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How Oligopeptides Work for Anti-ageing

July 29, 2019

Oligopeptides were first discovered to have therapeutic properties in the 1950s by du Vigneau and Tuppy when they characterised the chemical structure of the first peptide hormone, octapeptide oxytocin which led to an increasing interest in the field of bioactive peptides.

What are oligopeptides?

Oligopeptides are short sequence amino acids which are defined as peptide (protein) sequences which range from 2 to 20 amino acids. The key feature of these proteins is that they have been discovered to be biologically active, meaning that it can interfere with various skin processes both on the cell and the molecular level.

Oligopeptides have been described as early as twenty years ago when researchers discovered some chemicals in the body which can affect physiological processes. The understanding of how the same oligopeptides can influence activity within the skin has only been recently examined and it is an interesting and rapidly advancing field of dermatologist research.

What are some of the benefits that oligopeptides have been shown to have in skin?

Several dermatologist led studies published in top journals have shown that common skin ageing conditions such as hyperpigmentation as well as skin thinning, loss of skin elasticity can be well-treated with good outcomes with these oligopeptides1.

How do oligopeptides work?

Oligopeptides interfere with the regulation of collagen and elastin production which accounts for many of the changes in ageing skin such as skin laxity, loss of skin plumpness and enlarged pores. Finally, it also helps to regulate pigment (melanin synthesis) which can help to treat pigmentary disorders. 

Are oligopeptides safe in cosmeceuticals?

The key benefits of oligopeptides are equivalent to retinoids which have been used in dermatologist offices for several decades but without the same side effects. Retinoid treatment can also help to increase collagen and elastin production as well as regulating melanin synthesis but not without the significant side effects of skin dryness and irritation, causing redness, flaking and sometimes flare-ups of cystic acne over time. Oligopeptides are considered much safer and easy for incorporation into skincare being well-absorbed. 

What happens during skin ageing and how do oligopeptides work?

Skin ageing is caused by a multitude of factors such as one’s genes, environmental damage, hormonal alterations and metabolic processes. During the process of ageing, one may notice increased wrinkles, skin sallowness and laxity, loss of radiance, enlarged pores as well as loss of skin volume, causing a haggard, dry and wrinkled appearance. What’s going on under the skin can really be explained in terms of physiological processes. If you refer to the diagram of the structure of the skin in Chapter I of the book, allow yourself to look at the second layer of the skin which is known as the dermis. The best way I can explain the process of ageing to my patients is via this skin model, so everything that has got to do with the loss of skin radiance, sallowness, pigmentation occur at the epidermal level which can be effectively addressed with topical cream applications as well as physical agents such as chemical peels which help to shed the top layer of skin which are known as the keratinocytes to stimulate cell turnover, leading to increased radiance. 

Most of skin ageing however, happens in the dermal level in the second layer of skin – the dermis, where collagen and elastin is present and production of these components are decreased during the process of skin ageing, leading to loss of skin volume. 

The proteins in the dermis are known as extracellular matrix (ECM) proteins. How oligopeptides work is mainly in the second layer of skin when they stimulate these ECM proteins and also, help to regulate the production of pigment at this level.

How do oligopeptides help wound healing?

Bioactive peptides such as oligopeptides have shown potential health benefits to combat inflammation, wound healing, angiogenesis and antimicrobial defense.

In the same way when one’s skin is wounded, for example either from trauma or severe inflammation such as in post-inflammation hyperpigmentation or in severe cystic acne flares leading to scars, oligopeptides interfere with the second layer of skin where most of the wound healing takes place to stimulate the production of collagen so that the wound heals faster as well as better.

Bioactive peptides as medical and therapeutic interventions have great potential. They have been utilised as treatments for infections, chemotherapy and in recent times as cosmeceuticals. The best qualities of this molecule I believe have to do with our ability to alter the penetration, delivery, stability and potency.

Reference:
1. Reddy, B. , Jow, T. and Hantash, B. M. (2012), Bioactive oligopeptides in dermatology: Part I. Exp Dermatol, 21: 563-568.

© 2019 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.

A Dermatologist’s Guide on Polyhydroxy Acid (PHA)

June 13, 2019

PHA Polyhydroxy Acid Needed

Is PHA (polyhydroxy acid) suitable for all skin types? How does it compare to AHAs and BHAs?

Polyhydroxy acids encompass gluconolactone and lactobionic acids. It has been reported in medical papers as early as 2004 to be effective and better tolerated by sensitive, aging skin.

PHAs works similarly to AHAs by causing the dead skin cells (keratinocytes) to shed at a higher rate, causing reduction in skin irregularities such as uneven pigmentation and texture. In addition, they fulfil the same function of allowing cosmeceutical ingredients such as hyaluronic acid and vitamin C serums to penetrate deeper into the skin.

Is there a possibility of suffering from a chemical burn using skincare products that contain PHA?

