Tag Archive: skin specialist

Best Dermatologist Tips on How to Treat Your Neck Lines

March 12, 2020

 

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Dr. Teo Wan Lin is an accredited dermatologist and an expert on cosmeceutical skincare research and development. She is the author of  “Skincare Bible – Dermatologist’s Tips for Cosmeceutical Skincare”  which was published July 2019 by leading bookstores Barnes & Noble, Baker & Taylor and Apple Books and available in bookstores islandwide from January 2020. She heads up Dr.TWL Dermaceuticals, a specialist cosmeceutical skincare line with evidence-based active ingredients for anti-ageing and skin health. Its subsidiaries, the Pi- Cosmeceutical Custom Makeup Lab and the Conscious Mask Bar are part of the Conscious Concept Pharmacy launched in December featuring environmentally sustainable makeup and skincare materials. In this series “Dermatologist Talks” she shares her top tips on common skincare topics. In this article, she shares about the importance of taking care of your neck area.

 

Do neck creams differ from other anti-ageing products out there (for example, as compared to moisturiser)?

In terms of the composition of neck creams vs a very good moisturizer, for example, they do not differ very much. A lot of this, sadly, is due to marketing. But in terms of what is beneficial for anti-aging, the neck area is prone to lines and sagging with age. These can be concerns for aging women as well. Active ingredients that will help to target this should contain those that treat surface wrinkling such as antioxidants. Some brands use superficial chemical peel acids such as alpha-hydroxy and beta-hydroxy acids. That, together with retinol, does help with surface wrinkling, and these are all over-the-counter ingredients. However, in my experience, it tends to cause a bit of skin sensitivity. The formulations I look for would thus be those that contain more moisturizing ingredients such as ceramide. Our MultiCERAM™ Moisturiser is an ultra intensive skin moisturiser for total skin barrier repair with pharmaceutical grade ingredients featuring phytoceramides. For the wrinkle component, I use in my personal formulation, in our Radiancé Fluide™ Hydrating Emulsion which is also meant for use over the neck area, oligopeptides which have been discussed in dermatology literature as a good substitute for retinol or retinoids, which can be irritating over the long term. Essentially, what peptides do is that they mimic the cells’ DNA so that it stimulates collagen production and it is without the adverse effects. 

 

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Do you think there is a need to use neck cream in the first place?

I think it is absolutely essential because a lot of skincare regimens neglect the neck area. It is one of the first areas to show signs of aging with the lines and wrinkles. I have seen some patients who are older, who just focus on their face and neglect the neck, even with some protection, there is a very dramatic difference between their facial areas and neck area. It is important to bear in mind that our skin should be viewed in totality so it does not mean that you focus all anti-aging on the face. Your hands and neck area will also show all these signs of biological aging. If you are constantly just applying the cosmeceuticals on your face, you are neglecting other areas and a visible difference can be seen. 

 

What is the right age to start using neck cream?

Most dermatologists and plastic surgeons would agree that the aging process actively starts from age 25 onwards. You may wonder why a child or teenager exposed to the same stresses such as UV, pollution and mental stress, and aging does not take place until a certain age. The reason is because our body is empowered with these antioxidants abilities to fight free radicals that contribute to ageing of all our organs. After the age of 25, the research seems to indicate that all of these start to decline and that is why we need to amend the body’s response to the aging response by supplementing it with topical antioxidants. I think it is good practice for all men and women to start a proper cosmeceutical regimen for anti-aging, and including the neck area. You can use the same moisturizer as long as it is formulated correctly for the face and the neck area. If for example, somebody has already much more wrinkles on the neck than the face for whatever reason, I would add on something which is rather new, and I believe it is the only one in the Singapore market right now, would be a polymer patch. I have been using these polymer patches in my clinic for the last 6 months. It is known as a Qraser patch and it recreates the optimal environment for your skin to start stimulating more collagen formation from the inside. How this works is that it is a bio-mimetic material. It convinces your skin that it is super healthy by forming a micro-environment on the surface and it starts to generate more of its own collagen. We have one special cut out for the neck area.

 

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Is your neck more susceptible to signs of ageing as compared to your face, body, etc?

The neck area is not more susceptible but it tends to be an area that is very visible because of our clothing. For people who are always out in the sun, and are conscious of only using sunblock on their faces and limbs, and forget about their neck area, they will find that indeed, there is accelerated aging in that area. There are some individuals with neck eczema, which is a common sight for skin irritation, where their neck area may appear to age a bit faster than other parts of the body. It is what we called a flexural area, where there is skin to skin contact, like in obese people for example who are very prone to getting these neck folds and can develop fungal infections and eczema there as well.

