Tag Archive: sun exposure

A Dermatologist Explains Under-Eye Care: Are Under-Eye Sunscreens Necessary?

April 30, 2019

It is not necessary to use a specific sunscreen dedicated to the under eye area if the sunscreen you’re using is already a medical grade sunscreen that has been dermatologist-tested and ophthalmologist-tested. Nevertheless, sunscreen should not be applied too close to the eye area such as the lid margin because the very nature of effective sunscreens means that it would contain chemical and physical components that may be irritating to the eye.

If you are worried about sun exposure to skin around the eyes, you may consider using the SunProtector™, a lightweight soothing sunscreen that is dermatologist-tested and formulated to be suitable for use on the entire face including the under eye area.

The question remains: Why does the under eye area require extra protection?

The difference between the under eye area and the rest of the skin is that the under eye area has much more delicate and thinner skin. This explains why we tend to get dark eye circles from those areas, which is due to genetic factors such as the blood vessels being seen much more prominently in areas of thin skin. In addition, with certain practices such as applying eye makeup over many years as well as wearing contact lenses, the process of dragging and pulling the areas of skin around the eye can make it much more susceptible to wrinkling and laxity. Natural facial expressions, such as smiling can also cause natural creases at the periorbital area, known as crow’s feet, or when one is laughing in the area near the nose known as bunny lines.

It is much more necessary to eliminate bad practices in handling of the skin around the eye area, and to advocate good eye moisturising and antioxidants in the form of an eye cream and daily sun protection. One eye cream product you may opt for is the Elixir-VTM Eyes, which is a dermatologist-formulated eye cream that targets regeneration and repair of skin around the eye area with pharmaceutical-grade bioactive ingredients. Also, as a tip, use your ring finger instead of the index finger to apply any sort of eye cream or makeup, in order to avoid exerting repeated high pressure (from the index finger) over the delicate eye area, which drags down the skin and may cause or worsen eye bags and wrinkles. More importantly, to fight aging effects on the skin and in general, one should have an overall healthy lifestyle, with frequent exercise, adequate sleep, a diet filled with antioxidants, reduced alcohol intake and should stop smoking habits.

If someone were to look for additional protection for the under eye area, would an under eye sunscreen benefit in any way?

The premise overall is that there is no need for a specific under eye sunscreen, other than a sunscreen that is formulated for the face and tested by a dermatologist in a laboratory environment. If one is to experience irritation with such sunscreens, it may help to look for a pure physical sunblock made up of Zinc Oxide and Titanium Dioxide, rather than chemical sunscreen components, as these tend to be less irritating although conferring less broad spectrum protection compared with one that is a combination of physical and chemical components.

It is more important that one re-applies sunscreen regularly, rather than to apply an additional type of sunscreen. This is because layering different sunscreens one on top of the other does not increase the efficacy beyond the time period that the sunscreen is effective for. Conventional wisdom is to reapply sunscreen every 3 to 4 hours, especially when outdoors. However, there are many aspects to aging around the eye area and one of the reasons is actually not due to sun exposure, but rather due to the fact that skin around the eye area is much more delicate, hence more prone to daily tugging for example for people who wear eye make-up and contact lens wearers. For these individuals, it is much more advisable to use a good eye cream which can be applied both day and night, to moisturise the eye area and packed with antioxidants to reverse free-radical damage caused by sun exposure and environmental pollutants, and also to get adequate sleep at night. Having a pair of good sunglasses is also helpful to protect the cornea from UV damage.

Can exposure to the sun make the under eye area more susceptible to dark spots or lead to other undesirable effects?

This is not a very realistic scenario as when someone has excessive exposure to sunlight, it happens over the entire face and is never just localized to one area. Someone who has extensive sun damage in their life will find that they are more prone to get pigmentation as well as dark spots as well as the entire face including the eye area. It is far more common to notice such pigmentation at facial areas of more prominence such as the cheek bones rather than the under eye or say the under the chin area which are relatively protected from sun due to the facial bone structure. In addition, if you have been undergoing treatments such as phototherapy for other skin conditions, it is always advisable to wear protective eyewear.

Will sunglasses work as well as an under eye sunscreen would?

