Acne Singapore. Pimples. Acne scars. Acne marks. Red marks |

ACNE MARKS

Acne Singapore. Our heat humidity is the primary cause. Learn more about Acne today.

ACNE Singapore

howto getridof-net
ACNE Singapore
Acne, acne scars, pimples, whiteheads, blackheads…(Blackheads are open comedones, whiteheads are closed comedones, below is an example.)
how acne starts
ACNE Singapore | CAUSE
We have all battled with acne before. Some more than others, some ongoing, some successfully conquered.Our hot humid climate does not help one bit. This, coupled with our natural tendencies for oil glands to go into overdrive has left notable battle scars.
How many of us have been bothered by these thru our teens? Who amongst us had struggled, tried numerous over the counter cleansers, toners and cosmetic products but to no avail, or worse still, triggering more outbreaks?
This should never be a battle fought alone. This is a battle best fought with the help of your Doctor and his array of treatments.

So what causes acne?

how-acne-develops

Well, to put it simply, it’s the blockage of our pores. And if we dont manage it carefully, it leads to acne scarring. Acne is the most common skin problem among young adults in Singapore, affecting up to 88% of them, with half having moderate or severe acne. And, the bulk of cases seen by dermatologists are acne related. It is worth seeing a dermatologist if your acne is moderate to severe, so as to reduce your acne scarring risk. 

Most acne medications BOUGHT OVER THE COUNTER are drying to the 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 inflammationNever attempt to wage this battle alone. Acne is not rocket science, but there is a complex range of conditions. If over the counter medications do not work after 2 weeks, it is time to enlist the help of your friendly dermatologist to guide you thru the various treatment regimes.

Cost of acne scarring treatment starts from $2000 in Singapore, and depends on the combination modalities used, and can be in the form of 

  1. Lasers and Peels
  2. Microneedling +/- Injectables to fill up acne scars
  3. Skin treatments to improve skin quality and promote collagen growth for long term skin maintainence 
CIMG7289

 


So the question is- how do we treat acne?

In the latest 2016 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. Acne should be actively managed to reduce the risk of permanent scarring.

How do Dermatologists treat acne?

My approach is to divide and conquer. Acne can be divided into non inflammatory, inflammatory and acne scars. Non inflammatory:  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: Angry, red, bumpy  pimples

1) Benzoyl peroxide based treatment, plus minus oral antibiotics

2) Lasers and AHA based medical peels to control the oil, 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.


Dr Daniel Chang’s 3 STEP ACNE Treatment protocol: 

1- Laser/ Light/ Peel

2- Topical medication +/- oral

3- Lifestyle changes ( Pls refer to my lifestyle guide)


 

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


What are common acne triggers?

  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. 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.

How can we prevent acne? 

Dr Daniel Chang’s GOLDEN rules – 3 steps to acne free skin – DAILY SKINCARE REGIMEN:

  1. Cleanse gently, splashing with warm water and pat dry
  2. Apply moisturiser gently. No rubbing.
  3. Dab anti acne cream, gently, no rubbing, with a cotton bud. Key to effective treatment here are ingredients containing retinoid and benzoyl peroxide. But balancing the side effects require time and careful use. Differin cream, clindoxyl and clindamycin are my top choices for this. (Retin A based creams like retacnyl, differin work best with benzoyl peroxide based antibiotic creams like clindoxyl, but these do cause skin irritation, so its important to learn how best to apply them onto your face.)

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

  1.  Cleanse, exfoliate and treat. 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. Your pillows otherwise collect all the sebum, makeup and dirt that contribute to pore clogging.

What are common mistakes in acne treatment? 

  1. No moisturiser used OR Mistaking aloe vera gel for moisturiser: – A well moisturised skin will help with sebum control and reduce clogging of pores, which leads to acne. 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 their pimples, squeezing them. –  This is a NO no! Scar and pigmentation risk is high.
acne-face_7
acne-face_4
acne-face_6

acne in females
INFLAMMATORY ACNE
hormonal acne
HORMONAL ACNE

(pictures courtesy of dermnetnz)

Moving on, we will dive into acne scars.

What are the types of acne scars? 

There are different types of acne scarring. Different types of acne scars on the face can undergo different types of laser treatments for optimal results.

