Dr. Teo Wan Lin is an accredited dermatologist and an expert on cosmeceutical skincare research and development. She is the author of “Skincare Bible – Dermatologist’s Tips for Cosmeceutical Skincare” which was published July 2019 by leading bookstores Barnes & Noble, Baker & Taylor and Apple Books and available in bookstores islandwide from January 2020. She heads up the Pi- Cosmeceutical Custom Makeup Lab and the Conscious Mask Bar.
Is masking actually more effective than simply applying a thick layer of moisturiser? While both moisturisers and overnight masks are formulated with leave-in ingredients rather than those that require you to rinse off, such as cleansers or exfoliators, overnight masks encourage the user to distribute a liberal amount of product onto the skin, whereas people often skimp on the moisturiser. In her book, The Skincare Bible, dermatologist Dr Teo Wan Lin writes that the efficacy of masks all depends on the concentration, type, preservative and vehicle of the active ingredients. When selecting a mask to deliver moisture, Dr. Teo suggests looking out for glycerin, ceramide, plant-derived antioxidants and hyaluronic acid
Dr. Teo never recommends clay or astringent masks to anyone – even those with super oily skin – “it may give the feeling of your skin being clean but first of all, it will never cure the problem of acne or oily skin because it is the underlying inflammation that needs to be stopped in acne. Astringents such as salicylic acid, alcohol – which are present in these clay masks – and even calamine, which is a natural mineral that absorbs moisture and oil, will only temporarily give you a squeaky clean feeling. Subsequently [using these masks] can lead to, number one, skin irritation in the form of eczema, or even cause a condition called Reactive Seborrhea whereby you produce even more oil because your skin is feeling dehydrated, so this is a paradoxical reaction.” In Dr. Teo’s opinion, the most helpful mask for skin would be “one that delivers moisture as well as active cosmeceutical ingredients.” With these moisturising masks, there are no issues with leaving them on for longer than the recommended amount of time. Says Dr. Teo, “when I say to leave it on for a minimum of 15-30 minutes it’s really because of the principle of wet wrap. When your skin is in contact with a damp surface, whatever is on the skin will also be absorbed much easier.”
It can be frustrating to try a multitude of different products – all of which don’t achieve anything beyond superficial results. Sometimes it isn’t the product, but the delivery method. Due to the impervious nature of the stratum corneum, the outermost layer of the skin, applying topical formulations is not enough to create lasting results due to the inability for topicals to penetrate past the first few layers of the skin. This isn’t to say that all topical formulations are useless in skincare, but their limitations are often overlooked. Some of these shortcomings can be solved by using transdermal drug delivery to administer the product.
When it comes to allowing active ingredients to pass through the stratum corneum and penetrate deeper layers to optimise the effectiveness of cosmeceuticals, transdermal drug delivery is at the forefront of “smart skincare”. Some things to consider when selecting the appropriate polymeric materials for a transdermal delivery system are: bio and chemical compatibility with the drug, shelf life and effectiveness of delivery. By selecting the appropriate material, the active ingredient is able to diffuse through the membrane at a set rate – a rate controlled by the composition and thickness of the membrane (Kandavilli, Nair, Panchagnula).
QRASER™ Transdermal absorption patch
While developing the QRASER™ Transdermal Absorption Patch, Dr. Teo and lead chemical engineer Mr. Teo Zhi Liang sought to optimise the delivery and absorption of cosmeceuticals so users could maximise the effects of topical formulations. The QRASER™ Transdermal Absorption Patch, part of the Dr. TWL Biomaterials range, enables cosmeceuticals to penetrate past the first few layers of the skin and allows bio-active ingredients to be released at a consistent rate. It uses polymer technology to create a microenvironment that imitates the skin’s natural hydration state, thus allowing cosmeceuticals to pass through the often impervious barrier. QRASER™ Polymer Patch employs a matrix system of transdermal delivery consisting of two polymeric layers: a backing that prevents the loss of active ingredients and a layer that doubles as an adhesive and rate-controlling membrane. By using this transdermal drug delivery system, the cosmeceutical is able to enter the microenvironment and target fibroblasts, the cells responsible for healing wounds. Pair it with Vita C Gold™ Serum, Elixir-V™ Recovery Serum, Radiance Fluide™ Sleeping Mask for optimal results. In addition to enhancing the absorption of cosmeceuticals, QRASER™ Polymer Patch can also be used alone. The product encourages collagen production and speeds up the skin’s recovery process. The increase in healthy collagen reduces fine lines and wrinkles, thus creating an “anti-aging” effect.
