Tag Archive: scar treatment

Keloid Treatment, Symptoms, and Causes

June 1, 2021

A keloid is a smooth, raised scar that is generally larger than the original injury and darker than the surrounding skin. An estimated 10% of people will experience keloid scarring. Due to their raised appearance, they are some of the most conspicuous types of scars, which might pose a challenge to minimize. In this article, we will discuss keloid treatment options, what they usually look like, as well as their causes.

What is a keloid?

Keloids form when there is an overgrowth of fibrous tissue (scar tissue) on the skin, presenting itself as a raised scar. When the skin tissue is damaged, scar tissue will develop above the wound to repair the injury. 

What do keloids look like? How do I know if I have a keloid? 

keloid treatment

Credit: American Academy of Dermatology Association

Keloids may vary in shapes and sizes. If it’s on the earlobe, it mostly presents itself as a round, solid mass. When it develops on the shoulders or chest area, the keloid is likely to be spread out across the skin. To identify a keloid, they usually feel painful or itchy and begin as a pink, red or purple scar raised above your skin. In some cases, if this scar covers a large area on the body, it may decrease an individual’s mobility at that certain body part.

Once you see a keloid, it tends to grow slowly. Most continue to spread for weeks and months. They can become increasingly irritated, itchy or painful when rubbed against your clothes. Additionally, keloids may become darker with time – the border is usually darker than the center.

How do people get keloids? 

Keloids are classified as a type of tumor, but not malignant. Surprisingly, they can develop from the most common types of skin injuries such as acne scars, burns, chicken pox scars, piercings, vaccinations as well as surgical incision areas. Keloid scarring can also stem from genetic factors, which means a child has a higher risk of getting it if either parents have them. They are also more likely to develop on people of darker skin colours as compared to those with lighter skin tones. Therefore, researchers believe that this scarring may be linked to a gene related to dark skin pigment. 

Keloids on a man’s chest. These keloids appeared slowly after severe acne cleared.
Credit: American Academy of Dermatology Association

Keloids vs Hypertrophic scars

It is not uncommon that some people confuse keloids with hypertrophic scars. Unlike keloids, hypertrophic scars are smaller and flatter, and the colours can range from pink to brown. They can also fade or go away over time, but keloids are not able to. Causes of hypertrophic scars are similar to keloids, such as piercings. Initially, they can be itchy and painful but symptoms will alleviate as the skin heals. 

Do keloids go away? What are the keloid treatment options available?

Unfortunately, keloids are considered quite difficult to get rid of and even if they are treated, there are chances of them resurfacing again. However, the success of keloid treatment can vary, and it is advisable to seek a dermatologist to help develop a treatment plan to best suit the removal of keloid scarring. 

Steroid Injection or Cream

These are also known as intralesional injections, which involves injecting steroids directly into the scar tissue in order to reduce its size. This keloid treatment method is one of the more common approaches, however, it is important to note that 50-80% of keloids reform after this treatment. Steroid creams are also an alternative. According to studies, there is a 9-50% chance of the scar resurfacing. 


Cryotherapy, also known as cryoablation, refers to the use of extreme cold to freeze and remove abnormal tissues. This treatment method involves freezing off a keloid scar, and is generally more successful for smaller scars.

Surgery and Radiotherapy

Surgery is usually the last resort for keloids treatment, mainly because it may cause a larger scar to develop. Radiotherapy can aid in decreasing the size of the scar and also produces much better results if it occurs after surgery. 


This keloid treatment is non-abrasive and is a type of superficial radiation therapy and is significantly effective in getting rid of keloid scarring, with a success rate over 90%. Performing surgery will still lead to keloids growing back eventually but with the SRT-100TM, there is a less than 10% chance of the regrowth. The mechanism behind this is that keloid cells are destroyed, which allows low chances of resurfacing. Due to its high success rate, it has been described as The Keloid Cure and is also approved by the FDA. 

Prevention of Keloids 

Prevention methods include avoiding piercings, cosmetic surgeries and tattoos and adopting proper wound care habits. Practice proper wound care by washing the injured skin area immediately using soap and clean water, followed by using a sterile gauze to cover up and bandage the affected area. Do visit an accredited dermatologist, for advice on your keloid scarring. 

Have a keloid concern? Book a TeleConsultation, with MOH accredited dermatologist, Dr. Teo Wan Lin, to have your condition addressed. Click on bottom left button to contact us or simply click here to book an appointment now.

