Tag Archive: eczema

Top 5 Harmfup Chemicals in Your Makeup and Other Beauty Products

October 15, 2019

Skin irritation? Breakouts? Allergies? Think it may be due to bad diet and unhealthy lifestyle? Or maybe because of your dirty beddings or perhaps pollution? All of that may be possible contributors to your unlikely skin concerns but have you ever wondered that maybe the problem could be in the makeup that you use?

 

 

Makeup is all fun and games until you learn about the risk it comes with using them. If using makeup products is part of your daily routine, then it is important to know about what you put on your skin! Did you know that the average woman ingests about 6 tons of lipstick in her lifetime? You may not notice because you don’t literally eat your lipstick, but every time lipstick gets unto your teeth, or whenever it transfers on to your food when you eat, the main thing is it’s now down your tummy! So before anything else, it’s now time to question on whether or not the products that you use are safe for you.

You may be reading the ingredient list of your makeup products but do you think that’s all it is? Some companies hide “certain substances” or mask it under deceptive titles. Others may have listed them, but what’s lacking is that there is not enough information on the potential harm it may cause for their consumers.

 Certain ingredients used in the production of makeup and cosmetics can cause more harm than benefits and these can cause problems that may put your health at serious risk. Issues related to the use of products with these harmful ingredients may associate with skin allergies, cancer, weakened immunity, and more.

“For patients who suffer from sensitive skin and allergies, it’s often a vicious cycle with makeup products which are used for concealing the skin imperfections, and the same preservatives and ingredients in these products cause an exacerbation of the underlying skin condition,” says accredited dermatologist Dr. Teo Wan Lin.

How about for those without skin problems? Dr. Teo says, “Makeup is in direct contact with skin, and as skincare can deliver benefits to skin via topical absorption, makeup can also be used as a means to improve the health of the skin when it is incorporated with cosmeceutical active ingredients as an anti-ageing formula— while at the same time offering concealing of imperfections, which can improve individuals’ self-esteem. For products applied to mucosal areas such as the eyes and lips, it’s worthwhile to switch to pure mineral colorants in cosmeceutical bases because these are sensitive areas that are prone to irritation, and have thinner skin that will cause any harmful substances to be directly absorbed.”

 We have listed down below the Top 5 harmful chemicals that are used in the production, preservation, and manufacturing of makeup products that you may be using everyday. Guess what, these ingredients don’t have to be present in your makeup— if you switch to mineral makeup for the eyes and lips!

 

 1. Phthalates

 This chemical is most commonly found in perfumes, colour cosmetics, nail polish, and hair care products. Phthalates are linked to endocrine disruption, developmental and reproductive toxicity, and cancer. Phthalates may be labeled as phthalate, DEP, DBP, DEHP and “fragrance”. Some companies intentionally exclude this on their ingredients list. Products that list “fragrance” on the label should be avoided to prevent possible exposure to phthalates.

References:

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

 

2. Paraben

Paraben…paraben… One of the most famous ingredients for makeup. Though you may not know much about this chemical, you’ve probably heard about this already because you may have previously encountered the term “paraben-free” on some beauty products and wonder what does it mean. Parabens are preservatives used in a wide variety of personal care products and foods to prevent the growth of microbes. Parabens are not water soluble and can penetrate the skin. As a result, repeated application of a product or multiple products containing parabens could mean almost continuous exposure. These endocrine-disrupting chemicals can be absorbed through skin, blood and the digestive system.

Effect of Paraben: causes endocrine dysfunction, interferes with male reproductive functions, and can lead to rapid skin ageing and DNA damage.

 Paraben may be labeled as ethylparaben, butylparaben, methylparaben, propylparaben, isobutylparaben, isopropylparaben, and other ingredients ending in –paraben.

References:

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

 

3. Lead

Lead has continuously been a very controversial component of lipstick. But did you know that it is often used in makeup foundation and whitening toothpaste as well? High levels of lead may pose a very serious risk on our health and studies have shown that there is no safe amount of lead exposure as though even at small amounts, lead can be very dangerous. Medical experts are clear that any level of lead exposure is unhealthy. The FDA or Food and Drug Administration has been determined to limit the usage of lead in lipstick and in a variety of other cosmetics. Read here.

 Exposure to lead has been linked to a host of health concerns:

  • Neurotoxicity: It has been linked to learning, language and behavioral problems.
  • Reduced fertility in both men and women
  • Hormonal changes and menstrual irregularities
  • Delayed onset of puberty in girls and development of testes in boys.

References:

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

 

4. Asbestos

 Talc is used as an ingredient in face powders, blush, and eyeshadows. The incorporation of asbestos in talc is due to poor regulations involving cosmetic-grade talc, which is also known as talcum powder. Talc and asbestos are minerals that form together. That means talc mined for commercial uses can be contaminated with asbestos — a known cause of lung cancer and mesothelioma. Before purchasing any product that has talc, make sure it is labeled as asbestos-free. Health concerns of asbestos may include skin irritation, cancer, organ system toxicity.

