needle (0.3mm in diameter). From the injection point, the carbon dioxide diffuses easily into adjacent tissues. How does the carbon dioxide work? Carboxytherapy works in two complimentary ways. Firstly, and quite simply carbon dioxide mechanically kills fat cells. Secondly, it also has a strong vasodilatory effect (causes dilation of blood vessels) on the capillaries in the area. Wider vessels mean bigger and stronger blood flow to the area, which means more oxygen. The increase in oxygen is important because it eliminates the built up fluid from between the cells. The end result is fewer fat cells and firmer subcutaneous tissue. Is it painful? No. Some patients can experience a light tingling sensation near the injection site, It disappears within a matter of seconds. As a result of the increased circulation, the area surrounding the injection site may feel warmer for 10 to 20 minutes. There are no restrictions on any activities after the treatment. You can go right back to what you were doing as soon as you step out from our clinic. It depends on the quantity of your cellulite and sagging of your skin. Usually, you should be carried out twice a week. Between 5-10 sessions are necessary and each session lasts between 10-15 minutes. Around the 3-5 sessions mark, you will appreciate that your subcutaneous tissue is firmer. Before the treatment program ends . Romrawin Clinic is pleased to introduce the breakthrough body contour treatment ThermaFirm, which combines detoxification with massage. ThermaFirm is a non–invasive treatment delivers an RF current (0.45 – 0.6 MHz.) into areas with excessive fat, creating an internal thermal increase. This procedure, also known as Hyperthermia , activates blood flow, increases metabolism to liquefy and disperse fat as well as cellulite, thus, in effect, also acting to detox the body. Hyperthermia has been well known since the 19th century, as an inflammatory therapy. Now, though, it has been adopted as an effective cosmetic procedure that can successfully treat cellulite and contour bodies. One of the best features of ThermaFirm is that it is virtually painless. The application is pleasant and relaxing. Its Capacitive Electric Transfer function – CET – using insulated electrodes creates an initial drainage and its Resistive Electric Transfer function – RET – using stainless steel electrodes completes the treatment, leaving you feeling like you have just undergone a relaxing body massage. How many sessions are necessary? Results can be seen after the first session. But an effective treatment program to eliminate cellulite should consist of between 10 to15 sessions. Therefore , ThermaFirm is the ideal device for clients who have cellulite and fat deposits and need a quick fix because the treatment is safe and can be administered daily. Romrawin Clinic Visit any of our 15 current clinics and take advantage of our renowned breakthrough beauty treatments. Good news for our members living in Phuket, Romrawin Clinic just opened the new branch in Phutket at Jung Ceylon Shopping Center, on Patong beach, in Phuket provice (on ground floor - near the Carrefour entrance ) The clinic opens 10.00 AM - 8.00 PM everyday. Please come to visit us or call 076-600-148-9 .


	I would like to find some information on your procedures. 1)How often can dermaroller be done? 2)Can dermaroller be done at the same time as subcision? 3)What are the prices for a)dermaroller b)subcision? 4)Do you anesthetic cream before you do the dermaroller? 5)What is the downtime of the dermaroller? 6)Will a dermatolgist be performing the procedure?
	1)How often can dermaroller be done? -Derma Roller only sets penetration Channels into the epidermis. It can be used repeatedly for several hundred times. If necessary it can be use daily without any harm to the skin. 2)Can dermaroller be done at the same time as subcision? -Yes 3)What are the prices for a)dermaroller b)subcision? The price of derma roller treatment 10,000 bath per time and Course Derma roller 30,000 bath per 5 times. I have to say sorry about subcision because we do only Derma Roller treatment. 4)Do you anesthetic cream before you do the dermaroller? Yes, I do Pre-treatment approximate apply numming (Anesthesia) medication 45-60 minutes before Derma roller treatment. 5)What is the downtime of the dermaroller? Should not be used on pustular acne lesions active herpes outbreak or only other active infection or inflammation of skin. May feel a slight pinching or burning sensation when treatment performed shortly after the commencement of the treatment the skin will more or less start to get red. This redness, depending on the type of skin, wills quickly disappear after 2-3 days. 6)Will a dermatolgist be performing the procedure? Yes, their will


	Hello, I wounder if you do lip enlargment with Restylane ? and how much it cost.
	If you want to do lip enlargment with Restylane.You would like to make an appointment for a consultation and possible treatment next time (anytime) The price of Restylane initial price 12,000 baht up.