Sunglasses are a good way to block out UV radiation and it is a form of physical protection. It is advisable to wear sunglasses primarily within the context of preventing excessive harmful UV exposure to the eyes for example the cornea. At the same time, when one applies a good quality medical-grade sunscreen together with physical measures such as a broad-rimmed sun hat and a pair of sunglasses, the amount of UV exposure to the face as well as the under eye area can be reduced.

How can you take extra care of the under eye area?

As mentioned, the eye is a very delicate area. It is well-said that the eyes are the windows to one’s soul and are very often the first feature that one notices. For someone who actively looks after their skin and does treatments such as lasers and peels, ageing in the eye area starts to become more obvious because these lasers and peels do not target the eye area and are often the top giveaway signs of a person’s age. So it is indeed very important to take extra care of the eye area, where prevention is key as well as using a good eye cream. In terms of physical treatments that can be done for the eye area, you may consider treatments such as CO2 laser resurfacing, as well as plasma nitrogen treatment which is very safe and uses ionic plasma nitrogen to help to resurface and tighten skin around the eye area.

© 2019 TWL Specialist Skin and Laser Centre. All rights reserved.

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

To book an appointment with Dr Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may book an appointment online by clicking here.

What You Need to Know About Dry Skin

September 25, 2018

Dry skin (medically known as xerosis) usually appears rough, scaly and even itchy. Xerosis can be caused by factors ranging from cold weather to frequent showering, and is also a common symptom of several chronic skin diseases. While xerosis is not a critical condition, it can cause significant discomfort, affect one’s appearance, and accelerate skin’s aging.

So what causes xerosis and how can it be managed?

What is dry skin?

In normal skin, lipids and natural moisturizing factors (NMFs) are needed to maintain barrier function and optimal skin hydration. NMFs attract water molecules while lipids controls the amount of skin that evaporates from the skin surface.

NMFs keep the skin hydrated by binding to water and holding onto it, preventing excessive water loss as the skin cells have sufficient hydration to remain turgid. An effective skin barrier keeps the skin’s water content at a healthy level of 15 to 20 per cent.

Dry or dehydrated skin has reduced NMF levels which compromises the skin’s ability to retain water. As a result, moisture is lost much faster than replenished. When the skin’s water content falls below 10 percent, visible scales form and the skin starts to have a rough dry appearance. Individuals with dry skin can also often notice cracks or experience flaking.

The precise organisation of lipids are important as it determines the amount of water that can be trapped in the skin. In healthy skin, sufficient lipids are present to keep Transepidermal Water Loss (TEWL) values low, as less water is lost to the surroundings.

What causes dry skin?

Dry skin arises largely due to abnormal epidermal differentiation.

The epidermis is produced by cells that divide and proliferate in the deeper skin layers before travelling towards the skin surface. At the surface, skin cells mature, flatten and die. These dead skin cells are sealed together with fatty lipids to form a continuous skin barrier. This process is termed epidermal differentiation.

A disruption in the skin barrier can cause epidermal differentiation to become abnormal and the skin barrier function to become damaged. This disruption can happen for a variety of reasons:

  • Genetics: Dry skin is a major manifestation of several skin diseases such as atopic dermatitis (eczema) or psoriasis (itch) which has a genetic component.
  • Aging: In aging skin, a marked decline in lipid and water content ultimately impairs skin barrier function. A decline in filaggrin, a protein that produces NMFs, is also observed as we age, leading to diminished NMF levels
  • Low humidity: Low humidity causes less amino acids and filaggrin to be produced in the stratum corneum, as they require optimal humidity to function well. As a result, NMF levels are lower.
  • For example cold dry weather often causes ‘winter itch’ where skin is rough, red and irritated. Winter xerosis is aggravated by the presence of hot, dry air from modern central heating, causing impaired desquamation and scaling. You may also experience dry skin in hot weather if most of your time is spend in air-conditioned surroundings.
  • Sun exposure: Ultraviolet (UV) radiation from the sun can also affect normal epidermal proliferation by compromising the skin barrier’s function and resulting in greater water loss to the environment.
  • Frequent bathing: Such habits, especially with hot water, can further irritate the skin and damage the skin barrier function. Hot water should be avoided, and a shorter bath duration is recommended.
  • Other environmental factors: Chemical agents such as soaps, lotions, perfumes or detergents can also contribute to xerosis.

