• ACNE

    • WHAT IS ACNE?

      Ask any teenager and he will be able to tell you. Whiteheads, blackheads, pimples, zits, red bumps, pussy bumps, and cysts, these are all signs of acne. Acne appears most commonly on the face, but can also occur on the neck, back, chest and shoulders. Occasionally you can get acne on the bumps or the scalp. To the dermatologist acne is the medical name for pimples or zits. Most people do not realise that blackheads or whiteheads (also called comedones) are in fact early acne. To prevent complications from acne or from getting acne scars, dermatologist treats acne early even when they are only comedones.

      There are two stages of acne:

      – the non inflammatory acne consisting of comedones and these will not cause scarring and

      – the inflammatory acne consisting of red bumps, painful pussy bumps and cysts which often leads to acne scars.

    • HOW IS THE ACNE TREATED?

      Acne treatment aims to unclog the plugged pores and to keep them clear. By doing this, the bacteria that grow in our clogged pores will be controlled and acne flare-ups will be reduced. Effective treatment should also regulate the secretion of sebum to a more manageable level.

      Dermatologist treats acne with creams, oral medication, chemical peels, LED light or laser treatments depending on the severity of the acne.

    • CAN BE ACNE BE CURED?

      Unfortunately no.

      Genes play a part. Have you ever wondered why some of your friends have good skin even though they are not bothered about their skin while some others have acne no matter how careful they are with their skin care?

      Acne will have to run its course. For some people acne may clear by late teens while others may have acne till late adulthood. The aim of acne treatment is to clear acne and to prevent acne scar formation.

    • WHAT CAN I USE TO TREAT MY ACNE?

      If your acne is mild with a few whiteheads or blackheads (the non-inflammatory acne) you can buy acne creams from the retail pharmacy. Products that contain benzyol peroxide, salicylic acid or antiseptic can remove the minor acne

      However, if your acne continues to grow or if you have red bumps or painful bumps with pus, then you need to consult a dermatologist. These are the inflammatory acne and early treatment is important to prevent you from getting acne scars.

    • WHAT ACNE TREATMENT CAN MY DERMATOLOGIST OFFER?

      Dr Joyce Lim uses prescription creams to treat acne as these are more specific and effective. There are creams that are comedolytic (ie they break open the comedones inside the skin) and which prevents the comedones from becoming inflamed and forming scars. If you have inflammatory acne then your dermatologist will give you an antibiotic gel or lotion.

  • Aging Skin & Wrinkle Treatment

    • Changes In The Skin When We Age

      Our skin is a living organ, and it ages as we get older. At first, fine lines appear but over time, our skin loses its elasticity and becomes loose and wrinkled. The skin feels dry and rough and develops new skin growths, which may be benign or malignant. Brown spots, increased facial veins and redness appear and the skin has a sallow appearance. The face loses its volume and looks deflated and hair starts to thin out. The signs of aging can be seen as

      • Age Related Pigmentation
      • Age Related Facial veins / Red spots
      • Wrinkles and Folds
      • Sagging skin
      • Age Related Volume Loss
      • Skin Growths
      • Dry Skin/ Skin Rash
      • Hair Loss
    • Aesthetic Procedures To Address Aging

      There are many creams and treatments available, and many people spend time and money to fight against the effects of ageing.

      Dr Joyce Lim will assess your skin condition and offer solutions which include

      • Preventive measures – use of sunscreen, hats
      • Prescription products / professional skincare (Joyce Lim Dermaceuticals)
      • Aesthetic procedures to reverse or reduce the signs of aging
  • The Red or Vascular Birthmarks

    • Port wine stain

      If left untreated portwine stain may bleed, it is susceptible to trauma and it can get infected. Over time they will cause distortion of the face or the limbs. Portwine stain should be treated early, even in infancy as the birthmark is thin and flat and easier to treat. The Pulse dye laser treatment is the treatment of choice. When done by an experienced dermatologist the treatment is safe and is usually started as soon as the condition is diagnosed and on infants as young as a few weeks old.

    • Haemangioma

      Although haemangioma resolve on its own, 40-50% of them may leave a scar. If it is growing rapidly then early treatment may prevent scar formation. Treatment is needed if the haemangioma compromised body function like blocking the airway, the eyes, the mouth, the ear or the ano-genital region. If complications are present like ulceration, bleeding and infection then treatment has to be started. Treatment is by oral medication, topical creams, and by the pulse dye laser.

  • Eczema

    • WHAT IS ECZEMA?

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    • WHAT CAUSES ECZEMA?