References:

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

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

 

5. Butylated Compounds (BHA, BHT)

 Mainly used for preservation of our beauty products and personal care products such as moisturizer, lip products, hair products, makeup, sunscreen, antiperspirant/deodorant, fragrance, creams. Butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT) are chemicals are linked to several health concerns including endocrine disruption and organ-system toxicity.

Don’t get fooled by this because butylated compounds are also used as preservatives in food like meats, sausage, poultry, baked goods, beer, etc.

References:

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

 

We have no control over the ingredients or manufacturing of the mass market makeup available in the market, but is that where custom blend mineral makeup can perhaps fill a need? “Custom blend mineral makeup has its advantages especially for eye and lip makeup because pure minerals are utilised. The eyelid and lip area are high-risk locations and naturally have thinner and more sensitive type of skin—known as mucosal skin. “ says Dr. Teo, who remarks that she has been seeing an increasing number of patients in her practice with eyelid and lip eczema, often triggered by makeup products such as mascara, eyelash extensions and lipsticks.

Especially if the sources are clearly labelled and audited, the risk of manufacturing contamination for sensitive products such as lipsticks and eye shadows, which is of the highest concerns to regulatory authorities like the FDA and HSA as well, due to the risk of ingestion and absorption, is eliminated. “When produced in smaller batches, custom blended mineral makeup is preservative free and avoids the problems of lead contamination in mass market manufacturing, which is important in lip products because of the lead content which is inevitably ingested.” Dr. Teo says.

How does one avoid getting these toxic chemicals incorporated into your daily routine? Also, isn’t it time that skincare is infused into makeup, since both are applied for long hours on the skin? Head over here to get your hands on cosmeceutical make-up.

Dr. TWL Dream Concealer™

ACTIVE INGREDIENTS

[Pigment]

100% Mineral Pigments Without Bulking Agents

Bismuth Oxychloride(BMO)/Talc-free

FDA Eye/Lip Approved

[Cosmeceutical Base]

Oligopeptides [Lifting][Repair]

Niacinamide [Brightening]

LARECEA™ Extract [Regeneration]

PEACH Covers dark circles on light skin 

ORANGE Cancels dark circles brown spots on medium to deep skin 

PALE PURPLE Conceal brown spots on light skin dullness 

PURPLE Brightens/Neutralizes dull yellow on medium skin 

PINK Brightens/Neutralizes dull yellow on light skin 

BLUE Neutralizes sallowness & hyperpigmentation on fair skin 

YELLOW Cancels purple/blue tones Corrects mild redness 

GREEN Neutralizes redness/pimples 

A Dermatologist Talks: Enhancing Skin Absorption of Cosmeceuticals

August 21, 2019

by: Dr. Teo Wan Lin

In my previous articles, I have talked about cosmeceuticals and the importance of incorporating them in our daily routines. However, how do we enhance the skin absorption of these cosmeceuticals? Here I will be talking about the limitations of topical formulations and how we can overcome them to ultimately achieve the results that we desire.

 

The problem with topical formulations

 

 

The outermost layer of the skin, called the stratum corneum, acts as a natural barrier. It prevents foreign material from entering our system, shields us against environmental factors and prevents excessive water loss. The skin is a formidable barrier to the passage of substances into and out of the body, but it can be manipulated to allow it to become a viable pathway for drug administration.

Drug products applied to the skin’s surface penetrate the skin layers to a certain extent, where they can exert their effects. This is the case for topical formulations for treatment of skin disorders such as acne, dermatitis, and psoriasis. However, very few drugs are suitable for delivery by the topical route, as passive penetration through the skin is limited to very small molecules (<500Da), which are neutral and relatively lipophilic. Some considerations of dermatologists would be the vehicle of the topical, specifically if it is in a lotion, cream or ointment form, in increasing order of absorption and effectiveness. This however, is often limited by user preferences, with ointment formulas (more efficacious) deemed cosmetically less acceptable.

The skin is the largest organ of the human body, comprising 15% of body weight and therefore its use to deliver medicine to the body is not a new concept by any means. Advancements made by modern science are improving the skin’s potential as a route for drug administration. Dermatologists are at the forefront of research relating to transdermal drug delivery, given the unique accessibility of the largest organ of the body.

Owing to the drawbacks of topical formulations, transdermal patches have been developed to improve drug delivery through the skin and this is an area that my team has actively researched in the last year as an adjunct to our cosmeceutical formulations.

I have always been interested in finding new methods to allow my patients to achieve optimal results from our cosmeceuticals, thus in this article I shall share some tools which I employ in my clinical practice to achieve optimal absorption of cosmeceutical active ingredients.

Wet Wrap/Occlusion Therapy & Facial Masks

A well known method employed by dermatologists to treat severe eczema known as wet wrap is actually a simple process involving applying a wet textile together with topical medications to skin, to increase absorption of skincare. An example of how and when wet wraps are used— during particularly intense eczema flares with severe itch or pain, wet wrap therapy rehydrates and enhances the absorption of topical medications applied on the skin. The fabric wraps are soaked in water and applied to the affected skin on the body. Wet wraps are best done after bathing, moisturising and applying topicals, then left overnight.

