Written by : Dr. Teo Wan Lin
Whether you are a local or an expat living in Singapore, you might be struck by the stark weather of this equatorial city – constantly humid with temperatures soaring above 30 degrees Celsius. We are all convinced that’s the cause of our sweaty pimply skin, simply put, Singapore’s weather causes bad skin-acne on the face, pimples on the chest and back. Is that true?
Besides, every other aesthetic clinic and medi-spa is selling some sort of acne treatment for our humid climate. How do you tell if it’s required or will even work? Is it bad skincare that causes these outbreaks, and what exactly constitutes good skincare?
Here, I share my top five DIY tips on maintaining good skin in Singapore, and how to get treatment when you really need it:
1. Do you have a true skin problem? Get checked by a dermatologist.
Do you believe that you have sensitive skin and experienced break-outs if the products were not right? Constant red face? Having flaky itchy skin whenever you travel to a cold country or experienced that when you moved to Singapore? Always having a pimple breakout at that time of the month?
If you have any of these symptoms, stop self-medicating and applying a bunch of anti-redness or “sensitive skin” products if you have these symptoms, it’s just going to make it worse. See a dermatologist (check your doctor’s qualifications on the Singapore Medical Council website) as soon as you can because all of the above can be promptly treated with proper medications.
Eczema treatment for flaky, sensitive and itchy skin, hormonal acne treatment for pimples around that time of the month, and sometimes it isn’t even really acne. I’ve seen cases of perioral dermatitis (read: mix of eczema and pimples) that have been wrongly diagnosed as acne and obviously did not improve.
Acne on the chest and back may also not be true acne, but rather a fungal infection. This sort of chest and back “acne” requires treatment with specific anti-fungal lotions and creams. People who are at risk include athletes or those living in a humid country like Singapore, as the constant sweating and the moist environment worsens it. When left untreated, it leaves bad scars and even develops secondary bacterial infections.
Red face? You likely have rosacea, treatment is with correct oral antibiotics and creams before anti-redness lasers (to eradicate the blood vessels) are used.
Rosacea is triggered off by hot climates, spicy foods, emotions in certain people who are at risk. It is likely to be related to increased blood vessel sensitivity as well as certain mites that live on your skin (demodex mites).
Bottom-line: if you have any of the above, there’s no need to pile on more makeup or put more products but first get checked by a dermatologist.
2. Use a dermatologist-tested and formulated cleanser
It almost feels like because Singapore is so hot we constantly need to shower and keep clean because of the sweat! As a dermatologist, I’ve heard from countless patients with acne how they struggle to wash their face three times a day and are puzzled that they still have pimples. Truth is cleansers perform one function, it grabs the dirt, oil and bacteria in the foam which is rinsed off with water.
Acne isn’t caused by dirt or bacteria, although they both can worsen people who already are prone to acne, such as those who have a family history of acne, so no amount of washing can actually get rid of acne.
However, there is a difference between normal cleansers and those which are dermatologist-tested/formulated. That is, those which are approved by dermatologists are gentle on the skin, due to a good balance of the lathering agent and use of quality ingredients that do not strip the skin dry of its natural moisture while cleansing effectively.
I personally formulate a honey-based cleanser which is suitable for both oily skin and sensitive skin types in Singapore (honey is a natural emulsifying agent which also has anti-bacterial properties) for my patients. Cleansers that leave your skin feeling squeaky clean is usually a bad sign, so stop using your supermarket cleanser and start looking carefully for those “dermatologist-tested and formulated” labels.
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3. Don’t scrub or use a clay mask
It amuses me that most of my patients are shocked when they hear this from me, their dermatologist, almost as if I am wrong to say that. Truth is, dermatologists do not agree with a lot of what beauty companies/aesthetics providers (who are not qualified dermatologists) are telling the public, and for a very good reason.
The beauty industry is limited by what they are allowed to use in their salons (none of the prescription medications that would actually work is found in these places) and are are very happy to include more products in your regimen to earn your dollar.
Revolution Skin Pink Clay Detoxifying Face Mask
Dermatologists have seen way too many complications because of an incomplete understanding of the actual science of how skin behaves. Scrubbing with harsh beady grains of sand would work if your skin was made of wood, like sandpapering it down.