PHAs are not as commonly used as AHAs and BHAs, especially as chemical peels in dermatologists’ office setting mainly because the depth of penetration and effectiveness may be less. However, in skincare, the medical literature seems to report that it is a much gentler and moisturising type of chemical exfoliant than the other acids present in skincare, which translates into a much lower risk of skin irritation. In fact, PHAs are large molecules which function as humectants meaning that they trap water under the skin, prevent trans-epidermal water loss and have moisturising properties.

Is there one form of PHA that’s stronger than the others? eg. Lactobionic acid vs Gluconolactone  

Clinical studies to date have grouped the use of gluconolactone and lactobionic acids under PHAs which differ from glycolic acids in the fact that they have a larger molecular structure, penetrate the dermis less and hence is less irritating in addition to having humectant (moisture trapping) properties. I am unaware of any head-to-head study which show whether one form of PHA is stronger than the other.

When should I use PHA? Should I use it in the toner, serum, moisturiser, or cleanser step?

The use of PHAs in skincare has been well-reported to have good exfoliating effects but without the irritation that glycolic (AHA) or salicylic acids (BHA) have. However, I generally do not put in chemical exfoliants in skincare because there is always a risk of skin becoming sensitive after being exposed to it on a daily basis.

While there are some studies which have shown that compared to glycolic acids which are incorporated in several brands of skincare, those which incorporate PHA are much more suited for people with sensitive, eczema skin, I would not prescribe that for my patients with eczema and rosacea in the first place.

What should I be looking out for when I use PHAs?

I would say PHAs seem to be rather novel because it’s a term that hasn’t been used in the recent times but our knowledge of it has stemmed since the 1970s and clinical studies have been done with it since 2004. I think it’s important to prioritise, so the main concern really would be to ask yourself what your skin concern is. If it is anti-aging, then chemical exfoliation itself is not going to give you a miracle result. Chemical exfoliation can be achieved with glycolic acids, BHAs and in this case PHAs may have the same function but with reduced skin irritation. However, chemical peels alone do not satisfactorily target all skin aging concerns, which lasers in combination with a good cosmeceutical regimen can achieve. It is important to caution that while all anti-aging treatments are aimed at increasing collagen production in the skin, an accredited dermatologist still needs to access the individuals’ problems and side effects before recommending combination treatment.

PHAs should be used in conjunction with cosmeceutical ingredients such as vitamin C as well as phyto which are plant-derived antioxidants that have been proven to fight free radical damage which is the key process in anti-aging. Nevertheless, PHAs are a beneficial form of chemical exfoliation and should be placed in the same category as the use of AHAs and BHAs in chemical peels.

One more thing to add, the clinical results in terms of the depth of skin penetration are likely to be less with PHAs. For patients with other forms of skin concerns, for example acne, they may still find that glycolic acid is much more effective in reducing oil control. If their concern is a medical condition like eczema and rosacea, then certainly I would recommend not using any form of chemical exfoliant at all and rather get treated by a dermatologist.

© 2019 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.

A Dermatologist Explains Under-Eye Care: Are Under-Eye Sunscreens Necessary?

April 30, 2019

It is not necessary to use a specific sunscreen dedicated to the under eye area if the sunscreen you’re using is already a medical grade sunscreen that has been dermatologist-tested and ophthalmologist-tested. Nevertheless, sunscreen should not be applied too close to the eye area such as the lid margin because the very nature of effective sunscreens means that it would contain chemical and physical components that may be irritating to the eye.

If you are worried about sun exposure to skin around the eyes, you may consider using the SunProtector™, a lightweight soothing sunscreen that is dermatologist-tested and formulated to be suitable for use on the entire face including the under eye area.

The question remains: Why does the under eye area require extra protection?

The difference between the under eye area and the rest of the skin is that the under eye area has much more delicate and thinner skin. This explains why we tend to get dark eye circles from those areas, which is due to genetic factors such as the blood vessels being seen much more prominently in areas of thin skin. In addition, with certain practices such as applying eye makeup over many years as well as wearing contact lenses, the process of dragging and pulling the areas of skin around the eye can make it much more susceptible to wrinkling and laxity. Natural facial expressions, such as smiling can also cause natural creases at the periorbital area, known as crow’s feet, or when one is laughing in the area near the nose known as bunny lines.

It is much more necessary to eliminate bad practices in handling of the skin around the eye area, and to advocate good eye moisturising and antioxidants in the form of an eye cream and daily sun protection. One eye cream product you may opt for is the Elixir-VTM Eyes, which is a dermatologist-formulated eye cream that targets regeneration and repair of skin around the eye area with pharmaceutical-grade bioactive ingredients. Also, as a tip, use your ring finger instead of the index finger to apply any sort of eye cream or makeup, in order to avoid exerting repeated high pressure (from the index finger) over the delicate eye area, which drags down the skin and may cause or worsen eye bags and wrinkles. More importantly, to fight aging effects on the skin and in general, one should have an overall healthy lifestyle, with frequent exercise, adequate sleep, a diet filled with antioxidants, reduced alcohol intake and should stop smoking habits.

