DIFFERENCE BETWEEN BOTOX AND FILLERS

Botox and fillers are all together different things serving a different purpose.

 

WHAT  ARE BOTOX AND FILLERS MADE OF:

BOTOX: Botox is a protein available in powdered form in a bottle.

FILLER: Filler is transparent gel made of hyaluronic acid. It’s available in pre filled syringes.

Filler: Transparent gel containing syringe

 

 

 

Botox: Powdered form in a bottle which after adding  to saline water  is loaded into syringes.

 

BOTOX AND FILLERS SERVE DIFFERENT PURPOSE

BOTOX: Botox is injected into the muscles to relax them.  When muscles contract the overlying skin is thrown into fold giving rise to wrinkles. When muscles relax post botox, the overlying skin also relaxes giving a smooth wrinkle free appearance.

Botox: Erases lines which come while making facial expression

BOTOX RESULTS

 

FILLER: It’s a transparent gel available in pre- loaded syringes. When young, face is like a ripe grape, as we age, it loses volume and shrinks to become a raisin. So the wrinkles and volume loss is filled with transparent gel giving an instant filled up affect.

Filler : Used to fill depressions

 

FILLERS IN UNDER EYE REGION

 

 

 

BOTH HAVE DIFFERENT LONGEVITY

Filler effect lasts for 12 to 16 months.

Botox results last for 4 to 6 months.

BOTH GIVE THE RESULTS AT DIFFERENT TIMINGS

Botox results are visible at 7 day post injection.

Fillers give instant results.

SIDE EFFECTS OF BOTOX AND FILLERS

Both are safe provided done using high quality products and done by an experienced person having complete knowledge.

Botox done properly doesn’t have a side effect. It can create problems only when not injected into the right muscle. The near by muscle which we didn’t intent to get relaxed gets relaxed by botox migration or direct injection into it. For example: while trying to relax forehead muscle, upper lid muscle may get relaxed and may lead problems in eye opening. But the good part is, the effect anyways wanes off in 3 to 6 months.  And injecting into wrong muscle doesn’t happen when done by an expert. So nothing to worry.  Such cases are rarely reported.

Fillers: Mild swelling and bruising might occur post injection. It goes off in few days time. Rarely filler might get into blood vessels and occlude them. It might stop the blood supply to concerned region and lead to ulcer formation in that region. But all this can be prevented by timely intervention. Hyaluronidase can be injected on suspicion of such things. It immediately dissolve the filler and release the blockage.

 

BLOG – DR ANVIKA

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GLUTATHIONE – SKIN WHITENING TREATMENT

Fair skin is considered a mark of superiority. It’s an obsession among st dark Asian races. No wonder research is at peak to find wonder molecule for fairness. Glutathione is the latest breakthrough in this regard.

Glutathione is a natural anti oxidant which is produced in liver with help of three amino acids- L-cysteine, glycine, and L-glutamate.

Giving glutathione to a patient suffering from cystic fibrosis lead to an accidental discovery of it leading to fairness.

Fresh fruits, vegetables, and nuts are natural sources of glutathione. Tomatoes, avocados, oranges, walnuts and asparagus are some of the most common edibles that help to increase levels of glutathione in the body. Whey protein is another rich source of glutathione.

WAYS OF CONSUMING GLUTATHIONE

Glutathione can be consumed in various ways:

Oral tablets: to be taken 1000mg per day for three months, then given a break of two to three months. Restart for another two months.

Efficacy after oral consumption is questionable as various studies shows variable absorption into blood. Glutathione once consumed needs to be absorbed through intestine into blood. Its absorption through intestines is questionable, thus inject able forms is preferred.

Sublingual sprays: better than oral and cream form since there is direct penetration into blood, bypassing the intestines.

Injections: To be given intravenously, once a week a minimum dose of 1200 mg, for at least ten weeks.

Glutathione Injection

Creams: Doesn’t seem to be promising as penetration into skin is questionable.

Soaps: Doesn’t seem to be promising as penetration into skin is questionable.

Glutathione Soap

 

HOW DOES GLUTATHIONE WORK AND WHAT RESULT CAN ONE EXPECT?

