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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—Treatment & Removal 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.

Mole Removal/ Treatment

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. 

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. A slightly raised small solid growth that resemble a small cauliflower with a rough texture are commonly found on hands. A flat, rough with spongy surface warts are called the plantar warts, they are commonly found on the soles of the feet. Lastly, small slightly raised, smooth warts 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. The plantar warts on the feet may be painful due to the pressure areas as they get pushed into the skin. 

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. 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. 

Wart Removal at Ensoul Clinic Singapore

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.

Eczema

Eczema

Eczema refers to a broad spectrum of diseases where skin is affected by chronic inflammation. It is usually patches of skin that are inflamed, itchy, red, cracked and rough. Eczema is a condition that can be an extremely stressful and frustrating. The most common form of eczema we see is called atopic dermatitis, it is frequently seen on children but it can also occur at any age. Atopic dermatitis  and can affect any area of the body. This internal allergy is hereditary and manifests as an itchy rash. The itch can be so frequent and intense as to make your daily life challenging and uncomfortable. The strong itch often causes poor sleep, and can even force you to take days off from your job or school. Certain activities like swimming, active sports and hot weather frequently aggravate eczema and the rash can also disfigure the skin. Eczema sufferers often make significant lifestyle changes because of their condition. Sometimes, they will wear certain clothes to cover the skin’s appearance.

Treatment For Eczema

The treatment for Ecezema is not easy and a multifactorial approach is required. It entails a detailed consultation and a customized program of energy devices, topical and oral medications, prescribed to address your unique situation. I will personally monitor carefully your program and modify your treatment accordingly for optimal results as you progress. Results are very gratifying as the relief from the intense itch, and the healthier skin appearance can make a substantial improvement in your life.


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.

What is 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 are groups of skin cells (keratinocytes) that contain melanin, the brown skin pigment on the outer layer of the skin, so the spots are flat and cannot be felt. Unlike mole, freckles do not cause a lump. Freckles occur when melanin is produced by a specialized cell called a melanocyte. Exposure to sunlight stimulates the melanocyte to increase the amount of melanin it makes and the pigment seeps out and is picked up by the surrounding skin cells. That’s why the color appears in spots, instead of uniformly across the skin. Since people generally get more sun exposure in the summer, they tend to freckle more at that time. Freckles can also develop on all types of skin tones. 

Treatment for Freckles 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.

Frequently, individual or a combination of treatments may be required for best results as not everyone’s skin will improve with the same set of treatments. Following your consultation, I will customize the most appropriate treatment for you.

To ensure freckles from recurring, prevention is key. I recommended to apply water-resistant sunscreens with at least SPF (sun protection factor) 30 and above. Ensure your skin are fully covered before going under the sun. As freckles are usually caused by sun exposure, ensure you are well protected from the UV to reduce the probability 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 typically appears on the upper cheeks, upper lip, forehead, and chin of women 20 – 50 years of age. Melasma is primarily caused by external sun exposure , external hormones like birth control pills, and internal hormonal changes as seen in pregnancy. Most people with melasma have a history of daily or intermittent sun exposure, although heat is also suspected to be underlying factor. Melasma is most common among pregnant women, especially those of Latin and Asian descent. People with olive or darker skin, like Hispanic, Asian, and Middle Eastern individuals ,also have higher incidences of melasma.


What Causes Melasma?

The exact cause of melasma remains unknown. Experts believe that the dark patches in melasma could be triggered by several factors, including pregnancy, birth control pills, hormone replacement therapy (HRT and Progesterone ) family history of melasma, race, and melasma , especially in individuals in individuals with general disposition to this condition.

When melasma occurs during pregnancy, it is also called chloasma. Pregnant women experience increase in oestrogen, progesterone, and melanocyte-stimulating hormone (MSH) levels during the second and third trimesters of pregnancy. Melanocytes are the cells in the skin that deposit pigment. However, it is thought that pregnancy-related melasma is caused by the presence of increased levels of progesterone and not due to oestrogen and MSH. Studies have shown that postmenopausal women who receive progesterone hormone therapy are more likely to develop melasma.

