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Face & Skin

Cystic Acne Treatment in Singapore

Last Reviewed: 28 Oct 2026

Cystic acne is a severe inflammatory skin condition characterised by deep, fluid-filled lesions that form within the deeper layers of the skin rather than at the surface. In Singapore’s hot and humid tropical climate, high temperatures and humidity may increase sweat and sebum production, which can contribute to follicular congestion and may worsen deep breakouts. Managing cystic acne is typically guided by a structured clinical assessment rather than over-the-counter spot treatments.

Because cystic lesions sit deep within the skin tissue, early professional assessment is often important to help control active inflammation and may reduce the risk of permanent structural damage. Understanding how cystic acne is diagnosed, how it differs from other lesion types, and what medical options are available can help patients navigate their treatment pathway safely.

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https://www.idsclinic.com/wp-content/uploads/2026/10/close-up-of-skin-with-blemishes-and-imperfections-2026-09-23-19-09-49-utc-1-scaled.jpgCystic Acne Treatment in Singapore

What is Cystic Acne?

Cystic acne is an inflammatory form of acne vulgaris that originates deep within the dermis and subcutaneous tissue. It can develop when a hair follicle becomes severely congested, causing the follicular wall to rupture beneath the skin surface. This rupture releases trapped oil, keratin, and bacteria into the surrounding tissue, triggering an intense immune response that may form a painful, fluid-filled sac.

This depth distinguishes cystic acne from superficial breakouts:

Epidermal Lesions: Comedones (blackheads and whiteheads) remain on the outer skin layer without significant inflammation.
Dermal Lesions: Papules and pustules involve moderate inflammation near the surface.
Deep Dermal / Subcutaneous Lesions: Cysts and nodules extend deep into the dermis, creating painful, long-lasting swelling that carries a higher risk of structural scarring.

Because over-the-counter topical products act mainly on the outer skin layer, they may have limited effect on deep cystic lesions, which is why medical assessment is often advised.

What are the Different Types of Acne?

Accurate identification of lesion depth and characteristics is important when selecting a treatment plan.

Acne Subtype	Lesion Depth	Key Clinical Features	Scarring Risk
Comedonal	Superficial (epidermis)	Blackheads and whiteheads; non-inflammatory clogged pores	Low
Papulopustular	Mid-dermis	Red, raised papules and pus-filled pustules; mild to moderate inflammation	Low to Moderate
Nodular	Deep dermis	Firm, solid, painful lumps without a fluid centre	Moderate to High
Cystic	Deep dermis to subcutaneous tissue	Soft, fluid-filled, painful sacs; severe inflammation	High

Scarring risk is a general guide and varies between individuals.

While nodular and cystic acne are frequently grouped together as nodulocystic acne, their internal structure differs. Nodules are firm, solid tissue masses, whereas cysts are fluid-filled sacs that can rupture easily and may carry a higher risk of dermal tissue damage and scarring.

Additionally, conditions like fungal acne (pityrosporum folliculitis) can resemble inflammatory breakouts but stem from yeast overgrowth rather than bacteria. Because treatments differ, an accurate assessment is important when evaluating widespread breakouts, including truncal and back acne.

young woman looking at reflection in mirror 2026 09 24 08 17 19 utc 1 scaled

What Causes Cystic Acne?

Cystic acne develops through four interconnected biological mechanisms:

Excess Sebum Production: Androgen hormones stimulate the sebaceous glands to produce high volumes of sebum (skin oil).
Follicular Hyperkeratinisation: Skin cells lining the follicle shed abnormally fast, clumping together with excess oil to block the pore opening.
Bacterial Proliferation: Cutibacterium acnes (C. acnes) can multiply rapidly within the anaerobic, oil-rich environment of the blocked pore.
Inflammatory Cascade: The immune system responds to bacterial growth and follicular rupture by sending white blood cells to the area, creating severe, deep-seated swelling and pus.

Hormonal fluctuations can drive this pattern, particularly in adult women. Elevated androgen activity may keep sebum synthesis high, contributing to persistent breakouts along the jawline, chin, and lower face. Genetic predisposition, high-glycaemic diets, and Singapore’s persistent tropical humidity may further contribute to follicular blockage, although the evidence for individual factors varies.

