Learn more about acne and how to achieve acne free skin.

ACNE free Skin | 青春豆.痤疮治疗

With year end coming, and heaps of feasting and merry making, the last thing we want are pesky zits appearing on our faces and spoiling our selfie taking habits. I hear you so sharing some tips to bring your best face forward this festive season! =P

What are the 3 causes of acne?

Acne is caused by clogging of your pores by…

1. Sebum
2. Dirt and impurities
3. Bacteria P acne

How can I clear up my acne?

1. Good skincare and lifestyle measures – Which will be discussed later in this chapter
2. Topical skincare – Your retinoids, keratolytics and antibiotics
3. Special – Laser, Medical Peels, etc

Why acne happens?

When your hair follicles are blocked, acne develops. It starts with non inflammatory comedones, your whiteheads and blackheads. Whiteheads are closed comedones, blackheads are open ones. When inflammation with P bacteria sets in, you get angry red pimples.

So basically,

1. Sebum and dirt collect in your pores.
2. Clogging occurs blocking your pore. = Clogged Pore
3. And once P acne inflammation sets in, you have a pimple = Swollen pore

How common is acne in Singapore?

Acne vulgaris is the most common skin conditions in young adults in Singapore. It affects up to 80% of teens and young adults in Singapore. Stress, lifestyle and diet are the main triggers.

Should I see a GP, or dermatologist for acne?

Mild cases can be dealt with by your friendly GP.

Severe cases are referred to see a dermatologist.

Severity is determined by extent of acne, number of inflammatory papules, and presence of scarring, cysts and deep seated nodules.

What is the complication of acne?

Acne if untreated can develop into acne scarring, characterised by atrophic scars of different depth dimensions – ice pick, rolling, boxed scars. Read more about scarring.

This is the blockage of our pores. And if we dont manage it carefully, it can lead to scarring. Most medications BOUGHT OVER THE COUNTER are drying to your skin. They work by reducing sebum. Benzoyl peroxide works by killing the P Acne bacteria.

The flipside of course is the triggering of skin irritation and inflammation. 

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So the question is, how do we treat acne?

In the latest 2022 guidelines released, the American Academy of Dermatology recommends combination treatment for acne. The aim of treatment is to reduce acne outbreaks and minimise the dreaded acne scarring.I believe in the combination of good basic cleansing and toning, topicals+/- medication, chemical peels and laser treatment, to obtain optimum results. It should be actively managed to reduce the risk of permanent scarring.

non inflammatory, inflammatory and acne scars.

Non inflammatory:  consists of comedones, blackheads, whiteheads

1) Blackheads – extraction BY A PROFESSIONAL

2) Whiteheads – retinoids ( retacnyl, differin), AHA peels and scrubs to remove the gunk and unclog the pore. Retin A based creams work well on long term acne control, and have anti ageing benefits too.

Inflammatory: Consists of angry, red, bumpy  pimples

1) Benzoyl peroxide based topical treatment, plus minus oral antibiotics. | This is my secret and you can do this without seeing a doctor. Depending on skin sensitivity, I like to use clindamycin, clindoxyl and epiduo. I will explain more in my video.

2) Laser and AHA based medical peels | control your skin sebum, and increase exfoliation.

3) Blue light and antibiotics | to kill p.acne bacteria. Only when active acne is controlled, can we proceed to acne scar treatment.

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Dr Daniel Chang’s 3 STEP SECRET Formula

1- Laser/ Light/ Peel

2- Topical medication +/- oral antibiotics

3- Lifestyle changes |

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Combination Treatment |

Medical peels + Laser  Light + Blue light therapy ( unclog pores, control oil, kill p. acne bacteria)

What topicals work best?

adapalene | Vitamin A	topical retinoid + keratolytic
alpha hydroxy acid | glycolic acid	keratolytic
BP	antiseptic + keratolytic
clindamycin	antibiotic

Here’s my TOP TIP: A skincare regime using glycolic acid wash and toner + retin A at night and topical clindoxyl in the day time is my recommended for best results. Not all patients can jump to this regime so its best to start low and go slow.

Dr Daniel Chang

What can trigger?

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1. Diet | Studies have shown that dairy products, food rich in GI, and fried oily food are a no no. They tend to provoke a hormonal surge, which is the trigger for acne. Thats probably why acne tends to affect people in developed countries, where the diet is so rich.
2. Lifestyle | Stress is no good. Thats why breakouts tend to occur after frequent OTs, after a flight (as the cabin air is super-drying to your skin), before an important photo-event etc. Keeping a regular exercise regime and sleeping sufficiently helps!
3. Contact | In this day and age, its our dreaded mask. Minimise contact with your fingers. Dap, and not wipe, your face with a towel. Apply cosmetics sparingly. Use oil-free, non comedogenic products. And when applying acne treatment like benzoyl peroxide, retinoids, adopt a hands-free approach. All these serve to reduce inflammation. As for how to select the right products for your skin, and how to use them appropriately, please speak to your Aesthetic physician for further information.
   

Now, let me share with you my TOP skincare tips for control.

1.  Cleanse, exfoliate and go easy | Gently clean your face 2x a day, using a minimal touch technique. Dont overclean your face. (This is to remove all the old and dead skin that is clogging the pores, but not over irritating your skin.)
2. Use oil free or ‘non comedogenic’ makeup products | Remember, you use makeup to look more beautiful, not to look worsen your acne.
3. Never ever squeeze a pimple and minimise touching your face | I know its easier said than done. You risk scarring, darkening and spreading the pimple to other parts of your precious face
4. Wash your pillowcase, and your pillow on a regular basis | *Question: How many of you still let your parents do this for you, own up now lol* Your pillows otherwise collect all the sebum, makeup and dirt that contribute to pore clogging.

Common pitfalls: Lifestyle mistakes

1. No moisturiser used OR Mistaking aloe vera gel as a moisturiser | A well moisturised skin will help with sebum control and reduce clogging of pores. And keep yourself well hydrated. Healthy skin starts from within. Oftentimes, the patients I see having breakouts do not use mositurisers. They may use aloe vera gel (which is NOT a moisturiser). Moisturising helps. The skin takes a month to get used to a new product. 2 months to stabilise. 3 months to gain good control.
2. Too much makeup | When you cover your skin with heavy makeup, this becomes a vicious cycle as makeup clogs pores. If u run your fingers over your skin, you may feel mini bumps, common over the cheeks, jawline and forehead.
3.  Habit of picking your pimples, squeezing them | *raises hand* I confess i have itchy fingers too lol! This is a major NO no! Scar and pigmentation risk is high. Some people go to beauticians for their extractions. I dont recommend this, but if you must, find a professional to do it for you.

There are 3 main reasons.

1. Skin is too dry. Hence not suitable for treatment.
2. Your skin is unstable, having active breakouts. This can be due to a multitude of reasons. Any treatment during this period acts to purge pimples.
3. Skin is reacting to the skincare that was used after the treatment. Remember, it takes time to get used to a new product.

Why do i get breakout always over the same spot?

Pores are like pipes. Repeated inflammation and swelling of your pore causes the pipe to be narrower. So that very pore gets clogged more easily. With time you notice zits occuring more frequently over that same spot.

Why do many people get breakouts after a holiday?

1- Stress. This can be in the form of unhealthy sleep habits, unhealthy lifestyle, unhealthy diet, which often happens when we want to ‘live life to the fullest’ during our vacation. =)

2 – Change in humidity. This stresses your skin and oil water balance.

3 – They had too much yummi-licious food during the holiday!

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