Tag Archive: dermatologist singapore

Best Dermatologist Tips on How to Treat Your Neck Lines

March 12, 2020

 

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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 shares about the importance of taking care of your neck area.

 

Do neck creams differ from other anti-ageing products out there (for example, as compared to moisturiser)?

In terms of the composition of neck creams vs a very good moisturizer, for example, they do not differ very much. A lot of this, sadly, is due to marketing. But in terms of what is beneficial for anti-aging, the neck area is prone to lines and sagging with age. These can be concerns for aging women as well. Active ingredients that will help to target this should contain those that treat surface wrinkling such as antioxidants. Some brands use superficial chemical peel acids such as alpha-hydroxy and beta-hydroxy acids. That, together with retinol, does help with surface wrinkling, and these are all over-the-counter ingredients. However, in my experience, it tends to cause a bit of skin sensitivity. The formulations I look for would thus be those that contain more moisturizing ingredients such as ceramide. Our MultiCERAM™ Moisturiser is an ultra intensive skin moisturiser for total skin barrier repair with pharmaceutical grade ingredients featuring phytoceramides. For the wrinkle component, I use in my personal formulation, in our Radiancé Fluide™ Hydrating Emulsion which is also meant for use over the neck area, oligopeptides which have been discussed in dermatology literature as a good substitute for retinol or retinoids, which can be irritating over the long term. Essentially, what peptides do is that they mimic the cells’ DNA so that it stimulates collagen production and it is without the adverse effects. 

 

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Do you think there is a need to use neck cream in the first place?

I think it is absolutely essential because a lot of skincare regimens neglect the neck area. It is one of the first areas to show signs of aging with the lines and wrinkles. I have seen some patients who are older, who just focus on their face and neglect the neck, even with some protection, there is a very dramatic difference between their facial areas and neck area. It is important to bear in mind that our skin should be viewed in totality so it does not mean that you focus all anti-aging on the face. Your hands and neck area will also show all these signs of biological aging. If you are constantly just applying the cosmeceuticals on your face, you are neglecting other areas and a visible difference can be seen. 

 

What is the right age to start using neck cream?

Most dermatologists and plastic surgeons would agree that the aging process actively starts from age 25 onwards. You may wonder why a child or teenager exposed to the same stresses such as UV, pollution and mental stress, and aging does not take place until a certain age. The reason is because our body is empowered with these antioxidants abilities to fight free radicals that contribute to ageing of all our organs. After the age of 25, the research seems to indicate that all of these start to decline and that is why we need to amend the body’s response to the aging response by supplementing it with topical antioxidants. I think it is good practice for all men and women to start a proper cosmeceutical regimen for anti-aging, and including the neck area. You can use the same moisturizer as long as it is formulated correctly for the face and the neck area. If for example, somebody has already much more wrinkles on the neck than the face for whatever reason, I would add on something which is rather new, and I believe it is the only one in the Singapore market right now, would be a polymer patch. I have been using these polymer patches in my clinic for the last 6 months. It is known as a Qraser patch and it recreates the optimal environment for your skin to start stimulating more collagen formation from the inside. How this works is that it is a bio-mimetic material. It convinces your skin that it is super healthy by forming a micro-environment on the surface and it starts to generate more of its own collagen. We have one special cut out for the neck area.

 

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Is your neck more susceptible to signs of ageing as compared to your face, body, etc?

The neck area is not more susceptible but it tends to be an area that is very visible because of our clothing. For people who are always out in the sun, and are conscious of only using sunblock on their faces and limbs, and forget about their neck area, they will find that indeed, there is accelerated aging in that area. There are some individuals with neck eczema, which is a common sight for skin irritation, where their neck area may appear to age a bit faster than other parts of the body. It is what we called a flexural area, where there is skin to skin contact, like in obese people for example who are very prone to getting these neck folds and can develop fungal infections and eczema there as well.

Are there any specific neck creams in the market you’d recommend?

In terms of specific neck creams, I would say that a good moisturizer should have a few components to it. The first would be repairing the skin barrier itself. If your skin barrier is defective, it does not matter what anti-aging ingredients you have in there because your skin is just going to be dry. It is not going to look plump and elastic. Ceramide is the current state of technology for skin barrier restoration and it can be derived from two sources: Phytoceramide from plant seed oils and bovine ceramide (synthetic ceramide). The moisturizer that I personally prescribe in our clinic is manufactured by our pharmacy as a MultiCERAM™ Moisturiser and I always recommend that for the neck area. For anti-aging, the Radiancé Fluide™ Hydrating Emulsion which is fortified with oligopeptides and a plant extract LARECEA from Brassica oleracea which is a family of kale, broccoli and cauliflower, that is very effective for anti-aging. It is good to use retinol-free and AHA and BHA-free anti-aging formulation simply because the neck area is much more sensitive and you are perhaps more prone to getting eczema. 

