skin care

hot or cold water acne wash face

Hot or Cold Water for Acne: Which is Better?

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Have you ever thought about which temperature of water is best when washing your face? Is it hot or cold water for acne? Here is what AC Skin Health dermatologist, Dr. Amy Chua has to say.

Let us look at the pros and cons of using the different temperatures in washing our face.

Hot water

Using warmer temperature of water may make you feel like you are enjoying a hot bath or sauna. This may be relaxing and destressing. However, when you read the next paragraph, it may not be so relaxing for you anymore.

Washing our face (or body for that matter) with hot water strips off protective oil from our skin. Our skin may perceive this as being dry, hence it responds with overproduction of oil. In general, more oil relates to more acne and uh-oh, that is bad news. Hot water, especially temperature over 40C may affect the integrity of the skin barrier and make you more prone to irritation, infection, and acne. Another effect of hot water on our skin is making you more prone to wrinkles! It seems then that washing your face (or taking a bath) with hot water, may bring your skin more harm than good.

Cold water

Have you tried melting an ice cube on your pustules and papules? If you haven’t, you may try getting an ice cube and sliding it over your inflammatory pimples a few times. You might notice that applying ice can lessen pain, redness, and swelling of inflamed acne.

We don’t know however if using cold water may produce the same results. Most likely not. Water from the faucet is usually not that cold. More so, your skin will be exposed to cold water for only a short period of time. How many seconds or minutes does it take you to wet and rinse off your facial cleanser? While using cold water may not be harmful, it will most likely have minimal benefits on our skin.

Our verdict

It is recommend to wash your face with lukewarm water – not too hot, not too cold, just right! Most products are also designed to be used with lukewarm water. But if you prefer to use cold water, feel free to do so too!

Here are more of AC Skin Tips for healthy and safe washing of face:

  • Use lukewarm to cold water.
  • Perform gentle washing of face using hands.
  • Avoid scrubbing cloths, loofah or scrubbing and exfoliating tools.
  • Use a gentle cleanser, or a soap/wash prescribed by your dermatologist for your specific skin needs.
  • Limit washing to 2x a day. Washing too often may dry your skin and result in overproduction of oil and we don’t want to suffer from more acne!

Hope you learned something today!

Keep safe and stay healthy! Cheers to healthy skin!

For inquiries and to set your appointment, CONTACT us here.

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Insect Bites: How to Treat

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Insect bites can be quite bothersome for some people. This article discusses how to treat your insect bites to make the itch go away and avoid complications.

Mosquitoes, ants, bed bugs, mites, and fleas are the common causes of insect bites we encounter in the clinic. Others that may cause bites and stings include flies, bees, wasps, spiders and ticks.

Usually insect bites present as erythematous or red, slightly swollen papules that fade in a few minutes. They may cause slight discomfort or none at all.

In some patients who are sensitive to insect bites, their reaction tends to be more severe. Patients experience more severe erythema or redness, swelling, itching. It may even be painful. The symptoms may last for days to weeks. Symptoms may even worsen especially when patients scratch the bites.

what can we do? how do we treat insect bites?

To avoid insect bites, you may use insect repellants and wear protective clothing. Use of mosquito nets is a simple and cheap yet effective way in keeping nasty mosquitoes out especially when you sleep at night. At home, keep house clean. Necessary measures may be done to control ant, mosquito and other bug infestation. If your pet is the source of flea bites, have your pet treated too.

As a home remedy, a cold pack may be applied to relieve the itch. Soothing creams such as Suu Balm, Calamine, and others also help control the itch. Over-the-counter medications such as anti-histamine tablets and Hydrocortisone cream may also be tried.

If symptoms persist or worsen, you may consult a board-certified dermatologist for prescription medicines. This usually includes a more potent steroid cream, anti-histamines and oral steroids if needed. You may also be prescribed antibiotics if the bites become infected.

dark spots / PIH

Once the insect bite heals, you may notice a dark spot over the involved skin. This is called post-inflammatory hyperpigmentation or PIH. This usually fades over time. It may take weeks or months or even years depending on the severity of the bite reaction and your skin healing. Sun exposure may also play a role in the development of PIH.