Various internal and external factors lead to formation of oxidants in body. Oxidants are the main culprit leading to diseases, ageing and wear and tear in body. Glutathione is the main scavenger of these oxidants. Thus it’s called master antioxidant. By depleting the oxidant load in body, its makes one feels more energetic. Also one can appreciate the skin glow and brightness.

As far as its results in skin whitening are concerned, results are variable.

WHAT IS THE MOST EFFECTIVE WAY OF CONSUMING GLUTATHIONE

Injections are the most effective way, since 100 percent of the drug is available

WHAT ARE THE SIDE EFFECTS

Oral glutathione capsules are considered generally safe by US FDA.

Inject able glutathione is not given approval by US FDA for its safety. That means enough scientific data is yet not available to consider it safe. Though, considering the demand for these injections, they are given rampantly all across the globe. In my personal experience and the experience gathered from my colleagues, we dint come across any major side effects. All we came across were temporary urticarial red rashes, and breathlessness. Breathlessness may have been caused due to slight vasodilatation which glutathione causes. However, here is the list of side- effects which might occur due to glutathione injections.

Thyroid imbalance, kidney failure, Steven Johnson syndrome : it’s an allergic skin reaction where the entire skin slowly peels off almost like that of a burn injury patient.

WHAT IS THE MAINTENANCE SCHEDULE

There is no fixed protocol for same. After 10 to 20 i.v. injections, one can consume oral glutathione to maintain the results or get few injects every 3 to 4 months interval.

 

BLOG – DR ANVIKA

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TCA : CHEMICAL PEEL USES AND BENEFITS

WHAT IS TCA PEEL?

TCA stands for trichloro acetic acid. It available in white crystals forms.

 

HOW IS TO BE DONE?

A thin and even layer of TCA peel is applied all over face. Immediately a burning sensation is felt. It goes off in 2 to 3 minutes. A white frost is formed. White frost turns black next day. These black crusts keep falling in next 3 to 6 days.

          TCA : WHITE FROST

CAN ONE DO TCA  AT HOME?

Never ever try doing it at home. Done properly it’s a miracle chemical, gone wrong it can burn the face. So it’s very important to get it done by an experienced dermatologist who is using high quality TCA peels.

 

WHAT IS THE RECOVERY TIME?

Black crust forms the next day. They keep falling own its own for another 3 to 6 days time.

                 TCA : CRUSTS

 

IS IT SAFE?

Yes provided done by an experienced dermatologist, who has complete knowledge about TCA peel.

              BEFORE TCA
AFTER TCA SINGLE SESSION  : DETANNING , GLOW AND REDUCED SKIN MARKS CAN BE APPRECIATED JUST AFTER SINGLE SESSION. 

WHAT ARE THE USES OF TCA PEEL?

It can be used to treat melasma (chiyaan), black spots left after acne, to remove tan .

             BEFORE TCA

AFTER TCA : SINGLE SESSION , SOME CRUSTS PEELING OFF CAN STILL BE APPRECIATED AT THE SIDE OF EARS.  VISIBILY REDUCED TANNING AND MARKS.

WILL PEELS THIN MY SKIN?

No, they don’t. New skin keeps forming from beneath to replace the superficial layers. It’s an ongoing process, which continues throughout life.

 

CAN ONE GO OUT IN SUN AFTER PEELS?

It’s better to avoid sun for a week post treatment. Especially direct sun bathing and beach holiday. For general work one can go out in sun after taking proper sun protective measures like covering face with scarf or sunscreens.

HOW MANY SESSIONS ARE RECOMMENDED?

We recommend around three sessions scheduled every 15 days apart.

ARE THE RESULTS PERMANENT ? 

In case done for acne black marks , they wont recur.  Melasma can recur . It’s advised to take a single maintenance session once every three to four month after initial three sessions.

    MELASMA RESULTS AFTER TCA

 

 

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VITILIGO TREATMENT: MICROPIGMENTATION

 

WHAT IS MICROPIGMENTATION

Micropigmentation is a technology where colors are filled in superficial layers of skin. They are natural colours . Put into skin with help of a machine. The colours remain there for around 12 to 24 months.

HOW MICROPIGMENTATION DIFFERENT FROM TATTOO

Tattoo colours have metals in them. Colours used in micropigmentation are natural. Also the needle width is too large in tattoo as compared to ones used in micropigmentation. Micro pigmentation needles are very fine.