 

What are the best ways to prevent your skin from ageing pre-maturely?

The take-home point is that for the neck area, if you are in doubt, just use a dermatologist-recommended moisturizer. Some anti-aging formulation that you use on the face contains retinol and when applied on the neck, you may develop sensitivity. Another important area of research now is using materials to increase the absorption of topicals. I personally would add that to my regimen. I think we are probably the only brand that is focusing on that right now. We have a polysaccharide material from plant root fibers which forms micro-reservoirs that release cosmeceuticals over a period of time and this is proven to increase the absorption of skincare. 

 

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The other thing would be the polymer patch. One of the best ways of preventing your skin from aging prematurely would be to have a good cosmeceutical regimen that is never like a one-step thing. In order for an active ingredient to be stable, it has to be sometimes formulated in a certain way and you can just combine everything into one and hope for the best. We also need to cleanse our skin. For the neck area, I would recommend cleansing with the same cleanser you use for your face and hopefully, it is a gentle one. 

 

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The second thing would be the application of serums such as the Vita C Gold Serum or Hyaluronic Acid Serum because serums are able to carry a high concentration of certain active ingredients. They are also readily-absorbed by the skin. 

 

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The third thing would be the application of a ceramide containing moisturizer that is also fortified with peptides and antioxidants. Finally, sun protection

 

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Meet with Dr Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.
To book an appointment with Dr Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.

How a Singapore Dermatologist treats Blackheads

February 24, 2020

 

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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 shares about the importance of taking care of your neck area.

 

Treatment of Blackheads

  1. How do I get rid of blackheads?

First and foremost, it is important to know what blackheads are and how they arise. Blackheads, the colloquial term for open comedones, are a type of acne caused by an overproduction of oil, and tend to cluster around areas like the nose. The buildup of keratin and oil around the follicle is oxidised and turns blackish because the oil itself is oxidised by air.

Open comedones are best treated with:

  • A mixture of chemical peels, containing salicylic acid, lactic and glycolic acids to control the oil production.
  • Carbon laser peels to help shrink oil glands and reduce production of oil.
  • Prescription creams, containing tretinoin, that accelerate skin regeneration.
  • Oral medication will be necessary for acne, and a medication known as isotretinoin, may be prescribed to help to shrink your oil glands, which has to be taken under close medical supervision.

I do not recommend manual extractions as they can cause more inflammation, infections, and scarring. I personally treat both open and closed (whiteheads) comedones using a specialised machine with a vacuum handpiece that gently extracts blackheads and whiteheads without pain or scarring, at the same time infusing a customised blend of fruit-based acids that exfoliate the skin. Last year, we launched the Dr.TWL SilkPeel Home Medi-Facial Kit with our biomaterials team.

 

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The device basically combines the microdermabrasion benefits that we use in our clinic with a very gentle chemical peel effect to increase the absorption of the cosmeceuticals. This allows for the physical removal of the debris from both open and closed comedones (ie. Blackheads and whiteheads), reducing the appearance of blackheads and preventing subsequent formation.

  1. How do I reduce the formation of blackheads?

A good cleanser is important. For cleansers, look for the labels ‘’dermatologist-tested and formulated’’ for maximum clinical efficacy. I personally use a cleanser based on medical-grade honey which I have partnered with a laboratory to formulate, it effectively cleanses away dirt, bacteria and grime, as honey is a naturally derived emulsifier, unlike chemical lathering agents, and also possesses antibacterial properties, without stripping away the skin’s natural oils. Overall, a good cleanser should leave the skin feeling clean (not squeaky clean though as this usually means overcleansing) and also still soft and moisturised. It’s a misconception to go for really ‘strong’ harsh cleansers because it generally strips the skin of all moisture with strong lathering agents like SLS (Sodium Laureth Sulfate) leaving the skin red and flaky while the acne problem doesn’t go away.

 

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  1. Do over-the-counter treatments work?

Nothing over the counter actually works well.

Pore strips help to physically remove the bits of keratin and oxidised oil but it tends to accumulate again and the problem recurs.

Products which contain salicylic acid usually have too low concentrations to be actually effective and higher concentrations can cause irritation.

