Dr Maggie Ju
Acupuncture London

Distinct facial skin

The facial skin is slightly different from the body skin though it is a part of it. The skin cells on the face are generally smaller than those on the rest of the body. The skin on the face is thinner than that on the body. There is less fat on the facial skin and more hair follicles, sweat and oil glands. If hair follicles become plugged with oily secretions, acne starts. Water is lost from the face more quickly than from the body. when facial skin becomes dry, it can feel rough and tight, even reddened, scaly and itchy.

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Unique facial expression muscles

Facial expression muscles (or mimetic muscles) are a group of muscles on the face which control facial expression. They are innervated by the facial nerve. They are different from other muscles. They attach to the bones at one end and attach to the skin at the other end. When they contract, the skin moves and is folded forming the wrinkles that we see on the skin surface. There are five groups of expression muscles. These muscles are responsible for facial wrinkles and facial tension.

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Blue spot in the brain

In the brain there is a blue spot called the locus coeruleus. It is a small pigmented region in the pons of the brainstem- a part of the brain just above the skull base at the back. The blue colouring is caused by the production of a pigment formed by chemical reactions involving the neurotransmitter noradrenaline. This is the principal site for brain synthesis of noradrenaline. This blue spot sends noradrenaline almost to all regions of the brain including mood control regions prefrontal cortex, amygdala and hippocampus. It is involved in physiological responses to stress and panic. Neurons in this blue spot are less active at calm situation and sleep, but their activities are increased in response to alert situation such as stress. In response to stress, the blue spot is activated and produces more noradrenaline to alter cognitive function and activate hypothalamic-pituitary adrenal axis to produce more stress hormones and increase sympathetic nerve activities. It also affects amygdala to induce most stress-induced fear-circuitry disorders, such as anxiety. Aging is associated with a significant loss of neurons in the blue spot.

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What is collagen?

Collagens are the most plentiful insoluble fibrous proteins and major building blocks in the body accounting for 1/3 of the protein composition. They can be found in bones, skin, muscles, tendons, and ligaments. They are also found in many other body parts, including blood vessels, corneas, and teeth. The collagens in the human body are strong and flexible. They give the skin strength and elasticity and help blood clot etc.

With aging, the body produces less and lower quality collagen.

For example, the skin becomes less firm and less elastic. Wrinkles form, Joint cartilage also weakens with age.

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Which muscle can cause you headache, neck and shoulder pain?

Trapezius muscle: the muscle can cause you headache, neck and shoulder pain.

You may experience headache, neck and shoulder pain and feel aching and burning from the base of your skull to between your shoulder blades. One of the first muscles to cause this pain is trapezius. This is a broad triangular muscle at neck and upper back, one of the largest superficial muscles at the back. It attaches to the base of the skull and extends down to the neck, the upper back until mid back; laterally it inserts to the shoulder blades. There are three functional regions to the muscle: the Upper, middle, and lower trapezius, and each region has its own function: upper region moves the shoulder blades and support the arms; the middle region retracts the shoulder blades and the lower region rotates and depresses the shoulder blades.

Pain caused from the upper trapezius includes headaches on the temples, facial, or jaw pain, pain behind the eye, dizziness, neck pain, stiff neck, limited movement, intolerance to weight on the shoulders. Pain caused by middle trapezius includes headache at the base of the skull, mid back burning pain or aching along the spine or to the top of the shoulder. Pain caused from the lower trapezius includes headache at the base of the skull, aching on the top of the shoulder, neck, mid back and/or upper shoulder pain; pain at the back of the shoulder blade which could go down the inside of the arm to the ring and little fingers.

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The shoulder joint is a ball and socket joint connecting the upper limb to the trunk. It is the most mobile joint in the human body. It is flexible, but less stable. It is surrounded by muscles, ligaments, the capsule, and tendons to strength its stability. The shoulder joint is one of the most frequently injured joints of the body.

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Which muscle is related to headaches and wrinkles in the face?

The occipitofrontalis is an interesting muscle. It consists of two parts:

The occipital parts is the occipitalis muscle. This is the muscle that covers parts of the skull at the back of the head. It arises from the upper neck along the base of the skull (occipital bone) and innervated by the facial nerve. Its contraction draws the skull back and contributes to the headaches.

