Dr Jason Pek

Differin (or adapalene) is a type of retinoid (vitamin A derivative product). Purging is not common with Differin use. It is more common to experience some redness, dryness, irritation, burning/stinging sensation or peeling with the initial use of Differin. Should you experience this, it is advisable to use it just 2-3x a week every night while your skin gets used to the treatment. You can also use moisturizers to calm the skin down. Once your skin adapts to the medication, you may then increase the frequency of use to every night.

Hello Wot, Based on your description you may have a condition called tinea versicolor. This is due to a fungal infection and is more common in hot and humid climates and in people who perspire more. After a few weeks of treatment with antifungal creams, the infection may have resolved, but the residual hypopigmentation (white marks) can persist for a longer period, for months. In such an instance, a fungal scraping or culture will help to determine whether there is still active fungus infection.

It appears you have male pattern hair loss. The main cause of this is high DHT (dihydrotestosterone) levels, a type of male hormone. Oral finasteride helps to reduce the amount of DHT. Other options include minoxidil and hair supplements such as viviscal. However these may not reverse your hair loss completely if it is advanced or rapidly progressing, although they will help to slow down the progression. Hair transplant is an option to restore the front hairline. These medications do come with some side effects and it is best to speak to your doctor to understand these better.

Hello Chia, Prescription of Roaccutane (Isotretinoin) is based on your weight. The target dose in the treatment of inflammed acne (especially severe, pus filled acne) is 120mg/kg. While it is tempting to stop isotretinoin use once your acne has cleared up, hitting this target dose will reduce the chance of a relapse in future. For example if you are 60kg, you will need to completed 7200mg of isotretinoin. Depending on the dose that you are taking daily, the treatment duration will vary. Most patients are able to tolerate a dose of 20-30mg/day.

There is no complete cure to eczema. However with good control, the frequency and severity of flares can be reduced to a minimum. There are a few things to take note of. 1. Identifying triggers factors 2. Moisturizers are the cornerstone of eczema management. Regular use of a good moisturizer improves the skin barrier function and helps in retaining moisture. There is no best brand of moisturizer but you may consider some of the more popular brands such as physiogel, atopiclair, ceradan, uriage, cetaphil . Some trial and error is needed to see which suits your skin best.

Just to add on a point, there are other skin conditions that may look like acne. A common example is pityrosporum folliculitis. This is caused by an yeast infection and is commonly seen in those who exercise or sweat alot. This condition commonly affects the chest, back, shoulder but the face is spared. The treatment of this condition is different from acne. Hence it is best to get evaluated by your doctor first to establish the correct diagnosis.

Firstly we need to establish that closed comedones is that correct diagnosis as they are some other conditions that may look similar to the layman such as milia and syringomas. Topical comedolytic treatments such as acid peels and retinoids are generally effective in treatment of comedonal acne. I would suggest switching the retinol to tretinoin. This is a prescription medicine so you will need to see a doctor for this, who will also advise you which concentration to use. Persistent comedonal acne may require physical extraction in addition to the above mentioned treatments.

Hello, Urticaria or hives is a common condition that many people will experience at least once in their life. As Dr Wu has pointed out there many several causes of acute urticaria. These may not be just food allergies, and can include viral infections as well. In most instances, after the acute episode, the urticaria will subside and you will not experience another episode for a long time. However, if you experience recurrent episodes of urticaria or chronic urticaria (>6weeks) then further blood tests or allergy tests may need to be performed.

Hello J,Your picture is not very clear but it does look like post-inflammatory hyperpigmentation (PIH) marks from old acne. Use of topical retinoids such as tretinoin or epiduo may help but they usually take a longer time to work. I prefer to use a combination of bleaching agents (hydroquinone/arbutin) and laser treatment 1064nm wavelength on the spots for quicker results. As Dr Wu also mentioned, PDRN injections into the PIH marks will also speed up the recovery.

Hello AZ,The mole of concern is best treated by surgical excision. This will however leave a linear scar. Other forms of treatment like laser ablation in this case will lead to a high chance of recurrence. Lasers are still an option for flat and small moles.