	Kindly provide me with the cost of Thermage treatment and further details how ofter to do this treatment per course.
	Thermage procedure is the only non-invasive treatment that delivers tighten skin/wrinkle, renew facial contours and stimulate collagen. Pre-treatment approximately apply numming (Anesthesia) medication 45-60 minutes. Procedure approximately 20-90 minutes (Depend on treatment area ) Immediately following a Thermage procedure your skin. Should feel tighten, smooth. You will see maximum result 2-6 month after to do Thermage . You should do Thermage every 1-2 years. 1treatment only . The effect of the Thermage 1-2 years or longer based on the patient’s natural aging process. The cost depends on the area you are having treatment.Intuition price 90,000 bath up You would like to make on appointment for a consultation. (It free on charge for consultation) Visit any of our 15 current clinics and take advantage of our renowned breakthrough beauty treatments. Please come and visit us or call 0-2655-7511.


	I get lots of brown spots. Does that mean I'm likely to get skin cancer?
	"Brown spot" is used so loosely it's often unclear. There are three conditions that people tend to call brown spots. The first is freckles. Freckles are small flat brown spots on the face and other sun-exposed areas. They are most often seen in fair-skinned people, especially those with red hair, but they are an inherited characteristic that sometimes affects darker skin types as well. Freckles are more prominent in summer and fade considerably in winter as the cells which accumulate pigmentation are replaced by new ones. As people age, freckles generally become less noticeable. Apart from sun protection, you don't have to treat freckles. Nevertheless, many women want to. The second type is "age spots" or "liver spots". Liver spots are larger flat, brown or black spots arising on the face and hands in middle age. Dermatologists call these solar lentigo. They are caused by cumulative sun exposure and darker because they are filled with excess melanin pigment which is our skin's defensive against the sun. If the colour is patchy and diffuse, it could be "melasma". In addition to sun exposure, female hormones worsen melasma, especially during pregnancy (also called pregnancy mask) or when taking oral contraceptives. Unlike freckles, liver spots and melasma are frequently seen in Asian people or those with dark skin and they tend to persist for long periods and don't disappear as a person ages. The good news is that liver spots and melasma are harmless and can be lightened or minimised. Thirdly, if the brown marks are scaly, they may be sun damage or solar keratose. However, if the lesion is thick, waxy and wart-like, it takes the name seborrheic keratosis. These brown marks can also be faded or removed by chemical peels or lasers. Continued careful sun protection is essential because the pigmentation is likely to recur. However, these pigment lesions will rarely become cancerous. If there is any doubt whether you have a cancerous brown mark - for example, if a lesion seems to be growing rapidly and has irregular pigmentation, or develops a sore - you should see a dermatologist for an examination.


	I have brown spots on my face. Can laser treatment remove them permanently?
	Liver spots or brown spots are caused by the sun. Either you haven't worn enough sunscreen, or you have sun-sensitive skin. A mild chemical peel can help to reduce their visibility. Bleaching creams may be effective in lightening some pigmentation on the face. Lasers can be used on liver spots, but the results are variable. But, neodymium-doped laser treatment does an excellent job. In most cases the spots can be totally removed and in others they can be effectively lightened and minimised so they are less noticeable. However, there is a chance of recurrence, especially if you are exposed to the sun. You can prevent them occurring with sunscreen. A sun-protection factor of between 15 and 30 is recommended if you work in an office and between 30 and 60 if you work outdoors.