The frontal parts are called frontalis muscle. These two muscles are connected by epicranial aponeurosis. The frontalis is continuing from the aponeurosis and is inserted in the fascia of the facial muscle and in the skin above the eyes and nose. This muscle is facial expression muscle and it draws the scalp back to raise eyebrows and wrinkles the forehead.

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Tension triangle

Tension triangle is involved in the face, head, neck and shoulders. The muscles in this triangle are very sensitive to stress and emotions causing tension for these muscles. According to research, in the first two or three seconds of emotional upset, the muscles around the eyes, mouth and jaw almost always tighten. Prolonged stress leads to a chronic shortening of the muscles. Under stress circumstances, people hold their body in a tension without realizing it; continuing build-up occurs when the stress is persisting. Over the time their neck and shoulder muscles get shorter and shorter. All of the muscles in the tension triangle are particularly vulnerable to pressure. For example corrugators and frontalis muscle on the forehead tighten in response to emotional tension. Chewing muscles such as the masseter and the temporalis also react to mental stress by tightening. Many people clench their teeth when tense.

The trapezius, the large band of muscle spreads out from the base of the skull, down the neck, to the spine and shoulder blades. The trapezius helps the neck support the head. Also the sternomastoid muscles run down from the back of the ear along the sides of the neck to the chest. Sitting down on the desk for long time creates tension on these two muscles. The most common symptoms of problems in the tension triangle are the headaches and a stiff neck. Tense muscles in the jaw and neck cause headaches by constricting blood flow to the head and scalp. And tightness in the trapezius muscle causes stiff neck.

Muscle tension slows blood flow to the skin and muscles. Normally, the blood washes away the metabolic products which is toxic to the cells. But if the muscle stays tense, it becomes oxygen-starved and metabolites, say lactic acid, build up. The pain receptors in the muscles are sensitive both to shortening of the fibers and to a buildup of metabolites. When these receptors detect such conditions, they send a message of pain to the brain.

Immediate relief for a tense muscle comes from lengthening its fibers and getting the blood flowing to clear out the metabolites. Acupuncture is the best way to relax the muscles, release the muscle tension and restore blood flow.

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Which part of the brain is related to anxiety?

Research has found that amygdala, a brain region deep inside of the brain that governs many intense emotional responses. Hyperactive amygdala causes inappropriate fear and anxiety. There are also other brain regions formed a network and involved in anxiety by communicating with amygdala. The frontal cortex and hippocampus are the parts of the network. A part of the frontal cortex called the dorsal anterior cingulate cortex (dACC), amplifies fearful signals coming from amygdala producing anxiety which is shown on the functional magnetic resonance imaging (fMRI). Adifferent part of the frontal lobe, called the ventromedial prefrontal cortex, seems to reduce the signals coming from the amygdala. Patients with damage to this brain region are more likely to experience anxiety, since the brakes on the amygdala have been lifted. The hippocampus is the part of the brain that put threatening events into memories.

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How the body react to the heat? why?

As the body gets hotter, blood vessels dilate to increase blood flow to disperse the heat from the body. This leads to lower blood pressure and makes the heart work harder to push the blood around the body. The body sweats to help remove the heat too. Sweating leads to the loss of fluids and salt and ratio of fluids and salt. The reason for the body reacting to the heat is that the body has temperature about 37C to function; whatever the environment temperature is, cold or hot, the body need to maintain its own temperature to survive. If the weather gets hotter, the body has to work harder to eliminate the heat from the body and to keep its temperature down.

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Hyaluronic acid is produced in the body naturally. It is present throughout the body, especially in eyes, joints and skin.

The benefits of hyaluronic acid include

It helps joints move smoothly preventing pain and injury from bones grinding against each other.

It helps keep the body hydrated. 

It makes the skin flexible. Hyaluronic acid helps skin stretch and flex and reduces wrinkles. Hyaluronic acid is also proven to help wounds heal faster and can reduce scarring.

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How does the body heal itself?

