LED takes the power of light therapy to the next level to correct even more skin imperfections in one place than ever before.  Our specifically formulated treatments use over 4000 LED lights in a combination of red, yellow, green and blue to make an exclusive blend of skin-perfecting light therapy. LED Therapy is your secret weapon The effective LED system operates using of 5 different types of coloured light therapy paired with revolutionary for greater coverage. How does it work? Blue Light works to reduce acne causing bacteria, clear skin and reduce congestion Red Light increases blood circulation and lymphatic flow, encouraging the renewal and revitalisation of ageing skin Green Light targets skin tone correction and detoxifies the skin to reduce redness and irritation Yellow Light boosts the skins collagen production capacity, resulting in rejuvenated and younger looking skin Near-Infrared regenerates, rejuvenates, repairs and tightens ageing and lacklustre skin Who can benefit from LED light therapy?   Everyone! LED is not heat-based so all skin tones and types will benefit from LED light therapy. Targeted light therapy LED treatments are so versatile that treatment can be performed not only on the facial area, but on other areas of concern as well. Our large LED panel is simply positioned over the treatment zone which may be the décolleté, back, hands, or any other region of the body requiring treatment. Dr Joshi will conduct a detailed consultation to match your skin concerns with a targeted LED treatment. It’s simply the secret to skin that looks and feels radiant.

Previously we wrote about the types of acne and its causes. In this blog we'll discuss the long term effects and some of the treatments for problem acne. What is the treatment for acne? Mild acne Creams, gels and washes, OTC as well as prescribed, often work well, as part of a regular and basic skincare regimen to get into the habit of. With the confusing array of over-the-counter (OTC) products available, it is often wise to seek the advice from a doctor with training and an interest in acne across all stages, who can advise on the best products and active ingredients and also recognise their limitations and when to refer on.  For young women, the Pill can often work well as the oestrogen works to improve skin quality and have a positive  effect on hair and skin   Chemical peels of higher strength overseen by a doctor, using acids, may work well within 3-6 sessions - to be used with caution in skin of colour and under supervision by a doctor LED and laser therapy can also work well over a treatment course which may be as frequent as twice weekly initially for a few weeks and then for maintenance, every few weeks as needed. Moderate acne a variety of medications in conjunction with treatment options for mild acne above Severe acne Referral to a dermatologist for more restricted medication with more significant side effects, not usually used as a first line agent Lasting Effects of Acne  Unfortunately, depending on the severity of the acne, the duration as well as what was used to combat the issue, common outcomes include such complications as scarring and in many skin types, post inflammatory hyperpigmentation, PIH.  While these are often reminders of the acne one had, they can often significantly affect a person’s confidence in a time when we are bombarded with images of perfect skin. A personalised consultation and treatment plan will ensure that a plan specific to you, your skin type with its unique qualities, will be used, to help improve skin quality and may involve one or more of several methods, beginning with skin needling, a series of chemical peels and even laser treatment and subcision, which is a way to break up the scarring that tends to cause skin to tether, giving rise to a pockmarked appearance.   How do you know what is the appropriate treatment plan for you?  Book an appointment so we can begin with a personalised treatment plan for you, addressing your specific concerns, overseen by our doctor and undertaken with our trained staff.