	Changes in the weather make my skin dry, itchy and scaly. What can I do?
	The low humidity during winter can cause dry, irritated skin. When skin becomes dry and irritated, eczema (inflammation of the skin) can flare. Managing eczema involves keeping your skin comfortable and preventing it from getting irritated by avoiding triggers, as well as dealing with exacerbating conditions as they arise. Here are some tips to help skin feel more comfortable during cool season: Stay hydrated by drinking at least eight glasses of water a day. Use mild skincare products. The best choices are the ones that are formulated for sensitive skin and don't contain alcohol. Hot showers strip natural oils from your skin. You should spend no more than 10 minutes in the shower and keep the water temperature below 32 degrees Celsius. Wear sunscreen and use a petroleum or beeswax-based lip balm to protect your lips


	I have a skin problem that seems to get worse when the weather gets cool and dry. I'm 35 now, but ever since childhood I've suffered from dry skin around my nose, cheeks and all over my face. I have the same problem with my scalp. Help!
	This is a tough one to comment on without seeing you. It's possible you could have a type of facial eczema or seborrheic dermatitis or psoriasis, or a combination of those three. I really think you need to see a dermatologist for this one. He or she will be able to diagnose your particular problem and suggest a remedy. There is light treatment, such as the V-Beam Laser that helps calm hyperactive immune-system cells in the skin that can cause such conditions. V-Beam Laser is available in many skin clinics. In the meantime, you can use the over-the-counter Nizoral, Head & Shoulders or other dandruff-fighting shampoos that contain zinc. Make sure to use mild, non-irritating cleansers and moisturisers twice a day on your face until you get a chance to see a dermatologist.


	For four years now, my hair has been thinning. Strands fall out every time I use a comb. Can you suggest an effective treatment for hair loss?
	To confirm suspicions that your hair is falling out, you have to actually collect and count all of the hair that falls out in one 24-hour period. It's normal to lose 40 to 100 strands per day. More than that, and you are experiencing hair loss, or thinning. A number of things can contribute to hair loss, such as stress, thyroid diseases, pregnancy, infections and drug usage. You need to see a dermatologist, who may ask questions about your health and lifestyle to look for a specific cause. In your case, I'm not sure if you are male or female, the common cause of hair loss in males being male-pattern hair loss. This is genetic and - despite the name - can affect both men and women. The shedding of hair is caused by the hair follicles' sensitivity to DHT (dihydrotestosterone), a metabolite of testosterone. Follicles begin shrinking on exposure to DHT, the growth stage becoming shorter and the resting and shedding phases longer, until hair production stops completely. The end result is a very small, empty follicle which fails to grow a new hair. There are many hair-loss treatments for dermatologists and their patients to choose from. Some doctors prescribe medications which are taken orally together with topical cream or serum. My favourite therapy is the Dermal Injection Free procedure, which stimulates hair regrowth. The device uses safe pulses of electricity to help stimulate drug delivery into the scalp. The technique is pain-free and leaves no swelling or bruising. After the initial treatment series - two times a week for about a month - you can expect some of your hair to grow back. Then you might need once-a-week treatment for another three to four months. However, there are a lot of different regimens for hair-loss treatment, and it's important to find the one that fits your own case.


	What - besides Botox and surgery - can women do to reduce or get rid of wrinkles?
	Wrinkles predominately occur through the effects of the sun and facial expressions. Most people attribute an aged appearance to the passing of time, but if you compare the skin on your face to skin on other areas of your body, you'll see that there are fewer wrinkles elsewhere. Wrinkles appear mostly on the sun-exposed sites. When people lose muscle mass or weight, such as is commonly seen on people's bottoms with ageing, the skin will sag, but if you look closely, you'll see there are no wrinkles on the sagging skin.* * As the skin becomes less elastic from sun damage, the constant contracting of the muscle - each and every time you smile, frown or raise your eyebrows in surprise - creates lines in the skin. Botox, or Botulinum toxin, will help relax the muscles and smooth the wrinkles caused by facial expressions - crow's feet and frown lines - away. Other popular approaches to combating wrinkles are injectable collagen and hyaluronic acid. They work to plump up or reduce wrinkles, furrows and hollows in the face, especially the lines from your nose to your mouth, which are called nasolabial, and those from your mouth down to your chin, which are marionette lines. To improve wrinkles elsewhere on the face, there are also a number of laser treatments. Recently, fractional lasers have become extremely popular because there is ample data to demonstrate both their safety and efficacy in treating wrinkles. Among these, Fraxel is a laser, while Matrix is a hybrid. Both devices give the skin a smoother, firmer and more pleasing appearance. However, you should consult with your dermatologist about the best device or treatment. Last but not least, a sunscreen is a must. It makes no sense to treat wrinkles without preventing their further reoccurrence.


