Saturday, December 4, 2010

Can Facial Mists Dry Your Skin?

Facial mists for skin 
It depends on how often you use a facial spritz.

Facial mists help to hydrate the skin slightly as the water keeps it moist. However, due to a lack of binding agents, the excess water dissipates quickly so a facial mist will not offer a prolonged moisturising effect .

This rapid evaporation also helps to cool down overheated skin, making such sprays great perk-me-ups in humid weather. If you have sensitive skin, try facial mists made with water from thermal springs to soothe any inflammation or itch.

These mists are recommended for patients who have sensitive skin or eczema. The concentration and balance of naturally occuring minerals and trace elements make thermal water soothing and non-irritating to the skin. They also contain anti-bacterial properties. Such spritzes are also good if you are sunburnt or have just undergone treatments such as chemical peels and laser.

Some reputable brands that offer such spritzes include Avene ($20.30), La Roche-Posay ($20.90) and Uriage ($20.90), which are sold at personal care stores such as Watsons and Guardian.

However, despite its manifold benefits and ease of use, one should refrain from using facial mist more than 3 to 5 times a day. If you use it too frequently, for an extended period of time, you may paradoxically weaken your skin's protective barrier function, as water will weaken the bonds holding your skin's cells together. This results in greater water loss from your skin and dries it out in the long run.

Thursday, November 4, 2010

Bed Bug Epidemic!

"Don't let the bed bugs bite."

Anyone who has been bitten by bed bugs cannot forget the angry red welts and the excruciating itch!

Traditionally a pestilence associated with the Third World countries. Not anymore. With people travelling round the globe, so have the bugs. The problem can be said to have reached pandemic proportions! Read about the bed bug epidemic that has hit American cities. 

They stow-away in clothes, suitcases, mattresses and upholstery.

If you buy any new clothing, even underwear and socks, sheets, towels, put them in your clothes dryer for at
least 20 minutes. The heat will kill them and their eggs. DO NOT PURCHASE CLOTHES AND HANG THEM IN THE CLOSET FIRST.

Mattresses and upholstered furniture (such as netted office chairs) are potential minefields. Be extra vigilant with second-hand furniture that you have purchased.

Thursday, October 28, 2010

Is There A Total Sunblock?

This is a frequently asked question. 

FDA has recommended that sun protection products be referred to as sunscreen, instead of sunblock.

In theory, a sunblock can offer up to 97% UV protection. In practice, this is rarely achieved.

Because, there are simply too many variables to the equation.

Firstly, SPF refers to protection against UVB. The higher the SPF, the longer the time that one can spend under the sun without getting becoming toast. SPF does not encompass UVA protection.

Secondly, protection from sunscreen decreases over time. Some gets removed with sweat, water or blotting tissue. Ingredients degrade under the sun, losing protective function.

Should I pick an SPF that is as high as possible?

The higher the SPF, the denser will be the product, and would feel thicker when applied on the skin.
SPF selection should be based on the level of activity or sun exposure anticipated. SPF 15 for basic protection, SPF 30 if more time spent outdoors, SPF 50 or more if skin is particularly sun-sensitive, or if receiving treatment for pigmentation. 

What is the maximum UVA protection to look out?

PA is one of the standard of measure of UVA protection. Other indices are IPD (immediate pigment darkening), PPD (persistent pigment darkening), UVA seal or star rating systems.

Although FDA has approved a new rating system to measure UVA protection, this will not be enforced till 2011.

For now, the only safeguard is to look at the ingredients carefully. Only ingredients such as Titanium Dioxide, Avobenzone, Meroxyl  SX, Zinc Oxide can give the best protection against UVA.

Monday, October 11, 2010

Are You Treating Baby's Skin Right?

Prevent eczema from birth
The incidence of eczema is rising relentlessly, and we are looking into ways to stem the tide.

From the time baby leaves the blissful, damp milieu within the womb, her skin changes, to adapt to life outside.

