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A Dermatologist’s Guide to Enlarged Pores, Oily Skin and Acne in Singapore

April 13, 2018

 

One’s skin type is largely determined by the genetics of an individual.

The production of oil itself is genetically determined – if one has a family history of having oily skin, it is very likely that one would develop it as well, as this is directly linked to the production of androgens such as the male hormone testosterone at the onset of puberty which affects both males and females. Based on the proportion of patients at the clinic, there is a significant population of people with oily skin types in Singapore. This is because of overactivity of the sebaceous glands which are concentrated over the forehead nose and the chin area, but can also occur on any part of the face, as well as including the chest and back which are also the areas more acne-prone. Although further research needs to be done to prove the common belief that a humid climate like Singapore results in oily skin, what we do know is that climate changes can have an adverse impact on skin that is already diseased such as with underlying acne, facial eczema or rosacea which are the common skin conditions I see in my practice.

Problems associated with oily skin?

Acne is a major issue faced by those with oily skin. The cause of acne itself is multifactorial, involving primarily genetics which causes inflammation exacerbated by the production of oil often driven by hormonal factors, leading to the formation of whiteheads and blackheads. One of the ways of treating acne would include reducing oil production by the means of an oral medication known as isotretinoin or by physical methods, such as chemical peel microdermabrasion as well as laser treatments that will shrink the oil glands. To add clarity, while almost all acne prone patients have oily skin, this is not to say that having oily skin one definitely would suffer from acne.

Oily skin and ageing

One popular belief is that individuals with oily skin do not age as quickly. A desirable side-effect of oily skin perhaps? Or perhaps not.

Skin aging is due to a complex interplay of factors, with the key determining factor being a balance between one’s biology, influenced by genetics (have a look at how your parents are aging), as well as environmental aging, due to the exposure to ultraviolet rays, air pollutants, cigarette smoke as well as a stressful lifestyle. The key thing to note is that unhealthy skin ages poorly and much worse than healthy skin. In patients with facial eczema, for example, with dry dehydrated skin known as asteatosis, they are inherently unable to produce a fatty lipid known as ceramide, which helps to repair and restore the skin barrier. Without this, the skin is unable to protect itself from external allergens or changes in the environment and this can accelerate aging. Dehydrated skin has an unhealthy epidermis and dermis. As a result, this can accelerate aging in the form of wrinkles as well as the loss of volume.

If one has oily skin, the production of oil can form a barrier between the skin and the environment and this is a sort of protection which reduces the formation of fine lines and wrinkles or what cause free radical formation. Nevertheless, if one has an underlying skin condition such as scarred skin due to previous cystic acne, it doesn’t matter that your skin is oily, one would expect skin aging to progress faster than in a normal individual.

There is a study which shows that people with oily skin tend to look younger than their counterparts and this is well-proven in clinical practice. However, I would say that striving to have oily skin is actually not desirable, especially in a very humid climate like Singapore, as a shiny complexion could be quite embarrassing. Long-term overproduction of oil due to overactivity of the sebaceous glands can also lead to irregular skin texture and enlarged pores.

It is best to strive for healthy radiant skin that is well moisturized but not oily. There is a difference between moisturizer and oil, as I have seen many patients with nodular cystic acne and oily skin who also suffer from facial eczema which is dry dehydrated skin. Well moisturized skin is smooth and radiant, and looks healthy – a key component of the skin’s moisture is from molecules such as ceramide and hyaluronic acid which is an abundant water molecule in the second layer skin known as the dermis.

It is a myth that people with oily skin don’t really need moisturizer. In fact, you could have a lot of oil on your face and still have dehydrated skin that’s lacking in the key moisture molecules. Our patients who are on treatment for acne still use a good cosmeceutical moisturizer to lighten their scars, as well as Vitamin C and Hyaluronic acid serum that can restore the correct moisture balance in their skin to prevent excessive oil production known as reactive seborrhea. Reactive seborrhea occurs when one strips skin excessively of its natural oils causing the skin to produce even more oil.

Can someone with oily skin change to having normal skin with diligent skincare alone?

The amount of oil produced by an individual is genetically determined and influenced by the secretion of one’s hormones. It is however possible with proper long term cosmeceutical skincare, that one’s skin becomes adjusted in terms of restoring the normal moisture level.


Using improper skin care such as harsh oily-skin cleansers may strip skin completely dry and this leads to a vicious cycle known as reactive seborrhea.

The key ingredient involved in restoring skin moisture and not oil, is firstly a pure concentrated form of topical hyaluronic acid in our skin care. According to Dr Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin and Laser Centre,  “We use a 1% concentrated hyaluronic acid serum freshly-compounded for optimum absorption in a pharmaceutical setting. This is easily a hundred to a thousand times higher than the concentration available in cosmetic skin preparations boasting the same ingredients. Regular use of topical hyaluronic acid has the effect of visually filling and plumping up the dermis (the second layer of skin which tends to sag with dehydration and aging), leading to a poreless, even complexion”

In terms of cleansing, I would recommend using an antibacterial foaming cleanser. The honey cleanser is formulated to remove grime, oil, bacteria and other surface pollutants that tend to settle on the skin at the end of the day. The nature of oily skin is that it tends to be a breeding ground for bacteria as well as a certain type of yeast known as malassezia which thrives in a humid climate like Singapore. This is a non-chemical form of an antibacterial and antiseptic wash, using natural medical grade honey which helps in reducing the amount of grease on one’s face. As honey is a natural humectant, it traps moisture under the skin while cleansing. It thus helps to moisturize the skin and regulates the balance of the oils as well as health of the skin.

For a targeted approach, treating oily skin – medically known as Hyperseborrhea, a visit to a dermatologist is recommended. This would typically involve counselling on the use of appropriate cosmeceuticals as well as a retinoid which can regulate oil production. Our patients would also undergo chemical peels (glycolic, lactic and salicylic acid peels) in combination with laser treatments that can help to shrink the oil glands and reduce oil production. From then on, once the amount of oil production is reduced, it is easier to maintain with topicals alone.