Tissue repair is involved in the healing process which allows restoration of injured tissue. There are four phases during the healing process: blood clotting, inflammation, tissue growth (proliferation) and tissue remodeling (maturation). Blood clotting is initiated within a few minutes of injury. Plate. The inflammatory phase begins with damage to the capillaries, which triggers the formation of a blood clot and the various recruited cells to migrate into wound, such as inflammatory cells (neutrophils and macrophages), fibroblasts and endothelial cells and damaged tissue and cells, bacteria and other debris are cleared out. In proliferation phase, new blood vessels are formed and new tissue cells are crawling onto the top of the wound bed. Meanwhile the wound contract by gripping the wound edge to reduce the size of the wound and bring the tissues closer; new capillaries deliver nutrients and oxygen for the development of granulation tissue and proliferation of fibroblasts. Fibroblasts differentiate to myofibroblasts which have contractile properties containing stress fibres. The last phase of healing is regeneration and scar formation which is involved in a progressive remodelling of the granulation tissue. In this phase many enzymes and their inhibitors play a major role. Vascular cells and myofibroblasts are reduced in numbers. In the final stage, there are two separate processes: regeneration and replacement. In regeneration process, the new tissue completely restored the portions of damaged tissue to their normal state. collagen is realigned and cells no longer needed are removed. In replacement type of healing, severely damaged tissues are replaced by connective tissue forming scarring.

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What are hormones?

Hormones are produced in the endocrine glands. There are many endocrine glands in the body, such as the pituitary gland, thyroid, adrenal glands, and pancreas, testis in men ad ovaries in women. These glands produce specific chemicals and these chemicals act on the target organs and play a role in body function such as growth, metabolism, sexual function, reproduction and mood etc. Hormones are powerful molecules and only a tiny amount can cause big changes in the body. Too much or too little hormones can cause serious conditions. For example, if ovaries don’t produce enough hormones ie oestrogen and progesterone, it can cause infertility. If pancreas does not produce enough insulin, it can cause diabetes.

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How does your body temperature help you to know ovulation time?

What is basal body temperature? Basal body temperature (BBT) is the lowest body temperature during rest. It is usually measured in the morning as soon as you wake up and before you engage any physical activity. In women, BBT changes with the menstrual cycles. If you make a daily BBT chart in a full menstrual cycle you can see the BBT chart is biphasic which means there are two temperature phases. Ovulation increases BBT for about up to 0.5 degree Celsius. The average BBT is 36.37 ±0.12 ºC during follicular phase (the phase prior to ovulation) and 36.72 ±0.12 ºC in luteal phase (the phase after ovulation). If conception does not occur, the temperature goes down and then the next menstrual cycle starts. If the conception occurs, the temperature stays at the higher level until the end of first trimester of the pregnancy.

If you are trying to conceive, making your BBT chart is the easiest way to know if or when you are ovulated precisely, though it does not predict ovulation. Your BBT chart also can tell if your body is the best form and is ready to sustain a pregnancy. BBT was regulated by hormones estrogen and progesterone which produced by ovaries. High levels of estrogen lower BBTs while high levels of progesterone increase BBTs. If your BBT chart is normal, this means your ovaries are functioning well and you are ready for pregnancy.

If you have difficulty to conceive, it may reflex on your BBT chart. For example, if you are not ovulating, your BBT chart does not have two phases. If you have short luteal phase which is difficult to sustain your pregnancy it shows a disturbed BBT chart. If your first three day’s BBT is greater than 36.6 ºC, this may be associated with endometriosis.

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What are muscle knots?

Muscles knots are hard, sensitive areas of muscles that tighten and contract even when the muscle is at rest which can cause pain when touched. They’re also known as trigger points and can cause aching sensations and pain in the muscles and joints. When you touch it, it may feel swollen, tense, or bumpy which means the area is inflamed. It could also feel tight and contracted and sensitive to touch. Muscle knots is often caused by: overusing or injuring the muscles, poor posture, stress and anxiety. They can occur anywhere in the body, but they’re usually found in the back, shoulders, and neck, buttock. They can cause symptoms in areas outside of the muscles, such as headaches, toothaches, earaches. They are often accompanied with stress, anxiety, and depression, and difficulty sleeping.

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What is trigger point?

A trigger point is muscle knot in the muscle. It is a small patch of tightly contracted muscle or a micro-cramp. They form as a local contraction in a small number of muscle fibres in a larger muscle. These in turn can pull on tendons and ligaments associated with the muscle. The tight contraction of the muscle blocks its own blood supply, changing the metabolism of the muscles. Excessive production of some chemicals such as acetylcholine, noradrenaline and serotonin and a lower pH causes sustained contractions restricting local blood supply further and limiting local energy needs leading to energy crisis, pain, aching or soreness. It is tender when being pressed and it can also cause referred distant pain. Triger point is a source of the myofascial pain. If trigger point is present, there is often pain and weakness in the muscle. Trigger points can be found in many acute and chronic pain conditions such as back pain, neck pain, headache bladder pain etc. Trigger points may be caused by many factors, such as injury, muscle overuse, disease, psychological distress, hormone imbalance, infections etc.  Acupuncture can effectively remove trigger point and release pain.

