News -
How to identify your acne type, Occurrence of Acne in Singapore
Acne is a chronic inflammatory disease of prolonged course with recurrences and relapses. It affects about 650 million people worldwide, making it the 8th most common disorder globally [1, 2].
In Singapore, acne is the most common skin problem among adolescents and some adults.
Adults and Adolescent Acne Occurrence in Singapore
Although most commonly occurring in teenagers, acne can persist or occur for the first time in adulthood. National Skin Centre Singapore study reported that 41% of adults seeking acne treatment had experienced acne since teenagehood.
In another research, acne occurs in at least 88% of adolescents from 13 to 19 years old in Singapore. The more common type of acne among the average teenagers are comedones [3].
The study showed:
- Mild acne occurs in 51.4% of adolescents in Singapore
- 40% of local teenagers have moderate acne
- 8.6% of them suffer from severe acne
The paper further noted that teenagers expressed psychological distress over acne and believed that hormonal factors, diet and hygiene were essential factors in causing acne.
Female acne vs male acne occurrence in Singapore
According to The Journal of Clinical and Aesthetic Dermatology, females experience acne more than males due to hormonal fluctuations which can cause increased oil production in the pores, during these periods:
- before the menstrual cycle
- birth control pills consumption duration
- polycystic ovary syndrome (PCOS) sufferers
- during pregnancy
- around menopause
| Female acne in Singapore | Male acne in Singapore | |
|---|---|---|
| Experience acne in adulthood | 22% of adult women [4], especially those in their 20s and 30s | Less than 5% of adult men [4] |
| Mild adult acne | 20.3% of females [5] | 8.6% of males [5] |
| Acne severity in adults | 30.4% of females [5] | 48.6% of males [5] |
| Occurrence of adolescent acne in Singapore | 38.8% of female teenagers [6] | 61.3% of male teenagers [6] |
| Occurrence of adult acne in Singapore | 69% of female adults [6] | 31% of male adults [6] |
| Acne location | Females aged 14 to 50 can develop a deeper type of acne on their face and neck, while the nose, chest, and back are mostly spared. [4] | In addition to the face and neck, males are more susceptible to acne on the chest, back, upper arms, and shoulders. [7] |
The above studies indicated that more males than females suffered from acne during adolescence and more females than males suffered from acne during post-adolescence.
How to identify different types of acne that occurs in Singaporeans
Comedonal Acne
| How comedonal acne is formed |
 Comedones develop when hair follicles are blocked by sebum (skin oil) and dead skin cells. |
| What stage of acne is comedonal acne? | Stage 1: Non-Inflammatory Acne (Comedones) |
| What does comedonal acne look like? | Blackheads and whiteheads |
| Types of Comedones |
Open Comedones (Blackheads) happen when the oxidised trapped oil and dead skin cells in the clogged but opened pore into a blackhead. Closed Comedones (Whiteheads) occur when the clogged pore remains closed, causing tiny bumps to rise from within the skin. |
| Causes of Comedones | Clogged pores, hormonal changes, diet, irregular facial to remove skin impurities, improper skin care. |
| Who is likely to get comedones? | Men and women with oily skin type |
| Treatment of comedones | Skin care products containing salicylic acid or benzoyl peroxide as an active ingredient, topical retinoids, and/or professional extraction are also available. |
| How to prevent comedones | Skincare should include gentle ingredients, regular deep cleansing, consistent moisturising with a light, non-comedogenic moisturiser, and good face hygiene. |
| Is comedone painful? | Typically not painful |
| Is comedone itchy? | It is not usually itchy unless the comedone becomes inflamed or infected. |
Inflammatory Acne
| How inflammatory acne is formed |
 Develops when clogged pores become inflamed due to bacterial infection and the body's immune response |
| What stage of acne is inflammatory acne? | Stage 2 to 3: Inflammatory Acne |
| What does inflammatory acne look like? | Red, swollen, and painful. Contains pus, dead skin cells and excess oil. |
| Types of inflammatory acne |
Grade 1 Acne (Mild) Whiteheads, blackheads, papules and/or pustules. Grade 2 Acne (Moderate) Comedones, papules, and/or few pustules Grade 3 Acne (Moderately severe, Inflammatory Acne) Papules, pustules, inflamed nodules Grade 4 Acne (Severe Acne, Nodulocystic) Huge, painful, and inflamed pustules and nodules, with acne scarring risk |
| Causes of inflammatory acne | Excess oil, dead skin cells, and bacteria, leading to an infection within the skin. |
| Who is likely to get inflammatory acne? | Commonly affect teenagers, young adults, and adults especially women. |
| Treatment of inflammatory acne | Use skin care products containing salicylic acid, benzoyl peroxide, or retinol as their active ingredient and/or professional extraction with deep facial cleansing. |
| How to prevent inflammatory acne | Skincare should include gentle ingredients, regular deep cleansing, consistent moisturising with a light, non-comedogenic moisturiser, and good face hygiene. Manage stress healthily and mindfully. |
