Hirsutism Diagnosis And Treatment — New Recommendations

Dr. Shazia Ali
New recommendations on hirsutism advice for testing for elevated androgen levels in all women with abnormal hirsutism scores as a routine. But if the hirsutism score is normal there is no need to perform testing for elevated androgen levels. Hyper-androgenaemic women should also be screened for non-classical congenital adrenal hyperplasia (NCCAH) due to 21-hydroxylase deficiency, by measuring early morning 17-hydroxyprogesterone levels in the follicular phase or on a random day for those with amenorrhoea or infrequent menses.

·      For most women with patient-important hirsutism despite cosmetic measures, the recommendation is to start with pharmacological therapy and add direct hair removal methods such as electrolysis and photoepilation.
·      For women with mild hirsutism and no evidence of an endocrine disorder, the advice is either direct hair removal methods or oral combined oestrogen-progestin contraceptives, adding an antiandrogen after six months if response is suboptimal.
·      For women at higher risk for venous thromboembolism, initial therapy should be an oral contraceptive containing the lowest effective dose of ethinylestradiol and low-risk progestin.

The society advises against using insulin-lowering drugs. For most women who choose hair removal therapy, laser/photoepilation is recommended.

The new guideline is published in the Journal of Clinical Endocrinology & Metabolism  (JCEM).


A New Era In Skin Regeneration Just Got Ushered

In a heroic and ground breaking effort to save a dying 7-year-old boy, scientists have been able to successfully replace about 80 percent of the child’s skin using stem cells and gene therapy.

This procedure’s success marks a new era in skin grafting. Using this combination therapy approach many rare genetic skin disorders can be treated in the future. The study published in Nature magazine, sheds light on how the skin replenishes itself; and the pertinent details of this first of a kind clinical experiment.

In 2015, a boy with a rare genetic skin condition, called junctional epidermolysis bullosa, had lost most of his skin and was close to death. Children with the condition have mutations in one of three genesLAMA3, LAMB3 or LAMC2. Those genes produce parts of the laminin 332 protein, which helps attach the top layer of skin (the epidermis) to deeper layer (dermis).

People with this condition are sometimes called “butterfly children” because their skin is as fragile as the insect’s wings. Even mild friction or bumps can cause severe blistering. The blistering can also affect mucus membranes inside the body, making breathing, swallowing and digesting food difficult. About 1 in every 20,000 babies in the United States is born with this condition (roughly 200 children each year). More than 40 percent die before adolescence.

With more than 80% of the child’s skin blistered he was being treated under the care of Dr. Tobias Hirsch, a plastic surgeon at Ruhr University Bochum in Germany. Looking at the severity of this child’s skin condition his team of doctors thought the boy would also perish. Surgeons in a burn unit tried giving the boy a skin graft from his father, but the child’s body rejected the transplant. They didn’t have any options left to treat the child. In desperate need of help, Dr. Hirsch’s team turned to stem cell researcher Michele De Luca of the University of Modena and Reggio Emilia in Italy. De Luca and colleagues are famous for their cutting edge research pioneering techniques correcting the same genetic defect. In clinical trials, De Luca’s team had had already grown small patches of gene-repaired skin for children with the same condition.

Together, those cases had replaced 0.06 square meters of tissues, about the size of a piece of paper. But the boy, who has a mutation in the LAMB3 gene, had lost nearly all the skin on his back and legs and had blistering in other areas. The researchers needed to replace about 0.85 square meters of skin — 14 times more.  
In September 2015, the team took a 4-square-centimeter patch of unblistered skin from the boy’s groin and grew skin stem cells in the lab from that sample. Then De Luca and colleagues used a retrovirus to insert a healthy copy of the LAMB3 gene into DNA in the lab-grown skin stem cells.
Those genetically corrected skin cells grew into sheets that surgeons grafted onto the boy’s body in two surgeries in October and November 2015. After one more surgery to replace small patches of skin, he was released from the hospital in February 2016. 

