Tag Archive: sensitive scalp

Itchy Scalp? The Microbiome May be the Cause

January 15, 2021

An itchy scalp, or scalp pruritus, is a common problem that can lead to symptoms such as frequent scratching or discomfort, scabbed or flaking skin, or redness on the scalp. 

In this article, we’ll cover everything you need to know about itchy scalp and its links to the scalp microbiome, including excerpts from accredited dermatologist, Dr. Teo Wan Lin. We’ll also cover how the scalp microbiome can lead to various hair conditions, and how to keep the scalp microbiome healthy.

What causes itchy scalp?

The cause of an itchy scalp is inflammation. Is it possible that itchy scalp leads to hair loss? The short answer is no. But the long answer is that if your itchy scalp is due to an underlying scalp condition such as seborrheic dermatitis, this can in the medium to long term, disrupt your hair cycle and cause more hair to fall our faster, and hair to grow at a slower rate due to the underlying inflammation. Associated scalp symptoms can include redness, sensitivity. Some individuals experience pain when they’re tying up their hair. All that has to do with increased activity of the immune cells around the area where there is inflammation.

Seborrheic dermatitis

The commonest cause of scalp inflammation in this part of the world, in tropical Singapore, is seborrheic dermatitis. Seborrheic dermatitis is due to an overgrowth of yeast organisms that are otherwise normal commensals, meaning that they are part of the healthy scalp microbiome. What happens in seborrheic dermatitis is that the scalp inflammation leads to symptoms of itch, flaking, redness, sensitivity.

Over a period of several months, or years, this can cause disruption in the hair cycle. 90% of our hair should be in the growing phase known as the anagen phase. When there is active inflammation such as in the case of seborrheic dermatitis, psoriasis, or eczema, the hair cycle may be disrupted and as a result, more hairs may enter into the telogen phase. This expedites the hair cycle process, leading to more hair that is falling out, and comparatively, less hair that is growing back to compensate for the amount of hair that’s falling out. 

Itchy Scalp? Copper Peptide Hair Regrowth Serum

The Copper Peptide Hair Regrowth Serum contains Copper tripeptide, a novel molecule that stimulates hair growth. Copper tripeptide is a potent antioxidant with minimal to zero risk of scalp irritation. It helps to maintain healthy, immunological function of the scalp, promoting beneficial scalp microbiome.

What is 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. 

A microbiome is a community of microorganisms that exist in one habitat, like your gut, skin and scalp. In order for a microbiome to function efficiently, it must maintain a balance of diverse microorganisms, with each contributing to the productivity of the habitat. 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.

How does the scalp microbiome affect hair conditions?

Research in the scalp microbiome has intensified in the last 3 years. In 2017 in a paper submitted to Experimental Dermatology, a group of researchers stated that there was a difference in the scalp microbiome in terms of the bacterial and yeast flora in individuals who suffered from dandruff, also known as seborrheic dermatitis, compared to individuals with healthy scalps. What that really means that there is a definite role in the balance that microorganisms play in our skin, and now our scalp, in order to maintain scalp homeostasis. Homeostasis is the state of balance that is required for our organs to function at their optimal states.

A disturbance in the scalp microbiome can be influenced by the environment, one’s personal genetics as well as hormonally influenced oil production on the scalp. In this situation, we should zoom in on the specific problems that are brought about by the imbalances of the microorganisms living on one’s scalp.

Dandruff

Dandruff is one of the most common scalp complaints. Flaking on the scalp and white scales found on one’s clothes are one of the first symptoms of dandruff. The term dandruff is lay speak for any form of scalp inflammation that causes the cell turnover rate on the scalp to increase abnormally. There are several medical conditions that can result in this, the commonest being the following: scalp psoriasis, seborrheic dermatitis and scalp eczema. 

Dandruff and Seborrheic dermatitis 

We have spoken about seborrheic dermatitis earlier, and how it can lead to itchy scalp and scalp inflammation. Additionally, seborrheic dermatitis could also be the cause of your recent dandruff outbreak. It mainly affects the sebaceous, gland-rich regions of the scalp, face, and trunk. Seborrhea or seborrheic dermatitis is a common, chronic or relapsing form of eczema/dermatitis. 

Dandruff, also known as pityriasis capitis, is considered to be an uninflamed form of seborrhoeic dermatitis. Scattering within hair-bearing areas of the scalp, dandruff of such presents as itself as bran-like scaly patches. 

