Sheet masks work on the basis of occlusion, meaning when there’s a topical which is applied on the skin and also in contact with something moist such as a sheet mask, there is increased absorption of the topicals by the skin. The question of efficacy is not so much of whether it is a traditional mask (presumably referring to clay masks or gels applied onto skin as it is) or sheet mask, but really depends on what is the active ingredient contained in the mask. With precise active ingredients, the type of mask (sheet or gel for instance) becomes secondary in terms of efficacy, as in my practice for example, whenever I want to increase absorption of any topical that is dispensed to patients, I would advise them to apply a wet cotton sheet (as a wet wrap) on to their face to increase absorption.
Are overnight masks more effective?
It is too much to generalise to say that overnight masks are more effective because it really depends on the active ingredients. All sleeping mask formulas are the same as moisturisers, as these are leave-in rather than wash-off ingredients. They work by absorbing onto the skin to produce moisturising effects. In leaving a topical on the skin for more than 12 hours for example, it would be important to first ascertain suitability of the ingredients, preservative and vehicle, including concentrations and types, and all of the components being intended to be applied on the skin for an extended period and not as a wash off.
It is really a good marketing invention, because this encourages people to apply the proper amount of moisturiser, which is a really liberal amount, overnight, as during the day they may not be as inclined to because of whitish cream residue that may be seen under makeup. If the active ingredients contain irritating substances such as lactic, salicylic, glycol acids or retinols, one could actually develop skin irritation or skin allergies from masking over an extended period. Most topicals would be fully absorbed into the skin within a couple of hours, so it’s not necessary to leave something on overnight. It is more important to consider that a liberal amount of a good moisturiser is used during sleep, as that is when the skin repairs itself.
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Is it necessary to mask the skin? What are the benefits of masking?
I would consider masking as something which is very good to do if you are already diligent with other aspects of skin health such as cleansing and applying cosmeceuticals. Using a face mask would deliver moisture to the skin and include ingredients (wash-off) which cannot be incorporated into leave-on moisturisers. The benefits of masking is largely associated with increasing skin moisture, so it is important to look out for ingredients such as glycerin, ceramide and hyaluronic acid, as well as potent antioxidants which can be plant derived.
Can you overdo masking? If yes, how do you know if you are overdoing it?
If you are using some form of cosmetic clay masks, I do not recommend doing so as these frequently contain astringents which excessively dries out the oil on one’s face using salicylic and lactic acids, typically marketed as products for acne prone skin. I do not recommend any of my acne patients to do that because when they are on medical treatment for acne, a common side effect is dry dehydrated skin. Conversely, one who is doing a home masking regimen that is marketed for reducing oily skin as well as acne, in place of seeking medical treatment for acne, it is possible that he or she ends up using masks containing salicylic and lactic acids (or clay derived products that dries out the skin) too often and may develop skin allergies or eczema. Overdoing masking in this case leads to skin that is dry, irritated, flaky and some people may develop more severe reactions. It is therefore important to get your skin condition properly diagnosed by an accredited dermatologist, rather than simply relying on DIY methods.
My preference for a wash-off face mask is a gel mask formula – Amino Acid 360° Masque. This enables a gentle, non-astringent effect, delivers vitamin C(for acne scars) and other antioxidants in a soothing gel that can be refrigerated to cool post-laser/chemical peel skin, and can also be tolerated by eczema/rosacea patients as well.
Can you mask daily?
Yes definitely. When the mask contains cosmeceutical active ingredients clinically proven to work on skin, these help to reverse the process of photoaging can have a skin brightening effect. As long as the mask delivers moisture and appropriate antioxidant ingredients instead of astringents (such as clay or charcoal) there is no limit to the number of times one can mask. Another tip I have for budget DIY masks? Use your favourite ceramide-based moisturiser this way. For intensive treatment, apply a liberal amount of this moisturiser up to 3 times a day and on top of it use a soft damp cotton towel or the blank mask sheets (without essences) to increase absorption.
Can you combine different masks at one time? Or use one after another? And if so, what are some good combinations to follow?
