 My name is Raka Manishwal, I am the head of department of dermatology, Manipal Hospital, Varka, New Delhi. We are going to be discussing treatments which are available for rejuvenation. Now what is the word rejuvenation? Rejuvenation in simple words means reversal of aging. It means how we can look better. Now obviously when we talk about anti-aging. Anti-aging is a very holistic approach. We cannot stop aging in a person but we can slow down aging. We can reverse certain aspects of aging. When we discuss the process of rejuvenation, so we tell a patient it's a complete thing. A healthy body is very important. So you know you need to exercise well, you need to eat well, you need to stay fit. And it's my belief you know if you are fit that contributes to anti-aging in a very big way. Coming to the topic of rejuvenation. So there are multiple aspects of it. Let's get it straight. One single cream cannot take care of all your aging problems. You know people say one cream, seven anti-aging things. Come on that's not happening. It's not so simple. Otherwise everybody could look young and sweet and nice. It doesn't happen like that. To understand what are the treatments available. Let's just understand what are the points of aging. So just like look at me. So if I raise my forehead so you can see this muscles. So these are muscular wrinkles. And these wrinkles now can be helped with using Botox injections. So there are two types of wrinkles. One is wrinkles which are present at rest. Even if I am not making any facial expression I still have these lines on my face. But then there are certain lines. The front lines, the forehead lines, the lap lines which occur when I make expressions. So the muscular lines will work with Botox. So the Botox is a form of injections which are given into the muscle. So the medicine will relax the muscle. The effect comes within two to three days. It's superb. It works fantastic. And it lasts from four to six months on an average. But then if we talk of lines which are present at rest. Or if you look at put in some volume. Then we need to put in fillers. Fillers are materials which contain hyaluronic acid. It's a material which is naturally present in all of us. When we are born we are nice round in chubby like an apple. But as we age everything goes down southwards you know. So we need to put in some material to hold the whole thing up. We need to restructure the face. So that's a part of rejuvenation. So for that we use something known as fillers. Fillers are again simple injections. Non-surgical. Patient comes in. We put a numbing cream. Put in the material. The effect stays for one to one and a half year. It stays for that long and the effect is immediate. You can see it on the procedure table. So we can correct the wrinkles with the Botox and fillers. The third thing is a clear skin. So when we talk of a clear skin we have to understand what contributes to a tanned skin. So the biggest thing is sun exposure. So obviously people say I don't go out in the sun. But that's not true. Even in indoors we have these lights and we're doing cooking. So we're getting all this exposure to UV and that causes aging and tanning. So for detaining we have to start some procedures. So that starts with home treatment. The home treatment A most important thing is the use of sunscreens. A sunscreen has to be applied 30 minutes before sun exposure. It's not that you apply it under a shot. You've got to wait 30 minutes and then you've got B. A sunscreen works only for 4 hours. It doesn't protect you for the next 9 hours. No, if you're in the sun and you want to stay in the sun then after 4 hours wash your face and apply a thick layer of sunscreen. Then we need to put on some night creams. Creams which will reverse the tan which has already occurred. That is the first part of detaining treatment. The second part is something known as chemical peels. Chemical peels are some treatments which are done in the hospital in which some medicines will be applied on the face so they produce an exfoliation or controlled peel of the skin. There is no wound. It does not hurt. But 2-3 days of skin will look slightly dry, red and itchy and you have to avoid sun exposure. That is chemical peeling. Typically patients will need 6 sessions. We do it once in 3 weeks. Makes the skin more clearer and fairer. The third part of treatment which we are using in Manipa in our department is the Q-switch NDEAG laser known as laser toning. Laser toning. They are also known as laser facials. So again they work on the deeper layer of the pigmentation. So when we talk of pigmentation or tanning so it is in the upper layer and in the deep layer. The upper layer will be dealt by the medicines and the peeling but the deeper layer you need this detaining laser or the laser toning. Typically patients will need 6 sessions. We do it once in 3 weeks. It is not painful. You do not require anesthesia. There is no downtime. No downtime means you come, get it done, go back to work. It is a lunchtime procedure. Once a person is on this procedure they will improve tremendously and we take photographs to show them before, after and you know the effects will last quite long. But it is not permanent. We have to understand that clearly. We are aging every day. Even as we are talking now, we are aging. Every moment we are aging. So the processes of rejuvenation are ongoing process. You need to take care of your body. You need to eat well. You need your sun streams and the treatment also. Initially you might need a series of 6 sessions as I explained once in 3 months, 3 weeks depending on what we are doing but then again you need to be on a maintenance program. So if we combine these processes that is relax your muscle with Botox re-fill it with a filler re-surface it with peeling and laser toning we can make a person look much, much better. Thank you so much.