New Developments in Managing Atopic dermatitis (AD)/eczema

After a year of hiatus, I finally attended the first media event! Rightly so, to update myself about the latest developments in managing atopic dermatitis. Even though this event was meant for the public, I must say that I have also learnt a lot!

AD affects 20% children and 8% adults. 4 main elements in AD includes irretractable itching, dryness, redness/inflammation which can be complicated by secondary bacterial infection due to ineffective skin barrier function.

AD is more than a skin condition. It also affects productivity due to constant scratching. This can result in poor sleep up to 2.5hours! Furthermore, AD can also cause loss of employment, social and psychological burden, embarrassment from socializing and schooling. AD is also costly to treat.

The first talk of the afternoon was delivered by Dato’ Dr Noor Zalmy Azizan. She is a Consultant dermatologist at HKL/Thompson Medical Center. The talk was entitled Introduction to AD (causes, symptoms and impact on patients).

Eczema can be subdivided into Endogenous (eg atopic dermatitis, seborrheic dermatitis) vs exogenous (contact dermatitis due to specific triggers). AD is a clinical diagnosis and does not need blood/patch test to confirm.

AD is a complex, chronic and recurrent itchy inflammatory skin disorder. Disease can flare up with stress and dry environment. However, certain cases can also be continuous. Prolonged uncontrolled ezcema can cause lichenification/thickening of the skin or nodular prurigo. AD is also associated with asthma, allergic conjunctivitis and allergic rhinitis.

The prevalence of AD in Malaysian children has risen from 9.5% (1994)to 12.5% (2002) based on the ISACC studies. The risk is higher if there’s family history with filaggrin gene mutation, causing a lack of protein in the skin which moisturizes the skin naturally. Oxidative stress can further damage the skin. The real reasons behind AD are not fully understood yet. The vicious cycle of scratching, sweating, hot water and sun damage further causes skin breakdown, mimicking a failing brick and mortar model.

According to the Malaysian Clinical Practice Guideline of management of AD,
Emollients is the mainstay of treatment of all AD stages based on Cochrane systematic review and is able to reduce the need for steroid use.

The second presentation by Dr Leong Kin Fon, a prominent pediatric dermatologist spoke about the Management of AD & Tips for Parents.

AD is a dynamic disease with many faces. The distribution of the rash differs with age. Therefore, it is important to seek treatment from dermatologists as early treatment can prevent complications. AD usually starts after 6 months of life as the fetus was initially protected in amniotic fluid. The newborn skin was also protected with vernix.

In general, the amount of emollient needed is 500g for adults and 300g children in a week. Oil or cream based moisturizers should be used over the limbs and body as this can last over the day. Lightweight, lotion/gel based emollients can be used on the face instead. Look for hypoallergenic and low irritation emollient and cleanser which are effective against all these symptoms: Itchiness, dryness and erythema.

Other tips including:
-Avoid extreme weather
-Avoid prolonged bubble bath
-Bathe less than 15minutes with lukewarm water (test with closed eyes)
-Rebalance antioxidant levels on the skin
- Empower the patient in the management plan

6 principles of AD management are:

1. Fine tune expectation-eczema takes months to years to control, not cured. It’s like running for a marathon.
2. Always listen, demystify and educate patients - it is not possible to pinpoint the exact cause of AD as it is complex and multi factorial.
3. Need to mix and match treatment to 'flatten the curve' ( tackling itchiness, infection, dryness and inflammation)- persist with effective treatment until remission is achieved.
4. Learn how to befriend steroid cream (they are natural!) with 7 potency levels depending on severity and thickness of skin- usually 2 weeks long, need to review use regularly and watch out for skin thinning.
5. AD starts with itch first then red rash lastly weeping rash- start treating when it’s itching.
6. Natural products can be harmful and loaded with high potency steroids
--Scrutinize the research behind the products, if possible backed by Randomised Controlled Trials

Lastly, Dr V Shubashini, Medical Affairs Manager of Menarini launched their latest AD products– Introduction to Relizema™️-Dermarel™️

Relizema cream is a topical emollient used to protect the skin’s barrier function containing antioxidants (furfuryl palmitate and tocopherol). It has a fast onset and offered sustainable relief for itchiness.

Dermarel lotion containing 3 types of ceramides and plant based oils. It is a lightweight emollient.

Dermarel cleanser is made of ceramide and amino acids suitable for dry face and body.

Dermarel spray & go soothes red and burning sensation especially in inflamed and dry private areas without the need to rub in.

These tips really help our family of 4 to deal with AD. Be in control!

How to treat melasma? | Always Be Pure Marine Therapy Dark Spot Correcting Serum Review

Who doesn't like a fair complexion with even skin tone? I first started to notice worsening breakout and melasma during my second pregnancy. This is not uncommon due to the hormonal changes in pregnancy. It's already 1.5years down the road now. But I'm still troubled by these brown or grayish-brown blotches on my face. With the constant summer in Malaysia, this is making my melanocytes (skin pigment producing cells) even more active.