I would not recommend that because of the types of ingredients that may be present in masks that specifically target for example oily skin. In this case, some people may consider their T zone to be oilier and decide to use salicylic or lactic acid infused mask for those areas and a hydrating mask for other areas. In theory, this may seem like a good idea. However, from a dermatologist’s perspective, it is much more efficient in the treatment of oily skin, to apply chemical peel that contains a higher concentration of salicylic acid, lactic acid or glycolic acid as a procedure done at a dermatologist’s office and subsequently rinse it off, rather than having very low concentrations present in a leave-on mask, because the effects will most likely be not as good and over time, may cause skin irritation.
Are there certain masks better suited for certain skin types (eg: peel-off, clay, cream for dry skin, oily skin etc.)?
I typically do not recommend astringent masks (which may include those marketed as clay types or for oily skin) for any skin condition, even super oily skin, because these are not proven to help acne treatment. The face mask that I would recommend would be those for skin moisturisation.
How do you choose the right mask if you have a few different skin problems (eg: dull complexion, dehydrated skin, breakouts all at once) – which skin problem should you address first?
The key thing here is looking at the root of each of these conditions and treating them. For example, a dull complexion is actually related to the ageing process where the skin cells turnover at a slower rate than somebody who is more youthful. In terms of addressing this problem, I would recommend using cosmeceuticals which are applied on to the skin and absorbed, together with chemical peels as well as lasers if necessary as recommended by your dermatologist. Dehydrated skin is quite tricky, because if your skin is so dry that it starts flaking or becomes red, you may be suffering from a form of facial eczema and it is important to have it treated medically, understanding that this is not about face masking at all. In terms of breakouts, acne itself is considered a medical condition that can be treated. It is also not treatable by skincare or face masks on their own. If the acne is severe enough, one may require oral medications, or if it is hormonal, medications like oral contraceptive pills may help to control the underlying problem.
Must I follow strictly to the time stated on the instructions during mask applications? What can go wrong if the mask is applied for longer than required?
For sheet masks, when the mask has dried up due to the process of evaporation, there would really be no point in applying that to one’s skin as there will be no extra benefits. Also, if the active ingredients contain something which is meant to control oil production, it can cause the skin to be very irritated and dry with excessive application. In fact, it may cause problems as excessively long application could increase the likelihood of skin allergy towards such active ingredients.
With clay masks or other types of astringent masks for example, it can certainly cause the skin to develop facial eczema when applied for too long.
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The Mask Bar subscriptions comes with 2x Polysaccharide masks per month, and 3x customized cosmeceutical essence vials, and a 4L Mask Bar. The energy-efficient 4L Mask Bar is designed to toggle between optimal preset temperatures of 8°Celsius for anti-inflammatory cold therapy and 55°Celsius for relaxing thermal therapy for scalp and hair treatment.
The 360° Conscious Mask Bar also comes with private access to skin and haircare masterclasses by Dr. Teo Wan Lin. The dermatology masterclass series focuses on the science of skincare/haircare and the treatment of common dermatological conditions such as rosacea, acne and eczema. Class material includes video tutorials, transcripts and worksheets. A private access code will be sent to your inbox with the purchase of the Mask Bar System.
There has been a lot of skincare advice thrown around the internet- but not all of it is good. In fact, some of these “advice” may be harmful to your skin. It’s time to clear the air and put these skincare myths to rest, so that you can start making informed decisions when it comes to your skin.
Skincare Myth #1: Skin problems like pigmentation, acne and sensitive skin can be treated with skincare products and facials
Almost every brand is boasting a special cleanser or cream that can treat these problems over the counter, be it in the form of lightening cleansers or anti-acne cleansers or anti-redness creams. The truth is, healthy skin can be maintained with cosmeceutical skincare recommended by dermatologists, but when you have any one of these issues, they are actually true medical conditions of the skin.
My advice is, if you have any of these symptoms, stop self-medicating and applying a bunch of anti-redness or “sensitive skin” products. See a dermatologist as soon as you can because all of the above can be promptly treated with proper medications. This will probably save you a lot of pain, money and regret in the medium to long term.
I have seen so many patients who have spent thousands of dollars on online supplements, fad diets, facials at spas or aesthetic centres, did not get better and actually had a true dermatological condition, such as perioral dermatitis (which looks like acne, for example, but occurs in adults) and rosacea which can be effectively treated by a dermatologist with the correct medications.
Skincare Myth #2: Scrub and use a clay mask.
