Beautyknot ~ My Skin Care Diary

Any product or treatment is never an one-time-solution. Prior I went to this IPL treatment, I had taken three Nd-YAG laser treatments for skin tightening. Hyper-pigmentation is one of my major concern and I know the best way of  lightening/brightening is to minimize direct sun exposure, but you know I was not living like Vampire so I put my faith in Lightening/brightening/whitening skincare.

The clinic I had visited has two affordable treatments that I was interested in. Melasma clearing treatment with Nd-YAG laser and Brightening treatment with IPL. The Nd-YAG laser offered in this clinic is different with my previous GentleYAG laser treatment in another clinic; former is targeting pigmentation whilst latter one is meant for skin firming. What makes the difference here is depending on their technical specification of the treatment device. The therapist advised IPL treatment for my aging concern and she said it is more suitable for my sensitive skin.

Potential Risks: Although IPL is nothing new but I strongly encourage you to survey online for unbiased reviews if you never done IPL before. Potential side effects of IPL are temporary (few hours) swelling, redness, and increased visibility of small capillaries. In rare cases, blistering, bleeding, fat loss, hyper-pigmentation (darkening) and hypo-pigmentation (lightening) have been reported.

Expectation: Notably skin tightening/firming/lifting.

IPL (Intense Pulse Light): The IPL device in my treatment named Spectron II. I have no knowledge of various brands of IPL device so I am not much concern as long as it is safe and result-proven.

Clinic:  This clinic has an experienced dermatologist who is only taking care of those treatments that required done by licensed professional such as botox injection etc. A technical therapist who takes care IPL/Nd-YAG/Carbonize treatments in a single treatment room (Those technical therapists work on shift schedule between their ten branches in BKK). Additionally, several facial therapists who are responsible for facial/iontophoresis and reception. Overall this small-scale clinic is more like facial salon with a dermatologist stationed. They have their own skin care line and beauty supplement but they never tried to sell me anything.

Procedure:

1. Remove makeup myself with provided makeup removal stuff (cleansing milk, facial cleanser) and facilities (basin, clean towel).
2. The technical therapist slathered on generous “cool cream” over my full face.
3. Different technical therapist used different thing to cover my eyes (!). Some used wet cotton pads, another used plastic eye-cover. I could still “see” the light beam of IPL during treatment with both methods, I must say that was very uncomfortable to eyes.
4. The whole IPL treatment had not imparted single pain, it was pain-free due to the “cool cream” applied on skin, else it would be a little bit warm. At the end of the treatment you probably smell something burning (depend the parameter setting of your treatment) but overall it was painless, I felt it was milder than facial steaming.
5. Once the IPL treatment was done, I cleansed my skin again. Approximately 10~15 minutes for IPLsession.
6. Because I took the package, so the whole treatment included iontophoresis and deep collagen mask besides the IPL. I proceed to a “public” facial room that can accommodate 7 customers.
7. The facial therapist applied creams onto my skin from time to time throughout the iontophoresis. No pain but I felt a little bit stingy that most probably caused by the little electrical-shock on healing acne spot. When skin was clear of blemish, no stinging at all. Once it was done, she used wash sponge to remove the cream residue. This session took approximately 15~20 minutes.
8. Lastly, the facial therapist covered my eyes with wet cotton pads and placed a collagen mask sheet over the face. After removing the mask, facial therapist massaged the remaining essence into skin, followed by moisturizer and powder. Approximately 45 minutes for this session.

Time & Cost: THB2500 per Brightening treatment (IPL, iontophoresis and facial). I signed the package for THB5500/3 treatments. Advise the IPL treatment done every 2~4 weeks for optimal result.

1st treatment (300510):

Well, despite slightly flushed skin after the IPL session, my skin was feeling comfortable generally. The redness replaced by remarkably brightened, even-toned and rejuvenated complexion after completing the first treatment. I would say the brightening treatment was indeed effective but my freckles became more visible due to the lightened skin tone. Most surprisingly, my skin looked very well hydrated, bouncy soft, plump and firm, aging pores were greatly refined, the dynamic dry lines undereyes said bye to me (temporary). The amazing good effect faded off slightly after few days. Comparing to previous GentleYAG treatment, the positive improvement of skin texture from this IPL package is easier to be noticed. Nevertheless, my skin was started stinging again! I was not sure the irritation was caused by IPL treatment or irritating ingredients of facial, that seemed to devalid the good effect of my previous GentleYAG treatment.