From the cold, dry air of the delivery suite, to baby's first bath; every little event is a potential insult to fragile newborn skin. Every insult erodes a little of the tenuous barrier of the skin, gradualy tipping the scales in favour of eczema.

Now, experts believe that the holy grail of eczema prevention, lies in the way we care for baby's skin from the time of birth.

To investigate this hunch, the researchers from Oregon University of Science and Health enrolled 28 babies who were deemed to be at high risk of developing eczema subsequently. These babies would have had older siblings with eczema or other allergic diseases such as asthma or rhinitis.

From the time of birth, right up till 2 years of age, their mothers were instructed to regularly apply an emollient (moisturiser) twice daily. Babies were bathed with soap-free cleanser only.

When these infants were assessed at 2 years of age, an overwhelming majority remained well and had not developed any signs of eczema. 

The result of this study is promising. The regular use of emollient replenishes moisture attrition in the skin, maintains the skin barrier. It may also prevent eczema!

Coming next ...Which Moisturiser Is Best?

Saturday, October 2, 2010

Oral Sunscreen - Protection Against Skin Aging

With the gradual depletion of the ozone layer, there has been growing concerns about the level of ultraviolet radiation that reaches the earth and the increase in the incidence of sun-related diseases such as hyperpigmentation, photoaging and skin cancer. UV has many detrimental effects on the skin: it can directly cause DNA damage, and it can create so-called "reactive oxygen species" (ROS) or "free radicals." ROS are high energy molecules that collide with proteins and lipids in the cell and cause direct cellular damage. This damage is responsible for the effects of UV on skin: premature aging and a wrinkled and worn appearance.

Luckily, nature has provided us with a natural defense against the ROS rogues - antioxidants.Antioxidants quench the reactive oxygen species (ROS), decrease sunburn response. Antioxidants result in significant reduction in the number of ultraviolet induced sunburn cells and DNA damage.

Polypodium Leucotomos extract (PLE), which is taken orally, is one such antioxidant.

PLE has been traditionally used in Central and South America for the treatment of different inflammatory skin disease. Studies done on PLE have shown it to possess a range of benefits that include reduction in hyperpigmentation, skin firming effect which helps to improve the appearance of fine lines and wrinkles, and slows down aging of the skin.

Patients who had taken PLE, demonstrated significantly less hyperpigmentation after 48 hours following UV exposure.

For all those sporting junkies out there, take an oral sun protectant like PLE in addition to topically applied sunscreen for fail-safe protection the harmful effects of UV.

Have fun in the sun!

Monday, September 20, 2010

Choose Dewy, Not Oily

Get that dewy complexion,
 without makeup
Adapted from Simply Her, July 2010. By Justina Tan

So, what's the difference?

Oily shine is caused by excessive sebum on skin while dewy shine is a sign of healthy skin, says Dr Jean Ho, consultant dermatologist at Jean Ho Skin and Laser Clinic and visiting consultant dermatologist at KK Women's and
Children's Hospital.

ln excessively oily skin, the build up of sebum results in coarse skin. You'll also have enlarged pores, blackheads, pimples and irregular pigmentation, says Dr Ho. Dewy skin has the right balance of sebum to maintain skin hydration. Dr Ho says healthy skin has a radiant glow because of regulated cell renewal and skin metabolism. lt is smooth, even-toned and generally blemish-free.


Using astringents, foaming washes and mattifying lotions will strip skin of moisture, says Dr Ho. This increases sebum production as the skin tries to replenish lost lipids, resulting in greasier skin. Instead, wash twice a day with an oil-free cleanser with a pH of 4.5 to 5.5.

Especially if you have oily skin. Always choose an oil-free, water-based product. GO OIL-FREE For sunscreen and makeup (particularly blusher and foundation), so as not to clog your pores.