The QRASER™ Transdermal Absorption Patch is available in five unique cuts to cater to individual concerns: Smile Lines, Eye bags/Undereye wrinkles, Crow’s Feet, frown lines or a custom cut
MoistureMax™ Skin healing polysaccharide facial mask
The MoistureMax™ Skin-Healing polysaccharide facial mask was developed by the Dr. TWL Biomaterials research team. Created in an ISO certified biotechnology laboratory, the mask employs a patent pending skin biocompatible polysaccharide membrane technology. At the Dr. TWL Mask Bar, counterpart to the popular Dr. TWL Lip Lab, patients can have masks cut to fit their unique facial contours and work with experts to create customised cosmeceutical treatment vials to be used in conjunction with the mask sheets. The mask’s porous structure allows for the delayed release of cosmeceuticals overnight by storing the active ingredients in mini-reservoirs within the mask. The mask is suitable for sensitive skin, including those with Eczema and Rosacea, and despite it being a 100% preservative, additive and chemical free product, the mask can be reused up to five times when stored under proper conditions. For optimal results, Dr. Teo suggests pairing it with the Radiance Fluide™ Sleeping Mask for moisturising and Amino Acid 360° Mask for anti-aging; finish with the MULTI-CERAM™ cream for skin repair.
The Conscious Concept Mask Bar by Dr.TWL Pharmacy launches 12 December 2019 focussing on advanced eco-conscious materials engineering for improving skin absorption of skincare ingredients. Find out more here.
Custom beauty? You have probably heard this term recently, with the launch of multiple custom skincare lines. Fresh off the press for us at Dr.TWL Dermaceuticals though, is our new division of Custom Cosmeceutical Makeup. Read on in the first of a 2-part interview with our founder, accredited dermatologist Dr. Teo Wan Lin
Dr.TWL Dream Concealer in various colors to correct skin concerns.
What is the Pi-π Cosmeceutical Custom Makeup Lab about?
The Pi-π Cosmeceutical Custom Makeup Lab offers scientifically created skin-tone matched cosmeceutical makeup, including colour correction concealers, as an extension of my established skincare arm, Dr.TWL Dermaceuticals
. Our Flagship offering includes an in-house Dr.TWL Lip Lab which features a 100% edible, anti-ageing cosmeceutical, the LipSerum Stick™
, which is a solid state lipstick customised to any shade you want! Our advanced colour science system recommends different shades of each color- pinks, berrys, reds, nudes and corals that would uniquely flatter different skin tones.
Why does makeup— including concealers, foundations, lipsticks— need to be customised? Why not a generic “works for all” product, like most mass produced brands?
Why a generic “works for all” product is not ideal for makeup is because of the variety and uniqueness of skin tones. Every individual’s skin tone is different—based on our scientific database, we have on record at least 100 shades of distinct skin tones, whereas most makeup brands have at most 6 or 7 colour shades for foundations and concealers. This variation in skin tones translates into different shades of each lipstick colour that would work ideally for each individual.
What are the advantages of the LipSerum Stick, compared to store bought lipsticks, other than the fact it can be customised to any colour?
Store bought lipsticks cause allergies in individuals with existing lip conditions like eczema and cheilitis. The lips are also one of the first areas to suffer ageing related concerns such as lip discolouration, wrinkles and loss of volume. I then came up with the idea of a topically applied lip cosmeceutical serum with anti-ageing salmon roe DNA, which is also suitable for eczema sufferers, that could also be customised with your favourite lip pigment.
What are the limitations of traditional lipstick selections?
Lipstick brands have a limited selection of colours. Everyone has a favourite colour for a different mood—pinks, berrys, reds, nudes and corals— but did you know that different shades of each can be created to flatter different skin tones? We worked with veteran makeup artists and scientist to create the Dr.TWL Advanced Colour Science System to recommend the perfect lip colour match for each skin tone, whether you want it classic, sweet, sexy or nude.
What’s so unique about this custom makeup lab? Is it just custom blend makeup?
It’s the first dermatologist-led custom makeup laboratory in the world which fuses both skincare and makeup, via the use of cosmeceutical bases and unlimited variations of colours for foundations, concealers, colour correctors to match every skin tone, via our Advanced Colour Science System developed by our team of scientists, in consultation with veteran makeup artists. It’s not just custom blended for you, it’s cosmeceutical base is adjusted to target underlying skin conditions such as pigmentation, blemishes and ageing.
What was your inspiration for the Custom Cosmeceutical Makeup Lab?
My patients who I treat for a variety of skin conditions such as acne, pigmentation, rosacea, eczema and sensitive skin. There is a lack of sensitive-skin compatible makeup for these patients who need coverage and camouflage during the skin healing process. Besides, Singapore has a diverse ethnic mix which includes darker skin tones that many makeup brands do not cater for. I treat a lot of darker skin toned patients in my practice who cannot find their perfect foundation/concealer match.
What were some of the problems with the mass market makeup products that you faced?
Previously, I would recommend patients with sensitive skin/eczema
issues to use pure mineral makeup, which has the lowest risk for causing skin irritation and allergies, as pure mineral pigments are chemically stable/inert with no reactions. However, I soon realised that the these commercial brands also had additives such as bismuth oxychloride and talc which function as bulking agents, and these were irritating to skin, with some even reporting that they felt the texture was that of “cut glass”!
© 2019 TWL Specialist Skin & Laser Centre. All rights reserved.