What are the Symptoms of Cystic Acne?

Cystic acne presents with distinct clinical symptoms that differentiate it from mild surface pimples:

Large, soft, fluid-filled lumps located deep beneath the skin surface.
Throbbing pain or tenderness, even when the lesion is not touched.
Lesions that may linger for weeks or months in the same location rather than resolving quickly.
Deep red or purplish discolouration over the swollen area.
Dark marks or structural depressions that may remain long after the active swelling subsides.

When Should You See a Doctor for Cystic Acne?

Some patients wonder whether severe acne linked to hormonal issues requires a consultation with a urologist or an endocrinologist. A urologist focuses on the urinary tract and the male reproductive system, so is generally not the appropriate specialist for managing skin breakouts. Cystic acne is a dermatological condition, although an endocrinologist may be involved where an underlying hormonal condition is suspected.

You may wish to seek evaluation from a doctor under the following circumstances:

Breakouts consist of deep, painful, fluid-filled cysts that do not improve with several weeks of over-the-counter care.
Breakouts are leaving depressed scars or persistent dark marks.

Breakouts are accompanied by signs such as irregular menstrual periods or sudden severe inflammation, which may warrant a more comprehensive medical assessment.
Lesions spread extensively to the chest, back, and shoulders.

How is Cystic Acne Diagnosed?

Diagnosis begins with a thorough clinical assessment. Clinicians visually examine lesion depth, density, and anatomical distribution, using standardised frameworks like the Global Acne Grading System (GAGS) to establish a baseline severity score.

The clinician will also review:

Your complete medical, medication, and skincare history.
Prior treatment attempts and therapeutic responses.
Existing structural tissue damage or early scarring markers.

Blood tests are generally reserved for specific cases, such as checking baseline liver function and lipid levels before starting certain oral medications, or assessing hormonal parameters when an underlying endocrine disorder is suspected.

What are the Available Options for Cystic Acne Treatment?

Managing cystic acne often involves a combination of oral medication, targeted topicals, and procedural support, depending on the individual.

Oral Medications

Because cystic lesions sit deep within the dermis, oral (systemic) therapy is often used as a core part of treatment:

Oral Retinoids: An oral retinoid may be considered in suitable candidates with severe or persistent acne. It may help reduce sebaceous gland size, normalise cell shedding, and lower bacterial activity. Courses commonly run for several months (often around 4 to 8 months, depending on dose and individual response) under medical supervision. Oral retinoids can cause birth defects, so pregnancy must be avoided during treatment and for at least one month afterwards, and female patients are counselled on pregnancy prevention. Clinicians typically arrange baseline blood tests, including liver function and lipid levels, before starting. Common side effects include dryness of the skin and lips, increased sun sensitivity, muscle aches, and temporary hair loss. Clinical protocols are detailed in the AAD guidelines of care for the management of acne vulgaris.
Oral Antibiotics: Antibiotics (e.g., doxycycline) may be used for a limited period, usually alongside a topical treatment, to help control inflammation while long-term management takes effect.
Hormonal Therapies: Hormonal therapies may help regulate androgen-driven oil production in suitable female candidates, after a doctor has reviewed the risks and suitability.

Topical Prescription Treatments

Prescription and non-prescription topicals typically play a supporting role by managing surface bacterial load and helping prevent new follicular blockages. Topical retinoids, benzoyl peroxide, and topical antibiotics are common options.

Corticosteroid Injections and Procedural Options

Intralesional Corticosteroid Injections: For isolated, painful cysts, a doctor may inject a very dilute corticosteroid directly into the lesion, which may help reduce swelling and pain within days. Possible side effects include temporary or, occasionally, longer-lasting skin thinning or lightening at the injection site.
In-Clinic Procedures: Salicylic or glycolic chemical peels may help clear superficial congestion. Laser and light-based therapies are sometimes used alongside medical treatment, although evidence for their use as standalone acne treatments is limited and multiple sessions may be needed. Individual results vary.

close up of woman s face with acne 2026 09 22 11 41 13 utc 1 scaled

What are the Complications of Untreated Cystic Acne?