A skincare regime for oily skin

There is a recipe for healthy skin in the same way one is careful to have a healthy diet and lifestyle to prevent illness, rather than change one’s diet only after one gets sick. Whether or not you have dry, oily or combination skin, there is really skincare that is suited for you and the answer lies in dermatologist-tested cosmeceutical skincare. Cosmeceuticals are researched to include potent bioactive ingredients formulated to prevent the onset of aging, as well as to deliver nutrients to your skin.

Such a skincare regimen, is likened to a healthy diet that will prevent skin problems from developing later. If you have an underlying skin condition, cosmeceutical skincare can
also reduce the severity of acne and facial eczema. So it is indeed true, at least for cosmeceutical skincare, that there is a one-size-fits-all for all types of skin, as a recommendation for the basic healthy diet of skin.

The key conundrum in skincare that has been plaguing dermatologists in the last 50 years was really that the dermatologist-tested skincare (which is compatible with aging problem skin types) we advocated for our patients did not provide additional cosmeceutical benefits. These women then went looking for over-the-counter cosmetics skincare which promised them anti-aging, but clearly not without the irritation and side effects. Then the dermatological community turned its attention to clinically proven anti-oxidants in skincare and showed that cosmeceuticals were valid and important in the treatment of aging skin to restore skin health. The advent of cosmeceuticals promises the same level of non-irritating gentle skin cleansing and moisturizing, with all the power molecules antioxidants which can lighten scars, brighten your complexion and retard aging. What’s there not to love?

Find Out If Men’s Skin Is Really Different from Women’s Skin

April 8, 2018

Most males are not that into cosmeceuticals. That is skincare with medical or drug-like benefits to improve skin health. Cosmeceuticals have a more relevant function than coloured cosmetics. Men have traditionally been uninterested in skin appearance, and only think of skincare as necessary when they face a specific skin concern – acne, oily skin, wrinkles or other topical skin conditions. Yes, using targeted skincare products are likely to help with these isolated issues, but having a daily skincare regime in place can avoid them completely.

Most skincare products used by men are likely to be purchased by women, even though most are unaware that male cosmeceuticals are distinct from those that females use. Many of the male products are created to address male facial hair, such as preshave treatments, shaving products and post-shave skin care. Yet, men’s skin is structurally different from females and knowing these differences can be a good place to start your skincare journey.

Oil control

Sebum production is also greater in males, this is mostly due to testosterone secretions. This can mean longer-lasting acne for men. The oil glands on our skin are more receptive towards testosterone, so it is no coincidence that we see males having oily skin more often than females.

Collagen content

We see signs of our skin ageing such as wrinkles and sagging skin as our collagen content decreases as we age. After our thirties, both men and women start to lose one per cent of our collagen each year. But for women, this loss escalates greatly in the first five years after menopause, explaining for why women experience skin ageing faster than men do.

Thickness of skin

Male skin is typically 20 to 30 per cent thicker than that of females. The presence of testosterone accounts for this difference. A man’s skin will continue to thin gradually with age, while a woman’s skin will only thin significantly after menopause. With a higher collagen density which is the ratio of collagen to the thickness of the skin, it explains why men tend to age slower than women of the same age. However, this difference may not be readily noticed as men are less active in protecting their skin from sun damage. The lack of habit in using sunscreen would allow UV radiation to add years to the skin.

That being said, the importance of sunscreen should be emphasized. The skincare product that we should all have is really the sunscreen. We know we are nagging, but please put on your sunscreen.

The skincare regime of male usually fits into either one of these options. They could be either be using soap and water only, or products that are targeted to men, or cherry pick a product from their partner. There are several main concerns with these options. Cherry picking products would likely result in using something that is not suited for men skin. Using gender-focused products may also not be effective as manufacturers typically employ stereotypes to target shoppers. Lastly, common soap and water are never sufficient for facial cleansing, simply because it causes your face to go into an alkaline state that can result in dryness (your skin should ideally be slightly acidic, at about pH of 5.5). Washing with a bar soap can pull all the water out of the skin, leaving your skin dehydrated and a buildup of dead skin cells.

Most men hope to have clean, fresh, clear and smooth skin. And the preferred approach to achieving healthier skin is to have minimal steps in their skincare routine. An ideal skincare routine should begin with a proper cleanser. (No soap and water, please!) Use a pea-sized amount of Miel Honey™ Cleanser and work it into a lather over the entire face. This is to facilitate the removal of sebum and debris. Use cold water as heat can be irritating to the skin. The lather from the Honey Cleanser also doubles up as a “shaving lotion”, lubricating the shave with anti bacterial Honey which thoroughly cleanses the skin without over-drying the jaw line shave areas that could be especially sensitive and prone to acne breakouts!

Sun exposure can damage your DNA, and cause wrinkling and skin cancer. Add SunProtector™ to your routine for daily application. With an SPF value of 50, it is sufficient to safeguard the skin from free radicals and keep it sun damage-free. UV radiation is a common culprit that compromises our skin’s integrity and can lead to sensitive skin or dryness. Developed in a research laboratory, this sunscreen is also formulated in-house for Singapore’s humid climate, so rest assured and lather on.

Keep your face moisturised with Radiancé Fluide™ Hydrating Emulsion. As you age, your skin cells will start losing the ability to retain as much moisture as before, as collagen levels decline over time. Deliver essential nutrients such as amino acids and oligopeptides to your skin with this moisturiser to keep your skin bright and healthy.

© 2017 twlskin.com. All rights reserved.

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Meet with Dr. Teo Wan Lin, consultant dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.

To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.

The Beauty Routine for Bridal Skin

March 25, 2018

Planning for your big day? Yes, you have finally found your dress, and you are beyond ecstatic. Only to be bogged down with issues about the wedding venue, sending invitations, your flowers and finding suitable photographers. Nevertheless, don’t let all the stress get to you, and your skin! You would certainly want to walk down the altar with glowing radiant skin after all, so here’s a guide to prep your skin just in time for your D-Day.