Copyright © 2021 TWL Specialist Skin & Laser Centre. All rights reserved.

Hair Loss Shampoo for the Scalp Microbiome

December 10, 2020

Hair loss (alopecia) can be a major source of distress and is a common problem.

In this article, we’ll go through common causes of hair loss, including facts about the hair cycle, what constitutes a good hair loss shampoo, and all about the scalp microbiome. We will also share an excerpt from Haircare Bible: A Dermatologist’s Tips on Haircare and Hair Loss by Dr. Teo Wan Lin, Dermatologist at TWL Specialist Skin & Laser Centre

The Hair Cycle

Normal hair grows through a hair cycle that has three stages. The growth phase, or anagen phase, is the longest phase of the hair cycle, with 80 to 90% of the hair on our scalp in this phase. In the next stage called the catagen phase, the hair bulb detaches from the blood supply and is pushed from the scalp. In the last stage, the telogen phase, shedding occurs as the hair is released, leaving behind an empty follicle.

Each hair follicle is independent, going through the cycle at different stages as the other hairs. Hair problems occur when there is a disruption in the hair cycle.

What are the causes of hair loss?

Hair loss can be caused either by an isolated problem or a combination of factors including genetics, chronic medical diseases such as a thyroid problem or underlying anemia (low blood count), poor nutrition, etc.
Chemical treatments performed in hair salons, such as hair dyes, bleaching, perming and rebonding hair, can cause a form of hair loss from breakage of the hair shaft.

In the hospital setting, patients undergoing chemotherapy usually suffer from a form of temporary hair loss, caused by the hair follicles entering into the resting phase whereby they are shed.

Namely, as our hair growth cycle goes through 3 main phases — active growth caused by anagen, transitional growth caused by catagen and inactive growth and shedding caused by telogen — an impact in any of these stages caused by the abovementioned factors can lead to loss in hair density due to less hair on the scalp present in the growth or anagen phase.

Hair loss shampoo

What constitutes a good shampoo?

Caring for one’s hair is just as important as caring for one’s face, but often gets less attention. Understanding what constitutes a good hair loss shampoo is an important part of making sure your hair stays healthy and voluminous.

To help you navigate the world of shampoo products, we introduce you to the basics you need to know.

How should a shampoo function?

A shampoo is a viscous liquid (liquid with texture that tends to be thick). Its primary purpose is cleansing the scalp and hair of dirt, sebum, sweat, dead skin cells and environmental pollutants. It does so by dissolving oil-soluble dirt, which is water-insoluble and hence, cannot be removed by solely rinsing with water. A hair loss shampoo should also remove greasy residues from hair care products such as oils, gels and sprays. The overall effect is that of cleansing to maintain a good hygiene level to reduce the chance of scalp irritation, inflammation and odour.

While most shampoos can accomplish a thorough cleanse, the real challenge lies in removing just enough sebum to allow the hair to be clean without drying it out.

This explains why most shampoo formulations have a secondary function of smoothing the hair’s surface and imparting lustre, smoothness, buoyancy and volume.

Certain types of hair loss shampoos also treat the scalp with medicated ingredients, such as those targeting dandruff, a common scalp disorder caused by a yeast known as Malassezia.

Hair loss shampoo: Copper Peptide Hair regrowth deep cleanse shampoo

The Copper Peptide Hair Regrowth Deep Cleanse Shampoo is formulated for hair loss and sensitive scalps. It has degreasing, soothing, and anti-hairloss effects. It also contains amino acid surfactant for sensitive scalps, zinc pyrithione for anti-dandruff action, and copper peptide for healthy hair growth.

Types of surfactants

A surfactant is often amphiphilic, meaning its molecules contain both lipophilic (oil-attracting) and hydrophilic (water-attracting) parts. The oil-attracting parts bind to sebum while the water-loving sites parts to water. Such a mechanism allows sebum to be removed when in contact with water.

The type of surfactants used in hair loss shampoos is classified according to their hydrophilic polar group. The four common categories of shampoo surfactants are anionics, cationics, non-ionics and amphoterics. Most shampoo formulas rely on two types of surfactants.

The surfactant listed first in a shampoo’s ingredient list denotes the primary cleanser and also the ingredient in the highest concentration. The surfactant listed second is the secondary cleanser; this is often added to offset the weaknesses of the first surfactant.