2nd treatment (200610):

The 2nd treatment was done by different technical practitioner, which is more meticulous and in fact, she is the best amid the three. She explained every step and kept asking me if I was in pain, she is lovely. Like 1st treatment, the overall brightening result was greatly appreciable right after the treatment. My skin was well-behaved during the rainy season, basically no dehydration issue and I could feel my skin was more firm and moist.

3rd treatment (140710):

Again, the 3rd treatment was done by another new technical practitioner. The treatment result was quite consistent, the improved firmness was fantastic too. There was certainly a difference between firming and lifting. In my beauty interpretation, firming = soft + plump + good elasticity + moist + more defined contour; and lifting = look 5~10 years younger + tightening + more defined contour + flatter skin. Indirectly, firming doesn’t diminish fine lines and wrinkles totally (lifting will) but it does impart rejuvenated complexion, thus look more youthful as well.

Conclusion:

From what I could see and feel, I summarized these points as following:

• Improvements:

Skin firmness (good elasticity), slightly more defined facial contour (particularly in first two weeks), smaller pores (I believe that’s due to improved skin moisture), my skin sensitivity had been improved (most probably the joint benefit with GentleYAG treatment) that I rarely suffer any skin tingling nowdays. 

• I didn’t see the improvements on these aspects:

Facial veins, freckles, mild melasma on cheekbones and fine lines (may be). However, during July to Aug months in Bangkok, almost rainy everyday (May be the IPL helps), my facial veins, freckles, mild melasma on cheekbones were very less visible.

Personally I think IPL is a wonderful photo-facial for maintaining skin firmness and it is helpful to delay aging, you can see the best result with a treatment every 2~4 weeks. The cost is depending on many factors, such as the type of IPL device, reputation of the clinic, practitioner ‘s experience and skill, number of treatment, or your budget for skin treatment…etc. Since my last IPL treatment, at least 3 months has passed at the time of writing, I think my skin was slowly going back to pre-treatment stage, perhaps slightly better still.

In order to age gracefully, importance of daily skin care is unquestionable. As a skin care junkie, I cannot resist trying clinical treatment but restricted only to non-ablative treatment. After weighting the pros and cons over a year, I was ready to take the risk of laser treatment.

Potential Risks: Bear in mind any medical procedure comes with risk. Millions info of medical treatments are available online, including risk assessments, realistic outcome, both positive and negative testimonials. Depending on your chosen laser treatment, potential side effects are including redness, swelling, bruising, blistering, discoloration with minimal or no recovery time. Additionally, malpractice (which can accelerate aging) by inexperienced/unskillful/irresponsible practitioner.

My Lifestyle: A workaholic until 27 years-old. Adopting discipline and healthy lifestyle since five years ago. Never smoked, rarely drink. 

Sun Damage History: Having two sunburns in my puberty. A relatively mild one in 20s.   

Sun Protection: Only wear sunblock/suncreen after 30 year-old.

Previous Treatment: None. This is my very first medical facial treatment. Always home care, go for spa facial once in a bluemoon. 

My expectation: Minimized pore size. More defined and lifted facial contours.

GentleYAG Laser : 1064nm wavelength with Candela patented cryogen cooling system (DCD™). It is non-ablative treatment that targets the lower layers of skin (dermis), while leaving the skin’s surface (epidermis) unharmed and intact. There are two sessions of this treatment. According to my dermatologist, first session is for skin tightening that heating dermis to trigger new collagen production. The second session treats epidermis for skin rejuvenation. It has limited benefit for pigmentation and spider vein in my case. GentleYAG is also used for hair removal.

Treatment performed by: Dermatologist and assisted by one of the clinic assistant.