Skin irritation? Breakouts? Allergies? Think it may be due to bad diet and unhealthy lifestyle? Or maybe because of your dirty beddings or perhaps pollution? All of that may be possible contributors to your unlikely skin concerns but have you ever wondered that maybe the problem could be in the makeup that you use?
Makeup is all fun and games until you learn about the risk it comes with using them. If using makeup products is part of your daily routine, then it is important to know about what you put on your skin! Did you know that the average woman ingests about 6 tons of lipstick in her lifetime? You may not notice because you don’t literally eat your lipstick, but every time lipstick gets unto your teeth, or whenever it transfers on to your food when you eat, the main thing is it’s now down your tummy! So before anything else, it’s now time to question on whether or not the products that you use are safe for you.
You may be reading the ingredient list of your makeup products but do you think that’s all it is? Some companies hide “certain substances” or mask it under deceptive titles. Others may have listed them, but what’s lacking is that there is not enough information on the potential harm it may cause for their consumers.
Certain ingredients used in the production of makeup and cosmetics can cause more harm than benefits and these can cause problems that may put your health at serious risk. Issues related to the use of products with these harmful ingredients may associate with skin allergies, cancer, weakened immunity, and more.
“For patients who suffer from sensitive skin and allergies, it’s often a vicious cycle with makeup products which are used for concealing the skin imperfections, and the same preservatives and ingredients in these products cause an exacerbation of the underlying skin condition,” says accredited dermatologist Dr. Teo Wan Lin.
How about for those without skin problems? Dr. Teo says, “Makeup is in direct contact with skin, and as skincare can deliver benefits to skin via topical absorption, makeup can also be used as a means to improve the health of the skin when it is incorporated with cosmeceutical active ingredients as an anti-ageing formula— while at the same time offering concealing of imperfections, which can improve individuals’ self-esteem. For products applied to mucosal areas such as the eyes and lips, it’s worthwhile to switch to pure mineral colorants in cosmeceutical bases because these are sensitive areas that are prone to irritation, and have thinner skin that will cause any harmful substances to be directly absorbed.”
We have listed down below the Top 5 harmful chemicals that are used in the production, preservation, and manufacturing of makeup products that you may be using everyday. Guess what, these ingredients don’t have to be present in your makeup— if you switch to mineral makeup for the eyes and lips!
This chemical is most commonly found in perfumes, colour cosmetics, nail polish, and hair care products. Phthalates are linked to endocrine disruption, developmental and reproductive toxicity, and cancer. Phthalates may be labeled as phthalate, DEP, DBP, DEHP and “fragrance”. Some companies intentionally exclude this on their ingredients list. Products that list “fragrance” on the label should be avoided to prevent possible exposure to phthalates.
Paraben…paraben… One of the most famous ingredients for makeup. Though you may not know much about this chemical, you’ve probably heard about this already because you may have previously encountered the term “paraben-free” on some beauty products and wonder what does it mean. Parabens are preservatives used in a wide variety of personal care products and foods to prevent the growth of microbes. Parabens are not water soluble and can penetrate the skin. As a result, repeated application of a product or multiple products containing parabens could mean almost continuous exposure. These endocrine-disrupting chemicals can be absorbed through skin, blood and the digestive system.
Effect of Paraben: causes endocrine dysfunction, interferes with male reproductive functions, and can lead to rapid skin ageing and DNA damage.
Paraben may be labeled as ethylparaben, butylparaben, methylparaben, propylparaben, isobutylparaben, isopropylparaben, and other ingredients ending in –paraben.
Lead has continuously been a very controversial component of lipstick. But did you know that it is often used in makeup foundation and whitening toothpaste as well? High levels of lead may pose a very serious risk on our health and studies have shown that there is no safe amount of lead exposure as though even at small amounts, lead can be very dangerous. Medical experts are clear that any level of lead exposure is unhealthy. The FDA or Food and Drug Administration has been determined to limit the usage of lead in lipstick and in a variety of other cosmetics. Read here.
Exposure to lead has been linked to a host of health concerns:
- Neurotoxicity: It has been linked to learning, language and behavioral problems.
- Reduced fertility in both men and women
- Hormonal changes and menstrual irregularities
- Delayed onset of puberty in girls and development of testes in boys.
Talc is used as an ingredient in face powders, blush, and eyeshadows. The incorporation of asbestos in talc is due to poor regulations involving cosmetic-grade talc, which is also known as talcum powder. Talc and asbestos are minerals that form together. That means talc mined for commercial uses can be contaminated with asbestos — a known cause of lung cancer and mesothelioma. Before purchasing any product that has talc, make sure it is labeled as asbestos-free. Health concerns of asbestos may include skin irritation, cancer, organ system toxicity.
5. Butylated Compounds (BHA, BHT)
Mainly used for preservation of our beauty products and personal care products such as moisturizer, lip products, hair products, makeup, sunscreen, antiperspirant/deodorant, fragrance, creams. Butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT) are chemicals are linked to several health concerns including endocrine disruption and organ-system toxicity.
Don’t get fooled by this because butylated compounds are also used as preservatives in food like meats, sausage, poultry, baked goods, beer, etc.