Dr Ho suggests using products that regulate skin renewal, remove dead skin cells and regulate sebum production, and to use mattifying gels in moderation. For long-term oil control, look for skincare with sulphur, zinc oxide, niacinamide, salicylic acid or alpha hydroxy acids (AHA), which regulate sebum production and improve skin cell turnover. lf your sebum condition is severe, see your doctor about using contraceptive pills, anti-androgens or retinoids that act directly on sebaceous glands to reduce oil production.

Thursday, September 16, 2010


The Straits Times, July 2009
By Dr Jean Ho

Acne is an age-old enemy.

For some, it passes through like a breeze on a balmy evening, barely perceptible and fading into the night. For others, it sweeps over like a hurricane, leaving carnage and destruction in its wake.

Patient TG was 17 years old when he found himself in a desperate battle with acne.

He walked into my consultation room one day, with anxious parents in tow, feigning a cavalier demeanour as boys at this age would. It wasn't long before I discovered the silent anguish behind this facade.

'He has been skipping classes for two months, staying at home all the time. We are very worried about him," said his mother.

Looking at TG, I realised why he had become a recluse. His acne was of the most severe kind.

Click here to know the whole story...

Monday, September 13, 2010

EPF - Anti-Oxidant For The Skin

From Simply Her, Aug 2010. By Justina Tan

Much like how SPF measures the level of sun protection in your skincare, Environmental Protection Factor (EPF) measures how well an antioxidant protects the skin from free radical damage, including damage from UVrays.

The main culprit in premature skin ageing, free radicals are formed through everyday activities like eating, drinking and breathing. Sun exposure, smoking, stress, pollutants and alcohol worsen it by increasing free radicals in the body. This sets off a cycle of free radical formation in the body.

There are several types of free radicals.
Primary free radicals are unstable molecules that are created as a result of exposure to environmental assaults like UV rays and air pollutants.
Secondary free radicals, formed from exposure to primary free radicals, tend to damage the protective lipids in skin. Free radical activity also occurs within surface skin cells. All these result in visible signs of ageing like lines, wrinkles, uneven pigmentation, sun damage, loss of firmness and elasticity.

Antioxidants like vitamins C and E occur naturally in the body to prevent free radical damage. But when there's a lack of antioxidants, or if the production of free radicals is excessive, cell damage can still occur.

Can You Eat Your Way To Younger Skin?

Consuming antioxidant-rich foods, such as broccoli, berries, spinach and tea, is beneficial to the body. But Dr Jean Ho, consultant dermatologist at Jean Ho Skin and Laser Clinic and visiting consultant dermatologist at KK Women's and Children's Hospital, says that applying antioxidants directly on the skin has a more targeted and concentrated effect. "A good antioxidant serum can increase antioxidant activity in the skin eight-fold, something that can't be achieved by taking an oral antioxidant supplement," she says.

Saturday, September 11, 2010

Eczema - Bane of Childhood

19 March 2009, Mind Your Body, The Straits Times
By Dr Jean Ho

It is easy to withstand pain but difficult to withstand itch, so goes an ancient Chinese saying.

Indeed, tell a child with eczema not to scratch and all he will hear is the last word: Scratch.

Any eczema sufferer will swear that its itch is mindnumbing, sleep-depriving and dedicated to compel nonstop scratching. 'Relief' comes only when the skin has been scratched off and the sensation of pain overtakes the itch.

L, a bright 10-year-old girl who aces her exams every year, has found it harder to concentrate in school. She has had eczema since pre-school but her parents had resisted medical treatment.

They had heard that medication like steroids were bad and, instead, turned to alternative therapy and traditional healing. The skin over her neck and body darkened over the years because of recurrent eczema. Countless scars remained on her arms and legs where once there were sores and open wounds.

When she became my patient, she was still suffering from repeated and unexpected bouts of red itchy rashes. She would think twice about wearing her favourite skirt or taking part in social activities with friends. Her eyes were downcast as we spoke.

Atopic eczema, in recent years, has seen an exponential rise in numbers and severity. One in five children in Singapore suffers from this condition.

Click Here to read more of the story.

