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Dermatologist’s Lockdown Skincare Regimen

Episode 1: How COVID 19 is Changing the World of Beauty, Skincare, and Dermatology

Dermatology Weekly Flash Briefing – The COVID-19 pandemic has affected all of us, individually and collectively. It will likely change the world,  including the beauty, skincare, and dermatology industry. So what can we expect moving forward? Dr. Teo Wan Lin, accredited dermatologist, speaks on how the industry has changed in the short term, the changes she predicts will last, and why she thinks the world of beauty and aesthetics could have actually changed for the better. 

Chelsea: Hi I’m Chelsea, welcome to the first episode of our podcast Dermatologist Talks: Science of Beauty. If you’re listening to this podcast now, chances are you’re as much of a skincare fanatic as I am. 

Dr. Teo: A very big hello to all our listeners on Spotify, Apple, or wherever you get your podcasts. This is Dr. Teo Wan and in this podcast, Dermatologist Talks: Science of Beauty we’re going to cover some of the hottest topics all over the world in the field of science, beauty, and dermatology. 

Chelsea: First up, Dr. Teo is an accredited dermatologist practicing in Singapore, specializing in both medical and cosmetic dermatology.  She is the founder of Dr.TWL Dermaceuticals, a cosmeceutical skincare line. She is also a prominent researcher and a key opinion leader in the area of cosmeceutical skincare. She is the author of the Skincare Bible, the Haircare Bible and the very latest on Maskne- Masking Up, a Dermatologist’s Guide to Maskne- her books are available on Amazon Kindle, Apple Books and Barnes and Noble.

Dr. Teo: Thanks Chelsea, that was a very kind introduction. I’m equally excited to be part of this journey decoding science and beauty for our listeners. 

Chelsea: We’re really excited to start this podcast with you Dr Teo.

What are some of the topics our listeners can expect to hear about in this podcast series? 

Dr. Teo: Well I think I really want to touch on relevant topics in today’s world of beauty from my perspective as a cosmetic dermatologist, and also the founder of a cosmeceutical skincare line. 

Common skincare concerns

Now from common skincare concerns like acne, (especially with the wearing of fabric face masks, and COVID 19, we have maskne). Rosacea- which is a medical condition characterized by facial redness. Eczema- which is commonly passed off as merely dry, sensitive by a layperson. Now these are all big topics in dermatology. I feel that because they are also very common in our general population, it is also my aim to break down the medical science behind these conditions for our listeners.

All things dermatology

Well, basically, I’m here to teach you about dermatology. We’ll go in depth into active skincare ingredients as well. With increasing knowledge available on the internet, it’s important to be able to decipher between what is true and what is not. We also want to touch on exciting new developments in the field of beauty and technology. Which really brings us back to our original mission – to share with our listeners the evolving future of beauty.

Chelsea: I’m excited already! With 2020 looking the way it does, I certainly hope the future will be better.

How do you think COVID 19 has shaped the business of beauty, skincare, and medicine? 

Dr. Teo: I found that there has been a positive shift in sustainable practices with regards to home-care and self-care in the field of beauty. Alot of individuals have opted for eating at home, which hopefully translates to eating healthier, home cooked meals. From a dermatologist’s perspective, there has been an interesting de-emphasis on aesthetic and cosmetic interventions this year in 2020. Simply because of the reality of the lockdowns imposed because of COVID 19 – the circuit breaker in Singapore, and lockdowns imposed worldwide. Well, you may find it surprising, but I’m actually all for that. 

Positive perceptions of aging

If I may just deviate a little, I want to talk about how while toxins, fillers, and lasers do form a significant part of my dermatology practice, I personally do not find these practices either sustainable from a physiological, or humanistic perspective. Nor are they encouraging any sort of positive perception of aging. My patients know that I have always advised adjunct cosmeceutical skincare as the long-term maintenance goal for anti-aging and healthy skin in general. 

Chelsea: That’s really insightful, thank you for sharing!

There has been so much marketing for skincare problems this year on social media. I wonder what your take is on that? 

Dr. Teo: What is unfortunate is that a lot of true skin diseases have been masqueraded in the eyes of the public by non-dermatologists as a cosmetic diagnosis. But the truth is, there are reasons where you may have a symptom on your skin. Be it something as common as suffering from acne, or the dryness and flaking when exposed to a change in environment.

Before COVID 19, when people were still travelling, it was very common for me to see ladies or men who come in and say “my skin is actually very good, I’ve been using XX product for this period of time, and it’s only whenever I travel that I feel my skin is very sensitive. I don’t believe my skin is very sensitive, but it must be something that’s in this product I’ve been using.” Because somehow they’ve gotten this impression from something they’ve read, or what’s been on social media etc.

Eczema

To me, what is important for the patient to know is that they actually don’t just have skin sensitivity. Instead, they have a skin disorder known as eczema. Eczema itself can vary in severity, and a lot of people think it has to start in childhood. That’s not true because a lot of individuals start developing these symptoms of sensitivity, which are of eczema, as adults. It could also be related to certain lifestyle exposures.

