Have you noticed that some parts of your skin are dry while other parts are oily? This is known as combination skin. Combination skin is characterized by an oily T-zone while the cheeks are either normal or dry. How to tell if you have combination skin? Wash your face with your normal cleanser, then wait an hour. If your T-zone is oily whereas your cheeks are either normal or dry, you have combination skin.
Combination skin is thought to be one of the most common skin types. When it comes to skincare routines, hydrating creams are too hydrating, oil-absorbing masks are too absorbing, balancing lotions never seem to do much balancing… It can be tricky to figure out how to care for your skin properly.
Dr. Teo Wan Lin is an accredited dermatologist and an expert on cosmeceutical skincare research and development. She is the author of “Skincare Bible – Dermatologist’s Tips for Cosmeceutical Skincare” which was published July 2019 by leading bookstores Barnes & Noble, Baker & Taylor and Apple Books and available in bookstores islandwide from January 2020. She heads up Dr.TWL Dermaceuticals, a specialist cosmeceutical skincare line with evidence-based active ingredients for anti-ageing and skin health. Its subsidiaries, the Pi- Cosmeceutical Custom Makeup Lab and the Conscious Mask Bar are part of the Conscious Concept Pharmacy launched in December featuring environmentally sustainable makeup and skincare materials. In this series “Dermatologist Talks” she shares her top tips on common skincare topics. In this article, she tells us the science behind combination skin – skin that is both dry and oily.
Skin that is both dry and oily boils down to an underlying pathology of the skin which is much more common in acne-prone individuals is known as seborrhea, which is overactivity of the oil gland. It is part of the causes of teenage and adult acne. Even when you have seborrhea, it is possible for you to have a deficiency in the ceramide content of your skin barrier leading to dry skin. The production of ceramide is genetically determined. You could have inherited both the genes for oily skin as well as dry skin. The commoner scenario we see would be someone with acne and oily skin who started using over the counter medication such as those that contain retinol or benzoyl peroxide and these will break down the skin barrier and it can result in the skin being dry, sensitive and acne-prone.
Individuals with combination skin often have breakouts over the greasy T-zone area. This can be exacerbated, in the case of some women, especially during the time of their monthly menstrual cycles. On the other hand, their cheek areas can be very dry and when they travel, especially when there is a change in climate, these areas can become dry, flaky and sensitive especially if they are using skincare that is slightly harsher on their skin.
The recommended skincare routine for combination skin should address both the oiliness of the T-zone, which can sometimes get quite uncomfortable especially in a humid climate like Singapore, as well as the potential dryness that may occur over the cheek areas. An important thing to note would be a gentle emulsifying cleanser is recommended for combination skin such as the Honey Cleanser. Honey itself is a natural emulsifier which means it produces foam without the need for strong chemical lathering agents such as the laureth sulfates. At the same time, it is a natural humectant which means that it traps moisture under the skin. As a result, it helps to balance out the production of sebum without over-stripping the skin of its natural oils.
Individuals with combination skin should focus on using hydrating serums such as Hyaluronic Acid Serum, Vitamin C Serum and Elixir-V Serum as these contain cosmeceutical active ingredients which function as treatment over their T-zone to regulate oil production.
Also, use hydrating emulsions rather than creams, the former is an oil in water mixture rather than a pure cream formula. This helps to moisturize the skin without the cream becoming too thick or greasy. Finally, the excess grease over the T-zone can be addressed with the use of blotting papers (such as those infused with active ingredients like cannabis sativa). These blotting papers are infused with cannabis sativa, an extract of the hemp plant which helps to moisturize the skin and regulate oil production, at the same time physically removing excess grease over the T-zone. One should follow with a hydrating mist such as the Mineral Booster which helps to regulate the skin barrier.
It is not necessary to use a specific sunscreen dedicated to the under eye area if the sunscreen you’re using is already a medical grade sunscreen that has been dermatologist-tested and ophthalmologist-tested. Nevertheless, sunscreen should not be applied too close to the eye area such as the lid margin because the very nature of effective sunscreens means that it would contain chemical and physical components that may be irritating to the eye.
If you are worried about sun exposure to skin around the eyes, you may consider using the SunProtector™, a lightweight soothing sunscreen that is dermatologist-tested and formulated to be suitable for use on the entire face including the under eye area.
The question remains: Why does the under eye area require extra protection?
The difference between the under eye area and the rest of the skin is that the under eye area has much more delicate and thinner skin. This explains why we tend to get dark eye circles from those areas, which is due to genetic factors such as the blood vessels being seen much more prominently in areas of thin skin. In addition, with certain practices such as applying eye makeup over many years as well as wearing contact lenses, the process of dragging and pulling the areas of skin around the eye can make it much more susceptible to wrinkling and laxity. Natural facial expressions, such as smiling can also cause natural creases at the periorbital area, known as crow’s feet, or when one is laughing in the area near the nose known as bunny lines.
It is much more necessary to eliminate bad practices in handling of the skin around the eye area, and to advocate good eye moisturising and antioxidants in the form of an eye cream and daily sun protection. One eye cream product you may opt for is the Elixir-VTM Eyes, which is a dermatologist-formulated eye cream that targets regeneration and repair of skin around the eye area with pharmaceutical-grade bioactive ingredients. Also, as a tip, use your ring finger instead of the index finger to apply any sort of eye cream or makeup, in order to avoid exerting repeated high pressure (from the index finger) over the delicate eye area, which drags down the skin and may cause or worsen eye bags and wrinkles. More importantly, to fight aging effects on the skin and in general, one should have an overall healthy lifestyle, with frequent exercise, adequate sleep, a diet filled with antioxidants, reduced alcohol intake and should stop smoking habits.
If someone were to look for additional protection for the under eye area, would an under eye sunscreen benefit in any way?
The premise overall is that there is no need for a specific under eye sunscreen, other than a sunscreen that is formulated for the face and tested by a dermatologist in a laboratory environment. If one is to experience irritation with such sunscreens, it may help to look for a pure physical sunblock made up of Zinc Oxide and Titanium Dioxide, rather than chemical sunscreen components, as these tend to be less irritating although conferring less broad spectrum protection compared with one that is a combination of physical and chemical components.
It is more important that one re-applies sunscreen regularly, rather than to apply an additional type of sunscreen. This is because layering different sunscreens one on top of the other does not increase the efficacy beyond the time period that the sunscreen is effective for. Conventional wisdom is to reapply sunscreen every 3 to 4 hours, especially when outdoors. However, there are many aspects to aging around the eye area and one of the reasons is actually not due to sun exposure, but rather due to the fact that skin around the eye area is much more delicate, hence more prone to daily tugging for example for people who wear eye make-up and contact lens wearers. For these individuals, it is much more advisable to use a good eye cream which can be applied both day and night, to moisturise the eye area and packed with antioxidants to reverse free-radical damage caused by sun exposure and environmental pollutants, and also to get adequate sleep at night. Having a pair of good sunglasses is also helpful to protect the cornea from UV damage.