| Is inflammatory acne painful? | Often painful due to the inflammation and swelling |
| Is inflammatory acne itchy? | Deep, red, and painful due to inflammation and skin irritation. |
Cystic Acne
| How is cystic acne formed? |
 Bacterial-infected clogged pores that have deep swelling in the skin, thus developing cystic acne. |
| What stage of acne is cystic acne? | The most severe stage of acne |
| What does cystic acne look like? | Painful, inflamed, pus-filled, deep cysts |
| Causes of cystic acne | Hormonal changes, genetics, excessive oil production, bacteria infections, humid weather, not cleansing grime and sweat off skin thoroughly |
| Who is likely to get cystic acne? | More common in teenagers and young adults, and those with a genetic predisposition to acne. |
| Treatment of cystic acne | Recommended to have a tailored acne management plan with a physician who has varied experiences in treating acne in men and women in Singapore |
| How to prevent cystic acne | Skincare regime should include regular deep cleansing and good face hygiene. Manage stress healthily and mindfully. |
| Is cystic acne painful? | More painful and inflamed as cystic acne is developed deeper in the skin. |
| Is cystic acne itchy? | This is possible due to its deep-seated inflammation and potential for infection. |
Nodular Acne
| What is nodular acne? | A severe form of acne |
| How nodular acne is formed | Typically don't form a whitehead or blackhead. |
| What stage of acne is nodular acne? | A severe form of acne |
| What does nodular acne look like? |
Nodular Acne Large, painful lesions that develop deep within the skin. Nodulocystic Acne A severe form of nodular acne that includes both nodules and cysts. Acne Conglobata A rare and severe form of nodulocystic acne, often involving interconnected nodules and deep abscesses. Acne Fulminans A very rare and severe form of cystic acne. An ulcerated, nodular, and painful acne that can bleed, crust over, and lead to significant scarring. |
| Causes of nodular acne | Clogged pores, overactive sebum glands, and bacteria infection |
| Who is likely to get nodular acne? | Men and women who are experiencing hormonal changes such as puberty, menstruation or on birth control pills. |
| Treatment of nodular acne | Recommended to go for medical intervention and may involve oral and topical medications, cortisone injections or extraction. |
| How to prevent nodular acne? | Skincare should include gentle ingredients, regular deep cleansing, consistent moisturising with a light, non-comedogenic moisturiser, and good face hygiene. Manage stress healthily and mindfully. |
| Is nodular acne painful? | Often very painful and tender |
| Is cystic acne itchy? | Nodular acne can cause an itching sensation |
Acne treatment in Singapore at Amaris B. Clinic by Dr Ivan Puah
The different hormones make acne conditions unique, requiring a special acne treatment plan. It's essential to create a clear strategy that targets these hormonal factors to help manage the condition effectively while reducing the chances of acne scarring [4].
We welcome you to have a private consultation with Dr Ivan Puah, our medical director, who has almost 20 years of experience treating skin conditions and acne issues in teenage and adult men and women. He also holds a Graduate Diploma in Family Practice Dermatology.
FAQ on Acne in Singapore
What country in Asia Pacific is acne occurrence most common?
The prevalence of acne is:
- 68.1% in Malaysia
- 66.6% in India
- 62.2% in Portugal
- 57.8% in several European countries
- 55.9% in Pakistan
In China, 10.4% of students complain of moderate to severe acne [8, 9, 10, 11, 12, 13].
Why are Asians so prone to different types of acne?
Research has indicated that Asian skin may produce more oil compared to Caucasian skin, which could raise the risk of developing acne vulgaris.
The higher sebum production in Asian skin is often attributed to the warmer climates in which many people in these regions live.
These outbreaks often manifest as keloids and hardened bumps. Unfortunately, if left untreated, this condition can lead to scarring from acne.
Can Singapore's humid weather cause or worsen acne?
Dreno et al. have proven that hot weather is also a risk factor for acne. Acne occurrence was significantly more common and regularly experienced in hot or humid regions [4], like Singapore's humid weather.
What kills acne bacteria?
Benzoyl peroxide acts as an antiseptic and has an anti-inflammatory effect. It can significantly lower the bacteria level on the skin's surface and successfully remove blackheads and whiteheads. Benzoyl peroxide comes in either cream or gel form and should be applied topically once or twice a day.
How much is acne treatment in Singapore?
The costs of acne treatment may differ depending on the treatment offered at different medical practitioners, acne severity, length of treatment etc.
What antibiotics are used for acne in Singapore?
Doxycycline, erythromycin and minocycline are first-line management treatments for moderate or severe acne, including Isotretinoin. The prescribed antibiotics should be taken according to the doctor.
How to identify your acne type, Occurrence of Acne in Singapore