Friday, September 10, 2010

Are Hot Baths Bad For Your Skin?

A warm bath at the end of the day is not a bad thing.

It helps patients with eczema, as the bath cleanses and disinfects the skin by softening and removing dry flakes. However, when the water is 45 deg C or more, the heat breaks down the skin barrier and makes it more prone to irritation and dryness. Keep it close to body temperature – it should never exceed 38 to 40 deg C. Add fragrance-free bath oil for more hydration.

Public bath facilities like jacuzzis should be disinfected regularly. If not done properly, they will encourage bacterial and fungal growth, which can cause nasty skin infections.

Tuesday, September 7, 2010


Adapted from September issue Simply Her, by Justina Tan

Experiencing second adolescence on your skin isn't all that rare. Dr Jean Ho, Consultant Dermatologist, Jean Ho Skin and Laser Clinic at Mount Elizabeth Medical Centre, Visiting Consultant to KK Women's and Children's Hospital, says that 75% of women she sees at her clinic suffer from acne.

There are two groups of adult acne sufferers: You either have acne from adolescence, or late-onset adult acne, which develops after years of unblemished skin. It's distressing either way, but you don't have to put up with it.

What's the reason it's coming back?
It's a combination of genes, hormones and environmental factors. The sebaceous glands are stimulated by androgens in our system to produce sebum. Increased production of oil causes clogged pores and breakouts. Medical conditions like PCOS (polycystic ovarian syndrome) can also cause a surge in androgens in the body.

Stress, lack of sleep and diet?
Stress increase sebum levels, and lack of sleep causes hormonal imbalance. There is scientific evidence that dairy products worsen acne. The testosterone-like hormone in milk influence acne. Fermentation during cheese production also results in increased testosterone production, say Dr Ho.

Foods with high glycaemic index (GI), like polished rice and refined sugar, worsen acne. These are digested rapidly, resulting in a surge of blood sugar levels. This causes a spike in blood insulin levels, which trigger the sebaceous glands to produce more sebum.

Skincare of makeup?
Moisturisers, foundation, sunscreens may clog pores and contribute to breakouts.

How can it be treated?
It depends on the severity of the acne.
Mild acne You have blackheads and whiteheads with a few small bumps. Treat with an over the counter glycolic acid or salicylic acid product.
Moderate acne You have many blackheads and whiteheads, and angry red bumps, some with pus. Use a salicylic acid product as well as benzoyl peroxide which kills acne-causing bacteria.
Severe acne Skin is red and inflamed with large nodules. There's risk of scarring if the infections spreads or deepens. You should consult your dermatologist right away for treatment. Do not attempt to self-medicate.

Can acne relapse?
Hormones, pregnancy, stress and lifestyles will have an impact on acne. Dr Ho says that a consistent and well-planned maintenance skin care program is the best way to keep acne at bay.

Skin care tips for sensitive skin

So you have sensitive skin, and finding the perfect skin care has been like searching for the holy grail.

Your dermatologist can help you plan a non-irritating skin care routine that will ensure that the skin barrier is not compromised while at the same time debris, excess oil and surface organisms are removed.

Follow these easy steps to healthier skin:
1. Cleanse facial skin twice daily with tepid water splashed on the skin surface.
2. Use non-perfumed, gentle soap-free cleanser – gently massage onto the skin surface with fingers.
3. Do not use cotton pads or scrubbing pads – it is unnecessary and potentially irritating to rub skin vigorously during cleansing.
4. A rest period of up to 30 minutes should be taken before applying topical medications. This time can be progressively reduced once the skin has gotten used to the creams.
5. Apply medication as a fine film with single movement of finger pad.
6. Moisturiser or sunscreen should be applied after topical medications.
7. Avoid excessive use of moisturising creams. This can result in over dependence on moisturisers, and may also contribute to yeast infection.
8. When removing eye makeup with makeup remover, dab gently with a cotton pad. Do not rub.