If someone were to look for additional protection for the under eye area, would an under eye sunscreen benefit in any way?

The premise overall is that there is no need for a specific under eye sunscreen, other than a sunscreen that is formulated for the face and tested by a dermatologist in a laboratory environment. If one is to experience irritation with such sunscreens, it may help to look for a pure physical sunblock made up of Zinc Oxide and Titanium Dioxide, rather than chemical sunscreen components, as these tend to be less irritating although conferring less broad spectrum protection compared with one that is a combination of physical and chemical components.

It is more important that one re-applies sunscreen regularly, rather than to apply an additional type of sunscreen. This is because layering different sunscreens one on top of the other does not increase the efficacy beyond the time period that the sunscreen is effective for. Conventional wisdom is to reapply sunscreen every 3 to 4 hours, especially when outdoors. However, there are many aspects to aging around the eye area and one of the reasons is actually not due to sun exposure, but rather due to the fact that skin around the eye area is much more delicate, hence more prone to daily tugging for example for people who wear eye make-up and contact lens wearers. For these individuals, it is much more advisable to use a good eye cream which can be applied both day and night, to moisturise the eye area and packed with antioxidants to reverse free-radical damage caused by sun exposure and environmental pollutants, and also to get adequate sleep at night. Having a pair of good sunglasses is also helpful to protect the cornea from UV damage.

Can exposure to the sun make the under eye area more susceptible to dark spots or lead to other undesirable effects?

This is not a very realistic scenario as when someone has excessive exposure to sunlight, it happens over the entire face and is never just localized to one area. Someone who has extensive sun damage in their life will find that they are more prone to get pigmentation as well as dark spots as well as the entire face including the eye area. It is far more common to notice such pigmentation at facial areas of more prominence such as the cheek bones rather than the under eye or say the under the chin area which are relatively protected from sun due to the facial bone structure. In addition, if you have been undergoing treatments such as phototherapy for other skin conditions, it is always advisable to wear protective eyewear.

Will sunglasses work as well as an under eye sunscreen would?

Sunglasses are a good way to block out UV radiation and it is a form of physical protection. It is advisable to wear sunglasses primarily within the context of preventing excessive harmful UV exposure to the eyes for example the cornea. At the same time, when one applies a good quality medical-grade sunscreen together with physical measures such as a broad-rimmed sun hat and a pair of sunglasses, the amount of UV exposure to the face as well as the under eye area can be reduced.

How can you take extra care of the under eye area?

As mentioned, the eye is a very delicate area. It is well-said that the eyes are the windows to one’s soul and are very often the first feature that one notices. For someone who actively looks after their skin and does treatments such as lasers and peels, ageing in the eye area starts to become more obvious because these lasers and peels do not target the eye area and are often the top giveaway signs of a person’s age. So it is indeed very important to take extra care of the eye area, where prevention is key as well as using a good eye cream. In terms of physical treatments that can be done for the eye area, you may consider treatments such as CO2 laser resurfacing, as well as plasma nitrogen treatment which is very safe and uses ionic plasma nitrogen to help to resurface and tighten skin around the eye area.

© 2019 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 book an appointment online by clicking here.

Do you have cystic acne?

March 19, 2019

While acne is a common skin disease, it is often difficult to treat severe acne, like the nodulocystic form. Also known as cystic acne or nodular acne, such severe forms can cause significant damage to the skin and affect one’s self-esteem.

Is my acne mild or severe?

If you find that you have only one or two pimples appearing at a certain time of the month, it is considered physiological acne and it is mild. The occasional outbreak you experience is often resolved on its own.

However, if the original blackhead or whitehead becomes badly infected by surface bacteria that it triggers the skin’s inflammatory response, a cyst wall may form around the original site of inflammation.

How do I know if I have cystic acne?

Cystic acne, or nodular acne, are larger and more severe than the typical pimple. These nodules feel like stubborn, firm bumps under the skin and can last for months. You can get them on the face, neck, back, chests or shoulders.

What causes cystic acne?

Cystic acne develops from milder forms of acne. Oil and dead skin skins that clog the oil gland also traps bacteria within, causing inflammation. You may also be genetically disposed to developing cystic acne, if your parents had severe nodules, you are more likely to get it.

Hormones are also another major cause for cystic acne, which may explain why they can develop during puberty. Hormonal changes that take place during pregnancy can also trigger cystic acne.

What happens when your cystic acne is not treated?

Treatment of cystic acne can be challenging as topical treatment is usually less effective. If left untreated, your cystic acne may become a permanent scar. This can be painful, red and get secondarily infected over time. If the condition worsens, an abscess will develop, that is a collection of pus under the skin.

Do not squeeze or pick the pimple, as it introduces more bacteria to an already infected cyst. Extraction of the cyst with sharp objects by non-medical professionals should also be avoided, as they are not safe and sterilized in a medical environment. Doing so only introduces potential for bacteria to affect you, even if you are not acne prone. For example, we have been referred patients who had what started as an ordinary pimple, infected by a rare infection known as atypical mycobacteria. The bacteria originated from tap water with use of an unsterilized instrument by a facialist, leading to granulomatous infection of the skin and led to a sequence of biopsies as well as several months of oral antibiotics for treatment.