To save the life of this young boy who lost most of his skin (left, red), researchers took a small bit of his remaining skin (gray) and grew skin stem cells in the lab. Researchers then used a retrovirus to insert a healthy copy of the LAMB3 gene, needed to help keep skin layers attached, into the stem cells’ DNA. Several types of progenitor stem cells (purple, yellow) were present in the lab-grown skin cells, along with long-lived holoclones (pink). Sheets of lab-grown cells were transplanted to the boy. As the skin replenished itself, the holoclones gradually took over, suggesting a small number of stem cells are responsible for growing all the skin.

The kid is now back in school, playing soccer, and leading a healthy life. His new skin is fully functional. He still has some blistering in untreated areas, and his doctors are considering replacing more skin. Meanwhile, some of the corrected stem cells may be making their way into the boy’s untreated epidermis, and may eventually replace all of his skin. But researchers can’t take many samples of his skin to find out. “He’s a patient,” says De Luca. “He’s not a mouse.”

The case is a landmark in stem cell therapy, says stem cell researcher Elaine Fuchs of Rockefeller University in New York City. “It makes considerable headway in resolving a brewing controversy in the epidermal stem cell field” over exactly how the skin regenerates, she says.

One possibility is that a large number of stem cells populate the skin. Each stem cell can then either copy itself or morph into a variety of different types of mature skin cells. The other possibility is that only a small number of long-lived stem cells — known as holoclones — give rise to short-lived progenitor cells that are forerunners to mature skin cells.

Looking At the microscope images of the child’s skin before and after the genetically engineered skin grafts we see that in normal skin (left) the top layer, called the epidermis (purple in bottom images), is fused to the dermis by laminin 332 (green, in top images) and other proteins. When a 7-year-old boy was admitted to the hospital, he’d lost most of his skin (bottom middle, arrows show where the epidermis is peeling away from the dermis). Mutations in the LAMB3 gene prevented the boy from making laminin 332 protein (top middle, white dashed line indicates where the protein should be), which helps fuse skin layers together. Gene therapy (right panels show the boy’s skin 21 months after therapy) restored laminin 332 (top, green) and his skin stopped blistering (bottom).

When researchers inserted the LAMB3 gene, it landed in different places in each lab-grown stem cell. De Luca and colleagues used the different insertions like little bar codes to track the boy’s holoclones and other skin cells. At first, his skin was a patchwork of skin cells, with about 91 percent of progenitor cells having different insertions than the holoclones. After four months, only 37 percent of the progenitor cells were different from the holoclones. That indicates that most of the progenitor cells had died and were replaced by offspring of the long-lived holoclones. The data indicate that a small number of stem cells replenish the skin.

While progenitor cells live for just months, the researchers found, holoclones last a person’s lifetime. Those findings suggest that researchers need to be careful to nurture holoclones when growing skin in the lab, De Luca says.

This is a story of hope, accomplishment and scientific triumph over genetic skin diseases. The possibilities to take this work and apply it to newer indications look reassuringly bright. Being a dermatologist I feel especially inspired, as so many patients are going to reap benefits of this colossal medical break through.


40 Is The New 30 — Skincare & Beauty Regimen To Nurture Youth

How to take care of your skin in your 40's
Fourth decade of life is a crucial milestone, as round about this age most women feel that their youthful looks are beginning to fade. Skin looses the spring of youthfulness, complexion feels dull and the shape of the face starts to give in to the force of gravity. When you hit 40 it’s vital to reevaluate your beauty and skincare habits. During this fourth decade of life every youth conscious person’s skin ethos should be - preservation and rebuilding of youth. How does one go about doing just that? — Here’s a blue print to follow.

First Order of Business  — Lets Put That Spring OF Youth Back Into The Tired Old Skin
Skin stops making collagen and elastin after 25 year of age, by the time you turn 40 considerable amounts of these skin-plumping elements are depleted. As a results skin looks tired, saggy and lack luster. This is about time when you change your daily skincare routine and start to invest into youth building energy-based devises that can boost skin collagen and make you look youthful again. Furthermore volume loss in the fat layers and bone mass that has happened in the last 40 years of life has to be compensated also with professional anti-aging treatments that can instantly boost volume and deflating contours.