In reality, you do not brighten or “exfoliate’’ your skin with that; rather, you are causing damage and irritation to your skin, that’s maybe even the cause of your sensitive skin and red face problems.
Clay masks? Totally unnecessary, even for oily and acne-prone skin types because it’s actually the salicylic acid content in these masks that causes your acne to get better, but not without really dehydrating your skin after that (these masks are dry out your skin with an astringent). Most of my patients end up with a red itchy flaky face, on top of acne after they go on a clay-mask spree hoping that it would cure their oily face and acne.
Dermatologists do not prescribe clay masks for any skin problem because there are much more effective options for treatment of oily skin and acne. What counts in a skin treatment product is the active ingredient in these masks and products, so again, start looking down the ingredient list of your next bottle!
4. Use cosmeceuticals but do thorough brand research first
Haven’t heard of cosmeceutical yet? It has become quite a fashionable word among the dermatologists community (for those in the know). It’s a marriage of two words “pharmaceuticals” and “cosmetics”. It’s actually referring to skincare with active ingredients best for skin that is backed by dermatologists.
Am I too young? Or too old? Do I even need to get started? For best results, start on cosmeceuticals early, in your twenties for maintenance of your youth. If you are already in your thirties and forties or beyond, fret not — cosmeceuticals are a useful adjunct to the laser/filler/Botox treatments recommended by your dermatologist and help to enhance and maintain the effects of such anti-aging treatments.
There are a myriad of cosmetic brands that claim wonders. Unfortunately, cosmeceuticals are not regulated by the HSA and so are not bound to their claims. Hence, it’s difficult for the consumer to know if a given product can do what it claims it can do, contains the ingredients it claims to, or if the ingredients are even active forms?
Moreover, if the ingredients have phototoxic or photo reactive properties when exposed to the sun, among other concerns. What then?
There is true evidence for the anti-aging properties of cosmeceuticals, but you would be wise to consult a dermatologist before you buy. The HSA does not regulate the effectiveness of anti-aging products available without a prescription.
5. Do a chemical peel monthly at your dermatologist’s office and start in your twenties!
What is true about acne and the humid Singapore climate is that it all encourages the build up of dead keratin (read: skin flakes) which plug the pores and cause inflammation.
Even if you don’t have acne, the build-up of keratin on your face with reduced skin turnover as one grows older, or due to environmental conditions such as exposure to pollutants and to sun.
A regular chemical peel (salicylic, lactic or glycolic acids as suited for your skin type should be determined by your dermatologist) or a medi-facial (I use a vacuum handpiece with customised chemical peel solutions for patients), would reduce your chances of having oily acne-skin breakouts and reverse early signs of mild aging. It’s affordable as well.
However, this alone will not work for a lot of patients with more severe acne/oily skin, for which they may require laser treatments to shrink oil glands or take oral isotretinoin for control of severe acne.
What is a dermatologist?
A dermatologist (skin specialist) is a qualified medical specialist who has obtained qualifications to specialise in the diagnosis, treatment and prevention of skin, nail and hair diseases. Dermatologists are trained in cosmetic skin problems and aesthetic procedures. Only doctors listed as dermatologists by the Ministry of Health are recognised dermatologists. Cosmetic lasers, treatments, botulinum toxin and filler injections were developed by dermatologists. Aesthetic doctors are not skin specialists, they are family practitioners(GPs) who need to be accredited by the Dermatological Society of Singapore to carry out these procedures. Having a diploma in dermatology (Dip Derm) or a diploma in family practice dermatology (Dip FP Dermatology) does not qualify a doctor to be a dermatologist.
— Dermatological Society of Singapore
Dr. Teo Wan Lin is a leading dermatologist in Singapore and also the Medical Director of TWL Specialist Skin & Laser Centre. She formulates a proprietary line of dermatologist grade cosmeceuticals Dr. TWL Dermaceuticals which work synergistically with customised, evidence-based aesthetic treatments she offers to her patients. She is a regular contributor and resident beauty specialist for ZCOOP Singapore.