Beware of traditional facial blotters to remove oil because it can cause the skin to paradoxically feel ‘dehydrated’ and the oil glands to produce even more oil to compensate. For patients with greasy skin in the day , it may help to just wash the grease off with a good cleanser rather than keep blotting. Either that, or use a fragrance/alcohol-free baby wipe to wipe off the grease before touching up makeup.

  1. How often should I go for treatments?

It depends on your skin condition. We recommend patients to firstly get their skin condition properly diagnosed by an accredited dermatologist, who would then subsequently recommend a regimen most suitable for them.

The Dangers of Dealing with Blackheads yourself

  1. Can you extract them at home?

Never pick your pimples or squeeze your blackheads (or whiteheads) as the bacteria on your fingers will cause infection, subsequently causing inflammation which may result in the formation of cystic acne.

Cystic acne is a severe form of acne which warrants specialist dermatologist care as it can leave terrible scars and can be secondarily infected leading to cysts and abscesses (collections of pus under the skin) if left untreated. See a dermatologist early, you definitely need oral medication and also may need a stronger form of anti-acne medication known as isotretinoin which helps to shrink your oil glands. Isotretinoin has to be taken under close medical supervision as it can have side effects on one’s liver and cholesterol levels.

Do not use scrubs with rough beady material as these only irritate the skin further besides being totally ineffective at removing blackheads, whiteheads and definitely can worsen cystic acne. Persistent acne is not normal and should be treated by an accredited dermatologist to avoid infections and scarring.

  1. What happens if you leave them be? Will they form pimples?

If you leave them alone, there is a chance of secondary infection in which these blackheads develop into active pimples. Otherwise, they remain as black dots on the skin which may be rather unsightly.

  1. Some people think by putting toner, you close the pores. Is this true? 

Toners with an alcohol base as an astringent draws water and oil out via an osmotic difference.  They may provide symptomatic relief right after application, where the skin feels dried up instantaneously and the appearance of blackheads is subdued due to the temporary removal of debris. However, over time, I find that this gives rise to a condition known as reactive seborrhea. The skin being subjected to these harsh agents, decides that it is dehydrated and paradoxically, produces even more oil. Hence, I did not include any toners in the skincare regimen I designed. Instead, my recommendation for people with oily, acne-prone skin with blackheads is the Miel Honey™ Cleanser: a very effective anti-bacterial, anti-grease cleanser which also leaves a moisturising barrier. Medical-grade honey has a humectant property, meaning it is able to trap water underneath the skin. Additionally, we developed a specialised type of blotting paper for people with severely oily skin to help with the removal of oily patches throughout the course of the day. Our Anti-Inflammatory Oil Blotting Linen contains an extract of Cannabis Sativa which helps to restore the skin barrier when it comes into contact with the skin’s oil. This is unlike traditional blotters which dehydrate the skin causing it to produce even more oil. Finally, the use of a very lightweight moisturiser throughout the day, such as our Mineral Booster™, helps to restore the natural equilibrium of the skin with the environment. Overall, I find this cosmeceutical regimen is more sustainable for someone who is looking to reduce the production of oil and the appearance of blackheads, especially when used in combination with topical prescriptive items.

Read more on the Top Acne Tips and Treatments here.

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Dermatologist Talks: 10 things you need to know about BOTOX

February 17, 2020

 

Millions of BOTOX (Short for Botulinum Toxin Therapy) injections are performed annually, making it the most common cosmetic procedure in the world. Here’s all you need to know about BOTOX.

 

 

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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. 

 

1. What are the benefits of BOTOX?

Botulinum toxin therapy functions to diminish signs of aging and to treat hyperhidrosis— a medical condition characterised by excessive sweating.

  • Frown lines between the eyebrows.
  • Fine lines and wrinkles around the eye i.e Crow’s feet.
  • Excessive sweating in the underarms when treatment applied to the skin does not work well enough.

 

2. Can BOTOX be used to treat excessive sweating? 

BOTOX can be used as a treatment for a condition known as hyperhidrosis whereby the body produces excessive amount of sweat under normal environmental temperatures. It is predominantly injected over areas such as the face, underarms and palms. Speak to your dermatologist to find out if you are a candidate for BOTOX used to treat hyperhidrosis.

3. Is it mandatory to consult a dermatologist to undergo BOTOX?

The success of a cosmetic treatment is dependent on the skill and knowledge of the person performing the treatment. Board-certified dermatologists receive many years of education and training, which gives them expertise in this area. During the first consultation, Dr. Teo will inform you if the procedure will deliver the desired results, based on the condition of your skin as well as your age and health.