The cause of seborrheic dermatitis is associated with the proliferative species of the fungus Malassezia. Its metabolites (such as fatty acids oleic acid, malassezia, and indole-3-carbaldehyde) may cause an inflammatory reaction. Therefore, there is a link between dandruff and the bacteria and fungi that grow on the scalp. 

The Copper Peptide Deep Cleanse Shampoo can help to overcome itchy scalp

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. 

Scalp folliculitis

Scalp folliculitis is an inflammatory disorder of the hair follicles in the scalp, also known as “acne necrotica miliaris” or “Proprionibacterium folliculitis”.

It is characterised by small, very itchy pustules on the scalp, often most troublesome on the frontal hairline. Depending on the severity, there may be only a small number or may appear as very numerous lesions. Due to the itch, they are hard to leave alone and overtime often become sore and crusted. 

Causes of scalp folliculitis

The cause of scalp folliculitis is generally considered to be an inflammatory reaction to components of the hair follicle, particularly the micro-organisms. These include:

●  Bacteria (especially Cutibacterium acnes, but in severe cases, also Staphylococcus aureus)

●  Mites (Demodex folliculorum)

●  Yeasts (Malassezia species)

An imbalance in these microorganisms can lead to an inflammatory reaction on the scalp, causing scalp folliculitis. 

To explain, Malassezia is the causative yeast organism belonging to the family of fungi that colonizes the scalp of individuals who suffer from seborrheic dermatitis. Chronic inflammation of the scalp’s follicles can lead to pimple-like lesions that can be painful, lead to deeper cysts, and even abscesses in a more serious type of scalp folliculitis known as dissecting folliculitis. These are typically associated with imbalances in the bacterial flora of the scalp. Research shows a link between scalp folliculitis and scalp sensitivity, as well as the sebum and bacterial imbalances. The microorganisms interact with environmental factors such as increased temperature, humidity, the presence of sweat in a genetically predisposed individual to create chronic inflammation. 

Keeping the scalp microbiome healthy

Shampoo

Research has shown that zinc pyrithione medicated shampoo is a safe and effective way to treat dandruff. Fighting off Malassezia can help to restore the health of your scalp microbiome. 

Hair serum

Use of antioxidants serums on the scalp can encourage healthy cell talk between the immune cells, and improve the ability of the scalp to fight off disease-causing bacteria and fungus. This also helps to maintain regular sebum production. Copper tripeptide is a potent antioxidant with minimal to zero risk of scalp irritation. It helps to maintain healthy, immunological function of the scalp, promoting beneficial scalp microbiome.

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Sensitive Scalp: Can it Cause Hair Loss?

December 29, 2020

Do you feel itching, tingling, pain and redness on your scalp? Does your scalp feel tight and itchy? If yes, you may have a sensitive scalp.

In this article, we’ll take you through the signs of sensitive scalp, and hair and scalp conditions linked to it, including excerpts from Haircare Bible: A Dermatologist’s Tips on Haircare and Hair Loss by Dr. Teo Wan Lin, Dermatologist at TWL Specialist Skin & Laser Centre.

Do I have a sensitive scalp or is it a symptom of another condition?

Do you have an itch, redness or pain on your scalp? You may have an undiagnosed inflammatory scalp disease. Scalp “sensitivity” without any underlying scalp condition is a very rare condition attributed to abnormal nerve sensations known as scalp dysaesthesia.

It is far more common to have an underlying cause such as seborrheic dermatitis, which is due to proliferation of a yeast known as malassezia furfur in an individual with excess production of oil. It is also more common in tropical and humid climates such as Singapore, as such climates encourage this yeast to grow. Otherwise, malassezia is an ordinary inhabitant of one’s skin and scalp.

Under normal conditions, it does not cause any issues. However, under humid and sweaty environments, this yeast can proliferate to cause scalp inflammation and flaking. If you have scalp flaking which does not respond to over the counter anti-dandruff shampoos, usually contain zinc pyrithione as an antifungal agent, promptly seek the care of an accredited dermatologist rather than self medicate or DIY.

Other causes of scalp inflammation would be scalp eczema due to excessively dry scalp/skin conditions, scalp psoriasis which may be the case especially if one has a family history of psoriasis or rashes on one’s body. If you have been in contact with a ringworm infected cat or dog, do have your scalp and skin checked by a dermatologist as these infections are contagious. They could also cause a form of scalp inflammation presenting as a red, scaly and itchy patches with hair loss.

