In this article, we will explore the different types of acne, the possible causes, and acne treatment in Singapore that really works from a dermatologist. Including excerpts from Skincare Bible: Dermatologist’s Tips for Cosmeceutical Skincare by Dr. Teo Wan Lin, dermatologist at TWL Specialist Skin & Laser Centre.
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These appear like bits of black dirt stuck in open visible ‘pores’. These are actually hair follicles that also have oil glands(sebaceous glands)
Blackheads are actually a form of acne we call open comedones. The cause of this is an overproduction of oil that tends to cluster around areas like the nose. The buildup of keratin and oil around the follicle is oxidised. Then, it turns blackish because the oil itself is oxidised by air.
Blackhead Acne Treatment in Singapore
Acne treatment for open comedones are best with a mixture of chemical peels, containing salicylic acid, lactic and glycolic acids to control the oil production. Carbon laser peels also help to shrink oil glands and reduce production of oil. A good cleanser is important. Nothing over the counter actually works well. Pore strips help to physically remove the bits of keratin and oxidised oil. However, 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.
The Anti-Inflammatory Oil Blotting Linen can help to regulate oil production, is anti-redness, anti-bacterial, skin-soothing, and contains antioxidants. Dermatologist-recommended for Seborrheic/Oily/Acne-prone skin
For patients with greasy skin in the day, it may help to just wash the grease off with a good cleanser. For cleansers, look for the labels ‘’dermatologist-tested and formulated’’ for maximum clinical efficacy.
I use a cleanser with medical-grade honey which I have partnered with a laboratory to formulate. It effectively cleanses away dirt, bacteria and grime. This is as honey is a natural emulsifier, unlike chemical lathering agents. Additionally, it 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). This can leave the skin red and flaky while the acne problem doesn’t go away.
2. Whiteheads- AKA closed comedones
Whiteheads (closed pimples) or hidden pimples (those that are ‘stuck’ under the skin’s surface) are accurately known as closed comedones.
Theseare seen as tiny bumps on the skin surface. These tend to occur especially over the forehead and chin, whereas open comedones(blackheads) occur over the nose and cheeks.
The cause of closed comedones is due to the underlying genetic tendency of the skin to be inflamed. Then, they produce tiny seeds which slowly rise to the skin’s surface. Some types of makeup or skin-care products can actually cause acne. Look for the label non-comedogenic on your makeup, and for skin-care, for dermatologically tested labels. Also, if you are wearing certain types of headgear or face masks, you can develop a type of acne known as occlusion acne, over the specific areas of contact and pressure.
Whitehead Acne Treatment in Singapore
Closed comedones should not be ignored because they develop into more severe forms of acne like papules, cystic acne and gram-negative folliculitis. Never try to prick and extract the closed bumps or let any facialist do that because it will introduce bacteria. I treat closed comedones with 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. Do not use scrubs with rough beady material as these only irritate the skin further besides being totally ineffective at removing whiteheads.
In terms of skincare, do not use oil-based moisturisers if you have any form of acne, opt for emulsions(oil in water) or hyaluronic acid serum (water-molecule based skin hydration), which I prescribe for my patients with acne as no matter how oily one’s skin is, you still need moisture.
The Radiance Fluide Hydrating Emulsion contains LARECEA™ Extract for regeneration and skin brightening ingredients for a dewy glow. Specially formulated for a light-weight feel to impart a radiant glow without make-up.
The Hyaluronic Acid Serum has an intense concentration containing laboratory-grade pure hyaluronic acid serum, freshly compounded for total skin hydration. It is also paraben free.
Closed comedones should not be ignored because they develop into more severe forms of acne like papules, cystic acne and gram-negative folliculitis. Never try to prick and extract the closed bumps. I personally treat closed 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.
Cystic acne is harder painful bumps which may feel ‘boggy’, produce pus and leave a bad scar. These are red bumps which can appear anywhere on the face, chest or back which produce oil.
The cause of cystic acne is inflammation. When whiteheads or blackheads get infected, if left untreated, it can get infected with superficial skin bacteria. Picking on pimples, an excess growth of a certain skin bacteria known as Propionebacterium also causes cystic acne. Overall, it is to do with genetics: if you have a relative with bad acne, you likely have the genetics that will increase your risk of acne as well.
Cystic Acne Treatment in Singapore
Cystic acne is a severe form of acne which warrants specialist dermatologist care. This is as it can leave terrible scars and there can be secondary infection, leading to cysts and abscesses (collections of pus under the skin) if left untreated. Prevention is usually hard; but if you have a family history, don’t treat your acne problem lightly. Never pick your pimples or squeeze your whiteheads or blackheads as the bacteria on your fingers will cause infection. The way to remove whiteheads and blackheads is with prescription creams containing tretinoin, and with chemical peels and microdermabrasion. Oral medication will be necessary for acne. There may be a prescription for the medication isotretinoin to help to shrink your oil glands. Take this prescription under close medical supervision.
When to see a dermatologist
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.
In closing, I feel it is important to debunk the myths in common home beauty remedies for acne. Firstly, do not use scrubs with rough beady material as these only irritate the skin further besides being totally ineffective at removing whiteheads, blackheads and definitely can worsen cystic acne. In terms of skincare, even oily skin types do need moisture. However, do not use oil-based moisturisers if you have any form of acne, opt for emulsions (oil in water) which are more comfortable in a humid climate like Singapore, and help to restore the skin’s protective barrier.
Lastly, persistent acne is not normal and should be treated by an accredited dermatologist to avoid infections and scarring.