Ep 31: Functional Dermatology – Natural Acne Treatment That Works
Hi guys, welcome to Dermatologist Talks: Science of Beauty. Today we’re going to be talking with Dr. Teo Wan Lin, accredited dermatologist practising at TWL Specialist Skin and Laser Centre on the concept of functional dermatology, and how it’s relevant in treating different skin types such as acne prone skin. We’ll touch on promising botanical ingredients as natural acne treatment. Additionally, we’ll talk about how you can incorporate these into your skincare routine.
Can you explain the concept of functional dermatology?
Dr.TWL: Functional dermatology is a realm that crosses into the pharmaceutical industry. Dermocosmetics is increasingly evident to have benefits to medical conditions. Functional dermatology is essentially the use of pharmaceutically active botanical ingredients. We know that a lot of drugs are actually derived from plants. It applies these principles to formulas. That is what we’ve done in our mask bar system to treat medical conditions, primarily as an adjunct. For example, for the natural acne treatment in my clinic, we are now using botanical derivatives like Berberine. This has been proven to act via anti-inflammatory, sebum control pathways to address their route of acne and inflammation.
Chelsea: I’ve always used Benzoyl peroxide and tea tree oil for my acne. However, I find that it burns my skin when I apply it on my pimples these days. So I guess using botanical ingredients may really be less irritating on acne prone skin.
How do you think that the concept of using botanical ingredients can be further applied in the field of dermatology?
Dr.TWL: The application of botanical ingredients in dermocosmetics or cosmeceuticals, is one way we can approach functional dermatology. The concept of mixing and matching is very appealing to the consumer because of it being personalised. However you do need some level of knowledge as to what ingredients work for the condition. So the virtual dermatology physician assistant program on the pharmacy website is sort of a guide that helps the consumer get through this personalised process but with guidance. The final recommendation will be by an algorithm similar to what we would implement in the pharmacy practice itself.
Chelsea the Virtual Physician Assistant is an AI program that assesses your checked answers and evaluates uploaded photos for a directed history taking and skin assessment. Designed to complement the functional dermatology system by Dr. Teo Wan Lin.
Chelsea: Wow so you’re talking here about an AI algorithm in which you would answer a bunch of questions, and it will recommend ingredients and specific products for your skin type! I can foresee that really taking off! Especially for people like me who are often confused on what I should put on my face.
For me, I actually have combination skin and oiliness around my T-zone area. And maybe once a month around my period, I get some acne breakouts.
Do you have any tips for combination skin?
Dr.TWL: If you do suffer from mild symptoms like on and off acne, oily skin, you don’t really have active acne breakouts, but just a little bit of seborrhea, you can use a serum that perhaps contains an astringent. Certain botanical extracts like Chlorella from algae actually helps to regulate sebum production as natural acne treatment. This is found in the Blemish Spot Cream. If it is a single product that is targeting multiple concerns, then I feel it could be a little bit distracting and maybe misleading. Perhaps it should just be marketed as a product for general health benefits or for skin health benefits.
Chelsea: Ah well I see, on the topic of products that supposedly target multiple concerns. I’ve also seen that is marketed act as an all-in-one “miracle” product that achieves many different functions. What is your take on that?
Is it possible for a product to do it all?
Dr.TWL: What I find a little extreme is if a cleanser is being marketed as a shampoo and as a body wash. It’s just very confusing and it also is not consistent with cosmetic science. Shampoos are meant for application on the scalp, but the nature of scalp skin is different from your facial and body skin. Your body skin is also different from your facial skin. Your brand authenticity and perhaps overall brand story would not be very authentic, I feel, if you do not get the basics clear.
A gentle cleanser such as the Cetaphil gentle cleanser, which I do recommend in my practice as well, is used both on the face and the body. This is the same as with our Miel Honey cleanser that utilizes medical grade honey cleanser. The hallmark of a good cleanser is that anyone, whether they have sensitive skin, oily skin, acne-prone skin or any other type of skin disease, would be able to use the cleanser because it is going to be well-tolerated.
Chelsea: That makes sense, it’s too good to be true if one product could really do it all!
What are some up and coming natural, botanical ingredients you can share with us about?
Dr.TWL: Botanicals for acne and maskne is an area of promising research. My work is currently in natural acne treatment in the form of an active ingredient known as berberine. Berberine is derived from the bark of a plant known as phellodendron amurense, and has been used in traditional chinese medications. Only in the last 5 years or so did we study it in a research setting and realised that there are actually very specific drug-like effects that berberine has on the skin of acne patients.
Prescriptive Skin – Acne Treatment targets mechanisms in acne formation. It is ideal for maskne treatment under face mask. Zero irritation formula, safe on fabrics.
Firstly, it is anti-microbial, bactericidal – it kills the bacterium skin. It is also anti-inflammatory and has potent anti-oxidant properties which helps to minimise the post-inflammation redness and scarring that is associated with acne. Specific ingredients like these can be considered very promising in the field of dermocosmetics for therapy as natural acne treatment. The key here is that there is a body of evidence both in cell lab studies and in clinical trials that can support the use of these active ingredients. That is the premise of functional dermatology, which is the focus of Dr. TWL pharmacy arm.
What are the benefits of the functional dermatology concept of using natural, botanical ingredients compared to traditional prescription medications that seem to work for so many (for example, retinols) for acne or pigmentation?
