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At Ensoul, our aim is to provide you with information about your skin in a series of easy to understand videos.
By understanding your skin condition, you will be able to learn more about the type of
medical aesthetic skin and body treatment modalities that is suitable for you.

Sweaty Armpits

Sweaty Armpits

Underarm excessive sweating, also called axillary hyperhidrosis, can be uncontrollable, annoying and embarrassing. From the discomfort of sweat running down your sides, to the embarrassment of obvious sweat stains, to the fear of being laughed at, uncontrollable underarm sweating can make them even more anxious especially in social situations. Individuals with hyperhidrosis may feel that this has hinder the way they have lived and is affecting their quality of life. 

Treatment for Sweaty Armpits (Hyperhidrosis)

With the aid of technology, there are multiple of treatment options and preventive measures you can consider to resolve your sweat-soaked shirt problems.

  • Over the Counter/ Prescription Antiperspirants: an topical product that is applied on the surface of the skin
  • Iontophoresis 
  • Microwave Therapy
  • Neurotoxin Injections
  • Surgery

Our preferred method is to use neurotoxin injections to control the axillary hyperhidrosis (excessive underarm sweating). Neurotoxin injections are drugs that temporarily paralyze the muscles such as reducing facial movements (to reduce wrinkles) and blocking the secretion of the chemical that activates the sweat glands to stop sweat. A simple and painless procedure, with minimal to no downtime.

Solutions to Treating Sweaty Underarms & Palms
Dr Chiam CT

Tattoo Removal

Tattoo Removal in Singapore

Remove Your Unwanted Tattoo Effectively With Medical Lasers.

A tattoo is a form of body modification where a design is made by inserting ink, dyes, and pigments into the dermis layer of the skin. Tattoo is a form of self-expression in an art form. Body tattoo goes back to the beginning of recorded history and removal of unwanted tattoos has also been around for a long period too. In recent years, Permanent Make up, also known as micropigmentation is becoming a trend as well. An increasing number of people are seeking permanent cosmetic solutions such as eyebrow embroidery and eyeliner tattoo, to make for an easier morning. 

There are number of techniques used to apply tattoos, it is dependent on the type of ink, the area where it is applied, the colours, the designs as well as the depth of the skin which made them unique to every individual. Hence, removing of tattoo is different for every person.

Tattoo Removal - Dr Chiam CT

Treatment Options to Remove Stubborn Tattoos

While tattoos are a form of individualism, an artistic freedom and a visual display of a personal narrative. Some people might regret much later due to their impulse decision, or when the trends has changed or when the tattoos are done by a non professional artist.

One of the most effective ways to remove it without leaving a scar is by laser removal. I find that the non invasive Q-switched laser is one of the most effective lasers that uses short pulses of energy to remove stubborn tattoos. The short pulse uses a 1064nm wavelength to shatter the tattoo ink particles, breaking it into smaller fragments which can be absorbed by the lymphatic system and be eliminated naturally. Another laser, I like to use is the 755nm Alexandrite Picosecond Laser, a new patented technology that is approved by the FDA. The picosecond (one trillionth of a second) laser uses photo-acoustic energy to zap away the pigments in the tattoos with lesser downtime and side effects. A gentle treatment process that is comfortable and safe for the skin. By targeting the laser on the tattoo ink particles in picoseconds, it can effectively clear stubborn ink colours such as orange, yellow, red, blue , purple and green.

Before the advent of medical laser, common techniques included cryosurgery, dermabrasion or excision were used to remove tattoos. As people (and their tattoos begin to age), the tattoos start to fade and eventually became harder to treat. As lasers became widely available for a range of dermatological conditions, many different lasers were used to remove tattoos with a wide range of colours, intensity and depths.

To find out more about tattoo removal at Ensoul Clinic Singapore, feel free to book a consultation with us.

Xanthelasma

Xanthelasma Causes & Treatments

What is Xanthelasma?

Xanthelasma is a yellowish deposit of cholesterol underneath the skin and it usually occurs on or around the eyelids, and often, develop symmetrically around both eyes. While they are mostly harmless to the skin nor painful, these minor growths may cause the eyelid to droop. It can appear at any age but are more likely to develop during an individual’s middle years – and in women more often than men.

These lesions may remain the same size or grow very slowly over time. It can sometimes join together to form larger lumps. Individuals with xanthelasma may tend to have abnormally high lipid levels in the blood, which is known as dyslipidemia. Lifestyle factors can also cause cholesterol to deposit around the eyes, such as – a diet high in saturated fats and cholesterol, excessive alcohol and insufficient exercise.

How do we treat Xanthelasma in our clinic?

There are various of ways we can remove Xanthelasma. Surgical excision is one of the solutions to remove these growths, but this method requires a long downtime. For individuals who is unable to take a long downtime, I recommend the removal of Xanthelasma with medical laser or radiofrequency. As these modalities can be used to flatten the xanthelasma down to the skin level without cutting the skin.

The area will be numbed with an anaesthetic cream applied directly into the area to prevent any discomfort during the treatment. Eye shields would also be required to be worn during the treatment to protect patient's eyes as Xanthelasma usually occur very near the eyes. 

Skin Rejuvenation

What is Skin Rejuvenation and Resurfacing?

Sun, skin disorders, aging and even heredity can all contribute to skin irregularities on the face and elsewhere on the body. These include textural irregularities like wrinkles and acne scars, pigmentation changes like freckles, sunspots or visible blood vessels. In addition, skin may lose tone, feel less firm and lose the healthy glow that is evident in younger skin.

To understand the best skin rejuvenation treatment for you, we must first understand how the face ages. There are four aspects to how the face ages; 

1) Volume : Our face loses volume as we age, the volume loss can be in a form of bone or fat around the cheeks and brow areas that resulted in saggy upper eyelids and Nasolabial folds also known as the laugh lines. As our skin loses volume, we also began to develop wrinkles as well.

2) Elasticity : Skin Elasticity is what gives our skin that healthy, youthful glow look, as we start losing elasticity, wrinkles, frown lines, laugh lines and crow's feet will begin to surface as our skin is not tight and smooth. 

3) Skin Quality & Texture : As we aged, the quality of our skin decreases, our skin might not be able to absorb moisture as well as before. Our skin may start to feel flaky and dry and develop fine lines and enlarged pores.

4) Pigmentation :  We begin to accumulate pigments as we grow older and when it's not taken care early, it can give rise to problems such as Melasma, sun spots as well as aged spots. 

How Do I Reverse Aging? 

Different treatment modalities are available to treat the different aspects of skin damage.

Laser resurfacing, mechanical resurfacing, chemical peels and injectable products can improve the appearance of fine lines and wrinkles of the entire face or those that develop in specific regions of the face, such as the upper lip and around the eyes. These treatments can also be used to address pigmentation disorders, such as sun and age spots, and they can be used to improve the appearance of acne scars or other skin conditions.

The specific type of treatment that will best address your concerns are determined after a consultation wth me. Most skin treatments require a series of treatments and a multi-modality approach to achieving excellent results. Most importantly, the patient must be committed to protecting his or her skin going forward so that the results achieved will be longer lasting.

In the series of videos below, Dr Chiam will be sharing with you the different treatment modalities for the different types of aging conditions.

Facial Rejuvenation Episode 2 : Volume Loss

Facial Rejuvenation Episode 3 : Skin Elasticity

Facial Rejuvenation Episode 4 : Skin Quality & Texture

Facial Rejuvenation Episode 5 : Pigmentation

Keloids

Keloids Causes & Treatments

What Causes Keloid Scar?