But at the end of the day, we’re talking about a condition that has medical roots. Therefore, it’s related to a disorder in the skin barrier. The skin barrier is essentially what protects us from the external environment. It is best visualized as the building blocks of skin. With the bricks that form the barrier, and in between the bricks you have the joining cement – which is a fatty lipid known as a ceramide.

In this case, the correct type of skincare for individuals with eczema, according to latest dermatological research, is actually a type of moisturizer known as a PED – or prescription emollient device. Such a moisturizer should contain an optimal lipid balance that mimics the physiological balance of the ceramides in your skin. It should also contain antioxidant, anti-inflammatory ingredients in the skincare formula. This is in order to best address the inflammation and the barrier defect that’s occurring in the individual with eczema. 

New acne treatment

For another common skin problem, which is acne or in 2020 we’ve been talking about maskne. Traditional topical ingredients that are effective in the treatment of acne are sulphur, salicylic acid, tea tree oil, benzoyl peroxide. These are all over-the-counter preparations readily available to the public, and in cosmetic formulations. But these are no longer relevant in the age of the mask wearing COVID 19 pandemic. The reason is because we do find that all these active ingredients have astringent properties – which means it dries up the skin. Applying the conditions of a face mask throughout the day increases the risk of a condition known as irritant contact dermatitis. This is known as occlusion.

The occlusive microenvironment of wearing a face mask changes the bacterial and microbiological balance of the skin. These traditional remedies for mild acne will not be very relevant in the current maskne era. On the other hand, active botanical antioxidants and those with anti-inflammatory properties are increasingly being focused on in the area of dermatological research. They are highly relevant when you’re talking about the occlusive environment of mask wearing.

Chelsea: Thank you for sharing that! There are a lot of gems of information that I’m sure our listeners would love to know.

Another shift has been to virtual consultations in medicine. Tell us about your experience with teledermatology? 

Dr. Teo: We started teledermatology way before COVID 19, in November 2019 to meet the need for our international patients to fulfill their prescriptions. Especially when a lot of them live in regions where they may not have access to international hospitals where they can have specialist dermatologist care. The upside was that our practice had a bit of a headstart in terms of coordinating the protocols, and the logistics of our teledermatology and virtual consultation processes.

Something to highlight is that in Singapore at least, it is very much a process of self accreditation for teledermatology. You apply with the relevant ministries as part of your documentation. We derived a robust teledermatology protocol that fulfilled the essential requirements that were the same offered by a face-to-face consultation for medical, legal purposes. Let me break down what that means. If you see a doctor, you do want to feel that your doctor is there for you, wants to help you, and is a credible trustworthy individual for you to share your medical concerns with.

Teledermatology

In the case of dermatology, I would say that we are well suited for telemedicine. In particular, the term teledermatology has been around for the last decade. It has been in execution for certain institutions that may not have a resident dermatologist such as nursing homes, and where there is a predominantly outpatient caseload. This is as opposed to inpatient dermatological conditions which require closer follow up and evaluation of systemic systems. The key thing is that we are primarily a visual specialty that relies on the recognition of patterns, colors, and morphologies of rashes. This is a language that has been described in the specialty of dermatology for us to characterize different types of rashes. From there we formulate our diagnosis or list of differential diagnosis.

Translation to a virtual platform is made easier in this era. This is as it’s not difficult to request high resolution photos even if it’s taken with your smartphone. So that part is something that is easily qualified. We also ensure that patients are aware of the setting of the photographs they submit. As a baseline, we emphasize good lighting. Bright, natural daylight is preferred against a white background to minimize any color distortions. We know that the light should come in either in front of you or the side. We also give recommendations and samples on the distance of the photograph from. These could be in the form of a close up lesion. Or, from a slightly further up photo that gives us an idea of the distribution of the rashes.

Who qualifies for a teleconsult?

One more thing that is important for us to highlight is that not every everyone qualifies for a teledermatology consult. In fact, we have a robust triage process that is performed by our dermatology nurse. It essentially screens out individuals with acute screen conditions who may not be suited for a virtual consultation.

Finally, we also do recommend in-person photography with our professional camera and lighting, and video examinations as well. But overall, as the circuit breaker is lifted, and measures have somewhat relaxed, we have maintained the proportion of our patients that follow up with us via virtual consultations. This is largely because we are all concerned about the overall public health climate, and resurgence of this pandemic – which we certainly don’t take for granted. The other thing is that it allows us to control the traffic in our clinic a lot more precisely. So I feel that telemedicine, and teledermatology in particular, is here to stay. 

Chelsea: I totally agree, especially during the environment that is COVID 19 right now. Well, thank you again Dr. Teo for speaking to us today. Well that about sums up our first episode. Thank you guys for tuning in, and we’ll see you guys in the next episode.

Find us on social media: 

– Instagram: @drteowanlin

– Youtube: Science of Beauty

Read more about Dr. Teo’s latest research paper here: https://www.twlskin.com/mask-acne-book-launch-research-paper/

If you want to have a question answered on Dermatologist Talks: Science of Beauty, leave a comment on the post below, or send us a message through our various social media accounts. Or, record it on your smart phone then send it in an email to drtwlscienceofbeauty@gmail.com.

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Ep 1: How COVID 19 is Changing the World of Beauty, Skincare, and Dermatology