How should you treat cystic acne?

When you develop a single bump that becomes large and painful, it is a sign that your acne may be severe. If the acne does not disappear after a maximum of 2 months, it is unlikely that it is just normal physiological acne. This warrants medical treatment before the cystic acne worsens. Over-the-counter acne treatments are less effective against cystic acne and it is best to visit an accredited dermatologist as soon as possible.

Under the care of a dermatologist for assessment, one would expect an injection of triamcinolone, a steroid that can reduce swelling and inflammation, leading to the resolution of the cyst wall.

Another common therapy is oral isotretinoin, known for its efficacy for cystic acne. Severe acne tends to be unresponsive to drugs such as oral tetracycline or topical adapalene/benzoyl peroxide. It helps to fight acne by reducing the size and activity of your oil glands and reducing acne-causing bacteria.  However, isotretinoin also has side effects, limiting its usefulness for certain patients. Side effects include liver damage, depression, behavioural change and risk of causing serious birth defects. Isotretinoin can also make your skin feel very dry. Your eyes will also feel drier than normal.

Cosmeceuticals should also be used in tandem with oral medications. Use moisturizers regularly, such as Multi-CERAM™ Moisturizer for a healthy and hydrated skin barrier. Vitamin C serums have anti-acne abilities and help to accelerate healing scars. An anti-bacterial cleanser is also essential to allow a thorough cleanse, consider a gentle cleanser such as Miel Honey™ Cleanser.

To treat scars, chemical peels and laser resurfacing can be considered.

Visit a dermatologist to get a professional diagnosis, who will be able to pick the best form of treatment to suit the severity of your acne and reduce scarring.

© 2019 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.

 

 

 

A dermatologist’s guide on milia treatment

February 25, 2019

 

They may be small, but we definitely do not want these small, pesky bumps around. Milia, sometimes called ‘milk spot’ or ‘oilseed, are tiny white bumps that are benign, but hard to remove. You may have attempted to squeeze it out, given that milia can be cosmetically unappealing, but that would only worsen it.

If you are hoping to know the causes of those tiny bumps under your eyes, and how to get rid of it, read on.

Understanding what is milia – the white bumps under your eyes

Milia are keratin-filled bumps of 1-3 mm in diameter, arising from the outermost layer of the skin. Keratin is a structural protein that makes up your hair, nails and skin.

They are classified into primary and secondary milia.

What causes milia?

Primary milia is the most common, occurring spontaneously without a known stimulus. Secondary milia is induced by various stimuli, typically when the skin undergoes some form of trauma. This could be dermabrasion, physical trauma e.g. x-rays, inflammatory skin diseases e.g. acne or use of topical or systemic drugs.

Primary milia are connected to the sheath of our hair follicles, near our oil glands. Secondary milia connect to our sweat glands, rarely to hair follicles or the outermost skin layer. Milia are formed when there is an obstruction of the hair follicles or sweat glands.

Primary milia

Such form of milia is common in newborns, typically found on the face or scalp. They tend to disappear within weeks. In adults, benign primary milia occur spontaneously, often randomly distributed across cheeks and eyelids, and sometimes at the genitalia. While milia found on newborns go away in time, milia that develop later in life tend to persist.

Rarer forms of milia include milia en plaque, where multiple keratin-filled bumps are found in a cluster. It occurs without any apparent trigger and can arise spontaneously on healthy skin of predisposed individuals. Affected areas are often reddish, found under the eyes, on the ears, head or neck.

Multiple eruptive milia have a wider distribution than simple primary milia. It may be spontaneous or an inherited genetic condition. The bumps can be found distributed over the face, neck, upper chest, back and arms. It often numbers in the hundreds and can develop over a period of weeks to months.

Secondary milia

Secondary milia occur anywhere following traumatic stimuli after the skin is damaged in some way. Medications that may trigger secondary milia include topical steroids, penicillamine, benoxaprofen and cyclosporine. Other conditions can include contact dermatitis, skin grafts, second-degree burns and radiotherapy. In children, superficial abrasions can also lead to secondary milia.

Treating milia: can it be done at home or by a dermatologist?

Milia is benign and does not have any symptoms, thus treatments are only necessary if requested by the patient. However, all treatments must be recommended by your dermatologist.

  • Evacuation: For individual milium, the most effective way is to nick it with a scalpel blade, followed by applying pressure with a blunt edge. It is important to only have it done at a dermatologist’s office, as it may result in scarring when done without professional expertise. Any puncture of the skin may also cause infection.
  • Laser therapy: CO2 laser ablation can treat individual or multiple milia with minimal complications or recurrences
  • Oral prescription: Tretinoin or minocycline is often prescribed.
  • Microdermabrasion: A skin-resurfacing procedure to help gently sand the outer skin layer, causing cell turnover. Skin that grows back is smoother.
  • Electrolysis: Current is applied through a tiny needle on the milium, piercing through the keratin-filled bump. The contents of the milium are then soften, thus easy to remove.

