38 IRRAWADDY ROAD #07-28
MOUNT ELIZABETH NOVENA SPECIALIST CENTRE
CONTACT: +65 6355 0522

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.

—–

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.

Brightening dark spots

December 25, 2018

Struggling with dark spots? To treat them, you first have to know the kind of pigmentation you have.

Melasma

Melasma is characterized by irregular brown patches on the skin and can typically be found on the forehead, upper lip, nose and the chin. Melasma is the result of an overproduction of melanin (the pigment that gives colour to our skin, hair and eyes).

Excessive sun exposure is one of the greatest contributors to melasma as melanin-producing cells are easily stimulated by UVA and UVB rays. Pregnancy, hormone treatments and genetic predisposition are other causes.

Postinflammatory hyperpigmentation (PIH)

PIH is the result of your skin’s melanin-inducing response to inflammation or injury, and appears at the injured site as a dark brown macule or patch. Such markings usually fade within a few months with appropriate treatment. However, the brown spots may darken or spread if not addressed. Sun exposure may also worsen PIH.

 Skin conditions that can cause the above inflammation include acne vulgaris, atopic dermatitis (eczema) and psoriasis (red, flaky skin patches).

Freckles

Freckles, also known as ephelides, are harmless small pigmented spots that are frequently found on the face, arms, neck and chest. Freckles are brown due to a diffusion of melanin into skin cells.

In winter, the activity of melanin-producing cells slows down. When exposed to UV radiation in sunlight, melanin-producing cells pick-up. As a result, freckles fade slight in the winter and darken in summer. Often, freckles partially disappear with age.

Genetics contribute to the formation of freckles. They are frequently observed in fair-skinned individuals, especially those with red hair.

Solar lentigo

Solar lentigines are harmless patches of darkened skin that are generally larger than freckles and have well-defined edges. They are caused by an accumulation of sun damage that leads to an increase in the number of melanin-producing cells and subsequent accumulation of melanin.

Solar lentigines are also associated with increased age. While freckles generally disappear over time, untreated solar lentigines are likely to persist indefinitely.

Treatments

For all dark spots, start by avoiding the sun and applying a sufficient amount of sunscreen every two hours. Use a lightweight sunscreen like Dr. TWL’s SunProtector™, which is dermatologist-formulated for the humid climate.

For melasma, consider a combination of topical therapies (outlined below) and chemical peels. Lasers should be considered last.

For PIH, first treat and prevent the skin condition triggering the inflammation. Then use topical treatments followed by chemical peels and lastly, laser and light treatments.

For freckles, use topical or laser/light therapies.

For solar lentigines, use ablative therapy with cryotherapy. Subsequent treatment options include topical agents and laser therapy.

Bleaching agents

 Bleaching agents are often used to inhibit melanin synthesis. The most commonly prescribed ones are hydroquinone, azelaic acid and kojic acid.

Hydroquinone inhibits the production of melanin by binding to tyrosinase, the enzyme responsible for the first step in melanin production.

Azelaic acid acts on abnormal melanin-producing cells but leaves the healthy ones untouched, ensuring optimal melanin levels.

Kojic acid binds to copper, which is required by melanin-producing cells.

Retinoids

Topical retinoids are often used in combination with bleaching agents. Retinoids target pigmentation issues by inducing the death of melanin-producing cells, accelerating turnover of new skin cells and inhibiting the enzyme tyrosinase.

Chemical peels

Chemical peels refer to the process of applying acids to the skin to destroy the outer skin layers. They accelerate the process of exfoliation by sloughing off dead layers of older skin and promoting smoother layers of new skin.

Superficial and medium depth peels are effective in treating pigmentation concerns. These peels differ in the depth of skin resurfaced. Superficial peels target only the surface skin layer while medium peels target the next layer.

To successfully achieve significant depigmentation, a patient needs to undergo at least 3 to 4 repeated peels. Common acids employed are glycolic acid, salicylic acid and lactic acid.

Laser and light treatments

Lasers are notably successful with solar lentigines, but less so with melasma and PIH. Such treatments damage the skin to stimulate growth of new skin cells.

To treat solar lentigo and freckles, use IPL, Q-switched lasers and fractional lasers.

To treat melasma and PIH (and only after topical therapy and chemical peels), try fractional radiofrequency, Q-switched or picosecond lasers, high-fluence/high-density non-ablative lasers, pulsed dye lasers, IPL, microneedling, and spot liquid nitrogen treatment.