How to replace skin’s water content

We often see buzz about the importance of hydrating our skin, but how exactly do we ensure our skin is hydrated enough?

Currently, the best approach to treating dry skin is to restore normal abnormal epidermal differentiation by using ingredients that can easily penetrate the skin and prompt it to produce healthy levels of lipids again. Effective ingredients are lipids, humectants and antipruritic agents:

Other types of lipids that are not found naturally in our body can also be beneficial by serving as an occlusive layer, such as petrolatum. They prevent water loss to the surroundings by trapping it. A common example of petrolatum is Vaseline.

Humectants, such as glycerol, lactic acid, hyaluronic acid and urea, attract and retain water in the skin. Glycerol or urea can improve skin elasticity and barrier function, and compensate for the lower levels of NMF in dry skin. Hyaluronic acid is a humectant capable of holding up to 1000 times their own weight in water, locking in moisture for the skin.

Antipruritic agents block histamine release to interfere with the itch sensation and break the itch-scratch cycle.

An ideal ingredient should prompt the skin to restore epidermal differentiation, reduce excessive water loss and itching. Multi-CERAM Moisturizer is dermatologist-formulated to treat eczema and dry skin with pharmaceutical grade ingredients. An ultra-intensive formulation, this moisturizer relies on ceramides, plant seed oils, sodium hyaluronate and glycerin to repair the skin barrier and restore skin moisture.

© 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.

Understanding Enlarged Pores & How to Treat Them

August 24, 2018

Enlarged facial pores are a cosmetic concern that plague individuals with oily skin types. Even though this condition besets a majority of individuals, especially those who live in humid climates, treatment options for large pores are elusive or unreliable.

Large pores may not be health-threatening or a disease symptom, but they can be the reason why we refuse to get up close with a mirror. A skin pore usually refers to an enlarged opening of pilosebaceous follicles. The pilosebaceous unit has the hair follicle, the sebaceous (oil) gland and skin muscles.

The mechanism by which visible facial pores occur remains unclear, but three possible causes have emerged: loss of skin elasticity, hair follicle size and excessive sebum production. Other potential factors that can influence this skin condition include genetics, chronic photodamageacne and vitamin A deficiency.

Excessive sebum production

Oily skin results from excess production of sebum by the oil glands, which fills the follicles and leaks onto the skin surface. During the menstrual cycle, sebum production levels are higher. Pore size is also larger during the ovulation phase. A surge of three hormones during the ovulation phase triggers the oil glands – luteinizing hormone, follicle-stimulating hormone and progesterone.

Severe acne

Previous cases of inflamed acne can destroy hair structures and leave them susceptible to influence by androgenic stimulation. Androgen is a hormone that exerts a major effect on sebocyte (cells found in oil glands) proliferation and sebum secretion. This means acne inflammation may cause you to be more prone to androgen activity, bringing about change in follicle volume and size.

Loss of skin elasticity

A main feature of skin’s ageing process is the loss of elasticity. Our skin’s collagen and elastin framework that supports skin resilience become less efficient due to ageing and chronic photodamage. A protein, crucial for elastic fiber assembly, called microfibril-associated glycoprotein-1 is also produced less over time. Without it, tissues around follicles provide less structural support and there is a loss of thickness in the skin dermal layer. Such changes lead to skin fragility, sagging and enlarged pores.

Hair thickness

The volume of our pores is dependent on the size of the hair follicle. There are dermal papilla cells in our hair follicles that contain androgen receptors. Our pore size is affected by the androgen activity in hair follicles.

Treatment options

Topical therapies

  • Topical retinoids are often considered as first-line therapies to reverse collagen and elastin-associated changes caused by aging and photodamage. Retinoids are vitamin A derivatives and were previously used as anti-ageing therapies before the efficacy for improving the appearance of facial pores were discovered.

Commonly used retinoids are tretinoin, isotretinoin and tazarotene for skin rejuvenation, regulating sebum production, and the reduction of wrinkles and large facial pores. Isotretinoin is the most potent inhibitor of sebum production.

Patients are advised to consult their dermatologist before any use of retinoids as side effects – such as inflammation, burning, redness or dry skin – are common.

  • Niacinamideis another cosmetic ingredient that can reduce sebum production.