Patients should not attempt milia extraction at home on themselves. While milia alone do not have any side effects, improper technique can cause skin trauma, leading to scarring or injury. If you would like to remove milia professionally, consult an accredited dermatologist.

© 2019 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.

 

 

 

How to reduce stretch marks

February 24, 2019

 

Stretch marks are extremely common. Yet, those squiggly lines on your skin are never welcomed. While such forms of dermal scarring are not medically dangerous, it can be aesthetically unpleasant to patients, causing distress.

Common occurrence of stretch marks includes the thigh, buttock, lower back, chest, upper arm and knee. Striae rubrae and striae albae are the two recognizable forms of stretch marks. Striae rubrae are flesh-toned scars, often accompanied by redness and ruptured capillaries that cause a subtle violet appearance. They then progress to striae albae – silvery, wrinkled scars that are hypopigmented (lighter than your usual skin colour).  

What causes stretch marks

Stretch marks, or striae distensae, occur typically during pregnancy, puberty, obesity or certain medical conditions e.g. Cushing syndrome. Other triggers include endocrine imbalance (a type of hormone), extended periods of mechanical stretch or any structural changes to the skin can lead to stretch marks. Chronic use of oral or topical corticosteroids can also contribute to the development of stretch marks.

Stretch marks are formed via three main mechanisms:

  1. Genetic predisposition
  2. Hormonal disorders
  3. Mechanical disorders/stretching of the skin

Genetic predisposition

No specific gene has been isolated as the cause of stretch marks developing. However, stretch marks have been identified among identical twins, families and inherited genetic skin conditions. This suggests genetic predisposition, that certain individuals may have a greater tendency of developing stretch marks based on their genes.

Hormones

A hormonal imbalance can contribute to the development of stretch marks. A hormone called adrenocorticotrophic causes an increased rate of protein breakdown. In turn, this leads to less collagen and elastin fibres being produced. With less collagen and elastin, the skin is less flexible and resilient to withstand stretching, causing stretch marks.

This effect is similar to that caused by corticosteroids, which explains why patients on long-term use of the drug are more prone to developing stretch marks.

Mechanical stretch

Rapid expansion or contraction of the skin causes it to stretch beyond its usual elastic ability. Fibres in the middle skin layer (dermis) stretch to accommodate when growth is slow. But with sudden stretching, the dermis may tear, causing the deeper skin layers to be seen and forming stretch marks.

In pregnancy, stretch marks frequently appear in the third trimester.

How to treat stretch marks

Topicals:               

Topical treatments only have mild effects in reducing appearance of stretch marks. Still, many patients prefer non-laser approaches, thus topicals remain as a common approach.

  • Tretinoin: Boost fibroblast production. Fibroblasts are molecules responsible for the structural support in our cells and synthesize collagen. Best for striae rubrae (for newly developed stretch marks), poor for striae albae (stretch marks that have been around for some time).
  • It is not recommended to use tretinoin during pregnancy as it carries a risk of birth defects
  • Phytochemicals: Plant extracts such as Centella Asiatica can boost the cells that produce elastic fibers and collagen. Resveratrol, naturally occurring in grapes and berries, can also boost skin elasticity. Elixir-V™ Total Recovery Serum contains a potent combination of phytochemicals, including resveratrol, to help fight ageing effects
  • Moisturizers: They can be applied as an adjuvant to treat stretch marks. Look out for moisturizers with active ingredients such as niacinamide. Apart from its brightening abilities, niacinamide stimulates collagen synthesis. You may consider Radiance Fluide™ Hydrating Emulsion, a dermatologist-designed lightweight moisturizer formulated with niacinamide.

While ingredients such as cocoa butter or olive oil are commonly marketed as effective in reducing stretch marks, it has not been scientifically proven to show results.

Chemical peels: They help to induce the production of collagen and improve the appearance of stretch marks. Salicylic acid, lactic acid and glycolic acid are most commonly used.

Microdermabrasion: In this process, physical agents such as aluminium oxide is used for skin resurfacing. A targeted injury is caused to trigger collagen production and to deposit elastin. Topical therapies are also more effective after microdermabrasion, as your active ingredients can better penetrate the dermis layer.

Light therapy: Different types of light treatment are available to stimulate collagen production in the dermis layer. Examples include infrared light devices, intense pulsed light (IPL) and ultraviolet light.

Ablative lasers: Such lasers are effective in reducing scars as they create a deliberate wound to induce healing of the skin.

Stretch marks are not medically dangerous, but if you are seeking for an effective treatment, it is best to consult an accredited dermatologist for best results.

© 2019 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.

 

Tips for a proper shave

January 27, 2019

 

Shaving-related irritation is one of the most popular cosmetic complaints among men. While it can affect any part of the face, the neck area is particularly sensitive to shaving nicks and redness.