      There is a genetic predisposition. Patients with eczema usually have family members who have eczema, asthma or allergic nose. You have a higher risk of getting eczema if one or both parents have eczema, asthma or allergic nose.

    • WHY MUST I TREAT MY ECZEMA?

      Eczema is not life-threatening but it disrupts you from leading a normal life. Itching can cause public embarrassment, and sleepless nights. Eczema flare-ups have caused its sufferers to miss school and work, and unable to attend to personal obligations. Constant scratching can lead to skin infections

      With proper diagnosis and treatment, many children outgrow their eczema by age 2. About 50% of the children who get eczema will have it as an adult. The good news is that the eczema often becomes milder with age. There is no way to know whether eczema will go away or be a lifelong disease. This makes treatment very important. If you think you have eczema make an appointment to consult Dr Joyce Lim, a skin specialist, who will help you control your eczema and prevent or minimise flares. Treatment consists of moisturisers and skin care, prescription creams and oral medication and lifestyle modifications.

  • Skin Allergy and Urticaria

    • WHAT IS SKIN ALLERGY?

      Skin can be irritated by a variety of factors. These include heat, chemicals, medications, plants and infections. When an allergen is responsible for triggering an immume response reaction, the skin rash is called an allergic dermatitis or eczema. The common allergens are nickel, perfumes, dyes, rubber and cosmetics.

    • HOW USEFUL IS SKIN ALLERGY TESTING?

      Skin allergy tests are undertaken when there is a suspected allergen and the test is done to confirm the allergen.

    • WHAT IS URTICARIA?

      Urticaria or hives are itchy swellings on the skin. A hive often goes away in 24 hours or less. New hives may appear as old ones fade, so hives may continue to form for a few days or longer. A bout of hives usually lasts less than 6 weeks (acute hives) but sometimes they last longer (chronic hives). Hives may result in swelling of lips and eyelids called angioedema.

      There are many trigger factors and they include Foods: Citrus fruits, milk, eggs, peanuts, shellfish , preservatives, colouring

      Medication

      Insect bites and stings

      Infections, including colds

      Exposure to sun, heat, cold, water, pressure

      Exercise

      Stress

      Treatment is to avoid trigger factors and oral medication like antihistamines or steroids

  • Skin Rash : Psoriasis, Pityriasis Rosea, Lichen Planus

    • WHAT IS PSORIASIS?

      Psoriasis is a chronic skin disease of the immune system. Skin cells grow too quickly (in days rather than weeks) and the skin cells pile on the skin surface. The psoriasis can be seen usually as raised red patches covered with slivery scales (plaque psoriasis). Sometimes numerous small red spot (guttate psoriasis) or pus- filled bumps (pustular psoriasis) may be seen. The nail (nail psoriasis) or joints or scalp (scalp psoarisis) may be affected. Psoriasis is not contagious

      Treatment consists of prescription creams, oral medication, laser / light treatment, biologics.

    • WHAT IS PITYRIASIS ROSEA?

      Pityriasis rosea is a scaly oval shaped skin rash which looks rose coloured or violet. The rash starts in a single patch, the herald patch, and within a week or two, smaller patches appear on the body and limbs. The face, scalp, palms and soles are usually not affected. The rash clears on its own after 6 weeks. Treatment is by oral medication or phototherapy.

    • WHAT IS LICHEN PLANUS?

      Lichen planus is an itchy rash seen on the wrist, lower back and shins and ankles. They appear as shiny, firm, and reddish purple bumps. Later the bumps form thick rough scaly patches. The nails, scalp, oral mucosa and genitals are often involved. Treatment is by prescription cream, oral medication and phototherapy.

  • Excessive Sweating Treatment

    • WHAT ARE THE TREATMENTS FOR EXCESSIVE SWEATING?

      Anti –perspirant is often used. If this fails, iontophoresis or Botulinum Toxin Injection are more effective. Recently there are heat and light devices to permanently control excessive sweating. One of them uses microwave technology.

    • HOW DOES BOTULINUM TOXIN INJECTION WORKS?

      For excessive sweating on the underarms or palms or forehead, botulinum toxin injections is helpful and may be life changing for some individuals.

      The injection works by reducing the activity of the sweat glands by stopping the nerve transmission to the glands. The area to be treated is first anaesthetised using an anaesthetic cream to reduce your discomfort. Lots of small injections are used to cover the area.

      There may be bruising and soreness which will subside within a few days. You can resume normal activities immediately.

  • Hair & Scalp Treatment

    • WHAT IS NORMAL HAIR LOSS?

      The hair is our crowning glory and most people gets upset when they see strands of hairs in the bathroom floor and the bedroom. But do you know that this is normal?