 

  • Chemical peelscan also help rejuvenate the skin and improve the appearance of large pores. At the epidermal or dermal level, the application of acids induces the temporary breakdown and regeneration of healthier cells. Glycolic acid, lactic acid and salicylic acid are commonly used for chemical peels.

Oral therapy

Common oral therapies targeted at enlarged pores are anti-androgens, such as oral contraceptives, spironolactone and cyproterone acetate. They modulate sebum levels by blocking androgen action.

Lasers and ultrasound devices

Advanced devices have been developed to deliver targeted thermal or ultrasound energy to the skin. Such therapies work by remodelling the collagen fibers near our pores for increased skin elasticity and decreased sebum production. Non-ablative lasers helps with facial pore minimalisation and improved appearance of photoaged skin.

Hair removal

Pore volume may decrease with hair removal, especially so if patients have thick and dark facial hair. Laser or intense pulsed light sources can create photothermal destruction of the hair follicles to minimise appearance of large pores.

 

© 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.

Everything You Need to Know About Melanin & Dark Spots

July 19, 2018

 

Melanin is the culprit behind the dark spots that give us an uneven complexion. It is a brown pigment found in the basal layer of the epidermis.

This pigment is synthesised by melanocytes. The process of melanin synthesis is termed melanogenesis. Melanocytes go through different stages of maturation, becoming more pigmented at each stage.

Certain stimulants trigger a gene to produce more of tyrosinase, a copper-containing enzyme that converts tyrosine into melanin. Stimulants that activate the melanocyte include hormones, inflammation (such as acne) and external environmental conditions (ultraviolet light that causes the production of free radicals).

One simple way to reduce melanin production is to use broad-spectrum sunscreens with zinc oxide, titanium dioxide or iron oxide. These substances help block UVA and UVB light, thus impeding the stimulation of melanocytes.

Pigmentary disorders

Common hyperpigmentation disorders that involve the darkening of an area of skin due to increased melanin include melasma, lentigo, and post-inflammatory hyperpigmentation.

Melasma is usually caused by chronic exposure to ultraviolet radiation or a spike in hormones due to pregnancy or the use of oral contraception. It can be found at the epidermisdermal layer or mixed, depending on the location of the pigment.

A lentigo is a light or dark brown area of discoloration that can range from 1mm to 1cm across, and is caused by an increased number of melanocytes. Its outline is usually discrete, but can also be irregular. Simple lentigines arise mostly during childhood on areas not exposed to the sun. Solar (or senile) lentigines are found on the backs of hands or on the face, most commonly after middle age.

Post-inflammatory hyperpigmentation (PIH) is the skin’s response to inflammatory skin disorders. Common causes are acne and atopic dermatitis. PIH is caused by the overproduction of melanin caused by skin inflammation.

Treating hyperpigmentation

Hydroquinone: For 50 years, hydroquinone has been the gold standard treatment for hyperpigmentation. This compound inhibits tyrosinase activity, thus limiting the amount of melanin to be produced. It also alters melanosome formation, possibly degrading melanocytes.

However, prolonged use of topical hydroquinone has shown to have side effects such as ochronosis and permanent depigmentation. Ochronosis is a disorder with blue-black discoloration. As such, hydroquinone is banned in cosmetic formulations and only available through a prescription that should be carefully managed by an accredited dermatologist.

Retinoids are forms of vitamin A that can treat acnephotodamage and PIH. They have various pathways that lead to skin lightening effects, such as accelerating epidermal turnover, reducing pigment transfer and slowing the production of tyrosinase.

With common side effects being erythema, skin irritation, dryness and scaling, it is recommended to use a retinoid only under the supervision of an accredited dermatologist. Corticosteroids (steroid hormones) have anti-inflammatory abilities and are often prescribed along with retinoids to prevent excess irritation.

Arbutin is a botanically derived compound found in cranberries, blueberries, wheat and pears. Though arbutin is a derivative of hydroquinoine, it has shown to be a more controlled way of inhibiting the synthesis of melanin as it does not permanently destroy melanocytes.

Kojic acid is a naturally occurring fungal substance. Its skin-lightening ability works by inhibiting the activity of tyrosinase. However, frequent use can cause side effects of contact dermatitis or erythema (redness of the skin).

