Sunday, September 18, 2016

Another doctor has been misrepresented as a Dermatologist, yet again. Be it either in print or on the internet, these actions confuse patients and deceive readers. Was it a case of careless misreporting or deliberate mischief?

For the benefit of my readers, I would like to set the record straight.

1. An Aesthetic Doctor Is NOT A Specialist

The self-titled "aesthetic doctor" is a common sight, on social media and Google search ads. This term has been loosely used to refer to general practitioners (GPs) who provide aesthetic treatments. What you may not know is that, "aesthetic medicine" is NOT a recognised medical specialty. An aesthetic doctor is not a specialist, and would not be listed on the Register of Specialists in Singapore

2. An Aesthetic Doctor Is NOT A Dermatologist

On the other hand, a Dermatologist is a specialist doctor who has undergone formal post-graduate training which spans a period of 6 to 8 years. This is known as the Advanced Residency Programme in Dermatology. Doctors who meet the high standards of the program would become board-certified Dermatologists. Only doctors registered as dermatologists by the Ministry of Health are recognised Dermatologists. 

The study of Dermatology encompasses all aspects of the skin. From the neonatal period and infancy, through adulthood, into old age. From molecular biology to histopathology. From eczema to skin cancers. From procedural dermatology (surgery and lasers) to cosmetic dermatology (botulinum toxin and filler injections; anti-aging and skincare). 

Dermatologists are undoubtedly the doctors with the most thorough understanding of the skin, hair and nails, both in disease and in health. These are honed from years of clinical experience, caring for patients with complex conditions. We are actively involved in research and advancements in the field. This wealth of training would naturally translate into more effective and safe treatments for our patients.

3. A Diploma In Dermatology Is NOT A Dermatologist

A doctor with a "Diploma in Dermatology (Dip Derm)", or the "Graduate Diploma in Family Practice Dermatology (Dip FP Derm)", does not qualify as Dermatologist. This is a certification course for general practitioners to equip them with basic skills in managing patients with skin diseases in the primary care. The course is based on distance-learning modules and a one-week clinical attachment. Patients who require specialized care should still be referred to a Dermatologist.

A doctor with a 'Diploma in Dermatology' is not a Dermatologist. He or she will not be registered on the Singapore Medical Council list of specialists. (Reference: Dermatological Society of Singapore)

Look It Up

Don't be misled again. Check out your doctor's credentials on the Singapore Medical Council Professional Registration System.

Monday, July 25, 2016

Beware Of Unproven Stem Cell "Cure"

Stem Cell "Cure" Gives Him Tumour

Stem cell therapy is illegal, unlicensed and dangerous.

(excerpt:  The Straits Times, July 1, 2016)

The patient Mr Jim Gass had suffered a stroke in 2009. Two years on, he was able to walk only with a leg brace and a cane. He had read about seemingly miraculous recoveries through stem cell treatments, which are offered by a growing number of unregulated and unlicensed clinics in places such as China, Mexico, South America and even Europe. The clinics have websites which claim to offer stem cell treatment for various diseases such as Alzheimer's, Parkinson's, and stroke.

Clinic websites feature hyped-up marketing claims

These websites would feature glowing testimonials. They also often claim to be doing clinical trials, giving a false impression that they are providing legal services. 

Attracted to these marketing claims, Mr Gass made multiple trips to these clinics, despite the best advice from his family and doctors. These clinics were under the company called Stemedica. Including travel expenses, the total cost had come to nearly US$300,000. 

Tragic Consequence of Stem Cell "Cure"

6 months later he felt a sudden pain in his back, and started to lose his ability to walk. When the doctors examined him, they found that the stem cells had caused a frightening growth to appear in his spine and over a period of a few months, it had almost filled his entire spine. The tumour was still growing with no way to remove it. He is now paralysed from neck down and is wheelchair-bound. 

The experience of Mr Gass is an example of countless of other patients who have suffered tragic consequences from stem-cell treatment in their quest for a cure. Many of these  patients had paid large sums of money to illegal or unethical clinics which promise them cures for all kinds of diseases. Many more patients seek the treatment for promoting health or beauty. 

Stem cell therapy currently remains at an experimental phase. Scientists and doctors say the stem cells may hold enormous promise, but are presently not widely used to treat humans because of the risk that stem cells can divide rapidly and transform to cancer cells. 

This story serves as a cautionary tale for all: If something sounds too good to be true, it is.

Wednesday, April 6, 2016

Feeling The Heat - Recovering From Burns

Healing Skin Burns

Published: ShinMin Daily News 3 April 2016

A 66-year-old man makes a stunning recovery from burns to his face and neck, which he sustained two months ago in a kitchen fire.

"Dr Jean Ho explains...
Burns are classified into:

  • First degree. A sun burn is an example of a first degree burn,
  • Second degree. Scalding injuries are examples of second degree burns. The damage to the skin may result in none to mild scarring.
  • Third degree. Chemical and electrical burns would fall into this category. As there is significant damage to vital structures in the skin including the hair follicles and glands, these burns frequently cause permanent scarring.   
With the exception of first degree burns, specialist treatment and early attention to burn wounds are crucial for improving outcomes. "

Saturday, April 2, 2016

Healing By Nature - Honey

Wound Healing By Nature - Honey

Before the discovery of antibiotics, honey was used on wounds to prevent and treat wound infection. You probably already have this botanically derived therapy right in your kitchen cupboard too!