      At any time, it is normal for a person to lose as many as 100-150 hairs a day and these usually show up on a comb or brush or at the bottom of the bathtub or sink especially after washing your hair. These strands of hairs have stopped growing usually 3-4 months ago and they must fall for new growing hairs to replace them.

    • WHAT IS ABNORMAL HAIR LOSS?

      Your hair loss may be abnormal if you are losing more than 100-150 hairs a day or if you see bald patches of scalp or if you noticed hair thinning. Thinning of hair may be seen as a general thinning on the crown or thinning in a specific pattern. Hair loss may be in patches such as a patchy loss of hair over the scalp and other hair bearing areas such as the beard or eyebrows.

    • WHAT ARE THE TREATMENTS FOR HAIR FALL?

      Treatment will depend on what causes the hair fall. If there is an underlying cause such as medication or infection or hormones, removal of the cause will stop further loss. Some hair fall like telogen effluvium does not need treatment. Others like androgenetic alopecia may require medication to slow or prevent further loss.

  • Melasma and Skin Pigmentation

    • Melasma

      Melasma is the presence of brown or greyish brown patches, usually on the face and occasionally on the arms. It is caused by an excessive production of melanin, the pigment that causes skin to tan. On the face the pigmentation is usually symmetrical on both sides of the cheeks, the upper lips, nose forehead and the chin. Melasma is a very common pigmentation seen in Asians affecting mainly women and occasionally men. There is a genetic predisposition for melasma, where in some families every generation will have melasma.

    • Other Skin Pigmentation

      Freckles are small brown spots seen on sun-exposed skin like on the face, neck and arms. Freckles are first noticed during childhood and are commonly seen in fair skinned individuals. It is common to see freckles among members of the same family. On sun exposure, more freckles are seen and they also increase in size and get darker.

  • Moles and Benign Skin Growths

    • DO ALL MOLES EVENTUALLY BECOME CANCERS?

      Fortunately most moles do not become skin cancers. However, there are signs to look out for to suggest that a mole is changing its character. We refer to it as the ABCD signs of a changing mole

       

      The ABCD signs stand for Asymmetry, Borders, Colour and Diameter of a mole •Asymmentry -the two halves of the growth is asymmetrical

      • Borders – the borders are jagged, no longer smooth
      • Colour – the growth becomes red or purple
      • Diameter – there is a sudden increase in size

      Suspect a mole is changing into a skin cancer if you have any of these signs and see a dermatologist early

      If you have a family history of melanoma, schedule a regular skin check with a dermatologist – to detect early changes in your moles.

    • HOW CAN I REMOVE MY MOLE?

      See a dermatologist who is a skin specialist, trained to identify moles and melanoma if you intend to have your moles moved. Moles can be removed by laser or by surgery. Moles should only be removed by laser if the dermatologist is sure they are benign. If there is any suspicion of an atypical mole or Spitz naevus, surgery is the only option and the mole is removed and sent for Lab test (histology).

  • Red Face Treatment

    • WHAT IS ALCOHOL FLUSH?

      Some asians show signs of facial flushing immediately after drinking alcohol. This redness is not rosacea and is temporary. It is caused by decreased activity of the enzyme that breaks down alcohol to aldehyde (alcohol dehydrogenase) and decrease breakdown of aldehyde (deficient aldehyde dehydrogenase).

    • WHAT IS THE BUTTERFLY RASH?

      Systemic lupus erythematosus is an autoimmune disorder that can affect many organs. On the face it causes a rash that spreads across the cheeks and nose and spares the forehead (the butterfly rash). The rash gets worse on sun exposure.

    • WHAT ARE THE OTHER COMMON CAUSES OF RED FACE?

      Red face can be seen in viral infections in children, in skin allergy, in hives, and in port wine stain.

  • Scar and Keloid Treatment

    Acne can heal with red scars, brown scars, shallow and pitted scars and keloids. These scars can be prevented by treating acne early. Different treatment modalities are used depending on the type of scars. Combination treatments are often used; red scar are treated with the pulse dye laser: brown scars with prescription medication, chemical peels and pigment or farxel lasers and deep scars with subsicion and the fraxel lasers.

    Keloids are difficult to treat. They can be itchy and painful and continue to grow. Treatment consists of repeated steroid injections and is often combined with the pulse dye laser or the fraxel laser.

    Laser resurfacing is a procedure whereby a laser (usually a fraxel laser) is used to resurface or smooth out scars. Fractional lasers are the best lasers for improving scars. They work by removing tiny columns of old scars while keeping the adjacent skin intact. Thousands of these microscopic laser columns penetrate deep into the scars, to remove old and damaged cells and scar tissue. The adjacent skin between the lasered columns is kept intact – this allows for better healing, faster healing and minimal side-effects – and eventually this too is replaced with new skin.

