Tag Archive: Oily skin

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.

Fighting back and chest acne

December 10, 2018

When it comes to acne, most of us tend to think of facial acne – the most visible form of acne vulgaris. Back and chest acne, or truncal acne, is often overlooked even though more than half of people with facial acne can also have truncal acne. Further, acne on any part of the body can impact one’s self-esteem, body image or self-confidence.

What causes truncal acne?

Truncal acne develops in a similar way to facial acne. Major causes of acne include excess sebum secretion, abnormal desquamation (shedding) of skin cells, the presence of the bacteria Propionibacterium acnes (P.acnes), and inflammation. These elements can be found as much on the back and chest as on the face.

Genetics is also a crucial component. Your genetic disposition can influence the formation of comedones or the way your body responds to the P. acnes on your skin.

Acne forms when abnormal desquamation of epithelial cells causes sebum and keratin to accumulate and block hair follicles. This creates comedones – either open blackheads or closed whiteheads.

An increased production of sebum also creates an ideal environment for P.acnes to thrive, especially during puberty when oil glands are excited by hormones called androgens. The activated oil glands produce inflammatory factors, such as cytokines, that increase the skin’s inflammatory response.

Your back, shoulders and chest are also more prone to acne mechanica, meaning acne caused by the pressure, occlusion, friction or heat of clothing or physical activity. Sports equipment, such as shoulder pads and tight straps, can further exacerbate acne. Sweaty clothing traps sweat, oils and substances that support the growth of  P. acnes. As a result, be sure to change out of sweaty clothing after a workout or seek shade when the sun is at its strongest.

How can I treat truncal acne?

First-line therapy for truncal acne should always be a combination of a topical and antimicrobial treatment to reduce the risk of bacteria resistance. Treatment lengths should also be kept as short as possible – to a three to four month course – and cautiously managed by an accredited dermatologist.

Topical treatments

  • Benzoyl peroxide: Decreases inflammation and abnormal desquamation. It also contains anti-microbial properties that kill bacteria, but can bleach clothing and bedding. As such, it may be less desirable for treatment of truncal acne
  • Retinoids: Reduce comedonal formation, expel mature comedones and exert anti-inflammatory effects.
  • Antibiotics e.g. erythromycin, clindamycin: Reduce the proliferation of P.acnes but are not recommended to be used as the only form of treatment due to the risk that bacteria will grow resistant to the effects of medication.
  • Azelaic acid: A newer form of treatment that has three pharmacological effects: anti-inflammatory, antimicrobial, and stabilizing on abnormal desquamation. Above all, azelaic acid also fades post-acne marks by inhibiting the release of tyrosinanse, an enzyme that controls the production of melanin.

While skin on the body can withstand acne medication that may be too irritating on facial skin, they can be harder to apply on the back. Also, skin on the body is thicker than the face and may respond more slowly to treatment.

Oral antibiotics

Antibiotics work to limit the proliferation of P.acnes, which makes them useful in treating moderate to severe acne.

Hormonal therapies

Oral contraceptives work to reduce androgen levels, which in turn decreases sebum production. Oral contraceptives are effective against inflammatory acne in females. Patients who do not mind being on contraceptives can consider this treatment.

Oral isotretinoin

Isotretinoin is a form of oral retinoid that is effective against severe. It helps to decrease sebum production, bacterial proliferation, inflammation and abnormal rate of skin cells shedding.

However, isotretinoin can have severe side effects.  It can disturb the development of a fetus and cause birth defects if the mother is taking it at the time of conception or during pregnancy.  Other potential side effects include mood changes, liver damage, or fluctuations in lipid levels. As a result, this medication should be cautiously managed by a dermatologist.

Cleansing

Proper cleansing should also follow alongside other treatment therapies. Dr. TWL’s Miel Honey™ Cleanser is a dermatologist-formulated cleanser ideal for acne-prone skin and uses medical grade honey as an anti-bacterial and anti-inflammatory agent. A gentle cleanser that lathers up from botanical emulsifiers, the foam produced is generous and refreshing on the skin.