Besides avoiding the sun and putting on sunscreen, there are many other treatments such as chemical peeling and laser treatment, as well as topical preparation like Always Be Pure Marine Therapy Dark Spot Correcting Serum.

Read this article from Harvard Health about Melasma.

Besides that, skin hyperpigmentation issues can also be caused by the ageing process, post-acne (post inflammatory hyperpigmentation) and certain medical conditions such as systemic lupus erythematosus.

Always Be Pure Marine Therapy Dark Spot Correcting Serum

The powerful whitening ingredients are:

50% deep sea water from East Sea is rich in over 70  types of natural minerals. From 200m-depth,  this is the cleanest water made by nature with similar composition to the mineral content in our bodies to replenish deficient.

10% sea grape extract aka Caulerpa Lentillifera extract with fucoidan that controls melanin formation.

Other important ingredients include

-4.9% niacinamide (vitamin B3 can be used to treat acne)
-NEUROLIGHT 61G (an extract of sea daffodil)
-magnesium ascorbylstate (a form of vitamin C with potent antioxidant properties) 
-pearl extract
-Oriental Beauty Fruits Newplex (pomegranate, fig, mulberry, and ginkgo are traditionally used by Asian ladies in skincare)
-topical collagen (to replenish dwindling production as we age)

Always Be Pure Marine Therapy Dark Spot Correcting Serum is free of alcohol and harsh chemicals. The ingredients are labelled in the “green” range in EWG’s Skin Deep® cosmetics database. Furthermore, the serum has passed the Skin Irritation and Sensitization Patch Tests. Therefore, The serum is suitable for daily use on ALL skin types, including sensitive and combination skin.

Full ingredient list:

Sea Water (50%), Water, Caulerpa Lentillifera Extract (10%), Butylene Glycol, Niacinamide (4.9%), Dipropylene Glycol, Propanediol, 1,2-Hexanediol, Pentylene Glycol, Arginine, Carbomer, Glycerin, Polyglyceryl-10 Laurate, Hydroxyethylcellulose, Laminaria Japonica Extract (893 ppm), Aloe Barbadensis Leaf Extract, Dioscorea Japonica Root Extract, Ulmus Davidiana Root Extract, Viola Mandshurica Flower Extract, Polyglyceryl-4 Laurate, Ethylhexylglycerin, Caprylyl/Capryl Glucoside, Dipotassium Glycyrrhizate, Adenosine, Disodium EDTA, Eucalyptus Globulus Leaf Oil, Hydrolyzed Collagen, Magnesium Ascorbyl Phosphate, Panthenol, Pearl Extract, Sodium Hyaluronate, Cynanchum Atratum Extract, Ficus Carica (Fig) Fruit Extract, Ginkgo Biloba Nut Extract, Morus Alba Fruit Extract, Punica Granatum Fruit Extract, Centella Asiatica Extract, Hizikia Fusiforme Extract (13 ppm), Undaria Pinnatifida Extract (13 ppm), Chlorella Vulgaris Extract (12.5 ppm), Ecklonia Cava Extract (12.5 ppm), Gelidium Cartilagineu

What does Dr Yingzangel think?

Always Be Pure Marine Therapy Dark Spot Correcting Serum is a great product to be used after cleansing and toning the skin. It is lightweight, soothes irritated skin and has definitely faint my hyperpigmentation as well as wrinkles. The serum gets absorbed quickly info the skin, leaving a cooling and refreshing effect.

Get yours from

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Environmentally Friendly Sheet Mask | NUViT Bio-Cellulose Mask Review

Want to have great skin but am worried about the carbon footprint we leave behind? There's now an option to use Bio-Cellulose sheet mask! I have been using NUViT Bio-Cellulose Mask for a week now and I would like to share about the science behind the product.

What is Bio-Cellulose?

Bio-Cellulose is an exopolysaccharide produced by various bacterial species. These are made of sugar residues, essential components of what we called biofilm which is a cosy home for microorganisms. Normally, doctors hate biofilm formation because it stops wounds from healing. However, biocellulose can also be made into wound dressing to maintain moisture balance of the wound bed by both donating or removing moisture in dry or wet wounds respectively.

In NUViT Bio-Cellulose Mask, the biocellulose is all natural and toxin-free from a unique bacteria strain. Biocellulose is able to hold fluids 100 times its dry weight and 10 times more than fabric or paper mask sheets. This helps to hydrate, nourish and soothe irritated skin. Funfact-do you know that the Water Absorption Capacity for Bio-Cellulose is as high as 1150% !

NUViT Bio-Cellulose Mask is also extra soft & gentle for the skin. At the same time, biocellulose adheres to the skin very well-- it is able to lock in moisture and effectively deliver serum to the skin. It's so fast, in fact, NUViT Bio-Cellulose Mask is capable of transporting 90% of active ingredients deep into the skin in a mere 10 minutes.

Why Quintuple Hyaluronic Acid?