When it comes to wedding beauty, women tend to get more hardworking with their regular masking and night-time routines. Changing your beauty routine two or three months before your big day can give you ample time for your skin to reach its optimal condition. Apart from religiously looking after your skin, keep a lookout for your lifestyle habits. Start exercising, take regular meals, and cut down on the alcohol. Make sure you are sleeping well; a lack of sleep will certainly play no help in skin recovery.

Treat those dark spots and wrinkles with a chemical peel

If a major skincare concern such as hyperpigmentation has been troubling you, visit a dermatologist to see what your options are. You can go for chemical peels to reduce the appearance of sun spots, fine lines, wrinkles, enlarged pores and acne scars.

Performed by a dermatologist, a chemical peel treatment improves the appearance of the skin by gently stimulating the top layer of the skin cells by applying a solution made of fruit-derived acids. Such acids include alpha-hydroxy acids, glycolic acid, lactic and salicylic acid. This treatment can stimulate the skin to regenerate, revealing a taut, baby-smooth skin.

Chemical peels are more cost-effective compared to other treatments such as lasers, and more beneficial for the skin than beautician facials. A thorough evaluation is required before proceeding with a chemical peel. It is not recommended to undergo chemical peels with aestheticians or beauticians. In Singapore, only medical doctors have access to the prescription-level peel strength required to allow results.

Consult your dermatologist for an assessment for a chemical peel treatment plan catered for best results leading up to your wedding day. After the treatment, you may experience a reaction similar to sunburn where redness can be seen. Commence your chemical peel treatment plan at least three months prior to the wedding, for time buffer in particular, for your skin to be optimally renewed ahead of time and avoid any potential redness.

Common beauty concerns before a wedding include back and chest acne. Being in a wedding dress means your back and neck area will most likely be exposed. Acne at these areas as well as the face, may be well managed and controlled with chemical peels by your dermatologist, for your most radiant self to be presenting on the big day. Do avoid the sun as much as you can and stick to complete sun protection, such as sunscreen and sunglasses to reduce the sun damage.

Makeup may have varying results on camera, so it’s probably unwise to count on that to capture your best on the wedding day. To ensure that radiant glow on photos, a little more effort now on your skincare routine, could be a very worthwhile investment to yield super glowing and almost flawless (if not flawless) skin on camera on your big day.

Pre-wedding skincare routine at home

Go for a rich, nourishing serum like the Elixir-V™ Total Recovery Serum for hydrating, lifting and tightening of your face for the sculptured V-face look. Such a serum is perfect for pampering your face before your big day. The Larecea™ extract found in the serum supports skin regeneration and helps in reversing signs of aging. Hyaluronic acid is also included to preserve and replenish moisture, working to keep our skin hydrated. Antioxidants such as Resveratrol protects the skin against sun damage and lowers incidence of skin disorders. Infused in the Elixir-V™ is also Oligopeptides, which are essentially protein molecules that can help to repair and lift the skin, giving brides the perfect V-face look.

Vitamin C should also be an imperative component in your pre-wedding skincare regime. Try the Vitá C Gold™ Serum if you are guilty of living without Vitamin C previously, as a proprietary formulation with a super-stabilized form of Vitamin C that delivers more anti-oxidant efficacy than the conventional ascorbic acid which deteriorates quickly. Vitamin C is a superstar ingredient that helps fade pigmentation and uneven skin tone. The ability of this vitamin to aid the skin in healing and resist acne, keeps it a top favourite ingredient, and you can also bid farewell to errant sun spots and scars from your youth. It also protects skin cells from damage, keeping the skin healthy and bright for your wedding day.

Other miscellaneous tips you will need

It’s a proud moment, and you have the right to flaunt it. Everyone will be throwing glances at your rings, so ransack your vanity drawers for that spare hand cream you never used. Toss it in your hand bag and perhaps another on your bedside table. Start a habit of lathering your hand cream on, and that will be one problem crossed off the list.

And if you are rocking a backless wedding dress, you would want to keep your back acne far away. It can be nerve-racking, but if you start a regimen early, you can still bring back the sexy back. Apply a minimum SPF30 sunscreen liberally, as clothing does not block all the UV light. Keep your sunscreen lightweight with like the SunProtector™ to avoid the greasy feel whilst ensuring that the sun does not cause more damage or breakouts. For mild acne, even on the back, commencing a diligent skincare routine with cosmeceuticals could yield very tangible results ahead of your wedding day. For best results and in cases of more severe acne, however, consult your dermatologist for peels, topicals and a complete treatment plan to help in skin renewal, to unclog pores and reduce back acne.

Lastly, to avoid looking greasy on camera, dust some good setting powder to limit the shine while still keeping the glow.

© 2017 TWL Specialist Skin and Laser Centre. All rights reserved.

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Meet with Dr. Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.

To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.

 

Your Guide to Melasma

March 18, 2018

 

What is melasma?

Melasma is an acquired skin problem of hyperpigmentation, frequently faced by women in their reproductive years. The condition is characterized by hyperpigmentation primarily on the face, so we may observe irregular brown or blue-grey macules on the face. Common areas where the brown patches appear are cheeks, nose, forehead, jaw and the chin.

How prevalent is the disorder?

While melasma occurs in all ethnic and population groups, studies have shown that there is a higher prevalence among more pigmented phenotypes. These include Asians, Indian, Pakistani and Middle Eastern. In the Americas, those who suffer from melasma mostly live in intertropical areas where exposure to UV rays are greater.

What are the different types of hyperpigmentation?

You may be doing your research diligently to find out more about melasma, but there are different types of pigmentation, and they are not all the same. Apart from melasma, your face could be suffering from freckles, sun spots or age spots. Freckles, or ephelides, are small, flat and brown marks that are prevalent in childhood. Sunspots, or solar lentigo, only surfaces in our late twenties and can increase in size and number with increasing sun exposure. Age spots, or seborrheic keratosis, is actually not a form of pigmentation, but a non-cancerous skin growth that kicks in with age.

