A Doctor's Guide To Pigmentation Treatment In Singapore (2019)

A Doctor's Guide To Pigmentation Treatment In Singapore (2019) undefined
Table Of Contents

Pigmentation treatments are on the rise here in Singapore and there is a reason for that. Due to our hot weather all year round, we are constantly exposed to UV (Ultraviolet) rays.

This makes us more prone to develop skin pigmentation issues, and even more for those with darker skin due to their prolonged UV exposure. Women are also more prone to develop skin conditions like melasma, freckles, and Hori's naevus. 

Our users have these concerns as well and this is well-reflected on DoctorxDentist. If you go to our homepage, you can see that Acne & Scars and Aesthetic Medicine are the top two topics that we receive most questions about.

Despite how prevalent the issue is, we tend to be misinformed on how we can effectively treat our pigmentation issues. As such, I have put together this guide on pigmentation treatments in Singapore, to help you make more informed decisions.

Read on to know how you can find a pigmentation treatment that best suits your skin condition and skin type!

 

Pigmentation treatment should start with the right diagnosis.

illustration on getting a  diagnosis

A misconception everyone seems to have is that ALL pigmentation issues are the same and laser treatments are the ONLY cure that treats them all. However, in reality, it’s not that simple and they should not be treated the same.

You may hear of these skin conditions which all commonly result in pigmented skin:

  • Freckles
  • Melasma
  • Age or Sunspots

While they may look the same, they all require different treatments. Most importantly, not all require a laser procedure

Hence, you should always first have your skin condition diagnosed by a trusted doctor. This will save you the hassle and spending on unnecessary treatments that are not suited for you.

 

The most common types of pigmentation problems I see in Singapore

1. Melasma

asian woman with magnifying glass on melasma skin

Melasma is a skin condition that is known for being resistant to treatments. Some of its features include:[1]

  • blotchy patches of light-to-dark brown discoloration that looks like a "world map on your face".
  • forms on sun-exposed parts of the body, usually on the cheeks and forehead. 
  • often in middle-aged and dark-skinned women of Asian descent.
  • linked to age, genetics, hormonal, vascular and sun exposure.

2. Freckles

asian woman with freckles on cheeks and nose

Freckles are termed as:[2]

  • Tiny light brown spots on the cheekbones and nose.
  • look like “dashes of pepper scattered on the skin”.
  • often in younger people.

3. Solar Lentigo

solar lentigo formed on elders arms

A condition commonly found in elders and is caused by prolonged exposure to UV radiation. [3]

  • Single or a few dark spots on the face
  • round in shape and uniform in color
  • looks like a "setting sun"

4. Hori's Naevus

closeup on blue patches of discolouration on the cheeks of an indian woman

Source: Blue Patches of Discolouration over cheeks

Hori's naevus is a skin condition with these features: [4]

  • dark bluish-grey marks that are clustered together
  • forms on the cheekbones, nose, or forehead
  • found in middle-aged Asian women
  • linked to genetics

5. Post-Inflammatory Hyperpigmentation (PIH)

closeup on woman 

Post-inflammatory hyperpigmentation is often found in darker skin types and has the following features: [5]

  • Discolored spots or patches on the face
  • forms after an injury, inflammation or infection to the skin
  • can result after an acne outbreak or inappropriate squeezing of pimple
  • can also be a reaction after using unsuitable cosmetics or undergoing certain skin procedures

6. Seborrheic keratosis or “Pigmentation Bumps”

pigmentation bumps on asian man

Seborrheic keratosis is often mistaken to be pigmentation or moles, but it is different. You can identify them with these characteristics[6]

  • Light brown or black spots on the face
  • rough in texture and is slightly elevated from the face
  • looks like "small bumps on the face" which you can feel when you run your fingertips over them
  • found in elders and especially those with a family history of seborrheic keratosis

Could You Tell The Difference?

Have a look through these images! Don’t they look almost similar to each other?

It can be challenging for us, who I assume most are not experts in this field, to correctly determine the skin condition that we face. Hence, if you wish to effectively treat your pigmentation issues, you should never self-diagnose but always seek an expert's help.

Besides, there are other reasons that can complicate the diagnosis of your skin condition. For instance, you may be suffering from more than one condition at the same time (E.g. Melasma and Hori's naevus). As always, you should seek medical assistance! 

 

Are over-the-counter pigmentation creams in Singapore effective?

asian young woman applying cream on hand

Ever thought of self-medicating with over-the-counter (OTC) creams to help treat your skin pigmentation? While OTC products are an affordable option, they have their own limitations.

Indeed, OTC creams such as sunscreens can help you prevent skin pigmentation. However, OTC skincare products and oral supplements are not very effective when it comes to treating pigmentation. 

