Spa wars (Amended)

From face spas to medispas to aesthetic clinics, BT Weekend takes the guesswork out of navigating the network of face-saving options available today.

GORGEOUS skin is big business in Singapore, with beauty spas raising the bar with news of increasingly advanced facial machines being brought in almost every other day. Forget the old-fashioned fix-it-all facial using steam and creams. Today, luxurious spas and even "medispas" take the guesswork out of face-saving, jostling for clients promising them flawless skin - but at a price. Navigating this network of aesthetic services can be more vexing than relaxing. So here's an easy guide of the various categories of skin-savers, and the best options for your budget.

Face spas

Facing a particularly stressful period in the office, or just need to rejuvenate your senses for a couple of hours? Take a chill pill in the form of a facial in a day spa, while getting that pick-me-up that your skin needs.

"Spas typically offer a relaxing environment, targeted at providing wellness and aesthetics solutions," says Pauline Ng, founder and managing director of Porcelain Face Spa.

"For patients looking to improve their appearances or problem skin condition, or maintain the health of their skin, trained aestheticians at spas may combine more holistic methods with low-intensity or non-invasive equipment."

If you're less than vigilant at exfoliating or experiencing skin dullness after missing out on beauty sleep, schedule an appointment with a facialist skilled at balancing out your skin. Porcelain Face Spa, for example, is known for its traditional extraction techniques to unclog every pore. Rather than address serious problems or achieve dramatic results, regular sessions at a spa are also perfect as part of a beauty regimen.

"One perspective labels doctor-administered aesthetic treatments as a 'quick fix' to address a specific need, while a day spa is more about long-term maintenance and care," says Angelyn Lim, general manager, Essence Vale Spa at Hotel Jen Tanglin Singapore.

"A day spa will always be one of the best places for complementary therapies that help to augment any recovery process a person may be going through. These therapies are non-invasive, and usually utilise cosmeceutical ingredients that achieve remarkable results over time."

While a shot of Botox will ease away lines almost immediately, consistent facials at a reputable spa can help maintain its effects - especially with the use of machines.

"If you are looking for something that's more maintenance based, like a facial, skin lightening, collagen remodelling, or pore reduction, and you are looking for something that's more budget friendly, then you should seek out a reputable spa or medispa," says Gladys Cheng, founder and CEO of face spa chain Jet Concepts.

"Customers get to relax and enjoy a painless treatment, yet emerge with glowing skin."

Spas such as Jet Concepts fill the gap between medical treatments and topical beauty products, using high-tech equipment that is non-invasive for an affordable beauty fix.

"There are many aesthetic clinics that offer basic facial services now. However, as doctors are trained to treat a skin problem and not perform facials, the experience will be very different from that of a medispa or a spa," explains Ms Cheng.

And apart from facials, body treatments can also be offered at spas, medispas, beauty salons and clinics. But the experience also varies according to location.

"The day spa or salon focuses more on an overall sense of health and well-being and may provide more pampering treatments with little thoughtful touches and gestures to soothe and relax the customer," says a spokesman for hair removal salon chain STRIP.

"At STRIP, we are more than just a waxing salon. The ambience is welcoming and not intimidating or clinical, and we specialise in IPL hair reduction which is safe and delivers long-lasting results."

While it might not be a medical clinic, the salon chain uses only US Food and Drug Administration (FDA)-approved intense pulsed light (IPL) machines that are proprietary to the group, and staff members undergo up to eight weeks of training in a dedicated training school.

"From a customer's point of view, it is reassuring to know what a salon or spa stands for, and what specialisation it has, rather than go to a place with a dauntingly long menu of services to choose from, and where the technologies may not be as well-known or time-tested," adds the spokesman.

"We keep our treatments simple, safe and efficacious for our customers."

Treatments to try:

  • Porcelain Face Spa Illuminate Facial to remove dead skin cells and infuse cells with oxygen for a smooth and radiant complexion, S$406.60;
  • Jet Revitalizing Facial fuses medical grade equipment with sensory touches, stimulating 15 unique Meridian acupoints on the face by hand, S$88 for an introductory session, S$150 for a single session;
  • Essence Vale Spa at Hotel Jen Tanglin Singapore Kerstin Florian K-Lift Age Management - Ultimate Elastin combines its skincare products with the K-Lift Machine, which taps on impulse micro-currents and LED light to reverse the signs of ageing, S$320+.

Medispas

Medical spas, or "medispas" are facilities that are operated under the supervision of a medical professional, and often use medical-grade equipment such as LED lights and radiofrequency devices, or higher-grade body equipment that are more effective than conventional spa equipment. And many dermatologists, and even plastic surgeons, are finding the sweet and lucrative spot that melds treatments developed by a doctor with an inviting and relaxing space.

Often, customers can combine a doctor-administered treatment such as a series of laser treatments with an intensely hydrating facial conducted by an aesthetician to maximise results.

"As we understand the procedures offered in medical aesthetic clinics, we are able to offer the appropriate complementary therapies for the client," says Elizabeth Wong, founder and director of Rexults medSpa. It is part of the Rexults Group which includes an aesthetics clinic.

"If one seeks improved skin health and prefers not to go to a medical aesthetics clinic, then the medispa is an option. Still, the client needs to know that there are limits to the types of treatments that can be performed at a spa therapist versus those by a doctor."

Rexults medSpa designs bespoke therapies that fit procedures at Rexults Clinic, such as micro-current therapies with Ultherapy ultrasound treatment (which only can be performed by doctors). A medispa is also less intimidating for consumers who aren't quite ready for a nip and tuck, but seek a higher level of treatment that isn't offered at a regular facial salon.