Melasma, on the other hand, can be identified with a greyish-brown discolouration, at times in the shape of a butterfly.

What causes melasma?

While the cause of the disorder remains unknown, current research point towards sex hormones and sun exposure as the greatest culprits.

These brown patches appear on our face as when there is an excessive production of a pigment called melanin. UV radiation induces the increase in melanin production to protect the skin from sun damage. This causes the development of pigmentation to take place on the skin. A leading cause of melasma is excessive sunlight exposure.

Hormones can also be another cause of melasma. You may develop this condition at the start of your pregnancy or if you are on birth control pills. Pregnant women experience higher levels of increased progesterone, estrogen and melanocyte-stimulating hormones. Melanocytes are cells that produce melanin in your skin.

Other causes can be due to certain medications, scented or deodorant soaps, or your toiletries. These products may contain an ingredient that causes a phototoxic reaction that can trigger melasma.

What are the types of melasma?

There are three types of melasma: epidermal, dermal and mixed.

The epidermal layer affects the outermost surface of the skin, and the easiest type to treat. It can be identified by the presence of excessive levels of melanin in that layer. Patches will be a darker brown colour, with a defined outline.

The dermal layer will affect a deeper layer of the skin beneath the superficial layer, and we can recognise it by the occurrence of melanophages throughout the dermis. Melanophages are cells that ingest melanin. The dermal layer can be more deep-rooted, and may not respond well to treatment. For this layer, patches have a less defined outline, with light brown or bluish colour.

A mixed condition of melasma would be having both the epidermal and dermal types, and improvements on the condition can be expected with treatment.

How to treat melasma? 

The response of melasma to treatment can be slower if the condition has been present for a longer time.

Excessive sun exposure leads to the deposition of melanin cells within the dermis and can persist long term. Coming into contact with UV radiation will deepen the pigmentation as it will activate the production of more melanin, causing your brown patches to turn darker and harder to remove.

Generally, by including sun protection into your skin routine, hyperpigmentation can be resisted. With Singapore’s tropical weather, it is recommended to reapply sun protection every 2 hours with a broad-spectrum sunscreen having at least SPF 30. Consider bringing along sunglasses or a hat when you are outdoors.

For clinical treatments, consultation with a trained dermatologist is recommended. A proper diagnosis of melasma should be conducted, and screened if there are any underlying conditions that may require treatment.

Prescriptions may be given to inhibit the formation of melanin. Hydroquinone is a controlled ingredient that is frequently included in medications to treat melasma, as it allows lightening of the skin. A precise concentration of hydroquinone should be administered for treatment, and may be professionally managed so by your dermatologist.

Procedural treatments for melasma can also be considered, such as chemical peels and lasers. Expected efficacy of each treatment can vary depending on the severity of melasma, with topical combination therapies being one of the most effective treatments for hyperpigmentation.

Speak to your dermatologist for a tailored recovery experience.

© 2017 TWL Specialist Skin and Laser Centre. All rights reserved.

—–

Meet with Dr. Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.

To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.

 

 

 

Dermatologist Tips: How Does Pollution Affect The Skin?

March 7, 2018

The outermost layer of the skin often serves as a physical barrier against harmful environmental toxins, as it is directly exposed to various pollutants such as particulate matter and free radicals. As its immediate proximity to external environment puts the skin at greater risk of being damaged by stressors, it is important that we take extra care in avoiding such environmental hazards as much as we can.

Oxidative Stress in Skin

Our skin is often exposed to a variety of harmful electrophiles and free radicals, often produced as a result of exposure to chemicals and ionizing radiation. Our body naturally produces reactive oxygen species (ROS) as byproducts of cellular processes, but an excess of ROS causes oxidative stress in skin cells.

According to Dr Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin and Laser Centre, she said: “Our body keeps levels of ROS in check with free-radical-scavenging mechanisms, such as antioxidants. External sources of ROS, such as UV radiation, environmental pollutants and harmful chemicals, can cause a state of oxidative stress when they overwhelm our body’s defences and become unable to keep up with the frequent ROS production. It is the excessive generation of ROS that we should avoid for healthier skin.”

Oxidative stress causes our cellular components and macromolecules such as DNA, RNA, protein or lipids to be damaged. When ROS reacts with the lipid bilayer of our skin, it can lead to a weakened skin barrier function.

Particulate matter

Environmental air pollution consists of various particulate matter (PM). PM includes harmful suspended contaminants in the air and is heavy contributors to air pollution. We are familiar with PM 2.5, which can be found from diesel-exhaust particles that are less than 2.5μm in diameter. Composed of organic carbon compounds, nitrates and sulfates, PM2.5 can settle on the skin and aggravates inflammatory response in our skin cells, triggering skin symptoms.

The main mechanism of PM2.5 is the generation of ROS, leading to greater oxidative stress on skin cells. These particles can act as carriers for unwanted chemicals and metals that can localise in our mitochondria. This leads to the production of ROS in the mitochondria, and causing the effect of collagen degradation in our skin and thereby result in wrinkle formation and skin ageing.

On the surface of PM are polycyclic aromatic hydrocarbons that can lead to not only an increased production of ROS, but also interfere with our gene expression for wrinkle formation and pigment spot formulation.

Our skin condition is also affected by ultraviolet (UV) radiation. The solar UV spectrum is divided into two specific wavebands according to wavelength: UVA and UVB. Excessive sun exposure initiates photo-oxidation reactions, causing damage to our skin cells as it affects pathological processes.

Radiation from UVA penetrates into the deeper layers of our skin, inducing the production of ROS and causing extensive damage. Sunburns are caused by UVB, as an inflammatory response from our skin due to photodamage. UVB can also cause mutation and skin cancer.