Acne is a common, ongoing skin disorder affecting the skin, hair follicle and the glands in the skin that produce an oily substance called sebum.  Acne typically first may be noticed around the onset of puberty due to hormonal and other changes associated with it. It affects men and women of all races and ethnicities but is more common in adolescents and young adults though it may occasionally be seen in children and older adults also.  Science does not exactly understand the cause of acne, but it is believed that many factors may contribute, including a family tendency, use of steroid hormones, particular strains/ species of bacteria that live on the skin (we ALL have bacteria that live on the skin and help maintain its health) as well as dietary and other factors that are not as well known.  Certain medical conditions may also make acne worse, such as women with Polycystic Ovarian Syndrome, certain medications and perhaps, a diet high in dairy and highly processed foods.  When doctors examine a person suffering from acne, we will often examine the skin on the face, but it may also involve other parts of the body, usually the shoulders, neck, chest and back, depending on the individual.  Based on what we see, and certain features, we will then classify the acne in terms of severity.  For mild and moderate acne, there are many options that are over-the-counter(OTC) in combination with prescribed medication by your family doctor that will take commitment and care on your part, as well as patience. Skin, on average takes about 3-6 months to really begin to show signs of positive change, and patience is one of the hardest things to come by when one is affected by what one sees in the mirror, but it does take time and commitment.  For those with severe acne, a medication prescribed by dermatologists works really well, but is not without significant and serious side effects, which are not to be taken lightly.  As a GP myself with a background in surgical training as well as in skin, I love working with skin conditions in my dual role as a GP as well as a Cosmetic Physician, as the combination of prescribed medication with medical grade cosmetic treatments can work wonders for skin issues, especially in those with skin that does not respond quickly or easily, or with skin of colour, which often responds differently to Caucasian skins. If you are undecided as to your acne type and severity, it is best to seek a consultation with a doctor you know and trust who has an interest in skin - healthy and unhealthy skin!  Next week I will continue on the topic of acne. I will cover a range of treatments for acne, as well as other possible treatments once the acne is under control.  

There has been a recent surge of interest in thread lifts and I have been getting some questions around them. There are different types of threads that can be used to lift areas of the face that are traditionally less responsive to the use of fillers, which typically can help add some volume to parts of the face, traditionally the mid face (cheeks, temples). For patients who are bothered by jowls and sag around the lower face, the best way to manage it, provided it has not been left too long, is via threadlifts. Usually, the best result is still in women who would benefit from a combination of dermal fillers, some anti wrinkle treatments and thread lifts. I tend to work from a top down approach - beginning with adding volume to the mid face to help fill sagging skin up, which may add a small amount of lift, so that when we get to the lower face, the threads can be used to lift sagging skin that is not responsive to fillers. Here are some examples of people that I have done this procedure on. I myself underwent the procedure in November 2018, so I could understand the process from a patient’s point of view. Key take home points: The procedure is slightly more uncomfortable than dermal fillers It may be undertaken using local anaesthetic, or if you prefer, under light sedation If done while awake, it takes about an hour from start to finish A needle is used to pass fine threads under the skin, which are then pulled to stretch lax skin taut. You may go home straight after the procedure (someone will need to drive you home if you opt for sedation) You may return to work the next day You may not exercise for 3 weeks afterwards and will be advised to sleep on your back for 3 nights afterwards. Over the following two weeks, as you move your face, there will be gradual sag of your skin. Over time, the threads will cause new collagen to form under the skin, which may last around 1.5-2 years. At that point, due to the ageing process, you may need revision of the procedure to adjust the tissue again Depending on your face and areas of concern, you may have between 2-4 threads on each side of the face.The cost begins around $3000 but is dependent on the number of threads needed, which varies based on the patient - their age, their concerns, their skin quality and more. This procedure is best for people in their 30s and 40s, but my oldest patients have been in their 60s, who wanted some improvement, without the cost of a facelift ($20-50k). As with all procedures that involve the face, commonest side effects are bruising, bleeding, and a small risk of infection especially if you have other medical concerns. We advise that you not undertake any significant medical procedures 2 weeks prior to any travel, or any big events such as weddings, parties and similar due to bruising and time to settle being the commonest side effects, which may cause anxiety. If you would like more information on thread lifts, and to discuss options and a personalised treatment plan for you, please get in touch on 02 9734 8845 or email us on contact@skinessentials.com.au Get in touch to organise a personalised consultation with Dr Joshi to plan your treatment for your best skin ever.