Dos and Don’ts of Cosmetics for Patients with Sensitive Skin

Did you think that cosmetics were taboo for sensitive skin types? Well, think again. You can use cosmetics safely by following a few simple steps.

Dos of cosmetics

1. Use powder cosmetics with matte finish
2. Use new cosmetics
3. Wear light earth tones for eye shadow (tan, peach)
4. Apply a separate sun-block after topical medication and before cosmetics
5. Avoid cosmetics containing formaldehyde, propylene glycol, alcohol, toners
6. Use a brush applicator
7. Use facial foundation with matte finish
8. Wear only black mascara
9. Use pencil forms of eyeliner
10. Use mineral make up which has less chemicals and artificial colourings

Don’ts of cosmetics
1. Don’t use cream/liquid cosmetics
2. Don’t use old cosmetics
3. Don’t wear deep eye shadows (blue, purple, green or pink)
4. Don’t use cosmetics containing perfume
5. Don’t apply makeup with a sponge
6. Don’t massage creams into skin
7. Don’t use peeling “rejuvenating” agents
8. Don’t use light reflective powders
9. Don’t use nail polish
10. Don’t use waterproof eye cosmetics as they need to be removed by solvents, which can be irritating.

Wednesday, September 1, 2010

Dr Jean Ho's Footcare Tips

Indulge in a DIY foot spa at home

In my practice, I see patients with various problems on their feet, from warts to corns, and cracked heels and toenail infections.

As we spend most of our waking hours on our feet, they deserve some serious pampering.

1. Always keep feet clean and healthy.

2. Proper footwear. For men, thin cottony socks and padded leather footwear are best. For ladies, 3-inch heels kill your pads, by forcing the body weight onto the front of the feet. So swap the punishing stilletos for mid-heels or ballerina flats, which are so IN now.

3. Wear footwear even when at the beach or padding around the pool. Nasty things like viral warts lurk on moist public areas.

4. Moisturizing the skin on the feet regularly is important, especially in persons with dry skin. The best time to do this is right after a shower or bath. Look for a moisturiser with high lactate content, which hydrates and gently exfoliates at the same time.

5. Avoid hot water, as it removes the naturally occuring skin lipids and aggravates the cracks. Instead use lukewarm water for bathing or soaking.

6. As with everything else, skin condition deteriorates with age. One problem is gradual thickening of the hard skin and callus. Keep the soles of feet in prime condition by filing away dead skin after a shower, and moisturising after.

7. Treat yourself to a DIY foot spa. These are available at departmental stores or hypermarts. I got one for $39. If it pleases you, use it with bath salts too.  

8. For very stubborn cracked heels, use a foot cream in the night and cover feet with socks or cling wrap. Remove in the morning. Do this for several nights in a row and you will be rewared with baby soft skin.

9. Deep painful fissures or itchy blisters may be signs of disease such as eczema. You should be treated by a dermatologist.

10. Examine your feet regularly. This way you will detect any problem like toe nail infection or warts and get them sorted early.

Happy feet!

Monday, August 30, 2010

Botox - Erasing Frowns, Gaining Friends

Wear a smile and have friends, wear a scowl and have wrinkles. By George Eliot

A psychologist friend shared with me an interesting finding last Christmas, over roast chicken and our neighbour’s scrumptious sheperd’s pie.

We had just launched into a hearty discussion about botulinum toxin treatment (commonly referred to by the trade name ”Botox”) and its psychological effects.

“ Do you know that botox can improve your mood, and perhaps even treat depression?” said my friend

Hmm, I have suspected that for some time. Patients, following their first treatment with botulinum toxin, reported that they felt better than they had in a long while.

“There is research, which showed that patients who had treatments to their frown lines were able to maintain a positive mood more easily, compared to patients who did not have the treatments,” she added, citing the study findings.

Also these findings were independent of whether the patients in the study were deemed attractive or otherwise.

Click here to read more.