Can exposure to the sun make the under eye area more susceptible to dark spots or lead to other undesirable effects?
This is not a very realistic scenario as when someone has excessive exposure to sunlight, it happens over the entire face and is never just localized to one area. Someone who has extensive sun damage in their life will find that they are more prone to get pigmentation as well as dark spots as well as the entire face including the eye area. It is far more common to notice such pigmentation at facial areas of more prominence such as the cheek bones rather than the under eye or say the under the chin area which are relatively protected from sun due to the facial bone structure. In addition, if you have been undergoing treatments such as phototherapy for other skin conditions, it is always advisable to wear protective eyewear.
Will sunglasses work as well as an under eye sunscreen would?
Sunglasses are a good way to block out UV radiation and it is a form of physical protection. It is advisable to wear sunglasses primarily within the context of preventing excessive harmful UV exposure to the eyes for example the cornea. At the same time, when one applies a good quality medical-grade sunscreen together with physical measures such as a broad-rimmed sun hat and a pair of sunglasses, the amount of UV exposure to the face as well as the under eye area can be reduced.
How can you take extra care of the under eye area?
As mentioned, the eye is a very delicate area. It is well-said that the eyes are the windows to one’s soul and are very often the first feature that one notices. For someone who actively looks after their skin and does treatments such as lasers and peels, ageing in the eye area starts to become more obvious because these lasers and peels do not target the eye area and are often the top giveaway signs of a person’s age. So it is indeed very important to take extra care of the eye area, where prevention is key as well as using a good eye cream. In terms of physical treatments that can be done for the eye area, you may consider treatments such as CO2 laser resurfacing, as well as plasma nitrogen treatment which is very safe and uses ionic plasma nitrogen to help to resurface and tighten skin around the eye area.
Meet with Dr Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.
To book an appointment with Dr Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may book an appointment online by clicking here.
Most males are not that into cosmeceuticals. That is skincare with medical or drug-like benefits to improve skin health. Cosmeceuticals have a more relevant function than coloured cosmetics. Men have traditionally been uninterested in skin appearance, and only think of skincare as necessary when they face a specific skin concern – acne, oily skin, wrinkles or other topical skin conditions. Yes, using targeted skincare products are likely to help with these isolated issues, but having a daily skincare regime in place can avoid them completely.
Most skincare products used by men are likely to be purchased by women, even though most are unaware that male cosmeceuticals are distinct from those that females use. Many of the male products are created to address male facial hair, such as preshave treatments, shaving products and post-shave skin care. Yet, men’s skin is structurally different from females and knowing these differences can be a good place to start your skincare journey.
Oil control
Sebum production is also greater in males, this is mostly due to testosterone secretions. This can mean longer-lasting acne for men. The oil glands on our skin are more receptive towards testosterone, so it is no coincidence that we see males having oily skin more often than females.
Collagen content
We see signs of our skin ageing such as wrinkles and sagging skin as our collagen content decreases as we age. After our thirties, both men and women start to lose one per cent of our collagen each year. But for women, this loss escalates greatly in the first five years after menopause, explaining for why women experience skin ageing faster than men do.
Thickness of skin
Male skin is typically 20 to 30 per cent thicker than that of females. The presence of testosterone accounts for this difference. A man’s skin will continue to thin gradually with age, while a woman’s skin will only thin significantly after menopause. With a higher collagen density which is the ratio of collagen to the thickness of the skin, it explains why men tend to age slower than women of the same age. However, this difference may not be readily noticed as men are less active in protecting their skin from sun damage. The lack of habit in using sunscreen would allow UV radiation to add years to the skin.
That being said, the importance of sunscreen should be emphasized. The skincare product that we should all have is really the sunscreen. We know we are nagging, but please put on your sunscreen.
The skincare regime of male usually fits into either one of these options. They could be either be using soap and water only, or products that are targeted to men, or cherry pick a product from their partner. There are several main concerns with these options. Cherry picking products would likely result in using something that is not suited for men skin. Using gender-focused products may also not be effective as manufacturers typically employ stereotypes to target shoppers. Lastly, common soap and water are never sufficient for facial cleansing, simply because it causes your face to go into an alkaline state that can result in dryness (your skin should ideally be slightly acidic, at about pH of 5.5). Washing with a bar soap can pull all the water out of the skin, leaving your skin dehydrated and a buildup of dead skin cells.
Most men hope to have clean, fresh, clear and smooth skin. And the preferred approach to achieving healthier skin is to have minimal steps in their skincare routine. An ideal skincare routine should begin with a proper cleanser. (No soap and water, please!) Use a pea-sized amount of Miel Honey™ Cleanser and work it into a lather over the entire face. This is to facilitate the removal of sebum and debris. Use cold water as heat can be irritating to the skin. The lather from the Honey Cleanser also doubles up as a “shaving lotion”, lubricating the shave with anti bacterial Honey which thoroughly cleanses the skin without over-drying the jaw line shave areas that could be especially sensitive and prone to acne breakouts!
Sun exposure can damage your DNA, and cause wrinkling and skin cancer. Add SunProtector™ to your routine for daily application. With an SPF value of 50, it is sufficient to safeguard the skin from free radicals and keep it sun damage-free. UV radiation is a common culprit that compromises our skin’s integrity and can lead to sensitive skin or dryness. Developed in a research laboratory, this sunscreen is also formulated in-house for Singapore’s humid climate, so rest assured and lather on.
Keep your face moisturised with Radiancé Fluide™ Hydrating Emulsion. As you age, your skin cells will start losing the ability to retain as much moisture as before, as collagen levels decline over time. Deliver essential nutrients such as amino acids and oligopeptides to your skin with this moisturiser to keep your skin bright and healthy.
Meet with Dr. Teo Wan Lin, consultant dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.
To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.
The word anti-aging alone turns many heads. Living in a beauty-centric society, we are pressurised to maintain our youth. Although it’s a natural process to age, once we hit the big 3-0, we are told to maintain our youth with an onslaught of anti-aging products that promotes and stimulates collagen production. You can’t really blame yourself for getting sucked into this black hole and there’s nothing really wrong about wanting to look young.
Are you looking for the fountain of youth? Look no further. Fillers are actually becoming a popular option for those wanting a youthful look. In comparison to anti-aging skincare, injectables such as fillers offer an almost instant youthful look and are fairly safe and natural looking when done right at the right place.
Although our skin is remarkable in protecting our bodies from the outside world and repairing itself every day, with age, lifestyle and environmental factors such as sun damage, smoking and poor diet, the condition of our skin deteriorates. This is inevitable. When it comes to giving your skin a refreshing and youthful appearance by giving it definition, firmness and a deep hydration, fillers are an effective method. Done by injecting a gel-like substance into lines and wrinkles, these injectables either fill or add volume to the sunken areas.