In consultation with patients, I’m frequently surprised by the confusion and misinformation that exists out there, even among otherwise educated patients. It’s no surprise then, that the beauty industry is as successful as it is, with so many markets selling regimens that aren’t based in fact or evidence. At Skin Essentials we try our best to stick to evidence, and to what works while acknowledging and stressing to patients that as with anything that has a human component to it, individual results may vary. One of the commonest problems I encounter, as a Woman of Colour (WOC) myself, is that of pigmentation in its various forms. Whether it’s Melasma, Post Inflammatory Hyperpigmentation (PIH), photo ageing or a mixed form, uneven pigmentation, especially on the face, can be quite distressing and hard to remove completely. It is a pigment disorder that most commonly occurs in women of childbearing age, though it may affect women at other stages of life, as well as postmenopausal women. It is also far more likely to affect women (1:4) than men (1:20) Commonly known as the “mask of pregnancy”, it’s causes are varied- from genetics, to ethnicity (more commonly affects women with light brown skin from sunny areas in the world) to the use of hormonal contraceptives, pregnancy and lack of sunscreen use. Once present, it is typically hard to remove completely and requires meticulous care and treatment to prevent it worsening. There is so much misconception that abounds about Melasma, and improvement is typically seen with a combination of skin treatments, typically a course of religious sunscreen use, a skincare regimen formulated with Melasma in mind, as well as a course of skin treatments such as graded medical grade chemical peels and/or skin needling. On the flip side, due to the likelihood of these skin types to be more prone to pigmentation problems, if not undertaken carefully and with a thorough understanding of underlying issues, including any medical conditions that may predispose to it, one may find the condition worsening. So what works? While each skin and person is different, here are some general guidelines. Sunscreen- always, rain or shine, winter or summer, reapplied frequently through the day. Enough to leave a shiny hue on the skin on initial application. Sun protection, always - even an hour of sun exposure can undo weeks of treatment. A skincare regimen that incorporates a combination of ingredients that will facilitate increased skin cell turnover and even out skin tone. A series of skin treatments eg 3-6 sessions of graded chemical peels and/or a series of 3-6 sessions of skin needling if you are on hormonal contraceptives, consider coming off them as they all have potential to worsen hyperpigmentation Consider a twice yearly course of SkinBoosters, non-lifting injections of hyaluronic acid under the skin to stimulate collagen and improve evenness of tone and texture. These are usually conducted under the supervision of a doctor, and once maintenance is achieved, ongoing care as directed. When is a good time to begin these treatments? Anytime, but the best time in the Australian climate is often winters- reverse sun damage, and take advantage of the cooler weather to achieve significant gains on skin improvement in time for summer and the holiday season. Ready to get started? Get in touch to organise a personalised consultation with Dr Joshi to plan your treatment for your best skin ever.

Your skin is the largest organ in your body, yet for most of us, unless we have diseases affecting our skin, such as eczema (atopic dermatitis), or worse, we simply take this amazing organ for granted, and all the ways in which it protects us every single day over years of our lives.  Regardless of whether we care for this organ, it protects us from chemicals we come into contact with, it acts to hold organs inside and give us a boundary between what we understand to be “me” and the outside world. Often the first time we think of our skin, is as children, when we wear sunscreen to go to the beach, or at school prior to playing outdoors. For many of us, that is about the extent of our skincare regimen, especially if we are Caucasian, until decades later. If Asian, where beautiful and fair skinned people are highly regarded, girls grow up with strict admonitions against freckles, sunburn and protecting skin at all times. So when people comment on my skin, I can honestly say that most of it is due to genetics, diligent sun protection and a basic but effective skincare regimen that fits in with my lifestyle as a busy mum of 4. Well before I discuss injectables with a potential patient, I’m looking at, and assessing your skin quality, its hydration, its sun damage, if any. I’m looking for other signs of ageing such as wrinkles, sag, and other common and preventable conditions such as acne and more. That’s a big part of why I began Skin Essentials. The skin market is so huge, with so many people clamouring to get a foothold, it’s truly bewildering to know where to begin, much less who to trust.  While I love my other jobs as a GP and educator, Skin Essentials is intended to be a clinic where I indulge my passion for all things skin to help my patients achieve personalised goals to their best skin ever discreetly. What do we offer and how does it all work? Well, we offer everything from: basic skincare regimens personalised to you and your unique skin concerns, from teenage years through to your 60s and beyond.  Treatments that complement your skincare and help prevent (further) damage - acne, rosacea, hyperpigmentation, ageing and more by way of a treatment plan, duration and number of treatments, all packaged for you. Injectables such as anti wrinkle treatment, dermal fillers to reverse wrinkles and sag Thread lifts, especially for those who may not intend to go down the facelift path. So when is it a good time to care for this amazing organ we all have?  The best time is to begin before you think you’ve any problems, ie now, because without maintenance all skins suffer. There is no better time to begin your skincare plan than in winter, when the sun isn’t as harsh to undo some of the sun damage, especially since skin usually takes 3-6 months to respond. Are you ready to commit to your skin?

