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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
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.
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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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.
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
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.
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.
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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