Micropigmentation looks very natural as compared to a tattoo result.

IS IT PAINFUL

It’s done after local anesthesia, thus is rendered comfortable for person.

HOW MANY SESSIONS ARE REQUIRED?

Two sessions done a month apart.

FOR HOW LONG DOES THE COLOUR STAY

After the initial two sessions colour stays for 12 to 24 months. Post that a person requires a single touch up once every two months.

ARE THERE ANY SIDE EFFECTS

The technology doesn’t have side effects. But almost similar colour match is important.

WHAT CAN MICROPIGMENTATION BE USED FOR

Micropigmentation can be used to cover vitiligo patches, scars, stretch marks, to give natural pink colour to dark lips.

HOW IS COLOR MATCHING DONE

It’s done by hit and trial. Various shades re mixed till one reaches the shade similar to person’s natural colour.

HOW MUCH TIME DOES IT TAKE

Time required depends upon the area to be covered. It can take somewhere between half an hour to three hours.

VITILIGO TREATMENT WITH MICROPIGMENTATION

WHAT ARE THE POST CARE INSTRUCTIONS

There might be little swelling and pain post procedure for few days. It goes off completely in few days.  A topical antibiotic and moisturizers are prescribed.

                    Micropigmentation Lips

CAN ANYBODY WITH VITILIGO GET IT DONE

No. In case vitiligo is active and still spreading. Then micropigmentation is not the answer. Micropigmentation is advised when vitiligo is stable i.e. no new patches have occurred since a year.

 

 

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BOILS: CAUSE AND TREATMENT

WHAT IS A BOIL?

Infection of the hair follicle in the skin is called folliculitis. In common language it’s called boil. When few adjacent folliculitis blends, it gives rise to a larger boil medically it’s called furuncle.

                                  Boils

 CAUSES OF BOIL

Through impaired skin barrier, a cut or an abrasion microorganism enters the skin. It proliferates in oil gland lying next to hair. Microorganism releases substances which give rise to swelling and pain.

Most common causative bacteria is: Staph Aureus. It’s a part of normal flora on skin. Though it’s majorly present around nasal nares and anus.

At times, fungus too can cause folliculitis. It mainly affects back. Then it’s called pityriasis folliculitis.

Though it can affect any part of body, butts, pubic region and axillae are commonly afflicted. People with low immunity, diabetics, malnourished, alcoholics etc. are more prone.

                            Folliculitis

WHAT IS THE TREATMENT FOR BOILS:

  1. Hot fomentation i.e. cotton swabs soaked in warm water placed over lesion several times a day.
  2. Topical antibiotics like soframucin, mupirocin etc. prescribed by doctor.
  3. Oral antibiotics may also be required at times.
  4. If boil is deep within skin, a surgical drainage is advised.
  5. Application of mupirocin ointment at nasal nares and anus region twice a day for first five days of every month for six months would eliminate the hidden source of Staph. Aureus infection. By doing so chances of recurrences are reduced.
  6. Maintain general hygiene, by changing clothes twice a day, bathing twice a day with antibiotic soaps containing triclosan eg: Soapex.
  7. In case, dermatologist suspects, folliculitis to be of fungal origin, a course of topical and oral antifungal is advised.
                          Carbuncle

If a boil is ignored, infection may penetrate deep into skin. It can also spread through blood to entire body causing septicemia.  Long lasting follicilitis and carbuncle may leave scars and marks too. Thus, it’s important to seek medical advice well on time.

 

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SKIN FUNGAL INFECTION : CAUSES TREATMENT

 

Fungus proliferates in moist and damp environment. Thus, most commonly affected sites are under breast, groins and underarms. Sweat accumulates here and ventilation is least. Both these factors provide an excellent breeding ground for fungus to proliferate.

General advice for prevention of skin fungus infection;

  1. Wear loose cotton clothes. Thick fabrics especially denim are made for countries under snow for most of the year i.e. USA and Europe. Wearing them in hot and humid countries like India would lead fungus proliferation. Since they don’t allow skin to be well ventilated. Also, adds to sweat production. That again facilitates fungus proliferation.

 

  1. Keep the skin dry especially over groin region. Use tissue paper to pat dry after using the washroom. If one let the region wet, it invites fungus growth.