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How does the face age?

The aging process involves both intrinsic and extrinsic influences.

Intrinsic (cellular and genetic) aging begins in our twenties as the production of collagen decreases, eventually leading to a loss in skin elasticity. Cellular turnover also gradually slows, leading to duller-looking skin.

Extrinsic aging consists of environmental and lifestyle-related factors which can speed up the aging process. These include diet, alcohol consumption, smoking and sun exposure.

Everyone experiences these aspects of aging differently which lead to aging at different rates chronologically and physically.

Twenties are the most glorious year for the skin with glow of youth. Only towards the end of the twenties the skin may begin to look slightly duller than it used to. The early signs of sun damage, including wrinkles, enlarged pores and sun spots start emerging.

In thirties, skin dead cells become visible, the skin is duller; lines and brown spots begin to form and the skin starts loosing and losing volume.

In forties, aging signs become more noticeable: apart from further signs of dull and loose skin, lips are loose, face was dragged downwards, eye brows, eyes and mouth descend and jaw line slackens, face becomes empty due to loosing fat pad. Some age more than others because of variation in genetics, environmental exposure and lifestyle behaviors.

By adding additional ten years, facial changes accelerate more and more. The face loses its volume in the muscles and soft tissues. The skin is dull and loose because of loss of collagen and elastin. Women lose about one-third of their collagen in the first five years of menopause, causing the skin to become drier, looser and more vulnerable to inflammation, sun damage and stressors, such as pollution and underlying health issues. This is the time that the skin needs to be rescued, if it was neglected for years.

Beyond fifties, facial aging could be accelerated dramatically as time passes by.

There are steps to take to avoid these aging influences; such as drinking enough water and wearing sunscreen, of course having facial acupuncture.

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Factors affect wound healing.

For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. Many factors can interfere with one or more phases of this process, thus causing improper or impaired wound healing. Generally, the factors that influence repair can be categorized into local and systemic. Local factors are those that directly influence the characteristics of the wound itself, such as oxygenation, infection, foreign body and venous sufficiency; while systemic factors are the overall health or disease state of the individual that affect his or her ability to heal such as age and hormones, stress, diabetes, ischemia, diseases, diabetes, obesity, medications including sterioids, chemotherapy, immunity deficiency, alcoholism, smoking, and nutrition.

The healing process can become abnormal. These abnormal repair processes are the result of an impaired remodelling of the granulation tissue. If there is the noxious stimulus, excessive extracellular matrix deposition and the continued presence of myofibroblasts is observed. This excess of extracellular matrix deposition leads to the development of organ fibrosis. The installation and persistence of fibrosis is the consequence of an imbalance between extracellular matrix synthesis and degradation by myofibroblasts.

References
S Guo et al J Dent Res. 2010 Mar; 89(3): 219–229.

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The frontal lobe of the brain

The frontal lobe is located at the front of the brain just underneath frontal bone.  It controls important cognitive skills, such as emotional expression, personality, problem solving, memory, language, communication skill, judgment, and sexual behaviors. It makes up about one third of the brain and is the largest lobe of the brain. It also controls muscles movement and speech. The frontal lobe enables us to respond to any changes accordingly. Acute stress can impair the function of the frontal lobe that required complex and flexible thinking by increasing both dopamine and noradrenaline release. Chronic stress induces the structural changes. chronic stress weakens the structures that provide negative feedback on the stress response and strengthens the structures that promote the stress response. Stress and anxiety are related to this part of the brain that is not functioning well. The stress and anxiety of frontal lobe is reflexed at the forehead tension.  Acupuncture releases the stress and anxiety.

References

Amy F. T. Arnsten Nat Rev Neurosci. 2009 Jun; 10(6): 410–422.

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Microcirculation and blood stasis

The microcirculation is the terminal branching network of the vessels consisting of microvessels with diameters <100 µm. Vessels of the microcirculation are almost entirely lined by endothelial cells (EC) to keep the entirety of the network. This network cannot be seen by our eyes due to its small sizes and it comprises arterioles, post-capillary venules, capillaries, and their cellular constituents (blood cells) including red blood cells, white blood cells and platelets. The lymphatic capillaries carry the extravascular fluid into the venous system. These vessels distribute blood to the body’s tissues and are the site where exchanges of oxygen and nutrients, solutes, hormones and inflammatory cells occurs between blood and tissue to provide energy for tissue function and mediate the functional activity of the immune system and hemostasis.