Clinic:  A clinic in BKK city with basic ambience.

Procedure:

1. Removed makeup/sunscreen on treating areas.
2. Placed an ice pack on both cheeks for about a minute prior to treatment. (optional if you’re more tolerant with pain)
3. Eyes were covered tightly by a towel by the assistant during the treatment.
4. The dermatologist used the laser handpiece to shot the whole face except eye area and lips. No pain but slight heaty on cheeks (feel like strong gas shot). A little bit of burning smell sometimes. Quite painful (like ant bite, but tolerable) for forehead and slightly for chin. According to the dermatologist, the skin on forehead is thiner and more attached to bone, thus more pain. Around 100+ shots for whole face each treatment. Skin looked reddening, slightly blotchy but felt tighter right after the treatment.
5. Take 1-3 minutes break to disperse the skin heat.
6. The dermatologist re-inputs the program setting and using optical light beam for treated area. Skin would be feeling comfortably warm like facial steaming. This is for rejuvenation, skin looked brighter and even toned right after this.
7. Done. Approximately 10-20 minutes for each complete laser treatment.

Time & Cost: THB2500 per treatment. Each treatment is about one month apart. Recommend 3~5 treatments for optimal result.

Skin care routine: According to my dermatologist, no after-care is needed because this is non-ablative treatment that people can put on makeup and go to work immediately right after the treatment. But, I do used anti-aging products consistently in order to accelerate the positive improvements. My daily staplers during the period are Kiehl’s 10.5% Vitamin C, Estee Lauder ANR Synchronized Complex, Rojukiss Protox Serum and mineral sunscreens, together with non-irritating lotion and moisturizer. In addition, I also try to minimize direct sun exposure, wear sufficient sunblock under sun and stop exfoliating few days before and after each treatment.

1st treatment (291109):

This was my very first time, so I was actually very nervous in the beginning. Right after the treatment, skin was evened up and brightened up with subtle redness and swelling on few spots. Besides, skin was feeling warm and slightly tighter gradually. The feeling continued for few hours.

During the 1st week, my skin obviously felt more hydrated, depth of dry line slightly improved, freckles had been slightly lighten and broken capillaries also slightly faded (temporary). Although the skin was returned to previous stage since the 2nd week, but the skin surely suffered  less dehydration than before.

There was one thing that actually got me terrified. While I don’t have nasolabial line, I felt like the line has become more visible. (Fortunately that returned to normal/invisible again since the second treatment).

2nd treatment (030110):

I had a post-treatment consultation with my dermatologist to evaluate my satisfaction level, skin improvement, expectation, concern, realistic goal…etc. She decided to increase the energy for 2nd treatment (Energy level:38) because she was actually using milder setting (Energy level:36) for 1st treatment since I was too nervous and worried about the pain.

With the experience of 1st treatment, I was more psychological ready. Skin was more tolerant and redness subsidized within 2 hours. Perhaps I got the 2nd treatment done in evening, thus no sun exposure after treatment.

Again, skin obviously felt firmer and smoother texture as I mentioned in 1st treatment. For unknown reason, the immediate result was not as fantastic as the first time, yet the improvement retained until the 3rd treatment. Sounds like the improvement was accumulating through multiple treatments.

3rd treatment (310110):

I was an obedient patient to follow proper guideline, so I continued with 3rd treatment although the actual result wasn’t as fantastic as I expected but I believed the pore size had became slightly smaller, with very small margin.

As usual, I had one-to-one consultation with my dermatologist first. I asked her about Frexel laser since she mentioned it previously for more dramatic result, but meantime I had done a little survey about Fraxel and I couldn’t afford the risk of hyper-pigmentation, and of course the extra digit of each treatment cost was also part of hesitation. She showed me the Fraxel laser (Reliant) device confidently and encouraged me to survey around with other clinics before making any decision. That was why I was happy with her, she always patient and friendly to answer all my queries until I asked enough. In addition, she never being pushy yet encouraged me to study around for best option. Virtually that was what I did but I appreciated her advise still. However I don’t think Fraxel is what I really want, it mainly targets enlarged pores and pitted holes (resulted from acne).

