Dr. Tan Hui Yun: Acne treatment in Singapore – overhyped, or necessary?

Acne Vulgaris. Zits. Pizza-face. Pimples. Whatever your name for acne is, the effects of this often enervating condition are boundless and felt by many in Singapore. Acne affects up to 88%1 of Singaporean adolescents, while 50% struggle with moderate to severe acne.

And it’s not just hormonal teens who struggle with the condition; adult acne can flare up after adolescence, affecting grown men and women all through their 40s. Unfortunately, studies seem to suggest that adult women2 struggle with acne more than men do – though the condition is usually more severe in the latter. 

Although acne is not a life-threatening condition, I’ve seen how it can lead to horrible outcomes such as permanent scarring, low self-esteem, and psychosocial problems. This is made worse with myths perpetuated by false marketing and treatment packages that claim to “cure” acne.

There is no cure for acne. 

Allow me to explain the difference between acne vs pimples, how to tell if you really need treatment, and what an appropriate acne treatment plan should look like.

What causes acne?

Acne is a skin condition that affects the skin’s hair follicles and glands. It occurs when our oil glands become clogged due to whiteheads, blackheads, and pimples. Acne also takes on these common forms:

Lady suffering from mild acne

Mild acne

Whiteheads (closed comedones) and blackheads (open comedones) that consist of oil and dead skin cells in pores.

Moderate acne

Moderate acne

Inflamed, reddish bumps (papules) and sometimes, pus-filled bumps (pustules).

Lady suffering from severe acne

Severe acne

Large nodules and cysts (nodulocystic acne).

Acne can occur on the face, chest, or upper back, and when it heals, it can leave atrophic (punched-out) or hypertrophic (thickened, keloid) scars. Pigmentation and dark spots might also develop after acne wounds heal, though this is more common with darker skin and if one picks their lesions. Don’t touch those pimples!

Lady with pigmentations on her face

Acne vs. pimples: What’s the difference?

Firstly, I’d like to address that acne is notthe same as pimples. The main difference between them is that acne is a condition, whereas pimples are one of the symptoms of this condition. 

So for example – a one-off pimple or two once in a while isn’t considered acne. But if you suffer from frequent breakouts with lots of pus-filled pimples and/or blackheads and whiteheads, then you may have acne.

Adult acne: An assailant of self-esteem

While some teenagers can get their condition in control after puberty, acne can follow its victims into adulthood – adult-onset acne usually occurs after the age of 25, and surprising to many, it’s not uncommon to have your first acne breakout as an adult.

Yes, so even if you did not go through the antagonising pain of suffering from acne when you were a pubescent teenager, it does not mean you will be spared from it as an adult. 

Now, you may think, 

“It’s just acne. What’s the big deal?” 

“Everyone suffers from breakouts once in a while, don’t be so superficial!” 

If you’re one of the lucky ones who can afford to think that way – good for you. But as mentioned, acne can be debilitating for many patients  as it can have the following effects:

  • Low self-esteem
  • Interpersonal rejection
  • Psychosocial, vocational, and sexual incompetence 
  • Lessened ability to cope with illness and life challenges
  • Anxiety, depression, and more

Patients with acne have been found to have higher rates of unemployment3 compared to their unaffected counterparts.

When should I seek treatment for acne?

You should seek treatment for acne if you are seeing more pimples or acne scars appearing on your skin, and your skincare regime is doing little to control your condition. As acne can affect one’s self-esteem, quality of life, and mental health, you should seek treatment from a professional you can trust, as soon as you possibly can.

Are facials and other aesthetic treatments effective in treating acne?

While a medical facial can help remove clogged pores to even reduce acne, I do not recommend it as a primary treatment option. Rather, it should be considered a routine that is supplementary to your main acne treatment. 

With that said, facials might not work the same for everyone – there are cases where patients with sensitive skin might worsen their condition by doing facials due to irritation of the skin.

Some clients often think that treating acne using a single module is effective. The truth is that acne is often caused or worsened by multiple factors such as:

  • Hormonal changes such as puberty, menstruation, and pregnancy
  • Picking and squeezing existing pimples
  • Bacterial overgrowth
  • An unsuitable or unhelpful lifestyle or diet
  • Reactions to products or medicines like corticosteroids and anabolic steroids
  • Stress.

As you can tell, there are endless factors that could cause acne. This is why we should always treat acne in a holistic way.

What should acne treatment be like?

With the medicine and technology that are available today, we have choices when it comes to treating and controlling acne effectively. Do remember though, that while there are many effective treatments available today, acne can be persistent, especially if not treated in a comprehensive manner. 

For example, a patient who has acne and polycystic ovarian syndrome (PCOS) would need to consult their gynaecologist regularly to help control their acne condition. This will go hand in hand with aesthetic treatments such as topical creams, lasers, oral medications and rejuran, all of which effectively control the excessive sebum production caused by PCOS. Simply put, treating acne might not always be a straightforward task.

There are also too many cases whereby acne patients go for one treatment after another, only to find out years and many scars later that they were dairy intolerant all along, and that they could have saved their skin just by avoiding dairy products.

Then, there are also those who find out later that they have rosacea acne, a very under diagnosed condition. The treatment of rosacea is not as simple as acne, as these patients have very sensitive skin. The key is always to control the red and sensitive skin first.

 The point is – all these patients could have helped their skin if they had been treated by a clinician with a better perspective and understanding of acne.

This is why I always strive to take an across-the-board approach when it comes to treating acne. I know how important it is to take time to understand my patient’s medical history and examine them thoroughly before recommending any treatment regime.

If you would like to control your acne, let me help you restore the harmony and balance you need in your skin and life. Feel free to contact me if you have any questions, or if you would like to schedule a personal consultation.

References

  1. https://www.singhealth.com.sg/patient-care/conditions-treatments/acne-vulgaris
  2. Collier, C. N., Harper, J. C., Cafardi, J. A., Cantrell, W. C., Wang, W., Foster, K. W., & Elewski, B. E. (2008). The prevalence of acne in adults 20 years and older. Journal of the American Academy of Dermatology, 58(1), 56–59. https://doi.org/10.1016/j.jaad.2007.06.045
  3. Gallitano, S. M., & Berson, D. S. (2017). How Acne Bumps Cause the Blues: The Influence of Acne Vulgaris on Self-Esteem. International journal of women’s dermatology, 4(1), 12–17. https://doi.org/10.1016/j.ijwd.2017.10.004