 

How is less severe melasma treated?

illustration on treatment types for less severe melasma

The treatment of melasma depends on the severity and depth of your condition. If you have melasma that is less severe, topical treatments like medical-grade creams and sunscreen will suffice. 

Are medical-grade creams the same as OTC creams?

OTC Products and Medical-grade creams... Do you know what is the difference between the two? While they may sound almost similar, they are not the same

First off, OTC products are generally more accessible as you can get them at nearby pharmacies. On the other hand, you can only obtain medical-grade creams in Singapore if you have a doctor's prescription

Next, medical-grade creams are also specially formulated and clinically tested to prove their efficacy in treating skin pigmentation. This is not the case for OTC products.

So... What are medical-grade creams? 

There are many kinds of medical-grade creams. The key ingredients are hydroquinone and tretinoin amongst many other topical agents. These topical agents can be used alone or in combination to treat melasma.

You can expect your melasma to lighten within 6 to 12 weeks after your treatment. While they are known to be rather effective in treating melasma, there are some downsides. You should monitor for any of these side effects when you use medical-grade creams:  [7], [8]

  • Redness
  • Itching
  • Stinging of the skin

If you are particularly concerned about these side effects, you may want to consider topical tranexamic acid instead.

Recent research has proven that tranexamic acid would incur lesser side effects as opposed to other alternatives. Not only that, but it was also proven to be as effective as using hydroquinone. This is especially so if you have darker skin. [9]

You can usually find topical creams in Singapore within the range of $60 to $300. For a good sunscreen (SPF 30-50, PA+++), it will cost you at least $50 to $120.

 

How is more severe melasma treated?

illustration on treatment types for more severe melasma

Topical treatments are typically used as the first-line of treatment for melasma. For more severe cases of melasma, you will need treatments that involve the use of lasers, chemical peels, and tranexamic acid, which is an oral medication. 

A study conducted in 2017 has compared the effectiveness of using different treatment combinations for treating melasma. Here is what they found. [10], [11]

  • If you use Pico Laser along with hydroquinone cream, you will show better results than using hydroquinone cream alone.

If you are considering a laser procedure, you can expect results to show after 4 to 10 laser sessions. Take note though, patients on average observe results after 5 to 8 sessions. 

Each laser session takes around 15 minutes. You can look on the bright side as there is not much downtime in between the laser treatments.

Finally, you can expect to pay around $1,500 to $4,000 for a laser pigmentation treatment in Singapore. But, take note that the final amount you will pay depends on these 3 factors:

  1. The clinical experience of your doctor
  2. The type of laser (Pico Lasers, which are the latest lasers tend to be more expensive)
  3. The number of laser sessions you require.

 Also read: A Complete Guide To Pico Lasers In Singapore

How is post-inflammatory hyperpigmentation treated?

causes and treatment of post inflammatory hyperpigmentation

When it comes to treating post-inflammatory hyperpigmentation, you can choose from these treatments which are used to treat melasma as well:

  1. Topical Treatments
  2. Oral Medication
  3. Laser Treatments
  4. Chemical Peels

Due to the identical methods used, the effectiveness of a post-inflammatory hyperpigmentation treatment ultimately boils down to the skill and experience of your doctor.

The key to achieving a good result for post-inflammatory hyperpigmentation is to start treatment earlier rather than later.

 

How is seborrheic keratosis or “pigmentation bumps” treated?

key points to note about treating seborrheic keratosis

There are two forms of treatment for seborrheic keratosis. You can choose either electrocautery or ablative laser surgery to remove the pigmentation bumps on your skin.

Both treatments are for a short-term, which will require you to undergo only 1 or 2 sessions to remove the pigmentation bumps. The entire process is almost painless with the use of numbing creams and each session lasts between 10 and 20 minutes.

You should set aside at least 3 to 7 days after the procedure to allow sufficient time for your wounds to heal. Although you may face some downtime after the procedure, the results are almost instant.

You can also expect the cost for your pigmentation bump treatment to be around $300 to $1,000.

 

How are freckles and solar lentigos treated?

asian woman applying cream on pigmented skin

If you walked into an aesthetic clinic here in Singapore, you will most likely be offered laser treatment. While laser treatments are effective in treating pigmentation issues, they can be costly

But ...

Do you know that freckles and solar lentigos can be treated with topical agents like hydroquinone?

Topical treatments are a good option to consider if you would like to save some bucks on your treatment for freckles and solar lentigos. Nonetheless, you should still consult your doctor first to check if your condition can be managed with topical treatments.

For persistent issues with freckles and solar lentigos ...

comparing treatment types for persistent freckles and solar lentigos

Medical-Grade Lasers

If you have freckles and solar lentigos for a while now, you should opt for medical-grade lasers like Pico Lasers or Q-switched Nd:Yag laser instead.

After these laser treatments, you can expect dry scabs to form and will require a week for them to fall off. You will also observe improvements with your skin after 2 to 3 laser sessions.