The CUTISCOOL Hair Cap has specifically engineered thermal and cold therapy capacities that allows comfortable home use of effective heat treatment for sensitive scalps. When heated, it can increase absorption of cosmeceuticals. When chilled, the Hair Cap has an anti-inflammatory effect on the scalp.

Is my sensitive scalp causing hair loss?

Most cases of scalp inflammation due to eczema, seborrheic dermatitis, scalp folliculitis or psoriasis should not cause hair loss. However, severe inflammation can push the hair growth cycle into a stage of telogen effluvium which is when hair reaches the end of its cycle and falls out, similar to hair loss that occurs after a major illness or post-pregnancy. In addition, if one picks and peels off crusted areas over the scalp, this can also cause damage to the hair root and lead to hair loss.

The ORZAT4 InfusionTreatment Comb is impregnated with Sandalore® which has been scientifically proven to stimulate hair regrowth. This comb is designed to stimulate and support vigorous, healthy hair growth when used regularly.

There are other causes of hair loss such as alopecia areata, which is an autoimmune disorder causing one’s immune system to attack hair follicles, leading to hair loss. This usually has no symptoms other than the appearance of round patches of hair loss over one’s scalp. Scarring causes of hair loss include folliculitis decalvans, which is the end-stage of a type of scalp folliculitis, whereby the hair follicles themselves are constantly inflamed and infected. Children may be more susceptible to tinea capitis, which is a fungal scalp infection that can lead to scarring hair loss if untreated.

Copper peptide serum for sensitive scalp hair loss.

The Copper Peptide Hair Regrowth Serum contains copper tripeptide for hair regrowth, root strengthening, and hair shaft thickening.

Scalp Folliculitis

Suspect suffering from a hair inflammatory disorder; scalp folliculitis?
Scalp folliculitis is an inflammatory disorder of the hair follicles in the scalp, also known as “acne necrotica miliaris” or “Proprionibacterium folliculitis”.

It is characterised by small, very itchy pustules on the scalp, often most troublesome on the frontal hairline. Depending on the severity, there may be only a small number or may appear as very numerous lesions. Due to the itch, they are hard to leave alone and overtime often become sore and crusted.

Causes of Scalp Folliculitis

Although the cause of scalp folliculitis is not well understood, it is generally considered to be an inflammatory reaction to components of the hair follicle, particularly the micro-organisms. These include:

●  Bacteria (especially Cutibacterium acnes, but in severe cases, also Staphylococcus aureus)

●  Mites (Demodex folliculorum)

●  Yeasts (Malassezia species)

Treatment for Scalp Folliculitis

Treatment plan includes washing the folliculitis affected scalp with a mild normal shampoo as often as desired. In some cases, antidandruff shampoos containing anti-fungal agents such as ketoconazole or ciclopirox are helpful in mitigating scalp folliculitis. If patients desire, hair conditioner can be used.

Copper peptide shampoo for sensitive scalp

The Copper Peptide Hair Regrowth Shampoo contains Zinc Pyrithione – an anti-fungal and anti-dandruff agent. It is dermatologist-formulated for sensitive scalps and hair loss.

The following medications may be helpful for scalp folliculitis:

●  Topical antibiotics eg fusidic acid gel, clindamycin solution, erythromycin solution

●  Mild topical steroid lotions or creams

●  Oral antihistamines

●  Oral antibiotics, such as the consumption of tetracycline in the long-term

●  Oral isotretinoin, as a long-term, low dose treatment option

Severe Forms of Scalp Folliculitis

One such severe form of scalp folliculitis is acne necrotica. It is also known as “acne varioliformis” or “acne frontalis”. In this condition, first, the larger follicular spots (papules) become inflamed then secondly they tend to develop blackened crusts, finally leaving permanent pox-like scars. It is to be noted that acne necrotica may affect the face, scalp or other areas.

Another rare and severe form of scalp folliculitis, sometimes associated with hidradenitis suppurativa, acne conglobata and spinal arthritis (spondyloarthropathy), is perifolliculitis capitis abscedens et suffodiens. It is also known as “dissecting cellulitis” or folliculitis, or “perifolliculitis capitis”. It rarely occurs in white-skinned individuals, females and children and most often affects black adult men. In this case, large nodules and cysts accompany smaller follicular papules and pustules, from which purulent material can be expressed. Temporary hair loss over the lesions eventually results in permanent scarring and bald patches.