Wet wraps work via 3 different ways:

●  Cooling — as water gradually evaporates from the bandages this cools the skin and helps relieve inflammation, itching and soreness

●  Moisturising — cosmeceuticals covered over with wet bandages are deeply absorbed in to the skin to provide a longer-lasting moisturising effect

●  Absorption — enhanced absorption of any topicals into both the superficial and deeper layers of skin where inflammation is present

Facial sheet masks work in a similar way, on the basis of occlusion. This means that when there’s a topical which is applied on the skin and also in contact with something moist such as a sheet mask, there is increased absorption of the topicals by the skin. In my practice, whenever I want to increase absorption of cosmeceuticals and moisturisers that are dispensed to patients, I would advise them to apply a wet cotton sheet (as a wet wrap) on to their face to increase absorption.

I would consider masking as something which is very good to do if you are already diligent with other aspects of skin health such as cleansing and applying cosmeceuticals. Using a face mask would deliver moisture and clinically active ingredients to the skin—so it is important to look out for ingredients such as glycerin, ceramide and hyaluronic acid, as well as evidence-based antioxidants for anti-ageing such as oligopeptides, vitamin C ( I use sodium ascorbyl phosphate which is a neutral, rather than acidic form of vitamin C, that has minimal skin irritation). Here’s a tip, use a cosmeceutical moisturiser like the Radiance Fluide™ and increase your skin’s absorption by applying it on damp skin, plus a soft wet cotton towel over it.

Facial Massage

 

Performing a facial massage, such as with the aid of a facial roller before application of cosmeceuticals could increase the skincare absorption, leading to better effects of the anti- aging skincare. Local massage is an established treatment method of improving surgical scars, by stimulating blood flow and improving wound healing. A peer-reviewed study published in a medical journal Complementary Therapies in Medicine led by author Miyaji Akane at the Institute for Liberal Arts, Tokyo Institute of Technology (Tokyo Tech) and colleagues at Tokyo Healthcare University and the Research and Development Center, MTG Co. Ltd. in 2019 had examined the effects of using a facial roller on facial skin and blood flow. The study concluded that there was significantly increased vascular (blood vessel) dilation with use of the facial massage roller. This means that there will be increased absorption of any cosmeceuticals applied on the face following the massage.

My recommendation would be manual rather than electric facial rollers as the latter may cause excessive pressure and irritation (being automated) and is also dependent on user training as well as the manufacturer’s settings, with a potential risk of overheating of electric components. Manual facial massage is a self-regulated process as the user can immediately sense irritation and apply just the right amount of pressure.

Transdermal delivery

Transdermal medications (usually in the form of a patch) are a little more modern and complex. Great strides in transdermal drug delivery have been made since the first transdermal drug was approved by the FDA in 1979.

Transdermal drugs bring medication through the skin, to the bloodstream. Once in the bloodstream, the ingredients circulate and take effect at a targeted location. Medication is delivered steadily and can be stopped simply by removing the patch. Since your body doesn’t have to digest the medicine through the stomach, a higher concentration reaches the bloodstream. The medication permeates the skin in a controlled fashion thus attaining more ready levels of the drug in the body.

The science behind polymers and transdermal drug delivery systems

Polymers are vital in a transdermal drug delivery system. Systems for transdermal delivery are assembled as a multilayered polymeric laminates consisting of a drug reservoir sandwiched in between 2 polymeric layers:

● An outer impervious backing — prevents the loss of drug

● An inner polymeric layer — functions as an adhesive and rate-controlling membrane There are 3 types of transdermal drug delivery systems:

● Reservoir systems

In this system, the drug reservoir is embedded between a backing layer and a rate-controlling membrane.

● Matrix Systems

In this system, the drug reservoir is either dispersed in an adhesive polymer or in a hydrophilic or lipophilic polymer matrix.

● Micro-reservoir Systems

This system is a combination of the above 2 systems. The drug reservoir is formed by suspending the drug in an aqueous solution and then dispersing the solution in a lipophilic polymer to form thousands of microscopic spheres of drug reservoirs.

Polymers used in transdermal delivery systems should have biocompatibility with the drug and other components of the system. They should also provide consistent, effective delivery of a drug throughout the product’s intended shelf life.

An example of a common polymer used are silicones, also known as polysiloxanes, made of many repeating units of siloxanes. Siloxanes are chains of alternating silicon and oxygen atoms that are often combined with carbon and/or hydrogen.
Medical grade silicones are silicones that undergo specific testing for their biocompatibility and have been deemed appropriate to be used for medical applications. Topical silicone therapy is often used by plastic surgeons and dermatologists to treat and heal scars.

Key considerations of a polymer patch used for transdermal drug delivery would be —conformability of the material to be applied to irregular skin or scar surfaces, sensitive regions such as the face/eye area and the overall durability and biocompatibility of medical grade polymers.

The process of skin ageing relates to the ability of the body’s natural healing processes. The same cells which are activated during cell injury are the ones which lose function with ageing, and are responsible for loss of collagen, elastin and the overall loss of volume and elasticity of skin. Specifically, antiageing cosmeceuticals target and stimulate cells known as fibroblasts, which are best thought of as the “soldiers” of wound healing which produce collagen to seal up injured or damaged skin. Injury to the skin occurs over a gradual process in the case of ageing, due to the slowing of one’s biological clock and photodamage.