In the clinic, our dermatologists will prescribe you with an appropriate lightening cream to help address your PIH. Soap, lotion, or oral medication, etc may also be recommended depending on your skin condition and goals. Chemical peel or SmartLase fractional CO2 laser may also be suggested depending on the scars.

Book your appointment now with AC SKIN HEALTH’s board-certified dermatologists.

Cheers to healthy skin!

For inquiries and to set your appointment, CONTACT us here.

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Acne Scars – Types and Risk Factors

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Learn about acne scars – the different types of acne scars and what factors increase your risk for developing acne scars.

Acne is usually temporary, while acne scars may last forever. Both acne and acne scars can cause anxiety, social withdrawal, even depression.

Different types of scarring

During the healing process, our body produces collagen in the area of the wound, or in this case, of acne.

Depressed or atrophic scars

            These scars signify lack in production of collagen in the wound healing process. The three types of atrophic scars area: rolling, box, and ice pick scars.

Raised or hypertrophic scars

            These scars signify overproduction of collagen. Scars may either be hypertrophic or keloid. You may develop this type of scars on the face, chest, back or shoulders. Unfortunately, our Asian descent is also a risk factor for hypertrophic scarring.

Who develops acne scars?

Anyone can get acne scars! Here are some of the factors that make you more prone to developing acne scars.

  • Family history

Like acne, scarring is also largely genetic. Look at your parents and other blood relatives. If they have scars – atrophic/depressed or hypertrophic/raised scars, then you are at greater risk of developing acne scars.

  • Inflammatory acne

Inflammatory acne is characterized by red, painful, and swollen pimples. Usually the deeper or more severe the pimples, the greater the risk of scarring! Acne that presents as cysts and nodules almost always heal with scarring especially if left untreated.

  • Delaying treatment or does not treat inflammatory acne

Already have acne but not paying mind to it?  Delaying or not treating your acne is another risk factor for developing those unsightly scars. Remember the more acne you have, the greater risk of each one to result in a scar.

  • Improper picking of acne

Some people love to pop, squeeze or prick their own pimples! Please try to avoid this especially if you are not trained professionally. This can cause more inflammation, hence more risk of scarring. Another danger is using unsterile hands and instruments in cleaning your zits. This is best left to dermatologists and well-trained skin therapists.

We have listed down the risk factors, not everyone who has risk factors develop acne scars, and vice versa! Some people who do not have risk factors may still get scars from acne! So what do you do? Treat your acne early and entrust your skin care and facial needs to your board-certified dermatologists.

For your acne, acne scars and other skin concerns, you may book your appointment with our board-certified dermatologists. Here is the booking link.

Cheers to healthy skin!

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Aging Skin Basics

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Aging skin basics by Dr. Mary Amy Fatima Cagayan-Chua, FPDS. This article originally published in Health and Lifestyle magazine August 2019 issue. This is also published in their website.

Learn more about aging skin basics: factors affecting aging, changes in the laters of the skin, and basic skin care for the elderly.

Aging of the skin is a complex process characterized by the interplay of both intrinsic and extrinsic factors. Intrinsic, or natural skin aging, is largely determined by genetics – and is inevitable with the passage of time. Hormonal changes, such as those seen in postmenopausal women, also contribute to intrinsic aging.

Extrinsic, or external skin aging, is primarily caused by ultraviolet (UV) radiation (photoaging). As much as 80 percent of facial skin aging is due to photoaging. Photoaging is markedly observed in sun-exposed areas, such as the face, neck and hands. Photoaged skin is wrinkled, rough skin, with poor skin elasticity, with pigmentary changes and growth of benign and possibly malignant neoplasms. Other extrinsic factors include atmospheric pollution, lifestyle (smoking, sleep deprivation) and diet.

Aging of the skin occurs throughout the different layers of the skin.

Epidermis

In aged skin, flattening of the dermo-epidermal junction (DEJ) is observed. This leaves the epidermis with insufficient blood supply and nutrients, resulting in impaired thermo regulation and skin pallor. There is also a slower epidermal turnover, which contributes to the dull and rough appearance of the skin. The epidermal changes influence the delay in wound healing.