Types of acne scars:

  • Ice-pick scars
  • these are deep, narrow, pitted scars
  • Rolling scars
  • broad depressions with sloping edge
  • Boxcar scars
  • broad depressions with with sharply defined edges
  • Atrophic scars
  • flat, thin scars or depressed scars
  1. Atrophic scars: Treatment with combination of fractional lasers, subcision +/- microneedling, Radiesse, Profhilo, Sculptra, Gouri injection 
  2. Hypertrophic and keloidal scars: Combination of fractional lasers +/-microneedling,  with silicone gel and steroid injections
  3. Post inflammatory hyperpigmentation (PIH) (red, brown) in scars: Non ablative lasers like Dual Yellow Laser, QS NDYag, long pulse ND Yag, Pulse dye lasers and  Alex lasers work well.
hyperpigmentation
Acne marks ( post inflammatory hyperpigmentation)

PIH ( brown or red marks)

ice pick acne scars
ice pick scars
boxcar-scars
box scars
atrophic acne scars
atrophic scars
rolling-scars
rolling scars

ice pick scars                                 

hypertrophied, keloidal skin
hypertrophic, keloidal scars

(pictures courtesy of dermnetnz)

What are hypertrophic, keloidal scars? 

Unfortunately, true acne scars never completely disappear. Treatments can improve their appearance. They can be disguised with make-up. So moral of the story is, do not lack acne scarring happen.

Scars can be treated elegantly with 2 main modalities, RF Microneedles and C02 lasers.

The Fractional CO2 Laser technology is a skin resurfacing treatment that tightens open pores, reduces wrinkles and fine lines, controls sebum production and improves the appearance of acne scars. It involves a laser beam that resurfaces the skin, destroying tissue a millimeter deep in microscopic spots. The “injury” triggers the self-healing mechanism of the skin, stimulating collagen and smoothing wrinkles.

It is effective for skin rejuvenation as it treats various skin problems such as skin laxity, fine lines, wrinkles, age spots, blotches and pigmentation, to unveil beautiful skin safely with minimal discomfort and micro-downtime.

fractional lasers
Fractional C02 laser / Erbium laser

Finally, I will do a review of existing treatments.

What types of chemical peels work best for acne? 

As mentioned, AHA and BHA work well for acne. They act to kill the P acne bacteria, exfoliate dead skin and control oil.

So my recommendations for chemical peels are the following:

  1. Glycolic acid
  2. Salicylic acid
  3. Jessner -> TCA

Moving on, here is an example of the Black Gold Peel Laser, which works on the principle of targeting angry active acne…

carbon laser peel

How does Carbon laser peel work? How does it help acne?

  1. Reduces oil gland activity, reduces bacterial inflammation, and promotes exfoliation, hence unclogging your pores to control your acne
  2. It also serves to tighten and improve the appearance of your pores
  3. And improves your skin tone, giving you a soft natural glow.

Common side effects include redness, mild bumps on the skin which are tolerable.

The non-ablative Brightening Laser uses an exclusive and versatile modified aesthetic device that gently corrects a range of skin problems. This unique Brightening Laser emits two shades of light: Yellow and Green, both of which have different functions. The combination of the two colours can penetrate more deeply and can be used together or separately, to help achieve a complexion that looks clearer, brighter, firmer and younger. In addition, the laser promotes re-growth of dull skin and reduces pigmentation and freckles for complete skin rejuvenation. This laser can also fade dark eye circles for a further brightened complexion. 

It is effective in stimulating collagen production, the essential protein for giving your skin elasticity, that produces fast results in improving vascular lesions, pigmented lesions, melasma and acne, all in a painless treatment with no downtime.

 

hormonal acne
hormonal acne
(here is an example of adult onset acne)As a general rule of thumb I find that this laser, which serves to kill the P acne bacteria, shrink pores, and reduce oil production, is a good treatment to undergo. In addition, I would recommend the following coupled with a good skincare regime to get on top of your acne.Now acne can be classified into mild, moderate and severe. Below is a summary and their corresponding treatment.
  1. Mild (comedonal acne or mild inflammatory acne): topicals retinoids +/- AHA, BHAs
  2. Moderate: oral and topical antibiotics for inflamed acne, + benzoyl peroxide, +/- OCPs
  3. Severe (nodular): please speak to your dermatologist    

Many have asked me,

Why do some people get breakouts after a chemical peel or laser? 

There are 3 main reasons.

  1. Skin is too dry. Hence not suitable for treatment.
  2. Skin is unstable, and having active breakouts. This can be due to a multitude of reasons. So 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 people get breakouts after a holiday?

2 main reasons.

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.

Dr Daniel Chang

To learn more about:
  1. ALL Aesthetic treatments, do click here Ultimate Guide to Korean Medical Aesthetics.
  2. Threadlifts, pls click here Facelift, V-Lift.
  3. Dermal fillers, pls click here ABCs to Dermal Fillers. 
  4. Pigments and pigmentation in skin.  Please click here PIGMENTS

 =============================================================