A medical license is required to purchase Botulinum Toxin. Products you can purchase online without a license are illegal and potentially dangerous. They differ greatly from products used by a dermatologist. Using online products may result in severe complications. Cases of long-term muscle paralysis, Bell’s palsy, and permanent eye damage are just a few examples

4. What occurs during the procedure at TWL?  

A consultation with our accredited dermatologist will determine if you are a suitable candidate for BOTOX. Full financial counselling is provided and informed consent is taken before the nurse prepares you for the procedure. Numbing cream is then applied to the areas where Botulinum Toxin will be injected. The procedure itself takes about 10-15 minutes depending on the number of injected sites. Thereafter a cooling lifting mask is applied to ensure optimal healing. 

When treating fine lines and wrinkles, the dermatologist injects botulinum toxin into targeted muscles on the face or neck. This temporarily relaxes the targeted muscles, causing fine lines and wrinkles to diminish. The effect lasts about 3 to 4 months — and sometimes longer.

When treating excessive sweating, a dermatologist injects directly into the skin on the underarm. A single treatment can provide up to 6 months of relief from excessive sweating. 

5. Are there any risks and/or side effects of BOTOX?

The side effects of the treatment tend to be mild and temporary. Bruising of injection sites may occur. If this happens, the bruising lasts about 1 week.

After receiving injections, people have experienced:

  • Swelling
  • Redness
  • Soreness
  • Bruising
  • Mild headache (uncommon)
  • Weakness in a neighbouring muscle, leading to a temporarily droopy brow or eyelid (rare)
  • Signs and symptoms of botulism, including problems breathing, swallowing, or speaking (very rare)

 

6. Will I lack facial expressions after treatment? Will it “freeze my face”?

Skilled injectors will ensure that the correct amount of toxin, proportionate to the severity of the wrinkles, is injected to avoid having the frozen face look. 

7. At what age can I start the treatment? Is BOTOX suitable for me? 

Aging is assessed based on the staging on the Glogau Photo-damage Classification Scale. Typically anyone beyond the age of 25 will start to show signs of aging and will hence be a suitable candidate. 

8. How often do I have to return for treatments?

The effects of the treatment last about 3 to 4 months — and sometimes longer. 

9. How soon will I see the results of the treatment?

Majority of my patients see results within 3 to 7 days.

10. Are there any alternatives to BOTOX? 

If you do not have time to visit a dermatologist for your BOTOX procedure, consider these home aesthetic treatments with cosmeceuticals that can help you. 

Dr. TWL’s Oligopeptide vegetal capsules contain argireline. With its clinically proven anti-aging properties, our Oligopeptide capsules relaxes facial tension lines resulting in less noticeable fine lines and wrinkles making it an alternative to BOTOX therapy. Read more about argireline and oligopeptide by clicking on the links below.

https://www.twlskin.com/how-argireline-works-for-anti-aging/

https://drtwlderma.com/ingredient-spotlight-peptides/ 

 

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 Argireline works for Anti-aging

February 5, 2020

 

 

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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 recent years, the beauty and cosmetic industry has experienced a shift towards products which contain bioactive ingredients with the effects of medical drugs. Argireline-based dermal creams, lotions and ointments are among the emerging cosmeceuticals with promises for anti-wrinkle and anti-aging effects from the comfort of home, replacing the need for extensive botox, laser treatments and surgeries to achieve that youthful look.

What is argireline?

Argireline is an established and innovative product used in the cosmetic market as creams, lotions and ointments and is well-known for its anti-aging properties. It is a synthetic hexapeptide produced in the lab, which is composed of chains of amino acids and patterned from the N-terminal end of the protein SNAP-25

It inhibits the movement of facial muscles, allegedly improving skin texture and tone. Research suggests that Argireline may not penetrate deep enough into the skin to consistently provide benefits.

Argireline is a synthetic hexapeptide peptide that is patterned from the N-terminal end of the protein SNAP-25 and has been shown to reduce the degree of facial wrinkles. It is reported to inhibit vesicle docking by preventing formation of the ternary SNARE complex and by interfering in catecholamine release. The anti-wrinkle efficacy of argireline has not been studied in Chinese subjects.

 

How does argireline reduce the effects anti-aging?

Argireline reduces periorbital wrinkles and prevents the formation of skin lines in a similar way the botulinum toxin (Botox) works, by inhibiting neurotransmitter release at the neuromuscular junction. When argireline is applied to the skin, it is absorbed into the body and its chemical composition causes the facial muscles to contract with less force. This diminishes the appearance of wrinkles and can smooth out fine lines that appear with aging. Argireline-based creams can be quite effective, and in some cases, users of argireline-based serums can experience as much as a 30% reduction in fine lines and wrinkles.