Scarring is a natural part of the healing process. Any injury, burn, surgical operation or skin problem, like acne, can cause a scar. Scarring is psychologically distressing and cosmetically challenging to treat. Concealing an inconspicuous scar is easy. However, facial scars or large visible scars are unattractive and can be difficult to conceal with make up.

Keloids are overgrown scars from overly aggressive wound healing. Excessive collagen were produced in the dermis during connective tissue repair resulting in the progressively enlarging scar that are thick, irregular, raised, red scars that extend beyond the wound boundary. A keloid scar is benign and is harmless, however they can be itchy, pain and may hamper movement.

Treatments to Remove Keloid Scars

We have many modalities of fractional skin resurfacing and non-fractional scar treatments. As Keloid is caused by over excessive collagen, to reduce it, we will need to use collagen remodeling lasers, to decrease the depth and improve the appearance of your scars.

There are many types of scars and different approaches are needed to achieve optimal results. A thorough examination to determine the extent, depth, colour and type of your scars will be required. We will then recommend a personalized blend of treatments for you according to your scars. Since each individual is unique, Dr Thean or Dr Chiam will be closely monitor your progress to modify your treatments on your journey to achieve a much smoother skin.

Moles

Moles—Removal & Treatment Options

Moles are brown or black colored skin growths on the skin. They occur when melanocytes, the skin cells which make melanin (the pigment to give our skin its natural color) grow in a cluster instead of being evenly spread throughout the skin.

Moles usually appear from early childhood, but sometimes develop during the first 25 years of your life. It is quite normal to have between 5 to 50 moles by the time you become an adult. Moles can be alone or in groups, and can appear anywhere on the skin. With time, some moles can slowly change and become larger, raised or darker in color. Moles can also darken after sun exposure or during pregnancy.


Frequently Asked Questions on Mole Removal 

  • What are the treatments for mole removal? 

    There are multiple treatment modalities to remove moles, the method of choice is dependent on whether the mole is raised or flat. Raised moles can be removed by an ablative laser - my preferred modalities to use is the Erbrium Yag instead of a CO2 laser for better results. The treatment uses bursts of light radiation to break down the mole cells in the skin. The number of session(s) to remove is dependent on the depth of the mole.

    As for flat moles, ablative laser is not an ideal treatment as this treatment can sometimes leave a depressed scar after the mole is removed. Instead, we use a Pro Yellow 577 nm laser that only targets the pigments for flat pigmented moles.

    Apart from excision and cutting methods to remove moles, laser removal is also another option which you may consider if you have multiple moles to remove at the same time or if your mole is located at a harder to reach area.
  • Can mole be removed permanently?

    Moles are made up of active skin cells, thus there is still a small chance of recurrence, especially if the entire mole is not removed entirely. Speak to an experienced and knowledgable doctor to find out what are the treatments you can consider to reduce the recurrence close to zero.

  • Is mole removal painful?

    Mole removal can be comfortable and tolerable. As local anaesthetic is usually given with an injection or topical numbing cream is applied prior to the procedure. Depending on the method of removal, the doctor will apply accordingly. 

  • How many sessions does it require to remove the mole completely?

    For most patients, 1 session is enough to remove the mole completely. However, depending on the method used, some patients may see early recurrence and may require further sessions to remove the mole.

  • Will the treatment leave a scar from mole removal?

    The procedure may or may not leave a scar depending on the depth of the mole, the body's natural response to injuries or an individual's ability to heal. Usually, if the mole is deep, removing the mole may have a greater risk of scarring. During the first few days after the treatment, you may see the scarring as the body's natural response to injuries as the treatment penetrates the deep layers of the skin. As the body will begin to repair the wound, the body will also produce collagen, making the injury thicker and denser than usual. Slowly, once the healing tissue begins to build up, the affected area will look a little red and harden; after a month or two later, the scar will start to look less red and flatten over time.


Oily Skin

Oily Skin Causes & Treatments

What Causes Oily Skin?

Our skin produces natural oil in the sebaceous glands, known as sebum. This natural oil is crucial for keeping the skin healthy as it helps to lubricate the skin, preventing it from drying out or become irritated. It is very common for us to have a certain amount of natural oil as it keeps our skin supple and moisturised.

However, when excess skin oil is produced within the pores, your skin will look greasy and shiny, which can lead to clogged pores over time, if you do not take proper care. This would eventually lead to occasional or persistent pimples, blackheads/ whiteheads, acne flare-ups and very large or obvious pores on the skin.

The symptoms of oily skin and the severity vary between individuals. Some of the factors that cause oily skin to occur;

  • Lifestyle (e.g. Diet)
  • Hot environment
  • Use of oil-based products
  • Genetics
  • Hormonal changes (Puberty / Pregnancy)
  • Stress

Here Is How We Can Control Your Oily Skin
Dr Chiam C.T

Our Solution for Oily Skin

Treatment for oily skin should start as early as possible. Left untreated, oily skin can lead to a buildup of dead skin cells clogging the pores, causing acne flare ups and resulting in scarred skin. To avert further damage, I use a combination of non-invasive epidermal and dermal laser treatments, together with Intense Pulse Light (IPL) to gently stimulate natural collagen growth, improve pores and reduce oil production.

These treatments are safe, effective and have no downtime. You can even squeeze in an aesthetic treatment during your lunch time and resume your daily activities. To learn more about your skin and the types of treatments you can avail, schedule a consultation with us today.

Wrinkles

Wrinkles

Fine lines and wrinkles occur because of ageing. As we we get older, the skin gets thinner when collagen and elastin synthesis slow down. This is made worse by UV damage and exposure to environmental contaminants. Wrinkles and fine lines can also be caused by dehydration or allergies in faces of any age. Young children with allergies, asthma or eczema have creases and folds under the eyes, call Dennie-Morgan lines.

Other factors like pollution, nutrition, genetics, smoking, and certain medications can also contribute to the formation of wrinkles. However the majority of wrinkles and fine lines are still related to photo damage from ultraviolet light. Damage from ultraviolet (UV) light exposure is responsible for almost 80% of the skin changes commonly attributed to the aging process. The biggest sources of UV light are the sun and indoor tanning beds.

Ultraviolet light damage causes both a breakdown of collagen and elastin (molecules in the dermis that give structure , strength and elasticity to the skin) by activating enzymes called matrix metalloproteinases (MMP) but also decreases the deposition of new collagen by dermal fibroblasts. When exposed to ultraviolet light, fibroblasts undergo aging or senescence.

Wrinkles and lines first appear in the lines of facial expression. Dynamic wrinkles are the ones that appear when a facial expression, such as a smile or frown, is made and go away when the face is relaxed. Eventually, these dynamic wrinkles become permanent or static as the facial expressions etch them into the skin that has lost some amount of strength and elasticity.

Treatment for Wrinkles

Facial skin rejuvenation has long been the most highly desired aesthetic procedure. The demand for no-downtime procedures in skin rejuvenation has spurred aesthetic researchers to develop newer non-invasive procedures. Depending on the severity of the skin, we will work a program that uses different modalities of equipments to stimulate the production of new collagen and elastin within the skin. Collagen acts as the major support protein for our skin and elastin allows our skin to stay firm and reduction of wrinkles.

Dermal Fillers made of hyaluronic acid gel can contribute to volume and hydration, rejuvenating the facial skin by reducing or eliminating wrinkles, raising scar depressions and replace soft-tissue volume loss.