For the last year, my team and I worked with a material scientist to develop a transdermal delivery patch, the QRASER™ Transdermal absorption patch, launched in July 2019. This patch works via a matrix system of drug delivery. In this system, the drug reservoir is dispersed in an adhesive polymer matrix. The transdermal delivery patch uses a unique polymer technology that mimics the natural hydration and homeostasis of the skin barrier, to enhance cosmeceutical absorption. The focus is on improving absorption via optimisation of the skin healing microenvironment.

The result? Healthy collagen production thus reducing fine lines and wrinkles.

In conclusion, cosmeceuticals in the arena of dermatologist-led skincare research will be increasingly prominent in the next decade of “smart skincare”. This should be emphasised along with understanding of how these topicals work, the limitations of skincare absorption and potential technologies such as transdermal delivery patches which can optimise the anti-ageing benefits of cosmeceutical skincare.

Dr. Teo Wan Lin, founder and medical director of TWL Specialist Skin & Laser Centre, is one of Singapore’s prominent dermatologists specialising in medical and aesthetic dermatology. She is also the founder of Dr.TWL Dermaceuticals which specialised in cosmeceutical skincare. In July 2019, a material science arm Dr.TWL Biomaterials was launched focusing on novel biomaterials for skin and hair application. Click here for the links to our product and here to read more about Dr.TWL Dermaceuticals and here to read more about Dr.TWL Biomaterials.

Footnote:

TWL Specialist Skin and Laser Centre grants parties a limited license to use and/or republish this article on for any legitimate media purpose, provided that you:

(1) reference TWL Specialist Skin and Laser Centre as the source and include a hyperlink to the original release on the company website; (2) do not modify any press release wording; and (3) do not modify or add hyperlinks, including but not limited to ad links, within the press release.

Common nail diseases explained by a dermatologist

March 15, 2019

Nail abnormalities are often neglected. Patients tend to visit the dermatologist for skin-related concerns, such as acne or eczema. Yet, nail diseases can be common and require diagnosis and management.

The nail (or the nail plate) is firmed rooted to the nail bed. Our nails are made of modified keratin. It serves as a protective shield for our fingertips and toes. Fingernails take approximately 5 to 6 months to grow out, while toenails require twice the duration. The slow growth rate and the difficulty of getting drugs to penetrate the nail tissue make it hard to treat nail diseases.

Here, we share a few common nail diseases.

Onychomycosis

Onychomycosis is a type of yeast or mould infection on the nail. The infection causes a discolouration (white, yellow or brown). Other characteristics include thickening, splitting, roughening of the nail.

Common factors that place individuals at greater risk include humidity, heat, trauma and diabetes. Basketball players may be more predisposed due to the direct trauma of having their toes stepped on by other competitors.

Onychomycosis may also be a symptom of the following conditions: psoriasis, eczema, trauma or ageing.

Treatment for onychomycosis: Topical antifungal agents are less ineffective, due to its inability for deeper penetration into the nail bed. Instead, oral terbinafine or itraconazole is often prescribed.

Do my nails have a bacterial infection?

When your nails suffer from bacterial infection, it is termed as paronychia. Paronychia can be acute or chronic. In acute paronychia, it is generally painful with pus present, caused by the bacteria Staphylococcus aureus. Repetitive minor trauma, nail-picking and nail-tearing can cause a tear in the skin, allowing bacteria to invade.

In chronic paronychia, individuals in wet working conditions or cold environment are at greater risk. Compared to acute paronychia, chronic paronychia is generally less painful.

How to treat acute paronychia: Antibiotics and drainage of any pus if present.

How to treat chronic paronychia: Topical imidazoles are often prescribed. The patient should also avoid wet conditions, e.g. to use cotton-lined gloves when exposed to wet work. Manicuring or finger sucking should be avoided. Apply emollient creams regularly.

Ingrown toenail

Ingrown toenails can be hard, swollen and painful. Trimming your nails too short, especially on the sides of your big toes, can cause an ingrown nail. Trimming the corners of your nails may encourage your toenails to grow inwards, digging into your skin. Your skin then breaks due to the pressure, triggering an infection. Tight shoe wear or trauma can also cause ingrown nails.

If excessive inflammation and swelling are present, patients are advised to visit a dermatologist for proper treatment. Oral antibiotics may be prescribed, and the dermatologist will assess if there is a need for surgical removal.

To prevent ingrown toenails, wear proper-fitting shoes that have adequate room for the toes. Wear socks too. Cut your nails straight across instead of rounding the corners.

Tumours

Nail tumours can be benign or malignant. Warts are the most common type of benign tumour affecting the nails.

Dermatological diseases that can affect nail conditions

Psoriasis: Patients who suffer from psoriasis may notice that their nails are scaly or pitted, with debris collected under them. In severe cases, the nail plate crumples, along with thickening of the nail bed.

Generally, nail changes should improve with effective psoriasis management. There are no nail-specific treatments for patients with psoriasis.