 

  1. Never ever use steroid based cream to cure skin fungus infection. Betnovate, Candid B, Quardiderm etc. all contains steroids. They do cure your fungus infection initially, but the moment you stop using them, disease flare up like never before. Also the fungus then becomes resistant to anti fungal treatments.

 

  1. Complete the anti fungal course prescribed by a dermatologist. People get a major relief in the problem after two weeks of treatment. Thus, they stop the treatment. Even though the doctor would have prescribed it for a month. One got relief because 80 percent of the fungus has been killed. What one need to remember is that 20 percent is still left. If one stop the medicine half way this 20 percent would proliferate to become 100 percent. Thus it’s very important to complete the course and stop medicine only after a dermatologist’s advice.
tinea corporis
  1. Anti fungal medicines. Combination of oral tablets and creams would be prescribed by the dermatologist. Like Terbinafine, Itraconazole, Grisofulvin etc. Never resort to self medication. It can do more harm than good.

 

  1. Antifungal soaps containing ketaconazole too are advised for a month.

 

  1. Potassium permagnate , a pinch should b put in a mug full of water. Pour this over your body as the last rinse. No need to put normal water after this. This too is helpful as an adjuvant therapy when don for a month.

 

Fungus is infection has become so rampant in India. That it should be declared as an epidemic. People are suffering from it since last 4 to 8 years continuously at stretch. Major reason behind this is misuse of steroids. Steroid creams are easily available over the counter. People use steroid based cream without dermatologist advice on local chemist or friends’s suggestion. Thus , stop doing this. Talk to your dermatologist and take proper treatment.

 

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HYPERPIGMENTATION TREATMENT 

Hyperpigmentation means darkening of skin. There can be various causes for same. Tanning , pigmentory demarcation lines, melasma, hormonal imbalances, vitamin B12 deficiency. Finding the cause is the first step towards treatment. Once the dermatologist pin point the cause various oral and medical creams can help. Various procedures too help a lot since they penetrate deeper into skin.

HYPERPIGMENTATION TREATMENT

Various treatment modalities for hyperpigmentation are:

Skin lightening Creams containing  hydroquinone, azaelic acid, retinoids. They should be used only on dermatologist’s advice. Drawback of creams is that they can penetrate only upto certain depth into skin. Thus they help in clearing superficial pigmentation. But fail to clear the deeper skin pigmentation.

Laser: Nd :Yag Q switched laser can help. Make sure to get it done by a USFDA approved laser only. Never by a cheap laser. Enquire about the quality of laser and Google it out to find if it USFDA approved or not.

IPL can also help, but Nd:Yag Q switched laser is far more effective.

Peels: TCA peel or salicylic acid peel would help. Peels take off the superficial dead layer of skin. Thus, the increased pigment embedded in them also goes off.

PEELS

Oral tablets: Tranexemic acid, vitamin E and C, oral anti oxidants are integral part of the treatment. Haldi or turmeric is the strongest antioxidant in the world. Taking two tablets (1gm in total) empty stomach in morning is advised.

Mesotherapy: Mesotherapy means injecting skin lightening agents into skin. This ensures that 100 % of drug has reached the skin. Creams only certain percentage penetrates. After consumption of oral tablets also, only a little percentage reaches skin. Thus, mesotherapy is very effective. Tranexemic acid is injected into skin at once fortnight intervals.

Make sure to consult a dermatologist  only for skin lightening treatment . Because a skin specialist is the right person to make the correct diagnosis. And to chose the right treatment options from the various treatments available. Apart from above mentioned medicines following things has also to be kept in mind .

mesotherapy

Sunprotection: Protection from UV rays is must to keep pigmentation in control. Do cover yourself with scarf or wear broad brim glares to protect yourself from sun. Sunscreens with SPF 30 should be applied.

UV RAYS INCREASING PIGMENTATION

Weight Reduction: A type of facial pigmentation called acanthosis nigricans presents in form of thick black velvety skin. Obesity and diabetes is the main cause. It responds to weight reduction and by keeping the sugar levels in check.

Vitamin b12 deficiency too can lead to overall skin darkening. Finding the serum B12 levels and taking the supplements in case found low is the solution.