Quintuple Hyaluronic Acid is the main ingredient in NUViT Bio-Cellulose Mask. In other words, the mask is infused with 5 forms of topical collagen, namely Sodium Hyaluronate, Hydrolyzed Hyaluronic Acid, Hydrolyzed Hyaluronate, Hydroxypropyltrimonium Hyaluronate and Hydrolyzed Sclerotium Gum.

These collagen molecules differ in sizes to allow different layer of skin penetration and moisture retention. In fact, Collagen regeneration of the skin is seen as early as 7 days after using NUViT Bio-Cellulose Mask

2 other important active ingredients are:

Palmaria Palmata aka Dulse, is a red algae found in the Atlantic Ocean. It is rich in antioxidants, vitamins and minerals which is able to nourish, soothe, heal, condition and brighthen the skin.

Avana Sativa Kernel is yummy colloidal oatmeal which has beta glucan, lipids and antioxidants like avenanthramide. This moisturizes, soothes and protects the skin from irritants and sensitivity.

What does Dr Yingzangel think?

NUViT Bio-Cellulose Mask uses the power of medical science to design high quality sheet mask to push skincare to another level. Having used biocellulose for my patients, I have experience in witnessing how good this is. This is definitely a good skincare product minus a sky high price tag. Topical collagen is great choice as it directly boosts skin condition after application.

Good news! NUViT Bio-Cellulose Mask is already available and selling on Egreenbeans.com since 4th of June 2020. Grab yours now!

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Dry Or Dehydrated Skin? | IMBZ Infinite Hyaluronic Silk Mask Review

No, dry and dehydrated skin are not the same! It's important to differentiate them because the management differs. Dry skin means the skin type lacks sebum/oil gland and production. This may manifest as itchy and flaky skin. Dehydrated Skin, on the other hand, is the lack of water caused by weather, environment, diet, including excessive caffeine consumption. Symptoms include dull, tight skin with wrinkles and dark circles looking more apparent, as well as congestion.

More information on Allure.

My face is fairly dehydrated recently which is explaining the breakout! Partly because I have to wear surgical face mask for prolonged period at work. This makes me less likely to consume enough water. Since work is picking up its pace post covid, I am also more tired and rely on my daily caffeine boost.

Besides drinking more water, topical collagen can be helpful. Collagen aka hyaluronic acid is an important skin component that is lacking in dehydrated and ageing skin. Topical collagen binds water to keep the skin supple, lock down the moisture content as well as to faint wrinkles and scars.

IMBZ Infinite Hyaluronic Silk Mask

IMBZ Infinite Hyaluronic Silk Mask contains Nano Miracle Hyaluronic Acid and Micro Hyaluronic Acid. The Micro molecules are bigger and get retained in the epidermis to stop moisture from evaporating. On the other hand, the nano molecules are able to penetrate deeper into the dermis which keep it hydrated, double the effect of conventional hyaluronic acid.

There are 8 forms of hyaluronic acid used in the mask!

1. Conventional hyaluronic acid stimulates water channel insertion onto the skin to allow water molecules to enter the skin.
2. Hydrolyzed hyaluronic acid maintains skin moisture.
3. Potassium hyaluronate supplies the skin surface with constant moisture.
4. Sodium acetylated hyaluronate is lightweight and stays on the skin surface better to retain moisture.
5. Hydroxypropyltrimonium Hyaluronate forms a water film on skin surface.
6. Sodium Hyaluronate stops water from evaporating.
7. Sodium Hyaluronate Crosspolymer locks moisture in the skin and prevent wrinkle formation.
8. Hydrolyzed Sodium Hyaluronate is small and can penetrate deep under the skin.

Other active ingredients include:
Saccharide isomerate has anti-ageing properties and keeps the skin hydrated.

Chondrus Chrispus is rich in fatty acids which are important components of healthy skin.

Hydrogenated lecithin repairs dry skin and restores the skin's natural ability as a protective barrier.

Arginine is a potent antioxidant and promotes collagen formation.

What is IMBZ?

IMBZ is Malaysia's first company to have a fully mechanized sheet mask production. This allows  a controlled and hygienic environment with precise quality monitoring to ensure consistency and efficiency in production. Only quality ingredients are used.

IMBZ strives to deliver VIP level skincare products to your doorstep in this fast-paced world when people have very little free time, let alone to focus on good skincare.

How to use IMBZ Infinite Hyaluronic Silk Mask?

After cleansing and toning, apply a sheet mask onto the face. Leave on for 15-20mins. After removal, gentle pat the face to help absorption. The mask is suitable for daily use.

What does Dr Yingzangel think?

I absolutely love products with collagen. Topical collagen in the form of sheet mask is one of the safest ways to boost collagen content in the skin compare to consuming collagen by mouth, especially if one is pregnant or breastfeeding or has chronic illnesses and am worried about systemic side effects. IMBZ Infinite Hyaluronic Silk Mask is a great way to wind down after a busy day at work. Very refreshing and is definitely a great way to boost skin hydration.

IMBZ also has another sheet mask range called Aquagenic ColdMed Mask. The mask is made of ultra thin and light texture natural silk which is anti-ageing, boosts collagen synthesis and hydration.

More info about IMBZ
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