Lillian’s* face looked as if she had been through a case of a terrible skin disease. Her chin was bumpy and was covered in a mess of dark and light blemishes. It was difficult to tell what her original skin colour was, or whether this was a man’s or a woman’s face.

Lillian is the victim of a laser hair removal procedure gone bad. Before the disastrous operation, all the woman had wanted was to rid herself of facial hair. But her beautician chose the wrong laser-head for the job, and ended up badly burning her face. Lillian, who may have to live with a body-image problem, is among the hordes of people who today are checking into cosmetic and dermatological clinics in search of youthful skins. Going by the numbers seeking to alter their looks, beauty has indeed become a modern-day obsession.

Popular Skin care techniques today

Not long ago, a rub of Vaseline on the face was all it took to help a man face his day. The cosmetics corner at the supermarket was a woman’s section — and dermatologists were consulted only for genuine skin diseases.

Today, however, the line between illness and aesthetic imperfection is thin. We have myths, Tyra Bank’s secrets, secret portions, serums, creams, and a host of dermatological tricks to help everyone inch closer to that elusive fountain of youth, at least visually. Men, women and children are jostling for space at the cosmetics shop and dermatologist clinics. The fact that modern chemicals and procedures usually cost a fortune is not deterrent enough.

And many people, as aesthetician Maria Goes points out, will not be content until they have visited a facility like the Upperhill Laser and Aesthetic Centre in Nairobi, which she co-runs with Dermatologist Dr Saroop Singh Bansil. Converging at the clinic, friends and acquaintances are heard sighing in surprise: “I never knew you come here,” one says. “I never knew you come here,” the other responds. And they laugh it away.

Maria explains: “Women do not want to grow old. Look at me. You would never tell I have a 21-year-old child.” And she is right. Looking at her face — taut skin, not one sagging muscle or wrinkle in sight, plus her skin glows like that of a young girl — you would think she is in her early 20s. Maria is among the few women who have discovered that a beautiful, youthful skin is attainable, all without having to endure the scalpel. “The problem is that women, especially white women and those from the Asian community, will never refer you to the person who takes care of their skin or tell you what they do to have a beautiful skin,” she says.

Some skin care techniques

The clinic receives all manner of clients, skin colours and social classes. Even high-profile politicians and their wives consult with them.

Modern technology promises everything. Possible today are techniques like the non-surgical treatment of skin cancer lesions; procedures to rid clients of wrinkles, acne, laughter or smoker’s lines, sagging skin and pigmentation; and others to tighten lips and create dimples, even where none existed!

Whether one is a father or a mother, a son or a daughter, old or young, male or female, there is a procedure just for you. Here is a detailed look at the techniques in the dermatological menu.

Anti-wrinkle injections

Botox is an aesthetic injection that is used to reduce visible wrinkles temporarily. A brand name of Botulinum toxin, a potential lethal chemical produced by the bacterium Clostridium botulinum, Botox is a therapeutic muscle-relaxing agent which works by blocking impulses from the nerve to the tiny facial muscles that are related to expression lines. When injected into selected facial muscles, this chemical paralyses and keeps them from folding. Botox controls wrinkles, frown lines, crow’s feet, forehead creases, and neckbands.

“We use Botox for everything from sweaty hands to a smile that is not okay,” Maria explains. “If one wants a dimple, we can do that. If you do not want a lot of gum showing when you smile, we can help.”

Botoxing takes about 10 minutes and does not require anaesthesia. Following administration, an “improvement” in frown lines is evident within three to seven days, and the effects can last for between four and six months, after which readministered becomes necessary. With repeat treatments, thinning of the muscles occurs. This produces longer-lasting results.

One bottle of Botox costs about Sh22,000, and interested users must factor in procedure costs. In February, America’s Food and Drug Administration (FDA) warned that the toxin can spread beyond the target site, paralysing or weakening the muscles used for breathing and swallowing, sometimes with potentially fatal side effects. There is also fear that continued use might have other side effects.