Hyaluronic acid is a common component that is used in fillers. Before you shrug at the term acids, know that hyaluronic acid is a component naturally found in the human body. Its sole function is to provide hydration and structure. Since skin hydration and structure depletes as we age, it is quickly removed from the body. By injecting these fillers, we are essentially introducing hydration and structure in the skin. Lasting up to six to twelve months, these temporary fillers plumps up the eyebrow and temporal region, defines and contours the cupid’s bow, cheeks and jawline, smoothens out the under-eye hollows, facial creases and can even minimise the appearance of scars and other depressed creases.
Restylane is one of the many available injectables out there. Using a patented Non-Animal Stabilised Hyaluronic Acid (NASHA) technology, Restylane injectables are generally firmer for a more pronounced lifting capacity and targeted product integration. This delivers a longer lasting skin hydration. Its Optimal Balance Technology (OBT), ensures that the injectable is more evenly diffused in the injected area, creating a softer and more natural look.
Next question in mind would be what to expect before, during and after a filer procedure. First things first, always consult an accredited dermatologist or surgeon when getting a filler or any cosmetic surgery. Avoid going to any aesthetic spas or worse neighbourhood malls to get your fillers done. Hygiene and sanitary is pertinent when it comes to any corrective treatments, to avoid infections and side effects. Make sure you understand the procedure and don’t be afraid to ask any questions. Always remember to inform the dermatologist or surgeon about your present medical condition and allergies. Avoid taking any medications such as panadol that may hasten bruising, or intoxicants such as alcohol, and stay hydrated. Always ask your dermatologist, or trained practitioner what type of filler you are getting injected with. Do some background research of it and make sure you are comfortable with being injected with that particular type of filler chosen for you. Instead of going for a cheaper alternative, choose the type of filler that is recommended by your dermatologist or surgeon, to avoid a botched procedure.
If you feel uncomfortable or uneasy during your filler procedure, voice out your concerns. As for post-procedure, expect minor bruisings. Hydration is key when it comes to healing. So drink up. Avoid using controlled substances such as cigarettes and alcohol immediately after the procedure. To avoid irritating the injected area, minimise makeup or external touch such as facials, pinching or scratching of the skin, high-intensity workouts and even sauna sessions. It is pertinent to abide by the post-procedure instructions given by your dermatologist or surgeon. Although minor bruisings can be expected, always report any signs of abnormality such as bumps, unevenness or unforeseen side effect to your dermatologist or surgeon immediately.
Meet with Dr. Teo Wan Lin, consultant dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.
To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.
Hair loss (alopecia) can be a major source of distress and is a common problem.
Is my hair loss normal?
We may experience changes to our hair such as hair loss or thinning as we age, so be sure to distinguish the difference between normal changes and alopecia. 100-150 hair strands lost in a day is normal and they usually show up when you brush your comb through or after washing your hair.
Bald patches on your scalp or more than 150 strands a day can be classified as abnormal hair loss.
The hair cycle
Normal hair grows through a hair cycle that has three stages. The growth phase, or the anagen phase, is the longest phase of the hair cycle, with 80 to 90% of the hair on our scalp in this phase. In the next stage called the catagen phase, the hair bulb detaches from the blood supply and is pushed from the scalp. In the last stage, the telogen phase, shedding occurs as the hair is released, leaving behind an empty follicle.
Each hair follicle is independent, going through the cycle at different stages as the other hairs. Hair problems occur when there is a disruption in the hair cycle.
How do I diagnose alopecia?
According to Dr Teo Wan Lin, accredited dermatologist at TWL Specialist Skin and Laser Centre, she says: “There are two major forms of hair loss – scarring or non-scarring alopecia. If follicular orifices are absent on the scalp, and the underlying scalp has a shiny white color, the hair loss is scarring. Follicular orifice is the opening of a hair follicle on the surface of the skin. If follicular orifices are present, it is a form of non-scarring alopecia.”
Non-scarring hair loss is the loss of hair without any presence of scarring in the scalp. Scarring alopecia leaves scar tissues on the scalp and may show signs of inflammation, redness or swelling.
Another common type of hair fall problem is androgenetic alopecia, or female/male pattern hair loss. Patients with androgenetic alopecia have high levels of androgen, a type of steroid hormone. Effects of androgen include miniaturisation of hair follicles by increasing the rate of cell division, shortening the hair cycle and increasing the duration of the telogen phase.
How can I treat my hair fall problem?
A multifaceted approach is recommended, as there are likely to be multiple factors that cause your hair condition.
For topical agents, either a minoxidil solution or ketoconazole shampoo can counter female/male pattern hair loss. Oral ketoconazole has anti-androgen effects, while topical ketoconazole can suppress androgen activity. Minoxidil shortens the telogen phase, and increases the duration of growth phase.
Low-level light treatments, in combination with active ingredients such as minoxidil and copper peptide can encourage hair growth by triggering inactive follicles or increasing blood flow to follicles.
Avoid combing your hair when it is wet, as wet hair is most subject to trauma. Hair should only be combed when mostly dried with a wide-toothed comb. Also, the less that is done to thinning hair, the better. Stay away from bleaching, rebonding or perming your hair to reduce damage done.
Dermatologists also specialize in treating scalp and hair problems, so head to your dermatologist if your hair condition deteriorates.
As a dermatologist, one of the first signs of ageing I observe shows in the eye area, what we call the peri-orbital or peri-ocular region. The commonest complaints I hear from my patients old or young are “Is there anything I can do for my eye bags, dark circles and eye wrinkles?” This is tricky because while so many spas, medi-spas, aesthetics providers and skincare companies confidently brag about their treatments erasing eye wrinkles and waving eyebags goodbye, I often have to burst bubbles in my clinic when I tell my concerned patients their hopes may be misplaced in a single miracle product which probably doesn’t exist.
In my practice, I use a multi-dimensional approach to work the aged eye area— a combination of skin resurfacing (plasma nitrogen over laser for sensitive areas such as the eye region), injectables like botulinum toxins, dysport and Botox. This, in conjunction with an eye cream that I formulate for my patients to use on a daily basis for before and after care, with specific active ingredients to brighten, tighten, moisturise and anti-age periorbital skin, besides being tested for safety and efficacy to complement medical aesthetics treatments around the eye area.
Men and women alike are affected by concerns of ageing and looking older, there’s nothing vain about wanting to look like a younger version of one’s self. In fact, it has been shown that your skin starts to age at around the age of 25. Main areas of wrinkles are at the forehead, nose, mouth and especially around the eyes. Eye wrinkles are often noticed first and more evident as the skin in this area is thinner, making it susceptible to wrinkling. Regardless of gender, you are prone to getting wrinkles so start taking care of your skin to maintain your youthful appearance!
What is Plasma Skin Regeneration?
