Question: I am a 19-year-old female with very sensitive skin. For the past five years, my upper arms, face, upper chest and back area have ugly scars and pimple-like dots. I am afraid to wear anything apart from a T-shirt.
The blemishes tend to get itchy when the weather is hot or when the room is dusty. Some of them can be squeezed out like blackheads. I have tried Chinese medicine, antibiotics given by Western doctors, different cleansers and lotions.
Nothing has worked. Please advise on what else I can do.
Answers: You have mentioned three skin conditions: Sensitive skin, ugly scars and pimple-like dots.
Sensitive skin has many causes, such as a genetic predisposition to heightened sensitivity.
Usually, this affects people with allergies, such as asthma, eczema and a "sensitive nose".
The problem can also be attributed to the skin barrier being damaged by harsh cleansers and frequent washing, or inflammation of the skin from using certain topical creams, either prescription ones or those bought over the counter.
People with sensitive skin commonly experience itchiness in hot and dusty environments.
You should consult a dermatologist to determine the cause of your skin sensitivity and to learn how to manage it.
Ruling out allergies
Sometimes, a patch test is performed to rule out allergies to common substances that come into contact with the skin.
In the meantime, use a hypoallergenic cleanser that is free of fragrance and colouring - and if possible, free of preservatives and surfactants too.
Scars can refer to true scars, which are either depressed into the skin or elevated; or pigmentation changes.
For true scars affecting the areas you have mentioned, the most likely cause of them is acne.
Depressed scars may be improved by a variety of interventions. Examples are microdermabrasion, chemical peels and laser treatment.
Your dermatologist will be able to examine the nature of your depressed scars and discuss the best ways to get rid of them.
Elevated scars, on the other hand, can be treated with steroid injections which need to be administered on a regular basis.
Meanwhile, pigmentation changes can result from the resolution of active acne, inflamed skin (resulting from skin sensitivity) or from conditions such as melasma (skin discolouration on areas of the face that are exposed to the sun).
Your dermatologist will be able to determine the most likely cause and recommend the most appropriate treatment for you.
Cause of black bumps
Your "pimple-like dots" may be linked to acne, which is why some lesions can be squeezed out like blackheads. Or they may be due to a condition of the hair follicles called keratosis pilaris.
Keratosis pilaris is a very common genetic condition that shows up as uniform black bumps distributed primarily on the upper arms, back and thighs. Sometimes, the marks appear on the face, mimicking acne.
It is the result of excess keratin blocking the hair follicles on the skin surface.
Treatment is difficult, but some creams that contain ingredients such as urea and fruit acids may improve the skin's appearance.
You must, however, be careful of using creams that are too strong, given that you have sensitive skin.
Dr Derrick Aw is a senior consultant at the University Dermatology Clinic at National University Hospital
This article was first published on June 26, 2014. Get a copy of Mind Your Body, The Straits Times or go to straitstimes.com for more stories.