Pigment Problems in the Asian skin – Our Singapore context

Freckles, sunspots, age spots, melasma, pimples, you see it, you got it.

I have had many patients asking me about those spots on their faces. So to help you learn more about your skin, and understand those spots you see when you look into the mirror, I have decided to walk you through some of the common pigmentary conditions.

Allow me to first start with freckles, those brown spots that you get for working out in the sun since your schooldays.

– Freckles: 

What are they?

– Freckles are spots which commonly appear with sun exposure and are found on the cheeks and nose. They increase with age and darken with sun exposure. They lighten with sun protection.

How can we treat it? 

 

– In my opinion, treatment includes strictly avoiding the sun, using sun protection, using skin lightening cream and +/- laser therapy.

Here is an example of freckles.

freckles

Next up, Melasma. 

So what causes Melasma?

– Melasma is very common with the Asian skin. It is multifactorial, with a strong genetic and hormonal component. It is worsened with sun exposure, OCPs and pregnancy. It tends to be distributed either over the cheeks or a central distribution from the forehead down to the chin.

How can we treat it? 

– There are many treatment regimens for melasma. Personally, I would suggest an advanced treatment which consists of priming the skin with lightening agents for a month, +/- oral medication followed by careful use of chemical peels and laser skin toning under a Dermatologist’s prescription.

 

melasma

 

 

– Solar Lentigines/ Sunspots/ Age spots

What are they? 

– These are discrete lesions which progress with age. Prevention is the key with sun protection and sun avoidance.

 

How can we treat it? 

– They may be lightened with bleaching creams and pigment lasers.

solar lentigo

 

Hori’s Nevus

What are they?

This is a pigmentary condition characterized by multiple dark blue gray spots, commonly found bilaterally in the cheeks. They darken with sun exposure and childbirth.

How can we treat it? 

In my opinion, they can be successfully lightened with a careful combination of sun avoidance, skincare and lasers. 

 

abnom

 

So I hope this mini segment on pigmentary woes in the Asian skin has been useful. Remember, stay bold and beautiful.

Dr Daniel Chang

– Be Bold and Beautiful

– Making Raffles Place more beautiful, one face at a time

10 Comments

    1. Thanks for your query Nita.

      As this is a purely educational blog, it would not be convenient for me to discuss treatment cost. Perhaps you could do a google search for our contact and someone could advise you further? Blessed Christmas!

      Kind regards
      Dr Daniel Chang

    1. Dear Christina,

      Thank you for your interest. As this is a purely educational website, i am not in a position to comment on prices. May I suggest you do a Google search and forward your queries to the relevant clinic? Hope this helps. Happy New Year.

      Kind regards
      Dr Daniel Chang

  1. Dear Dr. Chang,

    I always wondered what are the brown spots on both of my cheecks which have been disturbing me for more than 20years and the colours are becoming darker. (I am 41 years old now). I suspected the spots were caused by hormone pills (doctor’s prescription) which i had to consume to regulate my menstruation cycle when i was a teenager (menses wouldn’t stop even after 2 weeks). I have tried many skincare products before, but didnt improve at all.

    After looking at the photos shared by you, mine look exactly like the sample photo of Hori’s Nevus … I would like to ask : will it really help by doing laser? Will there be any downtimes after laser treatment? I am a busy working mum and i need to travel overseas quite frequent… what would be your recommendation?

    1. Dear Mrs Lim,

      Thank you for your query.

      Indeed, Hori’s Nevus is common in Orientals, and has been linked to hornone pills, sun exposure and age, commonly starting after age 15. This was the findings supported by a population based study conducted in Shanghai, published in 2011.

      So if your pigments are indeed Hori’s Nevus, then yes, they do respond to laser treatment.
      Studies have shown that treatment once every 6 weeks over a course of 8- 10 sessions can help to lighten them. Your dermatologist may also recommend you skincare medication to further enhance this lightening treatment.

      Hence, despite your busy schedule, despite the travelling you have to do, with time and commitment, I think you can see some changes you would really like.

      Kind regards
      Dr Daniel Chang

  2. Dear Dr. Chang,

    Thank you for your reply. As much as i would like to go for laser treatment, i am concerned about the length of downtime after treatment. Will there be any redness, peeling, sweiling after laser treatment? Or the technology has advanced and there will be no downtime, can go out and go back to work immediately after the treatment?

    Thank you.

    1. Dear Mrs Lim,

      Thank you for your query.

      The short answer to your query is that it depends on your skin condition, so you would require a consultation with your dermatologist. Hori’s Nevus is a more deep seated pigmentation issue, so to target the dermis requires stronger laser settings. Hence downtime is inevitable, on average you can expect 3 to 7 days of mild redness, swelling, petechiae, but this is dependent on the patient, doctor and machine factors.

      I hope this answers your question.

      Kind regards
      Dr Daniel Chang

  3. Dear Dr. Chang,
    Will one be able to go through laser facial treatment while on long term low dosage accutane (one 20mg pill twice a week). Please kindly advise. Thanks.

    1. Dear JW,

      Thank you for your query.

      Generally it is not advisable to have laser treatment while on accutane. Accutane tends to interfere with skin healing.

      So I hope that answers your question.

      Kind regards,
      Dr Daniel Chang

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