It is a non-laser treatment that uses a device to convert nitrogen gas into plasma energy, to rejuvenate skin by improving facial lines, wrinkles and pigmentation caused by photoaging. This technology offers a wide variety of single pulse energy levels with different options of frequency that can most efficiently improve the precision of plasma delivery. This function allows accurate temperature irradiation to drastically improve topical drug delivery for a variety of dermatological indicators. Personalisation of settings to cater to different patients is available, as patients’ skin conditions differ in terms of downtime and receptivity to treatments. Through deep tissue re-modelling, the energy delivered by plasma skin regeneration is non-fractionated. This allows for even energy absorption, ensuring the consistency in treatments done to the skin. The high energy also supports significant skin tightening. With deep tissue re-modelling and accelerated healing, plasma skin regeneration usage is versatile and effective.
Plasma Delivery
The handpiece first releases the nitrogen plasma pulses.
This causes it to transfer thermal energy to the skin, allowing for controlled heating of the tissue.
The controlled duration of the pulse and temperature then allows the treatment to happen optimally.
This then leads to the possibility of treatments of many dermatological conditions due to the carefully controlled time frame.
Reliable Technology
Nitrogen plasma technology has been tested and backed by evidence. It has over 3 years of pre-clinical and clinical testing, 16 separate studies conducted, more than 450 clinical study treatments which proved to cause no scarring or pigmentation, and one year of clinical histology. This intense and detailed level of testing is uncommon in the industry, whilst clinically proven to perform skin resurfacing and regeneration using plasma energy.
Drug Delivery Effect
There are many treatable indicators like anti-aging effects, pore size reduction, wrinkle reduction, skin tightening, stretch marks reduction, acne scar reduction and more. However, one key effect is the drug delivery effect. When the skin is exposed to the nitrogen plasma, the permeability of the skin increases. This allows for better absorption of the drug, enhancing drug delivery and making the drug more effective during and after treatment.
Key Specialities
Advanced Technology
Plasma skin regeneration converts nitrogen gas into the fourth state of matter, plasma energy. It then emerges from the handpiece in controlled pulses and causes rapid heating of tissue. This allows for the transmission of thermal energy to the tissue.
Minimal Damage
The treated photodamaged skin layers undergo controlled thermal modification without additional harm. This allows for speedy healing and a natural layer of protection for the skin. At high temperature and energy, the skin epidermis breaks down and sheds, but only after a new healthier skin layer forms beneath. Plasma skin regeneration is non-invasive and will not cause any open wounds.
Treats the Whole Skin Structure
Plasma skin regeneration can treat the entire skin structure. It ensures that the entire skin surface is regenerated and produces conditions favourable for optimal results. It is associated with neocollagenesis and neoelastogenesis. Neocollagenesis is the process of making more collagen while elastogenesis refers to the mechanisms that drive elastic fiber formation for our skin.
Ideal for Eyelids Treatment
The skin around our eyes, our eyelids, are especially sensitive and thinner than the rest of our skin. Thus, not all treatments are suitable to prevent eye wrinkles and eye bags. However, plasma skin regeneration, with its precision safety and efficacy, is suitable for treatment of the eyelids to reduce wrinkles and achieve an anti-aging effect, whereas previous technologies might be less safe for sensitive thin eyelid areas or even deliver inconsistent and ineffective results. In addition, due to the significant skin tightening effect from skin regeneration, deepening of the eyelids (with a look of deeper-set double eyelids) is also achieved.
Long Lasting Effects
Plasma skin regeneration has been proven to show neocollagenesis and reduce elastosis (abnormal elastic tissue in the skin which is a result of excessive sun exposure). Elastosis can cause your skin to have wrinkles and even pigmentation. The nitrogen plasma technology has post treatment effects that can last for more than a year.
With its reliable and advanced technology, plasma skin regeneration can produce anti-aging and long-lasting effects with its non-invasive methods, helping you to achieve a bright and youthful appearance.
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.
People have been increasingly conscious about aging and the effects of aging on appearance. Skin aging will cause facial wrinkles and decreased collagen. Maintaining a youthful appearance seems to be the trend and many have resorted to skin treatments. There are many treatments like chemical peels, fractional laser and more but recently, ultrasound has been used in new treatments. HIFU and ultherapy are examples of ultrasound treatments. It has been introduced as non-invasive and effective in having anti-aging effects on the skin.
What is High-Intensity Focused Ultrasound (HIFU) Sygmalift?
High-Intensity Focused Ultrasound also known as HIFU Sygmalift, is used for rejuvenation, lifting and tightening of the facial skin. Research has been done to demonstrate the efficacy of HIFU Sygmalift. It has been found that HIFU Sygmalift is a safe and effective method for facial skin tightening. It can be used not only to improve skin texture, but also contour the upper arms, knees and thighs. Besides facial skin, it can be used for other parts of your body.
How does HIFU Sygmalift work?
HIFU mainly causes cellular damage and reduces volume of the designated area by coagulation and generating instant microthermal lesions. This is done by using high frequency ultrasound waves targeted at the tissue area without causing any damage to the skin epidermis and surrounding tissues. The targeted skin tissues get heated up which causes cells to be activated, generating new collagen to produce a skin lifting and anti-aging effect.
What is Ultherapy?
Ultherapy is a new Food Drug Administration (FDA) approved treatment that tightens and lift facial skin. The treatment is mainly for the eyebrow, chin and neck area but can be used anywhere where the skin is lacking tightening. Follow up treatments are recommended once a year to maintain the effects. The procedure has been used as it is non invasive and hence does not require anesthetic or sedation. However, it has been said to be painful and it would be better for some to use local anesthetic. It has been said to have no foreign substances or drastic changes but achieves to improve the health of the cells beneath your skin surface to result in a subtle, natural and healthy effect on the outside.
How does Ultherapy work?
Ultherapy is different from the common laser techniques that target the outer layer of the skin. It penetrates the surface and transmits energy to the deeper skin layers. This way, it causes damage to the collagen layers to stimulate more collagen production as the cells are tricked into repairing the collagen. It uses ultrasound technology which has been used in fat burning treatments. With collagen production, it produces skin tightening and anti aging effects.
How are HIFU Sygmalift and Ultherapy different?
HIFU Sygmalift and Ultherapy sound similar in terms of their methodology. Both use ultrasound treatment, a popular choice for non invasive and non-surgical face lifting and tightening treatments. Their main goal is to produce anti-aging effects, helping you to preserve your youthful look. However, there are still some small differences between the two which can impact your decision is choosing the most suitable treatment.
Extent of Pain
One of the main complaints about ultherapy treatment is that it is known to be painful and some people require local anesthetic. However, HIFU Sygmalift is mainly painless because it uses fractionated HIFU. Instead of traditional HIFU techniques which use one concentrated beam, HIFU Sygmalift breaks up the beam into fractions and penetrates the skin at precise extents. People who use HIFU Sygmalift may feel a small sense of tolerable pain but it is definitely less painful that Ultherapy.
Extent of Skin Penetration
HIFU Sygmalift targets the dermis and connective tissues to stimulate collagen production. Meanwhile, Ultherapy can penetrate deeper even into the muscle tissues, which is why some people feel pain. However, both result in skin tightening and lifting effects.
