Dr Chin Yee Choong

Hi, There are several effective treatments for acne scars, the choice of which depends of several factors which include: type of scars, effectiveness vs side-effects/downtime, expertise, costs, etc. Current treatments include fractional laser, fractional RF, subcision, scar excision and TCA-cross. In general, deeper scars tend to improve less compared to more shallow scars, more severe scars will require more effective modalities albeit more potential side-effects and downtime, a combination of acne scars will probably benefit from a combination of treatments.

Hi, The dose of botox should be tailored to the desired response while factoring safety and the avoidance of unwanted side-effects such as droopiness, excessive muscle paralysis rather than the treatment sessional number. In my experience, fewer units of botox are required for some patients after repeated treatments as the original muscles treated decrease in bulk and strength. Your preferred aesthetic doctor will be able to assess your response from previous treatments and advise if higher doses are needed to optimize your clinical results.

Hi, Small depressions from milia extraction will generally improve over the next 6-12 months due to collagen remodelling after injury. If they remain after this period, the persistent scars may be improved by resurfacing procedures such as fractional lasers and fraction RF devices.

Hi, Crow's feet around the corners of the eyes are dynamic wrinkles caused by the ring muscles encircling the eye (obicularis oculi). Hence, the best treatment (and the first-line treatment) is actually botox instead of HIFU or Thermage. Nevertheless, both HIFU and Thermage may give additional skin textural improvement and augment the results of botox in the treatment of crow's feet.

Hi, Topical clindamycin will often take 3-6 weeks to calm down mild-moderately inflamed acne. However, for severe acne such as nodulocystic acne, oral treatment with antibiotics or isotretinoin will probably be required to quickly and effectively control the inflammation and prevent scarring. For severe acne, do seek a consultation with a doctor with a special interest in treating acne early.

Hi, There is some scientific evidence that high glycaemic index (such as sugary) foods and excessive intake of dairy products may aggravate acne. Moderation is the key. Dairy products in normal quantities are probably fine but avoid snacking on cheeses, chocolates, and drinking an excessive amount of milk over long periods of time.

Hi, More aggressive TCA peels tend to cause significant post-inflammatory inflammation and has to be used with caution in darker Asian skin types. Use of TCA peels while on oral isotretinoin, even low dose, will increase the risk of chemical burns and is hence best avoided.

Hi, Deep scars after trauma including those arising laser mole removal may be improved upon by a variety of skin resurfacing techniques such as fractional lasering, subcision or surgical scar revision. A face to face consultation for assessment is required before recommendations can be made.

Hi, All effective acne scar treatments work by causing controlled injury to the dermis and stimulating new collagen formation over the next 2-6 months. Once the new collagen is formed, benefits are long-lasting. Most doctors will recommend a duration of 4-8 weeks between each treatment. Treatment duration less than 4 weeks may be overly aggressive leading to potential unwanted side-effects of prolonged redness or pigmentation. Treatment duration beyond 3-6 months lead to a rather protracted overall treatment course but may not affect end result significantly.

Hi, In general, PIH will gradually fade by itself over time and pigment laser treatment (which includes pico laser treatment) is strictly not essential. In fact, aggressive pigment laser treatment may in fact worsen the PIH. Hence worsening of pigmentation following pico laser treatment may reflect rebound PIH rather than from missing a session. It is best that you consult your attending doctor for further assessment and advice.

Hi, It appears you have multiple non-inflamed small keratotic papules on both cheeks. This could be due to either comedonal acne, facial keratosis pilaris or facial acanthosis nigricans. A close and detailed face-to-face examination by your doctor will be needed to distinguish the above differentials and prescribe you with the appropriate medication to improve the condition.

Hi, I agree with Dr Colin Theng’s opinion completely. In addition, the unpasteurized honey may serve as a medium promoting secondary bacterial growth and further complicate your recovery. The proven and recommended way would be to reduce skin inflammation via avoiding further skin irritants (make-up, facial masks, toners, abrasive cleansers, etc), the use of mild facial cleansers and moisturizers, short term use of an appropriate mild topical steroid or calcineurin inhibitor under medical guidance.

Hi, From the photo, you may have a benign skin condition called “lichen spinulosus”. The cause is not known and it is not contagious. The condition is harmless. Moisturizers and topical retinoids may help improve the appearance. Do see a doctor if the condition really bothers you and if you wish for some prescription creams to help improve it.

Hi, Maintenance products for post-treatment of acne scars based include Topical retinoids (tretinoin, adapalene) L-ascorbic Vitamin C AHAs Retinols The relative effectiveness of the above topicals may need to be balanced against its irritability index, hence proper assessment by your attending doctor factoring in how recent the treatment was done, your skin sensitivity index, prior use and tolerability is recommended.