Pigmentation removal/treatment Singapore: An aesthetics doctors’ guide
Dark spots on our skin are our worst enemies on our darkest days. Don’t let skin pigmentation get you down! Let us help you understand more about pigmentation removal treatments in Singapore and figure out what you can do for your skin to restore that youthful, healthy glow – free of dark spots.
What is skin pigmentation?
Skin pigmentation refers to the colorings of patches of skin, making them look darker than the rest of the skin.
The color is attributed to melanin, a brown pigment that is naturally produced by the body. Melanin can actually help to protect the skin against UV rays, but too much of them can cause dark spots of pigmentation. In a tropical country like Singapore, many people face the problem of skin pigmentation due to frequent and long-term exposure to the sun.
Dark spots on the skin are usually not a cause for concern and do not require treatment, but some people may want to remove them for cosmetic reasons.
What causes pigmentation on skin?
Melanin is the natural form of protection we have against the sun’s UV rays. Prolonged exposure to the sun triggers the body to produce more melanin, causing dark spots or patches on the skin. These are called age spots or sunspots. Age spots do not need medical attention.
The following are characteristics of age spots:
- Flat, oval shaped
- Dark brown
- Occur on skin that has been most exposed to sunlight over the years
- Back of hands
- Tops of feet
- Upper back
- Have a size similar to freckles or as big as about ½ inch (13 millimeters)
- Can group together which makes them more noticeable
Inflammation on the skin can cause areas of the skin to darken, such as acne, eczema, lupus, or an injury on the skin. Those with a darker skin tone are more likely to have post-inflammatory hyperpigmentation.
Hormonal changes such as during pregnancy commonly cause hyperpigmentation.
Reactions to drug use
Certain medications like antimalarial drugs or tricyclic antidepressants may cause hyperpigmentation where the skin turns grey.
Hyperpigmentation can also be caused by chemicals in topical treatments.
Underlying medical conditions may cause hyperpigmentation. Some of the more serious ones are Addison’s disease and haemochromatosis.
Addison’s disease is also known as adrenal insufficiency and can cause disruptions in hormone production. It can result in hyperpigmentation of the following areas of the body:
- Folds of skin
- Elbows and knees
- Inside of the cheek
Some other symptoms of Addison’s disease are:
- Muscle weakness
- Weight loss
- Stomach pain
Haemochromatosis is an inherited condition which happens when the body absorbs too much iron from the food eaten and can cause hyperpigmentation. The following are some symptoms of haemochromatosis.
- Stomach pain
- Joint pain
- Weight loss
What are the types of skin pigmentation disorders?
Pigmentation disorders are caused by excess or reduced pigmentation. This may be caused by inflammation, medication, hormonal changes, or UV exposure.
Post Inflammatory Hyperpigmentation and Hypopigmentation
This is a discolouration of the skin after an underlying skin condition has healed. The underlying skin condition could be inflammation, trauma, skin infection, eczema, or a drug reaction. This type of pigmentation disorder will improve with time.
Freckles (ephelides) and Lentigines
Freckles are small flat spots which are light brown and 1-2mm in diameter. They usually occur because of exposure to the sun and are normally found on the cheeks and nose. They usually appear at a young age and tend to increase with age.
Solar lentigines are light yellow to dark brown spots which are 1cm or greater in diameter. They are usually found on the face and back of the hands, occurring in individuals over 40 years of age who have had a long history of sun exposure.
Melasma is common among Asians, showing up as brown patches or grey patches, which can occur in these areas:
- Nasal bridge
- Upper lips
Other areas of the body that may be affected by melasma, especially after exposure to sunlight, include:
Melasma can be caused by the following factors:
- Hormonal changes such as during pregnancy (chloasma), hormone treatment, or when taking oral contraceptives
- Sun exposure
- Skin care products that irritate the skin
Melasma affects females more commonly than males. Women with dark complexions and those who are pregnant have a higher risk of developing melasma. Exposure to the UV rays and the use of oral contraceptives often worsen the condition.
Café au lait macules
Café au lait macules are brown macules that are about 1-20cm in diameter and are present at birth or early in life. They are found on the epidermis and can be located anywhere on the body, most commonly on the trunk. These are asymptomatic and treatment is not necessary.
This condition occurs in children and young adults. Pink scaly patches appear on the skin and later leave pale areas, which are more noticeable on those with darker skin. They also become more pronounced after exposure to sunlight.
The cause of pityriasis alba is unknown but it is thought to be caused by minor inflammation of the skin that is related to eczema.
Drug Induced Hyperpigmentation
There are some medications that can cause hyperpigmentation of the skin, from grey patches to blue-black discolourations. These include:
Vitiligo shows up as white spots on the skin due to a loss of pigment cells (melanocytes). The most commonly affected areas of the skin include:
- Mouth and eyes
- Fingers and wrists
- Inside the mouth
In some cases, vitiligo is due to an autoimmune condition where the body’s own immune system destroys its own pigment cells.
How do I prevent skin pigmentation?
Hyperpigmentation may be prevented by doing the following:
- Avoiding exposure to the sun – it is recommended to use sunscreen with an SPF of 30 or higher to protect the skin from hyperpigmentation or to prevent darkening of your spots.
- Avoiding picking at the skin – avoid picking at spots, scabs, and acne if you don’t want hyperpigmentation to form after an injury.
What is the best treatment for skin pigmentation in Singapore?
There are many topical treatments for hyperpigmentation to lighten the skin, such as:
Azelaic acid is a tyrosinase inhibitor so it inhibits melanin production, thus preventing hyperpigmentation effectively. It is also anti-inflammatory, which is good news for those who have acne and are prone to getting dark spots because of it.