Are there any specific neck creams in the market you’d recommend?

In terms of specific neck creams, I would say that a good moisturizer should have a few components to it. The first would be repairing the skin barrier itself. If your skin barrier is defective, it does not matter what anti-aging ingredients you have in there because your skin is just going to be dry. It is not going to look plump and elastic. Ceramide is the current state of technology for skin barrier restoration and it can be derived from two sources: Phytoceramide from plant seed oils and bovine ceramide (synthetic ceramide). The moisturizer that I personally prescribe in our clinic is manufactured by our pharmacy as a MultiCERAM™ Moisturiser and I always recommend that for the neck area. For anti-aging, the Radiancé Fluide™ Hydrating Emulsion which is fortified with oligopeptides and a plant extract LARECEA from Brassica oleracea which is a family of kale, broccoli and cauliflower, that is very effective for anti-aging. It is good to use retinol-free and AHA and BHA-free anti-aging formulation simply because the neck area is much more sensitive and you are perhaps more prone to getting eczema. 

 

What are the best ways to prevent your skin from ageing pre-maturely?

The take-home point is that for the neck area, if you are in doubt, just use a dermatologist-recommended moisturizer. Some anti-aging formulation that you use on the face contains retinol and when applied on the neck, you may develop sensitivity. Another important area of research now is using materials to increase the absorption of topicals. I personally would add that to my regimen. I think we are probably the only brand that is focusing on that right now. We have a polysaccharide material from plant root fibers which forms micro-reservoirs that release cosmeceuticals over a period of time and this is proven to increase the absorption of skincare. 

 

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The other thing would be the polymer patch. One of the best ways of preventing your skin from aging prematurely would be to have a good cosmeceutical regimen that is never like a one-step thing. In order for an active ingredient to be stable, it has to be sometimes formulated in a certain way and you can just combine everything into one and hope for the best. We also need to cleanse our skin. For the neck area, I would recommend cleansing with the same cleanser you use for your face and hopefully, it is a gentle one. 

 

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The second thing would be the application of serums such as the Vita C Gold Serum or Hyaluronic Acid Serum because serums are able to carry a high concentration of certain active ingredients. They are also readily-absorbed by the skin. 

 

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The third thing would be the application of a ceramide containing moisturizer that is also fortified with peptides and antioxidants. Finally, sun protection

 

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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.

Teledermatology

March 7, 2020

Teledermatology

 

 
 
 
 
 
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Staying home because of #covid19 ? Our Teledermatology service at TWL Specialist Skin & Laser Centre has launched! In conjunction with Dr.TWL Pharmacy—the first dermatologist led, one-stop specialised skincare pharmacy concept in Singapore—we are a full fledged online skincare pharmacy integrated with virtual consultation services via encrypted video call technology and an efficient door to door courier service of prescriptions. Check out www.drtwlpharmacy.com for our Custom Mask Bar System, a complete home aesthetics treatment system developed by the Dr.TWL Team, with customised cosmeceutical active ingredients for various skin conditions delivered with a proprietary Polysaccharide Mask and FDA Approved Radiofrequency Technology right in the comfort of your own home. . . . . . . #antimicrobial #sanitation #coronavirus #skincare #handsanitizer #handsanitiser #doctorsofinstagram #antiseptic #antibacterial #skincarecommunity #handrub #dermatologistformulated #skincaresg #beautysg #beautycommunity #dermatologist #sgbeautyblogger #skincarelover #sgclinic #sgdermatologist #cosmeceuticals #skincarebible #drtwl #beautylab #iloveskincare #skincaredaily #skincarejunkies #wuhanvirus

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Dr. Teo Wan Lin is an accredited dermatologist and an expert on cosmeceutical skincare research and development. She is the author of  “Skincare Bible – Dermatologist’s Tips for Cosmeceutical Skincare”  which was published July 2019 by leading bookstores Barnes & Noble, Baker & Taylor and Apple Books and available in bookstores islandwide from January 2020. She heads up Dr.TWL Dermaceuticals, a specialist cosmeceutical skincare line with evidence-based active ingredients for anti-ageing and skin health. Its subsidiaries, the Pi- Cosmeceutical Custom Makeup Lab and the Conscious Mask Bar are part of the Conscious Concept Pharmacy launched in December featuring environmentally sustainable makeup and skincare materials. In this series “Dermatologist Talks” she shares her top tips on common skincare topics. In this article, she focuses on a growing trend – Teledermatology.

