From dealing with maskne, to anti-ageing tips, and the best skincare regimen.
By Aiden Jewelle Gonzales
Beauty may be more than skin deep, but as any acne-riddled teenager can tell you, our skin still plays a vital role in our overall health, comfort, and confidence. “When patients come in, many are often insecure – they think their skin looks dull, or they have acne problems, and this affects their self-esteem,” Dr. Harpreet ‘Priya’ Boweja, the founder of Pierra SkinCare, concurs. “It’s one of the reasons I love being a dermatologist. After my patients find relief from their skin issues, it boosts their confidence, and that makes me happy.”
Born in Bangkok but raised in Phuket and India, Dr. Priya finished her Bachelor’s in Biomedical Sciences at Rangsit University, before pursuing her medical degree at Thammasat University. “While I always wanted to go into medicine, I had no love of dermatology in medical school,” she reveals with a laugh. “The turning point was when I was doing my internship and I was forced to take the place of the dermatologist who couldn’t come in one day. All I could recognise was eczema – we joke that for derm patients you can only think of three diseases: eczema, eczema, and eczema. It made me realise the importance of the field, and challenged me to learn more to help those patients better. Now I love it, and as a bonus, I know how to take care of my own skin!”
With the advent of maskne, and the debilitating effects that the PM2.5 particulates can have on our skin, good skincare is more vital than ever, and yet it can be overwhelming – what exactly is a good skincare regimen, why is it important, and does all the advice on TikTok have merit? I sat down with Dr. Priya to get her insights on these rash of issues.
Many of us have a general health check up every year, but we don’t see a dermatologist regularly. How often would you recommend we visit our dermatologist?
The main reason you need to see a dermatologist regularly is to screen for cancer, and thus I would recommend annual check-ups. But if you can’t get ready access to a health professional, you can do it yourself with a full-length mirror. Check yourself monthly, or have your partner check for you. Look at all parts of your body – including the palms of your hands, the soles of your feet, and between your fingers and toes – to look for any unusual lesions, moles, or growths.
What should we be looking out for?
We all have moles, but we need to look for any changes in them. The ABCDEs to look out for are:
A: asymmetry; if it’s uneven or if the two sides are not equal
B: borders; if the borders are uneven
C: colour; if there is more than one colour in the lesion
D: diameter; if it grows more than 6mm or is bigger than a pencil eraser E: evolution; if it’s bleeding or crusting, or if anything changes.
If you see any of these, go see a doctor. Other signs include dark spots underneath your fingernails, sores that don’t heal, or ones that come up in your scarred areas, or abnormal growths.
What are some lifestyle changes we can make to achieve healthy skin?
The most important considerations are how you eat, how you sleep, and how you manage your stress.
Firstly, eat the rainbow. Eat as many (natural occurring) colours as you can, because those are the natural anti-oxidants that you can take in. Secondly, eat good fat, like avocadoes, nuts, fish, and olive oil. Thirdly, eat probiotics. Naturally-occurring sources of probiotics include natural yoghurt, kombucha, kimchi, and miso soup. Drink green tea often, which has a lot of antioxidants, and don’t be afraid to add spice to your diet, as it’s anti-inflammatory.
We already know what to avoid – sugar and processed foods. But I believe in moderation, so just cut down and don’t avoid it completely. Opt for minimally-processed, low-glycaemic food; anything God-made. The second thing to avoid is cow’s milk, which is very much known to induce acne and inflammation.
To manage your stress, try to incorporate meditation and mindfulness into your daily routine. Personally, the Calm app has really helped me manage how I respond and react. The last factor is sleep, which is very important. Make sure you go to bed before 11pm, if possible. You can see the effects of a bad night’s sleep on your skin – it’s dull; it doesn’t glow.
A lot of products tout anti-aging qualities, and many have become viral on platforms such as TikTok. What is your professional opinion on popular products such as retinol?
Sunscreen is the best anti-aging product you can use, in terms of prevention and protection. But the best corrective anti-aging product you can use are retinoids. They are Vitamin A derivatives, namely, retinyl esters, retinol, retinaldehyde and retinoic acid. Retinol is an over-the-counter retinoid, and it’s one of most common ingredients in the skincare world. It’s a good option for beginners as it’s efficient, and doesn’t cause much irritation at low concentrations.
Retinol not only helps with anti-aging, but we use it to treat acne as well. What does it do? Retinol addresses signs of skin ageing like fine lines and superficial wrinkles, as well as improves skin tones and texture by increasing skin renewal, boosting collagen and hyaluronic acid production, and decreasing cell degradation.