Dilated Veins

Dilated Veins Causes & Treatments

What is Dilated Veins?

Dilated facial veins (Varicose Veins) also known as “spider veins”, is a common benign skin disorder. The widened blood vessels give the appearance of fine, easy visible, threadlike red lines or patterns that appear just beneath the skin surface. It grows gradually and is often seen in clusters. Spider veins are generally seen on areas frequently exposed to sunlight, like the cheeks and the nose. The causes that enlarge these blood vessels are unknown. There is a genetic predisposition, aggravated by sun damage, extreme heat or cold.

Patients more likely to develop spider veins include those who:

  • work or play outdoors;
  • are older, as your blood vessels begin to weaken and spider veins are more likely to form as skin ages;
  • use health and beauty products that cause skin irritation, such as abrasive soaps and sponges;
  • use corticosteroids and some skin products which thins and weakens the skin;
  • drink too much alcohol, which increases the flow of blood in vessels; and are affected with diseases like rosacea, scleroderma, dermatomyositis and systemic lupus erythematosus.

Treatment for Spider Veins

Many patients find their dilated facial veins unattractive and want to have them removed. Treatment is done to improve your skin’s appearance. I treat dilated facial veins using a 577 nm Pro Yellow pulse dye laser. This laser is specially designed to target the widened blood vessel, forcing its walls to collapse. This reduces the appearance of the red marks or patterns on the skin. Widespread and persistent facial flushing which give the face a ‘ruddy’ complexion is caused by many tiny dilated broken facial veins. This condition requires treatment with the Pro Yellow laser scanner which carefully and precisely seals the many dilated blood vessels in the skin.

Treatment with the Pro Yellow laser is painless and takes 5 to 15 minutes. There is no recovery period required and you can continue with your daily activities without interruption. However, to reduce new spider veins from forming, it is good practice to protect your skin from excessive sun exposure and extreme temperatures.

SPIDER VEINS REMOVAL | Dr Kenneth Thean

Warts

What are Warts? - Causes & Treatments

A skin wart is an infection by viruses in the human papillomavirus (HPV) family. A skin wart usually occur on the forearms, palms, fingers, and/or feet and its appearance depends on its location.

What are the types of warts? 

There are several types of warts including:

  • Common warts: a slightly raised small solid growth that resemble a small cauliflower with a rough texture are commonly found on hands.
  • Plantar warts: a flat, rough with spongy surface warts that are commonly found on the soles of the feet. The plantar warts on the feet may be painful due to the pressure areas as they get pushed into the skin.
  • Flat warts: a small slightly raised, smooth warts which can be found on the face, hands and shins. They are less common as compared to the other warts and they appear in large numbers
  • Mosaic warts: are a cluster of smaller plantar warts joined together. They are white, often tender and is about the size of a pinhead. They can be commonly found on the balls of the feet or under the toes, but may also spread and cover larger areas on the entire sole of the foot. It does not hurt as much as compared to the plantar warts. 

Wart Removal at Ensoul Clinic Singapore

Although skin warts are harmless, they are contagious and can spread from one part of the body to another or to children.Thus it is important to always wash your hands regularly. As warts are developed when tiny blood vessels grow into the core of the wart to supply it with blood. To remove it, we must first destroy the blood in the tiny vessels and lasers are one of the ways to do it. The traditional method to treat skin warts was to use an ablative laser to destroy the wart. However, to carry out a complete removal, the surrounding skin will also get damaged, leaving a depressed scar. The newer method I now practice is to use a vascular laser to cut off the feeding blood vessels to the wart. The infected tissue eventually dies and the warts falls off while the surrounding skin remains intact.

Frequently Asked Questions on Warts 

1) How long does each treatment session take and how many sessions do I need? 

Each treatment takes about 15-30mins or even up to 45mins depending on the number of warts to be removed and most skin lesions can be treated in a single session while some may require about two to three treatment sessions to remove. 

2) How long does the skin take to heal and what is the after care process? 

After each treatment session, the lesions will take about one to two weeks to dry up and slowly fall out. The skin will take about another one to two weeks (depending on individual) to dry and heal. It is important to wash and clean the treated areas gently and avoid scratching, rubbing or aggravating.

3) Is removal of warts painful? 

Warts removal is a relatively comfortable procedure and there is minimal to no discomfort after the treatment. For maximum comfort, numbing cream can be applied to ensure the treatment process is comfortable. 


Eczema

What is Eczema?

Eczema is a skin condition encompassing  a wide range of diseases, in which chronic inflammation troubles the skin. Common symptoms include inflammation, itchiness, redness, roughness and cracks, in the skin surface.. However, atopic dermatitis (AD) remains the most common form of eczema. Usually,  observed among children, below five years of age,  the condition can linger on through adolescence and up to adulthood. It is also possible to manifest in adults. 

Atopic dermatitis can affect the skin on any part of the body. The term "atopic" alludes to an allergy, and it has been observed that most of the people coping with eczema are suffering allergic conditions such as asthma coupled with itchy, and red skin. 

The most common symptoms of atopic dermatitis include

  • Rashes erupting in the creases of joints such as the elbows or knees
  • Skin surface, in areas afflicted by rash, likely to have a lighter or darker appearance, or it could even grow thicker.
  • Small bumps develop and ooze fluid, on scratching them.
  • In babies, the rash could appear on cheeks or scalp.
  • Possible infections  if skin scratched till it bleeds.

This is an eczema that is caused by weakening of the skin's natural barrier, leaving your skin susceptible to irritants and allergens.  Genetic makeup, dry skin conditions, immunity problems, external factors  like swimming, sports, and humid weather conditions can further intensify eczema, leading to bleeding or  infections when skin is scratched constantly, ultimately disfiguring the skin surface. Quite often, eczema patients have to make substantial lifestyle changes due to their condition. 

Contact dermatitis (caused by allergic reactions) or dyshidrosis (appearance of blisters on hands and feet), is the other significant type of eczema that we come regularly across. This condition occurs when the skin comes in contact with certain allergy-inducing substances such as   detergents, paint, latex, nickel, poison ivy, perfumes, skin care products,  and tobacco smoke that irritate the skin or cause allergic reactions.

The common symptoms of contact dermatitis are;

  • The skin gets itches, turns reddish, feels burning, and stinging sensations.
  • Itchy bumps, also known as hives can develop on the skin.
  • Formation of fluid-filled blisters that could ooze and crust over.
  • The skin surface may thicken and acquire a scaly or leathery look with time.

Types of Treatments for Eczema

These are some of the common treatments for Eczema;

​1) Creams

  • Over-the-counter medication: Most of these products are meant to either relieve symptoms or prevent the infection.
  • Topical applications: These are medications, available on doctor’s prescription, to be applied on affected portions of the skin

2) Non-Invasive Treatment (Energy Devices)

  • Phototherapy: Better known as light therapy, this treatment  uses a machine to generate Ultraviolet B(UVB) light. Phototherapy is certified as a safe treatment since only healthy, and controlled amounts of UVB light are released, and even the procedure is conducted under medical supervision. This treatment reduces itching, and skin inflammation, apart from enhancing the skin’s bacteria-fighting ability.
  • Ultrasound Therapy:  Using dual-frequency ultrasound waves, this treatment has the capability to regulate the dynamic processes involved in tissue production and destruction, which are the primary factors in the different aesthetical applications or treatment of dermatological conditions. This therapy basically uses physical energy to modulate the homeostasis of the skin and the subcutaneous tissues.