If you are considering laser or light treatment, be sure to first consult an accredited dermatologist to recommend suitable treatments for the skin condition you are experiencing.

Cosmeceuticals

Patients who are not ready to commit to laser treatments can consider cosmeceuticals. These are cosmetic products with bioactive ingredients that are scientifically proven to deliver results to the skin. Active ingredients that fight dark spots include vitamin C and niacinamide. As a powerful antioxidant, Vita C GOLD™ Serum can help fade dark spots on your face and neutralise some of the free radicals that damage your skin. Niacinamide, found in Radiance Fluide™ Hydrating Emulsion, helps to brighten skin by reducing the amount of melanin.

© 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.

Understanding Fillers

December 18, 2018

 

Dermal fillers are minimally invasive mainstay cosmetic treatments used to help return the appearance of volume and youth to ageing skin. Volume deficiency, scars, wrinkles, lip augmentation (plumping), facial sculpting and contouring are common facial concerns targeted by dermal fillers.

This guide will tell you everything you need to know about them: how they work, the choices of products on the market, and their possible side effects on your body and skin.

What are dermal fillers?

Before starting on dermal fillers, we need a brief understanding of how the face changes as we age. Over time, the thickness and elasticity of our skin decreases, and our faces loses fat. Soft tissues sag, facial muscles weaken, and the outermost layer of skin wrinkles.

Enter fillers. Dermal fillers help restore lost volume to your face and add lift.

Types of dermal fillers

The classifications of dermal fillers vary according to their properties. Fillers are categorized based on their biodegradability, how long it takes before the filling substance is absorbed by the body, and the duration of a treatment’s effect.

Early attempts to use fillers for facial rejuvenation relied on dermal fat or collagen fillers. However, the effectiveness of fat as a filling agent was risky as a number of variables were involved. These included the method and type of fat harvested, both of which could cause inconsistent absorption rates by the body. There could also be significant side effects including prolonged swelling, internal bruising and cause infections. Bovine (cattle) collagen, the first collage filler used, also had limited success due to its short duration of effect (3-4 months) and potential risk of allergic reaction.

Human-based collagen has since been developed but demand for collagen remains low compared to more effective filling agents.

Biodegradable fillers

These are fillers that provide temporary or semi-permanent effects as they gradually degrade and get absorbed by the body. Common biodegradable fillers are collagen, hyaluronic acid, calcium hydroxyapatite and poly-L-lactic acid.

Hyaluronic acid

Naturally present in our skin and connective tissues, hyaluronic acid is a key structural component that stabilizes cellular structures and binds collagen and elastic fibers. Hyaluronic acid remains as the most widely used dermal filler due to its ease of use, safety and minimal side effects.

When hyaluronic acid is injected into the skin, it combines with the natural hyaluronic acid found in our body. Due to its hygroscopic nature (ability to absorb water from surroundings), hyaluronic acid binds to water quickly, creating volume that lasts for 6 to 12 months before degrading into the body. It also induces new collagen formation, a desirable quality as our bodies gradually stop producing collagen in our late twenties.

Poly-L-lactic acid (PLLA)

A synthetic, biodegradable polymer of the alpha-hydroxyl-acid family (natural acids found in food), poly-L-lactic acid (PLLA) is another common filling agent. Its safe profile enables PLLA to be actively used in other medical applications such as in dissolvable stiches or soft tissue implants.

PLLA triggers mild inflammation to promote the formation of collagen and tissue fibers. The accumulation of collagen creates volume at the site of injection. Over time, PLLA breaks down into lactic acid and is metabolized to carbon dioxide or incorporated into glucose molecules.

Calcium hydroxylapatite (CaHA)

CaHA is a synthetic compound with a chemical structure that resembles a component found in our bones and teeth. Treatment with CaHA is safe and will not cause allergic reactions. When injected into skin tissues, our body gradually absorbs CaHA, inducing new collagen to be produced. Such an effect typically lasts about 15 months or longer.

CaHA breaks down into calcium and phosphate ions before finally being excreted by the body.

Nonbiodegradable fillers

Silicone

Injecting silicone into the face adds volume directly and immediately and also triggers collagen production that adds to the effect. Silicone is favoured for its stable chemical structure, ease of use, low cost, and long-lasting effects. As a non-biodegradable filler, silicone stays in your body once it is injected.

