3 top FACE pigmentation Singapore Laser review | 皮秒激光

Face pigmentation is becoming an increasing problem, what with global warming and increased UV radiation.

I believe in a sharing community. I believe that everyone deserves to look and feel your very best. I believe that knowledge is power. And I believe in empowering people.

Hence I am starting a 3 part series on common skin concerns in Asian women based on my clinical experience. Disclamer: Many people have written in to ask me about what treatment is the best, what machines are the best etc. The treatments I suggest on this blog are purely for educational purposes and should not be confused with what your primary doctor recommends.

Today we will discuss top 3 skin pigmentation concerns. In the next 2 parts, we will be discussing top skin texture concerns in Asian women, and finally rounding up with skin laxity concerns. I hope you find this helpful.

How do I get rid of pigmentation on my face?

Homecare measures include use of lightening creams like hydroquinone, retinoids, and fruit acids.

Clinical measures include use of chemical peels, lasers and IPL.

What causes face pigmentation?

Hormonal change causes melasma.

Inflammation causes acne marks.

Sun exposure causes freckles and sunspots.

Genetic causes contribute to Hori’s Nevus and Nevus of Ota.

Is facial remove pigmentation permanently?

Unfortunately, studies show pigmentation tends to recur within 3 years, largely due to sun exposure.

TOP 3 SKIN Face PIGMENTATION CONCERNS IN Asians

1. Melasma
2. Sun Damage – Freckles + sunspots
3. Post inflammation hyperpigmentation – For which we have the brown spots and red spots.

1. Melasma

This is common is Asian women. It is a symmetrically distributed, ill defined geographical pattern commonly over your upper lips, cheeks, forehead and jaw. It is notoriously difficult to treat. It occurs in 3-5% of Asians, In my practice, 30% of my laser patients have melasma.

Melasma is a common skin problem that is also known as ‘cholasma’. It causes brown patches on your face; most commonly appearing over your cheeks, bridge of the nose, forehead, chin, and above the upper lip. It also can appear on other parts of the body that get lots of sun.  Hormone changes along with sun exposure are the most common triggers for melasma. Although melasma may affect both men and women, the majority of those affected are women. 

What is Melasma?

What causes Melasma?

Melasma is due to 3 key factors.

1. Genetics
2. Sun exposure
3. Hormones – So those post pregnancy or taking oral contraceptives tend to notice this.

In my clinical experience, majority of patients with resistant Melasma have both a vascular and pigment component. Hence optimum treatment is a combination approach.

How to treat melasma?

1. Sun protection | SPF 30 2x/day
2. Lightening agents | Hydroquinone 4% based is the gold standard.
3. Low dose laser toning | Pico vs Nano second laser | +/- medical peels

In my clinical experience, Melasma is best treated with sunblock and lightening agents. Only when that fails should we move to laser +/= peels. Majority of patients benefit from 5 sessions. |皮秒激光

2. SUN – DAMAGED SKIN

Sun exposure is a big problem here in Singapore. The temperatures are creeping up and the mid-day sun is blazing hot. This will lead to risk of more sun damage in our population, slowly rising to the levels seen in sunny Australia.

Sun damage is commonly a combination of the following.

1. Freckles
2. Sun spots | Age spots
3. Fine lines and skin wrinkling

In my experience, treatment is a combination of the following, in order to attain clean and clear skin.

How to treat sun damaged skin?

1. Strict sun protection ( with spf and hats ) + Lightening agents
2. Laser treatment | Pico + Nanosecond laser + Fractional Laser
3. Skin repair with Rejuran and Skinboosters

In my clinical experience, most patients benefit from 5 sessions. |皮秒激光

3. ACNE PRONE SKIN

This needs no introduction. It can manifest as angry red pimples, flat red macules or marks, brown darkened pigmentation and finally, acne scars.

1. Acne scars
2. Acne post inflammatory erythema
3. Acne cysts

What are the Triggers of acne?

1. Stress. So those of us who work late nights, get little sleep, diet rich in sugary and diary products are at risk.
2. Hormonal changes, so it tends to worsen during pregnancy
3. Lifestyle. Flying is a stress on the body and in my practice, I do see many air crew suffering from persistent acne.

In my clinical experience, I have treated many women who suffer from persistent acne. Below is my 3 step formula for acne treatment.

How do I treat acne?

1. Lifestyle changes. AVOID your triggers, especially during your menses.
2. Creams +/- oratane and antibiotics ( I strictly avoid oral agents as much as possible)
3. Laser peels

The aim of treatment is to tackle to root of the problem. Most patients improve in 3 months. 

1. P acne bacteria
2. Sebaceous gland over activity
3. Dirt and debris clogging your pores

What is the cost of Q switched laser in Singapore?

In experienced hands, depending on the severity and distribution, prices start from $288 / session.

What is the cost of Picosecond laser in Singapore?

In experienced hands, depending on the severity and distribution, prices start from $388 / session.

What can I expect post laser? |皮秒激光

1. Redness for 2 days
2. Brown discolouration for 2 days
3. Crust. Top layer of dead skin flakes off. You may experience this as rough skin while washing your face.

What is a good post laser care regime?

1. Masks
2. Moisturisers
3. SPF

The key is optimum hydration. As every skin is unique, your Dermatologist can advise you on the specifics – frequency and amount.

So I hope this has been helpful so you are armed with some information when you visit your doctor. Stay tuned for part 2 of this mini series.

• Dr Daniel Chang

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   Is this already available here? Do you know what’s the cost estimate for one session? Also where can I get…

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References:

1. Balkrishnan, R., et al. “Improved quality of life with effective treatment of facial melasma: the pigment trial.” Journal of drugs in dermatology: JDD 3.4 (2004): 377-381.
2. Tannous, Zeina S., and Susanne Astner. “Utilizing fractional resurfacing in the treatment of therapy‐resistant melasma.” Journal of Cosmetic and Laser Therapy 7.1 (2005): 39-43.
3. Wattanakrai, Penpun, Ratchathorn Mornchan, and Sasima Eimpunth. “Low‐fluence Q‐switched neodymium‐doped yttrium aluminum garnet (1,064 nm) laser for the treatment of facial melasma in Asians.” Dermatologic Surgery 36.1 (2010): 76-87.
4. Lloyd, Jenifer R., and Mirko Mirkov. “Selective photothermolysis of the sebaceous glands for acne treatment.” Lasers in surgery and medicine 31.2 (2002): 115-120.