Post Treatment Maintenance
For Ultherapy, most people may see visible results even after the first or second session. To follow-up, they are recommended to go for treatments once a year to maximise the effects. On the other hand, HIFU Sygmalift is used once a month to maintain your skin. Patients of HIFU Sygmalift are recommended to use anti-aging products that contains peptides to complement the treatment, supporting a gentler type of treatment.
Both HIFU Sygmalift and Ultherapy use similar technology and methods with very subtle differences. However, these differences can make a big impact on your comfort with the treatments. Both methods are still safe, striving to produce anti-aging effects on your skin. With the similarities and differences explained, you can now make the best decision for yourself and choose the treatment that suits you the most.
Meet with Dr. Teo Wan Lin, 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.
The word anti-aging alone turns many heads. Living in a beauty-centric society, we are pressurised to maintain our youth. Although ageing is considered a natural process, once we hit the big 3-0, we are told to maintain our youth with an onslaught of anti-aging products purportedly promoting rejuvenation and stimulating collagen production.Is the aesthetic and beauty industry just a vicious black hole sucking in the vulnerable and playing on our insecurities? Hey, if you are reading this, there’s nothing wrong about wanting to look good, or a youthful, energised version of yourself.
A myriad of cosmetic procedures are being offered by every aesthetic set up, beauty parlor and medi-spa. If you are looking to look your best this festive season and have decided to get some pampering, do read this article beforehand to educate yourself on what’s out there.
First things first, it’s important to understand, that according to the latest Singapore Medical Council guidelines has clarified its stand on who should and should not perform aesthetic procedures such as lasers, botox, fillers or other cosmetic procedures. Read all about it here. What does this mean? Well,
It’s best to visit an accredited dermatologist or a plastic surgeon who will ensure the safety and efficacy of the treatment, depending on what you are looking for. Non dermatologists who practise “aesthetic medicine” require additional certification of competency conducted by the Dermatological Society of Singapore. Not sure about the qualifications of your doctor? Check your doctor’s accreditation here.
Once you’ve decided on who to see, make a note of the research you’ve done and how you actually feel about yourself. Our take on this? Filler injections are one of the fastest, most dramatic yet natural-looking ( if well done) aesthetic procedures that can instantly rejuvenate a tired face. One of the reasons fillers have sometimes gained a bad- reputation amongst the beauty fans and watchers is that the early nineties were filled with images of Hollywood stars suffering less than ideal( sometimes botched) jobs with unnatural lumps of flesh on their faces or oddly elongated chins. Fast-forward to today, we asked Dr. Teo Wan Lin, a Consultant Dermatologist what her thoughts are on those in their thirties considering facial fillers. “ The benefits to having fillers in the younger age group, say those in their thirties to early forties, as compared to those in their midforties and beyond, is that hyaluronic acid -based facial fillers can provide natural-looking volume to restore areas of the face where fat has been lost or where gravity has taken its toll. Not a lot of product is required to be injected in these women to achieve the desired outcome, but at the same time thit;s a very quick pick-me up to a tired face, when injected at the correct areas, in addition to giving a smooth, radiant look to one’s complexion almost instantly, because hyaluronic acid itself is a water molecule that naturally exists in one’s skin and is depleted as one ages. The pores also end up looking more refined and one also has a smooth youthful contour of the face”.
So it seems indeed, that facial fillers rightfully remain a popular option for those wanting to achieve a youthful look. “Relying on a rigid regimen of filler injections alone is bound to disappoint,” says Dr. Teo, “as the skin itself, like the face structure, is dynamic, different for each individual and requires expert assesment to tailor treatments, all this in order to achieve the desired outcome. For an individual who needs a quick freshening up before the festive period, I start with facial fillers and combine with High Intensity Focussed Ultrasound to target the SMAS layer( Superficial Musculoaponeurotic System), together with cosmeceutical skincare for maintenance of clear radiant and hydrated skin.”
While we don’t need any further reminders that with each passing day, genetics, lifestyle and environmental factors i.e. sun damage, smoking, poor diet, the condition of our skin deteriorates. Before you despair at mankind’s seemingly inevitable fate, here’s some good news. Milennial skincare has extended its technological advances to the field of aesthetic dermatology, and take it from the dermatologists–when it comes to giving your skin a refreshing and youthful appearance, fillers work by giving your ageing face definition, firmness and deep hydration, talk about multi-tasking. No amount of skincare can do that overnight. What to expect?A gel like substance containing a natural water molecule in your skin, known as hyaluronic acid, is injected into parts of your face that has lost volume or sagging, erasing lines and wrinkles at the same time. Talk about getting rid of the tired and pissed look off your face, erase the years away!
Hyaluronic acid is a common component that is used in fillers. With many people reacting to “acid”, probably the last time they have heard of that term was in their chemistry class, where the corrosive substance was definitely not something one would put on their face. Here’s where it’s a fallacy. Hyaluronic acid is a component naturally found in the human body and it is no mean chemical acid! It’s actually really good for your skin, with almost every beauty product these days touting it as its superstar ingredient. According to dermatologist Dr. Teo Wan Lin, “Most commercial brands of hyaluronic acid products contain a concentration ranging between 0.01- 0.1%, simply because of the cost of the molecule. Injecting hyaluronic acid is a totally different story, purity and concentration is important, as it serves to hold up the structure of the face.” Seems like when the creator made hyaluronic acid for the human skin, He also found its sole function to provide hydration and structure, both of which get depleted as we age. So here’s the science of filler injections: one is essentially introducing hydration and structure in the the skin. The next time you see a young girl, notice the fullness of her facial contours. That, is the key to a youthful face. Besides, many who are risk-adverse and into an au-naturale look (who isn’t?) will be pleased to know that hyaluronic acid facial fillers are considered temporary. Lasting up to six to twelve months, these fillers have the ability to plump up the eyebrow and temporal region, define and contours the cupid’s bow, cheeks and jawline, smoothen out the under-eye hollows, facial creases and can even minimise the appearance of scars and other depressed creases.
Restylane is used exclusively at our clinic, for the following reasons. Using a patented Non-Animal Stabilised Hyaluronic Acid (NASHA) technology, Restylane injectables are generally firmer for a pronounced lifting capacity and for targeted product integration. What this means is, it’s now possible to deliver skin hydration that’s longer lasting, giving the dewy, glowy skin look. Its Optimal Balance Technology (OBT), ensures that the injectable is more evenly diffused in the injected area, creating a softer and more natural look.
