What is Atopic Dermatitis?

Atopic Dermatitis

Atopic Dermatitis, otherwise known as Atopic Eczema, is a chronic inflammatory skin condition. It is characterized by itchy, dry patches or bumps. Common triggers include: heat, sweat, dust, emotional stress and infections.

The disease commonly begins in childhood but can also develop in adulthood. In Singapore, studies have shown that 1 in 5 school-going children suffers from Atopic Dermatitis.  Patients with poorly controlled disease often report severe itch and uncontrollable scratching which negatively affects their quality of life.

What causes Atopic Dermatitis?

Research is ongoing regarding the causes of this complex disease. The main pathomechanisms driving the disease is thought to be

  1. Impaired skin barrier and
  2. Immunological dysfunction. 

Individuals with atopic dermatitis have a weak skin barrier that is prone to dryness, irritation and sensitization by environmental allergens and this triggers a cascade of immunonological reactions that result in skin inflammation and itch.

What treatments are available?

Atopic dermatitis is a treatable condition. The main principles of treatment are twofold.

  1. To restore a healthy skin barrier and 
  2. Control the skin inflammation. 

Using a mild skin cleanser and frequent moisturizing of the skin with a hypoallergenic, fragrance-free moisturizer form the basis of daily eczema skincare. In addition, there are various effective medical treatments available for eczema. A dermatologist will assess each patient looking at various factors such as his/ her age, skin condition, underlying medical conditions and lifestyle before making recommendations regarding treatment. Available medical treatments include:

  1. Anti-inflammatory creams ( eg topical steroids, topical calcineurin inhibitors)
  2. Anti-histamines
  3. Immunosuppressants- eg prednisolone, cyclosporine, methotrexate, azathioprine ( for severe atopic dermatitis) 
  4. JAK Inhibitors ( for severe atopic dermatitis)
  5. Biologics  eg Dupilumab ( for severe atopic dermatitis) 
  6. Phototherapy

Chemical Peels

A chemical peel is a procedure where a chemical substance such as glycolic acid or salicylic acid is applied to the skin, resulting in removal of dead/ old skin cells, rapid lightening of brown scars, revealing a clearer, smoother complexion.

It is useful for treatment of acne, blocked pores, pigmentation, mild acne scarring, fine lines and wrinkles. It is a quick, office based treatment. During the treatment, a slight stinging sensation may be experienced.  After the peel is complete, the skin may appear slightly red for 1 to 2 days; mild dryness and peeling may be experienced for about 1 week. After a peel, it is important to avoid sun exposure and apply a sunscreen.

Depending on the nature of your skin problem, it may be beneficial to have a few sessions of chemical peel every 1-2 months. Your doctor will assess your skin and decide which type of chemical peel you are best suited for.

What is HydraFacial™?

Hydrafacial MD

The “HydraFacial” treatment is the newest advance in non-laser skin resurfacing. HydraFacial is the only hydradermabrasion procedure that combines cleansing, exfoliation, extraction, hydration and antioxidant protection simultaneously, resulting in clearer, more beautiful skin with no discomfort or downtime. The treatment is soothing, moisturizing, non-invasive and non-irritating. The HydraFacial treatment improves the appearance of fine lines, wrinkles, congested and enlarged pores, oily or acne-prone skin, hyper pigmentation and brown spots.

How does it work?
Vortex-cleansing

The HydroPeel tip hydrates the skin with nutrient-rich solutions, deeply cleanses the pores, and softens and lifts away impurities

Painless Vortex-Extraction

The vortex effect is created to easily dislodge and remove blackheads, whiteheads, and sebum, allowing for quick and painless extractions

Hydropeel Exfoliation

The patented HydroPeel tip has multiple abrasive edges that exfoliate the skin several times each pass to achieve better, even skin resurfacing results without irritation Vortex-Fusion

The unique spiral design Vortex-Fuses hydrating skin solutions and potent antioxidants into the skin, improving the appearance of fine lines, wrinkles, oily skin and hyper pigmentation

Why is HydraFacial™ good for my skin?

The HydraFacial™ is a hydrating and non-irritating treatment. It not only removes surface damage such as dead skin cells and impurities, it also replenishes the skin with antioxidants through Vortex-Fusion®, the most advanced application of nutrients to the skin.

Am I a candidate for this treatment?

The HydraFacial™ treatment is designed for all skin types. Even the most sensitive skin easily tolerates the HydraFacial™ treatment. Your physician or skincare professional may choose specific treatment serums and/or customize the treatment for your unique skin conditions and needs. Consult your physician or skincare professional for a skin evaluation.