    Dr Joyce Lim uses the Fraxel Dual Restore and the Fraxel CO2 repair to treat scars.

    Dermal fillers are injected into the base of scars to lift them up. They are useful for shallow scars and the filler effect lasts for a year. It is better to treat your scars with lasers rather than dermal fillers as the results from laser treatments are more effective and longer lasting.

  • Skin Cancer Screening

    • WHEN SHOULD I GO FOR SKIN CANCER SCREENING?

      Early detection of a skin cancer ensures that it is diagnosed early and treated early, giving the best possible treatment outcome or cure. Schedule an appointment to see Dr Joyce Lim, a dermatologist, who will perform a full-body skin cancer screening if

      • You suspect you may have a skin cancer/ atypical mole
      • You have a history of skin cancers in the past
      • There is a family history of melanoma

      You should also do regular self examination for skin cancers.

  • Skin Infection and Treatment

    • WHAT ARE VIRAL WARTS?

      Viral warts are skin infection caused by the human papillomavirus (HPV) which infect the skin and cause rough skin growths. The virus can infect any part of the skin and is commonly seen on the fingers and soles of feet. Viral warts are contagious and they should be treated.

    • WHAT ARE GENITAL WARTS?

      Genital warts are transmitted by sexual contact and are caused by the human papilloma virus (HPV). They have an average incubation period of three months, although they can develop anywhere within three weeks to eight months of exposure. The warts typically occur around the genital areas, the anus and the urinary passageways, appearing as single or multiple cauliflower-like pink or red swellings.

      Not only are genital warts highly contagious, but there is strong evidence that the HPV virus causes cervical cancer in women, cancer of the penis in men, and anal cancer in both sexes. The HPV virus can also be transmitted from a pregnant woman to her child through the birth canal as she gives birth. It is important that all sexual partners be treated for genital warts and screen for concomitant sexually transmitted diseases. Early recognition and prompt treatment can help prevent later complications. Young women should have vaccination against the HPV virus.

      Genital warts can be very resistant. Many require more than one treatment. Close follow-up for a few months after complete clearing is necessary to ensure the absence of recurrences and new smaller warts within or near the treated area.

      Treatment is by cryosurgery or laser surgery or a prescription medication.

  • Spider and Leg Veins Treatment

    • WHAT ARE SPIDER VEINS?

      Spider veins are formed by the dilation of a small group of blood vessels located close to the surface of the skin. Although they can appear anywhere on the body, spider veins are most commonly found on the face and legs. They usually pose no health hazard but may produce a dull aching in the legs after prolonged standing. Treatment is by the pulse dye laser or the LP ND YAG laser.

    • WHAT ARE VARICOSE VEINS?

      Varicose veins are abnormally swollen or enlarged blood vessels caused by a weakening in the vein’s wall. They can be harmful to a patient’s health because they may be associated with the development of one or more of the following conditions: Phlebitis or inflamed tender vein; thrombosis or a clot in the vein; and venous stasis ulcers or open sores from inadequate tissue oxygen and fluid retention. Treatment is by laser treatment or sclerotherapy.

  • Stretch Marks Treatment

    • WHAT ARE STRETCH MARKS

      Stretch marks are breaks in the skin when the skin is stretched. They are seen during puberty, pregnancy, sudden weight gain and as a side-effect from topical steroid use.

      There two types of stretch marks:

      • Recent or red stretch marks
      • Late or white stretch marks
    • WHAT IS THE TREATMENT FOR RED STRETCH MARKS?

      Stretch marks are difficult to treat. They respond better to treatment when they are new and red. The pulse dye laser targets the blood vessels in the red stretch marks and reduces the redness. It also releases growth factors from the vessels and this in turn smoothes out the breaks in the skin.

    • WHAT IS THE TREATMENT FOR WHITE STRETCH MARKS?

      White stretch marks are scars in the skin and usually do not respond well to treatment. The fraxel laser may improve some of the white marks.

  • Vitiligo Treatment

    • WHAT IS VITILIGO?

      Vitiligo is a skin condition whereby the skin loses its colour and develops in areas where there is pigment like the skin, hair (scalp, eyebrow, eyelash, beard), inside the mouth and genitals. The skin lightens or turns completely white.

    • WHAT IS THE TREATMENT FOR VITILIGO?

      There are many treatment options depending on the severity, the duration and type of vitiligo. They include camouflage cosmetic, sunscreen, prescription medication, phototherapy, laser treatment and surgery.