Finally, know what to expect before, during and after a filler procedure. First things first, always consult an accredited practtioner, such as a dermatologist or plastic surgeon prior to getting a filler. This should be taken seriously, and performed in a accredited medical clinic rather than in a spa or a beauty parlor. He or she will run through which areas are suitable for filler treatment, and what to expect. Hygiene and sterility is pertinent when it comes to any cosmetic treatments, to avoid infections and side effects, and a licensed practitioner will take steps to make sure that all risks of infection are minimised. Next up, during your consultation, make sure that you understand the procedure and don’t be afraid to ask questions. Always remember to inform the dermatologist or surgeon about your present medical condition and allergies. Avoid taking any medications such as panadol that may hasten bruising, or intoxicants such as alcohol, and stay hydrated. Here are more tips: always ask your dermatologist, or trained practitioner what type of filler you are getting injected with. Do some background research and make sure you are comfortable with being injected with that particular type of filler chosen for you. The important thing to know here is, Instead of going for the cheapest deal available, choose the type of filler that is recommended by your dermatologist or plastic surgeon, to minimise risks of any botched procedures. Remember, there is a cost to quality fillers, in addition to the skill of the practitioner injecting it. So if the price or the deal seems too good to be true, it probably is!
Some final words. If you feel uncomfortable or uneasy during your filler procedure, voice out your concerns. Your doctor will reassure you or make adjustments to ensure that the procedure carries on to your comfort level. Post-procedure, minor bruising is expected. Tips for recovery would be staying well hydrated with fluids, avoiding smoking and alcohol as these delay wound healing. Recovery is typically quick and uneventful and one could return to work or activities the same day except for maybe high intensity workouts which are best avoided for a couple of days.
Meet with Dr. Teo Wan Lin, consultant dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.
To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.
With the term “organic skincare” gaining popularity among the masses, I was recently asked, more than once by different people, what I felt were the benefits relating to organic skincare and why people should be using that. Perhaps my answers would surprise people but I feel that it is time the public gets a honest take on this topic by a dermatologist.
Let me first clarify my position, I am an accredited dermatologist and practice evidence-based medicine, whereby specialist recommendations are always made based on peer-reviewed journal publications or at least on an international consensus of the medical community. The terms “organic skincare”, “all-natural”, “chemical-free”, “pregnancy-safe” skincare are rampant in mass media these days, so I certainly don’t fault the lay person or even beauty writers who get the impression that this is the real thing.
In light of these, I seek to discuss “organic skincare” in this article. You will discover my choice of putting the term in parentheses and hopefully this will open your eyes to what the term really means, and does not, information only your dermatologist would tell you about . Without bias, I personally formulate a cosmeceutical skincare line myself as an adjunct to my cosmetic dermatology practice, with natural ingredients which are also evidence-based for anti-ageing and skin rejuvenation, but by the end of the article you will discover for yourself why I do not label any of the skincare as “organic”, and why “organic” is not exactly my key priority when it comes to skincare.
1.To a dermatologist, organic skincare does not exist
First and foremost, the term “organic skincare’’ itself is not regulated and from a dermatologist perspective, organic skincare does not exist as anything more than a marketing fad. Organic is a term relating to food or farming practices, and is applied correctly to vegetables or other crops which are grown without the use of chemical pesticides. If organic skincare manufacturers are keeping to the above definition at all, what this should mean is that were plant derived ingredients are used in skincare, these are grown in a chemical pesticide-free environment. What would be surprising to the lay person is that neither the FDA or HSA (in Singapore) makes any provision in their regulation of cosmetics for labelling “organic skincare”. As such, any skincare label touting this would be responsible for their own definitions of such and the consumer should be wary of such claims and what it implies.
2.There are no specific benefits to skin of using an organically-derived skincare brand
Contrary to popular belief, there are no specific dermatological advantages of using such a brand over any ordinary skincare. In fact, most of these eco-skincare brands often go untested and unquestioned as well. Often, these organic skincare brands boast plant or nature derived ingredients, without “preservatives” and parabens, also being touted as “home-made”. Despite the seemingly positive branding surrounding these skincare, the associated pitfalls are not different from any other cosmetic skincare — they all have the ability to cause irritation, or allergic reactions in individuals who are susceptible, such as those with sensitive skin i.e. atopic dermatitis.
3. An important factor to consider in anti aging skincare is the effectiveness measured by bioactivity of the active ingredients,as well as the scientific literature surrounding it
Plant-derived ingredients, depending on the source and type, may have anti-oxidant or moisturising properties, but simply including it in the skincare does not guarantee that it is effective. Bioactivity has to be measured by a trained chemist or scientist, which is when the extract is carefully distilled or harvested from the plant in such a way that the effectiveness is proven in the laboratory and can be measured.
4. The safety of organic skincare is not guaranteed, and could be even riskier than normal skincare with chemical preservatives
Brands touting “organic skincare”, especially when home-made, lack the stringent quality controls present in a laboratory setting, which is required for the formulation of dermatologist-grade cosmeceutical skincare. One real danger of certain types of “organic skincare”’ is that they are not regulated for safety, in terms of bacterial contamination. Preservatives such as parabens have gotten some bad press in recent years but the overall consensus in the dermatological community and by the FDA is that they are still regarded as safe and necessary to reduce bacterial growth in applied creams. The lack of “preservatives” is again a questionable label because this means that something else should be added to the product to increase the shelf-life of such a product which is meant for public sale. If not, this product should state the expiry of within 2 weeks to a month maximum of opening, because bacterial contamination will set in and this will cause problems when applied to skin.
Furthermore, the current Singapore Health Sciences Authority — HSA requirements for cosmetic skincare distributed via public sale, requires that the production facility acquires a basic certificate of Good Manufacturing Practices (GMP) before it is allowed approval. Home-made formulas that are sold online or by individual proprietors are hence on a “at your own risk basis”, and as a dermatologist, I do not recommend using any home-made or naturally derived products (from plants etc.) on a DIY basis because the irritation and allergy risk, i.e. phototoxic or photoallergic risks are high. Besides, the benefits of plant ingredients can only be harvested and extracted under a controlled laboratory setting with proper testing, as in the case with cosmeceutical skincare. Anything else, the public would be better off with a simple dermatologist-recommended pharmacy-brand moisturiser that is free from fragrances.
5. Problem-skin can’t be treated with ANY type of skincare but can be worsened with certain products
If you have problem skin, no amount of good skincare can treat medical skin conditions such as acne, eczema (dry sensitive skin) or rosacea (a condition that results in red flushed face with pimples). Such conditions require treatment with prescription medications and can be well controlled. These also do not disappear on their own so waiting to “outgrow” the condition, no matter what age you are at, is not a wise idea. Also, avoid consulting the internet, or beauty forums as suggestions there are not based on medical evidence and could even result in worsening of the condition or create a new problem, such as skin irritation or allergies from these DIY remedies.
I have encountered patients who developed phototoxic or photoallergic reactions from citrus (lemon/ orange juices) applied to their skin. A common misconception is that these DIY home remedies are ‘’natural and organic” but from a dermatologist perspective, this is not true. There are no skin benefits to applying lemon or orange juice such as vitamin C, which is only beneficial when one ingests it as a fruit or a juice. Topically applied vitamin C needs to be in a certain formulation, either ascorbic acid or Sodium Ascorbyl Phosphate — I incorporate a nano-formulated form of SAP in the cosmeceutical Vita C Gold which I prescribe in my practice for it to have brightening and anti-oxidant properties for skin.