An exposure to UV radiation is the main factor of skin aging, known as photoageing. The rate of degeneration depends on the frequency, duration and intensity of our cumulative exposure to solar rays and the degree of protection of our skin pigmentation. Given that photoaging accounts for as much as 80 per cent of facial aging, we should always be armed with sun protection.

There are various ways to protect your skin against environmental aggressors. A good supply of anti-oxidants in your diet can provide photoprotection against solar UV radiation. Carotenoids, vitamin E and C are good anti-oxidants.

Any prevention must be complemented with the use of topical sunscreen with a high sun protection factor. Not all sunscreens are created equal. Dermatologists would recommend only a few brands of sunscreens. Effective sunscreens will protect against skin cancer and block out harmful UVB rays. Ingredients that a good sunscreen should include are derivatives of vitamin C, antioxidants or phytochemicals.

Those blessed with normal skin conditions should continue regular application of sunscreen, and stick to gentle skincare products. Patients with eczema are advised to visit a dermatologist if their condition continues to worsen from environment aggressors. Topical steroids and emollients may be prescribed, as eczema is not a condition that will go away in time.

Lifestyle habits such as smoking and drinking as it can increase the production of free radicals and accelerate skin aging. For those at high-risk with excessive exposure to sun, sun avoidance is advocated whenever possible. Avoid the sun from 10am to 4pm, and don on long sleeves for greatest protection.

© 2017 TWL Specialist Skin and Laser Centre. All rights reserved.

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Meet with Dr. Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.

To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.

 

 

 

 

 

A Dermatologist’s Guide to Skin Resurfacing

February 9, 2018

What is skin resurfacing?

Regardless of the technique employed, skin resurfacing is a form of controlled, targeted injury to your skin. By stimulating your skin to heal from the injury, the new skin cells that form after would be smoother, tighter and more youthful. Skin resurfacing can be achieved through different techniques to treat different aspects of skin damage and conditions, mainly laser, dermabrasion and chemical peels.

Are you suitable for skin resurfacing?

These treatments can help skin that suffers from acne, damage from sun exposure, ageing effects, hyperpigmentation, scars and wrinkles. Any skin condition that you wish to treat likely has an appropriate treatment at your dermatologist, go for a professional diagnosis before having any skin resurfacing treatments done.

Chemical Peel

Before the peel, your face will be cleansed thoroughly to remove oil and to prep the skin for penetration. A gentle, medically formulated milk/fruit acid solution is applied, which removes the epidermis layer, allowing the acid to penetrate into the first layer of the dermis. Various acids can be used in different combinations to remove the surface layer of the skin. Note not all acids are the same nor are all chemical peels the same, best to have an accredited dermatologist assess and recommend the most suitable peel for your skin.

According to Dr Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin and Laser Centre, she says: “A chemical peel removes the damaged epidermis to reveal a brighter complexion. You may experience a warm sensation after the chemical application, and stinging when the peel is removed. Depending on the concentration of acids used, you may need some time to recover before resuming activities.”

Dermabrasion

To smoothen scars and wrinkles, dermabrasion is a surgical technique that uses anesthesia and/or a freezing agent before smoothening skin surface irregularities. With a high-speed rotating brush, the surface layer of the skin will be removed till ideal results are obtained.

Laser Resurfacing

A wand is passed over your skin and emits a pulse of high-intensity light to damage the surface layers of the skin. The different invisible wavelengths of light stimulates various layers of skin for rejuvenation. Shield goggles will be provided to protect your eyes during the treatment.

Two types of lasers are commonly used in laser resurfacing: carbon dioxide and erbium. Both lasers work to vaporize damaged skin cells in the epidermis.

What can I expect after the treatment?

Follow-up care is essential to ensure a smooth progress for skin healing and resurfacing. Patients may experience uneven pigmentation of the skin at the treated area after the treatment, but this effect will subside when the skin restores its original level of pigment. Meanwhile, sunscreen is an absolute must to protect the skin as chemical peels along with other resurfacing treatments will render your skin temporarily more sensitive to the sun. At this stage, it is also imperative to use skincare catered for sensitive skin, which are dermatologist-tested, to mitigate risk of irritation and flare ups during the course of recovery post-treatment.

© 2017 TWL Specialist Skin and Laser Centre. All rights reserved.

—–

Meet with Dr. Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.

To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.

Dermatologist Tips: Most Stable Vitamin C Derivative

February 2, 2018

 

The benefits of Vitamin C are well-known – an efficient collagen booster, and an amazing ability to treat effects of photoageing and hyperpigmentation. A favoured ingredient in skincare products, this vitamin helps to gently brighten and smoothen the skin.

Whilst Vitamin C is a naturally occurring antioxidant in the botanical world, humans do not possess the enzyme L-glucono-gamma lactone oxidase for the production of Vitamin C. When administered orally, Vitamin C is not efficiently delivered to the dermis. The concentration of the vitamin when introduced into the body is not sufficient to allow an activated effect. In the practice of dermatology, topical vitamin C is frequently recommended as an adjunct to treatments, which results in a drive towards newer advanced delivery forms of the vitamin into the dermis or discovery of more stable Vitamin C compounds.

Vitamin C exists in two forms – L-ascorbic acid and D-ascorbic acid. L-ascorbic acid is the chemically active form of Vitamin C, but it is not stable in nature. When exposed to light, Vitamin C may get oxidized to Dehydro Ascorbic Acid for example, which loses the beneficial activity of the vitamin. This gives rise to the interest of stable ascorbate molecules for dermatological uses.

What are the common Vitamin C derivatives?

Not all forms are physiologically effective as some will not be delivered to the dermis in sufficient quantity, or will not convert to a chemically active form in the skin.

Some stable derivatives of L-ascorbic acid are Magnesium Ascorbate, Magnesium Ascorbyl Phospahte, Sodium Ascorbate, Sodium Ascorbyl Phospate, and Calcium Ascorbate, with varying effectiveness.

What is the most stable Vitamin C derivative?