Eczema: While eczema does not typically cause nail changes, certain patients may suffer from brittle nails. Nail plate may also be rippled and deformed, due to the body’s inflammatory process. Horizontal ridges can be seen across the nail, with thickening and sometimes discolouration.

Emollients

Nail abnormalities can benefit from the application of moisturizers, especially for patients suffering from eczema. Use a dermatologist-formulated emollient such as Multi-CERAM™ Moisturizer, with phyto-ceramides for skin barrier repair and multi-ceramides for skin lipid restoration.

© 2019 TWL Specialist Skin and Laser Centre. All rights reserved.
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Meet with Dr Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.
To book an appointment with Dr Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.

How does your skin react to alcohol?

January 19, 2019

 

What happens to your skin when you drink too much?

To maintain the health of your skin, you may want to think twice before you reach for one too many drinks. Alcohol can be pretty harsh on the skin.

Here’s why.

Premature ageing

When broken down, alcohol produces molecules called aldehydes. Such molecules cause damage to the body’s cells by destroying their ability to function. When cells are damaged or die, our body produces new cells to replace them. However, a single exposure to alcohol can reduce the body’s ability to multiply cells.

Another effect of alcohol is the widening of small blood vessels in the skin. This allows more blood to flow closer to the skin’s surface, which produces the distinctive flush and feeling of warmth often associated with alcohol consumption. Over time, this can cause an unhealthy appearance including dullness, enlarged pores, sagging, discoloration and a lack of skin resilience. Such effects can last for days.

Excessive alcohol consumption can further limit the liver’s ability to remove toxins, which can also make you look older.

Dehydration

Alcohol interferes with the body’s ability to regulate water levels. Your brain produces a hormone called anti-diuretic hormone (ADH) that acts on our kidneys to control the amount of water secreted in your urine. When your body is dehydrated, your brain sends a signal to pump out ADH. ADH stops you from urinating as much, allowing you to retain your water levels.

Alcohol inhibits ADH levels. So even when you drink a lot of water alongside your alcoholic drinks, your body only hangs on to about a third of it while the rest goes out in your urine. In other words, alcohol increases urine volume and leaves your body dehydrated.

This dehydrating effect worsens skin elasticity, thickness and density. It also makes wrinkles and fine lines more noticeable. 

Itchy skin

Most itchy skin diseases are exacerbated by alcohol consumption. Alcohol causes eczema to be twice as common, likely due to its suppressive effects on the immune system.

Alcohol also makes psoriasis harder to treat. Psoriasis refers to the condition of red, itchy skin. While alcohol itself does not cause psoriasis, it increases the body’s susceptibility to infection and exacerbates the condition. Heavy drinkers are also more resistant to therapy.

Flushing and Rosacea

Flushing is a common after-effect of drinking and tends to go away the next day. It is more prevalent in individuals who do not have an enzyme that breaks down aldehyde. (Alcohol is broken down via two general steps, first into aldehydes and then to acetate.) An accumulation of aldehydes causes flushing and rapid heart rates.

An impaired alcohol metabolism can also worsen rosacea, a common skin disease with a tendency to blush or flush more easily than others. It can further cause an increased incidence of telangiectasia or the appearance of spider veins at the surface of the skin. 

Inflammation

When alcohol is broken down in the body, reactive oxygen species (ROS) is released as a by-product. ROS are important signalling molecules in the body.

However, excess ROS production can be harmful to the skin as it alters the body’s immune response, triggers inflammation and causes the body to attack itself. This can compromise the skin’s wound healing processes.

Consequently, alcohol can cause skin conditions such as eczema, psoriasis or, in some cases, acne to take much longer to heal than before.

Resveratrol in red wine

Resveratrol is an antioxidant often found in red wine. (Antioxidants work to fight against the oxidative stress that your skin cells encounter.) Resveratrol also has therapeutic benefits against various skin disorders and protects the skin against harmful UV rays. Given that UV radiation is a major cause of ageing, resveratrol is popular for its anti-ageing abilities.

However, there are other ways to get resveratrol that do not include the harmful effects of alcohol.

For a dermatologist-formulated anti-ageing serum, go for Elixir-V™ Total Recovery Serum. It contains a potent concoction of resveratrol, hyaluronic acid and oligopeptides that work together to give you the perfect V-face look.

Seek for help

If your skin condition worsens, schedule a visit with a dermatologist as soon as you can. The dermatologist can determine the best course of action and suitable treatment that would be effective for your condition and your lifestyle.

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

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

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

 

 

 

 

 

Is It Bad to Pick on Your Acne?

November 4, 2018

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

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

Characteristics of excoriation disorder

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

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

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

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

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

Psychological aspect of the disorder

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

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

Treatment

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

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

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

Behavioural interventions

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

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

Pharmacotherapy treatments

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

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

Selective serotonin reuptake inhibitors

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

Opioid antagonists

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

Glutamatergic agents

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

When to visit a dermatologist

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

© 2018 TWL Specialist Skin and Laser Centre. All rights reserved.
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Meet with Dr. Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.
To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.

 

 

A Dermatologist Explains Eczema & Its Treatment

August 4, 2018

 

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

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

How does atopic dermatitis arise?

