Tag Archive: hormones

How to reduce stretch marks

February 24, 2019

 

Stretch marks are extremely common. Yet, those squiggly lines on your skin are never welcomed. While such forms of dermal scarring are not medically dangerous, it can be aesthetically unpleasant to patients, causing distress.

Common occurrence of stretch marks includes the thigh, buttock, lower back, chest, upper arm and knee. Striae rubrae and striae albae are the two recognizable forms of stretch marks. Striae rubrae are flesh-toned scars, often accompanied by redness and ruptured capillaries that cause a subtle violet appearance. They then progress to striae albae – silvery, wrinkled scars that are hypopigmented (lighter than your usual skin colour).  

What causes stretch marks

Stretch marks, or striae distensae, occur typically during pregnancy, puberty, obesity or certain medical conditions e.g. Cushing syndrome. Other triggers include endocrine imbalance (a type of hormone), extended periods of mechanical stretch or any structural changes to the skin can lead to stretch marks. Chronic use of oral or topical corticosteroids can also contribute to the development of stretch marks.

Stretch marks are formed via three main mechanisms:

  1. Genetic predisposition
  2. Hormonal disorders
  3. Mechanical disorders/stretching of the skin

Genetic predisposition

No specific gene has been isolated as the cause of stretch marks developing. However, stretch marks have been identified among identical twins, families and inherited genetic skin conditions. This suggests genetic predisposition, that certain individuals may have a greater tendency of developing stretch marks based on their genes.

Hormones

A hormonal imbalance can contribute to the development of stretch marks. A hormone called adrenocorticotrophic causes an increased rate of protein breakdown. In turn, this leads to less collagen and elastin fibres being produced. With less collagen and elastin, the skin is less flexible and resilient to withstand stretching, causing stretch marks.

This effect is similar to that caused by corticosteroids, which explains why patients on long-term use of the drug are more prone to developing stretch marks.

Mechanical stretch

Rapid expansion or contraction of the skin causes it to stretch beyond its usual elastic ability. Fibres in the middle skin layer (dermis) stretch to accommodate when growth is slow. But with sudden stretching, the dermis may tear, causing the deeper skin layers to be seen and forming stretch marks.

In pregnancy, stretch marks frequently appear in the third trimester.

How to treat stretch marks

Topicals:               

Topical treatments only have mild effects in reducing appearance of stretch marks. Still, many patients prefer non-laser approaches, thus topicals remain as a common approach.

  • Tretinoin: Boost fibroblast production. Fibroblasts are molecules responsible for the structural support in our cells and synthesize collagen. Best for striae rubrae (for newly developed stretch marks), poor for striae albae (stretch marks that have been around for some time).
  • It is not recommended to use tretinoin during pregnancy as it carries a risk of birth defects
  • Phytochemicals: Plant extracts such as Centella Asiatica can boost the cells that produce elastic fibers and collagen. Resveratrol, naturally occurring in grapes and berries, can also boost skin elasticity. Elixir-V™ Total Recovery Serum contains a potent combination of phytochemicals, including resveratrol, to help fight ageing effects
  • Moisturizers: They can be applied as an adjuvant to treat stretch marks. Look out for moisturizers with active ingredients such as niacinamide. Apart from its brightening abilities, niacinamide stimulates collagen synthesis. You may consider Radiance Fluide™ Hydrating Emulsion, a dermatologist-designed lightweight moisturizer formulated with niacinamide.

While ingredients such as cocoa butter or olive oil are commonly marketed as effective in reducing stretch marks, it has not been scientifically proven to show results.

Chemical peels: They help to induce the production of collagen and improve the appearance of stretch marks. Salicylic acid, lactic acid and glycolic acid are most commonly used.

Microdermabrasion: In this process, physical agents such as aluminium oxide is used for skin resurfacing. A targeted injury is caused to trigger collagen production and to deposit elastin. Topical therapies are also more effective after microdermabrasion, as your active ingredients can better penetrate the dermis layer.

Light therapy: Different types of light treatment are available to stimulate collagen production in the dermis layer. Examples include infrared light devices, intense pulsed light (IPL) and ultraviolet light.

Ablative lasers: Such lasers are effective in reducing scars as they create a deliberate wound to induce healing of the skin.