Sodium ascorbyl phosphate is a stable and effective derivative of Vitamin C. It is significantly more stable than magnesium ascorbyl phosphate and ascorbyl palmitate. The stability is attributed to the introduction of a phosphate group into the second position of the cyclic ring.

How does sodium ascorbyl phosphate work?

At our skin’s pH of 7, ascorbic acid is present in a form called ascorbate anion. This form has poor penetration ability into the skin and is unable to prevent effects of photodamaging due to low antioxidant concentrations.

With sodium ascorbyl phosphate, antioxidant levels are substantial and can be absorbed into deeper skin layers and allow effective photoprotection. With ongoing research on this stable derivative, it is understood that sodium ascorbyl phosphate is absorbed in the skin and converted by enzymes into ascorbic acid, increasing the intracellular concentration of ascorbic acid.

Skin cells continuously take up sodium ascorbyl phosphate and convert it into ascorbic acid by the process of dephosphorylation, with the help of the enzyme acid phosphatase in the skin layer. This process allows elevated levels of ascorbic acid in the skin long after the introduction of sodium ascorbyl phosphate to the skin.

How does sodium ascorbyl phosphate help acne?

As a potent antioxidant, sodium ascorbyl phosphate can help improve acne conditions by combating oxidation of sebum and comedogenesis.

According to Dr Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin and Laser Centre, she said: “Patients with acne are found to have a higher concentration of polar lipids, which are by-products of squalene oxidation. Squalene is most abundant lipid in our skin and is highly susceptible to oxidation due to its structure. It has six carbon double bonds, allowing atmospheric oxygen to bind. This produces squalene oxides that are highly comedogenic, as it causes inflammatory reactions that further depletes the level of antioxidants in our skin and leads to acne. Sodium ascorbyl phosphate is useful in acne treatment as it prevents sebum oxidation.”

How does sodium ascorbyl phosphate prevent sebum oxidation?

Sodium ascorbyl phosphate works as an antioxidant to neutralise free radicals, reducing oxidative stress. When exposed to UV light, reactive oxygen species such as the superoxide ion, peroxide and singlet oxygen are generated. Sodium ascorbyl phosphate works to protect the skin from oxidative damage to sebum by donating electrons to neutralise the free radicals.

How does sodium ascorbyl phosphate fight ageing?

Sodium ascorbyl phosphate is an oxygen species scavenger, protecting against UV damaging and enhancing properties of sunscreen. Photodamage such as sunburn cell formation, DNA fragmentation and lipid peroxidation can be prevented. The protective effect of sodium ascorbyl phosphate comes from the maintenance of a healthy ascorbic acid level in the skin tissue.

Sodium ascorbyl phosphate reduces UV susceptibility and protects against damage from UV exposure.

Are there any side effects of sodium ascorbyl phosphate?

Formulations containing sodium ascorbyl phosphate are considered safe and has shown no side effects in multiple clinical studies conducted.

Which Vitamin C serum should I use?

Although sodium ascorbyl phosphate boasts many desirable benefits, it is important to choose a Vitamin C serum that is well-formulated to allow its benefits to be realised. Avoid concocting your own serum of Vitamin C, as it may lead to phytophotodermatitis if you include ingredients such as lemon, lime or bergamot oranges.

For a reliable and effective serum, you may consider Vita C Gold™ Serum. Dermatologist-formulated and tested for bio-activity in a laboratory, it is completely safe for use. It is a concentrated serum containing nano-formulated sodium ascorbyl phosphate as a powerful and stable antioxidant.

 

© 2017 TWL Specialist Skin and Laser Centre. All rights reserved.

All You Need To Know About Vitamin C

January 11, 2018

 

Vitamin C is likely to be no stranger to any of us, we see it present in plenty of fruits and vegetables like oranges, grapefruits or pineapple. Yet, it is rather new to most of us to have Vitamin C on our face. This obsession with Vitamin C could be why you are googling up on this ingredient now, and we are about to tell you.

The vitamin brings benefits to the skin that we love: antioxidative, photoprotective, antiaging, and anti-pigmentary effects.

Vitamin C in our body

Vitamin C is the most abundant antioxidant in human skin. Antioxidants work to reduce the damage that free radicals can bring to our skin cells. We are unable to synthesize vitamin C as we do not have the enzyme needed to do so. Even as we consume high doses of vitamin C supplements, only a small fraction of the vitamin will remain in our body and skin cells. This brings us to rely on external supplements, with topical application being the most common form.

What should the concentration of my Vitamin C be?

When choosing a Vitamin C product, you may come across the different concentrations available. Of what percentage of the Vitamin C should we be using? That really depends on the type of Vitamin C in use. Conventional Vitamin C derivatives such as Ascorbic Acid may require 10 to 20 percent to have any reasonable efficacy, and is limited inherently by the fact that higher concentrations, for instance above 20 percent, may cause irritation to the skin. On the other hand, studies have shown that a mere 1 percent concentration of Sodium Ascorbyl Phosphate – considered to be a new generation of Vitamin C derivatives, has strong antimicrobial efficacy against acne.

What are the common forms of Vitamin C?

Out of all the various forms of Vitamin C, L-ascorbic acid is conventionally recognised as one of the most biologically active molecules. This compound is likely to be found at a pH below 3.5 for greater stability and permeability. Above that, the acid becomes very unstable in aqueous solutions and is prone to immediate oxidation, turning to a brown colour when oxidized.

Other formulations of vitamin C are magnesium ascorbyl phosphate, ascorbyl-6-palmitate and sodium ascorbyl phosphate. These formulations are stable at neutral pH of 7. As a water-soluble derivative of Vitamin C, magnesium ascorbyl phosphate is more stable in water but less potent than L-Ascorbic acid.

Sodium Ascorbyl Phosphate is one of the most stable and effective forms of Vitamin C. As it will not oxidize as easily, it is a preferable choice for skin care formulations. A well-formulated product allows sodium ascorbyl phosphate to penetrate the skin epidermis without causing irritation. You may consider a dermatologist-formulated product such as Vita C Gold™ Seruma Vitamin C formulation that has been tested for bio-activity in a laboratory, for safe and effective results.

