Tag Archive: acne

Top 5 Harmfup Chemicals in Your Makeup and Other Beauty Products

October 15, 2019

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!

 

 1. Phthalates

 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.

References:

http://www.safecosmetics.org/get-the-facts/chemicals-of-concern/phthalates/

 

2. Paraben

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.

References:

http://www.safecosmetics.org/get-the-facts/chemicals-of-concern/parabens/

 

3. Lead

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.

References:

http://www.safecosmetics.org/get-the-facts/regulations/us-laws/lead-in-lipstick/

 

4. Asbestos

 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.

References:

https://www.asbestos.com/products/makeup/

http://www.safecosmetics.org/get-the-facts/chemicals-of-concern/talc/

 

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.

References:

http://www.safecosmetics.org/get-the-facts/chemicals-of-concern/butylated-compounds/

 

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™

ACTIVE INGREDIENTS

[Pigment]

100% Mineral Pigments Without Bulking Agents

Bismuth Oxychloride(BMO)/Talc-free

FDA Eye/Lip Approved

[Cosmeceutical Base]

Oligopeptides [Lifting][Repair]

Niacinamide [Brightening]

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 

A Dermatologist’s Guide on Polyhydroxy Acid (PHA)

June 13, 2019

PHA Polyhydroxy Acid Needed

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

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

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

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

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

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

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

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

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

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

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

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

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

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

© 2019 TWL Specialist Skin and Laser Centre. All rights reserved.

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

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

A Dermatologist’s Guide to 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.

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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.

 

 

 

 

 

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.

—–

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.
—–
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.

 

 

Stressing Out Can Aggravate Your Acne – Here’s How

October 22, 2018

Any acne google search will reveal links between acne breakouts and a variety of factors including cosmetics, spicy food, sunlight, chocolate, and even sweat. However, one less tangible factor that is often included but rarely explained is stress.

Stress is truly a significant factor in acne. While it is unlikely to cause acne alone, it can trigger flares and aggravate the condition by causing excessive oil production and delaying the wound recovery time of acne.

Stress induces excessive oil production

During periods of high stress, the hypothalamic-pituitary-adrenal (HPA) axis is activated and produces hormones. The HPA axis is the interaction between our body’s central nervous system (brain) and the endocrine system (hormonal-related).

The HPA releases androgens and corticotropin-releasing hormones (CRHs) in response to stress. CRHs bind to the receptors on our oil glands and accelerate lipid synthesis. CRHs also activates the testosterone in our body, which further enhances lipid production.

When the body experiences stress, neuropeptides are also released. Neuropeptides are small proteins found in the brain that are engaged in the functions of signalling and communication. Neuropeptides can also influence hormones. In particular, a neuropeptide called Substance P can stimulate the growth in the number and size of oil glands, which contributes to acne.

Stress delays wound recovery

Individuals with high levels of perceived psychological stress have shown significantly delayed recovery rates of the skin barrier. In other words, stress slows down the body’s ability to heal wounds, which can be a factor in slowing the repair of acne injuries.

Stress also triggers the increased level of the hormones glucocorticoids and catecholamines, which can adversely influence the healing process.

Glucocorticoids reduce the number of cytokines at the site of injury. Cytokines are essential in the early stage of wound healing as they protect against infection and prepare the injured site for repair by sending signals for phagocytes. Phagocytes kill and digest unwanted microorganisms. The later stages of wound repair are thus delayed with lower level of cytokines, meaning more time is required for acne to heal.

Further, catecholamines regulate a range of immune functions such as cell proliferation, production of cytokines (essential in wound-healing process) and antibodies. Elevated catecholamine levels during times of stress can inhibit the production of cytokines or suppress the body’s natural immune response to attacks.

Stress promotes habits that aggravate acne

The stresses of daily life may encourage individuals to pick at or scratch their skin. Such habits cause further inflammation, scarring and hyperpigmentation.

Stressed individuals are also more likely to have unhealthy habits, such as poor sleep patterns, imbalanced nutrition, and excessive consumption of alcohol. Stressed-out individuals can, at times, overeat in the face of chronic stress or increase their intake of calorie-rich food to calm the nerves. Comfort foods such as ice cream or cake can help to tone down the body’s stress responses but trigger acne or inflammation.

Finally, stress can cause people to neglect good self-care, including maintaining a usual skincare routine.

How to lessen the impact stress has on your skin?

Physical exercise can alleviate stress and regulate the production of stress-related hormones. Patients suffering from acne may be tempted to steer from exercise due to the discomfort from sweat, but exercising can provide important benefits to your skin. Just shower immediately after exercising and use a gentle moisturizer to keep your skin hydrated.

Experiment with other stress-reduction techniques as well such as meditation, yoga or reading a good book. If a stressful event is around the corner, be sure to get sufficient sleep and consume proper meals to eliminate other potential triggers that can aggravate your acne.

