PIGMENTS. Skin Facial Pigmentation Singapore

1) Pigmentation

2) Dark eye circles

3) Red, sensitive skin 

Under Pigments, I will discuss the common pigmentary woes affecting Asian skin. Key is the use of creams, peels and lasers for this type of condition. There are many lasers. And choosing the right laser will form the cornerstone in the treatment.

TOP 10 pigmentation concerns in Asian Skin 

1. Freckles

2. Melasma

3. Sunspots

4. Hori’s Nevus

5. Nevus of Ota

6. Becker’s Nevus

7. Tattoos

8. Underarm pigmentation

9. PIH (Post inflammatory Hyperpigmentation)

10. Acanthosis Nigricans

How can we prevent skin pigmentation?

Lifestyle changes – 3 Ss

1. Sunblock, Q 4 hours
2. Shade, stay away from the sun. Stay cool, in the shade.
3. Shield, sun glasses and wide brim hat, UV coated umbrellas when you head out for lunch especially
   

Pigments in the Asian Skin:

What does skin pigmentation look like? 

We will share some clinical photos for educational purposes below. Dark spots, red spots, brown spots, blue spots, gray spots, what are they? 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.

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How does Laser WORK for skin pigmentation?

How can we get rid of skin pigmentation?

Pigmentation Solution

1. Treatment: Laser/ light/ peels

2. Cosmeceuticals: Sunblock + Lightening agents – ORAL and topical

3. Skin renewal: Boost hydration and repair

After laser, what can I expect?

Lasers and pigments

Here is a schematic cartoon showing how laser breaks down pigments into granules, which are subsequently engulfed by macrophages.

FRECKLES

What are freckles?

– Freckles are spots which commonly appear with sun exposure and are found on the cheeks and nose.

– They  darken with sun exposure.

– They show up in the teenage years, increasing with age.

– They lighten with sun protection and a combination of therapies.

How can we treat freckles? 

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

– Here are examples of freckles.

FRECKLES

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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 Melasma? 

– There are many treatment regimens for melasma.

– Melasma is a condition that can be controlled and not cured. 

– It is a spectrum, and there is no one size fits all regime.

– A carefully personalised programme works best as every melasma is different.

– Personally, I would suggest an advanced treatment which consists of priming the skin with lightening agents for a month, +/- oral medication followed by careful chemical peels and lasers.

1. Use good sunscreen, apply it 15min before going out. And reapply it every 2 hours.

2. Use gentle lightening agents

3. Laser light +/- Cosmelan

MELASMA

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Solar Lentigines/ Age spots

What are sun spots, age spots?

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

– They  first appear in your 30s and can get increase in number with age.  

– Some age spots thicken and darken with time.

How can we treat sunspots age spots?

 – They may be lightened with sun protection, lightening agents and lasers light. (sunspots, solar lentigo)

SOLAR LENTIGO/ SUN SPOTS / AGE SPOTS 

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Hori’s Nevus

What are Hori’s Nevus?

– 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 Hori’s Nevus?

– They can be lightened with a careful combination of sun avoidance, lightening agent and lasers.

HORI’S NEVUS

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NEVUS OF OTA

What is Nevus of Ota? 

– Present at birth

– A blue grey pigmentation deep in the dermis

– They darken with sun exposure

– Can be lightened with sun protection, lightening agents and lasers.

NEVUS OF OTA

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BECKER NEVUS

– birthmark commonly found in males

– one sided 

– epidermal nevus

– associated with hair growth 

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CAFE AU LAIT SPOTS

What are cafe au lait spots? 

– These are light brown macules that can be found over jawline, neck, face. 

– Effectively treated with sunblock, lightening agents and pigment lasers, but can recur.

 

It is vital to distinguish this from a melonocytic nevus – which can turn malignant, meaning cancerous.

CAFE AU LAIT SPOTS

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TATTOOS 

How can we treat tattoos? 

– Q Switched lasers are good for black, blue, brown tattoos.

– No. of sessions depends on the location, size, age, colour of tattoo and whether it was performed by a professional or amateur tattoo artist.

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UNDERARM PIGMENTATION

What causes underarm pigmentation? 

Causes:

1. Contact Allergy: From DEODORANTS commonly
2. PIH from shaving: Tiny hair stubbles can also add to the darkening
3. Infection: You might have a skin infection that causes darkening
4. Acanthosis Nigricans. A skin condition that causes hyperpigmentation
5. Hormones/Pregnancy. Changes in your body may cause discoloration

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POST INFLAMMATORY HYPERPIGMENTATION:

What causes hyperpigmentation? 

1. – As the name suggests, these are pigmentation that form after an injury, be it picking a pimple, derma-roller performed on a skin, injury to the face etc…
2. – It can happen anywhere.
3. – Treatment entails careful use of laser toning with lightening agents and strict sun protection.
4. – They take 3 months to improve. 

POST inflammatory pigmentation or PIH can happen anywhere on the body

PIH ( Post inflammatory hyperpigmentation)

What is hyperpigmentation?

It is an area of localised hyperpigmentation (excess melanin), as a result of damage to the skin from inflammatory process. It can range from light brown to black. It is temporary.

Distinguish PIH from PIE, which is post inflammatory erythema. This consists of superficial blood vessels that grow during the wound healing stage and is common after inflammtory acne, especially in lighter skin people. Darker skin folks would end up with Post inflammatory hyperpigmentation.

How can we treat hyperpigmentation?

1. Sun block
2. Laser light
3. Antioxidant and lightening agents

What are the causes of hyperpigmentation?

1. Sun
2. Injury. This can be as a result of over zealous chemical peel, laser, or other energy based devices.
3. Heat

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ACANTHOSIS NIGRICANS

What are the causes of acanthosis Nigricans? 

Hereditary vs acquired

Common acquired causes

1. DM
2. Obesity
3. Drug induced

Common in skin folds,neck,axilla and groin.

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Here are treatment videos of using LASERS for your pigmentation woes.

What is pigmentation laser treatment? 

Pigment laser treatments involve a light laser that generates heat and penetrates into the deep layers of your skin to stimulate collagen production without damaging the dermis. 1064 laser is a highly advanced laser that can deliver highly controlled energy into the skin. It is able to combine high peak power and short pulse width, to target and get rid of pigments without allowing the heat produced to damage the surrounding tissue.

Is laser effective for skin pigmentation? 

It is an effective treatment for skin conditions such as pigmented lesions, freckles, solar lentigo, age spots, sun spots, hori’s nevus, nevus of ota, cafe au lait, melasma, post inflammatory hyperpigmentation, skin redness, scars, tattoo removal, with minimal downtime.

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

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1. 

   Essentially, there will be no or very little downtime with this procedure. You can occasionally notice some redness that goes…

2. 

   Good write up!!

3. 

   Some patients report experiencing pain during treatment; others describe a “sharp” sensation, as if they are being pricked by tiny,…

4. 

   This is a topic that is near to my heart… Thank you! Exactly where are your contact details though?

5. […] area of expertise includes 1. non-surgical facelift | threadlift 2. Non-surgical noselift 3. Acne scars + […]

1. 

   Essentially, there will be no or very little downtime with this procedure. You can occasionally notice some redness that goes…

2. 

   Good write up!!

3. 

   Some patients report experiencing pain during treatment; others describe a “sharp” sensation, as if they are being pricked by tiny,…

4. 

   This is a topic that is near to my heart… Thank you! Exactly where are your contact details though?

5. […] area of expertise includes 1. non-surgical facelift | threadlift 2. Non-surgical noselift 3. Acne scars + […]