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Coping with acne in Singapore: Guide to common causes and effective treatments for break-outs and scarring

Do you find yourself suffering from acne well into your twenties, thirties, and even forties? Don’t worry – pimple break-outs and scarring aren’t just teenage problems. The good news is there are tried and tested ways to deal with this pesky skin condition, no matter what age you are. Dermatologist Dr Ang Chee Beng from Ang Skin Clinic takes us through the common causes of spots, when to seek help, and different treatment options for mild to severe cases. With the right skincare solutions, you’ll be well on the road to a smooth, clear face.


Oh, the horror of discovering a new pimple that popped up overnight...
Oh, the horror of discovering a new pimple that popped up overnight…


So, just what really causes acne?
“Acne is a condition that develops in and around the hair follicle and the surrounding oil-producing glands,’ says Dr Ang. ‘These sebaceous glands produce sebum, and this is where all the major events that cause acne happen.”

Although the exact cause is unknown, this is what we do know about the formation of acne:

* People with more severe acne produce more sebum than others – this could be genetically or environmentally determined.
* Excess sebum can block the oil glands, producing blackheads, or whiteheads that are also called comedones.
* Bacteria situated within the hair follicle beneath the sebum blockage release chemicals that act upon the sebum, breaking it down and in the process releasing other chemicals.
* These chemical reactions result in inflammation and redness, producing those classic red bumps (clinically known as papules and pustules).

Why do we get spots?
Hormones – These are one of the main reasons that acne can flare up around puberty, as well as later in adult life or for premenopausal women.

Diet – High-glycaemic diets can spike blood glucose levels, triggering a series of hormonal changes that can cause outbreaks. Some reports have also shown that eating dairy products can increase acne severity.

Environment – Polluted environments and contact with certain industrial chemicals like chlorinated hydrocarbons can cause acne in skin that comes in contact with the chemicals.

Stress – This is another factor that can exacerbate acne and increase inflammation.

Try not to squeeze spots, as this could make things worse...
Try not to squeeze spots, as this could make things worse…


Acne Scarring
“In some individuals,” says Dr Ang, “this reaction is so severe that it gives rise to bigger lesions that we call nodules and cysts – these are the type that can give rise to scarring, be it sunken scars, pits or hardened, raised swellings.”

In less severe cases, acne leaves red or brown pigmented marks that, he says,  understandably still cause distress for many patients. The main goal of most clinical acne treatment should be to prevent these scars from developing in the first place.

When should you take action?
It’s better to treat acne earlier rather than later – it would be a mistake these days to wait to “outgrow” bad skin. Considering the number of treatments available, there is no need to suffer in silence.

What options are available?
The treatment prescribed depends on the type and severity of the acne.

For mild acne

Topical treatment:
– Benzoyl peroxide (a topical antiseptic).
– Salicylic acid (also present in a number of cleansing products).
– Topical antibiotics such as clindamycin or erythromycin, or a combination of these with benzoyl peroxide or with a steroid preparation.
– Topical treatment is also prescribed to treat residual scarring. This may consist of chemicals such as vitamin C, hydroquinone and azelaic acid.

For moderate acne
Oral treatment is the first remedy for mild to moderate acne, and consists of antibiotics such as the tetracycline group or erythromycin. More severe cases could warrant the use of oral isotretinoin or oral contraceptives. In addition, you could try lasers or light therapy (IPL, blue light or red light) to target acne-causing bacteria, red marks, sebum production and scarring.

For severe acne
Once scars have formed, treatment is more difficult; it involves the use of ablative lasers (for example, CO2 fractional lasers) or non-ablative lasers. These could be combined with minor surgery to remove deep scarring.


To make an appointment, contact Ang Skin at 6353 3851. #06-51 Block D, Mount Alvernia Medical Centre, 820 Thomson Road.


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