A randomized, placebo-controlled study by Wang, Y. conducted in 2013 has also shown that argireline reduced the depth of the wrinkles with a total anti wrinkle efficiency of 48.9% in 60 patients. When the same test was performed on mice, there were notable improvements in the morphology of skin tissue and the amount of Type Ⅰ collagen fibers increased while the amount of type Ⅲ collagen fibers decreased.

The total anti-wrinkle efficacy in the group with patients tested with argireline was 48.9 % whereas the efficacy was 0 % in the placebo group. The parameters of roughness were all decreased in the argireline group, while no decrease was observed in the placebo group.

 

Dr. TWL’s Oligopeptide vegetal capsules contain argireline. With its clinically proven anti-aging properties, our Oligopeptide capsules relaxes facial tension lines resulting in less noticeable fine lines and wrinkles. 

 

References:

  1. Argireline. (2019, April 05). Retrieved from https://thedermreview.com/argireline/
  2. The anti-wrinkle efficacy of argireline, a synthetic hexapeptide, in Chinese subjects: a randomized, placebo-controlled study. Wang Y, Wang M, Xiao S, Pan P, Li P, Huo J. Am J Clin Dermatol. 2013 Apr;14(2):147-53. 
  3. The anti wrinkle efficacy of synthetic hexapeptide (Argireline) in Chinese Subjects. Wang Y, Wang M, Xiao XS, Pan P, Li P, Huo J. J Cosmet Laser Ther. 2013 Apr 22. 
  4. The study of cellular cytotoxicity of argireline – an anti-aging peptide. Grosicki M, Latacz G, Szopa A, Cukier A, Kieć-Kononowicz K. Acta Biochim Pol. 2014;61(1):29-32. Epub 2014 Mar 17.

Dermatologist Talks: The Ideal Skincare Routine

December 28, 2019

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.

 

Many beauty writers have asked me what the ideal skincare routine should be, for today’s busy woman. Is there even such a routine? I have outlined the following— which are frequently asked questions posed by readers and my patients. In the following article, I plan to outline, in a scientific manner the way I have structured my own skincare routine. I recommend this also for my own patients and readers. It is important to learn how to efficiently apply cosmeceuticals as well as to understand the scientific basis for such a routine.

 

Dr.TWL Dermaceuticals is a dermatologist formulated cosmeceutical skincare range that is produced in a EUROISO22716 manufacturing facility, the gold standard in skincare manufacturing. The Dr.TWL Research and Development Team includes chemists working under the supervision of a pharmaceutical engineer and an accredited Singapore dermatologist.

 

Why do I need to have a different skincare routine in the morning or night? 

Skincare routines recommended by dermatologists contain cosmeceutical active ingredients which help to repair and rejuvenate skin via topical absorption. Day skincare routines should include active ingredients like plant based anti-oxidants to actively fight photoaging due to sun exposure, cosmetic enhancers that can double up as skincare makeup. Dr.TWL develops a range of colour correction concealers to use with skin tone concealers for daytime use, they function as skincare that’s also makeup. They are infused with a cosmeceutical oligopeptide base— these function as makeup with pigments to cancel out redness, blemishes, pigmentation spots and sallowness, as well as skincare to treat and heal these problem areas.

Difference between Day and Night Cosmeceutical Actives

  1. Night- Cosmeceutical Actives

Some ingredients, such as retinols or retinoids cause sunsensitivity and should only be used at night and not in the day, due to the potential of sun exposure. Skin repairing ingredients such as phytoantioxidants, as well as ceramide based moisturisers (which tend to be thicker formulations, unsuitable for day time) help to regenerate the skin during the sleep cycle, which is an important time for cellular rest and repair.

  1. Day Cosmeceutical Actives        

Vitamin C serum, for example, is a potent antioxidant that should be incorporated in the daytime routine(and night as well) especially because it helps to actively fend of the free radical formation due to sun-induced ageing (photoaging). Same goes for phyto(plant-derived) antioxidants.

  1. Texture of product 

Daytime routines should include a gentle cleanser to remove debris, brighten and prep skin for absorption, minimum vitamin C based cosmeceutical, a moisturiser and sunscreen.  The texture of all these products should be as “light” as possible while fulfilling the function of delivering the active ingredients, because wearing heavy creamy thick products on the face disturbs application of makeup and gives a greasy look in our humid climate. The priority of daytime skincare would be to give the user the feel of the product being instantly absorbed and as invisible on skin as possible.