 

What is teledermatology?

Telemedicine is the practice of using telecommunication technologies to transfer medical information. Information can be shared through audio, visual and data communication. Teledermatology is a subset of telemedicine involving the dermatology specialty, that incorporates healthcare management such as during consultation, diagnoses, treatment and education via an encrypted digital platform.

What are some examples of teledermatology practices?

Teledermatology can be practiced in the following ways: Store and forward (SAF) and real time or interactive teledermatology. A simple example of SAF could be sending an email inquiry with an attached digital image of a lesion to receive advice on how to treat the skin condition. For real time teledermatology, it includes a live video conference between the medical provider and the patient. TWL Specialist Skin & Laser Centre developed a stringent teledermatology protocol incorporating both store and forward as well as real time interactive technology via an encrypted platform.

How is it relevant for me?

Teledermatology has many benefits. First, it is a convenient practice as it does not require both parties to be present at the same location. Some skin conditions require follow up appointments up to two times per week. This can takes up a lot of time. As such, teledermatology can be used to drive down the time and costs required in such follow-up visits.

Teledermatology can also be used to help patients receive a second opinion on their diagnosis to improve accuracy. In the unusual healthcare situation such as that of the COVID-19 Virus currently, the availability of remote consultations will greatly assist in public healthcare needs. Teledermatology enables you to consult with a dermatologist right in the comfort of your home.

How do I get started on teledermatology?

First, find an accredited dermatologist who offers teledermatology services. You may refer to the list of accredited dermatologists here http://www.dermatology.org.sg/about-us/member-dermatologists/

Twl Specialist Skin & Laser Centre offers accredited Teledermatology services, via virtual interactive real time technology with our dermatologist. Available as of 1st February 2020, all consultations are also integrated with online pharmacy dispensary services. Delivery to doorstep fulfilment of prescriptions available for local and international patients.

What should I expect from a teledermatology appointment? 

1. Book an appointment via our online booking system or call 63550522. Key in a valid email address and phone number which will be the main form of correspondence. You will receive a confirmation of the appointment within 1 working day.

2. A Payment Link will be sent, to be completed for First Consultation/Subsequent Consultation Fees before commencement of consultation.

3. A Post-Payment Secure Process will be communicated to you via email for the subsequent steps which will involve the following:

Filling up of 3 single page forms, submission of required images at least 2 hours before scheduled consultation time with our dermatologist*, a fully encrypted video call saved on our secure patient data base will be conducted.

Subsequent fulfilment of prescription is done by our in-house pharmacy with full courier services to your home.

How a Singapore Dermatologist treats Blackheads

February 24, 2020

 

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Dr. Teo Wan Lin is an accredited dermatologist and an expert on cosmeceutical skincare research and development. She is the author of  “Skincare Bible – Dermatologist’s Tips for Cosmeceutical Skincare”  which was published July 2019 by leading bookstores Barnes & Noble, Baker & Taylor and Apple Books and available in bookstores islandwide from January 2020. She heads up Dr.TWL Dermaceuticals, a specialist cosmeceutical skincare line with evidence-based active ingredients for anti-ageing and skin health. Its subsidiaries, the Pi- Cosmeceutical Custom Makeup Lab and the Conscious Mask Bar are part of the Conscious Concept Pharmacy launched in December featuring environmentally sustainable makeup and skincare materials. In this series “Dermatologist Talks” she shares her top tips on common skincare topics. In this article, she shares about the importance of taking care of your neck area.

 

Treatment of Blackheads

  1. How do I get rid of blackheads?

First and foremost, it is important to know what blackheads are and how they arise. Blackheads, the colloquial term for open comedones, are a type of acne caused by an overproduction of oil, and tend to cluster around areas like the nose. The buildup of keratin and oil around the follicle is oxidised and turns blackish because the oil itself is oxidised by air.

Open comedones are best treated with:

  • A mixture of chemical peels, containing salicylic acid, lactic and glycolic acids to control the oil production.
  • Carbon laser peels to help shrink oil glands and reduce production of oil.
  • Prescription creams, containing tretinoin, that accelerate skin regeneration.
  • Oral medication will be necessary for acne, and a medication known as isotretinoin, may be prescribed to help to shrink your oil glands, which has to be taken under close medical supervision.