The primary long-term complication of deep cystic acne is permanent dermal scarring. When deep inflammation damages the surrounding dermal matrix, healing often results in structural change:

Atrophic Scars: Depressions caused by loss of collagen. Subtypes include ice-pick (narrow, deep pits), boxcar (broad depressions with sharp edges), and rolling scars (undulating texture).
Hypertrophic Scars: Raised, firm tissue caused by excess collagen production during healing.
Post-Inflammatory Hyperpigmentation (PIH): Lingering dark spots caused by temporary excess melanin production at the site of inflammation.

Stabilising active inflammation is generally recommended before beginning procedural revision. Clinicians address active breakouts first before starting acne scar laser treatment or broad acne scar treatments, as resurfacing skin while new cysts form may produce less predictable results, a principle supported by literature on acne scarring.

How Can You Prevent Cystic Acne and Scarring?

While deep hormonal breakouts often benefit from medical treatment, daily habits can support skin barrier health and may reduce the risk of complications:

Avoid Picking or Squeezing: Attempting to extract deep cysts at home may push infected material deeper into the dermis, which can increase inflammation, tissue damage, and scarring risk.
Gentle Cleansing: Cleanse twice daily with a gentle, non-comedogenic cleanser. Avoid harsh scrubbing, which can irritate inflamed skin.
Daily Sun Protection: Apply a broad-spectrum sunscreen daily. UV exposure can darken existing post-inflammatory hyperpigmentation.
Post-Exercise Care: Change out of damp clothing promptly after exercise, as sweat that stays on the skin may contribute to clogged pores.

Conclusion

Cystic acne is a severe form of inflammatory acne that often benefits from a clinically grounded treatment strategy, which may include oral medication, rather than superficial skincare changes alone. By addressing sebum overproduction, bacterial growth, and localised inflammation through prescription oral therapies, topicals, or procedural interventions, many patients can better manage active breakouts and reduce the risk of permanent scarring, although individual results may vary. Early clinical evaluation may help support a tailored treatment plan aligned with your specific skin presentation and suitability.

Frequently Asked Questions

Can cystic acne go away on its own?

While individual cysts may eventually subside, the underlying biological mechanisms driving them often persist. Without medical management, recurring breakouts may cause cumulative dermal tissue damage and permanent scarring.

Is cystic acne treatment painful?

Many patients tolerate medical treatments well, though experiences vary. Cortisone injections typically involve a brief sting, and laser or light therapies may cause mild heat sensations. Your doctor will discuss comfort options prior to any procedure.

How long does it take for cystic acne to clear with treatment?

Many patients notice initial improvements within about 6 to 12 weeks of starting systemic therapy, with more marked improvement over 3 to 6 months, though individual results vary. Patients on oral retinoids typically complete a course lasting several months, commonly around 4 to 8 months, depending on dose and response.

Can I wear makeup during cystic acne treatment?

Many patients can, provided they choose non-comedogenic, oil-free formulations. Heavy, occlusive cosmetics are best avoided during active inflammatory flares or immediately following in-clinic procedures, and your doctor can advise when it is suitable to resume makeup.

Our Doctors

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Dr. SK Tan Dr. Ben Yim Dr. Michelle Wong Dr. Vivian Yong Dr. Sean Lim Dr. Roy Soo VIEW ALL

Dr. SK Tan

Special Interest

Hyper-pigmentation
Anti-Aging
Acne
Acne Scarring
Ingredient Studies

Dr. SK Tan

Dr Tan graduated in 1971, with a Bachelors of Medicine (MB) and a Bachelors of Surgery (BS) from the University of Malaya. Dr Tan’s interest in dermatology led him to train at the St John’s Institute of Dermatology in London in the 1970s and he has since been focused in the field of aesthetic dermatology.