3) Medications

  • Oral Medication
  • Oral Steroids 
  • Oral Immunosuppressive Drugs : Usually prescribed in severe cases, these medications reduce inflammation by controlling the immune system response.
  • Injectables Biologics: These medications work by specifically attacking the protein that causes the inflammation response. 

How We Treat Eczema?

You must discuss these treatment options with your doctor who will carefully monitor and regulate the use, so as to avoid overburdening your immune system. My approach to Eczema treatment is slightly different, as I prefer to fortify the weak epidermis, so that the dermis regains health and inflammation is reduced which is different from the conventional medical treatments of eczema which is used to suppress the skin’s overactive abnormal immune response.

I prescribe a treatment regimen that couples with multiple different medical lasers, ultrasounds and energy-based devices, with nutrients, and supplements for the skin. The use of multiple energy-based devices allow us to control this disease by strengthening the overall health of the sufferer's skin. This treatment is to increase the amount of quality collagen, elastin and hyaluronic acid (HA) to diminish the inflammation in the dermis. As the skin’s collagen, elastin and hyaluronic acid are very important for its proper function and these components are essential for proper skin regeneration and its reduction is responsible for faster skin aging. 

Multimodal energy-based treatments augment conventional treatments, the aim is to lessen and even eliminate the use of steroid creams entirely. Eczema should be viewed as a systemic disease, not only a skin disease and every patient is unique, and therefore there can be no ‘one size fits all’ approach to treatment as well. We need to meticulously monitor and alter the settings,  frequencies, and deploy energy devices in accordance with your skin’s particular nature and requirements. 

Some Tips to Control Eczema Outbreaks

Here are some tips for avoid eczema flare-ups, and symptom management:

  • Stay away from foods that cause or aggravate the symptoms. 
  • Apply cool compresses or take a baking soda bath to soothe the itch.
  • Use gentle eczema-friendly moisturizers and lotions to maintain skin hydration.
  • The cream must be applied to the skin, immediately after you step out of the shower, to trap the moisture.
  • After you finish bathing, gently dab your skin with a soft towel. Avoid rubbing your skin too hard.
  • Avoid scratching to reduce chances of infection.
  • Use fragrance-free makeup, cleansers, detergents, cleansers, and other skin care products.
  • Don gloves and protective clothing when handling chemicals.
  • Wear clothes that are loose-fitting, and made of soft fibers such as cotton.
  • Introduce Positive Lifestyle changes; Take sufficient rest, learn to relax and meditate, to control daily stress


Skin Tags

Skin Tags Removal in Singapore

Skin tags are very common and generally occur after midlife, and can appear anywhere on the skin. A skin tag is a small raised piece of skin which may also have a stalk, and looks like a small piece of soft, hanging skin. Under the microscope, skin tags are thicker skin containing clusters of collagen and blood vessels. It is believed that skin tags form as a result of skin rubbing against skin. That’s the reason why skin tags are most often found around skin creases and folds, and where skin rubs against clothing. Common areas include the neck, eyelids, under arm area, under the breasts and the groin.

The Difference Between Skin Tags And Warts

Warts are caused by a virus called human papillomavirus (HPV) and are known to be very contagious whereas skin tags are not not. Skin tags are a type of harmless skin growth or benign tumor, it does not become cancerous if left untreated. Skin tags can be removed by an ablative laser. We prefer to use an Erbrium Yag instead of a CO2 laser, as there is lower risk of post inflammatory hyperpigmentation.

How We Remove Skin Tags?

Aging Skin

Aging Skin

There are so many factors that contribute to our skin as we age; such as environment, weather, lifestyle choices, diet, heredity, and personal habits.  When we grow older, the 3 Ds of naturally-occurring age-related facial changes will begin to occur; Deterioration, Descent, and Deflation.

  1. Deterioration of the skin becomes more and more obvious when we age. The skin becomes thinner, less elastic, loses hydration as well as its strength. The skin no longer has its youthful glow and radiance. Pigmented brown spots, uneven skin colour, fine lines, wrinkles, and small veins begin to appear. This is due to the inefficient shedding of old dead cells from the skin’s surface, resulting in enlarged pores, rough skin, and irregular skin texture. Aesthetic treatments which make use of energy devices like medical lasers, radiofrequency and Intense Pulse Light (IPL) are very useful in treating these changes.

  2. The descent of the lower face and fat around the cheeks is caused by gravity. As older skin is thinner and less elastic, more folds appear. Of particular concern are the deepening folds of skin between the cheeks and the upper lip area (nasolabial folds), and downward folds from the corners of the mouth to the jawline (marionette lines). The facial triangle of youth with a narrower lower face will later age into a square-shaped face.

  3. Deflation arises as the fat pockets in the face shrink as we get older. Reabsorption of bone structure follows, and this makes the face even more sunken. The bone loss may also occur around the mouth and chin and may become evident after the age of 60. 

HOW TO BUILD COLLAGEN

By Dr Kenneth Thean

Non Surgical Treatments To Reverse The Aging Process

While aging is inevitable, there are many ways we can do to slow down or reverse the aging process. With the aid of advanced technology and our unique treatment plans, we have developed many non-surgical treatments to successfully deal with these age-related changes. Our treatment approach is always to combine a few cutting edge aesthetic modalities to give the best results. Because every face is different, and that there is no –one size fits all– treatment.

In order to tailor a suitable plan for you, consultation is advisable. During the consultation, a detailed assessment will be conducted so that we can have a clearer understanding of your skin and concerns, to plan together with a unique customized treatment strategy specifically suited to meet your desires.

In the series of videos below, our resident doctor, Dr Chiam CT will share with you which facial rejuvenation is suitable for the different types of aging concerns. 

Dull Skin

What is Dull Skin?

Dull skin is one of the most common skin care problems caused due to lifestyle and environmental factors. It is usually described as lack of radiance or glow – making the face appear lacklustre and unhealthy. One of the contributing factors is excessive buildup of dead skin cells on the surface of the skin, causing it to clog and lose its natural luminosity.

Another contributing factor is low collagen levels. Collagen is an amino acid protein found in the dermis, and is the most abundant protein, making up almost 75% of the skin. It provides strength and structure to our connective tissue. Elastin is also another protein found together with collagen, in the dermis. It is also responsible for giving structure and support to the skin. More collagen and elastin in your skin can make your skin more vibrant, firm and smooth, giving you a youthful, and healthy look.

To regain the skin’s radiant look, we must first understand the signs of dull skin and take necessary steps to restore its youthful glow.

Other common factors causing dull skin may include;

  • Excessive sunlight exposure without proper protection
  • Lack of moisturiser
  • Insufficient sleep
  • Stress
  • Dehydration
  • Poor diet
  • Excessive alcohol consumption
  • Smoking
  • Dry/Cold/Polluted environment

Treatment for Dull & Tired Looking Skin
Dr Chiam CT

How to Achieve Glowing Skin?

Skin is an important feature that represents our state of health. When your skin looks rough and dull, it makes you look tired and older. There are multiple medical non-surgical treatments now, which could help you restore a youthful glow to your skin. These treatments are safe, non-invasive and have little to no downtime.

Every individual’s skin is unique due to genetics, lifestyle and medical history. It is important that I evaluate the condition of your skin to determine which treatment (or treatment combination) will result in the most significant improvement to trouble areas.

Other benefits of the treatment can include;

  • Reduction in fine lines & wrinkles
  • Skin tightening
  • Encouragement of collagen production – thicker and firmer skin
  • Elimination of uneven skin colour
  • Reduction of large pores
  • Lightened pigmentation
  • Improved scars

To find a suitable treatment best suit you, consult today! 