However, the use of silicon in cosmetic treatments is controversial due to its potential to cause long-term complications such as abnormal swelling, blindness or nerve damage. Issues can also arise from poor injection technique, the amount of silicone used and differences in silicone grades. For these reasons, it is strongly recommended you get your fillers done only by a trained dermatologist.

Warnings and alternatives

Administered professionally and with the proper technique and expertise, a dermal filler comes with minimal side effects. However, with many different rejuvenation treatments available, it’s important you consult a trusted dermatologist for a professional assessment before commencing treatment.

For those who prefer plumping effects without an injection, go for Dr TWL’s Hyaluronic Acid serum. As a skincare ingredient, hyaluronic acid draws moisture from its surroundings and keeps the skin well-hydrated; it is able to hold over 1,000 times its own weight in water. This gives a desirable plumping effect and improves fine lines and wrinkles without the needles.

© 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.

Fighting back and chest acne

December 10, 2018

When it comes to acne, most of us tend to think of facial acne – the most visible form of acne vulgaris. Back and chest acne, or truncal acne, is often overlooked even though more than half of people with facial acne can also have truncal acne. Further, acne on any part of the body can impact one’s self-esteem, body image or self-confidence.

What causes truncal acne?

Truncal acne develops in a similar way to facial acne. Major causes of acne include excess sebum secretion, abnormal desquamation (shedding) of skin cells, the presence of the bacteria Propionibacterium acnes (P.acnes), and inflammation. These elements can be found as much on the back and chest as on the face.

Genetics is also a crucial component. Your genetic disposition can influence the formation of comedones or the way your body responds to the P. acnes on your skin.

Acne forms when abnormal desquamation of epithelial cells causes sebum and keratin to accumulate and block hair follicles. This creates comedones – either open blackheads or closed whiteheads.

An increased production of sebum also creates an ideal environment for P.acnes to thrive, especially during puberty when oil glands are excited by hormones called androgens. The activated oil glands produce inflammatory factors, such as cytokines, that increase the skin’s inflammatory response.

Your back, shoulders and chest are also more prone to acne mechanica, meaning acne caused by the pressure, occlusion, friction or heat of clothing or physical activity. Sports equipment, such as shoulder pads and tight straps, can further exacerbate acne. Sweaty clothing traps sweat, oils and substances that support the growth of  P. acnes. As a result, be sure to change out of sweaty clothing after a workout or seek shade when the sun is at its strongest.

How can I treat truncal acne?

First-line therapy for truncal acne should always be a combination of a topical and antimicrobial treatment to reduce the risk of bacteria resistance. Treatment lengths should also be kept as short as possible – to a three to four month course – and cautiously managed by an accredited dermatologist.

Topical treatments

  • Benzoyl peroxide: Decreases inflammation and abnormal desquamation. It also contains anti-microbial properties that kill bacteria, but can bleach clothing and bedding. As such, it may be less desirable for treatment of truncal acne
  • Retinoids: Reduce comedonal formation, expel mature comedones and exert anti-inflammatory effects.
  • Antibiotics e.g. erythromycin, clindamycin: Reduce the proliferation of P.acnes but are not recommended to be used as the only form of treatment due to the risk that bacteria will grow resistant to the effects of medication.
  • Azelaic acid: A newer form of treatment that has three pharmacological effects: anti-inflammatory, antimicrobial, and stabilizing on abnormal desquamation. Above all, azelaic acid also fades post-acne marks by inhibiting the release of tyrosinanse, an enzyme that controls the production of melanin.

While skin on the body can withstand acne medication that may be too irritating on facial skin, they can be harder to apply on the back. Also, skin on the body is thicker than the face and may respond more slowly to treatment.

Oral antibiotics

Antibiotics work to limit the proliferation of P.acnes, which makes them useful in treating moderate to severe acne.

Hormonal therapies

Oral contraceptives work to reduce androgen levels, which in turn decreases sebum production. Oral contraceptives are effective against inflammatory acne in females. Patients who do not mind being on contraceptives can consider this treatment.

Oral isotretinoin

Isotretinoin is a form of oral retinoid that is effective against severe. It helps to decrease sebum production, bacterial proliferation, inflammation and abnormal rate of skin cells shedding.

