What is acne? 

Acne is an inflammatory skin condition that manifests as blemishes, such as whiteheads, blackheads, pimples, and sometimes deeper lumps like cysts and nodules. Acne is most prevalent among teenagers– (88%), but it can affect people of all ages.

What causes acne? 

Acne develops when the hair follicles, or pores, on your skin become blocked with oil and dead skin cells. Each follicle is connected to sebaceous glands, producing an oily sebum. Sebum is vital for keeping the skin lubricated and protected, but excessive sebum production can lead to clogged pores. This blockage becomes a breeding ground for bacteria, particularly Propionibacterium acnes (P. acnes), which can cause the follicle wall to break down and form pimples. 

Certain bodily changes can trigger sebum production, such as hormonal fluctuations associated with menstruation, pregnancy, and the use of certain medications like oral contraceptives.

What are the symptoms of acne? 

The symptoms of acne can vary depending on the severity of the condition but typically include the following types of skin blemishes:

• Whiteheads (closed clogged pores): these appear as small, round, white bumps on the skin's surface.
• Blackheads (open clogged pores): these are visible on the skin’s surface as small, dark spots. Contrary to popular belief, their dark colour is not caused by dirt but originates from a pigment produced within the hair follicle.
• Papules: papules are small, red, raised bumps caused by inflamed or infected hair follicles.
• Pustules: similar to papules, pustules are raised, red skin lesions with pus.
• Nodules: nodules are large, solid, painful lumps beneath the skin's surface, formed by the buildup of secretions deep within hair follicles.
• Cysts: these are painful, pus-filled lumps beneath the surface of the skin, similar to nodules, but even more severe and likely to scar.

Symptoms typically occur in areas of the skin with the densest population of sebaceous glands, including the face, forehead, chest, upper back, and shoulders. In addition to the visible symptoms, acne can also cause emotional distress and low self-esteem, mainly if it is persistent or severe.

Is acne painful? 

Yes, acne can be painful, particularly when it involves more severe types of blemishes. While mild acne, like whiteheads and blackheads, might not cause discomfort, inflammatory acne, such as papules, pustules, nodules, and cysts, can be quite painful. Papules and pustules are red, raised bumps that can be tender to the touch due to inflammation. Nodules and cysts are even more severe forms of acne, which form deep within the skin and often cause significant pain due to their size and the extent of inflammation. These deeper lesions can be particularly uncomfortable and lead to scarring if not treated properly.

Who is at risk of acne in Singapore? 

Acne can affect individuals of all ages, but some groups are more susceptible to developing it. These groups include:

• Adolescents and young adults: this group is particularly prone to acne due to hormonal changes during puberty, which can increase sebum production and clog pores. 
• Hormonal fluctuations: hormonal fluctuations related to menstruation, pregnancy, and the use of hormonal contraceptives can also make women more susceptible to acne.
• Genetics: genetic factors play a significant role, meaning if your parents had acne, you are more likely to develop it. 
• Skin type: individuals with oily skin types are at a higher risk since excess oil can clog pores.
• Stress: while stress doesn’t cause acne, it can exacerbate acne by triggering hormonal changes that increase oil production.
• Medications: certain medications, such as corticosteroids, lithium, and some anticonvulsants, can also cause acne. 
• Using heavy or greasy cosmetics and skincare products: such products can block pores and contribute to acne development. 
• Dietary factors: dietary factors, such as the consumption of high-glycemic foods and dairy products, have been linked to an increased risk of acne in some individuals.

How is acne diagnosed? 

Acne is typically diagnosed through a physical examination. Dr. Hoe will inspect the skin, focusing on acne's type, number, and distribution. The severity of acne and the patient’s medical history, including previous treatments, medication consumption, lifestyle and family history, will also be analysed. 

Dr Hoe’s in-depth skin analysis prioritises finding the root cause of acne presentation rather than just superficially treating them. Her bespoke solutions have provided a sustainable and long-lasting result for her patients– overcoming even the most complex and stubborn cases of acne.

What are the treatment options for acne in Singapore? 

Acne treatment usually depends on the severity of the condition. Common treatment options include:

• Topical treatments:
  • Skincare and cleansers: these often contain ingredients like benzoyl peroxide, salicylic acid, or alpha hydroxy acids to help reduce oil and promote exfoliation.
  • Prescription topical medications: topical medications for acne may include retinoids (like tretinoin), stronger benzoyl peroxide formulations, or topical antibiotics to reduce bacteria and inflammation.

• Oral medications:
  • Antibiotics: oral antibiotics such as doxycycline reduce bacteria and inflammation.
  • Hormonal treatments: for women, oral contraceptives or anti-androgen medications like spironolactone can help regulate hormones that contribute to acne.
  • Isotretinoin: medication used for severe, resistant acne. It requires close monitoring due to potential side effects, which include the risk of birth defects.

• Procedural treatments:
  • Chemical peels: performed by doctors, high-strength acids are used to exfoliate the skin and treat acne.
  • Laser treatments: such as the BBL HERO Forever Clear (link to service page), remove acne bacteria and reduce inflammation in acne lesions. On the other hand, PicoSure Laser (link to service page) treats post-inflammatory hyperpigmentation and resurfaces acne scars.
  • Medi-Facials: such as Hydrafacial involves a multi-step facial treatment that resurfaces the skin, clears dirt and impurities from clogged pores and infuses nourishing serums.
  • Skinboosters: injectibles such as Rejuran (link to service page) help promote healing, reduce inflammation, and lower sebum production.
  • Combination treatments: depending on the individual's skin type and the severity of acne, a combination of treatments is often used to achieve the best results.

• Lifestyle and skincare adjustments:
  • Skincare routine: using gentle cleansers, non-comedogenic (non-pore-clogging) moisturisers, and sunscreens can help manage acne.
  • Diet and lifestyle: maintaining a balanced diet, managing stress, and avoiding picking at acne lesions can also support treatment.