Seborrheic Keratosis

Seborrheic Keratosis

Moles, seborrheic keratoses (age spots), skin tags and warts are non-cancerous growths that are quite common. Seborrheic keratosis are known as age spots, liver spots, sun spots, senile lentigo and solar lentigines. These are flat or slightly raised, and can appear as black, brown or even grey spots on the skin. Patients who experience age spots are commonly over 40 years of age, have fairer skin, and have a history of frequent sun exposure or use tanning beds.

Age spots occur when there is an excess localized production of melanin, or skin pigment, that occurs with skin aging and ultraviolet light exposure. They can be most commonly be found on skin that receive the most sun exposure, like your face, shoulders, back, upper forearms and the back of hands. 

Seborrheic Keratosis Removal

Although Seborrheic Keratosis may not be painful, it might cause itchiness and become irritated depending on where the age spots are located.  There are a variety of treatment modalities that can be used to remove age spots. My preferred treatment option is to use an ablative laser to remove the raised pigmented skin. One of the lasers I prefer to use is Erbrium Yag instead of a CO2 laser, as there is less risk of developing Post Inflammatory Hyperpigmentation (PIH).  The Erbium Yag laser uses an intense beam of light to burn and destroy the growth of the age spots, the laser light also cleans and seals as it cuts the tissue. This treatment reduces bleeding, pain and recovery time and does not cause scarring as compared to C02 laser. 

Treatment Options to Remove Seborrheic Keratosis
Dr Chiam CT

Post Inflamatory Hyperpigmentation

Post Inflammatory Hyperpigmentation

Post Inflammatory Hyperpigmentation, PIH in short is due to the skin’s pigment cells overreacting and produce more pigmentation during the healing process. Inflammation in the epidermis stimulates melanocytes to increase melanin synthesis and to transfer the pigment to surrounding keratinocytes (epidermal melanosis).
If the basal layer is injured (e.g. lichen planus), melanin pigment is released and subsequently trapped by macrophages in the papillary dermis (dermal melanosis or pigment incontinence). PIH often appears after other skin injuries like cuts, acne, burns and insect bites, etc.

Post Inflammatory Hyperpigmentation patches are located at the same area after it has healed. These lesions are range from light brown to black in colour can
become darker when it is exposed to sunlight (UV rays). PIH can develop in all skin types but it tends to be more severe and longer-lasting for individuals with medium
to darker skin complexions as compared to lighter skin colours. 

Treatment for Post Inflammatory Hyperpigmentation

There is a diversification of topical treatments that are available to help lighten the hyperpigmented lesions. However, We have tested and proven that by using a combination of treatments laser treatments and topical treatments can allow us to achieve an optimal results for your skin. Following your consultation we will customize the most appropriate hyperpigmentation treatment for you to treat the dark spots.

Solar Lentigo

Solar Lentigo

Solar lentigo is a harmless patch of darkened skin. It results from exposure to ultraviolet (UV) radiation, which causes local proliferation of melanocytes and accumulation of melanin within the skin cells (keratinocytes). Solar lentigos or lentigines are very common, especially in people over the age of 40 years. Sometimes they are also known as an “old age spot” or “senile freckle”.

What does a solar lentigo look like?

A solar lentigo is a flat, well-circumscribed patch. It can be round, oval or irregular in shape. Colour varies from skin-coloured, tan to dark brown or black, and size varies from a few millimetres to several centimetres in diameter. They can be slightly scaly.

Solar lentigines are found as groups of similar lesions on sun-exposed sites, particularly the face or the back of hands. They occur in light and dark skin, but tend to be more numerous in fair-skinned individuals.

What treatments are available for solar lentigo?

If left untreated, solar lentigo will most likely persist indefinitely. There are multiple ablative lasers that could be used to expel these spots but it varies for each individual. In this video, Dr Thean will share with you the different type of brown pigmentations and the treatment solutions. If you would like to learn more about your condition, please visit us for a detailed consultation, we will customised a suitable treatment plan according to your needs. 


Birthmarks

What are Birthmarks?

Birthmarks are a common type of discoloration that appear on your skin at birth or during the first few weeks of life and they’re usually noncancerous. It can occur anywhere on your face or body. Birthmarks vary in colour, size and appearance as well as shape.

Birthmarks are split into two categories, Vascular Birthmarks (Red) or Brown Birthmarks (Pigmented birthmarks)

1.Vascular coloured (Red) birthmarks are caused by a localized area of abnormal blood vessels.

Types of Vascular Birthmarks;

  • Salmon patches – which are usually red or pink patches occur around the eyes area of the back of the neck.
  • Hemangiomas – these birthmarks are usually in pink, blue or bright red colour and be found on extremities, head or neck.
  • Port-wine stains (nevus flammeus) – is a discoloration of the human skin caused by a vascular anomaly, they usually start out as pink, or red and turn to dark red or purple.

2. Pigmented (Brown) birthmarks arise from localized areas of excessive pigmentation.

Types of Pigmented Birthmarks;

  • Moles – moles range in colour from pink to light brown to black, they are usually flat or raised that can occur on your face or body.
  • Café au lait spots – translate as “”coffee with milk”” in french, this spots are often pale brown in color and shape like an oval.
  • Mongolian blue spots – are flat, bluish gray spots that are often mistaken for bruising, usually occur in individuals with naturally dark skin.

Methods to Remove Birthmarks

Laser treatments has been proven to remove or significantly lighten brown spots or bring your skin closer to its normal colour. The laser uses highly concentrated pulsing beams of light that can be adjusted for strength dependent on the type of birthmarks. To date, laser therapy has been proven successful for removing birthmark. Following your consultation, we will customize the most appropriate treatment for you based on the types of birthmarks you have.

Freckles

Freckles – Causes, Treatment & Removal Method

What are Freckles?

Freckles usually appear on parts of the skin, such as the face and arms, that are regularly exposed to sunlight. Freckles are basically groups of skin cells (keratinocytes) in which  melanin, the brown-colored skin pigment is located on the skin’s outer layer. This is why freckle spots are  flat in appearance. While you can touch and feel  moles because of their lumpy structure, freckles are unidimensional spots that can only be seen but not felt. Freckles are formed when specialized cells known as melanocytes, produce melanin. Regular exposure to sunlight, induces the melanocytes to increase their output  of melanin. This in turn, forces the pigment to seep out and get absorbed by the adjoining skin cells. That’s why freckles form in spots, rather than as a  uniform pattern stretching across the skin. Since people tend to get more exposure to the sun, in the summer, freckles are more likely to form during this time of the year. Irrespective of tone, all skin types can develop freckles. 

Freckles elimination and how can I prevent it from appearing

We have a range of treatment options for freckles removal in Singapore, which can lighten your brown spots and bring your skin closer to a balance tone as most brown spots can quite easily be lightened.

Usually, specific treatments or a combination thereof, are used to deliver the best results. This is because,  every individual’s skin is unique and must be treated in a customized manner.  Following a detailed consultation, we will formulate the most suitable treatment for you.

Prevention is key, to stop the recurrence of freckles from recurring. My  recommendation is to to rely on water-resistant sunscreens with SPF (sun protection factor) 30 and above. Make sure to fully cover your skin before venturing outdoors in  the sun. Since freckles are the result of sun exposure, ensure proper protection for the skin, from the UV rays, to minimize the possibility of developing freckles. 