Sunday, August 29, 2010

3 Things You Should Know About Eczema

If eczema is inherited, how come my child has eczema when I do not? Is it caused by something in the diet? Is eczema contagious? I know steroid creams work, but I am scared to use them on my child... The list goes on.

These are questions which parents ask time and again. If you are a parent of a child with eczema, you would probably have similar concerns and uncertainties.

Uncertainty #1: Is Eczema is caused by food allergy?

No. Trust me, even if you were to feed your child nothing but rice water everyday, your darling will still have eczema. Yet, there are parents who continue to subject their children to numerous, and often, costly tests, only to be told that they are "allergic" to nearly everything under the sun. When parents act on these test results, eliminating vital foods such as milk or eggs from the child's diet, they risk depriving the child of precious nutrition required for growth and health.

If you still suspect that it was the spinach from yesterday's dinner, speak to a dermatologist or allergy specialist about it. Have it properly evaluated. It also helps to keep a food diary. In the diary, detail the foods which your child has taken, and the reactions that follow.

Uncertainty #2: We do not have eczema, so why should our child?

Not having the disease, does not equate a clean slate. This is because the genes for eczema can remain hidden, till an opportune time. Or change as they are passed on.

Junior inherits genes from both parents. Eczema can be analogised to hitting the jackpot. The "perfect" combination lands Junior the "prize". Also, the disease becomes more or less severe depending on the genetic permutation.

One of the key genes which has been widely studied, is the Filaggrin gene. Filaggrin is found in our skin. It behaves like a sponge, trapping precious moisture within the skin. Children with eczema has lower than normal amount of fillaggrin. So the skin dries out too quickly, cracks up and itches.

The cornerstone in eczema treatment is therefore to use a moisturiser regularly. (More about Moisturisers later)

Uncertainty #3: No more steroid creams for me, please!

There is certainly no lack of bad press surrounding topical corticosteroid creams. While it is true that topical corticosteroids can cause undesirable side effects such as dryness and thinning of the skin, they are mostly a result of unregulated and unsupervised use of these medications.

Steroid creams are prescription-only medications in Singapore. Topical corticosteroids are available in various strengths (potency) and your doctor will advice on the appropriate one for your child.

Topical corticosteroids are still by far, the most effective treatment for reducing the symptoms of eczema. Do not be too hasty in rejecting them outright.  When used appropriately and under a dermatologist's supervision, they are effective and safe. 

I always provide my patients with specific instructions on when and how corticosteroid creams should be used. This ensures speedy recovery, which is safe at the same time.

Most of all, we fear what we do not understand. But to understand is half the battle won.

Wednesday, August 25, 2010

Eczema is on the RISE

The rash that heralds the start of childhood eczema

Dear Mummies and Daddies,

Do you have a child (or children) who has eczema? Perhaps you might know of a friend's kid who has. Or you might have noticed your son's playmate at the playground scratching away.

If so, it is not surprising. The incidence of eczema is indeed rising. Going by current statistics, your child would have a 50% chance of suffering from eczema at some point in his or her lifetime! This is staggering!

Whether you are already a parent to a child with eczema, or a newbie to the "club", the best defence is knowing what makes eczema tick. You can conquer eczema!

As a dermatologist, I have treated countless children with eczema.

Read on to find out the Skin Secrets to vanquishing eczema.

Monday, August 23, 2010

Beginning of Blogging

I am a Dermatologist at Mount Elizabeth Hospital and KK Women's and Children's Hospital.

I am starting the blog on Skin Secrets to engage my patients and empower you with the information that you crave.

The information is updated and cutting-edge. Founded on scientific evidence and experience gleaned from treatment thousands of patients. 

My areas of interest are Paediatric Dermatology and Laser Surgery. Areas of expertise include eczema, birthmarks, pimples and pigmentation. 

Professional qualifications:

•MBBS (Singapore)
•MMed (Singapore)
•FAMS (Dermatology)
•Visiting Specialist to KK Women’s and Children’s Hospital