Different formulations of Vitamin C exists, and you may decide which forms would be preferable in your skincare by weighing in on the cost, potency, texture or formulation. Although the conventional L-ascorbic acid is perhaps the most potent derivative of Vitamin C, it oxidizes too quickly when exposed to oxygen to be much efficacy on the skin. One may prefer newer Vitamin C derivatives – Sodium Ascorbyl Phosphate, which are much more stable and able to deliver better efficacy even at lower concentrations.

Vitamin C helps to produce collagen

Vitamin C is required by our bodies to produce collagen, making this vitamin crucial for anti-ageing. Think of it as an anti-ageing shield your skin needs to reduce the damage your skin suffered, and also to prevent future damage. The vitamin facilitates enzymes that lead to the stability of collagen fibers. It also increases expression of collagen and synthesizes inhibitors to block enzymes from degrading collagen.

Vitamin C has anti-pigmentary effect

Vitamin C plays an important role in skin-lightening, as it inhibits an enzyme called tyrosinase. This enzyme works by converting tyrosine into melanin, so by reducing the activity of tyrosinase, our skin cells produce less melanin. 

Should I DIY my own Vitamin C serum?

According to Dr Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin and Laser Centre, she says: “Concocting your own serum of Vitamin C can be dangerous as it can lead to phytophotodermatitis, a condition where itchy blisters and reddened patches appear on the exposed skin. The redness and blistering will settle down in a few days, but it leaves pigmentation at the same sites. Phytophotodermatitis results from the action of UV radiation on a plant chemical called furocoumarins. Citrus fruits such as lemon, lime or bergamot oranges are often responsible for the reaction.”

It is best to avoid DIY recipes for Vitamin C or you may end up with rashes that scar for a long time.

© 2017 TWL Specialist Skin and Laser Centre. All rights reserved.

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Meet with Dr. Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.

To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.

 

 

 

 

 

 

 

Dermatologist Tips: Does Diet Cause Acne?

January 5, 2018

 

Suffering from acne? Also known as acne vulgaris, patients who suffer from this inflammatory disease typically develop it in adolescence.

Does my diet cause the acne?

The answer is not straightforward, because acne itself is multifactorial in origin, with genetics, inflammation, hormone related oil production in a complex interplay. However, a quick answer would be yes, diet does appear increasingly to influence the severity of acne and treatment outcome to a certain extent.
Acne vulgaris is often touted to be the epidemic disease of civilization, typically in first-world countries. Caused by an unhealthy diet fueled by modernization, it affects the sebaceous follicles of adolescents and adults. Today, a typical diet is characterized by high glycemic index foods, insulinotropic milk proteins and saturated fats.

So, does a Western diet trigger acne?

To convince you, populations that are exposed to diets with low glycemic load and no milk/dairy consumption are acne-free, such as the Inuit, Ache hunters of Paraguay, rural areas of Brazil. Prevalence of acne increased as Okinawa islanders and the Chinese switch from traditional diets to Westernized food.

How do hyperglycemic carbohydrates cause acne?

High glycemic index foods are those that are extremely high in glucose. The glycemic index works by measuring the impact that your food has on your blood sugar level. High glycemic index foods cause your blood sugar to rise faster.

Eating lots of food like white bread and cereal can also cause the elevation of hormones, leading to increased sebum production. The high glycemic load changes the composition of sebum fatty acids, causing proinflammatory and comedogenic responses. A diet-induced change in sebum composition can trigger acne inflammation and drive the process of comedogenesis, also known as the formation of blackheads.

Can saturated fats lead to my acne problems?

The major culprit is a saturated fatty acid called palmitate, and it consists of 32% milk triglycerides. Palmitate triggers the abnormal proliferation of keratinocytes, a cell that produces keratin, resulting in micro-comedones. The continuous sebum accumulation, enlargement of follicle and build-up of keratin within the micro-comedones causes the formation of comedones.

Trans-fats, produced industrially that structurally resemble palmitate, are in the fast food that we eat. With the replacement of natural solid fats and liquid oils with hydrogenated fats in fast food, fried food and baked goods, it has led to unhealthy diets that contribute to acne. Such a diet contributes to inflammatory responses of our sebaceous glands and hair follicles.

Does milk cause acne too?

The link between milk consumption and acne is not a breakthrough, adolescent acne is closely associated with their diets being rich in milk, cheese, yogurt, cakes and low in fish, fruits and vegetables. Milk contributes to increased insulin levels which prevent that production of an important protein FoxO1. The deficiency of this protein has been linked to major factors of development of acne.

Milk intake can also influence comedogenesis as it contains androgens, a type of hormone, steroids and other components that can affect the sebaceous gland and hair follicle. Such molecules survive processing, and for instance, in cheese, fermentation leads to more testosterone being produced from the precursors in milk.

Milk facilitates the pathway of sebaceous lipogenesis and sebocyte proliferation. Excessive intake of milk protein also explains the onset and aggravation of acne.

How can I adjust my diet to be less acne-prone?

You may opt for a palaeolithic diet – no hyperglycemic carbohydrates, no milk and dairy products. Fish consumption has shown to have anti-acne effect, as the fatty acids from the fish can reduce inflammation.

Resveratrol, a compound found in the skin of grapes, has shown to inhibit the growth of P.acnes, a bacteria that facilitates ace development in optimal environments.

Though multifaceted, dietary factors can worsen breakouts in acne-prone individuals. For a clearer skin, a good tip is to bear in mind what you consume, have a healthy balanced diet and lifestyle. However, if you have a persistent flare of acne for anything more than several months, medicated treatments such as oral antibiotics and topical retinoids may be necessary. So do visit a dermatologist early to prevent complications such as secondary skin infections i.e. gram-negative folliculitis, or severe acne scarring.

© 2017 TWL Specialist Skin and Laser Centre. All rights reserved.

—–

Meet with Dr. Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.

To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.