  1. Cleansing differences between day and night

For normal to dry skin- gentle milk cleansing is recommended in the morning, to fulfil the function of removing debris, oil and residual skincare products overnight.  For oily, acne-prone skin, an emulsifying cleanser helps to remove excessive oil and to prep skin for absorbing skincare. Night cleansing for those who wear makeup is a double cleanse— oil-soluble makeup pigments have to be dissolved in an oil or micellar formula, while the residue should be removed in a lathering(foaming) formula. Double cleansing is especially important for those with combination or oily skin.

Are there any products reserved for day-time use or night-time use? 

Depends on the active ingredients— as above, if it contains retinols or its derivatives it would be sun-sensitising and should only be used at night, same with any topical cosmeceutical ingredients with the potential for skin irritation, these should be reserved at night.  For daytime- plant derived anti-oxidants and vitamin C help to stave off photoaging by fighting free radical formation.

What are the products you would recommend for a day-time skincare routine?

Cleanser, hyaluronic acid based serumvitamin C serum, emulsion based moisturiser (for Singapore’s humid climate), SPF 50 broad spectrum sunblock 

What are the products you would recommend for a night-time skincare routine?

Double cleansing with an emulsion cleanser for makeup removal and a gentle cleanser thereafter, an antioxidant serum ( such as containing Resveratrol, vitamin C, phytoantioxidants) and a moisturiser containing ceramide.

Some dermatologists are known to recommend sunscreen-use at night. Would you say you agree? Why?  

I do not think it is necessary nor practical. Sunscreen is meant to protect against the damaging UV rays, which can cause sun induced  photoaging and skin cancers. Sunscreens tend to contain some oil- based solvents and sleeping in it will cause stains on pillowcases.

Will having a separate day-time and night-time routine have a significant positive impact on your complexion?  

I would say having evidence based cosmeceutical active ingredients in your regimen is the key determinant of the efficacy of a routine. It is important to respect that certain ingredients as above are best incorporated  into either a morning or nighttime routine due to its innate functions to maximise benefits and reduce side effects.

Dermatologist’s Best Guide to Melasma

March 18, 2018
Melasma Treatment by Singapore Dermatologist

What is melasma?

Melasma is an acquired skin problem of hyperpigmentation, frequently faced by women in their reproductive years. The condition is characterized by hyperpigmentation primarily on the face, so we may observe irregular brown or blue-grey macules on the face. Common areas where the brown patches appear are cheeks, nose, forehead, jaw and the chin.

How prevalent is the disorder?

While melasma occurs in all ethnic and population groups, studies have shown that there is a higher prevalence among more pigmented phenotypes. These include Asians, Indian, Pakistani and Middle Eastern. In the Americas, those who suffer from melasma mostly live in intertropical areas where exposure to UV rays are greater.

What are the different types of hyperpigmentation?

You may be doing your research diligently to find out more about melasma, but there are different types of pigmentation, and they are not all the same. Apart from melasma, your face could be suffering from freckles, sun spots or age spots. Freckles, or ephelides, are small, flat and brown marks that are prevalent in childhood. Sunspots, or solar lentigo, only surfaces in our late twenties and can increase in size and number with increasing sun exposure. Age spots, or seborrheic keratosis, is actually not a form of pigmentation, but a non-cancerous skin growth that kicks in with age.

Melasma, on the other hand, can be identified with a greyish-brown discolouration, at times in the shape of a butterfly.

What causes melasma?

While the cause of the disorder remains unknown, current research point towards sex hormones and sun exposure as the greatest culprits.

These brown patches appear on our face as when there is an excessive production of a pigment called melanin. UV radiation induces the increase in melanin production to protect the skin from sun damage. This causes the development of pigmentation to take place on the skin. A leading cause of melasma is excessive sunlight exposure.

Hormones can also be another cause of melasma. You may develop this condition at the start of your pregnancy or if you are on birth control pills. Pregnant women experience higher levels of increased progesterone, estrogen and melanocyte-stimulating hormones. Melanocytes are cells that produce melanin in your skin.

Other causes can be due to certain medications, scented or deodorant soaps, or your toiletries. These products may contain an ingredient that causes a phototoxic reaction that can trigger melasma.

What are the types of melasma?

There are three types of melasma: epidermal, dermal and mixed.

The epidermal layer affects the outermost surface of the skin, and the easiest type to treat. It can be identified by the presence of excessive levels of melanin in that layer. Patches will be a darker brown colour, with a defined outline.

The dermal layer will affect a deeper layer of the skin beneath the superficial layer, and we can recognise it by the occurrence of melanophages throughout the dermis. Melanophages are cells that ingest melanin. The dermal layer can be more deep-rooted, and may not respond well to treatment. For this layer, patches have a less defined outline, with light brown or bluish colour.

