Botox treatment lasts for three to six months. Lines and wrinkles gradually reappear as the Botox wears off. With repeated treatment, doctors have observed that Botox may last longer as the muscles become less prominent from non – use.

The most common side effect of this treatment is temporary bruising. You may also have a temporary headache. If Botox spreads outside of the muscles being treated, there may be temporary eyelid drooping in a small percentage of patients. This is why the doctor will ask the patient not to rub the treated area for several hours and not to lay down for a few hours.

However, Botox should not be administered to patients who are pregnant, are breastfeeding, or have a neurological condition. Botox cannot be used on all types of wrinkles it important to have a detailed consultation with a doctor before proceeding with treatment.

Looking after your make-up.

Different products have different expiry dates. In general, if the make-up changes in colour or smell, of if the liquid foundation separates out, don’t use the make-up.

There are some general guidelines from industry experts on time limits for certain types of make-up however, they have not been supported by clinical studies.

• Foundation: 1 year after opening, 2 years if not opened

• Eye Shadow: 1 year after opening, 2 years if not opened

• Lipstick: 18 months after opening, 2 years if not opened

• Mascara: 2 months after opening, 1 year if unopened

In general, keep your products in a cool, dry place – not in your car or under the sun!

Sharpen your make-up pencils regularly and always cover the heads to keep them clean.

If you use make-up brushes, clean these at least once a month by washing with soap and water, or even with shampoo. Dry the brushes thoroughly before use.

Should you share make-up?

Sharing make-up increases the risk of getting infections. These include spreading of conjunctivitis (pink eye) from sharing eye make-up and mascaras, to cold sores caused by herpes simplex virus from sharing lip products.

This includes using samples at make-up counters. Make sure that the product has been cleaned and that appropriate disposable brushes or applicators are used by the counters before you try the products.

Chemicals, make-up and you.

Cosmetics sold in Singapore are registered with the Health Sciences Authority which ensures that potentially harmful ingredients are not present.

Although studies show that true make-up allergy is not common, 4 it is important to realise that there are components in make-up which can irritate the skin in certain individuals.

The most common components of make-up (or even skincare products) that lead to allergies or irritation are fragrances and preservatives.4

If you are having a reaction to a particular product, discontinue use but don’t throw it out, bring the product and the ingredient list when you see your doctor.

Permanent make-up.

There is always a risk of a reaction to eyelash or eyebrow tinting or to the application of lip liner tattoos. There have been reported cases of irritation leading to inflammation granulomas (small reactive bumps around the area) to lip liner and eyebrow tattoos.5

In addition, reactions to eyeliner tattoos have been reported and such allergic reactions have required surgery to remove the tattoo pigment.6

Allergic reactions have also been reported with eyelash tinting which have resulted in loss of eyelashes in some individuals.7

If you are considering any of these procedures, you may wish to ask the artist to do a test spot on your skin first to check for allergy or sensitivity.

References

4 Biebl KA et al. Allergic contact dermatitis to cosmetics. Dermatol Clinics 24, 2006: 215-232 lbid iv.

5 Martin JM, et al. Granulomatous reactions to permanent cosmetic tattoos successfully treated with topical steroids and allopurinol.J Cosmetic Dermatology 2007 6(4): 229-31.

6 Vagefi MR, et al. Adverse reactions to permanent eyeliner tattoo. Ophthal Plast Reconstr Surg 2006 22(1): 48-51.

7 Bhat J, et al. Xanthelasma palpebrarum following allergic contact dermatitis from paraphenylenediamine in a black eyelashtinting product. Contact Dermatitis 2003; 49(6): 311; Wachsmuth R, et al. Loss of eyelashes after use of a tinting mascara containing PPD. Contact Dermatitis 2006; 54(3): 169-170.

The writer is the medical and scientific director at Cutis Medical Laser Clinics at 81 Club Street, Telephone 6237 9700 (formerly known as Dermacare). She is a Harvard trained epidemiologist and is US board certified.

PART 2 will include more make-up tips and will be posted on Monday.

There is nothing more effective than a good make-up touch-up to improve your self-esteem. Numerous studies have documented an improved quality of life with the regular use of make-up, particularly in individuals with skin conditions.1

Furthermore, in a study evaluating whether cosmetics enhance attractiveness, both men and women rated the use of eye make-up as having a marked impact on facial attractiveness.2

Understanding that attractiveness has a positive impact on mood and well-being, suggests that regular make-up use may be beneficial. But how do you choose between the hundreds of make-up brands that are available in the market today?

Your skin and make-up.

Make-up colour selection is an art. It’s primarily a lifestyle choice rather than a medical opinion. However, consider the following points in using and choosing make-up.

Most make-up is safe when used properly although some individuals may be sensitive or allergic to certain components of make-up.

Less is more. Try not to overload your make-up and skincare schedule. Talk to your doctor about the types of skincare products which will suit you.

Consider using mineral make-up as it contains natural minerals which provide benefits such as sun-block. Also mineral make-up may be less likely to irritate the skin as it does not contain talc or oral fragrances/preservatives.

In choosing a mineral make-up brand, look at the ingredients. It should include protective minerals like titanium dioxide and zinc oxide, but it shouldn’t include talc.

Finally, when selecting a foundation, make sure that it matches your skin exactly – this is more practical rather than medical advice! The aim should be unobtrusive, flawless coverage without tide marks around the face.

Take care of your skin.

Have a good skin care regimen that suits your skin before you put on make-up. Use a broad-spectrum sun block with a minimum SPF of 30 to make sure that your skin is protected from harmful UV rays.

If you have an active inflammation, whether it’s due to acne or skin sensitivity, be particularly careful in applying make-up. Mineral make-up contains ingredients that may actually be anti-inflammatory reducing the redness and irritation.

Always remove make-up and cleanse the face before going to bed. Cleaning the face removes dirt and bacteria on the skin surface. Avoid using soap-based cleansers as these increase skin pH and may affect the skin barrier.3 Non-soap based cleansers are gentler, with minimal change to skin pH.

To be continued…

1 Korichi R, et al. Why women use makeup: Implication of psychological traits in makeup functions. J. Cosmetic Science 2008 Mar-Apr 59(2): 127-37.

2 Mulhern R, et al. Do cosmetics enhance female Caucasian facial attractiveness? Int J of Cosmetic Science, 2003, 25:199-205.
3 Kuehl BL, et al. Cutaneous cleansers. Skin Therapy Letter 2003; 8(3):1-3.

Suprise the people around you by turning up and looking like a superstar….

Healthy Glominerals Mineral Make-up Workshop!

Dr. Sylvia and make up artist Francis are holding a fun and informative workshop on the benefits of using mineral make up.  This complimentary workshop will cover topics such as :

• Health advantages of mineral make-up
• Foundation selection
• Camouflaging scars
• Camouflaging acne
• Eye colour selection
• Proper lip colour selection
• many more

Participants will also get a change to participate in a lucky draw that is giving away great prizes.

Check out for further details at Dr Sylvia Ramirez Glominerals Make-up Workshop

I am Dr Sylvia Ramirez….

Our marathon-running aesthetic doctor

I am an internationally recognized global health expert with in-depth experience in program building and implementation, population-based research, health policy, and health economics analysis. Recognized
for conceptualizing, developing, and implementing a novel public health paradigm of a cost-effective
and clinically efficient approach to preventing resource-draining chronic diseases.  Leadership in
building of national health programs, including medical clinics and health screening buses.

Significant experience in population-based research of chronic disease trends and their clinical outcomes.  Demonstrated leadership skills in managing and working with individuals, teams, health care organizations and government bodies in both Asian and American environments.

I hail from a family of doctors and my grandparents owned a hospital in the Philippines.  My parents are doctors too.  My father is a surgeon while my mother is a neonatal intensive care doctor.

I was first trained as a paediatrician, followed by specialist trainings in nephrology (kidney) and chronic disease epidemiology.  I was not contented with just a Medical Degree, so I pursued a Master of Public Health (MPH) from Harvard University and a Master of Business Administration (MBA) from The University of Chicago.  Later, I took a Diploma in aesthetics industry as the medical and scientific director for US Dermacare’s first overseas clinic in Singapore.

As mentioned in Healthy Times Magazine Aug/Sept 08 issue “She has a burning passion for public healthcare, be it paediatrics, nephrology, epidermiology or aesthetics.  The fundamental aspect of public healthcare is safety, and that treatments offered to patients are appropriate and based on medical and scientific evidence.”

My motto is “Helping people, regardless of their ethnic background, with “safe and effective” medicine.”

I will be sharing my thoughts and views on skin, aesthetics, brown spots, hair removal issues on the blog from time to time.  Do visit my blog to get the latest updates or visit my website, www.custislaser.com.  You can also get a complimentary of my ebook titled “Aging Gracefully – How Non-Invasive Technology can help you look your best“. 

Dr Sylvia Ramirez

Board Certified in Pediatrics, American Board of Pediatrics
Board Certified in Pediatric Nephrology, American Board of Pediatrics
Fellow, American Academy of Pediatrics
Associate Member, American Society of Nephrology
Member, International Society of Nephrology
Member, American Heart Association, Epidemiology
Council, Kidney Council
Scientific Journal Reviewer for major research journals including Journal of the American Medical
Association,  Journal of the American Society of Nephrology, Diabetes Medicine, among others
Guest Editor, Journal of the American Society of Nephrology 2003 Jul; 14 Supplement 2

SELECTED PUBLISHED SCIENTIFIC MANUSCRIPTS AND
INVITED TALKS
Selected Manuscripts
Ramirez S.P. (2003) A comprehensive public health approach to address the burden of renal disease in
Singapore.

Journal of the American Society of Nephrology. 14 (7 Supplement 2):S122-6.
Ramirez S.P.; Summit on Kidney Disease Prevention Participants. (2003).

First International Summit on Kidney Disease Prevention, 25-27 July 2002: consensus document. 

Journal of the American Society of Nephrology. 14 (7 Supplement 2):S205-7.
Ramirez, S.P.B. (2003) Paradigms of Public-Private Partnerships in end-stage renal disease care: The
National Kidney Foundation Singapore.

Kidney International. Vol 73, Supplement 83: S101-S107 Ramirez, S.P.B., Hsu S.I.-H., Nandakumar M,
Friedman E.A., Durai T.T. Owen W.F., Jr. (2001)
Funding ESRD care through charity: the paradigm of the National Kidney Foundation of Singapore.
Seminars in Nephrology 21: 411-418

Selected Invited Talks
American Society of Nephrology Symposium: November 2005, Philadelphia, PA: Impact of Bone and Mineral Metabolism Measures in Cardiovascular Outcomes in Dialysis.
Renal Research Institute Annual Meeting: 28-30 January 2004, Puerto Rico, USA in Chronic Kidney
Disease Programs: Methods and Economics. Title of Talk: “Developing Chronic Kidney Disease Programs
in Singapore”
World Congress of Nephrology 2003: 8-12 June 2003, Berlin, Germany; Title of Talk: “Screening and
Prevention Programs for Chronic Kidney Disease in Singapore”
Renal Disease in Racial and Ethnic Minority
Groups: Satellite meeting of the World Congress of Nephrology: 18-20 October 2001, Santa Fe, New
Mexico, USA Title of Talk: “Taking a Public Health Approach to the Prevention of End-stage Renal
Disease: The NKF Singapore Program” Renal Disease in Racial and Ethnic Minority Groups:  Satellite meeting of the World Congress of Nephrology: 18-20 October 2001, Santa Fe, New Mexico, USA Title of Talk: “ Public-Private Partnerships in Health Care”National Kidney Disease Education Program, 15-16
March 2001, National Institutes of Health, NIDDK, Bethesda, MD, USA, Symposium entitled: “National
Kidney Disease Education Program: High Risk Professional Performance”, Title of talk: “Programs for the Prevention of Renal Disease in Singapore”

EDUCATION
UNIVERSITY OF CHICAGO GRADUATE SCHOOL OF
BUSINESS, Singapore March 2005
Executive Program, Asia
Master of Business Administration

HARVARD SCHOOL OF PUBLIC HEALTH, Boston, MA April 1998
Master of Public Health Concentration on Epidemiology and Biostatistics

UNIVERSITY OF THE PHILIPPINES, Philippines May 1989
Doctor of Medicine, Bachelor of Science in Basic Medical Sciences Student of the first 7-year medical program in the country