Dermis

As we age, the dermis undergoes about 20 percent decrease in thickness and has relatively fewer cells and blood vessels. Both intrinsic and extrinsic aging are characterized by increased expression of matrix metalloproteinases (MMP), enzymes which degrade collagen. Collagen production decreases at a rate of about 1 percent per year. Collagen bundles in the aged are thicker but more disorganized and fragmented, resulting in less structural support. Decreased collagen types IV and VII at the base of the wrinkles imply their role in wrinkle formation. Degenerative changes seen in elastin result in sagging skin with poor elasticity and resilience. There is also a decrease in glycosaminoglycans (GAG), particularly hyaluronic acid. The decrease in functional melanocytes causes decreased protection from harmful UV rays.

Subcutis

On a deeper level, there is atrophy of subcutaneous fat particularly in the face and back of the hands. This contributes significantly to sagging or the aged look.

All these changes in the skin predispose the elderly to skin disorders and not just aesthetic concerns. With the increasing life expectancy, there is now more focus on the aging skin disorders and skin care. The most common skin disorder in the geriatric population is senile xerosis. This is closely associated with pruritus, or itching.

Geriatric patients are also frequently diagnosed with skin tears and moisture associated skin damage (MASD). Skin tears are commonly found on the arms and are associated with trauma, such as bumping into furniture. MASD is linked to incontinence-associated dermatitis (perineal dermatitis), intertrigo, ostomy leakage, periwound skin, etc.

Skin care regimen

The most basic and important goal of skin care for the aging is to maintain the integrity of the skin barrier. These are the recommendations in literature.

1. Use gentle cleansers. It is best to use syndets (liquid) with neutral pH and preferably with an emollient.

2. Avoid further friction with use of scrubs, bath cloths, and loofahs. Instead, gently pat the skin dry using a towel.

3. Avoid hot and prolonged baths (i.e., more than 10-15 minutes).

4. Generally, bath oils are not recommended in the elderly due to an increased risk of accidents (may result in slippery floors, causing falls).

5. To relieve xerosis (drying of the skin), pruritus and prevent skin tears, use emollients containing humectants (moisture-retaining substances) and skin lipid replacement agents. Some ingredients to look for are ceramides (20-40 percent concentration), dimethicone, lactic acid (5 percent), urea (10 percent), glycerin and alpha-hydroxy acids (AHA). These improve hydration of the stratum corneum and enhance skin barrier function.

6. Some also advise avoiding perfumes and fragrances that can cause skin irritation.

7. For incontinence-associated dermatitis, a protective barrier cream is recommended. These are usually emulsion with a metal oxide (zinc or titanium), or siliconbased with dimethicone.

8. In the geriatric population, it is still important to protect the skin from UV radiation. Apply a generous amount of a broad-spectrum sunscreen in sun-exposed areas. Wear wide-brimmed hats and clothes with UV protection when outdoors. Often neglected areas include the ears, eyelids, and lips.

Lifestyle and the aging skin

The aging population is advised to increase intake of antioxidant-rich food and avoid a hyperglycemic diet. Attaining the recommended nutritional micronutrients is more challenging in the elderly due to their usually restricted diets and the loss of some of their ability to absorb nutrients.

Avoid smoking and exposure to secondhand smoke. Minimize exposure to pollution, if possible.

A good night’s sleep is important in maintaining healthy skin. A study has shown that elderly women who slept for less than 5 hours a day had compromised transepidermal water loss and skin barrier recovery after UV-induced erythema. Likewise, poor sleep quality results in disruption of the circadian rhythm, leading to cellular dysfunction and changes in various tissues, including the skin.

With the increase in life expectancy, we expect its related comorbidities including its effects on the skin. Having a thorough understanding of the causes of skin aging can help us manage the skin problems of our patients.