If you are looking to keep your shave smooth and irritation-free, stick around as we share a few useful tips below.

Shaving and your skin

Shaving close to the skin without causing trauma is challenging. Also, shaving can compromise your skin barrier. Specifically, our skin has a layer of lipids that works to retain moisture and regulate the entry of any chemicals. When we shave, this lipid layer is compromised, especially if alcohol-containing aftershaves are used. When the lipid layer is damaged, the skin becomes extremely vulnerable to external stimuli. Moisture is easily lost to the surroundings and foreign chemicals can enter the skin easily. The skin can be more irritable at this stage.

Shaving may also be a physical stimulus for the receptors in our skin. While the sensory receptors in the skin are meant to perceive pain, they also react to more innocent environmental stimulus like a razor. Upon shaving, the skin releases mediators that cause a flare response, which leads to redness or a burning sensation.

Ingrown hairs

When shaved, the hair is left with a sharp tip. Ingrown hairs happen when the tip grows out of the follicle, curves downwards and re-enters the skin. Alternatively, it can grow inwards and penetrate the deeper skin layers.

Your body recognizes the hair’s reentry as a foreign object and triggers an inflammatory reaction that causes redness and itchiness. The follicles can resemble a pimple filled with pus.

To avoid this, do not stretch the skin while you shave as it causes newly cut hair to retract underneath the skin.

Razor burns

Razor burns occur when there is skin inflammation. Symptoms include burning, itching, stinging and redness. In mild cases, the discomfort can last for a few hours and resemble a rash or scratch. If the condition worsens, you may notice bumps that resemble pimples.

Tips for a smooth shave

  • Dry beard hair is stiffer more resistant to applied forces, which means stiffer hair requires greater force when shaving. To soften the beard hairs, first, wash your face with warm water and a gentle antibacterial cleanser like Miel Honey™ Cleanser. The cleanser is formulated with natural honey and Arnica Montana that reduces the risk of infection. The motion of washing your face also releases embedded hairs.
  • Shave with the grain, i.e. in the direction of hair growth, to reduce razor burn.
  • Use a sharp and clean razor blade with every shave. Dull blades require more pressure and unclean blades can introduce bacteria and trigger inflammation. 
  • If ingrown hairs are a significant issue, switch to electrical razors that reduce the closeness of the shave. Maintain beard hair at length of 0.5 to 1 mm to prevent hair from penetrating the skin.
  • Use a moisturizer after your shave to decrease irritation and rehydrate the skin. An emulsion-based, lightweight moisturizer like Radiance Fluide™ Hydrating Emulsion is recommended.

If you experience persistent shaving-related irritation, it is best to visit an accredited dermatologist. A thorough consultation can identify any underlying condition and provide advice on suitable treatment options.

© 2019 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.

 

 

A Dermatologist’s Guide to Exfoliation

January 20, 2019

Exfoliation, or the removal of dead skin cells from the outermost layer of the skin, is an important and necessary part of any skincare routine. However, if the word ‘exfoliation’ conjures up the action of scrubbing your face with harsh granules, you may be doing more harm to your skin than good.

So what is the right exfoliation technique for your skin?

Benefits of exfoliation

We shed dead skin cells naturally as new skin cells slowly travel up from the deepest skin layers to the surface. On average, this process takes about 27 days.  As we age, this cell turnover process slows down.

When we exfoliate, we remove the build-up of dead skin cells. Regular exfoliation can reveal younger, brighter skin with an even tone. 

Types of exfoliation

Exfoliation can happen in two forms: physical and chemical.

  • Physical exfoliation: Physical exfoliation relies on the rubbing of tiny granules or particles over the face to remove dead skin cells by physical force.

While this kind of exfoliation can leave you feeling refreshed, the technique can be too harsh for the skin, especially for individuals with acne-prone or sensitive skin. Physical exfoliation may even weaken the skin’s barrier function and leave your skin red or irritated.

For those of you without sensitive or acne-prone skin, physical exfoliation can still be an option. However, make sure to look out for exfoliating agents that are not too large.

  • Chemical exfoliation: Chemical exfoliation relies on fruit enzymes and gentle acids to slough off dead skin. This mechanism is much gentler than physical exfoliation and more suitable for acne-prone and sensitive skin types.

Types of acids

The two most well-known type of exfoliating acids is alpha hydroxy acids (AHA) and beta hydroxy acids (BHA).

AHAs: Alpha hydroxy acids work by causing skin cells to detach from the outermost layer of skin, making them easier to slough off. Once the dead skin cells are removed, new cells can rise to the surface.

Common AHAs used as chemical exfoliants are lactic, glycolic and mandelic acid.

Glycolic acid: Glycolic acid is the strongest AHA as it has the smallest AHA molecule. As such, it is able to penetrate deeper into the skin and can exfoliate at lower concentrations compared to other acids. However, if you are just beginning to try out chemical exfoliants, a different acid should be considered.