Applying orange or lemon juice directly will simply result in skin irritation due to the acidic nature of these juices, worse still, some individuals may react to sunlight (UVA component) with the citrus component and develop a severe skin allergy that can result in scarring or pigmentation.
6. Facials, organic or not, makes no difference to your acne-prone skin
The above also applies to skincare services (e.g. facials) similarly labeled with the “organic” term, that organic skincare does not offer any true differentiation from any ordinary cosmetic skincare. Similar to any individually-applied skincare products, it is pertinent to know what is in the products applied during facials and skincare services. As your skin absorbs whatever you apply on them, it is important to always read through the labels and ingredient list, conduct prior research and then a patch test on the inner part of your arm. This helps to prevent any form of skin allergy and sensitivity you might get from trying such new products.
Besides, most aestheticians and facialists use instruments such as extractors and needles which are not medically sterilised (i.e. autoclaved, there is a difference between a new clean needle vs a sterilised instrument). This may lead to infections and scarring, besides having absolutely no benefit in the treatment of acne. Acne is primarily a inflammatory process, worsened by hormones, genetics and oil production. Treatment of acne by dermatologists involves addressing inflammation using oral or topical medications, as well controlling hormonal and oil production factors, via medications or certain cosmeceuticals. Comedonal extraction is only sometimes performed by dermatologists, as the preferred method of eliminating comedones is by the use of retinoids, which modulate the way skin turnovers, as well as with chemical peels whereby the top layer of skin dissolves with glycolic, lactic and salicylic acids, preventing the accumulation of keratin (read: dead skin cells) which can worsen comedonal acne.
7. Environmentally friendly? Perhaps. Skin-friendly, not necessarily
Most people think organic skincare are either eco-friendly, natural or vegan. Here’s the catch, they can and cannot be. Organic skincare products can have components which are organically farmed and also approved by the FDA (which simply means it does not contain toxic or banned ingredients), but having the HSA or FDA approval does not necessarily mean that these are effective or deliver significant benefits. Organically farmed produce can be friendlier on the environment in general, as less pesticide use means less harmful release of chemicals to the environment which accumulates as waste and potentially harms wildlife. However, these can also come at a greater cost, and by no means does that translate into any real benefits when incorporated into skincare which is not consumed but applied.
In fact, organic skincare often boasts essential oils which can cause both allergic( in susceptible individuals) and irritant contact dermatitis( due to the concentration of most essential oils, it is not medically advisable to apply any type of essential oil directly to skin as it can result in a chemical burning type of reaction).
For patients with otherwise healthy skin, whether they are in their twenties, thirties or beyond and who are interested in maintaining youthful skin in a cost-effective manner, I would suggest getting started on cosmeceuticals, and regular medical grade chemical peels supervised by a dermatologist, who would determine the concentration and type of acid suitable for your skin. A chemical peel treatment is designed to improve the appearance of the skin by gently stimulating the top layer of skin cells (epidermis) by applying a solution composed of fruit derived acids such as alpha-hydroxy acids, glycolic acids, lactic and salicylic acids. This stimulates the skin to regenerate, smoothening out wrinkles.
Rounding up the discussion here, I hope readers have gained some insight on the labelling of skincare as “organic” and what that doesn’t mean. It is not a defined or regulated term in dermatology and can lead to great misconceptions by the public, in addition to brands riding on a fad which delivers no real benefits skin-wise. As a dermatologist, I am all for public education for skin health. Skin health is not about “aesthetics”, the skin is an organ of the body just like the heart, lungs and the liver, and these tend to degenerate due to genetics, age as well as poor lifestyle habits. Healthy skin certainly looks good, but in the pursuit of beauty, one should always be wise, consult a dermatologist if you have a skin issue such as acne or skin sensitivity, rather than trying all sorts of products. While there is no miracle product that exists that can cure your skin woes, non-dermatologist-tested cosmetic skincare can worsen problem skin. If you have healthy skin and desire some radiance and want to preserve your youth, then go for cosmeceuticals, instead of ‘‘organic skincare” or any other type of skincare fad.
Meet with Dr. Teo Wan Lin, consultant dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.
To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.
By Dr. Teo Wan Lin, Consultant Dermatologist at TWL Specialist Skin & Laser Centre
The evolution of beauty treatments seems to have reached its pinnacle in this millennia, since there appears to be a whole new branch of medicine dedicated to “aesthetic medicine”. The regulatory medical council of Singapore worked with dermatologists and plastic surgeons last year to release a set of updated guidelines on the practice of aesthetic medicine in Singapore. It sought to stipulate what aesthetic medicine, was, and it was not, as well as regulations surrounding its practice in Singapore.
As a dermatologist, I am often asked by members of the public, my patients or even my colleagues in other specialties if I practice aesthetic medicine. The short answer is yes, but the long answer is that the question itself was wrong.
Since then, I realised how confusing it was for the layperson to navigate in this medical “specialty” and how I could not blame them for not understanding or asking the wrong question fundamentally. I seek to provide an insider perspective on how aesthetic practice should be regarded by the public.
Fundamentally, and amongst my peers, I do think that we, as as a community of medical professionals still believe (perhaps with some naivete on our part) that public opinion does hold us in an altruistic light. This is why I believe we owe it to the public to tell the truth. At the heart of it, I hope to show an honest perspective in the cut-throat aesthetic industry, advice that I have shared with friends, relatives and patients of mine and along the way enlighten readers on what to expect.
1. Doctors are trained to help people with diseases and aesthetic medicine is not regarded as a medical specialty
The public will be surprised to know that there is no internationally accepted definition of “aesthetic practice”. Aesthetic medicine is also not regarded as a specialty or subspecialty. For conditions relating to plastic surgery, the specialist recognised by the Ministry of Health would be an accredited plastic surgeon. In the same vein, accredited dermatologists specialise in treating both cosmetic and medical dermatology conditions, relating to skin, hair and nail health. The realm of aesthetic medicine encompasses the field of research and development that dermatologists and plastic surgeons specialise in. However, due to the increase in the number of non-specialists practising aesthetic medicine, medi-spas and the overlap with the lucrative beauty industry, it’s easy to get confused. Amongst these are also medical practitioners who have undergone rotations in dermatology or have pursued a family practice diploma in dermatology but are not accredited dermatologists.
The current Singapore guidelines issued refer to the UK Cosmetic Surgery Interspecialty Committee definitions for “cosmetic surgery” as the boundaries of “aesthetic practice”. Precisely, this would refer to procedures or surgeries that alter the appearance, colour, texture, structure, or position of bodily features, which otherwise would be considered to be within the socially acceptable range of ‘normal’ for that individual.
2. I am a dermatologist and practise aesthetic dermatology, but I am not an aesthetic doctor
The term “aesthetic doctor” is not regulated and is actually disallowed under the latest regulations. In the early years of my dermatological training, I spent a good amount of time in the medical dermatology department of a local tertiary hospital, mentored by an inspiring professor of dermatology, whose golden words I remember distinctly till today. In response to my enthusiasm to enter the dermatology specialty training programme, he reminded me, that “Wan Lin, you are training to be a dermatologist, and not a beautician. Dermatologists are not beauticians.”