What do I mean when I say subtle, sensible rejuvenation? What’s my demographic? Who is my average patient? Most of my patients are professional women- accountants, lawyers, media people and nurses. Others are single mums, stay-at-home mums and more. Regardless, the common theme for many  is that they don’t want to look silly, they don’t want to look fake, and they do want to look the best possible for their age. Many are Muslim, and wear hijab, and some even cover their face, and want to look their best at home, and for their chosen friends and family. My patients worry about looking fake and being made fun of at work or by friends. Some have had disastrous results elsewhere, especially with lip fillers; some had to go back and have it reversed due to the obvious enhancement. They want deep set lines to soften, they want to look and feel good when they look in the mirror, they don’t want makeup to cake into wrinkles and they don’t want to spend ages applying makeup to more shadows and wrinkles and hollows. At the same time, they do not want to look like they have had work done. All admirable and achievable goals. The only problem? Money and fear. Money, because by the time they’ve been feeling old, haggard and worn out enough to see someone, they’ve left it a bit late. Leaving it too long means their expectations are often not realistic in terms of both what’s needed, and associated cost. They often think 1ml of filler will fix a problem they’ve watched developing over 3 years and which will need 4-6 mls over 6 months. Or they come to see me 2 weeks before a wedding, or a relocation overseas for something that would normally take 3 months to treat. Or they tried the latest offer at the local clinic, but it didn’t give them the results they wanted. Or they want deep frown lines that have taken 20 years to develop to be gone after 3 or 6 months of anti wrinkle treatment. And, while they don’t say it, I’m sure fear is another part of it- fear of fillers. Fear of looking unnatural. Fear of “looking like those Kardashians” or “The Real Housewives of Sydney”. So here are two examples of two of my patients. This woman in her early 50s, whose deep frown lines I’ve been treating for 9 months every 3 months’ she didn’t believe the lines were fainter or weaker at all. But photographs don’t lie. Good results take time, decent products, money and patience. That’s why your consult is obligation free. It’s why I don’t do fillers on the first consult. Because I plan your treatment for you and only you. It is not a one-size-fits-all treatment, it is a treatment plan tailored specifically for you, by me. As Dr Mauricio de Maio says, I aim for “surgical results, without the surgery”. Only you can decide if that’s worth it to you. Here is an example from someone who has consented to being “on display”. She is in her early 40's. Great bone structure. Slim, with no significant sag to her lower face. I’d been seeing her for anti wrinkle treatment for some time, but despite encouragement to consider filler, she was nervous and afraid of looking fake and stupid. With the ageing process, she was losing fat under the eyes and from her cheeks causing lines from her nose to mouth, darkness and a hollow look under her eyes and in her cheeks. These were more prominent when she was animated, with telltale sausages in her midcheeks. Here she is after a total of 4 mls of dermal filler, primarily to her midface, then under her eyes. Notice it doesn’t make her look heavy, or saggy. It does give her  subtle volume, like she would have had when she was younger. Note: She looks younger and fuller The volume replaces the fat pads we all lose with age The lines around her nose and mouth are fainter with the added volume She looks softer, less harsh, less sad. Even her freckles look less dark and heavy, as the volume lifts the skin off the bone and reflects light better. This is what 4 ml of dermal filler looks like, over 3 months. No one can tell, except she looks fresher.

