Skin pigmentation is the bane of crystal clear skin! Those who have experienced it (some of them still continue to live it) are definitely well acquainted with its confidence-killing powers.
Fortunately, Dr Justin Boey has dedicated his practice to wage war on these pesky spots. He has helped many patients restore their confidence by resolving their pigmentation problems!
He was invited to host a DoctorxDentist session on lasers & pigmentation to share his expert opinions with the DoctorxDentist community. From tips on melasma treatment to pigment marks caused by acne, these are his pearls of wisdom.
Melasma is triggered by excessive sun exposure and genetics
Melasma is a common skin condition in Singapore. They appear as brown to gray patches on the face. People tend to get it on their forehead, cheeks, nose, and even chins. If you are constantly under the sun, you may also find these patches on your forearms or neck.
They are many triggers of melasma. The most common ones are:
- Excessive sun exposure
- Change in hormones (pregnancy, birth control pills)
Sadly, it is difficult to get rid of melasma
If you think that it's hard to completely eradicate melasma, you are spot on (no pun intended, really).
Dr Boey admits that melasma is a challenging condition to treat. It can be "improved and well-controlled" rather than "totally removed".
But stay hopeful! With the advancement in technology, there are many ways to keep it control.
There are three lines of treatment for melasma
Most people mistakenly think that lasers are the first line treatment for melasma. According to Dr Boey, lasers are effective but they aren't the top choice.
Doctors would usually start with sun protection, discontinuation of birth control pills, or intra-uterine devices containing estrogen and medical-grade whitening creams first.
If there's no improvement after 6 months, then they'd recommend Azelaic acid, Kojic acid, Ascorbic acid, Niacinamide, and Arbutin.
Finally, the most powerful of the lot: Glycolic acid peels, Lasers like Nd:YAG lasers or Oral tranexamic acids
Creams and chemical peels will do the trick
When it comes to melasma, you can expect to see improvements just by using creams and chemical peels. Beyond the marketing hype, lasers are usually only reserved for severe melasma cases that won't improve with other types of treatments.
Find a doctor who is experienced in treating pigmentation and be patient. Dr Boey likens it to a marathon, not a sprint.
Laser treatments might not work for sun spots
If you’ve been diagnosed with solar lentigos and nascent melisma and are wondering why you’ve had poor experiences with lasers, here are 2 reasons why.
1. Post laser skin care might have been insufficient - you have to use sun protection and lightening creams are before and after laser treatment.
2. Inappropriate laser settings - A low setting leads to sub-optimal results while excessively high settings cause burns.
3. Choice of laser used - you need to seek advice from a trusted doctor to find the best type of laser for your condition.
There are 2 forms of post acne pigment marks
Post acne pigment marks are very common amongst Singaporeans, especially for back acne. They can either be:
- Post inflammatory hyper-pigmentation- PIH (brown marks)
- Erythema (red marks)
Make sure you get an experienced doctor who can identify which ones you’ve got before seeking treatment.
Sorry, exfoliation is not the cure to post acne pigmentation
Suffering from pigment marks on your back caused by acne? Sorry to burst your bubble but exfoliation alone is unlikely to help much.
Apart from "over-the-counter" exfoliation products, you can try medical-grade chemical peels like Glycolic or Jessner's peels which help to lighten pigmentation over several treatment sessions.
The IPL (Intense Pulse Light) treatment is your saviour
The type of treatment you need depends largely on the type of pigment marks.
Intense Pulse Light (IPL) is considered as the most effective type of treatment methods. It's best for removing brown coloured marks (post-inflammatory hyperpigmentation).
Here's the best part, it's also just as effective in removing the red marks from post acne erythema too.
Sun protection is key!
If you have pigmentation on your cheeks and face and are desperate for a solution to manage your condition (which may be genetic), Dr Boey emphasised the importance of sun protection.
Regular Application of high-quality SPF sunscreen every 4-6 hours is necessary when exposed to the sun. On top of that, remember to apply sunscreen to neglected regions such as around the eyes and neck.
Consider oral sunblock for added sun protection
Sometimes, more is more. Oral sunblock like Heliocare can provide another layer of sun protection, in addition to topical sunblock.
When it comes to the health of your sensitive skin, can there ever be too much protection?
Dr Boey combines treatments for improved results
In his practice, he tends to use a combination of treatments including creams, chemical peels and lasers because of their synergistic effects.
With that being said, he advices everyone to speak to a trusted doctor to find the most suitable treatment plan for themselves. There is no "one size fits all" treatment plan.
Seek the right type of treatment!
Skin pigmentation can be a tricky condition to tackle. If left unchecked, patients might expose themselves to further skin deterioration. If done right, skin pigmentation treatments can work wonders and seriously improve things. You might not even need lasers!
Take Dr Boey's advice above and stay strong on your quest towards better, healthier skin.
To find out more, you can read his full Q&A session on lasers and pigmentation here.
Dr Justin Boey’s practice of aesthetic medicine centres around the busy modern individual. He is experienced in Facial Aesthetics (lasers and injections) and hair loss treatments. Learn more about him here.