Cosmeceuticals

Truncal acne patients can also consider cosmeceuticals as part of their treatment. Cosmeceuticals are cosmetic products that contain active ingredients that deliver medical benefits to the skin. Vitamin C, in particular, works as an antioxidant that helps clear the skin of inflammation. Another botanical to consider is Arnica Montana flower extract, which is especially beneficial for acne-prone skin as it stabilises inflammation and reduces skin flaking.

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

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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.

 

 

 

Stressing Out Can Aggravate Your Acne – Here’s How

October 22, 2018

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

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

Stress induces excessive oil production

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

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

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

Stress delays wound recovery

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

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

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

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

Stress promotes habits that aggravate acne

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

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

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

How to lessen the impact stress has on your skin?

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

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

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

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

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

A Dermatologist’s Guide to Oily Skin and Acne in Singapore

April 13, 2018

 

One’s skin type is largely determined by the genetics of an individual.

The production of oil itself is genetically determined – if one has a family history of having oily skin, it is very likely that one would develop it as well, as this is directly linked to the production of androgens such as the male hormone testosterone at the onset of puberty which affects both males and females. Based on the proportion of patients at the clinic, there is a significant population of people with oily skin types in Singapore. This is because of overactivity of the sebaceous glands which are concentrated over the forehead nose and the chin area, but can also occur on any part of the face, as well as including the chest and back which are also the areas more acne-prone. Although further research needs to be done to prove the common belief that a humid climate like Singapore results in oily skin, what we do know is that climate changes can have an adverse impact on skin that is already diseased such as with underlying acne, facial eczema or rosacea which are the common skin conditions I see in my practice.

Problems associated with oily skin?

Acne is a major issue faced by those with oily skin. The cause of acne itself is multifactorial, involving primarily genetics which causes inflammation exacerbated by the production of oil often driven by hormonal factors, leading to the formation of whiteheads and blackheads. One of the ways of treating acne would include reducing oil production by the means of an oral medication known as isotretinoin or by physical methods, such as chemical peel microdermabrasion as well as laser treatments that will shrink the oil glands. To add clarity, while almost all acne prone patients have oily skin, this is not to say that having oily skin one definitely would suffer from acne.

Oily skin and ageing

One popular belief is that individuals with oily skin do not age as quickly. A desirable side-effect of oily skin perhaps? Or perhaps not.

Skin aging is due to a complex interplay of factors, with the key determining factor being a balance between one’s biology, influenced by genetics (have a look at how your parents are aging), as well as environmental aging, due to the exposure to ultraviolet rays, air pollutants, cigarette smoke as well as a stressful lifestyle. The key thing to note is that unhealthy skin ages poorly and much worse than healthy skin. In patients with facial eczema, for example, with dry dehydrated skin known as asteatosis, they are inherently unable to produce a fatty lipid known as ceramide, which helps to repair and restore the skin barrier. Without this, the skin is unable to protect itself from external allergens or changes in the environment and this can accelerate aging. Dehydrated skin has an unhealthy epidermis and dermis. As a result, this can accelerate aging in the form of wrinkles as well as the loss of volume.

If one has oily skin, the production of oil can form a barrier between the skin and the environment and this is a sort of protection which reduces the formation of fine lines and wrinkles or what cause free radical formation. Nevertheless, if one has an underlying skin condition such as scarred skin due to previous cystic acne, it doesn’t matter that your skin is oily, one would expect skin aging to progress faster than in a normal individual.

There is a study which shows that people with oily skin tend to look younger than their counterparts and this is well-proven in clinical practice. However, I would say that striving to have oily skin is actually not desirable, especially in a very humid climate like Singapore, as a shiny complexion could be quite embarrassing. Long-term overproduction of oil due to overactivity of the sebaceous glands can also lead to irregular skin texture and enlarged pores.

It is best to strive for healthy radiant skin that is well moisturized but not oily. There is a difference between moisturizer and oil, as I have seen many patients with nodular cystic acne and oily skin who also suffer from facial eczema which is dry dehydrated skin. Well moisturized skin is smooth and radiant, and looks healthy – a key component of the skin’s moisture is from molecules such as ceramide and hyaluronic acid which is an abundant water molecule in the second layer skin known as the dermis.