I often hear from people, especially women in their 50s, “Oh I’d love to look 20 again!” Mostly, they are laughing and they know it is not possible, with far more money than they have, or want to spend on plastic surgery – and even then I am not convinced it is possible! But sometimes, it is a real longing. To these people, I say, “I don’t think it is possible to make you look significantly younger, I CAN help you look the best possible for your age bracket – fresher, less tired, rejuvenated.” What’s the difference? Here is a photo representation of someone ageing, from a young person in her 20s, through to possibly someone in her 60s. On the surface: Over time, there is more fine lines, then wrinkles, then sag from her 40s onwards. By her 60s, she may look weathered and tired, often earlier than this. But look at this. Me 12 years ago, and last week. I don’t have any significant wrinkles yet, but …I don’t look 18 or 20 or even 25 anymore! Why not? Because under the skin, this also happens: Ageing isn’t just about the surface changes. Other changes are occurring also, under the skin surface – with the structural support of bone, noticeable changes in overlying skin and tissue also occurs. Fat pads that give young people their youthful appearance, are gradually lost, or begin to sag. So while anti wrinkle injections can relax wrinkles, and fillers can replace some of the sag and lost fat pads, we don’t have much to reverse bony changes that occur with the ageing process. And that is why, a wrinkled young woman in her 20s or 30s will look tired and worn out, but still young, but a woman with over treated wrinkles, or naturally-no-wrinkles who is in her 40s or 50s will NOT look 20. The bony changes will give her away. Any questions? Email me!

“My lines seem more obvious again. Is it time for a topup?” Ask Dr Imaan : “My lines seem more obvious again. Is it time for a topup?” Like any decent doctor and surgeon, my consent process for any procedure is fairly extensive- I explain many many things; what can go wrong; what to expect- immediately, soon, in two weeks’ time and in the next few months. When it’s time for a top up. If I have consent to take photos and use them for my website; if I have consent to email reminders etcetc. Sometimes, because I have done this process so many times, I forget that patients can’t take it all in at the time, may be nervous and therefore inattentive or excited and eager to proceed or any combination of the above. Because of this, we miscommunicate. And the single biggest question I get after the treatment, is “Do I need a topup/more treatment already?” in relation to static lines. What are static lines versus dynamic lines and why does it matter?  If you ask a 5 year old child to look angry, they’ll develop wrinkles between their eyes; these go away as soon as they are laughing however. These, are dynamic lines. Lines that are visible when the muscle underneath is being used, but disappear when it is relaxed. As we age, and our habits keep us frowning when we concentrate, or squint  or concentrate; or we use our forehead lines to see better, to open our eyes up for photos; or we laugh and over time, crows feet form around our eyes. Over time and repeated use over years and years, the lines don’t disappear completely when we aren’t using those muscles. These lines are static lines and they deepen over time as we continue to use our muscles, lose the plumpness of the skin with age and skin damage. Anti-wrinkle treatment is great at treating dynamic wrinkles; it is less effective at treating static wrinkles, BUT it does soften these lines over time, usually within a year of ongoing, back-to-back treatment. So. When someone contacts me to say their lines are more obvious again, but frowning is still harder than usual, it’s usually because their static lines are still visible, and as the effect of treatment begins to wear off, they are beginning to use those muscles more. OR they didn’t have a big enough dose to begin with. So for eg, if someone really needed 25 units of Brand A but only had 20 units initially with a review planned at 2 weeks which wasn’t attended, an opportunity for topup was missed. Sometimes, as the effect of the treatment that wasn’t enough begins to weaken, the habit of frowning in this example, comes back, causing static lines to look more obvious next to the smoother treated skin. The solution, is a review. It’s not possible for any decent practitioner to give you a consult over texts or phone without seeing your face, your muscles in action and their strength. I understand it may feel like a waste of time, but it truly isn’t, and you may end up shortchanging yourself in the process. In this patient, I’d suspect that she’d been underdosed and would have benefited from a topup at the two week review with another 4-6 units for best effect. Or, quite possibly  due to the bunching effect next to her brows, that she was using other muscles instead of her frown muscles to cause the bunching and lines, none of which can be assessed except in person. Finally, everyone reacts differently to the same dose of treatment. Here is an example of another person at 6 weeks, still unable to frown, as seen by her squinting: