Hope all of you our fans and friends are staying home and staying safe during this period. We are happy to say that our specialist services by accredited dermatologist – Dr. Teo Wan Lin at TWL Specialist Skin & Laser Centre (TWL Skin) are under essential services by the Ministry of Health (MoH). As of 25 March, we have converted consultations to TeleDermatology reviews with door-to-door courier services (same day available). We will continue to support our patients and friends with e-commerce deliveries during this difficult period for our nation.
Here we have an exclusive piece by Singaporean-dermatologist Dr. Teo Wan Lin who is also the Co-founder of Dr.TWL Dermaceuticals. She is the key formulator for the dermatologist-developed line which has been launched since 2016. Dr.TWL Dermaceuticals is exclusively stocked at TWL Specialist Skin & Laser Centre, an MoH-accredited Dermatology Practice in Singapore. Our dermatologist skincare line has been serving our patients and the public with evidence based skincare ingredients via e-commerce, subscription plans and will continue to do so in this period.
Dermatologists are medical specialists trained in the specialty of medicine dealing with diseases relating to skin, hair and nails.
“Dermatologist Singapore,” this search term shows up with several listings on Google. Both the media and friends alike, often asks me, what exactly does a dermatologist do? And when do you see one? Is that the same as an aesthetic doctor? How about doctors that claim they are skin specialists? In my article today, I shall share with you what a dermatologist does. This will help you choose the correct doctor for your needs.
Who is a dermatologist?
A dermatologist (skin specialist) is a qualified medical specialist who has obtained qualifications to specialise in the diagnosis, treatment and prevention of skin, nail and hair diseases. Dermatologists are trained in cosmetic skin problems and aesthetic procedures. Only doctors listed as dermatologists by MoH are recognised dermatologists. Cosmetic lasers, treatments, botulinum toxin and filler injections were developed by dermatologists. Aesthetic doctors are not skin specialists. They are family practitioners (GPs) who need to be accredited by the Dermatological Society of Singapore to carry out these procedures. Having a diploma in dermatology (Dip Derm) or a diploma in family practice dermatology (Dip FP Dermatology) does not qualify a doctor to be a dermatologist.
What conditions do dermatologists treat?
Dermatologists are experts in the treatment of skin conditions. These include acne, eczema, psoriasis, skin infections, skin allergy, skin cancers and hair loss for example. Dermatologists also treat all kinds of cosmetic problems of the skin and provide advice on skin health.
Disorders of the Skin
Common disorders of the facial skin such as Rosacea, Acne, Acne Scarring Seborrheic Dermatitis, Pigmentation, Contact Dermatitis form the bulk of a dermatologist’s outpatient workload.
Disorders of the skin can also affect areas such as the body and limbs. Folliculitis refers to inflammation of hair follicles which can occur on the trunk, arms and legs. If you have acne-like rashes on your chest and back, this is actually a form of folliculitis. This may be fungal or bacterial in nature.
In addition, dermatologists manage conditions such as bullous disorders (blistering conditions of the skin), autoimmune disorders including Vitiligo.
Fungal infections or nail trauma (such as prolonged wearing of ill-fitting closed toe shoes) cause nail deformities, otherwise also known as Onychodystrophy. An autoimmune disease known as lichen planus may also cause such symptoms. Furthermore, they can occur as an associated skin condition such as in the case of psoriasis.
Hair and Scalp Conditions
Dermatologists are the only accredited medical specialists for any disorders of your scalp or hair, not trichologists or Medi-spas. If you are suffering from hair loss and/or itchy-sensitive scalp, you will need an evaluation by a board-certified dermatologist. The types of hair loss are medically classified into scarring vs non-scarring hair-loss. The former leads to permanent hair loss. It is important for you to visit a dermatologist early to minimise hair loss that is permanent and scarring. If you have known family histories of male/female-pattern hair-loss (baldness), do visit a dermatologist early. This could be in your mid-twenties onwards to minimise the impact of hair-loss and to promote hair-regrowth.
A Dermatologist Can Advise on Your Skincare Regimen
Do you have oily, acne prone skin? Or is your skin sensitive and gets red easily with the wrong cleansers? Looking for a time-efficient regimen to ace your anti-ageing skincare game at home? The latter has always been my focus on sustainable anti-ageing treatments.
What’s not sustainable? Constant visits for lasers and peels to “maintain your skin”. My philosophy is simple. We discharge almost 90% of my aesthetic dermatology patients within 6 months of their initial visit. Subsequently, they start on personalised home medical-facial regimens, with bioactive cosmeceuticals compounded by our pharmacy for long-term maintenance. We also document expectations before and after.
