Should I go to an aesthetic clinic or the NSC for acne treatment in Singapore?

Doctor's Answers 3

I wouldn’t say that either is particularly superior in terms of treatment for acne per se. Everyone has their own practices pertaining to the use of isotretinoin or spironolactone.

For instance, I have a lower threshold for using isotretinoin for cystic acne. My patient had suffered very severe acne and was kept on 6 months of doxycyline by her dermatologist, and finally plucked up the courage to visit me on a friend’s recommendation. Isotretinoin has solved her issue, and she can finally reduce the thick makeup and walk out with her confidence.

It boils down to the doctor you are seeing really, so I would suggest for you to look around for someone you have heard good reviews about. I would also like to entreat you to be compliant to medications to get the maximal effect, as well as for you to use the right products to augment the medications.

PS it’s not true that private clinics use only branded drugs, as I have found that the generic Isotretinoin had less complaints from my patients.

Wishing you the best!

In a nutshell, I think that the single most important factor is that the doctor takes a genuine interest in you, and treating your condition. Other considerations are secondary.

Of course, as Dr Winston pointed out, it’s very important that you’re compliant to the treatment regime as well.

From your brief history, I saw that the senior consultant at NSC thinks your case not serious enough for most doctors to start you on oral isotretinoin. I hope to remind you of the undesirable effects of oral isotretinoin, which include dry lips/mouth, skin peeling and itch, as well as risk of birth defects if pregnant while on the drug.

I use oral isotretinoin on male patients fairly regularly, but with ladies of childbearing age I prefer other medication, proper skincare and also laser treatments.

Laser treatments are seldom used in NSC to treat acne, because only the senior doctors there have access to the laser. Laser treatments are also very proven in acne treatment, with the erbium-glass laser shown to clear up to 40% of acne spots in just one treatment, and achieving nearly 100% clearance with long term control after an average of four sessions in one clinical study. This was active inflammatory acne and not just mild acne.

Please note that even spironolactone has possibility of systemic side effects like giddiness and blood potassium level disturbance.

Hence, I would recommend you to seriously consider laser treatments which provide other skin benefits (scar lightening) and which only treat the oil glands on the areas treated (unlike isotretinoin that dries up the entire body).

Hope this helps!

Similar Questions

How should I prevent Post-Accutane relapse, and advise on long term maintenance isotretinoin dose?

Hi S – 6 years is a long time to be on a course of isotretinoin, unless you were specifically prescribed a low dose, long term “maintenance” isotretinoin regime by your doctor. If you’ve been compliant to the dosage regime (at 120 mg/kg), 85% of patients only need one course to achieve complete remission of acne – this would take 4 – 6 months of treatment, depending on the dose administered. Relapse rates in patients after treatment with oral isotretinoin vary between 10% and 60%.

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Is Isotretinoin a permanent fix for acne?

I agree with Dr Winston Lee. Oral Isotretinoin is one of the most effective treatments for cystic acne. Through my experience with oral isotretinoin, most patients do not have a recurrence after their first course of Isotretinoin. And even if they do have a recurrence, it is usually milder. You should consider other adjunct treatments like chemical peels, lasers and hydrafacial to reduce comedonal acne and clogged pores.

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