In addition to managing your stress-levels, consider visiting a dermatologist. Acne is treatable with the help of an accredited dermatologist, so it is worthwhile to seek professional advice.

© 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 Enlarged Pores & How to Treat Them

August 24, 2018

Enlarged facial pores are a cosmetic concern that plague individuals with oily skin types. Even though this condition besets a majority of individuals, especially those who live in humid climates, treatment options for large pores are elusive or unreliable.

Large pores may not be health-threatening or a disease symptom, but they can be the reason why we refuse to get up close with a mirror. A skin pore usually refers to an enlarged opening of pilosebaceous follicles. The pilosebaceous unit has the hair follicle, the sebaceous (oil) gland and skin muscles.

The mechanism by which visible facial pores occur remains unclear, but three possible causes have emerged: loss of skin elasticity, hair follicle size and excessive sebum production. Other potential factors that can influence this skin condition include genetics, chronic photodamageacne and vitamin A deficiency.

Excessive sebum production

Oily skin results from excess production of sebum by the oil glands, which fills the follicles and leaks onto the skin surface. During the menstrual cycle, sebum production levels are higher. Pore size is also larger during the ovulation phase. A surge of three hormones during the ovulation phase triggers the oil glands – luteinizing hormone, follicle-stimulating hormone and progesterone.

Severe acne

Previous cases of inflamed acne can destroy hair structures and leave them susceptible to influence by androgenic stimulation. Androgen is a hormone that exerts a major effect on sebocyte (cells found in oil glands) proliferation and sebum secretion. This means acne inflammation may cause you to be more prone to androgen activity, bringing about change in follicle volume and size.

Loss of skin elasticity

A main feature of skin’s ageing process is the loss of elasticity. Our skin’s collagen and elastin framework that supports skin resilience become less efficient due to ageing and chronic photodamage. A protein, crucial for elastic fiber assembly, called microfibril-associated glycoprotein-1 is also produced less over time. Without it, tissues around follicles provide less structural support and there is a loss of thickness in the skin dermal layer. Such changes lead to skin fragility, sagging and enlarged pores.

Hair thickness

The volume of our pores is dependent on the size of the hair follicle. There are dermal papilla cells in our hair follicles that contain androgen receptors. Our pore size is affected by the androgen activity in hair follicles.

Treatment options

Topical therapies

  • Topical retinoids are often considered as first-line therapies to reverse collagen and elastin-associated changes caused by aging and photodamage. Retinoids are vitamin A derivatives and were previously used as anti-ageing therapies before the efficacy for improving the appearance of facial pores were discovered.

Commonly used retinoids are tretinoin, isotretinoin and tazarotene for skin rejuvenation, regulating sebum production, and the reduction of wrinkles and large facial pores. Isotretinoin is the most potent inhibitor of sebum production.

Patients are advised to consult their dermatologist before any use of retinoids as side effects – such as inflammation, burning, redness or dry skin – are common.

  • Niacinamideis another cosmetic ingredient that can reduce sebum production.

 

  • Chemical peelscan also help rejuvenate the skin and improve the appearance of large pores. At the epidermal or dermal level, the application of acids induces the temporary breakdown and regeneration of healthier cells. Glycolic acid, lactic acid and salicylic acid are commonly used for chemical peels.

Oral therapy

Common oral therapies targeted at enlarged pores are anti-androgens, such as oral contraceptives, spironolactone and cyproterone acetate. They modulate sebum levels by blocking androgen action.

Lasers and ultrasound devices

Advanced devices have been developed to deliver targeted thermal or ultrasound energy to the skin. Such therapies work by remodelling the collagen fibers near our pores for increased skin elasticity and decreased sebum production. Non-ablative lasers helps with facial pore minimalisation and improved appearance of photoaged skin.

Hair removal

Pore volume may decrease with hair removal, especially so if patients have thick and dark facial hair. Laser or intense pulsed light sources can create photothermal destruction of the hair follicles to minimise appearance of large pores.

 

© 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.

A Dermatologist Explains Eczema & Its Treatment

August 4, 2018

 

Eczema is one of the most common skin disorders in infants and children. Apart from dealing with the medical aspect of the disease, affected patients may experience significant psychosocial effects.

Also termed as atopic dermatitis, it is very common in children but may occur at any age.

How does atopic dermatitis arise?

Atopic dermatitis is caused by a complex interaction of genetic and environmental factors including:

  • Skin barrier dysfunction
  • Genetic predisposition
  • Immune dysfunction

The role of genetics in eczema

Most patients with eczema have a lower amount of filaggrin in the epidermal skin layer., due to mutations in the filaggrin gene. Filaggrin is a structural protein that plays a vital role in normal barrier structure and function. A lack of filaggrin contributes to the development of eczema in several ways.

Filaggrin breaks down into amino acids and protein derivative to form natural moisturizing factors (NMFs) in the outer skin layers. NMFs provide moisture retention, maintain the acidic pH and buffering capacity of the skin barrier and prevent an overgrowth of bacteria.