Lactic acid: Apart from exfoliating, lactic acid also moisturizes. Individuals with dry skin can consider lactic acid for this dual function.

Mandelic acid: With a larger molecular structure, mandelic acid is not able to penetrate deeply into the skin. This makes it a gentle AHA and safe to use, especially for people with sensitive skin.

BHAs: Beta hydroxyl acids (BHAs) differ from other AHAs as they are oil-soluble. This property allows them to penetrate deeper into our skin and pores.

BHAs exfoliate by softening the outermost layer of skin cells and dissolving unwanted skin debris. They also have anti-inflammatory and antibacterial properties, making them ideal for individuals with oily and acne-prone skin.

Chemical peels

Chemical peels are often done at a dermatologist’s office where the chemical agent used can be much more concentrated. Glycolic, lactic or salicylic acid is commonly used. A certified dermatologist is best able to identify the type of peel for your skin.

With regular use, these treatments exfoliate the surface skin and improve fine lines, wrinkles, skin discolouration and texture.

Chemical exfoliation at home

Most patients prefer to do chemical exfoliation on their own. However, this can cause skin sensitivity and redness for certain individuals over time without proper medical supervision.

As a result, Dr Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, recommends using active ingredients such as stabilised vitamin C (sodium ascorbyl phosphate), hyaluronic acid, phyto plant extracts or LARECEA™ extract. These ingredients are proven to deliver health to your skin without the sensitivity that AHA or BHA might cause when used without medical supervision.

Over-exfoliation

The benefits of chemical exfoliation may make it tempting to use AHAs and BHAs often. However, too much exfoliation can disrupt your skin barrier and cause the skin to become red and inflamed.

If you are a beginner to AHA and BHA, start slow. If you do not have sensitive skin, exfoliate every other day. Those with sensitive skin should stick to exfoliating once a week. Discuss with your dermatologist how often you should get chemical peels.

© 2019 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.

 

 

How does your skin react to alcohol?

January 19, 2019

 

What happens to your skin when you drink too much?

To maintain the health of your skin, you may want to think twice before you reach for one too many drinks. Alcohol can be pretty harsh on the skin.

Here’s why.

Premature ageing

When broken down, alcohol produces molecules called aldehydes. Such molecules cause damage to the body’s cells by destroying their ability to function. When cells are damaged or die, our body produces new cells to replace them. However, a single exposure to alcohol can reduce the body’s ability to multiply cells.

Another effect of alcohol is the widening of small blood vessels in the skin. This allows more blood to flow closer to the skin’s surface, which produces the distinctive flush and feeling of warmth often associated with alcohol consumption. Over time, this can cause an unhealthy appearance including dullness, enlarged pores, sagging, discoloration and a lack of skin resilience. Such effects can last for days.

Excessive alcohol consumption can further limit the liver’s ability to remove toxins, which can also make you look older.

Dehydration

Alcohol interferes with the body’s ability to regulate water levels. Your brain produces a hormone called anti-diuretic hormone (ADH) that acts on our kidneys to control the amount of water secreted in your urine. When your body is dehydrated, your brain sends a signal to pump out ADH. ADH stops you from urinating as much, allowing you to retain your water levels.

Alcohol inhibits ADH levels. So even when you drink a lot of water alongside your alcoholic drinks, your body only hangs on to about a third of it while the rest goes out in your urine. In other words, alcohol increases urine volume and leaves your body dehydrated.

This dehydrating effect worsens skin elasticity, thickness and density. It also makes wrinkles and fine lines more noticeable. 

Itchy skin

Most itchy skin diseases are exacerbated by alcohol consumption. Alcohol causes eczema to be twice as common, likely due to its suppressive effects on the immune system.

Alcohol also makes psoriasis harder to treat. Psoriasis refers to the condition of red, itchy skin. While alcohol itself does not cause psoriasis, it increases the body’s susceptibility to infection and exacerbates the condition. Heavy drinkers are also more resistant to therapy.

Flushing and Rosacea

Flushing is a common after-effect of drinking and tends to go away the next day. It is more prevalent in individuals who do not have an enzyme that breaks down aldehyde. (Alcohol is broken down via two general steps, first into aldehydes and then to acetate.) An accumulation of aldehydes causes flushing and rapid heart rates.

An impaired alcohol metabolism can also worsen rosacea, a common skin disease with a tendency to blush or flush more easily than others. It can further cause an increased incidence of telangiectasia or the appearance of spider veins at the surface of the skin. 

Inflammation

When alcohol is broken down in the body, reactive oxygen species (ROS) is released as a by-product. ROS are important signalling molecules in the body.

However, excess ROS production can be harmful to the skin as it alters the body’s immune response, triggers inflammation and causes the body to attack itself. This can compromise the skin’s wound healing processes.

Consequently, alcohol can cause skin conditions such as eczema, psoriasis or, in some cases, acne to take much longer to heal than before.