I do not recommend manual extractions as they can cause more inflammation, infections, and scarring. I personally treat both open and closed (whiteheads) comedones using a specialised machine with a vacuum handpiece that gently extracts blackheads and whiteheads without pain or scarring, at the same time infusing a customised blend of fruit-based acids that exfoliate the skin. Last year, we launched the Dr.TWL SilkPeel Home Medi-Facial Kit with our biomaterials team.

 

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The device basically combines the microdermabrasion benefits that we use in our clinic with a very gentle chemical peel effect to increase the absorption of the cosmeceuticals. This allows for the physical removal of the debris from both open and closed comedones (ie. Blackheads and whiteheads), reducing the appearance of blackheads and preventing subsequent formation.

  1. How do I reduce the formation of blackheads?

A good cleanser is important. For cleansers, look for the labels ‘’dermatologist-tested and formulated’’ for maximum clinical efficacy. I personally use a cleanser based on medical-grade honey which I have partnered with a laboratory to formulate, it effectively cleanses away dirt, bacteria and grime, as honey is a naturally derived emulsifier, unlike chemical lathering agents, and also possesses antibacterial properties, without stripping away the skin’s natural oils. Overall, a good cleanser should leave the skin feeling clean (not squeaky clean though as this usually means overcleansing) and also still soft and moisturised. It’s a misconception to go for really ‘strong’ harsh cleansers because it generally strips the skin of all moisture with strong lathering agents like SLS (Sodium Laureth Sulfate) leaving the skin red and flaky while the acne problem doesn’t go away.

 

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  1. Do over-the-counter treatments work?

Nothing over the counter actually works well.

Pore strips help to physically remove the bits of keratin and oxidised oil but it tends to accumulate again and the problem recurs.

Products which contain salicylic acid usually have too low concentrations to be actually effective and higher concentrations can cause irritation.

Beware of traditional facial blotters to remove oil because it can cause the skin to paradoxically feel ‘dehydrated’ and the oil glands to produce even more oil to compensate. For patients with greasy skin in the day , it may help to just wash the grease off with a good cleanser rather than keep blotting. Either that, or use a fragrance/alcohol-free baby wipe to wipe off the grease before touching up makeup.

  1. How often should I go for treatments?

It depends on your skin condition. We recommend patients to firstly get their skin condition properly diagnosed by an accredited dermatologist, who would then subsequently recommend a regimen most suitable for them.

The Dangers of Dealing with Blackheads yourself

  1. Can you extract them at home?

Never pick your pimples or squeeze your blackheads (or whiteheads) as the bacteria on your fingers will cause infection, subsequently causing inflammation which may result in the formation of cystic acne.

Cystic acne is a severe form of acne which warrants specialist dermatologist care as it can leave terrible scars and can be secondarily infected leading to cysts and abscesses (collections of pus under the skin) if left untreated. See a dermatologist early, you definitely need oral medication and also may need a stronger form of anti-acne medication known as isotretinoin which helps to shrink your oil glands. Isotretinoin has to be taken under close medical supervision as it can have side effects on one’s liver and cholesterol levels.

Do not use scrubs with rough beady material as these only irritate the skin further besides being totally ineffective at removing blackheads, whiteheads and definitely can worsen cystic acne. Persistent acne is not normal and should be treated by an accredited dermatologist to avoid infections and scarring.

  1. What happens if you leave them be? Will they form pimples?

If you leave them alone, there is a chance of secondary infection in which these blackheads develop into active pimples. Otherwise, they remain as black dots on the skin which may be rather unsightly.

  1. Some people think by putting toner, you close the pores. Is this true? 

Toners with an alcohol base as an astringent draws water and oil out via an osmotic difference.  They may provide symptomatic relief right after application, where the skin feels dried up instantaneously and the appearance of blackheads is subdued due to the temporary removal of debris. However, over time, I find that this gives rise to a condition known as reactive seborrhea. The skin being subjected to these harsh agents, decides that it is dehydrated and paradoxically, produces even more oil. Hence, I did not include any toners in the skincare regimen I designed. Instead, my recommendation for people with oily, acne-prone skin with blackheads is the Miel Honey™ Cleanser: a very effective anti-bacterial, anti-grease cleanser which also leaves a moisturising barrier. Medical-grade honey has a humectant property, meaning it is able to trap water underneath the skin. Additionally, we developed a specialised type of blotting paper for people with severely oily skin to help with the removal of oily patches throughout the course of the day. Our Anti-Inflammatory Oil Blotting Linen contains an extract of Cannabis Sativa which helps to restore the skin barrier when it comes into contact with the skin’s oil. This is unlike traditional blotters which dehydrate the skin causing it to produce even more oil. Finally, the use of a very lightweight moisturiser throughout the day, such as our Mineral Booster™, helps to restore the natural equilibrium of the skin with the environment. Overall, I find this cosmeceutical regimen is more sustainable for someone who is looking to reduce the production of oil and the appearance of blackheads, especially when used in combination with topical prescriptive items.