Skincare Look for daily skincare products loaded with Vitamin C, A, and fruit acids. These products will help exfoliate the dull skin and add luster and shin to the skin. They will also stir epidermis and dermis to help rebuilt fresh collagen to plump up the skin to youthful levels.

Cleansers: Pick up a cleanser that can gently exfoliate and compensate for the slowed down rate of cell renewal that happens naturally around mid thirties. As we age dead skin cells pileup on the top layer of skin and don’t slough off efficiently this contributes to dryness and dull tone and even accentuates existing spots and wrinkles. Look for products with fruit acids like lactic acid, salicylic acid or glycolic acid.
cleansers for 40 year old skin

Day Time Skincare: The moisture-trapping molecules in the dermis, like hyaluronic acid, start to diminish in the 40s. These waning humectants trigger dehydration, while also predisposing skin to volume loss by creating a collapsing or deflating reaction in the skin. To help plump and rehydrate, start replacing what’s been lost with a skin hydrating serum.

To repair and protect, look for a serum rich in antioxidants, like vitamin C or E, or epidermal growth factors to help stimulate collagen production. Most people around 40 are also particularly concerned about the fine lines and wrinkles that strain the eye area, using an eye cream containing the same ingredients can help with improving the skin quality. When out and about add a layer of a broad-spectrum UVA/UVB SPF 30 moisturizer.
Dermatologist recommended best skincare for 40 year olds

Night Time Skincare: Regular use of a prescription retinoid is like making a deposit in your beauty bank. Retinoids boost reserves of collagen and elastin, preventing future sagging. Not only are they antiaging, they also reduce acne, a bonus for women still suffering through breakouts in the form of adult acne.

Clinical Treatments: Research into aging has shown us over time that volume loss more than gravity lies at the heart of an aging face. Volume loss in skin as well as the other layers of the face (namely fat and bone) slowly leads to all signs of aging. With this volume loss we see wrinkles, expression lines and facial contours changes.

To plump up the skin and revive the youthful contours of face what are our best choices?
Energy based devices: Research has shown radiofrequency, ultrasound as well as different forms of lasers that can heat up the skin up to 42-45 degrees can boost collagen and elastin production. Judicious use for such devices can help turn back the hands of time in your favor. I am a big fan of such devices as they impart youth without changing the natural shape of the face.

Dermal fillers: Volume loss in the mid face, temples, as well as the dynamic areas of the face leads to deep grooves that run under the eye, around the smile lines and corner of the mouth. Replacing the lost volume with dermal filler injections can give instant and natural results.

Neurotoxin: Dynamic lines that appear because of the muscle movements exaggerate over time. Neurotoxins like Botox or Xeomin can help relax the over active muscles and make the face look more relaxed and refreshed with few strategic injections.

Antiaging medical solutions


Fact Or Fiction – Lets Bust Some Hairy Myths

Shaving myths busted by dr. Shazia Ali
I want to sport hairy limbs, said no well-groomed female ever. That being said, the biggest dilemma every female faces in the unwanted-hair-department is: what method of hair removal should I adopt? Nowadays we have a plethora of choices that cater to female body grooming that range from shaving, chemical depilation, waxing, threading, mechanical epilation, lasers and IPL assisted permanent hair reduction. Which one is the best? It’s not an easy question to answer. One simple answer is: it all depends on you, your lifestyle, your threshold of pain, and off course affordability.
To get clarity and expert opinion on the topic, Gillette Venus recently conducted a survey. Three hundred and fifty dermatologists across Saudi Arabia, U.A.E, Kuwait, Qatar, Bahrain and Oman were contacted to identify what in their opinion was the safest, most convenient and least painful method of female hair removal. And guess what? ---- Female Shaving ranked as the top-of-mind method for all ages.

This survey also honed on to the top aspects dermatologists and women consider while choosing their preferred method of hair removal. The top considerations that got highlighted while filtering available choices included: a chemical-free process, hygiene factors, the element of convenience and pain during hair removal.