A mixed condition of melasma would be having both the epidermal and dermal types, and improvements on the condition can be expected with treatment.

How to treat melasma? 

The response of melasma to treatment can be slower if the condition has been present for a longer time.

Excessive sun exposure leads to the deposition of melanin cells within the dermis and can persist long term. Coming into contact with UV radiation will deepen the pigmentation as it will activate the production of more melanin, causing your brown patches to turn darker and harder to remove.

Generally, by including sun protection into your skin routine, hyperpigmentation can be resisted. With Singapore’s tropical weather, it is recommended to reapply sun protection every 2 hours with a broad-spectrum sunscreen having at least SPF 30. Consider bringing along sunglasses or a hat when you are outdoors.

For clinical treatments, consultation with a trained dermatologist is recommended. A proper diagnosis of melasma should be conducted, and screened if there are any underlying conditions that may require treatment.

Prescriptions may be given to inhibit the formation of melanin. Hydroquinone is a controlled ingredient that is frequently included in medications to treat melasma, as it allows lightening of the skin. A precise concentration of hydroquinone should be administered for treatment, and may be professionally managed so by your dermatologist.

Procedural treatments for melasma can also be considered, such as chemical peels and lasers. Expected efficacy of each treatment can vary depending on the severity of melasma, with topical combination therapies being one of the most effective treatments for hyperpigmentation.

Speak to your dermatologist for a tailored recovery experience.

© 2017 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.

Achieve A Youthful Look with Skin Filler

February 24, 2018
Filler procedure by Dermatologist

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. Then there is the whole array of anti-aging treatments such as a filler or botox procedure. 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 Filler

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.

Filler Procedure

Next question in mind would be what to expect before, during and after a filler 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.

© 2017 twlskin.com. All rights reserved.

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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.

Best Guide to Facial Fillers by a Dermatologist

November 29, 2017
Facial Fillers according to Singapore Dermatologist

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? How about facial fillers? 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.

Where to get Facial Fillers?

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, facial fillers or other cosmetic procedures. Read all about it here. What does this mean?

To put it simply, 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 facial 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.

Benefits of Facial Fillers

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 facial 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. Take it from the dermatologists when it comes to giving your skin a refreshing and youthful appearance. Facial fillers work by giving your ageing face definition, firmness and deep hydration, talk about multi-tasking. No amount of skincare can do that overnight.

Hyaluronic Acid

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 facial 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. Check out our 1% in-house Hyaluronic Acid formulation, customised by our dermatologist for her patients.

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.

The Filler Procedure

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 treatment using facial fillers, 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 facial 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!

Conclusion

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.

© 2017 twlskin.com. All rights reserved.

—–

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.

Organic Skincare – 7 Bold Truths by a Singapore Dermatologist

November 23, 2017

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 organic 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”. A

s 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.

Organic skincare mask dermatologist singapore

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 truly beneficial skincare that has measurable scientific results, I would recommend using cosmeceuticals instead. Cosmeceuticals refer to skincare that is a combination of cosmetics and pharmeceuticals. They have drug-like benefits, such as improving appearance by means of its ability to affect the structure and function of the skin as recognised by dermatologists and research scientists. Read more about cosmeceuticals here.

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.

© 2017 Dr Teo Wan Lin. All rights reserved.

—–

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.

Dermatologist’s Step-by-Step Guide to Atopic Dermatitis & Sensitive Skin

November 10, 2017
Dermatologist Treatment for Atopic Dermatitis Troubled Skin

Formerly known as Besnier prurigo, Eczema — also known as atopic dermatitis — is the most common form of dermatitis. It is categorised as a chronic, itchy skin condition. Eczema is less common in adults and more commonly affects 15–20% of children. It is almost impossible to predict whether the condition of one’s eczema will improve by itself or not in an individual.

Sensitive skin is a condition that persists life-long. In a meta-analysis of over 110,000 subjects, it was found that children who developed atopic dermatitis before the age of 2 had a much lower risk of persistent disease than those who developed eczema later in childhood or during adolescence. 20% of children with eczema still had persistent disease 8 years later. Fewer than 5% had persistent disease 20 years later.

Genetics in Atopic Dermatitis

Since ‘atopic tendency’ such as eczema, asthma and hay fever can be passed down through the family, knowing one’s own family history of asthma, eczema or hay fever is very useful in diagnosing atopic dermatitis in infants. The complex interaction between genetic and environmental factors causes and triggers atopic dermatitis. Defects in skin barrier function make the skin more susceptible to irritation by contact irritants such as soap, the weather, temperature and non-specific triggers.