Azelaic acid is known to be effective for treating PIH and acne. Azelaic acid depigments the skin in several ways. It can inhibit tyrosinase or reduce levels of abnormal melanocytes. This means that azelaic acid does not influence normal skin pigmentation but only acts on the proliferation of unwanted melanocyte activity.  Side effects are mild and only last for a short period of time. Irritation, burning sensation or mild erythema may emerge, taking 2 to 4 weeks to subside.

Niacinamide is a derivative of vitamin B3. It works by decreasing the transfer of melanosome to keratinocytes. Niacinamide is a stable ingredient as it is unaffected by light, moisture or acids. This ingredient is often incorporated into cosmeceuticals due to its safety profile.

Vitamin C or L-ascorbic acid is a naturally occurring antioxidant that helps with skin lightening. It prevents tyrosinase from converting tyrosine to melanin. Vitamin C is also favored for its anti-inflammatory and photoprotective properties. However, L-ascorbic acid is highly unstable and rapidly oxidized. It is not used in the treatment of PIH.

Stable forms of vitamin C include magnesium ascorbyl phosphate or sodium ascorbyl phosphate. For safe and effective results, consider a dermatologist-formulated serum VITA C GOLD™ Serum,a formulation tested for bio-activity in a laboratory.

As seen above, there are various treatment options to treat common hyperpigmentation disorders. Recognizing the underlying cause for pigmentation is critical for proper treatment and choosing the best-suited therapy. Visit an accredited dermatologist for effective and safe treatments catered to your condition.

© 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.

Understanding the layers of your skin

July 14, 2018


Our skin is the largest organ in the body, and the most visible. Yet, few of us really understand how it works. When searching the internet for causes and treatments of our skin conditions, for example, we often come across terms like ‘epidermis’ and ‘dermis’ that are literally Greek and hard to understand.

As a result, it’s difficult to know exactly how to care for our skin. As our outer layer endures harsh external conditions such as environmental pollutants, UV rays, pressure, temperature, and others, how can we best protect and keep it in good health?

To answer this question, we need to start with a skin 101 primer.

Our epidermis

The outermost layer of the skin is known as the epidermis. It consists of four layers of closely packed cells. Skin cells found in these layers are called keratinocytes. They manufacture and store keratin which is the protein that makes up the main structure of our hair, skin and nails.

From deep to superficial, the four skin layers in the epidermis are stratum basale (deepest), stratum spinosum, stratum granulosum and stratum corneum (outermost).

In the epidermis of certain body parts with thicker skin, such as palms, soles and digits, there is an additional layer of cells called stratum lucidum. It is found wedged between the stratum corneum and the stratum granulosum.

The dermis

The dermis refers to the inner layer of skin found between the epidermis and subcutaneous (=under the skin) fat. The dermis layers are made of connective tissues, linked by interwoven fibres of collagen and elastin, packed in bundles.

Collagen takes up 70% of the weight of the dermis. Collagen fibers provides the skin with structural support and tensile strength. Collagen proteins also bind to water, keeping the skin well hydrated. Accounting for 2% of the weight of the dermis, elastin fibers allow movement and are responsible for the elasticity of the skin.

Caring for the skin we see

In the outermost layer, known as the stratum corneum, the keratinocytes are actually dead cells pushed up from deeper layers. As these cells travel to the surface, they undergo keratinization, the process whereby the contents of the cell develop tough keratin proteins. Other components such as cholesterol, ceramides and free fatty acids in the stratum corneum also work together to give a toughness to the skin that can withstand all sorts of chemical and mechanical insults.

In this way, the stratum corneum becomes a barrier that prevents dehydration of underlying tissues and serves as a mechanical protection for the more delicate layers below. It is also the layer most crucial in maintaining the skin’s moisture.

The stratum corneum layer is usually replaced with cell division and renewal in a cycle of 4 weeks.

Ageing and exposure to ultraviolet radiation can stress the skin, leading to poor skin barrier function and an increase in water loss. The barrier function can also be affected by other factors such as a deficiency in fatty acids and lipids, detergents (usually from harsh cleansers) or dehydration.