However, isotretinoin can have severe side effects.  It can disturb the development of a fetus and cause birth defects if the mother is taking it at the time of conception or during pregnancy.  Other potential side effects include mood changes, liver damage, or fluctuations in lipid levels. As a result, this medication should be cautiously managed by a dermatologist.

Cleansing

Proper cleansing should also follow alongside other treatment therapies. Dr. TWL’s Miel Honey™ Cleanser is a dermatologist-formulated cleanser ideal for acne-prone skin and uses medical grade honey as an anti-bacterial and anti-inflammatory agent. A gentle cleanser that lathers up from botanical emulsifiers, the foam produced is generous and refreshing on the skin.

Cosmeceuticals

Truncal acne patients can also consider cosmeceuticals as part of their treatment. Cosmeceuticals are cosmetic products that contain active ingredients that deliver medical benefits to the skin. Vitamin C, in particular, works as an antioxidant that helps clear the skin of inflammation. Another botanical to consider is Arnica Montana flower extract, which is especially beneficial for acne-prone skin as it stabilises inflammation and reduces skin flaking.

© 2018 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.

 

 

 

Does Makeup Cause Acne?

November 27, 2018

 

Does makeup cause acne? The straightforward answer is no. However, certain ingredients in cosmetics can aggravate acne. We explain how and which products to avoid below.

How do cosmetics aggravate acne?

The two major causes of acne are genetics and a bacterium called Proprionibacterium acnes (P. acnes). Neither of these originate from makeup.

However, several substances in your makeup can be comedogenic or acnegenic, both of which can cause skin irritations that aggravate the acne condition.

Comedogenic products

Comedogenic substances cause comedones.

Comedones are small bumps that arise when pores get blocked by excessive sebum and dead skin debris. Closed comedones, or whiteheads, have a cover of skin cells that prevent oxidation. Open comedones, or blackheads, are exposed to the environment which causes the sebum to oxidate and turn black.

Comedogenic products trigger a disorder in the cells lining the pores.  The normal process of cells shedding is interrupted by an excess of keratin. This causes dead skin cells and sebum to stick together and cause blockage.

Acnegenic products

Acnegenic products cause inflammation of hair follicles which leads to the formation of papules or pustules. Papules are small reddish raised bumps on the skin. They are often painful and hard when you touch them. Pustules are swollen and resemble blisters with a yellowish pus.

How to choose the right cosmetic product?

When choosing your cosmetic products, look for non-acnegenic and non-comedogenic labels. The former is less common than the latter.

The absence of a label does not mean a product is acnegenic or comedogenic though so look next to the ingredients.

Potentially comedogenic substances include cocoa butter, corn oil, lanolin, oleic acid, olive oil, paraffin, peanut oil, safflower oil, sesame oil, sodium lauryl sulfate, stearic acid and stearyl alcohol. Potentially acnegenic substances include fragrances, harsh chemicals and alcohols.

However, this list should also not be blindly followed. In any cosmetic formulation, it is likely that the substance that may be comedogenic or acnegenic in raw form is present in much lesser concentrations. Certain individuals are also more prone to comedone formation than others so some users can use a moisturizer formulated with cocoa butter without difficulty while others cannot.

As a result, the only way to know for certain if a cosmetic product is going to irritate your skin is to try it and observe what happens. If a breakout is due to cosmetics, it typically occurs 48 hours after application. Such breakouts usually disappear quickly after application is discontinued.  In comparison, the development of acne takes about 2 to 4 weeks.

If breakouts continue even after discontinuing a product’s use, switch to dermatologist-recommended products or visit a dermatologist.

Are your makeup brushes clean?

If you find you’re having consistent reactions to cosmetics, the culprit may be your dirty makeup brushes. These applicators can provide the perfect environment for bacteria to thrive and cause an infection called gram-negative folliculitis. Gram-negative folliculitis causes pustules.

To avoid this, clean your makeup applicators weekly to remove bacteria, dead skin cells and sebum. Also, do not share your makeup brushes.

Keep your face clean and clear

To minimize breakouts and skin irritations, put greater care into removing makeup thoroughly. Use a gentle cleanser, preferably one that is formulated for acne-prone skin like Miel Honey™ CleanserA skincare regime for acne-prone skin should also include antioxidants, such as VITA C GOLD™ Serum Antioxidants help to reduce oxidation of sebum, thus reducing the inflammation that can lead to acne.

© 2018 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.

 

Are Wait Times Necessary in My Skincare Routine?