Resveratrol in red wine

Resveratrol is an antioxidant often found in red wine. (Antioxidants work to fight against the oxidative stress that your skin cells encounter.) Resveratrol also has therapeutic benefits against various skin disorders and protects the skin against harmful UV rays. Given that UV radiation is a major cause of ageing, resveratrol is popular for its anti-ageing abilities.

However, there are other ways to get resveratrol that do not include the harmful effects of alcohol.

For a dermatologist-formulated anti-ageing serum, go for Elixir-V™ Total Recovery Serum. It contains a potent concoction of resveratrol, hyaluronic acid and oligopeptides that work together to give you the perfect V-face look.

Seek for help

If your skin condition worsens, schedule a visit with a dermatologist as soon as you can. The dermatologist can determine the best course of action and suitable treatment that would be effective for your condition and your lifestyle.

© 2019 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.

 

 

 

 

 

Tackling oily skin

January 1, 2019

Are you tired of your skin getting greasy midday? Oily skin is a common cosmetic problem that gives the appearance of shiny skin. While there is no way to prevent it, there are certain techniques that can help fight it.

What causes oily skin?

We begin by understanding the oil, or sebaceous, glands on our face. These glands release a complex mixture of lipids (fats) onto the skin surface called sebum. Oil glands are highly concentrated on the face, upper chest, back and behind the ear. An excessive volume of oil glands is the main cause of oily skin.

Androgens

Our oil glands are stimulated by a hormone called androgen to produce sebum at puberty and beyond. The enzyme that catalyses androgen to its most active form is also found in higher concentrations in oil glands as compared to other skin parts.

At various life stages, your body experiences changes in androgen levels. This explains why you do not have oily skin all your life. Oil glands are present at birth but sebum production remains low until puberty when it increases exponentially. Sebum secretions are typically the highest among 15-35-year-olds and decline gradually afterwards. They stop after menopause for women, and for men in their sixties or seventies.

At any age, men are more likely to suffer from oily skin than women. This is because men have higher sebum production levels mostly due to testosterone secretions.

Diet

A diet rich in carbohydrates and a high glycemic index is associated with high insulin levels. Example of high glycemic load foods is sugary foods, white rice, white bread, and potatoes. Low glycemic load foods include fruits, legumes, soy products and porridge.

Insulin stimulates oil glands to produce more lipids. Switch to a low glycemic-load diet for an improvement in insulin level, which can, in turn, keep your oily skin in check.

Insulin levels typically peak during late puberty and gradually decline in the 30s, which explains why some of us develop oily skin at school.

Genetic disposition

Various genes control the activity of our oil glands. In most individuals, an overexpression of a gene called Smad7 leads to an increase in lipid synthesis. This means an individual with oily skin will not be able to eliminate the condition. However, with proper long-term cosmeceutical skincare, it is possible to have less oily skin.

Other factors

Temperature: Sebum production varies directly with temperature; an increase in 1°C leads to a 10% increase in sebum excretion rate. Unsurprisingly, summer is the season when our oil glands produce the most sebum. Hot, humid climates also cause skin to be oilier.

Cleansing habits: Using a harsh cleanser or over-washing to remove excess sebum can strip skin completely dry, leading to reactive seborrhea. This is a condition where the excessive skin drying is read by the body as a signal to produce more oil.

Treating oily skin

Retinoids: This vitamin A derivative helps reduce the growth of sebum-producing cells, decreases the size of oil glands and suppresses sebum production.

Hyaluronic acid: This moisture-binding ingredient delivers hydration to your skin and restores moisture balance. Ensuring your skin has sufficient moisture helps prevents your skin from producing excessive sebum. Hyaluronic acid also plumps up your skin for an even complexion.

Cleanser: Use a gentle cleanser, ideally an anti-bacterial one like Miel Honey Cleanser. Dermatologist-formulated for all skin types, even oily or acne-prone skin, this cleanser is effective in removing grime, oil, bacteria and other environmental pollutants without stripping the skin’s essential lipids off. With honey as a natural humectant, it also traps moisture under the skin while you cleanse.

Moisturizer: Individuals with oily skin may think their skin does not lack hydration. However, just because your skin has a lot of oil does not mean it has sufficient hydration. UV rays, environmental pollutants or harsh products can disrupt the skin barrier, affecting its ability to retain water. As a result, moisturizing regularly is an essential step.

If you have oily skin, look for a lightweight moisturizer. Radiance Fluide™ Hydrating Emulsion is an oil-in-water emulsion formulated for Singapore’s humid climate. An oil-in-water formula means small droplets of oil are dispersed in a larger volume of water. This gives a lighter texture compared to water-in-oil formulas where small droplets of water are dispersed in a larger volume of oil.

Oral isotretinoin

An oral retinoid has the greatest results in suppressing sebum production, often a 60 to 90% reduction. A significant consideration before starting on oral isotretinoin is teratogenicity though (ability to affect fetal development and cause birth defects at the time of conception or during pregnancy).

Oral retinoids are only available on prescription due to their side effects. For cautious management, always consult a dermatologist first.

© 2018 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.
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