 

 

 

 

Best Anti-Ageing Eye Treatment with Nitrogen Plasma Technology

January 1, 2018

 

 

As a dermatologist, one of the first signs of ageing I observe shows in the eye area, what we call the peri-orbital or peri-ocular region. The commonest complaints I hear from my patients old or young are “Is there anything I can do for my eye bags, dark circles and eye wrinkles?” This is tricky because while so many spas, medi-spas, aesthetics providers and skincare companies confidently brag about their treatments erasing eye wrinkles and waving eyebags goodbye,  I often have to burst bubbles in my clinic when I tell my concerned patients their hopes may be misplaced in  a single miracle product which probably doesn’t exist.

In my practice, I use a multi-dimensional approach to work the aged eye area— a combination of skin resurfacing (plasma nitrogen over laser for sensitive areas such as the eye region), injectables like botulinum toxins, dysport and Botox. This, in conjunction with the closest form of a miracle eye cream that I formulate for my patients to use on a daily basis for before and after care, with specific active ingredients to brighten, tighten, moisturise and anti-age periorbital skin, besides being tested for safety and efficacy to complement medical aesthetics treatments around the eye area.

Men and women alike are affected by concerns of ageing and looking older, there’s nothing vain about wanting to look like a younger version of one’s self. In fact, it has been shown that your skin starts to age at around the age of 25. Main areas of wrinkles are at the forehead, nose, mouth and especially around the eyes. Eye wrinkles are often noticed first and more evident as the skin in this area is thinner, making it susceptible to wrinkling. Regardless of gender, you are prone to getting wrinkles so start taking care of your skin to maintain your youthful appearance!

 

What is Plasma Skin Regeneration?

Specifically, the Portrait® PSR device is a nitrogen plasma technology used in dermatological and aesthetic treatments. It is a non-laser treatment that uses a device to converts nitrogen gas into plasma energy, to rejuvenate skin by improving facial lines, wrinkles and pigmentation caused by photoaging. This technology offers a wide variety of single pulse energy levels with different options of frequency that can most efficiently improve the precision of plasma delivery. This function allows accurate temperature irradiation to drastically improve topical drug delivery for a variety of dermatological indicators. On top of increasing energy levels over the Spa system, it improves effects of anti-aging protocols while reducing downtime and side effects of treatments. It allows room for personalisation of the settings to cater to different patients. Patients’ skin conditions differ in terms of downtime and receptivity to treatments. Through deep tissue re-modelling, the energy delivered by plasma skin regeneration is non-fractionated. This allows for even energy absorption, ensuring the consistency in treatments done to the skin. The high energy also supports significant skin tightening. With deep tissue re-modelling and accelerated healing, plasma skin regeneration usage is versatile and effective.

 

Plasma Delivery

  1. The handpiece first releases the nitrogen plasma pulses.
  2. This causes it to transfer thermal energy to the skin, allowing for controlled heating of the tissue.
  3. The controlled duration of the pulse and temperature then allows the treatment to happen optimally.
  4. This then leads to the possibility of treatments of many dermatological conditions due to the carefully controlled time frame.

 

Reliable Technology

Nitrogen plasma technology has been tested and backed by evidence. It has over 3 years of pre-clinical and clinical testing, 16 separate studies conducted, more than 450 clinical study treatments which proved to cause no scarring or pigmentation, and one year of clinical histology. This intense and detailed level of testing is uncommon in the industry. Portrait® PSR device is the first non-laser technology approved by the FDA Singapore (Food and Drug Administration) and clinically proven to perform skin resurfacing and regeneration using plasma energy.

Drug Delivery Effect

There are many treatable indicators like anti-aging effects, pore size reduction, wrinkle reduction, skin tightening, stretch marks reduction, acne scar reduction and more. However, one key effect is the drug delivery effect. When the skin is exposed to the nitrogen plasma, the permeability of the skin increases. This allows for better absorption of the drug, enhancing drug delivery and making the drug more effective during and after treatment.

 

Key Specialities

Advanced Technology

Plasma skin regeneration converts nitrogen gas into the fourth state of matter, plasma energy. It then emerges from the handpiece in controlled pulses and causes rapid heating of tissue. This allows for the transmission of thermal energy to the tissue.

Minimal Damage

The treated photodamaged skin layers undergo controlled thermal modification without additional harm. This allows for speedy healing and a natural layer of protection for the skin. At high temperature and energy, the skin epidermis breaks down and sheds, but only after a new healthier skin layer forms beneath. Plasma skin regeneration is non-invasive and will not cause any open wounds.

Treats the Whole Skin Structure

Plasma skin regeneration can treat the entire skin structure. It ensures that the entire skin surface is regenerated and produces conditions favourable for optimal results. It is associated with neocollagenesis and neoelastogenesis. Neocollagenesis is the process of making more collagen while elastogenesis refers to the mechanisms that drive elastic fiber formation for our skin.

Ideal for Eyelids Treatment

The skin around our eyes, our eyelids, are especially sensitive and thinner than the rest of our skin. Thus, not all treatments are suitable to prevent eye wrinkles and eye bags. However, plasma skin regeneration is suitable for treatment of the eyelids to reduce wrinkles and achieve an anti-aging effect. Other anti-aging technologies might be harmful for our thin eyelids or even deliver inconsistent and ineffective results.

Long Lasting Effects

Plasma skin regeneration has been proven to show neocollagenesis and reduce elastosis (abnormal elastic tissue in the skin which is a result of excessive sun exposure). Elastosis can cause your skin to have wrinkles and even pigmentation. The nitrogen plasma technology has post treatment effects that can last for more than a year.

 

With its reliable and advanced technology, plasma skin regeneration can produce anti-aging and long-lasting effects with its non-invasive methods, helping you to achieve a bright and youthful appearance.

© 2017 TWL Specialist Skin and Laser Centre. All rights reserved.

Meet with Dr. Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.

 

To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.

error: Copyright © 2017 twlskin.com. All rights reserved.