Jo Jo Chou maintains a frantic pace of life, yet there is one commitment the married executive in her 30s holds sacrosanct: monthly visits to the dermatologist for a variety of skin care treatments, part of a diligent effort to rewind the clock of ageing cells and recapture the firm, supple skin of a woman 10 years younger. That Chou spends just under half of her monthly income on anti-ageing products and treatments is, in her eyes, well justified. It is more important than any other luxury retail purchase she could make because the treatment results are highly visible and the impact is immediate. 'This is a worthwhile investment. After all, it is your face that makes the strongest first impression. My skin used to be dull, saggy and fatigued, but the treatments have worked wonders. That's why I am keeping up the treatments on a monthly basis. A youthful appearance boosts my self-confidence,' she explains. The quest for eternal youth is nothing new. But in a culture increasingly obsessed with looking younger, the desire to shave off years is common, for men and women - and even women in their 20s are signing up for anti-ageing treatments and products. 'Men and women in recent years have become more concerned about ageing, and are seeking in-depth treatments,' says Dr Grace Lam at Skin Focus Derm + Health Clinic. 'Not only are treatments less expensive, there is now also a wider portfolio of treatments.' To put things in perspective, the global market for anti-ageing products and services is expected to grow at an annual 11 per cent, reaching US$274 billion by 2013, according to United States-based consultancy BCC Research. Of this, the products market, which includes facial care, hair and skin care, will expand by an annual 10 per cent while the services segment, such as cosmetics, invasive and non-invasive services, spa treatments and bioregenerative services, will account for 56 per cent of the market over the next three years. In Hong Kong, the anti-ageing segment has grown by 27 per cent in the past 12 months, accounting for a quarter of the city's skin care market, according to global market research firm The Nielsen Company. Though external factors such as pollution, stress, diet, sun exposure and the intake of alcohol and cigarettes play a significant role in the deterioration of skin, the ageing process is also inextricably linked to the ticking of the biological clock. The reduction in oestrogen levels in older women, especially, can trigger common symptoms of ageing, such as crow's feet, discolouration of the skin, wrinkles and sagginess. 'The biggest misconception about skin is that people don't realise the importance of oestrogen, the equivalent of fertiliser for a plant. People try all sorts of different treatments in the hope they will find the result they want, but none seem to deliver the desired outcome. It doesn't matter where you put your pots of plants. If you don't add any fertiliser, it won't blossom,' explains Dr Joseph Wong at the A3 Medical Anti-ageing Centre. Though hormonal-replacement therapy is one way of boosting oestrogen count, there are many things individuals can do on their own. Wong adds: 'The skin requires nutrients, a good level of oestrogen and a healthy lifestyle, which includes adequate sleep, plenty of water intake and a diet rich in antioxidants. If anti-ageing treatments can be used to supplement adequate nutrients and hormones, the result can be excellent.' At department store counters, in glossy magazine pages and on billboards, the desired nourishment is often promised in luxurious containers, jars of moisturisers and bottles of serum, each claiming their hold on the elixir of youth, pledging to reverse the signs of ageing and prolonging a smooth, supple, radiant look. But dermatologists warn that even the best and most expensive products have their limitations. While all good skin care products can hydrate, most are unable to hold back the ageing process because they cannot penetrate the deeper layers of the skin. 'When it comes to tackling the issue of ageing, even the most well-researched creams and serums can only be 30 to 40 per cent effective,' Wong says. Lam concurs. 'The biggest difference between products and treatments is that the latter can change the structure of the skin, while products target only the corneal layer of skin, so their impact is very short term.' The most effective products are those using liposomes, nanotechnology and PET, a patented technology. These trigger a delivery mechanism, allowing the product's ingredients to be absorbed into the deep layers of skin. Other methods can help. Botox and filler injections are as common as dental check-ups, while women are having laser treatments and light therapy to remove pigmentation and tighten pores. 'Botox and hyaluronic acid fillers can eliminate wrinkle lines and crow's feet for a period of time, but they do not improve the quality of skin. Light therapy and laser treatments, on the other hand, can improve the quality of skin. It can also turn the clock back by repairing skin, regenerating collagen, tightening the skin and removing pigmentation. If your goal is to look younger, these treatments are complementary to each other,' Wong explains. Despite the advances in anti-ageing treatment, there is not a one-size-fits-all solution. Dermatologists say delaying the ageing of skin requires a bespoke multifaceted approach. 'Different ages require different programmes. Someone in their 30s, for example, might need Botox and some light therapy in combination with good skin care products. A woman in her 40s, however, might need to tackle nutritional deficiency and detoxification. For menopausal women, hormones are the most important factor impacting the ageing of skin, much more so than anything else. The older a person gets, the more problems they generally have,' Wong says. Medical spas are likely to define the future of the anti-ageing skin care market, blurring the line between medical clinics and traditional beauty salons, with the wealthy baby boomer generation seeking to maintain their looks and optimise their health in a pleasant and relaxed environment. The popularity of spas is growing worldwide, balancing the demand for non-invasive cosmetic medical procedures and standard skin care treatments in a pampered setting. In the US and Britain, where medical spas are more prevalent, doctors perform medical treatments for skin care alongside trained beauty therapists. If managed properly, such a set-up is beneficial for patients, doctors and the profession, Lam says. In Hong Kong, medical spas have been slow to get off the ground, primarily because there is little legislation governing the industry. Unlike in the West, where only trained nurses and doctors can conduct the more advanced cosmetic medical procedures such as Botox and laser treatments, such treatments are readily performed at doctors' surgeries and beauty clinics in Hong Kong. Switzerland's Clinique La Prairie in Montreux, one of the world's oldest and leading medical spas, is an exemplary model of how things should be done. The medical spa, which employs 20 full-time doctors and collaborates with more than 60 medical professionals on a demand basis, offers patients a gamut of medical and non-medical treatments. In addition to skin care treatments, customers can enjoy everything from teeth whitening to specialised medical consultations, weight management, general surgery and plastic surgery. Licensed beauticians work with medical staff to ensure treatments are offered based on each patient's diagnosis, while all spa treatments are conducted under medical supervision. Last year, Chinese clients became the single largest group to use Clinique La Prairie, displacing Russians, who had retained the leading position for the past decade. Despite its range of services, most guests visit the spa for its cellular revitalisation therapy, a flagship treatment designed to give the human body a stronger immune system by slowing down its ageing process. 'Our philosophy is to go from inside to out. The idea of the treatment is to take care of the inside; to stimulate cell division in order to make the immune system stronger and help patients fight against the symptoms of ageing so that they can feel good both inside and out,' says Yael Bruigom, the medical spa's marketing and public relations manager.