Anionic surfactants
Anionic surfactants are named for their negatively charged hydrophilic (water-loving) parts. Derived from fatty alcohols, they are good at removing sebum from the scalp. However, excessive cleansing with anionic surfactants leaves the hair harsh, rough, dull, frizzy and prone to tangling. Examples include sodium laureth sulfate, ammonium laureth sulfate, sodium lauryl sulfate, and ammonium lauryl sulfate.

Cationic surfactants
In contrast to anionic surfactants, cationic surfactants have a positively charged element. Cationic surfactants are poor cleansers and do not lather well. They are also not compatible with anionic surfactants. However, they are excellent at keeping chemically damaged hair soft and manageable. As a result, shampoos for damaged or coloured hair often include cationic surfactants. Examples include long-chain amino esters, ammonioesters, and cetyltrimethylammonium chloride.

Amphoteric surfactants
With both positively and negatively charged groups, amphoteric surfactants foam well and condition the hair. They help with the formation of micellar emulsion, improving the lathering ability of the shampoo, resulting in a thick liquid which is efficient to use. In addition, they do not cause stinging in the eyes and are gentle on the skin/scalp barrier, making them ideal for mild shampoos. Examples are cocamidopropyl betaine, sulfonate betaine, amphoteric acetate/diacetate.

Nonionic surfactants
Nonionic surfactants do not have a charged group and hence are compatible with any surfactant. Nonionic surfactants are the mildest type of surfactant. Such surfactants are often used in baby shampoos. Examples are fatty alcohol ethoxylates, cocamide MEA, sorbitan ether esters, and alkyl polyglucosides.

The Scalp Microbiome

The scalp is one of the thickest parts of the skin on the body, with on average about 100,000 hairs growing on it at a given time. It high production of vitamin-rich sebum (oil) and an unusually humid environment, which gives rise to microbes and microorganisms that aren’t found on any other part of the body. 

The scalp microbiome is the balance of healthy microorganisms that work together and contribute to our scalp health. Just like our skin microbiome, if the delicate microbiome is thrown off balance, skin conditions can develop, causing symptoms of flaking, itching, and irritation.

Keeping the scalp microbiome health: Shampoo 

Research has shown that zinc pyrithione medicated shampoo is a safe and effective way to treat dandruff. By fighting off Malassezia, it is a beneficial way to restore the health of your scalp microbiome. 

The Copper Peptide Deep Cleanse Shampoo contains amino acid surfactant for gentle cleansing of sensitive scalps,  zinc pyrithione that has anti-dandruff properties, and copper peptide that helps to promote healthy hair growth.


Dermatologist’s Expert Guide to Acne Scars Treatment

October 3, 2017
Acne Scars Treatment by Dermatologist

What is Acne Scars Treatment?

Acne Scar Treatment is a series of refined dermatological techniques which are performed on a patient to improve the appearance of his/her skin and to boost his/her self-esteem.

Who is Acne Scars Treatment for?

Acne Scar Treatment is for those with deep permanent scars such as pitting or crater-like scars caused by severe acne.

What are the types of Acne Scars Treatment available?

Based on the nature of the scarring by acne, the patient’s medical history, the dermatologist will choose a technique or combination of treatment that is most suitable for the patient. The below-mentioned techniques and procedures are commonly used to in improving acne scarring.

  • Laser Therapy: By delivering short pulses of the laser beam, dermatologist are able to smoothen, sculpt and normalize the appearance of acne scars. The non ablative and ultrapulse carbon dioxide lasers are commonly used for treating acne scars.
  • Chemical Peel: By applying a chemical solution to the skin, mild scarring and comedogenic acne can be treated. It also improves your skin tone and reduce pore size.
  • Excision and Punch Replacement Graft: By surgically removing a depressed acne scar and replacing it with a patch of skin from elsewhere on the patient’s body, excision and punch replacement graft can improve acne scarring.
  • Soft tissue fillers: By injecting a small quantity of hyaluronic filler or a patient’s own fat, taken from another part of the body, below the surface of the acne scarred skin, these soft tissue fillers are able to elevate depressed scars.
  • Adjunct Cosmeceutical Treatments: The use of skincare with bioactive ingredients targeting the healing of scars such as oligopeptides which enhances collagen growth, can help maximise the benefit of Laser and Chemical Peel treatments. These treatments does controlled damage to the epidermis and stimulates collagen growth to heal scars. The Elixir-V Serum for example, which is infused with oligopeptides and potent antioxidants, is frequently used by our patients as adjuncts during acne scar treatments.

© 2017 twlskin.com. All rights reserved.


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

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