These laser sessions are typically spread across 2 to 3 months. The average cost for such treatment is about $800 to $1,600 in Singapore.

Intense Pulsed Light (IPL) Treatments

Freckles and solar lentigos can also be treated using Intense Pulsed Light (IPL) devices. IPL treatments are a good alternative as it can save you $100 to $200 for the same number of sessions for a medical-grade laser treatment.

Take note that this treatment is suitable for you if you ONLY have freckles or solar lentigos.

Hence, you should first visit a doctor before signing up for a treatment involving IPL devices. This is especially so if you have combination or deep pigmentations, or unsure about the type of pigmentation you have.

Comparing the two ...

In a nutshell, medical-grade lasers (E.g. Pico Lasers) make a good option as it can be targeted at a more comprehensive range of pigmentation issues. 

 

This leaves us with THE hardest type of pigmentation to treat - Hori’s naevus!

illustration on horis naevus

Since Hori's naevus leave deep pigmentations on the skin, topical treatments will not be effective in treating them. Instead, you should opt for laser treatments, which would be the most effective form of treatment for Hori's naevus.

Unlike other types of pigmentation, Hori’s naevus is quite resistant to treatment. As such, you would not observe any immediate effects with just a single treatment session.

On average, you may require a minimum of 5 to 10 sessions of lasers to treat your condition. Hence, it may take you 3 to 10 months for any observable improvements.

Please do not be disheartened by this news!! There are many doctors in Singapore that can help you with your condition.

What you can do to get the most out of your treatment is ... 

You should choose a doctor that you trust and are comfortable with as laser treatments last for a relatively long period. You should also stick with the same doctor throughout as constantly switching doctors will only do more harm than good when it comes to treating Hori’s naevus.

Cost-wise, you can expect to spend about $3,000 to treat Hori's naevus in Singapore. But you should still take note that your actual treatment cost will still depend on the severity of your skin condition.

 

How much improvement should you expect after pigmentation treatment?

closeup on asian woman smiling

On average, you can expect your skin pigmentation issues to improve by 50% to 90%. The variation in observed improvements is due to the differences in the type and severity of skin pigmentation.

As such, it would be impractical for you to expect flawless skin after treatment if you have pigmentation that is on the severe side. It will only be wise for you to comply with your doctor’s instructions on post-treatment care to ensure you get the best results after your pigmentation treatment.

 

Will your pigmentation problem recur after treatment?

closeup on pigmented area of young asian woman

"Will I have skin pigmentation again after my treatment?" Well... the answer is not so simple as it depends on the type of pigmentation you have. 

The answer is NO if you have had a history of Hori's naevus as it does not recur easily once treated. This is the same for post-inflammatory hyperpigmentation as well unless you have caused new injuries or inflammation to the skin.

If you have had a history of melasma, freckles, or solar lentigo, then the answer is YES. These types of pigmentation are more likely to recur as they can easily be triggered by sun exposure. They can also resurface if you do not have proper after-treatment care.  

What can you do to prevent these conditions from recurring?

You should strictly adhere to your doctor’s instructions on post-treatment care. To stay protected from the sun, you should also follow a skincare regime that has sufficient sun protection measures.

Clearly, a good sunscreen is very important here in preventing the reappearance of skin pigmentation. Therefore, you should definitely not skimp on one!

You can obtain a good sunscreen here in Singapore within the $50 and $100 range, and trust me, it is definitely worth the price!

 

How to prevent your pigmentation from worsening

illustration of uva and uvb penetrating into skin

We should all know by now how damaging the sun can be to our skin. To prevent your skin pigmentation from worsening, you should:

  • follow your doctor’s advice on pre and post-treatment care
  • and adopt the skincare regime your doctor has advocated.

Here are some tips to keep you protected from the sun all-year-round here in Singapore:

  • You should find a sunscreen with SPF 30 - 50. Anything below SPF 30 may be insufficient to protect you from the sun while anything above SPF 50 may be too much.
  • The sunscreen should also have the label “PA+++” or “broad spectrum coverage for Ultraviolet-A &B”.
  • You should wear sunscreen even when indoors or during cloudy days to stay protected from any UV rays that may seep through windows or from the fluorescent lights in your house.

 

3 money-saving tips for pigmentation treatment in Singapore

asian woman inserting coin into piggy bank

There are no government subsidies for pigmentation treatments in Singapore at present. However, you can find some financial relief with the following cost-saving tips that I have to share!

Tip 1: Start with the Correct treatments

Many patients tend to self-medicate themselves instead of seeking medical help since the start. Very often, these patients try more than 5 types of over-the-counter cosmetic creams.

While cosmetic skin care can help with mild pigmentation, it is not sufficient to treat deeper pigmentation like melasma. They are also not cheap.

