What's New
Contact Us
290 Orchard Road
#19-01 Paragon
Singapore 238859
Tel: (65) 6883 6978
Fax: (65) 6883 6976
patyuen@pachealthholdings.com
International 24-Hr Answering Service: (65) 6535 8833
MEDICAL DERMATOLOGY
Acne
Acne is a condition which develops in and around the hair follicles and their oil producing glands (called the sebaceous glands). Although we have these glands all over the surface of our body, it is only on the face, chest and back that acne develops. The oil produced by sebaceous glands is called sebum and it begins to appear soon after puberty due to hormonal changes. Acne may be inflammatory or non-inflammatory. The primary non-inflammatory lesion is called “comedone”. Whiteheads are pale, slightly elevated papules categorized as closed comedones. Blackheads are plugs of material that accumulate in the sebaceous glands and are categorized as open comedones. Comedonal acne can become inflamed and lead to the formation of painful papules, pustules and nodules. Acne usually starts during teenage years but may also begin in the twenties or thirties.
There are a number of approaches to treating acne and the scarring it leaves behind. Your dermatologist can prescribe the appropriate skincare to treat your acne, as well as topical and/or oral medication. There are also procedures like microdermabrasion, acne booster peels and photopneumatic therapy (PPX) to help treat the condition. Vitamin C iontopheresis can help lighten the dark marks left over from inflammatory acne, whereas fractional lasers help improve the appearance of deeper scars.
Actinic Keratosis:
This is an epidermal skin leison directly related to chronic sun exposure and photodamage. The prevalence is highest in people with light-colored skin. It may progress to squamous cell carcinoma and these lesions are classified as premalignant. Electrodesiccation is required to remove the lesion.
Eczema
Eczema is a chronic recurring skin condition that causes the skin to become red, itchy, scaley, dry and cracked.
There are many forms of eczema, but atopic eczema is one of the most common. It mainly affects children but can persist into adulthood. Common sites are the inside of the elbows, behind the knees, side of the neck and around the eyes and ears. The exact cause of eczema is not clear but it tends to run in families. Patients with allergies ( eg asthma, allergic rhinitis) are more prone to developing it.
Other than using emollients, your dermatologist can prescribe certain topical corticosteroids, antibiotics and antihistamines to alleviate the condition. Different types of medications are needed for different parts of the body. The aim of the treatment is to heal the skin and prevent future flare-ups. It is safe to use corticosteroids for a short while under the guidance of your dermatologist.
Fungal Infections
Fungal infections are common disorders that can affect the skin, hair and nails. Moist, humid and warm environments are the important factors in the development of the fungal infections. The organism may be transmitted by direct contact from person to person or by inanimate objects such as towels and linens. Fungal skin infections can cause red, scaly and itchy rashes, depending on which part of the body is affected. Topical or systemic antifungal medications are needed to treat the infection.
Hair Loss
There are many reasons for hair loss including ageing, genetics, hormonal imbalance, and nutritional deficiencies. Although hair loss is not a serious health threat, it may cause negative self image and embarrassment. Most people normally shed 50 to 100 hairs a day as part of the hair renewal process. However some people suffer from excessive hair loss at one time. There are a few types of hair loss: male pattern androgenetic alopecia, female pattern alopecia, telogen effluvium, alopecia areata, alopecia totalis and alopecia universalis. Oral and topical medications are available to treat certain types of alopecia.
Hyperhydrosis (Excessive Sweating)
This is a common disorder of excessive sweating from palms, armpit and feet .There are few treatments available for this embarrassing condition. Injection of a neurotoxin is the most effective and non-invasive treatment to deactivate the sweat glands and results generally last for up to nine months.
Keloid Scars
These are raised, hardened and unsightly areas of excess scar tissue caused by overgrowth of granulation tissue during healing process, usually extending beyond the border of the original wound. Aside from causing potential cosmetic problems, these exuberant scars tend to be itchy and tender.
Keloids develop mostly on the chest, back, shoulders and earlobes. A person who has a history of keloid scars should not undergo unnecessary elective surgery or procedures, as prevention is the best solution. There are a few treatments available to treat keloids, including cortisone injections, lasers and silicone sheets.
Moles Removal
A mole (or melanocytic naevus) is an abnormal collection of pigment cells present within the skin, which is extremely common. Most people are born with a few moles and develop others during their lives. A few of these moles, called congenital melanocytic naevi, are usually present at birth. But most develop spontaneously or are caused by exposure to sunlight and tend to appear on those areas of the skin that catch the most sunlight. It is important to monitor nevi for indicators of transformation.
Moles that are suspicious looking should be removed by excision biopsy. Smaller moles can be lasered off for cosmetic reasons.
Please see "Skin Cancer Screening" below.