To begin with, I entered dermatology because I was really fascinated by how the skin manifested all sorts of underlying internal conditions of the body in such a unique way. When my dermatology professors were able to diagnose complex diseases of the kidney, liver and even organ cancers, just by analyzing the skin, seemingly at a single glance, I was floored and was determined to become like them.
This is interesting now, that the word “aesthetics” is linked to the medical profession, and to be exact, dermatologists and plastic surgeons are considered the key opinion leaders in this field, which is increasingly practised by non-specialists such as general practitioners. This leads me to reflect upon what my mentor said to me long ago, that “dermatologists are not beauticians”, which is probably why I react with a certain degree of chagrin whenever someone suggests that I am an aesthetics doctor.
3. What is beauty ?
As a junior doctor several years ago, I rotated through the department of plastic surgery before I entered into my dermatology training. A particularly memorable doctor I met there was a respected plastic surgeon that did exclusively reconstructive surgery, meaning he would not be involved in any surgeries for cosmetic enhancement, due to his personal beliefs. In my time there, I learnt from this surgeon the most about reconstruction, which meant restoring anatomy in patients who have suffered from trauma or tissue loss from cancers/infections. Of all the cosmetic/aesthetic surgeries I participated in throughout my rotation, the ones that left the deepest impression on me were all reconstruction cases, when I saw how true beauty was when one could restore to its original form and function, rather than just changing one’s appearance so you could recreate the same K-POP idol pin-up look. The latter, by the way, is always changing. That’s just my personal take. It led me to reflect on the true calling of a doctor, even in the field of plastic surgery.
My private practice encompasses both medical and cosmetic dermatology cases. I own a variety of laser/aesthetic machines equipped with advanced technology and work with injectables such as fillers and botox. For concerns relating to pigmentation, irregular skin texture, scars, these to me are not mere “aesthetic” concerns because a dermatologist can diagnose each of these as specific conditions due to an underlying problem affecting the skin. Patients are also suffering from poor self-esteem and a lot become withdrawn, depressed and anxious thinking that nothing can be done about their skin. All of these concerns can also be definitively treated.
For patients who come to me for ageing concerns such as face sagging, face-lifting…I always ask them first for a picture of themselves at a time when they felt they looked their best. The last thing I feel any doctor should do is to make a patient feel they are not good enough. As a society, we are already made to feel we aren’t. By the time a patient decides to go to a dermatologist for help, my position is really to offer hope, support and treatment.
I am a strong believer in natural beauty, the definition of which is what is unique and pleasing to the eye, and not what everyone thinks is beautiful( at the moment). My goal remains to restore one’s youth, at the same time maintaining the uniqueness and individuality of one’s facial features. Afterall, your skin, being the largest organ of your body, degenerates with time just like your liver, kidney, heart, bones and joint. With laser technology, light is harnessed to trigger off new collagen formation, re-setting the genetically-programmed cell ageing process. With high-intensity focussed ultrasound (HIFU), this technology goes deep to the SMAS (Superficial Musculo-Aponeurotic System) layers where patients can now have a mini face-lift without going under the knife.
Every patient that comes to me for an aesthetic procedure gets a thorough run-through of how the different layers of skin tissue which make up the face movements interact as one ages. Consequently, each patient’s individual ageing process and treatments will differ. Aesthetic procedures like botox, fillers and lasers are not treatments that can be ordered off the menu like your lunch bento, especially when each comes with a set of its own risks along with its benefits. An accredited dermatologist or a plastic surgeon will analyse your facial anatomy, break down the cause of your ageing face, and correct those elements. Any other method of shopping for aesthetic treatments will at very best give a mediocre result, and at worst it can be outright dangerous.
4. Have problem skin? You don’t have an aesthetic issue, you have a medical condition of your skin that should be diagnosed and treated
Any perceived flaw on one’s skin can be attributed to a dermatological condition. Dark mark on your face after having a pimple? It’s post-infIammatory hyperpigmentation. Uneven skin tone? Take care you don’t actually have a skin pigmentation condition such as melasma. Enlarged pores and irregular skin texture? You could have suffered from acne in your teens and still have seborrhea, which is excessive production of oil from one’s sebaceous glands. Untreated acne over a long time leads to blackheads and open “pores”, as well as acne scars that can be indented, “ice-pick” or “box-car” type. To a dermatologist, every single of these conditions can be broken down to the diagnosis, the cause and medical treatment, which may also include lights and lasers.
All dermatologists advocate gentle skin cleansing, regardless of your skin being oily or dry. It is a myth that oily skin needs to be stripped of its oil in order to be healthy. Au contraire, sodium-laureth sulfate laden foaming cleansers and astringents( read: often alcohol or salicylic-acid-based toners) dehydrate skin, cause eczema and sensitivity in the long term.
However, even though good dermatologist-formulated and tested cosmeceutical skincare delivers the nutrients for healthy skin, can improve acne and mild eczema, along with brightening and tightening skin for anti-ageing concerns, it does not actually treat medical conditions. With my brother, a pharmaceutical engineer, I formulate a brand of cosmeceutical skincare Dr. TWL Dermaceuticals which is an adjunct to the medical treatments I offer in my clinic. Even though I am a strong believer in the effectiveness and safety profile of cosmeceutical skincare, I always emphasise to my patients that no amount of good skincare can actually treat their skin problem (if they have one) since their conditions require medicated treatment. Skin conditions have to be diagnosed accurately before correct medical or laser treatments is administered. The use of cosmeceuticals helps to anti-age, lighten scars and complexion by delivering evidence-based pharmaceutical anti-oxidant ingredients to skin and also prolong/enhance the results of aesthetic treatments.
5. Everyone wants to look young and beautiful, but there’s nothing wrong with the existing you
No one really “needs” aesthetic treatments. Feeling overwhelmed by all the advertisements for fillers, botox, skinboosters, ultherapy and lasers? You probably are. It’s not wise to call up any medical aesthetics provider, check for the cheapest rate and order a botox or filler injection like you would deliveroo. These are all medical procedures which are regulated and comes with its own set of risks in the wrong hands. Do research, check your doctor’s accreditation. If you are concerned with ageing, seek the advice of an accredited dermatologist early from your mid-twenties onwards for prevention. If you are in your thirties, forties or beyond, fret not, your dermatologist would discuss your expectations and treatments and he or she can start you on a regimen including lasers and injectables like botox and fillers. Or refer you to a plastic surgeon if required. If you have a true skin condition such as acne, rosacea or eczema that’s troubling you, your dermatologist will first treat it. Very often, my patients have no more complaints about the look of their skin once its treated and realise that it was not anything “aesthetic” -related in the first place. Thankfully, before they spent a bomb on beautician facials, medi-spas or cosmetic skincare.
Meet with Dr. Teo Wan Lin, consultant dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.
To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.