It is a myth that people with oily skin don’t really need moisturizer. In fact, you could have a lot of oil on your face and still have dehydrated skin that’s lacking in the key moisture molecules. Our patients who are on treatment for acne still use a good cosmeceutical moisturizer to lighten their scars, as well as Vitamin C and Hyaluronic acid serum that can restore the correct moisture balance in their skin to prevent excessive oil production known as reactive seborrhea. Reactive seborrhea occurs when one strips skin excessively of its natural oils causing the skin to produce even more oil.

Can someone with oily skin change to having normal skin with diligent skincare alone?

The amount of oil produced by an individual is genetically determined and influenced by the secretion of one’s hormones. It is however possible with proper long term cosmeceutical skincare, that one’s skin becomes adjusted in terms of restoring the normal moisture level.


Using improper skin care such as harsh oily-skin cleansers may strip skin completely dry and this leads to a vicious cycle known as reactive seborrhea.

The key ingredient involved in restoring skin moisture and not oil, is firstly a pure concentrated form of topical hyaluronic acid in our skin care. According to Dr Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin and Laser Centre,  “We use a 1% concentrated hyaluronic acid serum freshly-compounded for optimum absorption in a pharmaceutical setting. This is easily a hundred to a thousand times higher than the concentration available in cosmetic skin preparations boasting the same ingredients. Regular use of topical hyaluronic acid has the effect of visually filling and plumping up the dermis (the second layer of skin which tends to sag with dehydration and aging), leading to a poreless, even complexion”

In terms of cleansing, I would recommend using an antibacterial foaming cleanser. The honey cleanser is formulated to remove grime, oil, bacteria and other surface pollutants that tend to settle on the skin at the end of the day. The nature of oily skin is that it tends to be a breeding ground for bacteria as well as a certain type of yeast known as malassezia which thrives in a humid climate like Singapore. This is a non-chemical form of an antibacterial and antiseptic wash, using natural medical grade honey which helps in reducing the amount of grease on one’s face. As honey is a natural humectant, it traps moisture under the skin while cleansing. It thus helps to moisturize the skin and regulates the balance of the oils as well as health of the skin.

For a targeted approach, treating oily skin – medically known as Hyperseborrhea, a visit to a dermatologist is recommended. This would typically involve counselling on the use of appropriate cosmeceuticals as well as a retinoid which can regulate oil production. Our patients would also undergo chemical peels (glycolic, lactic and salicylic acid peels) in combination with laser treatments that can help to shrink the oil glands and reduce oil production. From then on, once the amount of oil production is reduced, it is easier to maintain with topicals alone.

A skincare regime for oily skin

There is a recipe for healthy skin in the same way one is careful to have a healthy diet and lifestyle to prevent illness, rather than change one’s diet only after one gets sick. Whether or not you have dry, oily or combination skin, there is really skincare that is suited for you and the answer lies in dermatologist-tested cosmeceutical skincare. Cosmeceuticals are researched to include potent bioactive ingredients formulated to prevent the onset of aging, as well as to deliver nutrients to your skin.

Such a skincare regimen, is likened to a healthy diet that will prevent skin problems from developing later. If you have an underlying skin condition, cosmeceutical skincare can
also reduce the severity of acne and facial eczema. So it is indeed true, at least for cosmeceutical skincare, that there is a one-size-fits-all for all types of skin, as a recommendation for the basic healthy diet of skin.

The key conundrum in skincare that has been plaguing dermatologists in the last 50 years was really that the dermatologist-tested skincare (which is compatible with aging problem skin types) we advocated for our patients did not provide additional cosmeceutical benefits. These women then went looking for over-the-counter cosmetics skincare which promised them anti-aging, but clearly not without the irritation and side effects. Then the dermatological community turned its attention to clinically proven anti-oxidants in skincare and showed that cosmeceuticals were valid and important in the treatment of aging skin to restore skin health. The advent of cosmeceuticals promises the same level of non-irritating gentle skin cleansing and moisturizing, with all the power molecules antioxidants which can lighten scars, brighten your complexion and retard aging. What’s there not to love?