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

  • Skin barrier dysfunction
  • Genetic predisposition
  • Immune dysfunction

The role of genetics in eczema

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

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

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

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

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

How immune dysfunction contributes to eczema

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

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

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

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

How to treat eczema?

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

Repair & Maintain Healthy Skin Barrier:

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

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

Reduce inflammation:

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

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

Side effects include:

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

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

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

Itch control:

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

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

Taking care of the skin 

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

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

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

© 2018 TWL Specialist Skin and Laser Centre. All rights reserved.

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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.

 

 

 

 

Suffering from sensitive skin; eczema?

November 10, 2017

 

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 eczema 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.

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 Eczema. 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 if 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.

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 eczema 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 eczema may look very raw and uncomfortable. As they start to move around, eczema 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 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 eczema 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).

  • 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.

© 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.

3 Questions About Sensitive Skin Answered By a Dermatologist

October 3, 2017

By Dr. Teo Wan Lin, Consultant Dermatologist at TWL Specialist Skin & Laser Centre

Many patients that come to me say: “I have super sensitive skin and I break out easily from using the wrong kinds of products.” However, from a dermatologist’s point of view, skincare or makeup alone (especially if labelled non-comedogenic like most brands on the market are) do not cause breakouts or pimples. These are instead signs of acne-prone skin, which is a medical condition that needs to be treated with prescription medication.

1. How Do I Know If I have Sensitive Skin?

Make a visit to an accredited dermatologist. They will usually ask you the following questions:

Do you suffer from symptoms such as skin redness, flaking, itch or stinging pain? Did you have eczema, asthma or sensitive nose when you were young, or have a family history of eczema or sensitive skin? Does your skin get red and itchy when you use makeup or skincare products, or when you are exposed to a dusty or sweaty environment? Does your skin act up when travelling to a cold or dry climate?

Dermatologists diagnose true “sensitive skin”, with a medical condition known as eczema, where common exposures to the environment or skincare and make up can trigger off flare-ups.

2. What Is Defined As Sensitive Skin Then?

People with sensitive skin are likely to have atopic dermatitis, which is a genetically determined condition where the skin is deficient in certain fats. The skin acts as a barrier to the environment and, without a proper functioning skin barrier, any dust, climate change, pet fur, or even emotional stress can trigger off a flare-up.

 If you have never had any of these symptoms and suddenly experience “sensitivity”, especially soon after using a new skincare or makeup product, it might actually be a form of allergic contact dermatitis to an applied substance. This would be best reviewed by a dermatologist who might suggest a patch test and also receive appropriate medical treatment.

Undiagnosed and untreated skin sensitivity can become chronic and may result in scarring such as post-inflammatory hyperpigmentation which results in dark marks on one’s face.

3. So What Is The Solution To Sensitive Skin ?

RADIANCÉ FLUIDE™ is dermatologically formulated for sensitive skin to provide moisture and hydration, providing a light-weight feel in the day for a radiant makeup base.

Your dermatologist will prescribe you anti-inflammatory creams such as topical steroids of the appropriate strength and ceramide-rich emollients that replenish the skin barrier. In the case of any infection, oral antibiotics to clear the skin infection would also be prescribed. Oral steroids may also be required for severe eczema.

Here are three of the best skincare tips for people with sensitive skin: 

1) Look for “dermatologically tested and formulated” labels that are produced in certified laboratories and that work with dermatologists rather than cosmetic brands.

2) Get your dermatologist to recommend a gentle cleanser formulated for effective cleansing of eczema-prone skin.

3) Get your sensitive skin treated first before using anti-ageing products
Many anti-ageing products contain stimulating ingredients which may worsen sensitive skin. If you do use them, look for a product that’s recommended by your dermatologist.

© 2017 Dr. Teo Wan Lin. All rights reserved.

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Meet with Dr. Teo Wan Lin, founder and Specialist Consultant Dermatologist of TWL Specialist Skin & Laser Centre, an accredited dermatologist specialising in medical and aesthetic dermatology. She integrates her artistic sensibility with her research background and specialist dermatologist training, by means of customised, evidence-based aesthetic treatments using state-of the-art machines, injectables (fillers and toxins) which work synergistically with her proprietary line of specialist dermatologist grade cosmeceuticals Dr.TWL Dermaceuticals.

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

A Singapore Dermatologist’s Personal Skincare tips

April 13, 2017

Whether you are a local, or an expat that lives in Singapore, one is struck by the stark weather of this equatorial city- constantly humid with temperatures rising above 30 degrees celsius. The cause of our sweaty pimply skin, simply put, Singapore’s weather causes bad skin-acne on the face, pimples on the chest and back. True or false?

Also, too many aesthetic clinics and medi-spas are advertising some sort of acne treatment for our humid climate, how does one know if it’s going to work? Does bad skincare cause problems and what exactly constitutes good skincare?

As many of my patients have asked, I share my top tips on maintaining good skin in Singapore (which you could achieve on your own), and how to get treatment when you really need it.

1. If it’s bothering you, you may have a real skin problem. Do see a dermatologist.

Do you suffer from any of these: sensitive skin and break-outs if the products were not right? Constant red face? Having flaky itchy skin whenever you’re traveling? Always having a pimple breakout at that time of the month?