Micropeels and Chemical Peels

Susan has been visiting the clinic for the last two years. Initially, she had sought help for a general skin problem. It was during an early visit that an advert on medical microdermabrasion caught her attention. In this technique, the face is made crisply smooth and more attractive by ridding it of dead skin cells through mechanical ‘sandpapering’. Apparently, there were no side effects. Why not give it a try?

She remembers: “The first time I tried it out, I actually saw the effects almost immediately. My skin was a lot clearer… a lot of dirt had been removed.”

Microdermabrasion is a recent skin-care technique. It is often used as an alternative to the more costly procedures like plastic surgery, chemical peels and aesthetic injections. In the technique, the aesthetician uses a device like a fine sandblaster to shoot tiny crystals like aluminium oxide, sodium chloride or sodium bicarbonate across the face. Gentle abrasion is combined with suction procedures to remove the dead, outer layer of skin and used up crystals.

The logic behind the technique is that if you remove or break up the outer layer of the skin, the body interprets that as a mild injury. In a self-preserving response, it rushes to replace the lost skin cells with new, healthier ones. This faster cell production and replacement encourages blood flow, improves cell nutrition, skin elasticity and texture. The result is a fresher, healthier skin with enhanced absorption of medicinal cream and moisturisers.

Microdermabrasion is used to treat the skin’s visible imperfections, like clogged pores, sun damage, hyper-pigmentation, blemishes, age spots and blackheads.

Says Susan: “I have done the procedure five times. I would say it worked. I no longer do it so often now.”

The initial procedure cost her Sh10,000. She also uses a cleanser that costs Sh3,700 which, she says, lasts three months. “It is not expensive. Compared with the amount of money we use on creams, scrubs and cleansers — which worsen our faces — this is actually cheaper in the long term.”

Irene Kagundo, who has also been going for a micropeel for the last two years, is all praises for the procedure. “I had bad acne,” she recalls. “My face was very bad.” In another two months, she believes, her face will be in great condition.

Maria believes that most skin catastrophes result from using the wrong products. “A lot of people experiment with their faces,” she says. “They see the advertisements of products and they look very appealing. They buy a very expensive cream and try it out and it turns out to be disastrous.”

Dermal fillers

These are used to fill or replace the lost volume in static wrinkles, lines and folds. Unlike anti-wrinkle injections, dermal fillers do not affect facial muscle contraction. They are used in the treatment of lines and folds that appear at rest, rather than those that appear during facial expression. Dermal fillers smooth out wrinkles, plump lips, and remove smile lines, nasolabial folds and acne scars.

They are also used to change the shape of, or enlarge, lips, cheeks, chin and nose, and for eyebrow lifting. One branded dermal filler, JuvÈderm, is a gel implant that includes hyaluronic acid, a natural complex sugar that bolsters skin elasticity. Says Maria: “The transparent gel goes in and fills the space like cement. After six-to-nine months, the compound is naturally absorbed into the body and you have to go for another injection”.

The procedure takes about 15 minutes. Side effects include redness, tenderness, or pain at the injection site. Reversible discoloration may occur. One tube of JuvÈderm costs about Sh20,000, exclusive of procedure.

Laser Skin Treatments

Medical lasers have become common in cosmetic procedures. They are mainly used to treat skin ailments like psoriasis, eczema and acne, and for removal of hair, pigmentation and skin tags. Dr Bansil stresses the need for clients to insist on a properly trained practitioner. “In other countries, lasers cannot be handled without the direct supervision of a qualified doctor,” he stresses, explaining that some non-medical personnel in Kenya offer laser services.

Many clients, Maria adds, have been misled. “A woman goes to the beautician, he does laser without finding out why she is developing facial hair. And when the operation goes bad, she comes to us to correct it.”

Laser hair removal helps reduce hair growth and increases the manageability of excess hair by selectively targeting and disrupting hair follicles. To achieve a 60 to 80 per cent reduction in hair growth, about eight sessions are required at intervals of four-to-eight weeks.