We have no control over the ingredients or manufacturing of the mass market makeup available in the market, but is that where custom blend mineral makeup can perhaps fill a need? “Custom blend mineral makeup has its advantages especially for eye and lip makeup because pure minerals are utilised. The eyelid and lip area are high-risk locations and naturally have thinner and more sensitive type of skin—known as mucosal skin. “ says Dr. Teo, who remarks that she has been seeing an increasing number of patients in her practice with eyelid and lip eczema, often triggered by makeup products such as mascara, eyelash extensions and lipsticks.
Especially if the sources are clearly labelled and audited, the risk of manufacturing contamination for sensitive products such as lipsticks and eye shadows, which is of the highest concerns to regulatory authorities like the FDA and HSA as well, due to the risk of ingestion and absorption, is eliminated. “When produced in smaller batches, custom blended mineral makeup is preservative free and avoids the problems of lead contamination in mass market manufacturing, which is important in lip products because of the lead content which is inevitably ingested.” Dr. Teo says.
How does one avoid getting these toxic chemicals incorporated into your daily routine? Also, isn’t it time that skincare is infused into makeup, since both are applied for long hours on the skin? Head over here to get your hands on cosmeceutical make-up.
Dr. TWL Dream Concealer™
100% Mineral Pigments Without Bulking Agents
FDA Eye/Lip Approved
LARECEA™ Extract [Regeneration]
PEACH Covers dark circles on light skin
ORANGE Cancels dark circles brown spots on medium to deep skin
PALE PURPLE Conceal brown spots on light skin dullness
PURPLE Brightens/Neutralizes dull yellow on medium skin
PINK Brightens/Neutralizes dull yellow on light skin
BLUE Neutralizes sallowness & hyperpigmentation on fair skin
YELLOW Cancels purple/blue tones Corrects mild redness
GREEN Neutralizes redness/pimples
In patients with Eczema, there is an inherent defect of the epidermal barrier of the skin. When this barrier is compromised, bacteria and allergens are able to enter and thus there is an increased risk of secondary infections, which, in turn, can lead to aggravation of eczematous symptoms.
It is believed that the best way to manage eczema is to repair the skin barrier or prevent its dysfunction.
According to accredited dermatologist Dr Teo Wan Lin who is an expert on sensitive skin and eczema, “I formulated the Dr Twl Dermaceuticals Multi-CERAM™ Moisturiser after years of prescribing other brands of ceramide-containing moisturisers which I found did not meet the underground clinical needs of patients, at a competitive price point. The high cost of manufacturing ceramide-containing moisturisers lies in its reliance on synthetic sources of ceramide as well as bovine(cow derived) ceramide.”
“In the Dr Twl Dermaceuticals Multi-CERAM™ Moisturiser, which is very competitively priced with a high ceramide content, the novel focus and dermatological concept is on using multiple sources of ceramide for total skin lipid restoration, rather than just relying solely on the expensive synthetic and animal derived ceramide which results in low concentrations of ceramide being used in other moisturisers, or high price point which is prohibitive. In the Multi-CERAM™ Moisturiser, phytoceramides are used— these are plant seed oil derived sources of ceramide that directly repair the skin barrier. This is in addition to containing plant anti-oxidants which incidentally combat cellulite, large amounts of glycerin which functions as a humectant, preventing trans-epidermal water loss, as well as Sodium Hyaluronate (Hyaluronic acid), a natural component of the skin, for dermal hydration,” Dr. Teo says.
What are Ceramides?
Ceramides are lipids that are naturally found in the intercellular “mortar” within the outer layer of s the statue corneum. They make up 40-50% of the lipid component of the lamellar lipids and are integral to the function of the epidermal barrier.
In patients with psoriasis, eczema and other dry skin conditions, reduced levels of Ceramides are observed.
The stratum corneum is comprised of corneocytes compressed within a lipid bilayer, which is made up of 40-45% Ceramides, 25% Cholesterol & 10-15% Free Fatty Acids. If incorporated in the wrong ratio, barrier repair may be impeded. These 3 major components of the stratum corneum bind the protein-rich corneocytes into a water impermeable protective barrier. A deficiency in Ceramides results in excessive transepidermal water loss, dry skin and increased permeability to environmental irritants, allergens and microorganisms. Thus, reduced levels of Ceramides is associated with dermatological disorders such as atopic dermatitis.
Studies show that if topical ceramides is applied in the correct ratio with cholesterol and free fatty acids, it can help to improve the epidermal barrier in people with Atopic Dermatitis (AD), thereby reinforcing barrier function. Therefore, ceramide-dominant moisturisers and cleansers have been proven to provide substantial relief from the symptoms of eczema.
The 3:1:1 Ceramide Dominant Molar Ratio
In order for ceramide-containing products to have a positive effect on the barrier function. The optimal ratio is 3:1:1, with Ceramides being the most abundant. Any variations in this ratio may hinder the recovery of the skin barrier. Not all topical ceramide products are the same — our Multi-CERAM Moisturiser have unique formulations which have been designed to ensure the delivery of an optimal ceramide, cholesterol and free fatty acid ratio.