Dermatologists do not agree with a lot of what beauty companies/aesthetics providers are telling the public. Dermatologists have seen way too many complications because of an incomplete understanding of the actual science of how skin behaves. Scrubbing with harsh beady grains of sand would work if your skin was made of wood, if you imagine using it like a sandpaper. In reality, you do not brighten or “exfoliate’’ your skin with that; rather, you are causing damage and irritation to your skin, that’s maybe even the cause of your sensitive skin and red face problems.
Clay masks are also totally unnecessary, even for oily and acne-prone skin types because it’s actually the salicylic acid content in these masks that causes your acne to get better, but not without really dehydrating your skin after that and causing facial eczema in the long term. Yes it is possible to have oily acne prone skin and facial eczema at the same time.
Dermatologists do not prescribe clay masks for any skin problem because there are much more effective options for treatment of oily skin and acne. What counts in a skin treatment product is the active ingredient in these masks and products, so again, so, do thorough brand research, check the ingredient list of your next bottle or just go with what your dermatologist would recommend.
TheSilkpeel Home Medi-facial Kit is a home chemical peel equivalent. The effects of the SilkPeel Home Facial Peel System are that of microdermabrasion which has a similar effect to microscopic skin exfoliation.
“Glass skin, a poreless appearance of the skin, popularised by K-beauty isn’t a myth. Cosmeceuticals such as polyglutamic acid, which is a large molecule, sits on the surface of the skin while functioning as a humectant 5x more effective than hyaluronic acid. The SilkPeel system utiliizes polyglutamic acid based solutions with potent antioxidants delivered via vacuum microdermabrasion that helps to achieve a translucent appearance of the skin, reducing the appearance of pores,” accredited dermatologist, Dr. Teo Wan Lin.
Skincare Myth #3: Lower SPF coverage is fine, since SPF represents the duration of sun protection, not the quality.
I read this in a beauty magazine about an aesthetic doctor’s sunscreen product and honestly this is the sort of stuff that would make a dermatologist cringe, because it is dangerous to spread this sort of belief and sun protection isn’t just about beauty but also skin cancers. It is very enticing given our humid climate when such brands promise that their sun protection mist offers lightweight cover without leaving a white stain.
Skin cancer can be avoided with good sun protection. In fact, you should never go without a good sunscreen because the harmful sun rays is also the number one cause of ageing. However, beware of the dangers of misleading labels on sunscreens. You should go for a sunscreen recommended by your dermatologist that is at least SPF 30.
A sunscreen should effectively block both UVB and UVA rays, which is possible with an agent that has an SPF of 30 or greater. It is also important that your sunscreen is labeled with the term “broad spectrum”, which means it protects your skin against UVA rays. There are differences between 15, 30, and 50. SPF is measured in the laboratories whereby the amounts applied at 2g/cm2 and this never happens in real life.
And on top of that, most of us don’t apply sunscreen properly. SPF (sun protection factor) is derived by taking the time it takes you to burn with sunscreen on and dividing it by the time taken for you to burn without sunscreen on. SPF specifically protects against ultraviolet B (UVB) rays that cause sunburn. I would recommend a minimum of SPF 30 for an everyday sunscreen and SPF 50 when outdoors for extended periods of time.
The SunProtector is SPF 50/PA+++ and is exquisitely formulated for humid climates. It is a broad-spectrum sunscreen that also regenerates and soothes sensitive skin. Designed with unique pigments blended to be almost invisible under make-up.
The following is a transcript from Dr. Teo Wan Lin’s podcast, Dermatologist Talks: Science of Beauty on fillers and vaccines. Subscribe to her podcast on a journey to discover the science of beauty. We’ll cover the science behind active ingredients and get deep into the cosmetic formulations. Stay on trend with the latest on botanical actives, technology and be part of our FUTURE OF BEAUTY.
29 DEC 2020: Hi guys, this is Dr. Teo Wan Lin, and welcome to this week’s dermatology flash briefing. The Moderna COVID-19 vaccine apparently causes swelling and inflammation in patients with cosmetic facial fillers. The FDA advisory committee reviewing the new Moderna vaccine, has come out to state this very specific side effect that has involved several trial participants who have had cosmetic facial fillers. I want to just quickly share with you guys today what exactly this is about, how it occurs, and if that’s something we ought to be worried about.