If you have any of these symptoms, stop self-medicating and applying a bunch of anti-redness or “sensitive skin” products if you have these symptoms, it’s just going to make it worse. All of the above can be treated with proper medications. Eczema treatment for flaky, sensitive and itchy skin, hormonal acne treatment for pimples around that time of the month, and sometimes it isn’t even really acne. I’ve seen cases of perioral dermatitis that have been wrongly diagnosed as acne and obviously did not improve.

Acne on the chest and back is often actually a fungal infection known as pityosporum folliculitis. This sort of chest and back “acne” requires treatment with specific antifungal lotions and creams. People who are at risk include athletes or those living in a humid country like Singapore, as the constant sweating and the moist environment worsens it. When chest and back acne or fungal infections are left untreated, it leaves bad scars and even develops secondary bacterial infections.

If you always have a red face you may likely suffer from rosacea. Rosacea treatment is  with correct oral antibiotics and creams before anti-redness lasers (to eradicate the blood vessels) are used. Rosacea is triggered off by hot climates, spicy foods, emotions in certain people who are at risk. It is likely to be related to increased blood vessel sensitivity as well as certain mites that live on your skin (demodex mites).

If you have any such symptoms, stop all skincare products and promptly seek the care of a dermatologist rather than self-medicate, or adopt a “wait-it-out’ attitude. Some tips: Look for the labels “dermatologically tested and formulated” when it comes to choosing cleansers, moisturisers and cosmeceutical products. Avoid testing many different cosmetic products which have no scientific evidence proving effectiveness. Finally, where possible avoid dust, extremes of temperature and humidity, prolonged contact with sweat as these tend to worsen skin sensitivity.

2. Don’t use just any wash on your face, use a dermatologist-tested and formulated cleanser.

It almost feels like because Singapore is so warm we constantly need to keep washing  and keeping clean because of the sweat! As a dermatologist, I’ve heard from many patients with acne how they struggle to wash their face 3 times a day and are puzzled that they still have pimples. Cleansers perform one function, they emulsify the dirt, oil and bacteria in the foam which is rinsed off with water. Acne not due to dirt or bacteria, although they both can worsen people who already are prone to acne, such as those who have a family history of acne, so no amount of washing can actually get rid of acne.

There is a difference between normal cleansers and those which are dermatologist-tested/formulated. Cleansers approved by dermatologists are gentle on the skin, due to a good balance of the lathering agent and use of quality ingredients that do not strip the skin dry of it’s natural moisture while cleansing effectively. I personally formulate a honey-based cleanser which is suitable for both oily skin and sensitive skin types in Singapore (honey is a natural emulsifying agent which also has anti-bacterial properties) for my patients. Cleansers that leave your skin feeling squeaky clean is usually a bad sign, so stop using your supermarket cleanser and start looking carefully for those “dermatologist-tested and formulated” labels.

3. Don’t buy more scrubs or clay masks to clean your face better.

It amuses me that most of my patients are shocked when they hear this from me, their dermatologist, almost as if I am wrong to say that. Dermatologists do not agree with a lot of what beauty companies/aesthetics providers (who are not qualified dermatologists) are telling the public.  The beauty industry is limited by what they are allowed to use in their salons (none of the prescription medications that would actually work is found in these places) and are are very happy to include more products in your regimen to earn your dollar. Dermatologists have seen way too many complications because of an incomplete understanding of the actual science of how skin behaves. Scrubbing with harsh beady grains of sand would work if your skin was made of wood, like sandpapering it down. In reality, you do not brighten or “exfoliate’’ your skin with that but rather you are causing damage and irritation to your skin, that’s maybe even the cause of your sensitive skin and red face problems.

Clay masks? Totally unnecessary even for oily and acne-prone skin types because it’s actually the salicylic acid content in these masks that causes your acne to get better, but not without really dehydrating your skin after that (these masks are dry out your skin with an astringent). Most of my patients end up with a red itchy flaky face, on top of acne after they go on a clay-mask spree hoping that it would cure their oily face and acne. Dermatologists do not prescribe clay masks for any skin problem because there are much more effective options for treatment of oily skin and acne. What counts in a skin treatment product is the active ingredient in these masks and products, so again, start looking down the ingredient list of your next bottle!

4. Use cosmeceuticals but do thorough brand research first.

Haven’t heard of cosmeceutical yet?  It has become quite a fashionable word amongst the dermatologists community (for those in the know). It’s a marriage of two words “pharmaceuticals” and “cosmetics”. It’s actually referring to skincare with active ingredients best for skin that’s backed by dermatologists.

Am i too young? Or too old? Do i even need to get started?For best results, start on cosmeceuticals early, in your twenties for maintenance of your youth. If you are already in your thirties and forties or beyond, fret not, cosmeceuticals are a useful adjunct to the laser/filler/botox treatments recommended by your dermatologist and help to enhance and maintain the effects of such anti-aging treatments.