This is a skin-lightening agent that bleaches the skin for hyperpigmentation issues. They decrease the number of pigment cells or melanocytes so as to reduce the pigmentation on the skin.
It can take a month or more to see its full effects. Over-the-counter hydroquinones are sold in 2% concentrations. If they do not work, seek help from your dermatologist to get a prescription-strength formula.
Retinoids such as tretinoin
Retinoids are derived from vitamin A. The small molecular structure enables them to penetrate deep into the skin to treat layers below the epidermis. They can come from prescriptions or over-the-counter. OTC versions tend to be milder, so you may consult a dermatologist if they don’t seem to be working quite as well.
Vitamin C is a dietary vitamin that helps to block the enzyme tyrosinase which is needed for the formation of melanin pigment. It does not affect normal skin colouration but instead targets abnormal melanin deposits that are a result of sun damage.
There are also cosmetic procedures that can reduce hyperpigmentation, such as:
Different types of lasers target either melanin or water so that they can penetrate the skin and heat up the target to destroy them. The dark spots get darker, then flake and fall off after the treatment. Singapore has laser treatments such as Pico Laser and Thulium Laser.
This produces high energy microbeams that effectively clear skin pigmentation while reducing the risk of complications.
This removes the epidermis of the skin where the pigmentation is found in order to whiten the skin and stimulate collagen production.
Intense pulsed light (IPL)
IPL is a non-ablative laser treatment method, also called photofacial. It stimulates collagen growth and works especially well for flat spots. Additionally, IPL may help with wrinkles, spider veins and enlarged pores. It may require multiple sessions.
Chemical peels use acids at high concentrations to remove the epidermis (outermost layer of the skin) so as to reduce the appearance of hyperpigmentation. Deeper versions can remove the dermis for more effective results.
Chemical peels work for:
- Age spots
- Sun damage
- Blotchy skin
Many chemical peels are available over-the-counter, but you can also get a professional-grade peel from your dermatologist. These are more powerful and yield results in a shorter time. However, do note that they may also have more side effects. Talk to your dermatologist before proceeding to use any of the treatments for your hyperpigmentation.
One important point to note is that if you often go out in the sun, chemical peels may not be the best treatment option as they cause the skin to be even more sensitive to the sun’s rays. If there is insufficient protection from sunscreen, the sun may worsen your hyperpigmentation.
Microdermabrasion works for hyperpigmentation that only affects the epidermis (outermost layer of the skin). In this procedure, the dermatologist will use a drill-like handheld tool with an abrasive attachment that is swiped across the skin to remove the epidermis. It may require several sessions to achieve the desired result.
Is it possible to remove pigmentation permanently?
There are many treatments that may remove existing pigmentation, but a permanent solution may require more maintenance, such as:
- UV protection using sunblock
- Pigment-inhibiting serums
- Vitamins and antioxidants
What are the side effects of skin pigmentation treatment in Singapore?
Possible risks of chemical peels include:
Potential risks of laser treatment include:
- Unexpected burns and crusting
Some procedures may have some downtime, so it is important to take extra care during the post-treatment period. Seek help from professional and experienced dermatologists and discuss potential risks and precautions to take before undergoing treatment.
What is the cost of skin pigmentation treatment?
The cost of skin pigmentation treatment would differ based on where you go to and what type of treatment you’re getting.
Topical creams are definitely the cheaper option – they can cost about $80 to $150, and can last you a good few months.
For chemical peels, they can be below $100 to about $300.
For laser treatment, it can cost anywhere from $100 to $600, where high-end lasers cost more at about $500.
The above treatments are not MediSave claimable since they are cosmetic treatments.
How do you remove skin pigmentation naturally?
There are some home remedies available for skin pigmentation, but the best advice we have is to seek professional treatment from a dermatologist since you do not know how effective home remedies may be.
Apple cider vinegar
Apple cider vinegar contains acetic acid which lightens pigmentation.
Aloe vera contains aloesin which inhibits the production of melanin. Using pure aloe vera gel would do the trick.
There are some creams that use the skin of red onions (Allium cepa) to lighten the skin.
Green tea extract
Green tea extract may have depigmentation effects when applied to the skin. You may wish to buy green tea extract and apply as directed.
Milk, buttermilk, and sour milk have been shown to lighten skin discolouration due to the presence of lactic acid.
Hyperpigmentation is common, especially in Singapore where sunlight is abundant. While hyperpigmentation is normally a harmless skin condition, you may find it unsightly and wish to use removal techniques to get rid of them, which is perfectly fine! If you are facing hyperpigmentation problems, do seek help from a dermatologist who will be the best person to advise you on the best treatment methods for a better complexion. Here’s to clear and spotless skin!
Hyperpigmentation is common, especially in Singapore where sunlight is abundant. While hyperpigmentation is normally a harmless skin condition, you may find it unsightly and wish to use removal techniques to get rid of them, which is perfectly fine! If you are facing hyperpigmentation problems, do seek help from a dermatologist who will be the best person to advise you on the best treatment methods for a better complexion.
If you are having skin pigmentation woes, feel free to contact Dr. Wan from 1Aesthetics at +65 84899962 or +65 66125173. Or you may visit our 1Aesthetics clinic which is conveniently located near Clarke Quay MRT station. Let our professional medical team bring you clear and spotless skin!
- Hyperpigmentation: Treatment, types, and causes. (n.d.). Retrieved August 5, 2021, from https://www.medicalnewstoday.com/articles/323808
- Hyperpigmentation: what it is. (n.d.). Retrieved August 5, 2021, from https://www.eucerin.sg/skin-concerns/uneven-skin/hyperpigmentation
- Plensdorf, S., Livieratos, M., & Dada, N. (2017). Pigmentation Disorders: Diagnosis and Management. American Family Physician, 96(12), 797–804. www.aafp.org/afp