Because dissecting cellulitis is very resistant to treatment, the severity of the condition can be reduced with oral treatment such as isotretinoin, antibiotics, dapsone and injectables such as systemic steroids. If you have been diagnosed with dissecting cellulitis, you will need to be on long term treatment and followup with an accredited dermatologist to prevent scarring.

The Raser™ Hair Regrowth Comb is a multi-functional 5 in 1 comb that incorporates Diode Laser + Radiofrequency+ Red Photon + EMS + Massage with Ozone Sterilization. It is beneficial for hair follicle stimulation, hair regrowth, scalp serum absorption, and increases hair elasticity/anti-frizz/shine.

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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.

SHOP THE STORY

A Dermatologist’s Best Guide to Dandruff and Sensitive Scalp – 3 explanations for Your Hair Loss

October 5, 2017

In the third instalment of my series on dealing with hair loss in Singapore as a dermatologist, I’m going to discuss dandruff and scalp sensitivity. This is one of the commonest scalp complaints that my patients have in conjunction with hair loss symptoms and leaves many of them wondering if it is the cause of their hair loss problem.

1. What is dandruff and what causes it?

Flaking on the scalp and white scales found on one’s clothes are one of the first symptoms of dandruff. This is lay speak for any form of scalp inflammation that causes the cell turnover rate on the scalp to increase abnormally. Dead skin cells, which are rapidly shed from the cell turnover, in turn constitute the white scales observed as the primary symptom of dandruff. There are several medical conditions that can result in this, the commonest being the following: scalp psoriasis, seborrheic dermatitis and scalp eczema.

2. Do I have a sensitive scalp or is it a symptom of another condition?

Do you have itch, redness or pain on your scalp? You may have an undiagnosed inflammatory scalp disease. Scalp “sensitivity” without any underlying scalp condition is a very rare condition attributed to abnormal nerve sensations known as scalp dysaesthesia. It is far more common to have an underlying cause such as seborrheic dermatitis, which is due to proliferation of a yeast known as malessezia furfur in an individual with excess production of oil. It is also commoner in tropical and humid climates such as Singapore, as it encourages this yeast to grow.

Sensitive Scalp Inflammation Dandruff Dermatologist Singapore

Otherwise, malessezia is an inhabitant of one’s skin and scalp. Under normal conditions, it does not cause any issues. However, under humid and sweaty environments, this yeast can proliferate to cause scalp inflammation and flaking. Dandruff is observed as a result. If you have scalp flaking which does not respond to over the counter anti-dandruff shampoos, such as those containing zinc pyrithone which is anti-fungal, promptly seek the care of an accredited dermatologist rather than self medicate or DIY.

Other causes of scalp inflammation would be scalp eczema, which is due to an excessively dry scalp/skin condition. For example, scalp psoriasis, which may be the case especially if one has a family history of psoriasis or rashes on the body. If you have been in contact with a ringworm infected cat or dog, also do have your scalp and skin checked by a dermatologist as these infections are contagious and could also cause a form of scalp inflammation presenting as a red, scaly and itchy patch with hair loss.

3. Is my sensitive scalp and dandruff causing hair loss?

Most cases of scalp inflammation due to eczema, seborrheic dermatitis, scalp folliculitis or psoriasis should not cause hair loss. However severe inflammation can push the hair growth cycle into a stage of telogen effluvium which is when hair reaches the end of its cycle and falls out, similar to hair loss that occurs after a major illness or post-pregnancy. In addition, if one picks and peels off crusted areas over the scalp this can also cause damage to the hair root and lead to hair loss.

There are other causes of hair loss such as alopecia areata, which is an autoimmune disorder causing one’s immune system to attack hair follicles, leading to hair loss. This usually has no symptoms other than the appearance of round patches of hair loss over one’s scalp. Scarring causes of hair loss include folliculitis decalvans, which is the end-stage of a type of scalp folliculitis, whereby the hair follicles themselves are constantly inflammed and infected. Children may be more susceptible to tinea capitis, which is a fungal scalp infection that can lead to scarring hair loss if untreated.

© 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). These work synergistically with her proprietary line of specialist dermatologist grade cosmeceuticals, Dr.TWL Dermaceuticals, which include sensitive scalp and hair loss treatments.

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.