Seeing a doctor who is an expert in handling pigmentation issues shortens your treatment journey. In this way, you also do not waste time and money on ineffective creams.

Getting the correct medical treatment for your skin pigmentation (creams + laser) is often better in the long run. Not only will you get more effective results on your skin pigmentation, but it is also more cost-effective. 

Tip 2: Correct doctor and clinic

Pigmentation treatment is a journey. It is a marathon, not a sprint. Hence, it is important that you find an expert doctor whom you are comfortable to see for months to years.

This aspect of my job is very fulfilling as many of my patients have become long-term friends. Pigmentation treatment is a team sport - you will need some motivation and support every now and then. Pick the right team!

Convenience is key. Many patients underestimate the true time-cost of pigmentation treatments. Location is important when it comes to pigmentation treatments. Pick a clinic that is convenient for you! This is because you might have to visit the clinic for more than 10 times over the course of 6 months.

Tip 3: Prevention (or maintenance) is better than cure

Your skin is no different from other parts of your body. As the saying goes, prevention is better than cure. It is just as important (if not more) to prevent new pigmentations from forming than removing existing pigmentations.

As always, you should apply sunscreen religiously to prevent your skin pigmentations from worsening. By doing so, you are also able to maintain the results of your pigmentation treatment.

Start your journey now!

 


Dr Justin Boey is an Aesthetic Doctor with Sozo Aesthetic Clinic. Dr Boey has a special interest in Facial Aesthetics relating to pigmentation, acne scars, and facelift, as well as Hair Loss.

Read more from Dr Justin Boey in his Q&A here. 

 

Would you like to ask any related health questions?

You can Ask A Doctor right away, or view the complete list of DxD Sessions.


References

1. Sarkar R, Bansal S, Garg V. Chemical peels for melasma in dark-skinned patients. Journal of Cutaneous and Aesthetic Surgery. 2012;5(4):247. doi:10.4103/0974-2077.104912

2. Auburtin P, Wang T, Cockcroft SL, Mitchell A. Freckle formation and freckle criterion in superalloy castings. Metallurgical and Materials Transactions B. 2000;31(4):801-811. doi:10.1007/s11663-000-0117-9

3. Andersen WK, Labadie RR, Bhawan J. Histopathology of solar lentigines of the face: A quantitative study. Journal of the American Academy of Dermatology. 1997;36(3):444-447. doi:10.1016/s0190-9622(97)80224-1

4. Polnikorn N, Tanrattanakorn S, Goldberg DJ. Treatment of Horiʼs Nevus with the Q-Switched Nd:YAG Laser. Dermatologic Surgery. 2000;26(5):477-480. doi:10.1046/j.1524-4725.2000.99305.x

5. Cardinali G, Kovacs D, Picardo M. Mechanisms underlying post-inflammatory hyperpigmentation: lessons from solar lentigo. Annales de Dermatologie et de Vénéréologie. 2012;139:S148-S152. doi:10.1016/s0151-9638(12)70127-8

6. Elgart GW. SEBORRHEIC KERATOSES, SOLAR LENTIGINES, AND LICHENOID KERATOSES. Dermatologic Clinics. 2001;19(2):347-357. doi:10.1016/s0733-8635(05)70272-2

7. Sarkar R, Gokhale N, Godse K, et al. Medical management of melasma: A review with consensus recommendations by Indian pigmentary expert group. Indian Journal of Dermatology. 2017;62(6):450. doi:10.4103/ijd.ijd_489_17

8. Bandyopadhyay D. Topical treatment of melasma. Indian Journal of Dermatology. 2009;54(4):303. doi:10.4103/0019-5154.57602

9. Janney MS, Subramaniyan R, Dabas R, Lal S, Das NM, Godara SK. A Randomized Controlled Study Comparing the Efficacy of Topical 5% Tranexamic Acid Solution versus 3% Hydroquinone Cream in Melasma. Journal of cutaneous and aesthetic surgery. 2019;12(1):63-67. doi:10.4103/JCAS.JCAS_40_18

10. Choi Y-J, Nam J-H, Kim JY, et al. Efficacy and safety of a novel picosecond laser using combination of 1 064 and 595 nm on patients with melasma: A prospective, randomized, multicenter, split-face, 2% hydroquinone cream-controlled clinical trial. Lasers in surgery and medicine. 2017;49(10):899-907. doi:10.1002/lsm.22735

11. Chalermchai T, Rummaneethorn P. Effects of a fractional picosecond 1,064 nm laser for the treatment of dermal and mixed type melasma. Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology. 2018;20(3):134-139. doi:10.1080/14764172.2017.1376098

1271 views 12 Jul 2019 Medically reviewed by Dr Justin Boey on 7 Aug 2019.
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Disclaimer: Any answers provided are for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor immediately. Always seek the advice of your doctor before starting or changing treatment.

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