	What advice do you have for keeping children's skin healthy?
	There are many ways. Daily routines such as gentle cleansing and light moisturising are good, but the most important thing to remember is sun protection. Using sunscreens and wearing hats will help reduce skin problems the child might have in the future.


	How old should you be when starting Botox?
	This is very difficult to answer due to the fact that it's really a personal choice. If there are lines on your face, particularly horizontal forehead lines, frown lines and crow's feet, then you're a good candidate for Botox. If you want to have Botox injections, make 100-per-cent sure you're seeing a reputable and experienced professional.


	What is a Thermage Facelift, and what results can I expect from it?
	Thermage Facelift was developed to tighten skin without surgery. It uses radio waves to heat the tissue below the skin, while keeping the skin surface cool. This tightens your existing collagen and stimulates new collagen growth. The end result is tighter and firmer skin. However, results vary from patient to patient. While many patients have seen immediate improvement, some only notice changes after three, or perhaps even six, months. Generally though, there's a gradual improvement between two and six months after treatment. Results can last for years depending on your skin condition and ageing process. The treatment seems to work best with patients in their 30s through to their 60s, although patients of all ages and skin types have responded well. As of September, my staff and I have performed more than 2,000 Thermage treatments - we were recently granted the position of the leading practitioners of the treatment in Thailand.


	I never had acne as a teenager, so why am I now getting it as an adult?
	Usually, acne is an inflammatory disease that begins at puberty and is gone by the early 20s. For girls it's often associated with the menstrual cycle. In other cases, acne may not present itself at all until adulthood. Such acne is more likely to affect females than males. There are several reasons for this. Age, pregnancy or ovarian cysts change hormone patterns in women, affecting the sebaceous glands in the skin, which can result in acne. Some women get acne when they stop taking the Pill. Sometimes the type of cosmetic used can cause an outbreak. Whatever the cause, you should consider seeing a dermatologist, as scarring is possible if acne is improperly treated.


	I recently heard about hyaluronic acid. What's the difference between this and collagen?
	Both are filling agents for the treatment of the area around the mouth and nose. They are used to instantly plump up the skin and acne scars as well. Collagen is a natural protein providing structural support for human tissue. The collagen in human skin is very similar to that found in some animals. Collagen is derived from purified cow or sheep skin. Dermatologists will take two allergy tests before starting treatment. Collagen injections last for three months to six months. It wears off quicker in areas with a lot of movement, like the lips. Hyaluronic acid is a natural and basic component of human skin. In 2003, the Food and Drug Administration approved synthesised hyaluronan for filling soft-tissue defects. It is an alternative to collagen, doesn't require allergy tests and can last for four to eight months.


	The lines from my nose to the corners of my mouth are deep and now I'm starting to get them from the corners of my mouth down to my chin. What can I do?
	The lines from your nose to your mouth are called nasolabial folds and those from your mouth down to your chin are marionette lines. They are caused primarily by shifts in gravity as the different triangular areas around both sides of the mouth move in opposite directions. The lower third of the face from the nose down to the chin tends to fall not so much from gravity as from the supporting tissue getting thin. There are several ways to correct this. Filler substances such as collagen or hyaluronic acid are popular and injected to plump up the skin and "lines". Botox is an option for marionette lines. A small amount of Botox can sometimes lift up the corners of the mouth if that muscle is too strong.


	I've had acne for a few years and am frustrated. Sometimes I don't want to leave my room. Why isn't there a simple cure?
	Acne is never simple. It is caused by many factors, so it is important for you to work with a dermatologist. Acne can be controlled and cured with medical and laser treatments. Dermatologists can assess the severity of your problem and offer a personalised treatment. When a patient comes to my office, I evaluate the type of lesions and the therapy required. I allow one week for any therapy to show an improvement. So don't get frustrated and don't wait to start treatment. Untreated acne can get worse and leave scars.


