Questions & Answers
First of all, let me compliment you that it’s rare that the wife is taking the effort to find out more about the husband’s condition of ED. You can see this overview guide of Erectile Dysfunction treatment in Singapore to get a better idea of what are the options for treatment. In brief, when it comes to Erectile dysfunction, a good and thorough history taking by the doctor including sexual history etc is key. Some blood tests may also need to be done.
I agree with the answers by Dr Winston and Dr Israr. Intralesional injections are mainly recommended for acne cyst. As previously mentioned, frequent steroid injections can caused skin thinning and atrophy and if this happens it may be irreversible! There are many other effective treatments to get the acne under control like oral antibiotics and isotretinoin. So speak to your dermatologist and tell her your concerns and discuss if these other options are suitable for you.
Good questions! I agree with Dr Chua’s reply on the pros and cons of Fractional CO2 lasers versus Infini RF. In addition, I would like to address your question on the ideal length of time between subcision and Infini RF treatments. The ideal interval between treatments is 4-6 weeks. This is to allow for adequate skin recovery. Hope that this answers your questions!
Yes you are right that meibomian gland disease (MGD) is a major cause of dry eyes. If you do have a combination of MGD and dry eyes, there are many ways to treat them! However, since you mentioned that your eyes are neither dry nor painful without contact lens use, I suspect you may have another condition known as Giant Papillary Conjunctivitis (GPC). It is very common for chronic contact lens over-wearers to develop GPC. It is your body’s response or ‘rejection’ to the chronic use of contact lenses, which is regarded as a ‘foreign’ material to your eye.
With regards to your question: Fractional CO2 lasers generally penetrates deeper than Erbium lasers Fractional CO2 lasers also generally penetrates deeper than Fractional RF devices EXCEPT Microneedle RF machines that can reach a depth of 3. 5mm (only in some machines) which in this case will have a greater penetration depth as compared to Fractional CO2 machines.
Our face is constantly exposed to dirt, bacteria, skin care or cosmetic products. If you don’t clean your face thoroughly, it’s easy for pores to get clogged. The best way to prevent clogged pores is to follow a good daily skin care regimen and exfoliate your skin regularly to remove dead skin cells and excessive sebum.
Should I switch my acne treatment after 2 weeks if I’m still having bad acne breakouts and scarring?
2 weeks would be a tad early to stop the treatment, as mentioned. A course of antibiotics usually takes at least 3 – 4 months. Sometimes, Differin can cause an initial outbreak during the first month or so and if it causes excessive dryness, irritation and flaking of the skin, I would advise using it once every 3 days first and then slowly increasing the frequency to daily. If you have cystic acne, I would advise draining the cystic acne and consider injectable steroids so as to arrest the inflammation and swelling. This will decrease the risk of subsequent scarring.
Thank you for the question. It must be frustrating to be having recurrent folliculitis on the chest and back. The are a few possible causes of recurrent red bumps on the chest and back, including folliculitis, truncal acne and pityrosporom folliculitis (a type of folliculitis caused by a fungal infection). Sometimes, it can be a combination of the above which can make treatment tricky as treatment for one condtion can aggravate the other eg. truncal acne treatment can aggravate pityrosporum folliculitis. Pityrosporom folliculitis is also aggravated by heat and sweat.
Perlane fillers can be seen on CT scan as soft tissue at the location where it’s injected, especially if it’s injected as a bolus. Fret not, the radiologist and radiographer would have seen many such cases, so do not expect them to be surprised at the findings. In fact, you can let the doctor know this, so that the radiologist doesn’t mistake it as other structures in his interpretation of the scan.
You have asked a very interesting question and I am afraid the answer is yes and no! I will try to explain it as best I can. Braces CAN change profiles: Braces can change profiles only when the orthodontists and the patient plan to get it changed from the START of the treatment. A good example is when patients complain that when taking photographs, they notice that their side profile is sticking out and they have a very full smile (most patients use the terms, I look like a horse!) In this case, braces can help to retract the teeth to allow the patient to have a softer, gentler profile.
PRP at the present moment is not available in Singapore. It does help with acne scarring though, and you might have to go to neighbouring countries to do the treatment (including Malaysia). Having said that, you can consider Rejuran/skin boosters/microneedling that can help in a similar fashion. Your 2nd question on which is better — it depends on the severity and type of scars. But usually Fractional laser is the backbone of laser therapy. So consult your doctor early to discuss the available options.
I know how frustrating it is to face the issue of persistent acne. There is no real evidence that skin gets resistant to topical products but obviously anecdotal accounts would suggest otherwise. To cut it short, it sounds like you might need some oral medications like doxycycline or isotretinoin to improve the acute flares first, while using a appropriate skin regimen. From personal experience myself, when facing a flare we tend to overdo things, be it using OXY 10 five times a day and having chemical burns, or washing our face 10 times a day.
Folliculitis is a relatively straightforward condition to treat and get rid of – any dermatologist will be able to help you. There are, however, some other conditions that look similar. A dermatologist will be able to help you to diagnose and distinguish between possible causes.
Does a low dosage isotretinoin course which falls below the recommended total cumulative dosage increase the chance of a relapse?
There is a cumulative therapeutic dose in the range of 120mg – 140mg/kg that some doctors adhere to in the bid to reduce the relapse of acne. Sometimes, doctors may prescribe lower doses (with lower side effects) until the acne has cleared and continue the course for a few more months after. It really depends on the prescribing doctor as each has his/her own protocol. If you find that you are still having relapses with lower doses then discuss with your doctor the option of a course to achieve the therapeutic accumulative dose.
Dr Theng has answered you wonderfully. And yes hormonal acne can be a common cause of back acne. You may need to advise us further on whether you might be on any meds that throw your hormones out of whack. You can treat it like face acne, and I have used a combination of acne topicals and chemical peels/laser treatments for my patients with back acne conditions.