There are a myriad of cosmetic brands that claim wonders. Unfortunately, cosmeceuticals are not regulated by the HSA and so are not bound to their claims. Hence, it’s difficult for the consumer to know if a given product can do what it claims it can do, contains the ingredients it claims to, or if the ingredients are even active forms? Moreover, if the ingredients have phototoxic or photo reactive properties when exposed to the sun, among other concerns.What then? There is true evidence for the  anti-aging properties of cosmeceuticals, but you are wise to consult a dermatologist before you buy. The HSA does not regulate the effectiveness of anti-aging products available without a prescription.

5. Go for a chemical peel or a medi-facial monthly at your dermatologist’s office in your twenties. Lasers in your thirties and beyond.

What is true about acne and the humid Singapore climate is that it all encourages the build up of dead keratin (read: skin flakes) which plug the pores and cause inflammation. Even if you don’t have acne, the build-up of keratin on your face with reduced skin turnover as one grows older, or due to environmental conditions such as exposure to pollutants and to sun. All these cause free-radical damage and accelerated aging, makes one’s face look dull and hence lose the bright complexion of one’s youth. A regular chemical peel (salicylic, lactic or glycolic acids as suited for your skin type should be determined by your dermatologist) or a medi-facial (I would use a vacuum handpiece with customised chemical peel solutions for patients), would reduce your chances of having oily acne-skin breakouts and reverse early signs of mild aging. It’s affordable as well. However, this alone will not work for a lot of patients with more severe acne/oily skin, for which they may require laser treatments to shrink oil glands or take oral isotretinoin for control of severe acne.

© 2017 Dr. Teo Wan Lin. All rights reserved.

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Dr. Teo Wan Lin is a leading dermatologist in Singapore and also the Medical Director of TWL Specialist Skin & Laser Centre

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

Top Eczema Tips & Treatment by a Singapore Dermatologist – Eczema…Staying free of this treatable condition at any age

December 16, 2016

By Dr. Teo Wan Lin, Consultant Dermatologist at TWL Specialist Skin & Laser Centre

What causes eczema in children?

Eczema is primarily due to a defect in the skin barrier, which is genetically determined. It can be made worse by skin irritants, allergies, environment and stress.

Is eczema hereditary?

Definitely. If one or more parents suffer from eczema, the child is also more likely to develop the condition.

What should parents look for when trying to detect the onset of eczema?

Eczema typically starts as an itchy, dry skin condition in the first year of life or later. Parents may notice red, scaly patches occurring on areas such as scalp, face, chin, body, arms, legs or knees. Children may rub themselves against bedding to relieve themselves of the itch. This could be severe because it will interrupt children’s sleep at night.

Are food and allergies always linked?

Food does not cause eczema. However, some studies show that children below the age of 4 may find that certain foods worsen the condition of eczema. It is important to consult with your child’s dermatologist before excluding food from your child’s diet as children need a balanced diet . Only children with established food allergies will find that certain food can aggravate their eczema condition.

What should children with eczema refrain from doing?

Instead of scratching, children should be taught to pat their skin. At the same time, they should also keep the skin properly moisturised, keep their fingernails clipped and wear cotton gloves to bed. They should also wear clothing of light, breathable material such as cotton to sleep.

How should parents shower their child with eczema?

It’s best to use soap-free cleansers or bath oils. Try to avoid soaps containing sodium laureth sulphate as it contains a lathering agent that can irritate and dry the skin even more. Parents should also avoid abrasive materials such as loofahs or wash clothes.

The shower is preferably kept short, using lukewarm rather than hot water. After the shower, pat the skin dry with a towel and use moisturiser liberally when the skin is slightly damp.

After showering, diligent moisturising with a ceramide-based moisturiser such as the Multi-CERAM is also an important part of eczema management, in order to replenish ceramides naturally found in the skin (but deficient in diseased skin) and support restoration of healthy skin barrier function.

When do parents need to bring their child to a dermatologist?

Eczema at any age needs to be treated, ideally by a dermatologist. In the situation when eczema gets out of control, such as when the itch significantly affects the child’s daily activities. If the skin is infected — red with pus oozing out or if the child is unwell — then it will be necessary to seek medical attention.

I heard eczema cannot be cured, is that true? 

The root cause of eczema is in the genetics, which cannot be changed. With better understanding of eczema these days, it can be fully treated and controlled by a dermatologist. Topical steroids are of paramount importance when reducing inflammation caused by eczema.

Are there any side effects of steroid treatments?

If steroids they are used inappropriately, they can cause skin thinning, which is cosmetically disfiguring. There is also a phenomenon called tachyphylaxis, which is when normal steroids lose their effects, and stronger steroids are required instead.

However, if you are getting your eczema treated by a qualified medical professional, the correct dose, potency, duration and class of steroid will be given — appropriate to your child’s eczema depending on the location, age group and severity of eczema.

© 2017 Dr Teo Wan Lin. All rights reserved.

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Dr. Teo is an accredited dermatologist at TWL Specialist Skin & Laser Centre who is well-versed with childhood eczema. She has been interviewed on the topic by Singapore magazine, Motherhood, and Singapore news channel, Channel NewsAsia

To book an appointment with Dr. Teo regarding your child’s eczema problem, call us at+65 6355 0522, oremail appt@twlskin.com. Alternatively, you may fill up our contact form here