Melasma

Melasma Causes & Treatment

What is Melasma

Melasma is a very common patchy brown, tan, or blur-grey facial skin discolouration, usually seen in women in the reproductive years.

It generally forms on the forehead, upper cheeks, upper lip,  and chin of women who are between 20 to 50 years old. Factors such as exposure to sunlight, intake of birth control pills and similar external hormones,  and internal hormonal changes such as those caused by pregnancy. People suffering from melasma are usually found to have a history of constant exposure to sunlight, while heat is also believed to be responsible for the condition. Melasma is most prevalent among pregnant women, particularly from Latin and Asian descent. It has been observed in relatively higher ratios in people with olive complexion, or darker skin - Hispanic, Asian, and Middle Eastern natives and ancestry.


What Causes Melasma?

Although the specific cause of melasma is yet to be conclusively determined, medical experts opine  that several factors -  pregnancy, birth control pills, hormone replacement therapy,  family history of melasma, and race, could be the conditions favoring the manifestation of melasma, particularly in  persons with a tendency for this condition.

Melasma occurring during pregnancy, is also known as chloasma. During pregnancy, women in their second and third semesters, experience a rise in levels of hormones such as  oestrogen, progesterone, and melanocyte-stimulating hormone (MSH). Melanocytes, as many of us are aware, are the cells responsible for skin pigmentation. However, in the case of pregnancy-related melasma,  increased levels of progesterone are believed to be the cause, and not oestrogen or MSH. Some studies have also established the link between increased incidence of melasma and progesterone therapy, in post-menopausal women.

Moreover, some products or treatments that cause skin irritation the skin, are known to result in increased melanin production, and thus increase melasma symptoms.

Similarly, persons having a genetic predisposition or family history of melasma are potentially more vulnerable the possibility of developing melasma. Such people must avoid exposure to sunlight, and step outdoors only after applying  extra sunblock to prevent stimulation of pigment production.

Treatment for Melasma

Two types of patients are prone to suffer from Melasma;

1) Women who develop Melasma as a result of hormonal changes due to pregnancy or the use of birth control pills. For these individuals, the melasma condition will gradually subside after delivery, or once they stop using birth-control pills. 

2) Individuals who are afflicted with long-term or permanentMelasma, following exposure UV rays and other factors. 

While there are several treatment options available in the market, to reduce or eliminate these patches, not all treatments are uniformly effective for everyone. There are also instances where recurrence of melasma, may take place even after treatment concludes succesfully. Dr Thean is renowned for  his long years of aesthetics experience in the field of pigmentation. He has specially designed this treatment that illuminates dark spots, using a range of lasercombinations,  including the yellow laser. This method effortlessly treats the vast majority of undesirable skin spots. The treatment is also effective for addressing discoloration or redness, caused by blood vessels that are located amid the deeper network of veins, far beyond the usual depths that conventional lasers are able to access. Since pigmentations form in different levels of intensity, we offer a range of bespoke Melasma treatments in Singapore, with Dr Thean himself  devising the combination of treatments best suited to treat your dark spots.

 Clinic for melasma treatment in Singapore | Ensoul Medical Clinic

Options to Treat Melasma
Dr Kenneth Thean

Rosacea

Rosacea Symptoms & Treatment

Rosacea is a chronic, inflammatory skin condition that most often affects the face. Rosacea worsens with time if left untreated. It is often mistaken for acne, eczema, or a skin allergy. It often appears to be more common among fair-skinned people. Although the causes are not fully understood and there is no cure, there are a number of ways to relieve the symptoms.

Rosacea usually appears in phases:

  • Pre-Rosacea. Rosacea may begin as a simple tendency to flush or blush easily, and then progress to a persistent redness in the central portion of your face, particularly your nose. This redness results from the dilation of blood vessels close to your skin’s surface. This phase may sometimes be referred to as pre-rosacea.

  • Vascular Rosacea. As signs and symptoms worsen, vascular rosacea may develop — small blood vessels on your nose and cheeks swell and become visible (telangiectasia). Your skin may become overly sensitive. Vascular rosacea may also be accompanied by oily skin and dandruff.

  • Inflammatory Rosacea. Small, red bumps or pustules that resemble acne may appear and persist, spreading across your nose, cheeks, forehead and chin. This is sometimes known as inflammatory rosacea. The skin may feel hot and tender. 

Rosacea Treatment
Dr Kenneth Thean

Treatment for Rosacea in Singapore

A combination of medications, treatments and lifestyle changes generally give the best results for Rosacea. Apart from topical medications (applied to the skin) or oral medication to reduce the inflammation and redness. We also use a unique combination of lasers and intense pulse light to shrink them. The treatment is comfortable, minimally invasive and personally customised to suit every individual need. Followed by a detailed consultation, I will customised a suitable treatment plan to help you reduce the appearance of the blood vessels in your face and improve your skin quality and texture. 

Some other factors that may trigger Rosacea includes;

  • Sun Exposure
  • Temperatures
  •  Stress
  •  Spicy food or Hot Drinks
  •  Alcohol
  •  Intense Exercise
  •  Medicines such as steroids applied on the skin

To complement your laser treatments and improve your skin condition significantly, you may also consider the following steps to protect your skin; 

1) Apply sunscreen of SPF30 and higher and ensure you are properly covered

2) Use gentle skin care products that are alcohol-free

3) Change your dieting habits to equip with a more balanced diet

4) Apply water-based moisturizers



Vascular Lesions

Vascular Lesions Causes & Treatments

What is Vascular Lesions?

Vascular lesions are relatively common abnormalities of the skin and underlying tissues, affecting up to 50% of women aged 18 years and older. Spider veins, telangiectasia, and diffuse redness are often a result of aging, sun damage or pregnancy and sometimes genetic. Often mistaken for a sunburn or rosy skin, redness in the face are small blood vessels that can be easily treated. Vascular lesions include a range of conditions, whether it is leg veins, facial veins, angiomas, or venous lakes, laser and light-based devices have become a viable treatment option to safely and effectively remove and diminish unwanted vascular concerns.

How We Treat Vascular Lesions
Dr Kenneth Thean

Treatment for Vascular Lesions

Dilated and hence visible capillary vessels, so-called telangiectasis, are colloquially known as spider veins or facial veins. If they accumulate in the face, this is known as couperose. Couperose or spider veins can develop if the blood accumulates in capillary vessels and the vessels are overextended over a longer period. This is by no means a sign of aging, as 70 % of 30 – 39 year-olds are already suffering from visible branching of the vessels.

For the treatment of vascular lesions, I prefer to use the yellow laser. Pulses of yellow laser light are directly applied to the entire area of the blemish. The veins and capillaries of the lesion absorb the laser’s energy while the surrounding skin tissue does not.

The treatment causes the exposed vessels to break down and become less visible. The procedure time for vascular lesion treatments depends on the size of the lesion but never takes more than a few minutes. Side effects from the procedure are minimal – patients may experience some slight discomfort or redness in the area which will subside in a couple of hours. 

Open Pores

Enlarged Pores Causes & Treatments

What Causes Enlarged Pores

A very common complaint during times of hot and humid weather is enlarged pores and they are typically more obvious on the nose and cheeks. The size of your pores generally increases with age. If you have a genetic predisposition to excessive sebum production, you will experience oily skin and have bigger pores. With excess skin surface oil and inadequate exfoliation, dead skin cells accumulate inside the pores, making the pores appear even larger. The consequence of these oil plugs is more whiteheads (closed comedones), blackheads (open comedones), and pimples. Individuals with large/open pores, their skin tend to appear dull, lifeless and aged.