Ever heard of the Glogau Photoageing Scale? This is exactly what a dermatologist will assess you for your level of ageing, before prescribing an appropriate cosmeceutical regimen. Injectables like Botox, Fillers, or lasers may also be combined in conjunction with the regimens. Home devices are now based off state-of-the-art technologies like radiofrequency and microdermabrasion for an at-home aesthetic treatment.
Treatments Performed by Dermatologists
Dermatologists carry out special treatments such as surgery for skin cancers and pre-cancerous skin conditions. These treatments also include the use of ultraviolet light therapy, laser therapy, intense pulsed light (IPL), radio-frequency therapy, botulinum toxin and filler injections and hair transplantations. In fact, dermatologists initially developed many of the cosmetic lasers and treatments existing today.
Role of a dermatologist in Skin Cancer Screening
Dermatologists are the primary physicians managing skin tumours. These include Basal Cell Carcinomas, Squamous Cell Carcinomas and Melanomas of the skin. Dermatologists also treat early pre-malignant tumours such as actinic keratosis using cryotherapy. Doctors who are not dermatologists could easily overlook actinic keratosis which are rough, scaly small bumps. Dermatologists pick up these bumps during routine skin checks.
Where to find a dermatologist in Singapore
Dermatologists all undergo training at the National Skin Centre with stints at other public hospitals. For example, they train additionally in inpatient dermatology at Changi General Hospital, Singapore General Hospital and Tan Tock Seng Hospital. Their training is a minimum of 5 years in a public institution. This involves taking yearly examinations in basic science and physiology of the skin, in addition to clinical-viva examinations. Dermatologists also train in procedural dermatology. These procedures include performing electrosurgery of lesions on skin and scalp, laser vaporisation and resurfacing, and managing skin tumours. Dermatologists are experts in administration of topical steroids and intensive skin treatments such as wet wraps.
Public Vs Private Sector Dermatologists
I have colleagues both in private practice and in restructured hospitals. I myself practised at the National Skin Centre and Singapore General Hospital inpatient dermatology department for several years. This was before leaving for private practice at Raffles Hospital Skin and Aesthetics Centre. I set up my private practice at TWL Skin in 2016, at Mount Elizabeth Novena Specialist Centre. Subsequently, we moved to a bigger space at our current Royal Square Medical Suites.
The current premises house a full-fledged specialist skincare pharmacy and a makeup laboratory. This expands our focus on anti-ageing cosmeceuticals in both skincare and makeup. Our skincare arm houses a handy mask bar that delivers a subscription service of custom-compounded topical-mask essences to your doorstep.
I had envisioned this ideal even before the current COVID crisis. The reason? Todays women are looking not just for run-off-the mill anti-ageing facials, that’s been around forever. The change in beauty in this new milennial is this – sustainable regimens that can be personalised and optimised right at home, backed by cosmeceutically-active ingredients in skincare.
The Key to Choice of Dermatologist
My personal tip on choosing your dermatologist in Singapore boils down to your time, financial constraints as well as personal assessment of rapport with your doctor. Those who need to be seen in a timely manner should go the private route. This is because waiting times in the public sector are generally a month on the average.
However, public dermatology centres are able to offer subsidised rates to Singaporeans. This is for both consultation as well as prescription-medications, since you would be likely seen by a junior medical officer. The medical officer in turn reports to a consultant-level dermatologist overseeing an entire unit. The public sector also requires waiting time for procedures. If you require a procedure to be done promptly, you may wish to go to a private dermatologist instead.
Additionally, if you are a foreigner, such subsidies do not apply to you. In fact, you may be better off choosing an accredited dermatologist in the private sector, for a timely visit and treatment.
Teledermatology in the Era of COVID
The current COVID-19 pandemic is set to change healthcare behaviours forever. In most countries, there is currently a lockdown. This means only essential services like healthcare remains. Fortunately, dermatology is specially well-suited to telehealth and TeleDermatology, whereby remote consults are set to be the new norm. My clinic at TWL Skin was the first private dermatologist practice in Singapore to adopt TeleDermatology in January this year.
We offered this to our overseas patients initially. And then extended it to all our reviews and new consultations since the start of March. The convenience of consulting right-from-home with encrypted video streaming was also an added advantage for the safety of both patients and medical staff. Our clinic TeleDermatology protocol is comprehensive and allows for full evaluation of both medical and cosmetic dermatology concerns. The efficiency of our same-day courier service of prescription medications also win us praise from existing and new patients .
Furthermore, with TeleDermatology, we eliminate the inconveniences of traffic delays. Bad weather and parking are also non-consequential in this context. In addition, we do not lose the personal element, given that streaming technology allows high-definition streaming of both video and audio content. The only requirement? A stable WiFi connection.