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Skin Deep by Dr Thanisorn

What is the proper order for the application of medications, cosmetics and skincare products?

To optimise the functioning of the medication, you should always

apply it directly to a freshly washed face. If the medication is placed

on top of a sunscreen, it will not work, since the sunscreen will create a

barrier to medication penetration. I suggest you apply products in this

order: medication, moisturiser, sunscreen, facial foundation and, final¬

ly, powder.

I just moved to Thailand and have looked for a bleaching agent

called hydroquinone to fade my brown spots. Why can't I buy it over

the counter here?

Hydroquinone is not approved by the Food and Drug

Administration. There is no doubt that it is the most effective skin-

lightening ingredient, but it's a somewhat controversial substance. It is

actually toxic to melanocytes and has been shown to produce cancer

in test animals when ingested orally.

Hydroquinone is also a very potent oxidant that can cause damage

to the skin, accounting for its high irritant potential.

At this point, in Thailand, hydroquinone cannot be sold - or used by

anyone except a doctor. It you have brown spots, I think it's always best

to discuss treatment options with a dermatologist, rather than self-


I'd like to know why my hair becomes limp when exposed to high

humidity during rainy season.

This occurs because your hair shafts have elements that can be

deformed by water. These are the basis for curling immediately after

shampooing. They're released from their current form when wet and

reformed in that instant of time when the hair shaft goes from being

wet to completely dry. The shafts will remain in the set position until

wetted later.

Many women with thinning hair use curls to give it more volume.

Moisture releases the curl in a strand of hair, making it straight and

"limp". Your hair itself has not changed in thickness or physical char¬

acteristics. You can use the new water-resistant hairsprays that can

keep the hair curled despite moisture contact.

Should I get my facial treatment in a salon or dermatologist's clin¬


Many complicated multi-step facial procedures with fancy names

are available at spas or salons these days. They make you feel good

and care for.

However, the results are minimal and temporary. A spa or salon will

give you a very mild concentration of the active ingredient, which is

more limited in terms of the effectiveness than what you would get

from a dermatologist.

This limitation is restricted by law. The spas and salons are not

allowed to perform strong and effective treatments without a physi¬

cian involved. They are also not allowed to purchase medical devices

or the same-strength microdermabrasion machinery as dermatolo¬


You also should be aware of your risk of some type of irritation,

infection, early scarring or pigmentation problem according to the

treatments. The advantage of getting the treatments done in a doctor's

office is that the doctor is capable of handling the complication that

may arise.

I've gradually become redder and redder over the years, and it's

really starting to bother me. Would lasers be helpful in removing the

redness? And what type of lasers are used to treat redness?

The appearance of redness might occur from a number of spider

veins or broken blood vessels on the face and it can be treated by


For that redness, a pulsed-dye laser at a 580-nanometer wave¬

length has shown to be an effective treatment for returning your face

to its normal colour.

If you're extremely red and have been so for many years, five to

eight treatments might be needed.

Be aware that facial redness is also a common symptom of

rosacea. When it comes to having rosacea, only a dermatologist needs

to know!

Thanisorn Thamlikitkul, MD, is a member of the American Society of

Cosmetic Dermatology and Aesthetic Surgery, and a certificate in

Dermatologic Laser Surgery. Questions can be sent to her at

info@romrawin.com. Her column appears twice a

month on the Fashion & Beauty page.

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