Caring for your skin then should involve a regimen of protecting it from the sun with UV protection, using cleaners and other products that do not dehydrate the skin, and maintaining the moisture in the skin through moisturizers. Cleansers, in particular, can contain harsh surfactants that emulsify to remove grease and dirt but can irritate the skin. Use a gentle cleanser with a natural emulsifier instead. For example, Dr TWL’s  Miel Honey™ Cleanser uses medical-grade honey as a natural emulsifier, leaving the skin both clean and gently moisturized.

Many cosmetic treatments work by causing a change in the epidermal layer, thereby encouraging it to renew itself faster. Procedures targeting the epidermis include some forms of chemical peelslasers, intense pulse light (IPL), microneedling or topical drugs.

Caring for the skin beneath

The dermis, the layer beneath the epidermis, gets thinner and loses its elasticity over time.

Various cosmetic treatments available often aim to restore the amount of collagen lost during the ageing process, such as medium and deep chemical peels, microneedling, microfocused ultrasound and ablative lasers. Fillers can also restore the volume of collagen in the dermis layer, correcting fine lines and wrinkles.

Lasers, IPL or resurfacing treatments can differ according to the skin layer that it targets – the epidermis or dermis layer. Non-ablative treatments focus on the dermis while leaving the epidermis intact. Ablative lasers treat both dermis and epidermis layers.

Chemical peels can reach different levels of the skin depending on the frequency, the peeling substance (typically an acid), the concentration of the substance, and skin condition of the patient. In a controlled manner, skin cells are destroyed in a chemical peel to stimulate regeneration of a smoother epidermis and new collagen in the dermis.

© 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.

 

 

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.

Your Guide to Melasma

March 18, 2018

 

What is melasma?

Melasma is an acquired skin problem of hyperpigmentation, frequently faced by women in their reproductive years. The condition is characterized by hyperpigmentation primarily on the face, so we may observe irregular brown or blue-grey macules on the face. Common areas where the brown patches appear are cheeks, nose, forehead, jaw and the chin.

How prevalent is the disorder?

While melasma occurs in all ethnic and population groups, studies have shown that there is a higher prevalence among more pigmented phenotypes. These include Asians, Indian, Pakistani and Middle Eastern. In the Americas, those who suffer from melasma mostly live in intertropical areas where exposure to UV rays are greater.

What are the different types of hyperpigmentation?

You may be doing your research diligently to find out more about melasma, but there are different types of pigmentation, and they are not all the same. Apart from melasma, your face could be suffering from freckles, sun spots or age spots. Freckles, or ephelides, are small, flat and brown marks that are prevalent in childhood. Sunspots, or solar lentigo, only surfaces in our late twenties and can increase in size and number with increasing sun exposure. Age spots, or seborrheic keratosis, is actually not a form of pigmentation, but a non-cancerous skin growth that kicks in with age.

Melasma, on the other hand, can be identified with a greyish-brown discolouration, at times in the shape of a butterfly.

What causes melasma?

While the cause of the disorder remains unknown, current research point towards sex hormones and sun exposure as the greatest culprits.

These brown patches appear on our face as when there is an excessive production of a pigment called melanin. UV radiation induces the increase in melanin production to protect the skin from sun damage. This causes the development of pigmentation to take place on the skin. A leading cause of melasma is excessive sunlight exposure.

Hormones can also be another cause of melasma. You may develop this condition at the start of your pregnancy or if you are on birth control pills. Pregnant women experience higher levels of increased progesterone, estrogen and melanocyte-stimulating hormones. Melanocytes are cells that produce melanin in your skin.

Other causes can be due to certain medications, scented or deodorant soaps, or your toiletries. These products may contain an ingredient that causes a phototoxic reaction that can trigger melasma.

What are the types of melasma?

There are three types of melasma: epidermal, dermal and mixed.

The epidermal layer affects the outermost surface of the skin, and the easiest type to treat. It can be identified by the presence of excessive levels of melanin in that layer. Patches will be a darker brown colour, with a defined outline.

The dermal layer will affect a deeper layer of the skin beneath the superficial layer, and we can recognise it by the occurrence of melanophages throughout the dermis. Melanophages are cells that ingest melanin. The dermal layer can be more deep-rooted, and may not respond well to treatment. For this layer, patches have a less defined outline, with light brown or bluish colour.

A mixed condition of melasma would be having both the epidermal and dermal types, and improvements on the condition can be expected with treatment.

How to treat melasma? 