The Dr. TWL Dermaceuticals Multi-CERAM Moisturiser helps to support ceramide synthesis whilst reinforcing the skin barrier.
The Multi-CERAM™ Moisturiser contains:
- Ceramide 1 (EOP) which is significantly deficient in eczema patients and Ceramide 3 (NP) which is linked to the transepidermal water loss experienced in eczema patients.
- Phytoceramides which aids the repair of skin barrier
- Sodium Hyaluronate for skin hydration
- Ceramide complex (ceramides, cholesterol & FFA) which delivers ceramides topically in the optimal 3:1:1 molar ratio to aid in the reinforcement of the recovery of the skin barrier.
Management for patients with Eczema
A daily maintenance routine is vital. One of the main changes in eczema is a disruption and reduction in the layers of corneocytes in the stratum corneum. When the stratum corneum is well hydrated, it swells, allowing increased permeability of topical formulations. The key to managing eczema is through the regular use of a moisturiser with high ceramide content after showering or washing hands.
Successful management requires a holistic approach:
- Avoid triggering factors
- Maintain skin care through regular use of a moisturiser and a moisturising cleanser
- Pharmacotherapy during acute exacerbations
- Compliance of skin care products suggested by a dermatologist
More Eczema-related articles here:
Top Eczema Tips & Treatment by a Singapore Dermatologist – Eczema…Staying free of this treatable condition at any age
The ageing process is different for each person, but there are certain signs of ageing that are considered “premature” if you notice them before you turn 35. Our environment and lifestyle choices can cause our skin to age prematurely. We will discuss here 3 ways on how to prevent premature ageing.
1.) Never skip your sunscreen.
The sun emits a type of energy known as the ultraviolet radiation. There are 2 types of UV radiation— UVA rays which is mainly the culprit behind Premature Ageing (wrinkles, dark spots, and sagging skin) while UVB rays is responsible for sunburn, and both contribute to skin cancer.
One way to protect your skin from premature ageing and of course skin cancer is to wear a sunscreen that has SPF and is broad-spectrum.
SPF only measures protection against UVB so it’s important to wear a ‘broad spectrum’ sunscreen which blocks both UVA and UVB.
The fix: Shield, repair, and brighten your skin from the harmful sun rays with Dr. TWL Dermaceuticals SunProtector™️
✔️ Broad Spectrum
Contains Collagen Hydrosylate for skin regeneration, Oligopeptides for skin repair, and Portulaca Oleracea Extract for skin soothing.
Get yours here.
2.) Don’t drag your skin when applying skincare/makeup products.
Our skin is very delicate and we want to avoid excessively tugging it whenever we apply our skincare or makeup products because this can cause our skin to show early signs of ageing. Mishandling of the skin especially around our eyes like aggressive removal of eye makeup and heavily dragging eye care products and any other skincare product unto our skin can cause eye wrinkles, crow’s feet, and other skin irritations.
The fix: Use your ring finger in applying your skincare/makeup products. Our ring finger is said to have the lightest touch and it distributes an equal amount of pressure when used upon the skin.
Using a Jade Roller is also proven effective in applying skincare products like serum and cream for complete absorption while lifting our skin.
Try the Dr.TWL Rose Quartz Jade Roller here.
3.) Use products with anti-ageing cosmeceutical base.
The term cosmeceutical, according to the dictionary, is defined as a cosmetic that has or is claimed to have medicinal properties, especially anti-ageing ones.
Cosmeceuticals are currently used for adjunct treatment of skin conditions, as well as for anti-ageing. Dermatologist incorporates these evidence-based active ingredients for skin healing into makeup.
Here are some active ingredients for anti-ageing
– DNA from salmon roe
The fix: For skincare, try Dr.TWL’s Oligopeptide Anti-Wrinkle Vegetal Capsules.
For your makeup base, try the Dr.TWL CellTalk™️ Cosmeceutical CC Cream.
Colour and pamper your lips with the Dr.TWL LipSerum™️ Stick — contains Salmon Roe DNA and Phytoceramides for anti-wrinkling of the lips.
, Jade roller
, premature ageing
, premature aging
, Rose quartz jade roller
, signs of ageing
, signs of aging
, Sun protection
How we apply our skincare is very important. Have you ever wondered why most skincare brands recommend in their product directions to use the ring finger and not any other fingers in applying and gently massaging the product unto your skin especially when it involves the eye area? That is because out of our 5 fingers, our ring finger is said to have the weakest touch. The manner on how you massage your face while cleansing it and how you apply your skincare and makeup products, even just simply scratching it or wiping it can add up to protecting the quality of your skin.
Our skin is very delicate and we want to avoid excessively tugging it whenever we apply our skincare or makeup products because this can cause our skin to show early signs of ageing. Applying with our ring finger gives an equal amount of pressure when applying products. You can easily cause wrinkles with too much pressure, and our ring finger is recommended for the least amount of pressure and pull.