  • Bibliography:
  • Addor FAS. (2018). Beyond photoaging: additional factors involved in the process of skin aging. Clinical, Cosmetic and Investigational Dermatology, 20(11), 437–443. doi: 10.2147/CCID.S177448.
  • Baumann, L. (2009). Cosmetic Dermatology: Principles and Practice Second Edition. McGraw-Hill.
  • Humbert P, Dréno B, Krutmann J, Luger TA, Triller R, Meaume S, Seité S. (2016). Recommendations for managing cutaneous disorders associated with advancing age. Clinical Interventions in Aging. 12(11), 141-8. 10.2147/CIA.S96232.
  • Kottner J, Lichterfeld A, Blume-Peytavi U. (2013). British Journal of Dermatology.169(3), 528-42. doi: 10.1111/bjd.12469.
  • Ruxton, C. (2016). Tea: Hydration and other health benefits. Primary Health Care, 26(8), 34-42. doi:10.7748/phc.2016.e1162 Tobin DJ. (2017). Introduction to Skin Aging. Journal of Tissue Viability. 26(1), 37-46. doi: 10.1016/j.jtv.2016.03.002.

For your anti-aging skin concerns, you may book your appointment with our board-certified dermatologists and plastic surgeon, just follow the link.

Cheers to healthy skin!

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what’s up with parabens?

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learn more about parabens and their health-associated risks

Parabens are a group of compounds used as preservatives primarily for their bactericidal and fungicidal properties.

They are found in shampoos, commercial moisturizers, shaving gels, make up, toothpaste, and other personal care products. They are also used in topical/parenteral pharmaceuticals and as food preservatives.

In the past years, there were health controversies raised with chronic and cumulative exposure to parabens.

A study by AF Fransway MD, et al published in DERMATITIS January/February 2019 issue summarized the existing medical and scientific evidence against parabens as below:

CONTACT DERMATITIS

Parabens have been shown to have low allergenic potential. Parabens are deemed relatively nonirritating at levels used in current formulations as studied by the North American Contact Dermatitis group.

ESTROGENIC EFFECTS

Animal experiments have shown that parabens have weak estrogenic activity, acting as xenoestrogens. There are no studies in humans confirming effects of paraben exposure.

CANCER

The American Cancer Society mentioned a 2004 study by Darbre which reported presence of parabens in the breast tissue of mastectomy patients, however study did not find parabens to be the cause of the cancers.

EU’s Scientific Committee on Consumer Safety reviewed scientific data and noted that parabens generally have low toxicity and do not cause cancers.

Studies have shown that absorbed parabens from topical application are rapidly hydrolyzed by hepatocytes and do not accumulate in human tissue to any significant degree.

Parabens have been implicated in the impairment of the reproductive system of male laboratory animals. However, antiandrogenic physiologic or developmental effect in human have not been documented whether via ingestion or percutaenous absorption of paraben.

FERTILITY

Studies on humans have not demonstrated effect of paraben on semen quality parameters or sperm DNA.

PERINATAL EXPOSURE

Maternal levels were studied and found no statistical difference with samples from their children at age 3-4years. Methylparaben, ethylparaben, and propylparaben esters have been identified in breast milk however there are lower than the allowable daily intake and deemed safe.

ENVIRONMENTAL ISSUES

Cosmetic ingredients are potential emerging pollutants. Methylparaben was identified as the predominate paraben in natural waterways in a study that took samples from China, Wales, Spain, Switzerland, India, In one study that took samples 39 swimming pools in Beijing, they found 20dols higher concentration of total parabens (predominantly metyhlparaben and propylparaben) in indoor pools versus outdoor pools. The authors however assessed human exposure to parabens from swimming pool as negligible compared to total exposure dose from other sources.

Parabens are not completely removed from wastewater in the treatment plants hence an accumulation in the environment is alarming. Although presently there are limited studies and information on the effect of parabens to aquatic organisms, in contrast to benzophenone (oxybenzone).

The authors have concluded that claims regarding parabens and potential adverse health effects are premature based on currently available scientific information. Removal of parabens from consumer products could result in substitution with an alternative substance which is less proven and potentially unsafe too.

This study was published by dermatologists in the US.

REGULATION

The EU Commission Regulation No 358/2014 has banned use of the following parabens: Isopropylparaben, isobutylparaben, phenylparaben, benzylparaben and pentylparaben.