The response of melasma to treatment can be slower if the condition has been present for a longer time.

Excessive sun exposure leads to the deposition of melanin cells within the dermis and can persist long term. Coming into contact with UV radiation will deepen the pigmentation as it will activate the production of more melanin, causing your brown patches to turn darker and harder to remove.

Generally, by including sun protection into your skin routine, hyperpigmentation can be resisted. With Singapore’s tropical weather, it is recommended to reapply sun protection every 2 hours with a broad-spectrum sunscreen having at least SPF 30. Consider bringing along sunglasses or a hat when you are outdoors.

For clinical treatments, consultation with a trained dermatologist is recommended. A proper diagnosis of melasma should be conducted, and screened if there are any underlying conditions that may require treatment.

Prescriptions may be given to inhibit the formation of melanin. Hydroquinone is a controlled ingredient that is frequently included in medications to treat melasma, as it allows lightening of the skin. A precise concentration of hydroquinone should be administered for treatment, and may be professionally managed so by your dermatologist.

Procedural treatments for melasma can also be considered, such as chemical peels and lasers. Expected efficacy of each treatment can vary depending on the severity of melasma, with topical combination therapies being one of the most effective treatments for hyperpigmentation.

Speak to your dermatologist for a tailored recovery experience.

© 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.

 

 

 

What you need to know about Melasma

October 29, 2017

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What is Melasma?

Also known as the “mask of pregnancy”, Melasma is the presence of either brown or grayish brown patches, that typically appears on both sides of the face, especially on cheeks, upper lip, nose, forehead or chin area. The excessive production of melanin from melasma causes the pigment in the affected skin area to tan, resulting in a brownish or grayish brown discolouration.

Who does Melasma affect?

Although anyone can have melasma, it is more common amongst pregnant women, women who consume oral contraceptives and people with darker skin types. Even though sun exposure is seen to be a triggering factor, experts believe that the pigmentation is caused by hormonal changes that occur when a woman begins to consume birth control pills or is on hormone replacement therapy or during her second or third trimester of pregnancy.

What should I know about Melasma?

The duration in which the pigmentation fades, varies from individual to individual depending on the intensity and cause of Melasma. For some individuals, pigmentation caused by Melasma may worsen over time. For individuals who have been affected by Melasma during pregnancy or through the consumption of birth control pills or undergoing hormonal therapy, it may fade without treatment after childbirth or the discontinuation of such hormonal treatments. However, it is important to note that, Melasma can return with each future pregnancy, even if it fades after a prior child delivery.

What are the treatment plans available for Melasma?

Before starting any treatment against melasma it is important to consult a trained and accredited dermatologist. This is important to confirm the diagnosis of Melasma and to check that there is no underlying or associated skin disease that would require immediate treatment. Secondly, as Melasma can worsen over time and even become permanent, by having a consultation with a dermatologist this can be prevented. Thirdly, as effective medical melasma treatments require a prescription — as these treatments may sometimes produce mild side effects — these medications need to be consumed under medical supervision.

There are 3 ways that are used to treat Melasma:

  • Cosmetic: The use of cosmetics such as colour correctors, concealers and foundations to cover the dark areas. However, in the long haul, this method does not help melasma to fade.
  • Medical: Prescription medications such as those containing hydroquinone. These medications are aimed at inhibiting melanin production selectively, therefore causing a depigmenting effect, allowing Melasma to fade over time.
  • Physical: The use of topical agents such as chemical peels and lasers.

 

Dermatologists may recommend undergoing ‘combination therapies’ such as creams that combines a few active ingredients, in conjunction with laser treatments and chemical peels. This prescription treatment is able to lighten moderate to severe melasma quickly and effectively.

How to prevent Melasma from getting worse?

As tanning of the skin occurs when the pigment in the skin — melanin — absorbs the ultraviolet rays produced by the sun, with constant exposure to the sun,  Melasma has a tendency to get darker. It is recommended that one avoids exposure from the sun to prevent further darkening of existing melasma as well as the formation of new patches. By protecting your face from harmful UV rays of the sun by either wearing a hat or a sunscreen with SPF30 or higher, the possibilities of Melasma darkening could be reduced.

© 2017 twlskin.com. All rights reserved.

—–

Meet with Dr. Teo Wan Lin, 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.