How long does the treatment take? Is there any downtime or pain involved?

The HydraFacial™ treatment is a fast, efficient treatment that takes as little as 15 minutes. The treatment is often described as a feeling like “a cool paintbrush moving over the face”. You may put on make-up and return to your normal activities right after the treatment since there is no downtime.

What results may be expected? How many treatments are needed to see results? How long do the results last?

Many people report seeing visible skin refinement and an even, radiant skin tone after just one treatment. The smooth results and hydration may last 5 to 7 days or even longer. 1 treatment per month is recommened for improving the appearance of fine lines, wrinkles, hyperpigmentation, oily and congested skin. Continued HydraFacial™ treatments are highly recommended to maintain results.

Indiba radiofrequency therapy

Indiba is a radiofrequency based treatment for the face and body. By delivering heat deep into the dermis, and with its patented “Pro-ionic action” which facilitates the exchange of positive and negative ions within cells, it helps to increase metabolism, improve blood and lymphatic draining and stimulate collagen and elastic fibre production.

It is effective for treatment of wrinkles, cellulite, and skin laxity affecting the face, arms, abdomen and thighs. The treatment is non-invasive and painless.

6-10 weekly sessions are usually required, followed by monthly maintenance treatments.

Fillers

As we age, our face gradually loses its facial fat and volume, resulting in a gaunt, haggard appearance. Fillers can be used to effectively replace volume and restore a more youthful, rejuvenated appearance. Fillers can also help to fill and smoothen out certain facial lines and wrinkles. Commonly, areas such as the nasolabial folds (lines along the sides of the nose), marionette lines (lines that run from the sides of the lips to the chin), glabella ( the groove in between the eyebrows),  tear trough ( the hollow region below the eyes) can be treated. Fillers can also be used to add volume to the cheeks, chin and lips. Hyaluronic acid fillers are the most widely used fillers.

What is hyaluronic acid?

Hyaluronic acid is a naturally occurring substance found in our skin and body. In the skin, the main function of hyaluronic acid is to hydrate and add volume to the skin.

What does a filler treatment involve?

The filler is injected into the skin using a very fine needle. Usually, no prior anaesthesia is required. The whole procedure takes around 15-30 minutes.

How soon will I see the results?

The improvement is seen almost immediately after the injections.

How long do the results last?

Depending on the type of hyaluronic acid filler used, the effects last an average of  12 – 18 months.

What are the possible side effects?

The side effects from fillers are usually minor and temporary. It is common to have slight redness and swelling over the injection points. Occasionally, there may be slight bruising which takes a few days to disappear.

MIXTO SX FRACTIONAL CO2 LASER

The MiXto SX Fractional CO2 Laser is a well-established treatment for fine and deep wrinkles and acne scars. A single treatment can show significant improvement in skin texture and color while softening wrinkles.

How does the MiXto SX Fractional CO2 laser work?

The MiXto fractional CO2 laser is a revolutionary delivery system that works by delivering controlled heat to the skin. The depth of penetration and amount of heat delivered can be controlled precisely through a high speed scanner, driven by an algorithm that divides the treatment area into four quadrants (or fractions), and skips the beam from quadrant to quadrant so that each strike is separated by the longest possible interval. The process is repeated until entire area is treated. Dividing energy this way allows maximum time for thermal cooling of the tissue, less pain for the patient and faster recovery, resulting in:   

  • New skin remodelling and collagen growth for up to 6 months after treatment
  • Instant contraction of the damaged skin
  • Fine lines being softened and age spots removed
What benefits can the MiXto skin resurfacing treatment offer?
  • Acne scars, pore size, fine lines and textural irregularities are significantly improved.
  • Removal of age spots, sun spots and skin discoloration usually associated with aging skin
How does the treatment feel like?

Most patients will feel a warm sensation on the skin. A topical anaesthetic cream will be applied on the skin half an hour before the treatment to reduce the discomfort.

How long is the treatment?

Treatment time for a full face is approximately 30 minutes.

How would my skin look like after treatment? Any post care treatment I should be aware of?

Day 1 -2 

The skin will look red and sunburnt for 1-2 days post treatment. Subsequently, the fine pinpoint pattern will begin to disappear and the skin will have a tanned look. At this stage, makeup can be applied. 

Day 3 -4 

The top layer of skin will begin to peel during normal washing, revealing new rejuvenated skin with improved colour and texture. 

