Acne and pimples in teens: Singapore dermatologist Dr. Teo Wan Lin on how to treat problem skin

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If pimples and acne are ruining your teen's confidence then it's definitely time to call in the pimple police.

Being a teenager is a tough gig but, thankfully, we all got through those hideously awkward teen moments, eventually learnt some street smarts and finally managed to speak in more than two-syllable grunts. And now some of us have teens of our own! And despite ‘totes’ understanding how they feel about everything from their mono-brows to fear of speaking to the opposite sex, we’re not sure they totally credit us with understanding how completely awful suffering from teenage acne can be. It doesn’t matter to them that ‘we came through the other side’ of pimples and carbuncles – they are suffering right now and their confidence is taking a nosedive with it. Desperate to help one of our own, we turned to Dr. Teo Wan Lin of TWL Specialist Skin & Laser Centre to help us understand what we can do improve teenager acne, what treatments are available, and what should we NOT be doing when it comes to those angry-looking spots…

First of all, check out her amazing skin. Dr TWL knows her stuff. Our skin expert for this story is also Founder and Medical Director of TWL Specialist Skin & Laser Centre and a Ministry of Health accredited dermatologist, specialising in both medical and cosmetic dermatology.

Dr. Teo has already put a smile back on the face of our teenage acne-sufferer after just two consults

Now, here’s what you need to know about acne and problem skin, so you know what you’re dealing with…
Here’s a lesson we learned the hard way: over-the-counter promises of clear skin are just going to a) cost you and b) leave your teenager with little to no improvement. Consulting with a specialist and finding out what kind of acne your teenager is dealing with will make treatment quicker and easier.

Hormonal acne
Hormonal acne tends to cluster around the mouth area, jawline, flares occur before start of menstrual cycle in girls each month. It is NOT caused by make-up, the climate or other external factors often blamed for spots. Dr Teo recommends that for recurrent flares of more than around eight pimples every month, you should consult a dermatologist for oral antibiotics. Popular over-the-counter creams like benozyl peroxide will NOT help or prevent hormonal acne and may cause further issues including eczema.

Blackheads
Despite having the appearance of specks of black dirt, this common ailment is actually hair follicles in cahoots with oil glands (sebaceous glands) and an overproduction of oil is what’s going to cause those clogged pores. This is a form of acne known as Open Comedones and is best treated with a mixture of chemical peels, carbon laser peels and a really good cleanser – look for one that has a label stating “dermatologist-tested and formulated”.

Dr. Teo has developed her own range of dermaceuticals perfect for dealing with problem skin (she’s also created some anti-ageing superstars for us wrinkly types)

Cystic acne
This is the especially angry-looking acne that can, literally, pop up anywhere on the face, chest or back and is prone to developing into a pus-filled monstrosity. Most of us have some experience with this type of face-changer – usually on the day of a job interview, a hot date or some other important occasion… Sorry kids, genetics plays a big part in this one so the chances are that if your teen is suffering with this, then you probably did too.

A quick note on squeezing… and scarring
Beyond offering assurances that it WILL go away, this is the type of condition that really should be treated properly and effectively asap, to reduce the change of scarring. NEVER pick or squeeze the pimples, and see a dermatologist for a game plan to get it under control. Treatments include prescription creams containing tretinoin, chemical peels, microdermabrasion, oral medication and anti-acne medication, isotretinoin, which helps to shrink oil glands. This should only be taken under medical supervision to monitor unwanted side effects.

Papules
A lesser but similar condition to cystic acne known as papules will result in small red bumps. Treatment is along a similar line to cystic acne.

Pustules
These blemishes are similar in size to acne papules but with the added woe of a yellowish tip on top with dried pus, hence the term “pustule”. They tend to occur in groups or clusters and usually appear on the temple and hairline areas. Seek diagnosis and expect treatment to include antibiotic creams and oral meds that target the bacteria that causes these nasties.

Comedones
We’ve already ‘met’  Open Comedones (blackheads) but there is also Closed Comedones to add to the pimple party, otherwise known as whiteheads. These in turn can lead to more severe types of acne so never try to extract or prick the white bumps  – and definitely don’t let a facial aunty near your skin! This will introduce more nasty bacteria and spiral into more severe skin issues. While usually this skin condition is caused by a dose of bad luck genetics, there are also types of make-up and skin-care products that exacerbate the issue. Do NOT use scrubs despite promises on packaging as this will not only be useless in the battle against the whiteheads, but will irritate skin further. Make sure you use moisturisers that are not oil-based, and instead plump for emulsions (oil in water) or hyaluronic acid serum( water-molecule based skin hydration). Dr. Teo also offers treatment for both types of comedones, using a handheld specialised machine that will extract the offending blockages without pain or scarring.

Did seeing a dermatologist make a difference?
We are heading into our third week of skin advice and treatment for our 15-year-old, and after months of hiding in hoodies, covering his face at every opportunity and generally feeling pretty low in confidence, it looks like we are finally on the right path to clear skin. The diagnosis was cystic acne (sorry, kid: my crappy acne genes), so Dr. Teo started him on a routine of honey-based cleanser (developed by Dr. Teo herself), topical creams and oral meds. He was also advised to avoid dairy, which can aggravate cystic acne, and to absolutely stop touching his face when he didn’t need to… that nasty bacteria on his hands wasn’t helping his case at all. His skin has definitely improved, and while he still has moderate to severe acne, it is nowhere near as angry and inflamed as it was two weeks ago. Dr. Teo is confident that not only can his skin improve, scar-free, but that within a few short months it should have cleared up altogether. I am pleased to report that our teen almost smiled at such great news.

As a mum to an acne sufferer, and as a previous sufferer myself, I would absolutely advise that you seek professional help from a qualified dermatologist – NOT a spa or even a GP (other than for a referral) – as soon as you can. Treatments have come a looooong way since I lathered my own acne-ridden face with eight inches of cover-up, and given that teenagers have it tough enough what with all those hormones and weird growth spurts to contend with, getting their skin under control will make for so much easier a deal.

Dr. Teo Wan Lin, TWL Specialist Skin & Laser Centre, 38 Irrawaddy Road #07-28, 329563; www.twlskin.com

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