She decided to increase the energy level again to 40 since I was willing to give it a try. When I asked her what was the maximum level, she told me the level adjusted to skin color, for me the maximum level should be 42.

This time, the only painful part was my forehead (thinner and more attached to bone). The first round of shooting was still tolerable, but second round was really painful like biting by bee. I managed to bare the pain until the treatment done. My dermatologist told me that was because the heat of the first round yet to be dispersed hence the heat was accumulated to second round. Anyway, they gave me the ice pack to cool down the heat for a minute, feeling fine later. Right after treatment, my skin texture obviously much smoother than previous two treatments, but my forehead seemed bitten by many mosquitoes that left many temporary red blotches. (“b) The redness faded off completely within 3 hours.

I was happy that I didn’t quit in half way. Although all expression fine lines are still visible exist, pores appears a little smaller but my skin was bouncy soft (some people called that baby-butt soft) everyday! By the way, the intense bouncy softness lasted for 3 weeks only. Sad.

4th treatment (280210):

As usual, I reviewed the result with my dermatologist. She commented my skin looked better and the mild melasma faded slightly. However, she also told me the parameter setting wasn’t for brightening, hence limited improvement.

This 4th treatment had done with energy level-40, but reduced for forehead because the pain was really challenging my maximum tolerance. The skin refining and firmness were normally more noticeable on the 2nd or 3th day and again, first two week is fabulous then slowly degraded a little bit. As a whole the smaller pore is more obvious and the intense bouncy skin maintained for more than 4weeks this time. By the way, I hardly suffer skin irritation in nowadays, the treatments is truly helpful that improved the moisture in skin deep.

Conclusion:

I have summarized all above noticeable improvements here:

• Improved skin sensitivity – my skin was rarely stinging nowadays, eventhough nearly 9 months now since the last treatment.
• Hydration – The result in first few weeks was remarkably good (work synergically with skin care routine) although dehydration still occurs occasionally due to my naturally thin skin. 
• More balanced skin – my skin type is combination (in very humid weather) and normal (in drier weather, even in rainy season). Previously I think have oily-dry skin (oily but dehydrated).
• Firmness – I was told by two skin analysis devices (Kanebo & SK-II) that my skin dermis strength was strong but I saw no appreciable change of my skin texture. Apparently pores and dry lines neither vanish optically nor become noticeable smaller despite the skin should continue building new collagen in 1~3 months even the treatment stopped. 

In fact my dermatologist commented I don’t need skin tightening when she first saw me, instead she recommended Vbeam laser for my redness and pigmentation. After 4 treatments and now more than 8 months passed since the last treatment, I do believe there was some tightening in my skin deep. With untrained eyes, that was actually hard and very hard to tell if any improvement. My SO who had been seeing me everyday said he didn’t notice any difference of my face before and after. Hey! May I say I have maintained my skin fairly well?

Overall I think the GentleYAG treatment is more like a Skin Rejuvenation treatment instead of real Skin Tightening treatment that can lift face contour more dramatically. Eventhough a Skin Tightening technique such as Thermage (normally required one treatment only, more painful and costly, long recovery time) can only improve 20~30% in skin lifting. Finally I realized only costly and risky cosmetic surgery can really kick the age 10 years away, hence prevention is definitely better than cure.

If you are interested in laser skin treatment, I suggest you to read here for some basic knowledge of both ablative and non-ablative lasers.

Why no Before-and-After pictures

Frankly, that was difficult for me to do that. First, I’ve no wrinkle to give better insight of improvement. Second, I don’t have visibly saggy skin. The oval of my face looked almost identical before and after although I’m very certain that was increment of firmness, thus a tad more well-defined contour, but again picture can’t really show that precisely (at least with my photo-shooting skill). Third, basically the size of aging pores can tell the result better since they are the only visible sign on my face (well, don’t count the eye bags and fine lines in, the laser didn’t treat the area), but as I mentioned, they are still visible and very difficult to be differentiated in Before-and-After Pictures.