Most especially when it comes to applying eye creams, using our ring finger is the best. The skin around our eyes is the most delicate among the rest, and it is most commonly the first to show the earliest sign of ageing. Mishandling of the skin around our eyes like aggressive removal of eye makeup and heavily dragging eye care products and any other skincare product unto our skin can cause eye wrinkles, crow’s feet, and other skin irritations.
That being said, no matter how the ring finger is said to be the lightest, we still have to be mindful whenever we use it to come into contact with our skin. Same with any other finger. Always work your serums, eye creams, and any other product into your skin using light, tapping motions making sure to avoid rubbing and tugging. No matter how expensive your skincare product is, the manner on how you apply it will tell how to get the most out of it.
HOW TO APPLY EYE CREAM
Ever looked in the mirror and thought “My eye wrinkles are becoming more obvious each day”?
The Elixir-V™ Eyes is an eye cream that is meant to prevent dark eye circles, excessive puffiness of the eyes and eye wrinkles. Like the Elixir-V serum, it contains potent oligopeptides used for lifting and repair and our signature Larecea™ extract for regeneration. An additional ingredient is niacinamide, used for brightening. While the Elixir-V serum is meant for the skin, the Elixir-V Eyes is focused on protecting the beauty of your eyes. We believe that your eyes are the most noticeable and beautiful parts of your face. Hence, it is meant to anti-age the sensitive skin around your eyes.
by: Dr. Teo Wan Lin
In my previous articles, I have talked about cosmeceuticals and the importance of incorporating them in our daily routines. However, how do we enhance the skin absorption of these cosmeceuticals? Here I will be talking about the limitations of topical formulations and how we can overcome them to ultimately achieve the results that we desire.
The problem with topical formulations
The outermost layer of the skin, called the stratum corneum, acts as a natural barrier. It prevents foreign material from entering our system, shields us against environmental factors and prevents excessive water loss. The skin is a formidable barrier to the passage of substances into and out of the body, but it can be manipulated to allow it to become a viable pathway for drug administration.
Drug products applied to the skin’s surface penetrate the skin layers to a certain extent, where they can exert their effects. This is the case for topical formulations for treatment of skin disorders such as acne, dermatitis, and psoriasis. However, very few drugs are suitable for delivery by the topical route, as passive penetration through the skin is limited to very small molecules (<500Da), which are neutral and relatively lipophilic. Some considerations of dermatologists would be the vehicle of the topical, specifically if it is in a lotion, cream or ointment form, in increasing order of absorption and effectiveness. This however, is often limited by user preferences, with ointment formulas (more efficacious) deemed cosmetically less acceptable.
The skin is the largest organ of the human body, comprising 15% of body weight and therefore its use to deliver medicine to the body is not a new concept by any means. Advancements made by modern science are improving the skin’s potential as a route for drug administration. Dermatologists are at the forefront of research relating to transdermal drug delivery, given the unique accessibility of the largest organ of the body.
Owing to the drawbacks of topical formulations, transdermal patches have been developed to improve drug delivery through the skin and this is an area that my team has actively researched in the last year as an adjunct to our cosmeceutical formulations.
I have always been interested in finding new methods to allow my patients to achieve optimal results from our cosmeceuticals, thus in this article I shall share some tools which I employ in my clinical practice to achieve optimal absorption of cosmeceutical active ingredients.
Wet Wrap/Occlusion Therapy & Facial Masks
A well known method employed by dermatologists to treat severe eczema known as wet wrap is actually a simple process involving applying a wet textile together with topical medications to skin, to increase absorption of skincare. An example of how and when wet wraps are used— during particularly intense eczema flares with severe itch or pain, wet wrap therapy rehydrates and enhances the absorption of topical medications applied on the skin. The fabric wraps are soaked in water and applied to the affected skin on the body. Wet wraps are best done after bathing, moisturising and applying topicals, then left overnight.
Wet wraps work via 3 different ways:
● Cooling — as water gradually evaporates from the bandages this cools the skin and helps relieve inflammation, itching and soreness
● Moisturising — cosmeceuticals covered over with wet bandages are deeply absorbed in to the skin to provide a longer-lasting moisturising effect
● Absorption — enhanced absorption of any topicals into both the superficial and deeper layers of skin where inflammation is present
Facial sheet masks work in a similar way, on the basis of occlusion. This means that when there’s a topical which is applied on the skin and also in contact with something moist such as a sheet mask, there is increased absorption of the topicals by the skin. In my practice, whenever I want to increase absorption of cosmeceuticals and moisturisers that are dispensed to patients, I would advise them to apply a wet cotton sheet (as a wet wrap) on to their face to increase absorption.
I would consider masking as something which is very good to do if you are already diligent with other aspects of skin health such as cleansing and applying cosmeceuticals. Using a face mask would deliver moisture and clinically active ingredients to the skin—so it is important to look out for ingredients such as glycerin, ceramide and hyaluronic acid, as well as evidence-based antioxidants for anti-ageing such as oligopeptides, vitamin C ( I use sodium ascorbyl phosphate which is a neutral, rather than acidic form of vitamin C, that has minimal skin irritation). Here’s a tip, use a cosmeceutical moisturiser like the Radiance Fluide™ and increase your skin’s absorption by applying it on damp skin, plus a soft wet cotton towel over it.