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                                                            SKIN ALLERGY  OR ECZEMA

 

Allergy is common term we all know about. Allergy can affect many organ like eye, lungs etc. we would be talking about skin allergy in this blog. Intolerability of the skin to a certain substance is called allergy. Medically, we call skin allergy as eczema. Its notorious for being recurrent. But we can always nip the bud at the root and keep recurrences to minimum by having the right knowledge about the disease.  Knowing as to how and why eczema happens is the first step towards treatment.

 

HOW DOES ALLERGY  or ECZEMA LOOK LIKE?

Allergy may have various manifestations:

It may appear as red raised patches with white scales or as group of tiny water bubbles on red background. Bacterial infection may ensue on scratched skin and lead to development of pus. Itching is the hallmark of eczema.

Rashes can occur on any part of the body, not necessarily at the point of contact of allergen. They may either slowly spread to involve the entire body or may remain restricted to a certain body parts.

Microscopically, following things happen at the eczematous rash:

Blood vessels get dilated: giving rise to redness.

Fluid oozes out of blood vessels giving rise to swelling.

White blood cells from blood release certain substances giving rise to itching.

 

 

WHAT COULD BE THE CAUSE OF ALLERGY?

One can be allergic to anything under the sun including sun.  Any food item, any cosmetic, anything in the air, your pet, cement being blown in from the house etc. can trigger allergic response in the body.

The triggering substance can cause rashes after coming in direct contact with skin. Else after ingestion or inhalation too the triggering substance can cause skin rashes.

 

WHAT ARE THE TYPES OF ALLERGY?

There are two types of allergy:

Acute eczema: Skin developing allergy to a particular substance after very first exposure. Rashes are usually restricted to point of contact and develop within few hours of coming in contact with new substance.

Chronic eczema: Skin rashes slowly developing after years of exposure to certain substances.

Allergic attack my happen after the very first contact or after years of exposure to a particular substance. So when your doctor says you are allergic to your lipstick, it doesn’t matter you have been using it safely since years.

It’s like at times you hate a certain person instantly and at times you may start hating the person years later initially having loved them.

 

HOW DOES SKIN DEVELOP ALLERGY?

 

  1. Disrupted skin barrier: Skin protective barrier gets disrupted due to continuous exposure to harsh soaps containing SLS. Thus, allergens find easy access into body.
  2. The immune system overreacts: once the allergen enters body, it’s the duty of the immune system to throw the foreign substances out. But if, immune system over reacts, allergy and red rashes appear.

Allergic attack my happen after the very first contact or after years of exposure to a particular substance. So when your doctor says you are allergic to your lipstick, it doesn’t matter you have been using it safely since years.

 

WHAT IS THE TREATMENT?

 

  1. 1. Treatment primarily consists of finding the trigger and avoiding it.
  2. Avoid using harsh soaps for they disrupt the skin barrier. So stop using all soaps containing SLS like – Dettol, Lux, Lifeboy etc. Use Dove instead which is SLS free.
  3. Moisturizing the skin with moisturizer containing oats and ceramides is of prime importance as it helps heal the disrupted skin barrier. And at the same time it hydrates the skin.
  4. Flax seed oil: Apply flax seed oil just before bathing. They would lock in the skin natural oil and moisturizer and won’t allow soap to rip it off while bathing. Plus it contains essential fatty acids which heal the disrupted skin barrier.
flax seed oil
  1. For the current allergic episode visit a dermatologist who would prescribe you steroid based creams for few days. Oral steroids may also be needed in case of very severe reaction.

 

By:

Dr. Anvika Mittal

9999 747 717

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                               DARK UNDERARMS CAUSES TREATMENT AND PREVENTION

Underarms can get dark due to various causes. Finding out the causes of underarms darkening is the first step towards treatment. Various modalities are available for dark underarms treatment . Right knowledge would help make right decision.

                                                                           

  CAUSES OF DARK UNDERARMS 

  1. Direct application of deodorants and perfumes spray to skin over underarms can lead to underarms darkening. Never apply deodorants directly on skin. Spray it on clothes over waistline. Fumes anyways rise up and to spread fragrance everywhere.
  2. Never ever use hair removal creams. They kill hair  by denaturing protein. That means they are very strong chemicals which when applied on skin can trigger skin darkening. Those who are sensitive, skin darkening may happen in first use itself. In some, underarm darkening may happen after few applications.
Hair Removal Creams

3. Obesity: Yes, excessive weight gain may lead to a condition called acanthosis nigricans. Acanthosis nigricans  leads to skin thickening and darkening at skin folds like underarms, neck groin etc. Work towards  weight  reduction. Weight reduction would automatically lead to skin lightening.