When using it, use a form that you can easily tolerate. Because it increases cell turnover, initial side effects may include dry and flakey skin, and it may even initially exacerbate your acne. Go slow, use it on alternate days, make sure to moisturise before and after, and use a pea-sized amount. Let your skin adjust, and don’t use any other active ingredients.
What is a good daily skincare regimen?
The most important thing is to never skip sunscreen! 365 days a year, including cloudy days. Use a brand that you’re happy to use every day of the year.
A minimal regimen, for lazy people – including me – which takes 2-5 minutes is: in the morning, use a cleanser, moisturise, then add sunscreen. If your face is too dry, you can just rinse it with water in the morning then use moisturiser and sunscreen. In the evening, use a cleanser, moisturise, then add retinol. That’s it! You don’t need to use so many active ingredients. Less is more! And keep in mind that any new skincare regimen will take at least three months for you to see effects.
People tend to over-exfoliate; once a week is enough, or 2-3 times if your skin tolerates it. I would recommend AHA, BHA, or PHA-based exfoliating creams as they’re gentler, and physical exfoliators, with the scrubs, can abrade your skin and even cause more hyper-pigmentation.
It’s the time of year when the smog and air pollution gets worse. How does this affect our skin, and how can we prevent skin damage from this?
In the short-term, air pollution can cause you allergy and acne flare- ups. It also makes your skin oilier so you’re more prone to break-outs. In the long term, it can affect your skin as much as overexposure to the sun, or smoking, and can make you age faster, contributing to wrinkles, dark spots, and melasma.
Firstly, avoid going outside while the pollution is too high, but if you must, wear a mask and protective clothing. Avoid exercising outside, use an air purifier, use indoor plants that help purify the air, and whenever you come back home, as soon as you can, cleanse your skin thoroughly.
Secondly, consider antioxidant serums. If you have the time and budget, you can add Vitamin C or Vitamin E serums to your regimen; anything with anti-oxidants. They help combat the free radicals produced by the pollution in the air. But just stick to one and give it time to work.
Because of the mask mandates, many of us are suffering from ‘maskne.’ What is your advice?
What masks do to your skin is, firstly, cause irritation from the mask itself. Then you sweat inside them, and it creates a humid environment from your breath. When you speak, saliva accumulates inside your mask, and all of that makes your skin prone to breakouts.
Avoid topping layers of skincare in that area while you’re wearing a mask, and avoid makeup under your mask. Just apply one layer of skincare, such as sunscreen, and even if that is causing you to breakout, skip all the skincare under your mask. Just wear it outside, and then later at night, you can slather on moisturising creams, etc. Avoid going into crowds and hot humid areas if you can, and any time you can take a break from your mask, take it off when you’re alone. Choose makeup or skincare that is oil-free, noncomedogenic, and non-acnegenic, and wear a cloth mask.
Remember, there’s no miracle skincare that can treat acne. You’ll have to go for a consultation because you’ll need individualised care. All acne medication will come with side effects as well, so you’ll need to see your dermatologist.
What are some common skincare misconceptions that you’d like to address?
People think that sunscreen should only be used on sunny days or only when you’re spending time outdoors. This is wrong! Because we’re not in a dungeon, through the windows at home, or even in the car, you’re exposed to radiation. If you’re doing outdoor activities, make sure you reapply your sunscreen every 2-3 hours. Moreover, using sunscreen won’t make you Vitamin D deficient. We’re all under- applying sunscreen. You need two fingertips worth just for your face, including your ears.
People also tend to over-wash and over-exfoliate. They think that acne is because of grease and dirt. But over-washing will actually disturb the skin biome. Use a gentle cleanser 2x a day, and one that has a pH of around 5.5. People think that the drier and tighter your skin feels, the cleaner it is, but that’s not true. Even if your skin is still slippy, that’s good – that means that the natural oils are still there.
Don’t squeeze or pop your acne. It exacerbates it, making it more inflamed, and making the scars worse. Leave it alone, or use a silicone acne pad. Acne gel isn’t for longterm use! It’s an antibiotic, so if you apply it often, you’ll become progressively more resistant to it.
Finally, acne is not a cosmetic condition, it’s a medical condition. It needs to get attention because if it’s left untreated long-term, it can lead to scarring which will cost you a lot more money and time to treat. If you have moderate acne, see a doctor – I promise, we know what we’re doing!