Inadequate filaggrin would mean a reduced ability to maintain hydration, which can cause xerosis (dry skin), pruritus (itching) and subsequently, eczema. A dysfunction in skin barrier may also allow entry of allergens, leading to an inflammatory response thus causing eczema.

Having an impaired barrier function also causes colonisation of a bacterium called Staphylococcus aureus. Scratching disrupts the skin barrier, thus also leads to the bacteria adhering to the outer skin layers.

The extent of bacterial colonization is associated with the severity of eczema.

How immune dysfunction contributes to eczema

Apart from genetic factors, defects in immune pathways are usually observed in patients with eczema. They tend to have high levels Th-2 cells, which contribute to a defective skin barrier. Th-2 cells play an important role in the immune system. A poor skin barrier may mean water is lost from the skin and also allows the penetration of irritants (soap, dirt, detergent) and allergens (pollens, microbes, dust-mites).

There is also an overproduction of cytokines in the body. Cytokines are cell signalling molecules that aid in cell to cell communication. It regulates the movement of cells towards sites of inflammation and infection.

The excessive release of cytokines initiates new responses that eventually leads to inflammation, causing the red, itchy and painful symptoms common in eczema.

Patients also have high levels of an antibody called immunoglobulin E (IgE), which puts them at disposition for hypersensitivity to environmental allergens. Hypersensitivity is when the immune system produces undesirable or detrimental reactions, such as attacking the body’s own cells or tissues instead of protecting them. With elevated IgE levels, it would mean exposure to a certain allergen can causes the immune system to attack the body’s own tissues and therefore skin inflammation that may be observed with eczema patients.

How to treat eczema?

When it comes to treatment, there are 3 main components that target a specific manifestation of the disease. As a chronic, relapsing condition that may flare up at variable intervals, a comprehensive home treatment plan is important for successful management.

Repair & Maintain Healthy Skin Barrier:

Lubrication of the skin is required to maintain skin hydration, commonly known as moisturisation. This helps to alleviate the discomfort that xerosis (dry skin) may bring about.

Patients with eczema should use moisturizers that are fragrance-free and least amount of preservatives, as these are potential irritants.

Reduce inflammation:

Topical corticosteroids are the most effective and common treatment. Corticosteroids are drugs that mimic cortisol, a hormone found in the body. They work by diminishing inflammation, itching and bacteria colonisation.

This medication can be classified according to its potency, ranging from class VII (low potency) to class I (super potent). Great care must be taken to balance the potency of drug needed for results so as to minimise potential side effects.

Side effects include:

  • Atrophy (decrease in size or wasting away of a body part/tissue)
  • Striae (stretch marks)
  • Acne
  • Telangiectasisa (small dilated blood vessels)
  • Secondary infections
  • Adrenal suppression (body produces lower levels of cortisol)

For moderate to severe eczema conditions, wet wrap therapy can be used with topical steroids and dermatologist-approved moisturisers. After the medication is applied to the affected area, it is wrapped with a few layers of wet gauze, followed by dry gauze. Such therapy reduces itching and inflammation by preventing scratching and improves penetration of corticosteroids.

Topical inhibitors of calcineurin – protein phosphatase associated with activation of the immune system, are newer forms of treatment, which are considered on areas unsuitable for topical steroids (e.g. eyelids) or if other treatment options do not yield results. For example, Pimecrolimus cream and Tacrolimus ointment are calcineurin inhibitors that have demonstrated good efficacy for eczema treatments and do not cause side effects that corticosteroids bring, but have other considerations of use that should be managed with an accredited dermatologist.

Itch control:

Antihistamines are commonly used to treat itching. Even without a significant rash, itching can be present. Oral antihistamines help to reduce the sensation of itching, ideally to decrease scratching and trauma to the skin.

Antibiotic or antifungal medicines are used to treat the infected rash, to reduce the amount of bacterium Staphylococcus aureus. Topical mupirocin is often prescribed to prevent further infection.

Taking care of the skin 

Avoid dry skin. Asian skin is more susceptible to being dry. Dry skin can cause itching and scratching. Tips to avoid dry skin:

  • Moisturize, especially after a bath as evaporation can cause excessive drying. A ceramide-based moisturizer that is suitable for sensitive skin and face could be Radiance Fluide™ Hydrating Emulsion which is also infused with skin rejuvenation properties. For intensive replenishment of ceramides (which are naturally found in healthy skin barrier but deficient in diseased skin),  a dermatologist-tested moisturiser such as the Multi-CERAM may also be considered.
  • Bathe with lukewarm water for 10-15 minutes.
  • Use neutral or weakly acidic pH soap. Consider a mild cleanser that soothes the skin like Le Lait™ Milk Cleanser.
  • Avoid high ambient temperatures.

Avoid irritants that can cause or aggravate a rash, such as perfumes, scratchy clothing or bedding and sweating.

© 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.