Acanthosis Nigricans

 

 

  1. Excessive sweating: People who are exposed to hot and humid climate sweat a lot more in underarm region. Constant wet skin lead to skin darkening. try using sweat pads . Sweat pads are applied on inner side of  clothes at underarm region . They are disposable absorbent  sheets which are discarded after one use. Sweat pads keeps the skin dry. Thus reducing the chances of underarm darkening.

 

TREATMENT OF DARK UNDERARMS: 

  1. Keep the region dry as far as possible by either using sweat pads etc. or wiping it off with a dry tissue frequent times day.
  2. Opt for laser hair removal. No hair means no sweat accumulating in that region. Also laser itself leads to skin lightening. Get it done by a clinic using US FDA approved laser. Cheap laser is not recommended. Also a dermatologist supervision is very important to get desired results. Right energy levels delivered give results .

 

UNDERARMS LASER HAIR REMOVAL

 

UNDERARMS LASER HAIR REMOVAL                                          RESULTS

3. One can opt for few sessions of peel off peels (three sessions done at two weeks interval) done by a dermatologist. When topmost dead layers peel off the accumulated pigment also peels off along with it. thus subsequent sessions leads to skin lightening.

CHEMICAL PEELS

4. Skin lightening creams prescribed by a dermatologist containing – glycolic acid, hydroquinone and retinoids would help. Never ever use skin lightening creams without a doctor’s recommendation. For many of them contain steroids. Steroids give initial lightening but would ultimately lead to permanent skin darkening. thus using right creams is of paramount importance.

 

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ANTIOXIDANTS : IMPORTANCE FOR SKIN

  What are antioxidants?

Oxidants, also called free oxygen radicals are continuously formed in body. There formation is due to various reasons:

  1. Normal body functions like digestion, breathing etc.
  2. Stress
  3. Pollution
  4. Junk food
  5. Lack of exercise

Oxidants build up in body leads to all signs of ageing and diseases. Anti oxidants – as the name suggests are the scavengers of oxidants. They eat oxidants, and helps body get rid of them. Thus, they play pivotal role in delaying the signs of ageing and diseases. This explains the importance of having high supply of antioxidants in body and skin.

What are sources of antioxidants? 

    There are various sources of antioxidants:

  1. Fresh fruits and vegetables.
  2. Skin Care Products: Various day and night creams contain types of antioxidants.

Application of anti oxidant rich skin care products is important along with oral consumption. That because supply to skin after oral consumption is minimal. Amount supplied to skin would be much higher when applied in creams or serums form directly over it. Thus, to ensure good supply of oxidants to skin one need to take antioxidant rich cosmetics.

 

List of antioxidants:

 

  1. Vitamin c or L -Ascorbic acid or ascorbyl palmitate

Oral sources – (Oranges)

  1. Vitamin E or tocopherol –

(Oral sources -found in vegetables, oil, seeds, nuts, corn, soy, whole wheat flour)

  1. Grape seed extracts
  2. Caretinoids

Oral sources- yellow, orange and red fruits and vegetables- tomato, pumpkin, watermelon)

  1. Coenzyme Q10 or ubiquinone

Oral sources : Fish and shell fish

  1. Idebenone
  2. Lycopene : Oral source tomato
  3. Curcumin or haldi ( used in Indian spices )
  4. Glutathione
  5. Green tea extracts
  6. Silymarin
  7. Coffeeberry extract
  8. Polypodiumleucotomas
  9. Reseveratrol
  10. Grape seed extract – proanthocyandins
  11. Pomengranate extract containing- anthocyananins and tannins
  12. Alpha lipoic acid
  13. Genistein

(oral source – soyabeans)

  1. Pycogenol
  2. Dehydroepiandrosterone
  3. Meltonin
  4. Selenium : oral source : walnuts , fish

Make sure to buy a good quality antioxidant cream. Right concentration and easily absorb-able form is important to get desired results.

 

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