Microcirculation dysfunction causes tissue injury, organ impairment and dysfunction. In Chinese medicine this is known as blood stasis which means that the blood is not flowing or circulating as optimally as it could to all parts of the body. Microcirculation dysfunction will result in energy deprivation, oxidative stress to the cardiovascular system and the tissues, as a consequence, tissue injury and impairment in related organs.

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Understanding Inflammation: Friend or Foe?

Inflammation is a natural response of the body to injury or infection. It is a complex biological process that plays a pivotal role in maintaining our health and well-being. However, when inflammation becomes chronic or uncontrolled, it can lead to a range of health problems. In this article, we will delve into the fascinating world of inflammation, exploring its mechanisms, its dual role as both friend and foe, and ways to manage it effectively.

The Basics of Inflammation

Inflammation is the body's way of defending itself against harmful stimuli, such as pathogens (bacteria, viruses, fungi), injuries, and toxins. It is a tightly regulated process orchestrated by the immune system, involving various cells and molecules. The key components of inflammation include:

Immune Cells: White blood cells, including neutrophils, macrophages, and lymphocytes, are the primary cellular players in the inflammatory response. They are responsible for identifying and eliminating threats.

Chemical Mediators: Inflammatory signaling molecules like cytokines, chemokines, and prostaglandins coordinate the immune response. They trigger the recruitment of immune cells and promote inflammation at the site of injury or infection.

Blood Vessels: During inflammation, blood vessels dilate and become more permeable, allowing immune cells to migrate to the affected area. This is why redness and swelling are common signs of inflammation.

Tissue Repair: Inflammation also prepares the damaged area for repair. Once the threat is eliminated, tissue regeneration and healing processes begin.

The Dual Nature of Inflammation

Inflammation has a dual role, acting as both a friend and a foe, depending on the context:

Acute Inflammation: This is the beneficial form of inflammation. It is a short-term, self-limiting response that serves as our body's first line of defense. When you sprain your ankle, for example, acute inflammation helps the healing process by bringing immune cells and nutrients to the injured area. It typically subsides when the threat is eliminated or the tissue is repaired.

Chronic Inflammation: This is where inflammation can become problematic. When the immune response persists, inflammation can turn chronic. It is linked to various health issues, including autoimmune diseases, cardiovascular disease, cancer, and neurodegenerative conditions. Chronic inflammation can be caused by factors such as poor diet, smoking, obesity, and prolonged exposure to environmental toxins.

Managing Inflammation

Understanding the different faces of inflammation is crucial to maintaining good health. Here are some strategies for effectively managing inflammation:

Healthy Diet: A diet rich in anti-inflammatory foods, such as fruits, vegetables, whole grains, and fatty fish, can help mitigate chronic inflammation. These foods provide essential nutrients and antioxidants that reduce inflammation.

Regular Exercise: Physical activity not only helps maintain a healthy weight but also has anti-inflammatory effects. It reduces the production of pro-inflammatory cytokines and promotes overall well-being.

Stress Management: Chronic stress can contribute to inflammation. Relaxation techniques like meditation, deep breathing, and yoga can help reduce stress levels and its associated inflammation.

Adequate Sleep: A lack of sleep can trigger an inflammatory response. Ensuring you get enough rest each night is essential for managing inflammation.

Avoid Smoking and Excessive Alcohol: Smoking and excessive alcohol consumption are known to increase inflammation in the body. Quitting smoking and moderating alcohol intake can have positive effects on inflammation levels.

Medications: In some cases, healthcare professionals may prescribe anti-inflammatory medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids, to manage acute or chronic inflammation.

Last but not least acupuncture is an effective tool to reduce inflammation.

Inflammation is a fundamental and intricate aspect of our body's defense system. When appropriately regulated, it plays a critical role in maintaining our health. However, when inflammation becomes chronic, it can contribute to a range of health problems. By adopting a healthy lifestyle, including a balanced diet, regular exercise, stress management, and adequate sleep, you can help keep inflammation in check and ensure it remains a friend rather than a foe in your journey to well-being.

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