Read more on the Top Acne Tips and Treatments here.

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How Argireline works for Anti-aging

February 5, 2020

 

 

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Dr. Teo Wan Lin is an accredited dermatologist and an expert on cosmeceutical skincare research and development. She is the author of “Skincare Bible – Dermatologist’s Tips for Cosmeceutical Skincare” which was published July 2019 by leading bookstores Barnes & Noble, Baker & Taylor and Apple Books and available in bookstores islandwide from January 2020. She heads up Dr.TWL Dermaceuticals, a specialist cosmeceutical skincare line with evidence-based active ingredients for anti-ageing and skin health. Its subsidiaries, the Pi- Cosmeceutical Custom Makeup Lab and the Conscious Mask Bar are part of the Conscious Concept Pharmacy launched in December featuring environmentally sustainable makeup and skincare materials. 

 

In recent years, the beauty and cosmetic industry has experienced a shift towards products which contain bioactive ingredients with the effects of medical drugs. Argireline-based dermal creams, lotions and ointments are among the emerging cosmeceuticals with promises for anti-wrinkle and anti-aging effects from the comfort of home, replacing the need for extensive botox, laser treatments and surgeries to achieve that youthful look.

What is argireline?

Argireline is an established and innovative product used in the cosmetic market as creams, lotions and ointments and is well-known for its anti-aging properties. It is a synthetic hexapeptide produced in the lab, which is composed of chains of amino acids and patterned from the N-terminal end of the protein SNAP-25

It inhibits the movement of facial muscles, allegedly improving skin texture and tone. Research suggests that Argireline may not penetrate deep enough into the skin to consistently provide benefits.

Argireline is a synthetic hexapeptide peptide that is patterned from the N-terminal end of the protein SNAP-25 and has been shown to reduce the degree of facial wrinkles. It is reported to inhibit vesicle docking by preventing formation of the ternary SNARE complex and by interfering in catecholamine release. The anti-wrinkle efficacy of argireline has not been studied in Chinese subjects.

 

How does argireline reduce the effects anti-aging?

Argireline reduces periorbital wrinkles and prevents the formation of skin lines in a similar way the botulinum toxin (Botox) works, by inhibiting neurotransmitter release at the neuromuscular junction. When argireline is applied to the skin, it is absorbed into the body and its chemical composition causes the facial muscles to contract with less force. This diminishes the appearance of wrinkles and can smooth out fine lines that appear with aging. Argireline-based creams can be quite effective, and in some cases, users of argireline-based serums can experience as much as a 30% reduction in fine lines and wrinkles.

A randomized, placebo-controlled study by Wang, Y. conducted in 2013 has also shown that argireline reduced the depth of the wrinkles with a total anti wrinkle efficiency of 48.9% in 60 patients. When the same test was performed on mice, there were notable improvements in the morphology of skin tissue and the amount of Type Ⅰ collagen fibers increased while the amount of type Ⅲ collagen fibers decreased.

The total anti-wrinkle efficacy in the group with patients tested with argireline was 48.9 % whereas the efficacy was 0 % in the placebo group. The parameters of roughness were all decreased in the argireline group, while no decrease was observed in the placebo group.

 

Dr. TWL’s Oligopeptide vegetal capsules contain argireline. With its clinically proven anti-aging properties, our Oligopeptide capsules relaxes facial tension lines resulting in less noticeable fine lines and wrinkles. 

 

References:

  1. Argireline. (2019, April 05). Retrieved from https://thedermreview.com/argireline/
  2. The anti-wrinkle efficacy of argireline, a synthetic hexapeptide, in Chinese subjects: a randomized, placebo-controlled study. Wang Y, Wang M, Xiao S, Pan P, Li P, Huo J. Am J Clin Dermatol. 2013 Apr;14(2):147-53. 
  3. The anti wrinkle efficacy of synthetic hexapeptide (Argireline) in Chinese Subjects. Wang Y, Wang M, Xiao XS, Pan P, Li P, Huo J. J Cosmet Laser Ther. 2013 Apr 22. 
  4. The study of cellular cytotoxicity of argireline – an anti-aging peptide. Grosicki M, Latacz G, Szopa A, Cukier A, Kieć-Kononowicz K. Acta Biochim Pol. 2014;61(1):29-32. Epub 2014 Mar 17.

