SKIN CARE

Stress, hormonal change and environmental factors lead to different kinds of skin problems, e.g. acne and hyperpigmentation. Whether we admit it or not, having skin problems not only affect appearance, but also impact our quality of life as we are unable to fully embrace living it to the fullest. On good skin days, people are naturally more confident, presenting their best face to the world. So, let’s start to choose the right skincare products now!

Frequently Asked Questions

Acne
Alopecia.jpg
Androgenetic Alopecia
Dark Spot
Dandruff
Dermatoses
 
Q: How does acne form?

A: Acne is a skin disease that is characterized by the appearance of pimples on various parts of the body such as the neck, face, back, chest as well as shoulders. The disease, which is very common, is a result of clogging up hair follicles caused by oil and dead skin cells. The growth and reproduction of bacteria (Propionibacterium acne) in hair follicles further promote inflammation and acne formation.

Q: What are the impacts of acne?
  • Bad appearance

  • Anxiety

  • Lower self esteem

Q: What deteriorate acne?

A:

  • Pre-menstrual hormonal change

  • Squeeze acne by your hands

  • Cosmetic and skincare products containing oil

  • Stress

  • Scrub your skin hard

Q: How to treat and prevent acne?

A: When there is an acne outbreak, you may use drugs with anti-inflammatory and antibacterial effects. But if your acne hasn't gotten better with these treatments, a retinoid may help. When spread on the skin, retinoids can unclog pores, allowing other medicated creams and gels to work better. They also reduce acne outbreaks by preventing dead cells from clogging pores. By clearing acne and reducing outbreaks, they may reduce the formation of acne scars.

 

However, retinoids are usually quite irritating to skin, and can cause local adverse events such as dryness, redness and peeling. Therefore, it is recommended to choose a product which contains retinoids with good tolerability, e.g. BiRetix Duo.

Q: How to take care of acne-prone skin?

A: 

  • Apply sunscreen of at least SPF15 everyday

  • Gently cleanse your skin

  • Do not use skincare and cosmetic products containing oil

  • Remove make-up thoroughly

  • Do not touch affected areas frequently; pay attention to personal hygiene

 
Q: What is Androgenetic Alopecia?

A: Androgenetic alopecia is a common form of hair loss in both men and women. In men, this condition is known as male-pattern hair loss. Over time, the hairline recedes or hair loses at the crown (near the top of the head), often progressing to partial or complete baldness. While in female-pattern hair loss, the hair becomes thinner all over the head.

Q: What causes Androgenetic Alopecia?

A: Few factors including hormonal, genetic and inheritance likely play a role in causing androgenetic alopecia. A hormone called androgens is important for normal male sexual development before birth and during puberty. Androgens also have other important functions, such as regulating hair growth. Changes in the AR (androgen receptor) gene, which provides instruction to make androgen receptor and respond to the hormone, may increase the risk of hair loss. Other environmental factor and personal lifestyle may also cause Androgenetic Alopecia.

Q: How to treat Androgenetic Alopecia?

A: Current treatment options include:​

  • Minoxidil scalp solution

  • Oral androgen-dependent treatment: Finasteride

  • Hair transplantation/ Micropigmentation on scalp

 
Q: What is dark spot and its causes?

A: A dark spot refers to a hyperpigmentation of the skin which occurs when a localized patch of melanin produced accumulates on a specific area on the skin. It can be located on the forehead, face or cheek bone area, and can be worsened by sun exposure. There are several factors that lead to dark spot:

  • Sun exposure

  • Hormonal variances caused by stress, contraceptive pills and pregnancies, etc.

  • Inflamed or injured skin (including acne, folliculitis or laser therapy)

Q: What types of dark spot are there?

A:

 

  • Freckles – Freckles are flat, beige, brown circular spots that typically are the size of the head of a common nail. The spots are multiple and may develop after repeated exposure to sunlight. These are particularly common in people with red hair and a fair complexion. They may appear on people as young as 1 or 2 years of age.

     

  • Age spots – As one ages, dark spots do appear on the face, hands and chest. It might look like freckles, but spots as a result of age gets irregular and larger in shape.

     

  • Melasma– A common skin problem. The condition causes dark, discolored patches on your skin. It’s also called the “mask of pregnancy,” when it occurs in pregnant women. The condition is much more common in women than men, with 90 percent of people who develop melasma are women.

     

  • Sunspots – They develop on the skin after prolonged periods of sun exposure. Any age can get sun spots, although those with lighter skin complexion are more susceptible to them. They can vary in colour, shape and size and show up most commonly on the hands and face, or areas where there is the most sun exposure.

Q: How to remove dark spots?

A:

  • Whitening products which contains Hydroquinone/Retinoids/Kojic acid/ Vitamin C

  • Peeling

  • Laser treatment

  • Intense pulsed light (IPL) treatment

Q: How to prevent the formation of dark spots?

A:

  • Apply sunscreen of at least SPF15 everyday

  • Stay cheerful, and keep a balanced diet

  • Remove dead cells (Exfoliate) regularly 

 
Q: What is dandruff?