© 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.

Find Out If Men’s Skin Is Really Different from Women’s Skin

April 8, 2018

Most males are not that into cosmeceuticals. That is skincare with medical or drug-like benefits to improve skin health. Cosmeceuticals have a more relevant function than coloured cosmetics. Men have traditionally been uninterested in skin appearance, and only think of skincare as necessary when they face a specific skin concern – acne, oily skin, wrinkles or other topical skin conditions. Yes, using targeted skincare products are likely to help with these isolated issues, but having a daily skincare regime in place can avoid them completely.

Most skincare products used by men are likely to be purchased by women, even though most are unaware that male cosmeceuticals are distinct from those that females use. Many of the male products are created to address male facial hair, such as preshave treatments, shaving products and post-shave skin care. Yet, men’s skin is structurally different from females and knowing these differences can be a good place to start your skincare journey.

Oil control

Sebum production is also greater in males, this is mostly due to testosterone secretions. This can mean longer-lasting acne for men. The oil glands on our skin are more receptive towards testosterone, so it is no coincidence that we see males having oily skin more often than females.

Collagen content

We see signs of our skin ageing such as wrinkles and sagging skin as our collagen content decreases as we age. After our thirties, both men and women start to lose one per cent of our collagen each year. But for women, this loss escalates greatly in the first five years after menopause, explaining for why women experience skin ageing faster than men do.

Thickness of skin

Male skin is typically 20 to 30 per cent thicker than that of females. The presence of testosterone accounts for this difference. A man’s skin will continue to thin gradually with age, while a woman’s skin will only thin significantly after menopause. With a higher collagen density which is the ratio of collagen to the thickness of the skin, it explains why men tend to age slower than women of the same age. However, this difference may not be readily noticed as men are less active in protecting their skin from sun damage. The lack of habit in using sunscreen would allow UV radiation to add years to the skin.

That being said, the importance of sunscreen should be emphasized. The skincare product that we should all have is really the sunscreen. We know we are nagging, but please put on your sunscreen.

The skincare regime of male usually fits into either one of these options. They could be either be using soap and water only, or products that are targeted to men, or cherry pick a product from their partner. There are several main concerns with these options. Cherry picking products would likely result in using something that is not suited for men skin. Using gender-focused products may also not be effective as manufacturers typically employ stereotypes to target shoppers. Lastly, common soap and water are never sufficient for facial cleansing, simply because it causes your face to go into an alkaline state that can result in dryness (your skin should ideally be slightly acidic, at about pH of 5.5). Washing with a bar soap can pull all the water out of the skin, leaving your skin dehydrated and a buildup of dead skin cells.

Most men hope to have clean, fresh, clear and smooth skin. And the preferred approach to achieving healthier skin is to have minimal steps in their skincare routine. An ideal skincare routine should begin with a proper cleanser. (No soap and water, please!) Use a pea-sized amount of Miel Honey™ Cleanser and work it into a lather over the entire face. This is to facilitate the removal of sebum and debris. Use cold water as heat can be irritating to the skin. The lather from the Honey Cleanser also doubles up as a “shaving lotion”, lubricating the shave with anti bacterial Honey which thoroughly cleanses the skin without over-drying the jaw line shave areas that could be especially sensitive and prone to acne breakouts!

Sun exposure can damage your DNA, and cause wrinkling and skin cancer. Add SunProtector™ to your routine for daily application. With an SPF value of 50, it is sufficient to safeguard the skin from free radicals and keep it sun damage-free. UV radiation is a common culprit that compromises our skin’s integrity and can lead to sensitive skin or dryness. Developed in a research laboratory, this sunscreen is also formulated in-house for Singapore’s humid climate, so rest assured and lather on.

Keep your face moisturised with Radiancé Fluide™ Hydrating Emulsion. As you age, your skin cells will start losing the ability to retain as much moisture as before, as collagen levels decline over time. Deliver essential nutrients such as amino acids and oligopeptides to your skin with this moisturiser to keep your skin bright and healthy.

© 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.