Day 5-6 

The peel with will be complete in most cases. Avoid prolonged sun exposure for at least 3 months. Apply a moisturizing sun block with at least SPF30 daily.

How many treatments are required?

Superficial wrinkles and skin lesions typically disappear after one treatment. However, deeper wrinkles and acne scars may need 2 to 3 treatments, spaced about 4 months apart.

When can I see results?

You will see benefits by the time the skin is completely peeled and will continue to see results for up the six months with new collagen regeneration that “plumps” up the skin.

Who is best suited for the MixTo SX skin resurfacing?
  • Younger patients with acne scars
  • Middle aged patients with fine wrinkles and age spots
  • Older patients with wrinkles and age spots.
What are the risks and side effects?

Although side effects are uncommon, one should note the following: 

  • Erythema (redness of skin): the laser-treated areas have a distinctive redness representing increased blood flow due to the growth of the superficial tissue and collagen. It will gradually fade during the first few days.
  • Mild swelling may occur and this should subside within 24 hrs.
  • Hyperpigmentation may occur days after the laser but this is temporary. It is important to avoid the sun for a minimum of 2 weeks after the laser.
The Cutera CoolGlide Hair removal laser

Laser Hair Removal

At W Skin and Laser Clinic, we use the Cutera Coolglide Laser Hair Removal System.

This is long pulsed Nd-Yag laser- a well established laser system that is proven to effectively and permanently remove thick, dark hairs, and is suitable for all skin types.

How many sessions are needed?

Five to six sessions of treatment are usually required to achieve near-complete hair removal. For very hairy areas, more sessions may be needed. The treatments should be done every 6 to 8 weeks.

With each treatment, the hairs become progressively less and finer.

What do I expect during the laser treatment?

A numbing cream is applied for 30 minutes prior to the laser

During the laser, you may feel a slight warm/ pinching sensation as the hair roots absorb the laser energy.

After the laser, the skin may appear slightly red, this usually disappears in a few hours.

Can I shave in between the laser treatments?

Yes it is fine to shave in between the laser treatments. However, plucking/ waxing and use of the epilator machine should be avoided.

Medlite Laser

Medlite Laser Treatment

Reduces Pigmentation, Pore Size And Fine Lines; Removes tattoos.

Medlite Laser Treatment

The Medlite laser is a Q-switched Nd: Yag laser. This laser is designed for the treatment of pigmentation problems. It is highly effective for removal of solar lentigines and Hori’s naevus (an acquired deep brownish pigmentation in the skin).
It can also be used to remove certain birthmarks like Naevus of Ota and tattoo pigments. 

The well loved Medlite Laser Toning treatment can also help to rejuvenate and refresh skin, firming skin and tightening pores while achieving a smoother texture and more even skin tone.

What causes these unwanted spots?

Melanin is what gives our skin its color. The amount of melanin in your skin determines if you have a light or dark complexion. Pigmented lesions are dark in color because the melanin is concentrated in one area of the skin, usually as a result of overexposure to the sun’s damaging ultraviolet rays.

How does a laser remove unwanted pigment in the skin?

Q-Switched Nd:YAG lasers produce a special wavelength of light that is absorbed by pigmented lesions. The light vibrates and shatters the pigment, breaking the melanin into micro-particles and lightening the lesion. 

In general, the Medlite treatment can:

  1. Restore your skin from sun damage
    Over exposure to the sun can lead to increased pore size, skin pigmentation, and a dull complexion. The Medlite helps to lighten pigmentation, decrease pore size, and smoothen skin texture. The overall result is a refreshed appearance and younger looking skin.
  2. Stimulate collagen remodelling to reduce wrinkles and acne scars
    With aging, collagen is diminished resulting in wrinkles and fine lines to appear on the face. Acne scarring also occurs as a result of collagen damage. The PhotoAcoustic energy from Medlite stimulates collagen remodeling, thus helping to reduce wrinkles and improve acne scarring.
  3. Remove tattoos
    Lasers are the safest way to remove tattoos. But, not all lasers can erase tattoos. Hence the physician must choose the correct wavelength based on the color of the tattoo ink. The MedLite are considered the gold standard for single and multi-color tattoo removal. The PhotoAcoustic energy works to gently vibrate and fragment the tattoo ink into tiny micro-particles that are gradually eliminated by the body’s natural process.
What can I expect during the treatment?

Most people describe the Medlite laser toning treatment as a tingling sensation. As the light shatters the pigment and diffuses the pigmented lesions, the spot will turn gray or white for a few minutes as the skin absorbs the energy. Any post-treatment discomfort will feel similar to a mild sunburn, and any redness will dissipate within a day or two as the skin returns to its natural color.