MBBS
Diploma in Venereology (University of London)
Diploma in Dermatology (University of Wales)
Diploma in Cosmetic Science (UK)
Master of Business Administration
Fellow of the American Academy of Dermatology (FAAD)

He is a member of numerous medical associations, including the American Academy of Dermatology, the International Society of Cosmetic Laser Surgeons, and the International Academy of Cosmetic Dermatology. Dr Tan was one of the first local doctors to be certified by the American Board of Anti-Aging Medicine. His personal interest in pigmentary disorders and acne has also led him to become an International Member of the Pigmentary Disorders Society of India, the Asian Society of Pigment Cell Research, and the American Acne and Rosacea Society (AARS).

Dr Tan’s work has led him to be invited to speak at numerous international conferences in the US, Europe and throughout the Asia Pacific region. He is a co-editor of “Handbook of Cosmetic Microbiology”, a reference book published by Marcel Dekker, and his papers have been published in the Journal of Cosmetic Dermatology, International Journal of Dermatology, Journal of the European Academy of Dermatology and Venereology, Journal of Cosmetic and Laser Therapy, and Expert Review of Dermatology, and has contributed a chapter in the reference book ‘Pigmentary Disorders: A Comprehensive Compendium’.

Special Interest

Hyper-pigmentation
Anti-Aging
Acne
Acne Scarring
Ingredient Studies

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Dr. Ben Yim

Special Interest

Anti-aging
Hyper-pigmentation
Body-Contouring
Fat Reduction

Dr. Ben Yim

Dr Yim graduated from Monash University in Australia with a Bachelor of Medicine and Bachelor of Surgery degree. He has also earned a Master of Science in Clinical Dermatology from the University of London and more recently in Non-Surgical Facial Aesthetics from Anglia Ruskin University in UK, as well as a Graduate Diploma in Family Physicians in National University of Singapore.

M.B.B.S (Monash University) 1994
Diploma Practical Dermatology (University of Wales College of Medicine) 1998
MSc. Clinical Dermatology (University of London) 1999
MBA (University of Chicago) 2011
MSc Non-Surgical Facial Aesthetics (Anglia Ruskin) 2018
GDFM (NUS) 2019

Dr Yim has been practicing aesthetic medicine in private practice since 2000. The former director of Clinical Aesthetics & Laser Centre has been offering a wide armamentarium of aesthetic services including Botulinum Toxins, fillers for facial enhancement, skin tightening, fractional lasers, threadlifts, and non-invasive body contouring treatments.

As a trainer for Allergan Medical Institute in Singapore, Dr Yim has been invited to speak and train for numerous aesthetic workshops and conferences including “The Advanced Facial Anatomy and Injectables Workshop”, Botulinum Toxins and Filler injectable training workshops organized by Allergan, “The Singapore Disease Conference 2008” and “1st International Conference on Healthcare Transformation 2008” and Forum for Professional Self-regulation jointly organized by the SingHealth Centre for Health Services Research and the NUS Medical Society, to name a few.

Dr Yim comes from a family of four doctors, all in private practice in family medicine. Despite the move into full-time aesthetic medicine, Dr Yim has also taken an interest in family medicine pursuing a Master degree in Medicine in Family Medicine in NUS in which he hopes to complete in 2020.

Outside of his profession, Dr Yim also actively participates in social projects such as tattoo laser removal for prison inmates and teenage delinquents. For leisure, he enjoys golf, reading, playing the piano and running – he has participated in several half-marathons.

Special Interest

Anti-aging
Hyper-pigmentation
Body-Contouring
Fat Reduction

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Portrait of Dr Michelle at IDS Clinic Singapore

Dr. Michelle Wong

Special Interest

Acne
Acne Scarring
Focused Ultrasound Lifting
Skin Brightening
Cryo based Treatment

Dr. Michelle Wong

Dr Michelle Wong graduated from The University of Melbourne, Australia with a Bachelors of Medicine, Bachelors of Surgery and Bachelors of Medical Science. She obtained her post-graduate Diploma in Clinical Dermatology with Distinction from the Queen Mary University of London, and holds a Diploma in Aesthetic Medicine with the American Academy of Aesthetic Medicine (AAAM).