Dermatologist Talks: The Ideal Skincare Routine

December 28, 2019

Dr. Teo Wan Lin is an accredited dermatologist and an expert on cosmeceutical skincare research and development. She is the author of  “Skincare Bible – Dermatologist’s Tips for Cosmeceutical Skincare”  which was published July 2019 by leading bookstores Barnes & Noble, Baker & Taylor and Apple Books and available in bookstores islandwide from January 2020. She heads up Dr.TWL Dermaceuticals, a specialist cosmeceutical skincare line with evidence-based active ingredients for anti-ageing and skin health. Its subsidiaries, the Pi- Cosmeceutical Custom Makeup Lab and the Conscious Mask Bar are part of the Conscious Concept Pharmacy launched in December featuring environmentally sustainable makeup and skincare materials.

 

Many beauty writers have asked me what the ideal skincare routine should be, for today’s busy woman. Is there even such a routine? I have outlined the following— which are frequently asked questions posed by readers and my patients. In the following article, I plan to outline, in a scientific manner the way I have structured my own skincare routine. I recommend this also for my own patients and readers. It is important to learn how to efficiently apply cosmeceuticals as well as to understand the scientific basis for such a routine.

 

Dr.TWL Dermaceuticals is a dermatologist formulated cosmeceutical skincare range that is produced in a EUROISO22716 manufacturing facility, the gold standard in skincare manufacturing. The Dr.TWL Research and Development Team includes chemists working under the supervision of a pharmaceutical engineer and an accredited Singapore dermatologist.

 

Why do I need to have a different skincare routine in the morning or night? 

Skincare routines recommended by dermatologists contain cosmeceutical active ingredients which help to repair and rejuvenate skin via topical absorption. Day skincare routines should include active ingredients like plant based anti-oxidants to actively fight photoaging due to sun exposure, cosmetic enhancers that can double up as skincare makeup. Dr.TWL develops a range of colour correction concealers to use with skin tone concealers for daytime use, they function as skincare that’s also makeup. They are infused with a cosmeceutical oligopeptide base— these function as makeup with pigments to cancel out redness, blemishes, pigmentation spots and sallowness, as well as skincare to treat and heal these problem areas.

Difference between Day and Night Cosmeceutical Actives

  1. Night- Cosmeceutical Actives

Some ingredients, such as retinols or retinoids cause sunsensitivity and should only be used at night and not in the day, due to the potential of sun exposure. Skin repairing ingredients such as phytoantioxidants, as well as ceramide based moisturisers (which tend to be thicker formulations, unsuitable for day time) help to regenerate the skin during the sleep cycle, which is an important time for cellular rest and repair.

  1. Day Cosmeceutical Actives        

Vitamin C serum, for example, is a potent antioxidant that should be incorporated in the daytime routine(and night as well) especially because it helps to actively fend of the free radical formation due to sun-induced ageing (photoaging). Same goes for phyto(plant-derived) antioxidants.

  1. Texture of product 

Daytime routines should include a gentle cleanser to remove debris, brighten and prep skin for absorption, minimum vitamin C based cosmeceutical, a moisturiser and sunscreen.  The texture of all these products should be as “light” as possible while fulfilling the function of delivering the active ingredients, because wearing heavy creamy thick products on the face disturbs application of makeup and gives a greasy look in our humid climate. The priority of daytime skincare would be to give the user the feel of the product being instantly absorbed and as invisible on skin as possible.

  1. Cleansing differences between day and night

For normal to dry skin- gentle milk cleansing is recommended in the morning, to fulfil the function of removing debris, oil and residual skincare products overnight.  For oily, acne-prone skin, an emulsifying cleanser helps to remove excessive oil and to prep skin for absorbing skincare. Night cleansing for those who wear makeup is a double cleanse— oil-soluble makeup pigments have to be dissolved in an oil or micellar formula, while the residue should be removed in a lathering(foaming) formula. Double cleansing is especially important for those with combination or oily skin.

Are there any products reserved for day-time use or night-time use? 

Depends on the active ingredients— as above, if it contains retinols or its derivatives it would be sun-sensitising and should only be used at night, same with any topical cosmeceutical ingredients with the potential for skin irritation, these should be reserved at night.  For daytime- plant derived anti-oxidants and vitamin C help to stave off photoaging by fighting free radical formation.

What are the products you would recommend for a day-time skincare routine?