What exactly are dermal fillers?
Dermal fillers are used primarily for facial augmentation. The filling agents are meant to restore fullness in one’s appearance that could be lost over time with age as a result of subcutaneous fat atrophy, or a side effect of certain medications such as retroviral medications. The ideal facial filler should have the following properties: first of all, it should have physiologic compatibility with your body – meaning that it readily incorporates itself with your tissues. It should be free of complications or side effects, and ideally, it doesn’t degrade with time. But this is, of course, untrue for the commonest type of facial filler which is used in most cosmetic practices – that would be hyaluronic acid based and they should be relatively easy to administer. You also have alternatives such as those that are collagen based, or hydroxylapatite based – for example, Sculptra is from poly l lactic acid.
What are the side effects of facial fillers?
In terms of the known side effects from using these facial fillers as injectables, some of the common complications that occur would be tenderness, bleeding, bruising. When lumps and nodules occur, this can be because of inappropriate injection techniques, or accumulation of the filler in a more superficial location than expected.
So what’s the deal with the fillers and vaccines?
Now what’s happening with the Moderna vaccine and this painful facial swelling that occurs where facial fillers have been previously injected, its best thought of as an allergic reaction, or basically an immunological reaction. The key thing here is the process of injecting a vaccine, essentially causes the immune system to be stimulated. That in turn results in the body recognizing that the facial filler in that case, is not a part of the body tissues, and the body starts to mount an immunological reaction against it. Based on the cases that were reported to the FDA, the profile of these patients essentially had swelling and inflammation in the area that was administered the filler. A couple of the patients had the cheek filler 6 months prior to the vaccine, and one patient had lip filler done just 2 days after the vaccine. In all of these scenarios, the patients were treated with oral steroids, anti-histamines, and was observed that their reaction resolved.
What exactly is an allergic reaction?
Typically it is considered a medical event due to an immune system respond to a perceived allergen. It is not likely that these individuals would have developed this response had they not been given the vaccine. The reason is because facial fillers are medically engineered to be biocompatible, but in the case where you’ve had a vaccine, your immune system will start to detect that these substances that were injected, are actually not part of your body tissues.
What are your thoughts, as a dermatologist?
As a dermatologist, I have some opinions with regards to the observation of these adverse events. First of all, we do expect that massive rollout of vaccinations against the COVID19 virus is expected to be happening internationally, and I feel that it is a very important part in ensuring that we get some level of control and immunity in a very severe pandemic like COVID 19. In terms of immunological reactions that are occurring in response to facial fillers in this case, we note that the attendings have actually treated these patients with oral steroids.
We know that oral steroids suppress your immune system, and in fact, make you more vulnerable to the virus. Personally, I have not given oral steroids as far as possible to many of my patients in the last few months. For patients who otherwise would have benefitted from steroid therapy for chronic inflammatory disorders such as severe eczema, I have certainly been a lot more cautious in terms of exploring other therapies before using oral steroids. The reason is because it’s been known to worsen the prognosis in the event you do get COVID, and also, because it reduces your body’s natural immune system response – you’re going to be more susceptible to catching COVID.
The answer is not an easy one. Facial fillers are used in millions of people internationally, and it is not as if it is the first time we are hearing of an adverse reaction. Another known complication from facial filler injections that is relevant in the context of the modern vaccine would be non-allergic inflammatory responses- we call these granulomatous reactions. These don’t occur so quickly, and we right now have no long term data as to what the vaccination would do in terms of individuals who are going to have fillers or have had fillers, and who are going to receive the vaccine.
What are granulomatous reactions?
These granulomatous reactions are usually non-painful lumps, and it is all a part of inflammation that is caused by the immune system being stimulated. In fact, in 2017, there was a case report about a granulomatous reaction to a dermal filler that was hyaluronic acid based in the Journal of Cosmetic and Laser Therapy. A granulomatous reaction is a delayed onset inflammatory nodule that is usually painless, that occurs much later than the so-called allergic reaction in individuals who have painful swellings, such as those who have received the Moderna vaccine and found that the site of the facial filler injection previously became painful. The key thing here is that in order for us to diagnose a granulomatous reaction, it’s going to take a longitudinal study for as long as 5 years before we can determine if it was truly a problem in individuals who received the vaccine, and also had the facial filler injected.