MBBS from The University of Melbourne, Australia
Diploma in Clinical Dermatology from Queen Mary University of London
Diploma in Aesthetics Medicine from American Academy of Aesthetic Medicine
Diploma in Cosmetic Science (UK)

In aesthetics, Dr Wong believes she has discovered her ikigai – the intersection of what she is both good at and loves doing. Her preferred tools of the trade are injectables such as Botulinum Toxins & fillers, which she wields with finesse and intuition - often achieving what her patients desire but cannot express through words. Out of passion and interest, she regularly attends conferences and workshops, eager to learn about the latest treatments and techniques to further hone her craft.

Combining the science of medicine with the art of beauty, Dr Wong provides an honest consult to help her patients achieve their skincare and beauty goals. She believes in understated elegance – a focus on a less-is-more approach - and works to enhance her patients’ natural features whilst instilling self-confidence. Her reassuring and gentle approach puts patients at ease allowing her to achieve maximum results through safe and effective procedures.

In her free time, Dr Wong enjoys taking long walks with her dog at the park. Her family praises her inner domestic goddess that can whip up an impressive variety of home-cooked meals. She is also active in church medical missions and believes in contributing back to society through her God-given gifts and talents.

Special Interest

Acne
Acne Scarring
Focused Ultrasound Lifting
Skin Brightening
Cryo based Treatment

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Medical professional portrait taken in clinic environment

Dr. Vivian Yong

Special Interest

Acne
Acne Scarring
Fillers
Neurotoxin Injection - Botulinum Toxins
Face Lifting
Facial Enhancement

Dr. Vivian Yong

Dr Vivian Yong graduated from National University of Singapore in 2006, and has an experience of more than 10 years in Aesthetics. She has also accumulated extensive surgical skills and experience from various rotations in general surgery, ophthalmology, and ENT.

MBBS
GDFM

Dr Vivian has always had a natural inclination towards science subjects and this led her into medicine. During her medical graduate days, she developed a keen interest in Aesthetics and Skincare, and she believes that Aesthetics is one area that allows her to help a patient achieve their ideal artistic expression based on science. While Dr Vivian is always keen to accommodate her patients’ needs, she ensures that their welfare remains the utmost priority. This is why Dr Vivian is loved by her patients for always being meticulous and attentive to details.

Dr Vivian’s eye for beauty goes beyond aesthetics. Outside the clinic, Dr Vivian loves to spend her time in leather crafting and jewelry making, transforming basics into beauty. She also loves spending her quiet time exercising in the gym or chilling at home with her loved one.

Special Interest

Acne
Acne Scarring
Fillers
Neurotoxin Injection - Botulinum Toxins
Face Lifting
Facial Enhancement

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Dr. Sean Lim

Special Interest

Acne
Acne Scarring
Fillers
Neurotoxin Injection - Botulinum Toxins
Face Lifting
Facial Enhancement

Dr. Sean Lim

MBBS (Singapore)
Certified Personal Trainer

Dr Sean is a dedicated medical professional with a diverse background in procedural disciplines and holistic care. He graduated with an MBBS degree from the National University of Singapore, earning recognition on the Dean's List for his exemplary performance in his final year Professional Examination. Fully registered with the Singapore Medical Council (SMC), Dr Sean is also certified to perform aesthetic procedures by the Aesthetic Dermatology Educational Group (ADEG). Beyond his clinical practice, Dr Sean actively engages in community service and leadership endeavours. He has contributed his medical expertise to humanitarian missions, including Naamjai Medical Missions trips to Thailand and a collaborative effort with plastic surgeons from NUH at Yangon's Defense Services General Hospital (DSGH).

Dr Sean's commitment to excellence extends beyond the medical field. As a former Singapore national athlete in pole vaulting, he has represented Singapore in numerous international competitions, earning accolades and setting records. Dr Sean’s passion for health and fitness is evident in his certification as a personal trainer and his dedication to maintaining an active lifestyle.

A proud new father, Dr Sean cherishes quality time with his family outside of work commitments, demonstrating a balanced approach to life and well-being. His belief in delivering quality care with a personal touch reflects his ethos as a compassionate healthcare provider.