	I have stretch marks on my hips and I'm desperate to get rid of them. Is there anything that works?
	Stretch marks usually appear after rapid weight change and are the result of damage to the deep skin rather than its upper layers. Creams and lotions are, therefore, unable to penetrate deep enough to heal the scars. A more rigorous approach is carboxy therapy, which uses pressurised CO2 to "punch" the damaged tissue and stimulate collagen growth alongside the scar lines, resulting in a fading of the stretch marks. Finally, if you're prepared to go the extra mile, Fraxel Laser is an option.


	Hi, I have severe cellulite all over my thighs. It's very noticeable and no amount of dieting or exercise affects it. Is there something that can be done? Liposuction isn't the best place to start, is it? yes
	Good question. Cellulite is actually small amounts of fat that have herniated just below the surface of the skin. A poor diet, fad dieting, sluggish metabolism, hormone fluctuations and even dehydration may play a role. No amount of weight reduction or dieting can eliminate it once you have it. It is rarely helped even by superficial liposuction. However, combined treatment by carboxy therapy and a medical device called the VelaSmooth - two new technologies - has proved to be effective in reducing cellulite. VelaSmooth combines infrared light and high-frequency radio waves with vacuum-rolling massage to help break up the fat. The result is a smoother and tighter skin surface. With carboxy therapy, the patient has carbon dioxide injected into their cellulite, which breaks up the little boxes of fat. The end result is fewer fat cells and firmer skin. Though CO2 might sound potentially toxic, there's no need to worry - the gas is a natural by-product of human metabolism, and gets transported through the bloodstream to be exhaled through the lungs. A course of six or more sessions of this combined treatment is necessary for good results. To prevent "come-back" cellulite after treatments: - Eat a healthy diet rich in fruits, vegetables and fibre. - Stay hydrated with plenty of fluids. - Exercise regularly to keep muscle toned and bones strong. - And remember, prevention is definitely better than cure!


	Hi. I'm a 30-year-old woman who's had acne scarring since I was a teenager. I'm interested in getting rid of this problem once and for all! I'm wondering what treatments or technologies are available that might help?
	Micro-needle Therapy System (MTS) and Fraxel Laser Therapy usually work very well on scarring like yours. MTS is also called Collagen Induction Therapy (CIT) or "skin rolling". It uses a roller embedded with dozens of thin needles that is rolled over the skin surface. The needles penetrate deeply enough to induce the skin to produce collagen, which fills the depressed scar. All the studies that have been done have shown MTS to be very effective in smoothing acne scarring. Fraxel (or Fractional) Laser Therapy works on the same fundamental principle as the skin rolling technique, except that it replaces needles with lasers. The Fraxel Laser produces thousands of tiny but deep columns of light energy that cause micro-thermal zones in the skin. This stimulates new collagen production to give you skin resurfacing results without damage. Use of the Fraxel Laser has already been approved by the US Food and Drug Administration to treat acne and surgical scars. You should see a big improvement through a combination of MTS and Fraxel Laser Therapy.


	When I use my new shower gel I get a rash. Am I allergic?
	Not necessarily: It may just be an irritation, the common response to super-scented products. Unless you've got red bumps or hives - red, itchy patches - assume that your skin is merely irritated. Stop using the product, and if the redness and itching don't disappear within a week, contact a dermatologist, who can determine whether you've got an allergy.


	I am thinking of using Botox around my eyes. Where can I find the cheapest botox injection?
	Perhaps you should ask where you can find the best and safest Botox injection. Botox is unquestionably the most effective treatment to smooth away deep wrinkle lines, including crow's feet. It also enhances the appearance of the eyes by widening them slightly and improving the arch of the eyebrow, if done by a skilled professional. But remember: The active ingredient is the toxin botulinum, which paralyses muscles. Due to increased demand for these treatments, there are many fakes on the market, some called Botox, others a derivative of Botox. They might be cheaper, but they haven't been approved by the Food and Drug Administration. I recommend getting the injections only from a board-certified dermatologist or plastic surgeon. We shouldn't put ourselves at risk, should we?