November 21, 2018

Are you wondering if it is necessary to incorporate a ‘wait time’ between each step of your skincare regime? Read on as we ask a dermatologist, Dr Teo Wan Lin, to find out.

1. Do you agree with the ‘waiting time’ skincare routine method? If so, why? If no, why?

From a dermatologist’s perspective, a skincare routine does not need ‘waiting time’. How well a product is absorbed by the skin depends on the active ingredient and the formulation of the product. It has to be cosmetically acceptable; asking someone to apply a heavy ointment in a humid climate like Singapore is unacceptable.

The ease of absorption is often perceived by users as how quickly the product disappears into the skin. However, this is not an accurate indicator of how well the product is functioning or if it is better absorbed than others.

There is a certain logic to layering your products. For ease of application, I recommend applying the lightest product, such as your serums, followed by lotion and lastly your cream or oilment.

In theory, so long as the product is applied onto the skin, the active ingredient will be absorbed by the skin. Yet, the perception of ease of absorption is subjective, simply because in a humid climate, users may not feel heavier creams are being absorbed even when it is already having an effect on your skin.

It is more important to consider the active ingredient of the product and how comfortable it goes to the skin rather than the waiting time.

2. There are clearly several steps to this ‘waiting time’ skincare routine method that is recommended, but is it even possible for our skin to absorb so much product? How much product are we able to absorb? Does it differ from person to person?  

In my line of cosmeceuticals, we also advocate layering. Certain active ingredients are better delivered in a serum rather than lotion/cream as it is more effective. As long as one is applying products that are accurately formulated with evidence-based science such as in a dermatologist tested line, the active ingredients will be delivered to the skin and the user can enjoy its therapeutic benefit.

Instead of relying on ‘waiting time’, users can focus on how to enhance absorption of their product. A tip I tell my patients often is to apply skincare right after a shower, when the skin is slightly damp as it helps to enhance the skin’s ability to absorb the product.

Also, rather than considering the amount of product our skin is able to absorb, the more relevant question is to consider the environmental humidity and the formulation of product (cream/serum/ointment). The absorption of product is subjective on the environmental humidity.

Someone who applies an ointment will receive the therapeutic benefit of the medication but will not feel the product is being absorbed due to the greasy layer that is left on the skin. Consider again someone who applies a serum that contains nothing but the simplest of moisturizers, say glycerin. The user will feel this serum is very well-absorbed by the skin simply because it evaporates into the air.

3. What are the key steps/products/and or habits one should have to maintain a good complexion?

I always advocate proper skin cleansing. Most women do wear makeup. Yet, many makeup removers contain harsh astringents that can disrupt the skin barrier. Leaving behind makeup residue is also not desirable as it can cause bacteria and grime to build up, especially in our humid climate. For this reason, I always advocate the double cleansing method, such as with the Milk Cleanser and Honey Cleanser, for a thorough cleanse.

The second thing I would advocate is the use of cosmeceutical serums. The two must-have serums are Hyaluronic Acid serum and a stabilised Vitamin C serum. Hyaluronic acid helps the skin to retain moisture whilst Vitamin C is an essential antioxidant that helps to fight free radical damage.

One should also never forget sun protection. Your sunscreen should have UVA/B filters, an SPF of 30 to 50, and broad-spectrum protection. Above all that, a good sunscreen should contain antioxidants too. Another key thing is the amount of sunscreen applied, as people often apply too little sunblock needed. Reapplication every 3 to 4 hours is also advocated, especially when one is outdoors.

4. Do you feel that there are any skincare hacks out there that actually work?

Skincare ‘hacks’ can be dangerous as the skin is our largest organ and should be respected. There are no shortcuts to maintaining the health of your skin. When you visit a dermatologist, we often share with you the use of cosmeceuticals and retinoids for anti-ageing. Cosmetic procedures such as lasers are also available to help reverse effects of skin ageing.

A tip that everyone can abide by is to have a good diet rich in antioxidants, adopt a healthy lifestyle that has a sufficient amount of physical activity and to get adequate sleep every night.

© 2018 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.

Is It Bad to Pick on Your Acne?

November 4, 2018

Anyone who has survived adolescence knows the feeling of seeing an ugly head of pus on the face and having the urge to press it out. Despite many commonly known warnings about the evils that befall those that pop pimples (the pimples will spread, grow infected and/or scar), few resist.