How to Minimize Large Pores?

My treatment for enlarged pores is to prescribe a combination of laser rejuvenation, laser toning, gentle skin resurfacing lasers and Intense Pulse Light. As this treatment is safe and comfortable, you will not experience any pain nor downtime during the course of treatment. It can also be done as a lunchtime procedure and continue your usual activities without interruption.

Aside from laser treatment, it is also important to invest time and effort in your daily skin care regimen.  

  1. Select water-based skin care products instead of oil-based, to keep your skin unclogged.
  2. Cleanse your with gentle facial soap and gently exfoliate your skin at least once or twice per week.
  3. Apply broad-spectrum sunscreen with a minimum of SPF 30 everyday.
  4. Remove your make up before bed, because leaving your make up overnight can clog your pores
  5. Avoid food that are high in sugar and fat and eat more balanced diet such as fruits and vegetables

TREATMENTS TO REDUCE LARGE PORES

Pigmentation

Pigmentation Treatment & Removal

What is Pigmentation?

Pigmentations are brown spots or patches on the skin caused by an excess production of melanin in the skin. Melanin is produced by cells called melanocytes at the lower layer of the epidermis and can be triggered by sun exposure. Other common factors that can trigger pigmentation includes, hormonal changes, pregnancy, genetics and skin trauma and inflammation caused by acne.

Types of Pigmentation

  1. Melasma is often found in Asian skin. It manifests as irregular patches of darker brown discoloration, usually on the cheeks, forehead, nose and even the lips. It is more common in women and in darker skinned people, and can be aggravated by sun exposure and hormonal changes.
  2. Freckles are small brown spots on sun-exposed areas, seen in genetically more susceptible people.
  3. Birthmarks can be brown or red in colour. Red coloured birthmarks are caused by a localized area of abnormal blood vessels. Brown birthmarks arise from localized areas of excessive pigmentation.
  4. Sun spots, also known as solar lentigo, are dark brown spots found on the skin. They are caused by sun exposure and commonly seen in areas of the skin exposed to the sun such as the face, hands and arms.
  5. Many patients get brown spots after acne. They are also referred to as Post Inflammatory Hyperpigmentation (PIH), and is due to the skin’s pigment cells overreacting, which produces more pigmentation during the healing process. PIH often appears following other skin injuries like cuts and burns.
 Treating and removing pigmentation in Singapore | Ensoul Medical Clinic

Fig 1. A graph showing how pigments were formed and how the laser can remove the pigments on the skin


What Causes Pigmentation & 
What are The Options To Remove?

Pigmentation Treatment in Singapore

Dr Thean has devoted his years of aesthetics experience in pigmentation. He has designed this treatment to illuminate dark spots with a range of combinations of lasers and that include pico laser and yellow laser. With this method, the majority of visible unwanted skin spots, discoloration or redness (blood vessels) , are rooted in a deeper vascular network of veins that extend beyond the treatable depth of traditional lasers that can be addressed. Patients with pigmentation come in different levels of severity. Dr Thean will permutate the combination of treatments and topical medications to best treat the dark spots.

How many sessions do you need ?
Every individual is different, even for their treatments. Usually you would be able to see some results after one session, but you may need a few sessions to completely clear the pigmentation as it is also dependent on the severity of the pigmentation.

Is there any downtime in this treatment ?
It is a gentle treatment and almost no downtime from this treatment. The possibilities of redness could be seen and the redness should subside in few hours.

Can pigmentation recur? 
Pigmentations can sometimes recur even after successful treatments. The recurrence is due to the constant exposure to the sun as well as our hormones. We can prevent pigmentation from recurring by applying sunscreen with at least SPF 50 diligently and adopting sun protection measures to have long-term sustainable results. Treatments can only clear your pigmentations, ultimately, proper skincare routine is equally essential in preventing pigmentation recurrence.

Active Acne

Types, Causes and Treatment for Acne

Causes Of Acne

Active acne is a very common skin problem and can infect the face, chest, shoulders and back. Acne often begins to form during your teenage years. While it generally resolves, acne can sometimes persist and be a major problem throughout your life.

Acne during puberty is a result of your skin’s response to hormonal changes. During puberty, your skin’s sebaceous glands produce excessive sebum (skin oil). The sebaceous gland openings to the skin’s surface frequently get blocked, forming whiteheads and blackheads. The fatty acids within these blocked oil glands become infected by bacteria living on the surface of your skin. This infection leads to skin inflammation, followed by pustules, and sometimes, painful cysts.

Acne is aggravated by stress, insufficient sleep, changes in hormone levels around the time of menses, a hot and humid environment, using incorrect occlusive sunblock or makeup, close-fitting clothing, and headgear.

Types of Acne

Each type of acne lesion requires a different treatment. Receiving prompt, correct treatment can reduce the risk of long-term skin complications, such as dark spots and scarring. Acne blemishes fall into two categories, depending on whether they cause inflammation of the surrounding skin.

Acne treatments available in Singapore | Ensoul Medical Clinic


Types of Non-inflammatory acne lesions 

Whiteheads and blackheads are the mildest forms  of noninflammatory acne lesions. They generally don’t cause pain, or swelling.

  • Whiteheads
    Known as comedones in medical parlance, whiteheads are small spots or bumps that are  visible as white or flesh-colored blemishes. These blemishes are usually characterized  by a white, round  center that is encircled by a red colored halo. Sometimes, a strand of hair  may emerge from the midst of a whitehead, creating the impression of being trapped inside the blemish. The skin surrounding a whitehead, is likely to appear to be stretched or wrinkled, particularly so, if the whitehead is large in size, or elevated. Fortunately, whiteheads generally do not lead to scarring of the skin.

  • Blackheads
    Blackheads are known as  open comedones, in medical terminology. These spots are small in size, black or dark-colored, and may appear as slightly elevated bumps. While the blackhead’s central portion  is darker than the remaining parts, the area surrounding the blackhead, has a normal tone. Contrary to popular belief, the discoloration in the blackhead is not due to trapped dirt. Actually, the blackhead is formed when the skin on the bump cracks opens, exposing the contents of the whitehead to air, causing them to darken due to oxidation.

Types of inflammatory acne blemishes

These are blemishes or lesions have an inflamed, swollen look, are red in color,  and warm to the touch. Cysts, nodules, papules, and pustules are different types of inflammatory acne.

Minor-to-mild forms

  • Papules
    Papules manifest in the form of small red bumps that are present beneath the skin’s surface. Papules do not have a visible center comprising of pus, like whiteheads do.  They also differ from blackheads, because the papules’ pores do not have a widened appearance. Acne papules are formed  by the rupture of comedones, followed by the dispersal of bacteria into the skin tissue, resulting in irritation.

  • Pustules (pimples)
    Pustules are bumps that are larger in size, and tender to the touch. They are characterized by a well-defined, circular center. The center usually has pus that is whitish or yellowish in color that is caused by an infected pore cavity. Acne pustules acne are generally hard and painful to the touch. The skin adjoining the bump is likely to  have a red and inflamed look.

Moderate-to-severe forms

  • Nodules
    Nodules acne is a chronic version of acne, with large, inflamed, hard, and painful  lumps firmly ensconced within the skin. They are similar to larger, deeper papules and also have no visible head or center. These acne lesions form when the deeper tissues and cells underlying the skin, are damaged by clogged pores. The lesions can result in dark spots, scarring, and similar complications of the skin.