The following parabens are safe and repeatedly confirmed by the EU Scientific Committee on Consumer Safety (SCCS):

Methylparaben and ethylparaben are safe at maximum authorized concentrations (maximum of 0.4% for one ester, or 0.8% if in combination). Butylparaben and propylparaben are safe with maximum individual concentration of 0.19%. Butylparaben and propylparaben are prohibited in products designed for children under three years old and must have warning not to be used in the diaper area.

We hope this review clears the controversies associated with parabens. Though some of it forms are banned and deemed unsafe, other forms are with minimal health risks with no significant scientific evidence to propose discontinuation of its use. We may also choose to limit paraben exposure and choose “healthier” alternatives. Such alternatives are available at AC Skin Health.

You may book your appointment with our board-certified dermatologists, just follow the link.

Cheers to healthy skin!

Stay tuned for updates and promos, follow and like us on Facebook, Instagram and Twitter. For inquiries, CONTACT us here.

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7 ways to prevent “maskne” and other face mask-related skin problems

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We recently have been having consultations for increased breakouts and rashes on face, especially on area that is covered by face masks. So, we have listed down 7 ways to prevent “maskne” and other face mask-related skin problems just for you.

“Maskne” is a term coined for acne brought about wearing of face masks. “Maskne” is a type of acne mechanica – skin irritation that is caused by excess pressure, heat, and friction. The constant rubbing of poorly fitted masks and sweating can result in your breakouts or “maskne.”

If you have sensitive skin, the material of the face mask, the skin care products that you use, and the cleanliness of your masks can trigger your eczema.

tell us, What can we do to prevent this?

1. skin care fundamental: cleanse and moisturize

Dermatologists can never stress this enough! Gentle skin care is very important in preventing skin problems.  Use a mild, fragrance-free, cleanser and moisturize immediately after washing your face.

Some recommended ingredients are ceramides, hyaluronic acid, and dimethicone. Dimethicone also acts as a skin protectant. Dimethicone can be found in Oillan Multilipid Face Cream.

Moisturizers can prevent breakouts and skin problems, especially if you have dry or sensitive skin.

2. don’t forget your lips

You can prevent chapped lips by applying petroleum jelly. Remember to apply your lip moisturizer (petroleum jelly) after washing your face, before putting on your mask and before sleeping at night. Please avoid licking your lips, instead reapply your lip moisturizer.

3. Break up with your make up!

Now is not the time to put on your make up – at least not your primer, foundation, blush on, concealer, bronzer, contour, etc. Avoid applying any make up on mask area. Your face will be covered with the face mask anyway! So skip this step and apply your bland moisturizer instead.

For those however who cannot avoid wearing make up (due to work or for whatever reason), use a hypoallergenic, non-comedogenic make up.

4. keep calm and don’t experiment

Now is not the time to try and experiment with new skin care products. Wearing masks can make your skin more sensitive, even if you wear it only for a short while. Consult your dermatologist and ask for a skin care regimen that is suitable for you.

5. no new products, only new breakouts

You have been loyal to your skin care products for months or years and have not experienced any issues with your regimen. The pandemic happened and suddenly your face becomes irritated! This can be frustrating but don’t despair. Consult with your dermatologist and heed advice. Some of the products that you are using may be causing your skin problem, even if you have been using it for months or years. Remember, wearing masks can make your skin more sensitive.

6. check your mask

Make sure you wear the right mask! Check the fit and the fabric.  Is your mask too tight or too loose? Poorly-fitting masks can prompt you to keep adjusting it and the friction can irritate your skin. If you have sensitive skin, choose a mask with inner lining that feels soft. If you have oily and acne-prone skin, you may benefit from using a cotton material lining inside your mask.

7. reuse after washing

Wash your cloth masks every after use! Be hygienic and wash it every after use even if you feel it is not dirty yet.  The dirt, oil, and bacteria can be the cause of your skin problem.

For those with sensitive skin, remember to use a mild, hypoallergenic detergent. Make sure you properly rinse off the soap.

For your skin problems, consult with your dermatologist and comply with the treatment plan made for you.

We hope these AC SkinTips will keep your “maskne” and other face mask-related skin concerns at bay, while keeping you SAFE. Wear your facemask, practice hand hygiene and social distancing.

Cheers to healthy skin!

For inquiries and to set your appointment, CONTACT us here.

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