	I'm concerned about the dense, black and kind of hard hairs on my arms and legs. Can I have them removed with cosmetic surgery? I'm not fair-skinned.
	There is good news for you. Laser hair removal can reduce the number of hairs in any given area safely and effectively - if you go to a qualified nurse or dermatologist. The laser targets melanin, the pigment in the hair shafts, which absorbs the laser light right down to the hair bulb at the base of the follicle. The hair falls apart with the heat, and the replacement hairs grow in more slowly, with a smaller diameter. With repeated treatments, hair growth can be reduced or even stopped. Skin colour is no longer a major problem. I would suggest a Gentle Yag laser treatment, which uses long pulses. It can be applied to all hair and skin types without risk of burning. You should be very pleased with the results.


	I've gradually become redder and redder over the years, and it's really starting to bother me. Would lasers be helpful in removing the redness? And what type of lasers are used to treat redness?
	The appearance of redness might occur from a number of spider veins or broken blood vessels on the face and it can be treated by lasers. For that redness, a pulsed-dye laser at a 580-nanometer wavelength has shown to be an effective treatment for returning your face to its normal colour. If you're extremely red and have been so for many years, five to eight treatments might be needed. Be aware that facial redness is also a common symptom of rosacea. When it comes to having rosacea, only a dermatologist needs to know!


	Should I get my facial treatment in a salon or dermatologist's clinic?
	Many complicated multi-step facial procedures with fancy names are available at spas or salons these days. They make you feel good and care for. However, the results are minimal and temporary. A spa or salon will give you a very mild concentration of the active ingredient, which is more limited in terms of the effectiveness than what you would get from a dermatologist. This limitation is restricted by law. The spas and salons are not allowed to perform strong and effective treatments without a physician involved. They are also not allowed to purchase medical devices or the same-strength microdermabrasion machinery as dermatologists. You also should be aware of your risk of some type of irritation, infection, early scarring or pigmentation problem according to the treatments. The advantage of getting the treatments done in a doctor's office is that the doctor is capable of handling the complication that may arise.


	I'd like to know why my hair becomes limp when exposed to high humidity during rainy season.
	This occurs because your hair shafts have elements that can be deformed by water. These are the basis for curling immediately after shampooing. They're released from their current form when wet and reformed in that instant of time when the hair shaft goes from being wet to completely dry. The shafts will remain in the set position until wetted later. Many women with thinning hair use curls to give it more volume. Moisture releases the curl in a strand of hair, making it straight and "limp". Your hair itself has not changed in thickness or physical characteristics. You can use the new water-resistant hairsprays that can keep the hair curled despite moisture contact.


	I just moved to Thailand and have looked for a bleaching agent called hydroquinone to fade my brown spots. Why can't I buy it over the counter here?
	Hydroquinone is not approved by the Food and Drug Administration. There is no doubt that it is the most effective skin - lightening ingredient, but it's a somewhat controversial substance. It is actually toxic to melanocytes and has been shown to produce cancer in test animals when ingested orally. Hydroquinone is also a very potent oxidant that can cause damage to the skin, accounting for its high irritant potential. At this point, in Thailand, hydroquinone cannot be sold - or used by anyone except a doctor. It you have brown spots, I think it's always best to discuss treatment options with a dermatologist, rather than self - medicating.


	What is the proper order for the application of medications, cosmetics and skincare products?
	To optimise the functioning of the medication, you should always apply it directly to a freshly washed face. If the medication is placed on top of a sunscreen, it will not work, since the sunscreen will create a barrier to medication penetration. I suggest you apply products in this order: medication, moisturiser, sunscreen, facial foundation and, finally, powder.

Thanisorn Thamlikitkul MD, Dermatologist Certificate in Laser Surgery Member of American Society of Cosmetic Dermatology & Aesthetic Surgery info@romrawin.com