Can the excess pigmentation come back?

Common pigmented lesions do not return with good skincare and sun protection. Some birthmarks may return after a period of several months to a year. However, the procedure can be repeated.

How can I better maintain the results?

After the initial treatment series, most patients return for Medlite treatments bi-monthly or four times a year to maintain the great results. This anti-aging maintenance program is a good investment in the long-term appearance of your skin – and a clinically proven way to improve signs of photo damage and replenish ongoing collagen loss. Patients say their skin feels incredibly soft and many find they wear less make-up as their complexion becomes more radiant.

What is ClearSilk?

ClearSilk

The ClearSilk laser is a non-ablative laser technology which gently and effectively treats fine lines, wrinkles, large pores, uneven skin texture, diffuse redness and scars. You can expect to see subtle yet consistent results after each treatment. This amazing technology is suitable for all skin types and is ideal for those looking for a very comfortable and effective laser to rejuvenate their skin with zero down-time.

How does ClearSilk work?

This long pulsed Nd-Yag laser heats the upper dermis well below your skin’s surface, stimulating collagen production and fibroblast activity, leading to improved skin texture, reduction of fine lines, pore size and acne scars. It activates the body’s natural repair processes for a healthier and more radiant complexion. Additional heat is generated in dilated capillaries to reduce redness.

What kind of textural improvements can you expect with ClearSilk laser?

Over the course of four to six treatments, ClearSilk can help restore the skin’s youthful glow and appearance by smoothing out uneven texture caused by aging, sun damage or scars. You will see a more creamy, healthy complexion as large pores are reduced in size, and minor imperfections are diminished. The individual treatment results are subtle, but the overall effect of multiple treatments can be quite dramatic.

What areas can be treated?

The face and neck can be treated.

What is diffuse redness?

Diffuse redness is a general appearance of facial redness, such as rosy cheeks. This condition is caused by dilated capillaries, resulting in an appearance of general redness. The most commonly affected areas are the nose, forehead and cheeks. Diffuse redness is often associated with a condition called rosacea and it can be hereditary. ClearSilk will help your appearance by gently treating and reducing this condition.

What does the procedure feel like?

Patients often describe the treatment as relaxing and comfortable. You will experience a gentle warming of your skin’s surface during the procedure as the laser handpiece is moved back and forth about 1/2 inch above your skin. You can immediately return to normal activities, utilizing sunscreen if participating in outdoor activities.

How many treatments will I need?

On average, you may require four to six treatments in order to achieve optimal results. Every patient’s condition and needs vary. For more information about your expected results or the number of treatments necessary, consult your physician.

What are the possible side effects?

ClearSilk is not associated with any side effects or downtime. After the treatment, you may notice very faint redness on the face, which disappears within minutes or hours.

What is Broad Band Light (BBL)?

Broad Band Light/BBL

With its superior engineering, Sciton’s Broad Band Light (BBL) is the world’s most powerful Intense Pulsed Light (IPL) device on the market. BBL incorporates high technology to deliver exceptional results in skin rejuvenation. It has the ability to treat a wide variety of skin concerns including- pigmentation, redness, dull skin and acne. BBL uses photothermal energy to gently heat the upper layers of the skin, stimulating regeneration of skin cells, eliminating unwanted melanin and fine vessels that causes redness. The result: clearer, smoother and more radiant skin.

What areas can be treated?

BBL is ideal for rejuvenation of the face, neck and décolletage. It can also be used on other parts of the body eg. arms, chest, back. The advanced “BBL Hero” technology allows for large areas to be treated in a short amount of time.

What do treatments feel like?

When the pulse of light is delivered, you will experience a mild pinching sensation. Numbing cream is usually applied half an hour prior to the treatment, making the treatment comfortable.

How many treatments will I need?

Three to four monthly treatments are usually sufficient to see results. Additional treatments may be needed for excessively sundamaged skin. BBL is a wonderful treatment for maintaining the youthful quality of the skin, and many patients love the results of being on a maintenance program.

What happens after the treatment?

Immediately following treatment, brown spots will start to darken and your skin may appear slightly red. The redness usually disappears within minutes to hours, and the brown spots with flake off in a few days. There is minimal or no downtime.

When will I see results?

Within a few days, the darkened spots will flake off and fade. Diffuse redness or telengiectasia will decrease and your mottled complexion will improve. Your skin will appear visibly clearer and smoother.