Cleanser, hyaluronic acid based serumvitamin C serum, emulsion based moisturiser (for Singapore’s humid climate), SPF 50 broad spectrum sunblock 

What are the products you would recommend for a night-time skincare routine?

Double cleansing with an emulsion cleanser for makeup removal and a gentle cleanser thereafter, an antioxidant serum ( such as containing Resveratrol, vitamin C, phytoantioxidants) and a moisturiser containing ceramide.

Some dermatologists are known to recommend sunscreen-use at night. Would you say you agree? Why?  

I do not think it is necessary nor practical. Sunscreen is meant to protect against the damaging UV rays, which can cause sun induced  photoaging and skin cancers. Sunscreens tend to contain some oil- based solvents and sleeping in it will cause stains on pillowcases.

Will having a separate day-time and night-time routine have a significant positive impact on your complexion?  

I would say having evidence based cosmeceutical active ingredients in your regimen is the key determinant of the efficacy of a routine. It is important to respect that certain ingredients as above are best incorporated  into either a morning or nighttime routine due to its innate functions to maximise benefits and reduce side effects.

Acne Scar Treatment – Step-By-Step in 5 parts as Reviewed by a Singapore Dermatologist

April 26, 2017

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

“Pock-marks, enlarged pores, uneven skin, congested skin …” Ever been told that by your friendly beauty advisors at the cosmetic counters pushing their magical products or by your facial auntie? Those pimply bumps that last for months, are they just scars that don’t go away? Or am I still having an acne problem in my 20s and 30s?

The countless advertisements from skincare solution providers. They started with just the beauty parlours but now has spread to ‘medical spas’ with doctors purportedly offering solutions to bad skin. How could one even start to differentiate what works from what doesn’t? Afterall, it never comes cheap.. And what more, with every single beauty or “medi-spa”claiming the “skin-specialist title?’’

Well if you ever felt confused by the sheer multitude of “acne scar treatment’’ providers, and “skin specialists”, in all honesty, as a dermatologist, I don’t blame you. I’ve been equally baffled by the proliferation of “skin specialists’’ in Singapore, all promising to make you beautiful, either with customised serums, peels or lasers, and of course, at a price.

On this note, if you’ve already decided you want some help for your skin, my role here is to formulate a quick guide (albeit slightly unconventional compared to your magazine beauty writers) as to how one can make an informed decision as to who to go to for skin treatments, and what the treatments are all about!

In the spirit of providing honest, unbiased objective reviews and advice from an insider point of view, I seek to shed some light on a dermatologist’s perspective on acne scar treatment in this article, which is the same kind of advice I personally give to my patients, friends and relatives.

Acne Scar Treatments by Dermatologist - Clear Skin under the sun

1. Educate yourself first – science of acne scars?

I’m going to make a rather unusual illustration here and allude to how I purchased my audiophile sound system when I wasn’t exactly an audiophile.

I’m not sure about you but one of the ways I make decisions on a lot of things I buy, is really first to find out all the information out there. I try to understand myself how the “science behind it works”. I’ll let you in on this little secret on how to win my consumer heart: I usually am most impressed by a vendor that best explains how best that product fulfils a need in my daily life, for example, and actually being able to try it myself, rather than attractive packaging or freebies.

Along the way I go through a bunch of reviews on what actual consumers have to say about the product. Needless to say, all these are often what we find on the Internet.

I don’t stop there, I research the brand thoroughly, from the origins, the certifications, and well, generally if I’m looking for an audiophile sound system, I don’t go to a general electronics store selling washing machines and furniture to boot, or necessarily to the most beautifully built soundbox out there. For months, I spoke first to all the audiophiles I knew, read reviews on geek websites and auditioned several stores, trained my ears and finally decided on my final buy.

Honestly, I am thankful for all that. I have had so many different speakers before but 1000 of those could not compare to the single, solid, smooth system I have now. It wasn’t exactly the cheapest, but it was worth every single cent. Point is, as consumers, we should look for true value and substance, not marketing and packaging. It’s never easy in today’s world, but one way easy way is to check out certifications and do brand research.

Now, if that didn’t put you to sleep yet, let me translate that into the world of acne scar treatment.

Yes, research on the science of acne scar treatment all you want, but if you are like most people who want the very best results for their acne scar treatment, go to a dermatologist. Check on the qualifications of your doctor on the Singapore Medical Council website (https://prs.moh.gov.sg/prs/internet/profSearch/main.action?hpe=SMC) because they are the ones who know intimately the science and physiology of skin, and most importantly, have the experience and the know-how to avoid and manage complications which may arise from treatment.