The appearance of eczema varies from person to person. In acute eczema flares, inflamed, red, sometimes blistered and weepy patches are common. In between such eczema flares, the skin may appear normal or suffer from chronic eczema with dry, thickened and itchy areas. The appearance and feel of eczema varies from one’s ethnic origin, age, types of creams applies, the presence of infection or an additional skin condition. However, there are some general patterns to where the eczema is found on the body according to the age of the affected person.

Atopic Dermatitis Changes with Age

Although eczema can manifest itself in older people for the first time, the onset of eczema is usually seen before a child turns two. It is widely distributed amongst infants less than one-year-old. It is unusual for an infant to be affected with atopic dermatitis before the age of four months. However, they may suffer from infantile seborrhoeic dermatitis or other rashes prior to this.

As infant’s tend to scratch at their itchy skin with their sharp baby nails, the appearance of eczema in infants tend to be usually scaly, dry, and red. The signs of eczema are physically first apparent on cheeks of infants. Due to the moisture retention of nappies, the appearance of eczema in the napkin area is frequently spared. However, just like other babies, if wet or soiled nappies are left on too long, they can develop irritant napkin dermatitis. Although, eczema is often worst between the ages of two and four it usually improves after four and it may clear altogether by the time one enters into teenhood.

As toddlers tend to scratch vigorously at their itchy skins, the appearance of their atopic dermatitis may look very raw and uncomfortable. As they start to move around, the dermatitis tends to become more thickened and localised. Body parts and areas such as the extensor aspects of joints, specifically the elbows, wrists, knees and ankles and even genitals are most commonly affected in this age group. This changes as the child grow older. The pattern frequently shifts from extensor aspects of the joints to the flexor surfaces of the same joints, such as creases. This is when the affected skin often becomes lichenified; thickened and dry from constant rubbing and scratching.

However, the extensor pattern of eczema persists into later childhood in some children. Older school-age children tend to develop a flexural pattern of eczema which commonly affects the elbow and knee creases and other susceptible areas such as the scalp, eyelids, earlobes, and neck. It is possible for school-age children to develop recurrent acute itchy blisters on their palms, fingers and sometimes on the feet, medically known as pompholyx or vesicular hand/foot atopic dermatitis

Many children in this age group tend to develop a ‘nummular’ pattern of atopic dermatitis. This refers to the appearance of small coin-like areas of eczema scattered over the body. Commonly mistaken for a fungal infection such as a ringworm, the appearance of these round patches of eczema are usually red, dry and itchy. Most of the eczema tends to improve during school years and it may completely clear up by the time they reach their teenage years. However it is important to note that the barrier function of the skin is never entirely normal.

The presence of atopic dermatitis in adults are varied in many ways. Despite having a possibility to have a diffused pattern of eczema, eczema in adults is usually more dry and lichenified compared to eczema in children. Eczema is adults are commonly persistent, localised, and possibly confined to the eyelids, nipples, flexure, and hands or all of these areas. Hand dermatitis in adult atopic tends to appear thickened, dry but may also be blistered at the same time. Infections such as staphylococcal infections are both recurrent and a prominent possibility. Occupational irritant contact dermatitis can trigger eczema. This most often affects hands that are regularly exposed to water, detergents and /or solvents.

As eczema can be triggered by physical, environmental and cosmetic factors, particular occupations such as hairdressing, farming, domestic duties, domestic and industrial cleaning and caregiving tend to expose the skin to various irritants and, sometimes, allergens, aggravating eczema. As it is easier to choose a more suitable occupation from the outset than to change it later, tt is wise to bear this in mind when considering career options. Having atopic dermatitis does not exclude contact allergic dermatitis (confirmed by patch tests in children and adults).

Treatments

  • It could take many months to years to treat eczema and treatments plans often includes:
    – Intermittent topical steroids
    – Reduction of exposure to trigger factors
    – Ceramide based moisturisers (such as the Multi-CERAM which helps restore healthy skin barrier function)
    – In some cases, management may also include one of more of the following:
    – Antibiotics
    – Antihistamines
    – Crisabarole ointment
    – Phototherapy
    – Topical calcineurin inhibitors, such as pimecrolimus cream or tacrolimus ointment
    – Oral corticosteroids
    – Longstanding and severe eczema may be treated with an immunosuppressive agent.
    – Azathioprine
    – Ciclosporin
    – Methotrexate
  • Clinical trials of biologics such as Dupilumab are promising cures for eczema.

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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.