The survey asked skincare experts to shed some light on the myths of shaving as a primary method of female hair removal. While answering the misconceptions and myths that surround the shaving concept, 70% of the dermatologists agreed that shaving exfoliates the skin, and does not cause faster or thicker hair growth. All dermatologists pinpointed the fact that hair traits are genetically inherited and shaving can’t change that.

As the hair grows naturally through the skin the tip of hair gets tapered off and thinned. When we shave the hair shaft thickness appears more because the tapering journey of hair as it happens from under the skin to the top is omitted. We perceive that the hair is thicker but in fact hair diameter remains exactly the same. Thicker means blunt when it comes to shaving.
Additionally the dermatologists were questioned about the side effects commonly reported with depilatory creams (chemical burns, allergic reactions, etc). Over 80% of the respondents cited that they preferred shaving because it is chemical free and hence safer than creams.

Shaving myths by Dr. Shazia Ali

Additionally the dermatologists were questioned about the side effects commonly reported with depilatory creams (chemical burns, allergic reactions, etc). Over 80% of the respondents cited that they preferred shaving because it is chemical free and hence safer than creams. 

The Scientific Truth
Taking this survey into account lets get you all the valid scientific information that dermatologist and skincare expert rely on to dispel the notorious myths pegged with shaving: Will shaving cause my hair to grow back thicker, darker & faster?

Scientists have actually conducted multiple studies over the years to test whether shaving affects hair growth, size, and texture, this research has been published in dermatology textbooks as well as scientific peer review journals. All these studies unanimously conclude that shaving has no effect on hair's color, texture or growth rate.

Fact #1 - Hair Color And Thickness
Shaving hair myths by Dr. Shazia Ali
Hair color, texture, length, and thickness are genetically determined. Apart from genetics hormonal changes, low level laser stimuli, and certain medications can have some affect on the hair morphology and they can alter the hair color, length, and thickness. Hair bleaches and chemical depilatory formulations can seep under the skin and irritate the hair root, hence over time change the hair texture or length. But shaving only cuts hair from the skin surface it has no effect on the hair roots, which lie deep under the skin, hence it can never change those traits.

Fact #2 - Hair Growth Rate
Shaving myths by Dr. Shazia Ali
Research has shown that hair grows quarter of an inch every month. Hormonal changes and certain medications can alter the hair growth rates, but shaving can’t do so. As shaving only clips hair from the skin surface and has no access to or affect on the hair roots which lie deep under the skin. Hence scientifically speaking shaving can have no effect on hair growth rate.

No matter which method of hair removal you adopt, it’s always important to know the science behind the procedure of your choice and the right way to go about it. Shaving done with a proper razor, under hygienic conditions is a great choice for any modern girl who doesn’t want to break her bank while achieving smooth limbs on the go.

- Bulliard H. Influence de la section et du rasage repete sur l'evolution du poil. Annales de Dermatologie et de Syphiligraphie. 1923; Series 6:386-91
- Seymour RJ. The effect of shaving upon the rate of hair growth. Am J Physiol. 1926; 78:93-8
- Raymond J. Myers, James B. Hamilton. Regeneration and rate of growth of hairs in man. Annals Of The New York Academy of Sciences, March 1951; Volume 53, P 562-568
- Trotter M. Hair growth and shaving. Anat Rec. 1928; 37:373-379
- Lynfield YL, Macwilliams P. Shaving and hair growth. J Invest Dermatol. 1970 Sep; 55(3):170-2.
- Peereboom-Wynia JD. Effect of various methods of depilation on density of hair growth in women with idiopathic hirsutism. Arch Dermatol Forsch. 1972; 243(3):164-76.
- Elise A. Olsen. Methods of hair removal, Journal of the American Academy of Dermatology, Volume 40, Issue 2, February 1999, Pages 143–155
- K. Cowley, K. Vanoosthuyze. Insights into shaving and its impact on skin, British Journal of Dermatology, March 2012. 166: 6–12.


Uncovering The Dark Secrets Behind Panda Eyes

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

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

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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


Looking At Beauty Through The Eyes Of A Dermatologist

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

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

Golden Proportions of beauty

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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