Special Interest

Acne
Acne Scarring
Fillers
Neurotoxin Injection - Botulinum Toxins
Face Lifting
Facial Enhancement

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Dr. Roy Soo

Special Interest

Acne
Acne Scarring
Injectable procedures
Facial rejuvenation
Skin tightening and contouring
Energy-based skin treatments

Dr. Roy Soo

Dr Roy Soo is an aesthetic physician with almost a decade of clinical experience and a special interest in acne, acne scarring, facial rejuvenation, and regenerative aesthetic treatments. Having personally experienced adult-onset acne, he understands the impact that skin concerns can have on confidence and wellbeing. Guided by a "less is more" philosophy, Dr Roy focuses on achieving natural-looking results through evidence-based treatments, patient education, and personalised care. He works closely with patients to develop treatment plans that support healthy skin while respecting individual features and aesthetic goals.

Bachelor of Medicine, Bachelor of Surgery (MBBS), NUS
Master of Public Health (MPH), NUS
Postgraduate Diploma in Clinical Dermatology (Distinction), QMUL

Dr Roy Soo graduated from the National University of Singapore with a Bachelor of Medicine and Bachelor of Surgery (MBBS) as well as a Master of Public Health (MPH). He is also an alumnus of the Queen Mary University of London, holding a Postgraduate Diploma in Clinical Dermatology with Distinction (PgDipDerm, Distinction). He has obtained full accreditation mandated by the Singapore Medical Council and Ministry of Health to perform medical aesthetics treatments. Having experienced adult onset acne, he has extensive experience living with and treating acne and its sequelae such as hyperpigmentation and scarring. His other special interests include regenerative treatments using energy-based devices as well as injectable biostimulators.

With almost a decade of clinical experience as a medical doctor, Dr Roy approaches medical aesthetics through the lens of a physician and the hands of an artisan, respecting the science behind the skin while appreciating facial harmony with artistic judgement. Actively countering filler fatigue and trend toxicity, he is trusted by discerning patients for his carefully crafted combination treatments that are guided by the “less is more, elegance over excess” philosophy. Championing evidence-based treatments,

Dr Roy focuses on empowering his patients through education and shared decision-making. His patients delight in honest and open discussions during consultations, while his calm and assuring demeanour provides comfort during treatments. Emphasising on “beauty beyond clinic”, with greater ownership of results by patients through lifestyle modifications and use of skincare at home, treatment outcomes are amplified and longer lasting. Fostering a partnership rooted in transparency and centred on the patient’s wellbeing, care for their skin and beauty continues long after they step out of the clinic.

A proponent of complete wellness of the body, mind and spirit, Dr Roy supplements the intellectual stimulation at work with physical exertion in the gym after work. At home his responsibilities are toward his Doberman Pinscher, a faithful companion he adopted from an animal rescue shelter. When he is not in Singapore, he is almost definitely in the mountains snowboarding.

Philosophy: Less is more. Subtle and gradual improvements leave the longest lasting impact. The best aesthetic outcomes are those that preserve authenticity while elevating confidence - look and feel good in your own skin!

Special Interest

Acne
Acne Scarring
Injectable procedures
Facial rejuvenation
Skin tightening and contouring
Energy-based skin treatments

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Novena Specialist Center
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Weekdays: 10am – 8pm
Saturdays: 10am – 5pm
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+65‎‎ 6568‎‎ 3555

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International Building

360 Orchard Road 
#02-02 International 
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Weekdays: 10am – 8pm
Saturdays: 10am – 5pm
Sundays & PH: Closed

+65‎ 6450‎ 3555

info@idsclinic.com

Cystic Acne Treatment in Singapore

What Causes Cystic Acne?

Oral Medications

Topical Prescription Treatments

Corticosteroid Injections and Procedural Options

What are the Complications of Untreated Cystic Acne?

Dr. SK Tan

Dr. SK Tan

Dr. Ben Yim

Dr. Ben Yim

Dr. Michelle Wong

Dr. Michelle Wong

Dr. Vivian Yong

Dr. Vivian Yong

Dr. Sean Lim

Dr. Sean Lim

Dr. Roy Soo

Dr. Roy Soo

Novena Specialist center

International Building

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