"Medispas tap on medical knowledge so that treatments can be more safely and effectively delivered," says Dr SM Yuen, medical director and chief executive officer of Atlas Medical Clinic and director of Atlas Medispa.

"In cases where a medispa/spa claims to be able to solve problems like acne, scarring, pigmentation, sagging skin, it is important to clarify what kind of equipment they are using, and how the aesthetic therapists are trained. Most problems tend to occur because of lax supervision which results in excessive treatment power which leads to complications."

But while the "medispa" label might hint at some medical affiliation, it doesn't always mean that the facility is run by a doctor. Consumers should check that more intensive treatments are administered by a trained and experienced therapist, and that the procedures were reviewed or developed by a physician. Laser treatments, Botox or filler injections, and thread lifts, for example, can only be conducted by a trained doctor.

Treatments to try:

  • Rexults medSpa Age Resist Bespoke Face Therapy uses micro-currents to boost cellular repair and production within the skin, which in turn ups the production of collagen and elastin, improves circulation and stimulates lymphatic drainage to reduce puffiness which costs S$450+;
  • Atlas Medispa Korean Airshot Nano Therapy uses a jet spray of oxygen to infuse organic botanical peptides that help relieve stress and fatigue, whiten, increase hydration and reduce pigmentation on skin at S$289.

Aesthetic clinics

Face spas may be a godsend for those who simply need a deep cleanse, temporary lift before a big event, or even smoother, more even skin. But when it comes to erasing away melasma, smoothening out pesky crow's feet, or banishing sagging skin, a trip to the doctor's office might be in order.

But not all physicians who operate under the broad umbrella category of aesthetics medicine are made the same: they could be a board-certified cosmetic dermatologist or plastic surgeon, a doctor who has spent years undergoing training in aesthetics treatments, or another doctor who just did crash courses in a slew of common aesthetics procedures.

Therefore, feel free to ask questions about the person performing a treatment and the doctor's level of experience, before proceeding.

"As the 'aesthetics practice' is not regarded as a medical specialisation, doctors are not allowed to use titles such as 'aesthetic doctor' in Singapore," explains Ms Ng.

However, well-trained doctors will be able to prescribe a course of treatment with more dramatic results than those available at a spa as they are able to operate medical-grade lasers, or administer injectables, medication and prescriptive solutions.

"To understand and appreciate the types of treatments that can be administered by a doctor, it is vital to understand what your medical doctor does for you," says Dr Patrina Wong, a general practitioner with a special interest in aesthetics and medical aesthetic director of LinC Aesthetic Clinic.

"A medical doctor diagnoses a health condition that is presented, treats diseases and symptoms and prescribes medication and performs treatments. For aesthetic needs, the same view holds. It is not only important to know any one type of treatment and how it is administered, it also requires understanding the condition, the effectiveness of various treatments, supplying the patient with the pros and cons of each treatment, and assisting the patient in making an informed choice."

Hence, patients need to thoroughly consult with a responsible doctor on their needs and level of treatment that they require to achieve a particular beauty goal.

"In cases of severe skin conditions like acne, scarring, pigmentation, it would be best to consult a doctor," says Dr Yuen.

"In milder cases like dehydration, dull skin, tired looking eyes, medispas or spas can also provide solutions. A doctor cannot practise in a medispa, nor can he implement treatments that are meant for doctors only. His role is as an adviser and trainer - ensuring the aesthetic therapists and staff understand what can be done in a medispa, and what should be done in a clinic."

Increasingly, spas and salons have started offering more aggressive treatments that should only be offered by doctors. "We have come across cases of laser hair removal treatments that are not administered by doctors but by therapists," says a spokesman for STRIP.

"This breach of protocol can be very dangerous and may lead to injuries. Consumers are probably less careful with treatments such as lasers as they appear relatively risk free compared to more invasive treatments such as plastic surgery, fillers and Botox injections. But lasers, when applied incorrectly, may cause serious skin injuries and scarring as the voltage of a laser machine is very high."

Dr Wong, for example, is trained to operate a medical aesthetic device called Picoway that uses picosecond laser technology to rejuvenate the skin, and treat acne scars and pigmentation for a range of skin tones. It targets skin blemishes, pigmented lesions, age spots, botched eyebrow tattoos, and even lightens dark eye circles, without the risk of damage that can occur with other lasers that utilise heat energy.

"The power and potential of the laser is immense, and the doctor administering the treatment needs to understand the physics of the laser, have a good grasp of the facial anatomy and skin structure and skin conditions he or she is treating, as well as how to adjust the intensity and duration of the treatment," says Dr Wong.

Therefore, Dr Wong advises that one should choose a doctor carefully based on word-of-mouth recommendations from friends.

"No one can know about everything and there is only that much one can get from the Internet," adds Dr Wong.

"If one needs legal advice, one will go to a lawyer. Likewise, if one needs advice on an aesthetic procedures, one should approach a doctor practising aesthetics for information. After the information is dispensed, the patient should be able to decide if he or she is comfortable or confident with the doctor's abilities and being under his/her care."

Treatments to try:

  • LinC Clinic PicoWay Laser treatment is the new gold standard for treating enlarged pores, skin sagging and pigments, from S$600;
  • Rexults Clinic Ageless Skin Program consists of five sessions of Clarity Laser that emit dual wavelengths to improve skin texture and rejuvenate; and 100 units of Botox to improve the appearance of lines, S$3,200+.

Amendment note: An earlier version of this story wrongly stated that Dr SM Yuen is trained to operate a medical aesthetic device called Picoway. It is Dr Patrina Wong who is trained to operate the device. The story had also wrongly attributed several quotes to Dr Yuen, instead of to Dr Wong. The story has since been corrected.

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