The use of honey in wound healing dates back to the Sumerians in 2000 B.C.. The high sugar content can dehydrate bacterial cells, while acidity can inhibit growth and division of many bacteria. Honey also has an enzyme, glucose oxidase, that reduces oxygen to hydrogen peroxide, which kills bacteria.

The most potent naturally occurring honey is thought to be Manuka honey. It is derived from the flower of the tea tree bush which has additional antibacterial properties.

More recently, widespread prescription of antibiotics have resulted in the problem of antibiotic resistance and the emergence of hard-to-kill super-bugs such as MRSA (Methicillin-resistant Staphylococcus Aureus).  The use of honey as a wound antiseptic is not only desirable, but highly preferable (Journal of Wound Care, 2004).This is because, since honey is technically not an antibiotic, the use of honey on wounds does not contribute to the problem of antibiotic resistance.

Saturday, March 26, 2016

Be Skin Smart

Learn to recognise the early signs of skin cancer.

  • Examine your skin regularly at least once a month. All areas of the skin should be inspected, including the hands and feet, genital areas, eyes and mouth.

  • Learn the danger signs of skin cancer and see a dermatologist early if you detect ay new or changing moles, freckles or skin growths.

  • Go for regular skin checks by a Dermatologist at least once a year.

  • If you have risk factors for melanoma or skin cancer, you may require more frequent monitoring.

  • Your Dermatologist will use a special tool called the Dermoscope to detect early changes in your skin.

  • Consider the use of photography as an aid to track your moles or skin lesions.

  • Teach your children about the risks of sun exposure and sun burns. Encourage them to apply sunscreen regularly when they are outdoors.

Saturday, March 5, 2016

Be Sun Smart

Overexposure to ultraviolet light is a preventable risk factor for skin cancer and premature skin aging. Keep in mind the following precautions:

  • Avoid peak sunlight hours from 10am to 4pm.

  • Avoid artificial tanning parlors.

  • Apply broad-spectrum sunscreen with SPF of at least 30 regularly and liberally. Reapply every 2 to 4 hours when working or playing outdoors and apply half and hour before swimming.

  • Wear a wide-brimmed hat or sun protective clothing such as long-sleeved shirt and pants. 

Tuesday, March 1, 2016

Beware Of The Stubborn Rash - It Could Be Skin Cancer!

Have you noticed a stubborn scaly rash that simply refuses to go away?

It is important to take note that not all skin cancers are pigmented like moles. Non-pigmented skin cancers such as squamous cell cancer and basal cell cancer are in fact more common than mole cancers.

In the early stages, these cancers may not appear alarming at all. They have been mistaken for eczema or a case of skin allergy.

These skin cancers are linked to chronic or intense overexposure to ultraviolet rays. Some patients who are on long term medications which suppress the body's natural immunity (immunosuppressants) also have increased risk of developing skin cancers.

Thankfully, these cancers are highly curable when detected and treated at the early stage. Therefore, it is very important that any new growth or unusual-looking rash be promptly evaluated by a dermatologist.

Friday, February 19, 2016

Should you sign up for that laser package?

In recent years, a novelty has jumped onto the bandwagon of hyper-consumerism. I am referring to the phenomenon of laser packages.

Clinics offering low-price, express laser treatments have become a common sight.

Creative marketing has also coaxed potential customers into thinking that laser treatments on a frequent basis (daily, or even several times a day) are not only necessary but also highly desirable. Customers are encouraged to sign up for laser packages, even if they do not have any skin problem at all.

This is a disturbing trend.

Patient or consumer? Laser, as a licensed medical device, has been used to address and treat specific skin problems in patients. Each treatment has its accompanying benefits and risks. While the patient receives treatment which is specific to his or her need, the consumer, on the other hand, buys a product, often on impulse. The consumer would not have any more information of the product than what they have heard from advertising campaigns or social media. The consumer may not really need the product or service, but wants it anyway. The consumer cannot fully comprehend the effect that rampant laser treatments would have on the skin.

Encouraging over-consumption. A favourite marketplace gimmick is the sale of packages. A lump sum of money is paid upfront for a pre-determined number of treatment sessions. And since the person buying is not a patient but a consumer, the cost of the package would largely depend on the size of his pocket. Economies of scale is used to sweeten the deal for the customer: the more you buy, the cheaper per treatment it becomes. In the end, the consumer parts with a month's pay on that package. A package that the consumer does not really need, and is unlikely to completely utilize.

Laser abuse. The truth is, more is NOT merrier. Daily laser treatments are excessive, dangerous, and of questionable benefit. Dermatologists do not recommend it. Instead interval of 4 to 6 weeks is routinely advised for safety. Post-laser skin is allowed to heal, and sufficient time to lapse for assessment of treatment outcome. As a medical treatment device, laser exerts profound effects on the skin, even at sub-therapeutic doses. A well-documented complication arising from abuse of laser treatment is skin tone discolouration, uneven pigmentation and subsequent appearance of white patches on the face.

So, before you commit to that laser package, ask yourself, " Do I really need it?"