However, there are cases in which this behavior can become extreme. Such behavior becomes a condition called excoriation disorder (also known as dermatillomania, acne excoriée, neurotic excoriation, or psychogenic excoriation) when it is repetitive and intentionally self-harming.

Characteristics of excoriation disorder

Skin-picking is quite common and may occur at any age. It typically begins in adolescence as it coincides with the onset of puberty. Patients suffering from acne or eczema are more likely to pick their skin.

What distinguishes excoriation disorder from normal skin picking is that this behavior is self-injurious and involves repetitive scratching or picking at healthy skin, minor skin irregularities or general skin-picking automatically without realizing it. The behavior also results in tissue damage.

Sufferers of this disorder may skin-pick any area of the body and usually do so in multiple places. The most common areas are the face, followed by the hands, fingers, arms or legs. Acne, papules, scabs, scars, calluses and insect bites are also sometimes excoriation sites.

While potential skin-picking triggers may vary across individuals, common ones include emotions such as stress, anger, and anxiety. Skin-picking is often common during sedentary activities as well such as watching television and reading, boredom and feeling tired.

Excessive picking can result in tissue damage and lead to medical complications such as localized infections. Such behavior often begins with the onset of a dermatological condition like acne, and often worsens conditions by preventing wounds from healing properly.

Psychological aspect of the disorder

The behavior associated with skin picking shares similar symptoms with obsessive-compulsive disorder (OCD) and impulse control disorder. Features that resemble OCD include obsessions about an irregularity on the skin or preoccupation with having smooth skin and excoriating in response to the thoughts. Individuals who pick their skin may also experience mild to moderate levels of depression and/or anxiety.

Through the experience of picking, sufferers may feel tension prior to excoriating and relief or pleasure during or afterwards. However, any positive feelings are unfortunately transient and give way to the urge to pick again.

Treatment

Individuals who skin pick rarely seek dermatological or psychiatric treatment for their condition; they are either embarrassed or believe that the condition is untreatable.

Instead, some patients may avoid social activities as it may expose their scars or injuries. Others resort to cosmetics, clothing and/or bandages to camouflage their scars.

However, there are other ways out. For excoriation disorder, both pharmacological and nonpharmacological treatments can help.

Behavioural interventions

Cognitive-behavioral therapy and habit reversal therapy can be powerful interventions for excoriation disorder sufferers. Cognitive-behavioral therapy involves psychoeducation, cognitive restructuring and an emphasis on relapse prevention.

Habit reversal therapy involves self-monitoring and substituting skin-picking with an incompatible action. For examples, patients can be advised to clench their fists whenever they feel the urge to skin pick. Another example is to introduce a new behavioural sequence that ends with a harmless action: the hand approaches the face to pick the skin but then consciously deviates to a different location such as the ear.

Pharmacotherapy treatments

Research on the use of medications for excoriation disorder is currently limited. Individuals who suffer from skin picking should receive a thorough physical examination before going on any medication.

Having said that, many individuals can benefit from drug interventions. Pharmacological agents used to treat excoriation disorder include:

Selective serotonin reuptake inhibitors

It is widely believed that imbalanced or low serotonin levels contribute to depression, anxiety disorders and some personality disorders. Better regulating serotonin is believed to help improve the brain function and thereby reduce the urge to skin-pick. Common drugs that increase levels of serotonin to the brain include clomipramine, fluoxetine and sertraline.

Opioid antagonists

Like serotonin, people with low dopamine may exhibit more depression, anxiety, poor outlook, addiction and self-harming behavior. Opioid antagonists (naltrexone, nalmefene) increase the dopamine levels in our body and help diminish the urge to pick.

Glutamatergic agents

Examples include N-acetyl cysteine (NAC) and riluzole. Skin picking, along with other compulsive and habitual disorders, is said to arise from defective signalling of a substance called glutamate. With glutamatergic agents such as NAC, it helps to increase levels of glutamate in the brain, ensuring signalling functions normally again, reducing the urge to pick on skin.

When to visit a dermatologist

When picking on acne becomes serious, such as causing frequent infections or severe scarring, patients should seek help and visit a dermatologist. While skin picking is rather common, patients should take note if the intensity and frequency of such behaviour increases over time. Skin picking can inflict severe tissue damage, and may require a long period of time for scars to heal. A dermatologist will be able to provide professional treatment and advice before the condition worsens.

© 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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