Stretch marks are not medically dangerous, but if you are seeking for an effective treatment, it is best to consult an accredited dermatologist for best results.

© 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.

 

Tackling oily skin

January 1, 2019

Are you tired of your skin getting greasy midday? Oily skin is a common cosmetic problem that gives the appearance of shiny skin. While there is no way to prevent it, there are certain techniques that can help fight it.

What causes oily skin?

We begin by understanding the oil, or sebaceous, glands on our face. These glands release a complex mixture of lipids (fats) onto the skin surface called sebum. Oil glands are highly concentrated on the face, upper chest, back and behind the ear. An excessive volume of oil glands is the main cause of oily skin.

Androgens

Our oil glands are stimulated by a hormone called androgen to produce sebum at puberty and beyond. The enzyme that catalyses androgen to its most active form is also found in higher concentrations in oil glands as compared to other skin parts.

At various life stages, your body experiences changes in androgen levels. This explains why you do not have oily skin all your life. Oil glands are present at birth but sebum production remains low until puberty when it increases exponentially. Sebum secretions are typically the highest among 15-35-year-olds and decline gradually afterwards. They stop after menopause for women, and for men in their sixties or seventies.

At any age, men are more likely to suffer from oily skin than women. This is because men have higher sebum production levels mostly due to testosterone secretions.

Diet

A diet rich in carbohydrates and a high glycemic index is associated with high insulin levels. Example of high glycemic load foods is sugary foods, white rice, white bread, and potatoes. Low glycemic load foods include fruits, legumes, soy products and porridge.

Insulin stimulates oil glands to produce more lipids. Switch to a low glycemic-load diet for an improvement in insulin level, which can, in turn, keep your oily skin in check.

Insulin levels typically peak during late puberty and gradually decline in the 30s, which explains why some of us develop oily skin at school.

Genetic disposition

Various genes control the activity of our oil glands. In most individuals, an overexpression of a gene called Smad7 leads to an increase in lipid synthesis. This means an individual with oily skin will not be able to eliminate the condition. However, with proper long-term cosmeceutical skincare, it is possible to have less oily skin.

Other factors

Temperature: Sebum production varies directly with temperature; an increase in 1°C leads to a 10% increase in sebum excretion rate. Unsurprisingly, summer is the season when our oil glands produce the most sebum. Hot, humid climates also cause skin to be oilier.

Cleansing habits: Using a harsh cleanser or over-washing to remove excess sebum can strip skin completely dry, leading to reactive seborrhea. This is a condition where the excessive skin drying is read by the body as a signal to produce more oil.

Treating oily skin

Retinoids: This vitamin A derivative helps reduce the growth of sebum-producing cells, decreases the size of oil glands and suppresses sebum production.

Hyaluronic acid: This moisture-binding ingredient delivers hydration to your skin and restores moisture balance. Ensuring your skin has sufficient moisture helps prevents your skin from producing excessive sebum. Hyaluronic acid also plumps up your skin for an even complexion.

Cleanser: Use a gentle cleanser, ideally an anti-bacterial one like Miel Honey Cleanser. Dermatologist-formulated for all skin types, even oily or acne-prone skin, this cleanser is effective in removing grime, oil, bacteria and other environmental pollutants without stripping the skin’s essential lipids off. With honey as a natural humectant, it also traps moisture under the skin while you cleanse.

Moisturizer: Individuals with oily skin may think their skin does not lack hydration. However, just because your skin has a lot of oil does not mean it has sufficient hydration. UV rays, environmental pollutants or harsh products can disrupt the skin barrier, affecting its ability to retain water. As a result, moisturizing regularly is an essential step.

If you have oily skin, look for a lightweight moisturizer. Radiance Fluide™ Hydrating Emulsion is an oil-in-water emulsion formulated for Singapore’s humid climate. An oil-in-water formula means small droplets of oil are dispersed in a larger volume of water. This gives a lighter texture compared to water-in-oil formulas where small droplets of water are dispersed in a larger volume of oil.

Oral isotretinoin

An oral retinoid has the greatest results in suppressing sebum production, often a 60 to 90% reduction. A significant consideration before starting on oral isotretinoin is teratogenicity though (ability to affect fetal development and cause birth defects at the time of conception or during pregnancy).

Oral retinoids are only available on prescription due to their side effects. For cautious management, always consult a dermatologist first.

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