Molluscum Contagiosum
This is a common skin condition caused by the molluscum contagiosum virus. It causes raised, flesh-coloured, pearl-like papules on the skin, usually with a dimple in the centre. This is a common infection in children and occurs when a child comes into direct contact with a lesion. It is frequently seen on the face, neck, armpit, arms, and hands but may occur anywhere on the body except the palms and soles. The virus can spread through contact with contaminated towels, clothing or toys.
Although most symptoms are self-limiting, it can take up to a year to resolve. Lesions may be removed to reduce the chances of transmission and autoinnoculation. Treatment of Molluscum includes curettage and electrosurgery.
Nail Abnormalities
Discoloured, malformed, infected or thickened fingernails and toenails are very common problems encountered by people. Damage to the nail may be due to an underlying systemic diseases, fungus or trauma. It is important for patients to seek medical advice for effective treatment and correct diagnosis as many potential conditions cause nail abnormalities.
Pigmentation/ Melasma
Melasma is a hyperpigmentary disorder of the skin characterized by blotchy dark patches on the face and forehead. It is triggered by both sun exposure and hormonal changes due to pregnancy, oral contraceptive use or perimenopause.
Melasma commonly affects women of darker skin types and tends to run in families, only 10% of cases are men. The treatment involves use of hydroquinone, retinoids, and other topical agents. Adjuvant therapy with IPL, chemical peels and vitamin c iontopheresis may hasten the process. Under a dermatologist’s care, many people with melasma have a good outcome. Melasma can be stubborn, though. It may take a few months of treatment to see improvement. It is important to follow your dermatologist’s advice.
Psoriasis
Psoriasis is a chronic, recurrent, noninfectious skin disorder that is characterized by red, scaly patches with fine silvery white scales when scratched. The lesions may appear anywhere on the body, but most commonly occur on the elbows, knees and scalp.The actual cause is unknown, but some evidence suggests psoriasis may be autoimmune. It is exacerbate by a factors such as sunlight, stress, and illness. Treatment is tailored according to the type, severity and location of the psoriasis.
Rosacea
Rosacea is a common but poorly understood chronic skin condition that mainly affects the face. Symptoms begin with episodes of flushing (when the skin turns red) which can be exacerbated by heat, emotion and sunlight. People with rosacea may experience acne-like spots and persistent redness of their skin. Small blood vessels in the skin can become visible. In the most severe cases, the skin can thicken and enlarge usually around the nose. Other than oral and topical medications, there are vascular lasers which can help alleviate the redness on the face.
Please see "Telangiectasias" below.
Sebaceous/Epidermal Cysts
They are painless, benign, slow growths which may occur anywhere on the body of any age but usually found on the head and trunk. Both types of cysts rarely require treatment unless they become large and bothersome. However if the cyst becomes red, tender, swollen, ruptured or large, surgical excision is recommended to completely remove it.
Skin Cancer Screening
Skin cancer has a high cure rate if detected and treated early. Hence, vigilant and routine skin cancer screening is necessary especially in high risk, fair-skinned individuals. There are three types of skin cancer: Basal cell carcinoma, Squamous cell carcinoma and Malignant melanoma, with the first two being more common, making up 95% of all skin cancers, whereas melanoma is the most serious causing 75% of skin cancer deaths. UV radiation from the sun is the main causative factor for skin cancer.
The most common warning sign is a visible change on the skin, a new growth, or a change in an existing lesion or mole. Here are the ABCDE’s of what to look for in skin cancer:
A) Asymmetry
B) Border irregularity
C) Colour variations
D) Diameter greater than 5mm
E) Enlargement or Elevation.
Skin Tags (Acrochordon)
These are soft benign growths that protrude from the skin. These lesions have normal skin color and texture. Generally skin tags do not have to be treated unless they become bothersome. There are a few medical methods to remove a skin tag, like snip excision or using electro-desiccation.
Telangiectasias (Broken Capillaries)
Telangiectasias are small dilated capillaries that appear often on the cheeks and nose. Sometimes these can occur on the legs and are called spider veins. These lesions are most common in older adults and may result from photoaging.
The LVA Applicator combines safe and effective levels of laser and radiofrequency energies to remove facial spider veins, unsightly leg veins and other unwanted vascular lesions. Spider veins and small blue-green vessels on legs will gradually fade and can be treated until patient satisfaction has been reached. Treatment sessions are typically 4-6 weeks apart. LVA is the clear choice for patients who do not like needles or who have had adverse reaction to solutions that are injected into the vein during Sclerotherapy.
Warts are small, rough, painless growths on the skin caused by human papillomavirus. There are many varieties of warts, and since they are contagious, it is advisable not to pick at them as you may spread these lesions to other parts of your body. Warts can be treated with antiviral medication, as well as with electrodesiccation and curettage depending on the size and location.