In addition, products or treatments that irritate the skin may cause an increase in melanin production and accelerate melasma symptoms.

People with a genetic predisposition or known family history of melasma are at an increased risk of developing melasma. Important prevention methods for these individuals include sun avoidance and application of extra sunblock to avoid stimulation pigment production.

Treatment for Melasma

There are two types of patients suffering from Melasma;

1) Women who developed Melasma due to hormonal changes during pregnancy or while taking birth control pills . For this group of individuals, the melasma will tend to fade after delivery or once they stop taking the pills. 

2) Individuals who developed Melasma due to UV rays and other factors that may last them for years or even the rest of the lives. 

There are many treatment options that can help to reduce or remove the patches, however not all treatments work for everyone and melasma may tend to come back even after successful treatment. 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 yellow laser. With this method, 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 can be addressed.Pigmentations come in different levels of severity. We provide bespoke Melasma treatment in Singapore, where Dr Thean will permutate the combination of treatments best to treat the dark spots.

Melasma treatment Singapore

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.

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.


Active Acne

Types, Causes and Treatment for 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.

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.

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.

Types of acne


Noninflammatory acne types : Whiteheads and blackheads are types of noninflammatory acne lesions. They are the least severe forms of acne and are usually not painful and does not cause swelling.

  • Whiteheads
    The medical term for whiteheads is closed comedones. These are small, whitish or flesh-colored spots or bumps. They usually have a white, circular center surrounded by a red halo. A hair will sometimes emerge from the center of a whitehead, or it may appear to be trapped within the blemish. The skin around a whitehead may appear to be tight or wrinkled, especially when the whitehead is large or especially raised. Whiteheads typically do not cause scarring.

  • Blackheads
    Blackheads are called open comedones. They are small, black or dark-colored spots that may appear as slightly raised bumps. The skin around a blackhead usually appears normal, while the center of the blackhead is darker than the surrounding area. The coloration is not a result of trapped dirt, when the skin over the bump opens, exposure to air it causes the contents of a whitehead to darken.

Inflammatory acne blemishes types : Blemishes or lesions that are inflamed, or red, swollen, and warm to the touch can result from inflammatory acne. Types. s of inflammatory acne includes, papules, pustules, nodules and cyst

Minor-to-mild forms

  • Papules
    Papules are small red bumps under the skin’s surface. Unlike whiteheads, papules have no visible center of pus and unlike blackheads, the pores of a papule do not appear to be widened. Acne papules occur when comedones rupture and disperse the bacteria into the skin tissue, causing irritation.

  • Pustules (pimples)
    Pustules are larger, tender bumps with a defined circular center. The center is usually filled with whitish or yellowish pus, due to an infection of the pore cavity. Pustules acne are usually hard and can be painful and the skin around the bump may be red and inflamed.

Moderate-to-severe forms

  • Nodules
    Nodules acne is a severe form of acne that are large, hard, painful, inflamed lumps located deep within the skin. They look like larger, deeper papules and have no visible center or head. This type of acne lesion occurs when clogged pores damage tissues and cells deep beneath the skin’s surface and can cause skin complications such as dark spots or scarring.

  • Cysts
    Cysts acne is the most serious type of acne and they are usually very large, soft, painful, red or white lumps filled with pus that are situated deep in the skin. When the cyst bursts, the infection can spread, causing the skin to have more breakouts. Cysts can also cause skin complications, such as scarring if not treated.

Types of Acne
Dr Chiam CT

What are the treatment options for acne?

Different types of acne lesion requires 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, can usually clear active acne and improve the scar appearance quite rapidly. 

Other available acne treatment in Singapore

IPL Acne Therapy
LED PhotoTherapy
Repair Acne MediFacial
Skin Peel Renewal


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 ligten 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. CO2 resurfacing though is more suitable for Caucasian 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.

The CO2 resurfacing is more suitable for Caucasian skin as compared to using it on Asian skin, as it may cause complications of hyperpigmentation and burns, resulting in multiple treatments. Therefore, I 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.