A:​  Dandruff is resulted from the metabolism of the scalp. Stratum corneum of the scalp proliferates and peels off every day. Normally, the rate of proliferation equals to the rate of break-down. However, once this balance is broken, it causes the formation of dandruff. Dandruff not only affects appearance, it may also reveal some hidden health problems.

Q: Why do people have dandruff?

A: Some say that dandruff is caused by genetic or environmental factors. However, the exact cause of dandruff still remains unknown. One of the possible causes for dandruff is due to dermatoses of the scalp.


Dandruff can only be found in scalp. People with dandruff have itchy, flaking and scaling skin, usually without inflammation. Serious case is called seborrheic dermatitis.


Seborrheic dermatitis has similar symptoms as dandruff. The major difference is that seborrheic dermatitis is usually associated with inflammation. It often affects skin that is rich in oil-producing glands e.g. scalp.


Dandruff is observed in psoriasis patients too. Patients will have lesions with silver-white scaling and is characterized by itching, skin redness, skin tightness, etc. Scalp lesions can form beyond the hair border onto the face or retro-auricular area.

Q: How to treat dandruff?

A: There are many ways of treating and controlling the situation of dandruff. One of the most effective ways is to use anti-dandruff shampoo. Generally, washing hair with gentle shampoo can already reduce the build-up of oil and dirt and improve the condition. If it does not work, medicated anti-dandruff shampoos can also help. According to the active ingredients, we can separate them into 7 types: 

 

  1. 1.    Coal tar - it has been widely used as an anti-dandruff shampoo for almost 100 years and is one of the first-line treatments for the scalp dermatoses management. Coal tar is anti-pruritic, anti-inflammatory, fungistatic, sebosuppressive, keratolytic and anti-proliferative.


  2. 2.    Salicylic acid - it is anti-pruritic, anti-inflammatory, keratolytic and able to enhance the penetration rate of other agents into skin.


  3. 3.    Selenium sulphide – slows down skin turnover rate and is fungistatic.


  4. 4.    Zinc pyrithione – bacteriostatic and fungistatic.


  5. 5.    Ketoconazole – anti-fungal agent.


  6. 6.    Ciclopirox olamine – anti-fungal agent.

  7. 7.    Clobetasol propionate – topical corticosteroid. 

Source: https://dermatology.ca/public-patients/hair/dandruff/ 

 
Q: What are some of the common dermatoses? 

A:


•    Atopic dermatitis: atopic dermatitis (also known as atopic eczema) is a chronic condition. It usually develops in infants and young children.  At first, rashes are observed in areas with folded skin e.g. knees and elbow creases, etc. In later stage, people mainly have itchy, red and dry skin patches.


•    Contact dermatitis: it is an allergic reaction and can be divided into two types: “irritant contact dermatitis” and “allergic contact dermatitis”. It is caused by direct contact with irritants or allergens (such as plastics, metals, perfume). Symptoms include rash, itchiness, blisters, dry and cracked patches, and pain. The disease is only limited to the site of contact.


•    Psoriasis: it is a chronic autoimmune disease. Patients’ skin have increased proliferation, leading to the formation of red, itchy skin patches with silvery scales. Psoriasis can develop in all areas of the body. 

•    Lichenification: Dermatoses patients may scratch their itchy and inflamed skin. This damages the skin barrier and makes it more susceptible to allergens. The vicious cycle leads to “lichenification”. Skin is thickened, becomes rough and appears darker. 

Q: How to care for the common dermatoses?

A:​  The most common method to manage dermatoses is to use topical corticosteroids. It can relieve and soothe skin redness and itchiness. 


The way corticosteroids reduce inflammation is a complicated process. It involves inhibiting the body to react to chemicals, so the immune system will not trigger inflammation process and its sensitivity is reduced.


Although topical corticosteroids cannot completely cure dermatoses and discontinuation may results in rebound and exacerbation of the disorders, they are a relatively safe and effective treatment for dermatoses when used properly and under physicians’ supervision. Remember to consult with your doctors before using any topical corticosteroids. 

 (Adapted from the website of the Drug Office of the Department of Health

Q: What are the classifications of topical corticosteroids with respect to potency?

A:​ Topical corticosteroids can be classified into 4 groups according to their potency: (I) Mild, (II) Moderate, (III) Potent and (IV) Very Potent.


(I) Mild: for mild dermatoses like contact dermatitis or bug bites. Example: Hydrocortisone acetate.


(II) Moderate: for treating slightly difficult cases of dermatoses. Example: Fluocinolone acetonide.


(III) Potent: for treating unmanageable dermatoses and psoriasis. Example: Hydrocortisone aceponate.


(IV) Very Potent: used when the patients failed to response to the above corticosteroids. Please note that this group can only be used for a short time. Example: Clobetasol propionate.


Depending on the formulations and concentration of topical corticosteroids, their efficacy may differ. Corticosteroids with higher potency also have stronger anti-inflammatory effect. At the same time, they have higher risk of side effects if used for a prolonged period of time. In spite of this, a new generation of topical corticosteroids is developed, such as hydrocortisone aceponate. Its unique molecular structure compensates its shortcomings and enhances its efficacy, enabling it to have high local activity with reduced systemic effects.
 

Any dermatological products for these conditions?

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