In 2015, in the Journal of Dermatologic Surgery, there was a series whereby the author conducted a retrospective chart review of patients who were treated with HA fillers, within a 5 year period, to evaluate for delayed onset nodules. The conclusion was that although they are pretty uncommon, it is important to be aware of this side effect, and to have a management protocol in place. In their conclusion, the authors also said that from the patients responses and from the literature, that these nodules are immune-mediated in nature.
What I’m trying to say is that because we are currently in an unprecedented public health situation internationally, where we have a raging pandemic that’s deadly, we may have to reconsider the risk that we might be taking with aesthetic treatments. Now, I do perform facial filler and botox injections, but the truth is, vaccinations are going to be a priority for most people and most countries in order for us to get the pandemic under control. I feel that the public should realize that we are also not going to be 100% certain how these facial fillers will further on be affected by these vaccines -for example, the development of granulomatous reactions. The truth is, if you already had a facial filler, I certainly don’t think that should deter you from getting a vaccines because these are established complications. If you do have it then, visit an accredited dermatologist who will be able to diagnose it accurately and will be able to treat it.
A word of caution here, not all painful filler related swellings are due to an immunologic response to the vaccine, depending on the characteristics observed during clinical examination, your dermatologist will also evaluate you for other differential diagnoses which may also include atypical infections. These are usually a result of poor aseptic technique, which introduces environmental bacteria into the deeper tissues.
Overall, my two cents is that if you are thinking of getting a facial filler, as a dermatologist, I feel that you certainly can wait. The reason is really because the cost of human life in this pandemic, simply outweighs any other considerations that one may have.
The human facial structure is a composite of skin (the epidermis and dermis) the subcutaneous fat, the SMAS layer, the muscle and ageing affects all these structures dynamically, fillers only address one part of the ageing equation – restoration of volume. In terms of restoring facial structure and facial sagging – which can be corrected with other technologies such as: radiofrequency, High Intensity Focused Ultrasound, which do not involve injection of other substances into your body tissues. A board-certified dermatologist or plastic surgeon will be able to advise you on these options.
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In conclusion, if you’ve had a facial filler before, don’t let that deter you from getting the vaccine, as the cost of human life is much greater and this is a known filler complication (definitely enhanced by the vaccine) but the benefits will outweigh the risks. If you ARE thinking of getting fillers done, my personal opinion is that you may wish to consider alternatives, given the current context of our pandemic.
WHY YOU SHOULD APPLY YOUR SKINCARE PRODUCTS WITH YOUR RING FINGER
How we apply our skincare is very important. Have you ever wondered why most skincare brands recommend in their product directions to use the ring finger and not any other fingers in applying and gently massaging the product unto your skin especially when it involves the eye area? That is because out of our 5 fingers, our ring finger is said to have the weakest touch. The manner on how you massage your face while cleansing it and how you apply your skincare and makeup products, even just simply scratching it or wiping it can add up to protecting the quality of your skin.
Our skin is very delicate and we want to avoid excessively tugging it whenever we apply our skincare or makeup products because this can cause our skin to show early signs of ageing. Applying with our ring finger gives an equal amount of pressure when applying products. You can easily cause wrinkles with too much pressure, and our ring finger is recommended for the least amount of pressure and pull.
Most especially when it comes to applying eye creams, using our ring finger is the best. The skin around our eyes is the most delicate among the rest, and it is most commonly the first to show the earliest sign of ageing. Mishandling of the skin around our eyes like aggressive removal of eye makeup and heavily dragging eye care products and any other skincare product unto our skin can cause eye wrinkles, crow’s feet, and other skin irritations.
That being said, no matter how the ring finger is said to be the lightest, we still have to be mindful whenever we use it to come into contact with our skin. Same with any other finger. Always work your serums, eye creams, and any other product into your skin using light, tapping motions making sure to avoid rubbing and tugging. No matter how expensive your skincare product is, the manner on how you apply it will tell how to get the most out of it.
HOW TO APPLY YOUR SKINCARE- EYE CREAM
Ever looked in the mirror and thought “My eye wrinkles are becoming more obvious each day”?
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