Performing a facial massage, such as with the aid of a facial roller before application of cosmeceuticals could increase the skincare absorption, leading to better effects of the anti- aging skincare. Local massage is an established treatment method of improving surgical scars, by stimulating blood flow and improving wound healing. A peer-reviewed study published in a medical journal Complementary Therapies in Medicine led by author Miyaji Akane at the Institute for Liberal Arts, Tokyo Institute of Technology (Tokyo Tech) and colleagues at Tokyo Healthcare University and the Research and Development Center, MTG Co. Ltd. in 2019 had examined the effects of using a facial roller on facial skin and blood flow. The study concluded that there was significantly increased vascular (blood vessel) dilation with use of the facial massage roller. This means that there will be increased absorption of any cosmeceuticals applied on the face following the massage.
My recommendation would be manual rather than electric facial rollers as the latter may cause excessive pressure and irritation (being automated) and is also dependent on user training as well as the manufacturer’s settings, with a potential risk of overheating of electric components. Manual facial massage is a self-regulated process as the user can immediately sense irritation and apply just the right amount of pressure.
Transdermal medications (usually in the form of a patch) are a little more modern and complex. Great strides in transdermal drug delivery have been made since the first transdermal drug was approved by the FDA in 1979.
Transdermal drugs bring medication through the skin, to the bloodstream. Once in the bloodstream, the ingredients circulate and take effect at a targeted location. Medication is delivered steadily and can be stopped simply by removing the patch. Since your body doesn’t have to digest the medicine through the stomach, a higher concentration reaches the bloodstream. The medication permeates the skin in a controlled fashion thus attaining more ready levels of the drug in the body.
The science behind polymers and transdermal drug delivery systems
Polymers are vital in a transdermal drug delivery system. Systems for transdermal delivery are assembled as a multilayered polymeric laminates consisting of a drug reservoir sandwiched in between 2 polymeric layers:
● An outer impervious backing — prevents the loss of drug
● An inner polymeric layer — functions as an adhesive and rate-controlling membrane There are 3 types of transdermal drug delivery systems:
● Reservoir systems
In this system, the drug reservoir is embedded between a backing layer and a rate-controlling membrane.
● Matrix Systems
In this system, the drug reservoir is either dispersed in an adhesive polymer or in a hydrophilic or lipophilic polymer matrix.
● Micro-reservoir Systems
This system is a combination of the above 2 systems. The drug reservoir is formed by suspending the drug in an aqueous solution and then dispersing the solution in a lipophilic polymer to form thousands of microscopic spheres of drug reservoirs.
Polymers used in transdermal delivery systems should have biocompatibility with the drug and other components of the system. They should also provide consistent, effective delivery of a drug throughout the product’s intended shelf life.
An example of a common polymer used are silicones, also known as polysiloxanes, made of many repeating units of siloxanes. Siloxanes are chains of alternating silicon and oxygen atoms that are often combined with carbon and/or hydrogen.
Medical grade silicones are silicones that undergo specific testing for their biocompatibility and have been deemed appropriate to be used for medical applications. Topical silicone therapy is often used by plastic surgeons and dermatologists to treat and heal scars.
Key considerations of a polymer patch used for transdermal drug delivery would be —conformability of the material to be applied to irregular skin or scar surfaces, sensitive regions such as the face/eye area and the overall durability and biocompatibility of medical grade polymers.
The process of skin ageing relates to the ability of the body’s natural healing processes. The same cells which are activated during cell injury are the ones which lose function with ageing, and are responsible for loss of collagen, elastin and the overall loss of volume and elasticity of skin. Specifically, antiageing cosmeceuticals target and stimulate cells known as fibroblasts, which are best thought of as the “soldiers” of wound healing which produce collagen to seal up injured or damaged skin. Injury to the skin occurs over a gradual process in the case of ageing, due to the slowing of one’s biological clock and photodamage.
For the last year, my team and I worked with a material scientist to develop a transdermal delivery patch, the QRASER™ Transdermal absorption patch, launched in July 2019. This patch works via a matrix system of drug delivery. In this system, the drug reservoir is dispersed in an adhesive polymer matrix. The transdermal delivery patch uses a unique polymer technology that mimics the natural hydration and homeostasis of the skin barrier, to enhance cosmeceutical absorption. The focus is on improving absorption via optimisation of the skin healing microenvironment.
The result? Healthy collagen production thus reducing fine lines and wrinkles.
In conclusion, cosmeceuticals in the arena of dermatologist-led skincare research will be increasingly prominent in the next decade of “smart skincare”. This should be emphasised along with understanding of how these topicals work, the limitations of skincare absorption and potential technologies such as transdermal delivery patches which can optimise the anti-ageing benefits of cosmeceutical skincare.