Dr.TWL: Botanicals are generally better tolerated than synthetic cosmeceuticals. I have actually phased out the use of retinoids in the treatment of most diseases of hyperpigmentation in my practice. I also definitely don’t use any retinols in my practice. These are subtherapeutic, and I feel causes a lot more skin irritation in skin of color without actual benefits. Instead, we are using oligopeptides. These, however, are synthetic in nature and mimic the natural protein structure of your skin. It also has a retinoid-like effect by stimulating collagen production without the risk of skin irritation.
The Oligopeptide Vegetal Capsule is a Botox alternative that contains oligopeptides. These have been proven to function as a muscle relaxant and has clinical proven anti-wrinkle/sagging functions with Hexapeptide formula.
What are some key steps that everyone should have in their skincare routine, and how can we apply the principles of functional dermatology into our regimen?
Dr.TWL: The basic step in any skincare regime is definitely cleansing. Double cleansing in particular, and of course, the option of sonic cleansing. After cleansing, you will moisturise. Moisturising can be thought of as application of layers, textures ranging from the thinnest to the thickest, subdivided into application of serums, followed by emulsion of cream formulas which are heavier in texture than serums. The latter should have moisturising ingredients in the vehicle. Ingredients that directly repair the skin barrier.
What we now term a prescription emollient device (PED), is basically a moisturiser that contains the optimal balance of lipids together with anti-inflammatory botanical ingredients that have steroid-like effects, but in fact do not contain steroids. This is an example of how functional dermatology principles can be applied in the treatment of actual skin diseases.
The Multi-CERAM Cream is a new generation “Smart Moisturiser” formulated as a Prescription Emollient Device. It is formulated with an optimal skin lipid mixture, containing a mixture of plant-derived phytoceramides and synthetic ceramide.
This is actually the gold standard of moisturiser therapy now, and even if you do not have If you do not have dry skin, or eczema but you have acne prone or greasy skin, you still will benefit from a moisturiser like that, because you are rebuilding your skin barrier. It also can reduce the risk of getting reactive seborrhea, which is when you are dehydrating your skin too much with astringent cleansers, because you think that your skin is very oily. This leads to a paradoxical production of more oil.
Chelsea: Well what about in terms of skin type? I feel like my skin type changes depending on the climate, so I’m never sure what type of skincare products I should get – those that target dry skin, oily skin or combination skin.
How do we determine our skin type?
Dr.TWL: I think knowing your skin type is important. I have written about how to check what skin type you are whether you’re dry, oily or combination skin in my book, The Skincare Bible Dermatologist Tips for Cosmeceutical Skincare. We have included the checklist in our podcast transcript at www.scienceofbeauty.net.
How Do You Determine Your Skin Type?
The best way to do this is simple and you can even do it at home with the following steps:
1. Wash your face and let dry for 30 to 60 minutes.
2. Dab a tissue on the T-zone (nose, forehead) and cheeks.
3. If you feel that only your nose is oily, that means you have combination skin. 4. If you are oily on your nose and cheeks, you have oily skin. If both your T-zone and cheeks are dry, it means you have dry skin.
To check if you have dry skin, you may use the following checklist as well.
Do you have:
- Dry itchy skin which may be worsened by exposure to strong soaps, sweat, dusty environments, pet fur, pollen mould and carpets
- A personal history of atopy, which encompasses hay fever, sensitive nose (allergic rhinitis) asthma and eczema
- Family members with atopy
- Skin redness, flaking, itchiness, stinging whenever exposed to a new environment or to certain skincare or makeup products”
Excerpt From: Dr Teo Wan Lin. “Skincare Bible: Dermatologist’s Tips For Cosmeceutical Skincare”.
Chelsea: In Singapore’s humid climate, I find myself sometimes skipping out moisturizer. Because, I don’t feel like my skin is dry, or it’ll make my oily skin feel oilier.
Is moisturizer only important if I have dry skin?
A good moisturizer is still essential. In Singapore’s humid climate, I would prefer emulsions which are oil and water formulas instead of cream formulas because of the humid climate. The fact is that in a tropical or summer climate, our skin does react differently to the near 100% humidity levels. Our skin definitely produces more oil than if we were living in a temperate country.
Chelsea: Ok, so the trick is to look for emulsion formulas instead of heavy cream formulas that probably is not so ideal for tropical climates.
Well is there anything I should avoid in moisturisers if i have acne prone oily skin?
Dr.TWL: If you do have greasy skin that’s prone to acne breakouts then you definitely need to avoid would be occlusive ingredients like paraffin or mineral oil. It is used as part of treatment for very severe eczema because it prevents transepidermal water loss to the environment. However, for skin that is prone to developing acne, that is an occlusive, and can lead to the formation of comedones. Trends like slugging where users apply layers of Vaseline on their skin to lock in moisture would be detrimental in an individual who has greasy skin as it will cause pimples.
Chelsea: Well that’s it for today’s episode. We’ve spoken about the concept of functional dermatology and how we can incorporate that into the products we use and our skincare routine as natural acne treatment. We also touched upon the importance of moisturizing, even for greasy skin types, and beauty trends like slugging that may not be suitable for those with oily, acne-prone skin. Thank you guys for joining us, you can follow Dr. Teo on her Instagram for the latest podcast update @drteowanlin and also visit us on our website at www.science of beauty.net.
Dr. Teo Wan Lin is an accredited dermatologist treating acne in Singapore who specialises in the diagnosis and treatment of skin diseases. She is also the founder of cosmeceutical skincare line Dr.TWL Dermaceuticals, which develops evidence-based cosmeceutical actives for the adjunct treatment of acne. She is also the author of Skincare Bible: Dermatologist’s Tips for Cosmeceutical Skincare, and Masking Up: A Dermatologist’s Guide to Maskne.