A dermatologist talks: What you really should know about your skin problems

A dermatologist talks: What you really should know about your skin problems

Save our skin

Text: Teo Wan Lin

Dr Teo Wan Lin, an accredited dermatologist and medical director of TWL Specialist Skin & Laser Centre, starts off the first of a five-part series on the fundamentals of understanding your real skin condition

So it feels like you've been confronted by an onslaught of skincare products, customised serums and facial oils in recent times, leaving you at a loss, and wondering if you really need to add on that 101th skincare item to your regimen. Everywhere you turn there's an ad that screams 'Erase those lines, zap the wrinkles. Get dewy glowy skin.' You look into the mirror and wonder if it's really all that bad. Nope, you're not imagining it. There has been a proliferation of aesthetic clinics and medi-spas all over the island — and all of them claim to be 'designed by doctors and backed by science'. Well, if you've ever felt confused by the sheer multitude of skincare brands and a zillion laser facials... in all honesty, as a dermatologist, I don't blame you.

I'm equally baffled by the proliferation of 'skin specialists' in Singapore, all promising to make you beautiful. As a dermatologist in private practice, I start with the mission to revitalise the worn souls of women and men and, as I like to think, give birth to hope. I'm first of all a dermatologist, but more importantly, I speak also as a woman myself who's passionate about beauty. I have the knowledge and skills of a skin specialist that has gone through years of training to treat both medical conditions of the skin as well as cosmetic dermatology. I wish to shed some light with regards to aesthetics, which is the legitimate realm of dermatologists because it really refers to our work in cosmetic dermatology in using lasers, fillers and toxins — all of which were discovered and researched by dermatologists.

I seek to provide an authentic perspective because I have seen too many patients who come to my clinic for the first time, who have already committed time and money in their quest for beauty and are totally frustrated with the lack of results or are plainly confused by the time they book in to see me. Many have realised that they should have sooner visited the dermatologist rather than go one giant circle. The real reason I'm writing though, is that deep down in my heart I feel for every woman who's subject to the insecurities that they are plagued with, and hope — that even without seeing me in person — they get the good advice that will save them heartache and money. And so, our journey begins with five key questions that every woman should ask herself before even jumping on to the aesthetics bandwagon, for her own skin's sake (pun intended).Here's the first question you should ask.

Have you ever caught yourself complaining that you have sensitive skin and then broken out if products were just not right? Or has your face gotten itchy and 'reactive' in certain climates or when you perspire? Already an adult and always having a pimple break out at that time of the month? In my experience, eight out of ten women would say yes to one of these questions, for at least a period pertaining to their lives. Many would recount applying a myriad of anti-redness or 'sensitive skin' products or simply resort to not using anything but water to wash their face when they've given up.

Many simply live with having that stinging sensation on their face every time they work out, pile on tons of foundation like a mask to hide their perpetually red face, blame their pimples on hormones (or it being that time of the month), or just shrug off their uneven skin texture, scarring and open pores as a case of them simply not being blessed with good skin. The truth is, from a dermatologist's perspective, there is very likely a true medical condition of the skin, which needs to be rightly diagnosed and treated even before we talk about anti-ageing or beautifying your face. It's a little bit like getting your ABCs right before starting to write essays! Here are the top three skin conditions which I find plague many women in Singapore. The bad news? These conditions don't go away by themselves and have to be treated with proper medication prescribed by a dermatologist. The good news is that they can all be fully treated and symptoms do eventually disappear with the correct medication.

Girl popping pimples in the mirror

You could be suffering from rosacea, which has to be treated with the correct medication before lasers (to eradicate the blood vessels) are even a consideration. Rosacea is triggered  by hot climates, spicy foods and even by emotions in some people who are predisposed to it. We don't understand the exact cause of this ailment, but it's postulated to be related to increased blood vessel sensitivity as well as certain mites that live on your skin (called demodex mites). Rosacea is treated with oral antibiotics which help reduce inflammation, as well as certain creams.

It may not be simply pimples when it occurs constantly around the jawline and mouth. It's certainly not caused by makeup, the climate or the new moisturiser you are using (read: the product you use should have a non-comedogenic label on it). For one, it could be perioral dermatitis, which will not respond to simple acne medication. And, if it's a case of hormonal acne (with flares around that time of the month), check if your menstrual cycles are regular and if you have observed excessive hair growth over your body. Polycystic Ovarian Disease (known as PCOS) can cause acne as well and is actually a disorder of your ovaries which can lead to infertility if left untreated.

Do you have skin redness, flaking, itchiness or a stinging pain to common exposures in the environment or even to certain skincare or makeup? Patients with sensitive skin are likely to have atopic dermatitis, which is a genetically-determined condition whereby the skin is deficient in fatty lipids that act as a barrier to the environment. If you experience an acute episode of 'sensitivity', you may actually have a form of allergic contact dermatitis to a topically- applied substance, for which you need to be reviewed by a dermatologist and receive appropriate medical treatment.

Sometimes a patch test will be recommended. If you have any such symptoms, stop all skincare products and promptly seek the care of a dermatologist rather than self-medicating, or adopting a wait-it-out attitude. Some tips: Look for the labels 'dermatologically tested and formulated' when it comes to choosing cleansers, moisturisers and cosmeceutical products. Avoid testing many different cosmetic products which have no scientific evidence proving their effectiveness. Finally, wherever possible, avoid dust, extremes of temperature and humidity and prolonged contact with sweat, as these conditions tend to worsen skin sensitivity.

Dr. Teo Wan Lin is a leading dermatologist in Singapore and also the Medical Director of TWL Specialist Skin & Laser Centre