Dr. Teo Wan Lin, founder and medical director of TWL Specialist Skin & Laser Centre, is one of Singapore’s prominent dermatologists specialising in medical and aesthetic dermatology. She is also the founder of Dr.TWL Dermaceuticals which specialised in cosmeceutical skincare. In July 2019, a material science arm Dr.TWL Biomaterials was launched focusing on novel biomaterials for skin and hair application. Click here for the links to our product and here to read more about Dr.TWL Dermaceuticals and here to read more about Dr.TWL Biomaterials.
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Last year, June 2018, our very own Dr. Teo Wan Lin was invited by Lianhe Zaobao, a Chinese newspaper, to do an interview about the rise of DNA analysis in skincare. But before anything else, what exactly is this DNA analysis that many people want to incorporate with their skincare regime? For the information and awareness of the majority, let’s discuss about the said kit.
Several home DNA kits and beauty DNA kits have been released to the public via online shops, TV shopping channels, and even in the market which claims to provide detailed family history and wellness reports based on your genetics. I mean we get it that pregnancy test kits work, but most of the time it is also not really reliable. (comparing it since the concepts are quite similar)
These DNA kits have gotten really popular and mainstream that many people want to try it because apparently, these kits are your source to having a personalised and customised skincare.
Apparently, it claims to be able to help in explaining how your skin and hair look, feel, and react to various conditions and tell at approximately what age you most likely would have wrinkles, fine lines, when your skin will stop producing collagen, and basically every beauty problem that may arise with aging.
We heard these points and claims from the companies that manufacture and distribute these products, but what about from a dermatologist? From a doctor’s side and point of view, does it really work? And is it reliable and effective?
Dr. Teo Wan Lin on home DNA kits and analysis in skincare
According to our very own Dr. Teo Wan Lin, MBBS, MRCS, FAMS, home DNA test kits are not recognised or marketed by medical specialists because of the lack of evidence backing up the accuracy of such tests. Personally for her as a dermatologist, she does not recommend using any of these methods for diagnosis of one’s skin condition. Firstly, such skin tests are not validated by dermatologists in larger clinical settings and the results can be misleading and potentially dangerous for lay persons to rely on to diagnose their skin problems.
Well, truthfully speaking, admit it or not, as you are reading this, simply ask yourself how can a simple DNA kit analyse and tell about your skin concerns to treat?! Because it is of common sense that to know what underlying skin concerns you are trying to target, we use our sense of sight. Dermatologists rely on visual inspection and clinical diagnostic tools to diagnose skin diseases and photoageing, which is based on clinical experience and training. Specific gene testing can be done in research settings but mostly for genetic diseases of the skin, and is performed by accredited laboratories either in Singapore or overseas. This does not apply for the kind of home DNA test kits that is presently being marketed.
We asked Dr. Teo if she has personally taken a DNA analysis to learn about her skin traits and if she finds it insightful. Her response –
“I personally do not find it useful to take a DNA analysis. I would imagine that these tests would be accurate to a certain extent but it would truly be determined by data that is gathered from your own demographics, for example your age, the type of racial background you are of or ethnicity – these are very common demographic features which do help determine how your skin ages. Beyond that, based on what we see in these home DNA test kits as they are now, would be just very generic comments, on the amount of moisture, the elasticity, pigmentation on your skin and that’s something we expect to be age appropriate. If you are 50 years old versus you being 30 or 20, I think there would be meaningful differences in your skin quality, just simply based on your age alone. I do not think knowing this generic information with DNA analysis is useful in terms of how you should treat your skin.
In any case, we do know that healthy skin all have the same requirements. For example, if you actually have a skin disease, such as skin sensitivity, which is actually a form of facial eczema that needs to be first diagnosed by an accredited specialist and treated with medications in order to improve skin health. In addition, one who is knowledgeable in the area of skincare and healthy skin should already get started at an early age on cosmeceuticals which are recommended by dermatologists. To maintain skin health, it is also much more useful to take preventive measures, such as with sun protection – a proper medical grade sunblock, sun avoidance measures, implement lifestyle changes such as a good diet with regular exercise, avoid smoking and get started on cosmeceuticals as recommended by a dermatologist. At the end of the day, the most useful piece of advice I would give is if you have a skin issue or a concern on the health of your skin, it is best to visit an accredited dermatologist instead of attempting to DIY with home DNA test kits.”
With that being said, I guess it pretty much sums up about how DNA analysis may not be useful in terms of customising your own skincare regime. Let’s just leave this entire DNA testing procedure for maternity and paternity tests.
Dr. Wanlin Teo, MBBS (S’pore), MRCS (Edin), FAMS (Dermatology)
Founder and Medical Director TWL Specialist Skin and Laser Centre
Co-founder Dr. TWL Dermaceuticals
What Are Beauty DNA Kits, And Why Are They Popping Up Everywhere?
I Got DNA Tested to Determine My Skin Care Regimen
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.
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 email@example.com. Alternatively, you may fill up our contact form here.
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 firstname.lastname@example.org. Alternatively, you may fill up our contact form here.