2. Assessment – what type of acne scars?

Now, there are 2 types of acne scars — Post-Inflammation Hyperpigmentation (PIH) and dermal acne scars (otherwise known as ice pick, rolling or box car-type scars). It’s probably useful to know these terms which your dermatologist would tell you about in the discussion of your scar treatment.

What I share with my patients is this : Imagine your skin as having 2 layers, and now it has certain defects which are visible. Like a piece of pottery, PIH occurs in the top layer like the cracked glaze, while dermal scars in the second layer are like huge dents in the pottery which occurred during the moulding process.

Now if you were tasked to restore this clayware to its ideal form, what would you do? It’s intuitive to think one could paint over the cracks, or sand it off till it’s smooth. For the dents, well, how about filling it in with a huge clunk of new clay, maybe with superglue and paint it over again and pray no one would have noticed it.

A master potter, on the other hand, would assess first the defects and the overall aesthetic of the object. He will then determine how to most efficiently restore it without it looking artificial or fake, without damaging more parts of the clayware, and essentially, simply make it what it should look like — more beautiful.

Most importantly, the master potter understands the characteristics of clay when it is dry or when it is wet, the tools he has and how to use them. This is because he’s had years of experience training in that at far more complex levels. He also knows what it takes to make the final product look good, without making a bigger mess in the process. He would also be honest enough to tell you upfront if some defects simply cannot be corrected in a single treatment.

3. Tools for acne scars  – Ablative CO2 fractional lasers? Chemical peels? Carbon peels? Radiofrequency? Skinboosters?

All of the above are clinically proven to improve the appearance of acne scars. Now what that means is that a body of evidence exists behind this, with clinical studies that support the use of these methods, and that a good proportion of dermatologists agree with these safety and effectiveness of these studies before the machines are cleared by FDA for the treatment of acne scars.

There are recommendations for settings which are given by the manufacturers, but far from being a cut-and-dried formula, the best effects are realised with the correct choice of treatment, the correct combination, timing as well as personal experience/expertise with the use of these machines, tailored to the individual patient’s skin type and response. Otherwise, a robot could also treat your acne scars, better still, without human error (pun intended).

Did you know, for example, that the darker skinned you are, the more heat from the laser your skin absorbs, and hence the higher the risk of scarring from treatments itself? This applies to all Singaporeans out there, whether you are of Chinese, Indian or Malay or any other asian heritage, you have much higher amounts of melanin (pigment colour in your skin) than your counterparts in Europe or America (where most of these technologies were discovered and used). It is important for your doctor to carefully watch how your skin reacts to the laser, to achieve the desired endpoint (which shows the treatment has reached an effective level) without causing unwanted heat damage.

I personally use a combination of treatments- from ablative (CO2 laser, plasma nitrogen) to non-ablative (radiofrequency) fractional resurfacing for deeper scars and for a more dramatic effect, in combination with a well-timed chemical peel/microdermabrasion to prep the skin for best results. Pigment lasers work well for uneven skin tone. For a finishing touch, skinboosters work well to create a plump dewy skin texture.

On the topic of tools, not all laser machines are created equal, as those which are of more sophisticated engineering tend to be more precise, cause less potential side effects and downtime. For example, higher-end CO2 laser machines are different in terms of delivery of the shape of the pulse, the wave type and overall precision in delivering energy to the deeper layers of skin without burning the surface of skin. These also incorporate radiofrequency energy to enable higher energy delivery without increasing the risk of heat damage to the skin.

Superficial chemical peels are the commonest used type of peels. They comprise primarily of one of or a combination of these 3 — glycolic acids, salicylic and lactic acids. These can cause excessive irritation if the concentration or type of acid used is inappropriate and may lead to chemical burns, or if too mild, are simply not effective.

4. Maintenance  –  Proper skincare

So you finally restored that piece of beautiful pottery. Subject it to wear and tear, rough handling and you will be back to square 1. There is a true science behind evidence-based skincare. Go for reputable, dermatologist recommended brands formulated in laboratories rather than what your facial auntie recommends you or what the latest customised serum fad offers.

5. Conclusion

Obviously the scope of acne scar treatment is well beyond that of any article. What I’ve set out to do is to streamline the key factors, the “know-how” rather than the “what”, which I believe can help the lay person navigate a bit clearer on this cloudy path. There are way too many vendors selling their wares to acne-scar sufferers, adding more woe to their already battered self-esteem. Hope this helps!

© 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.