  • Cysts
    Acne cysts are definitely the most serious type of acne. They are usually distinguished by pus-filled lumps that are red or white in color. These lumps, located deep within the skin, are generally very large in size, soft to the touch, and painful. When a cyst bursts open, the infection can spread further, resulting in more breakouts on  the skin. If left untreated, cysts can lead to scarring and other skin complications.


Frequently Asked Questions on Acne Treatment

Q: What acne treatments are the best for me?

A: There are more than one type of acne treatments, to determine the suitable treatments for you, the doctor will have to carefully assess your skin type, severity of the acne and other factors in order to advise. The treatment can be a combination of topical cream, oral medications paired with energy devices or standalone. Contact us today to schedule a consultation.

Q: Will my acne go away?

A: Oftentimes, acne will go away on its own after puberty has ended. However, there are some people who will continue to struggle with acne in adulthood. But the good news is that all acne can be successfully treated, it is about finding the suitable treatment as well as having a proper skin care regime. It is also important to take care of your acne conditions early to prevent future scarring in the future which can be difficult and more expensive to treat.

Q: How can I better care for my skin to keep acne away?

A: There are multiple ways you can keep your skin healthy - such as using a gentle facial cleanser, avoid over exfoliating your skin, for women - select makeup that does not clog the pores or change your makeup if it is causing you to have blemishes as well as exercise. Exercising can help to promote skin cell health as it increases the blood flow. The increase in blood flow can provide both oxygen and nutrients to the cells and carries away waste products. By exercising, it can also alleviate stress which in turn keeps those stress levels down and helps your skin look radiant. 

Types of Acne
Dr Chiam CT

Acne Treatment Options in Singapore

Treatment for active acne should start early, untreated acne usually causes disfiguring skin scarring which may result in some acne sufferers developing emotional and social inadequacies.

Different types of acne lesion require different treatment approach. To avert further damage as quickly as possible, I use a multifactorial approach to treat active acne.

A combination of epidermal and dermal laser treatments, together with Intense Pulse Light (IPL) and phototherapy, with the concurrent application of topical medications such as chemical peels and medi-facials, can usually clear active acne and improve the scar appearance quite rapidly.


Acne Scars

Acne Scars – Causes, Treatment & Recommended Removal Method

What Causes Acne Scars?

Acne scars are usually caused by inflamed lesions and enlarged pores that leave a break in the follicle wall. As the body attempts to heal itself by forming a new collagen fibers to replace the lost tissue that has been destroyed, it doesn’t usually end up as smooth and flawless as before. As the wound heals, the body can sometimes produce either too much or too little collagen, creating raised tissue or an indentation on the skin’s surface.

Some treatments are more effective for specific types of acne scars. Suitable treatment options may vary slightly depending on the type of scarring that acne has caused. There are three types of acne scars;

1. Atrophic scars are small indentations in the skin. They occur when the skin does not produce sufficient fibroblasts during the healing process. As fibroblasts are cells that play a crucial role in wound healing and the synthesis of collagen. Atrophic scars are usually the results after acne, chicken pox, and indented scars. The indentation can form into one of three types of scarring:

Icepick, rolling, boxed acne scars and Keloid Scars

2. Raised / Hypertrophic scars occur when the skin produces many fibroblasts as the acne spot heals, causing a raised scar. 

3. Keloid scars are similar to hypertrophic scars but they are thicker than the original acne spot. Keloid scars are usually red or brown and may also cause symptoms, such as itchiness or pain.


Treating Acne Scars

Scarring after acne occurs frequently. It is an unwanted reminder of a painful and bothersome condition. However, acne scars do not have to be permanent, as recent advances in laser and ablative radiofrequency technology have allowed us to offer effective treatments in minimizing unsightly scar damage to the skin after acne.

There are several types of treatment that can help reduce acne scars and improve the overall skin quality

  • Medical Laser Treatment helps to lighten acne scars as it smooths away the top layer of the skin. It can also reduce the pores and helps with resurfacing the skin. It is not suitable for patients who are still suffering from breakouts as well as darker skin tones.

  • Non-Ablative Lasers help with stimulation of new collagen production. It helps to reduce pores as well as lighten and smoothen acne scarring.

  • Medical Peels uses strong acid to remove the top layer of the skin to reduce deeper scars. A good complement treatment for acne scars

  • Dermal Filler can help to plump the skin by  using collagen to smoothen out depress scars and even out skin tone.

  • Puro uses 160 micro pins to safely delivery heat via NanoFractional RF™ through the skin’s surface. The pins create tiny micro-dermal wounds, which the body then works to heal naturally. This process is what repairs signs of skin damage seen on the surface of the skin. And because the wounds are so small, the treatment is much more comfortable than lasers, and results in smoother, healthier skin with minimal downtime.

  • Intensif Microneedling RF is good for depressed scars that lie more than 1.5mm deep below the skin, microneedling helps. It is a procedure that uses a small, handheld, needle-studded roller containing multiple fine needles to puncture the top layer of your skin. How this works is that it encourages peeling it triggers the production of collagen and elastin as the skin tries to heal, leaving skin with a smoother appearance. Results can be seen within six to 12 weeks after treatment. This is a popular treatment because there’s less risk of side effects, although slight bruising can occur during the process. However, it is not suitable for those currently suffering from an acne breakout, rosacea or eczema.

ACNE SCARS TREATMENT
BY DR KENNETH THEAN

Acne Scar Removal in Singapore – Why We Don’t Use CO2 Lasers

In the past, treatment for acne scars were CO2 fractional resurfacing lasers. CO2 fractional lasers treat scars by gradually removing a few microns from the upper layer of the skin. This resurfacing treatment is more suitable for Caucasian skin as compared to Asian skin. If used on Asian skin, complications of hyperpigmentation and burns often occur, resulting in multiple treatments. Results when using this treatment for deeper scars is unsatisfactory, because more complications arise, as well as longer downtime for patients.

So here are some of the results why Dr Kenneth Thean and Dr Chiam Chiak Teng recommend a different approach when it comes to acne scar removal in Singapore. Instead of using the CO2 laser, I prefer to use the safer Erbrium Yag lasers, and ablative radiofrequency technology; these are more suitable for use on Asian skin.

We can now quite easily target the scar to almost the full thickness of the skin. The 500 micron ablative depth, can treat the deep scar tissue that pulls the skin surface down. Dermal lasers are also used to stimulate the growth of the skin's collagen. This triple-action of deep fractional skin resurfacing, which releases the tethering scar fibers and rebuilds the skin’s collagen matrix, means the skin is restored to its natural position, resulting in much smoother skin. Other treatments such as Chemical Peels can also reduce scarring appearance.

Significant improvement is achieved after just one treatment. With the reduction in the risk of complications, multiple treatment sessions can be carried out safely. We can thus achieve a considerably smoother skin surface safely and effectively.

Frequently Asked Questions on Acne Scars

1. There are many treatments in the market to treat acne scars, which one do I choose from?

The type of treatments is usually recommended by the doctor after careful assessment of the patient's skin condition and the scar type(s). Depending on the severity of the scars, the doctor may use a combination of lasers and other energy devices or injectables to achieve optimal results. 

2. Will it be painful?

Some of the treatments may have a slight tingling sensations during the session, however it is also dependent of individual's threshold. While other treatments can be comfortable as numbing cream will be applied to reduce any pain or discomfort for patients during the treatment. 

3. How many treatments do I need and how long will I see visible results?

It varies on individual's skin condition, scar type(s) as well as the treatments recommended by the doctor. A consultation is required in order to provide an accurate assessment and treatment plan for our patients.