Pigmentation problems? You’re not alone.
Singaporeans, especially those with darker skin, are highly predisposed to getting pigmentation due to excessive UV exposure from the year-long sun in our tropical climate.
Women in particular are highly susceptible to issues such as melasma, freckles, and Hori's naevus.
However, despite the widespread pervasiveness of pigmentation, a lot of patients I see seem to think that a simple “laser zapping” session will solve everything.
In truth, pigmentation treatment in Singapore is much more complex, and requires careful tailoring according to your condition and skin type. This post explains in detail how you can get the most appropriate treatment for your situation.
Pigmentation treatment should start with the right diagnosis.
Ever heard of “freckles, melasma, age or sun spots”?
The very first step to effective pigmentation treatment in Singapore is an accurate diagnosis.
A common mistake many people make is to go straight for laser treatments. Everyone seems to think that ALL pigmentations are the same, and that lasers are the best and only option.
THIS IS UNTRUE. Laser treatments are NOT always needed, so don’t waste your money (and risk unnecessary side effects) if you don’t have to.
Different conditions require VERY different treatment methods. The problem is they all look pretty similar to the untrained eye, so it can be hard for you to tell one from the other. Which brings me to...
The most common types of pigmentation problems I see in Singapore
|Post Inflammatory Hyperpigmentation (PIH)|
|Seborrheic keratosis (“Pigmentation Bumps”)|
See what I mean by they all look EXTREMELY similar?
It is also possible to suffer from more than one condition simultaneously (eg. melasma with Hori’s naevus), which makes diagnosis even more difficult.
If left unchecked, pigmentation can become very complicated and difficult to treat. It would be wise to seek expert treatment from trusted doctors as early as possible.
Are over-the-counter pigmentation creams in Singapore effective?
"Doctor, can I self-medicate with over-the-counter creams? I can save a lot of money!"
Although some over-the-counter products are useful for preventing pigmentation (especially sunscreens), over-the-counter skincare products or oral skin supplements are generally poor for treating pigmentation.
Over-the-counter products should not be confused with medical-grade creams (eg. hydroquinone), which are specially formulated to treat pigmentation. The latter have undergone rigorous clinical trials to prove their efficacy, and can only be prescribed by doctors in Singapore.
How is less severe melasma treated?
Treatment for melasma depends on the severity and depth. For less severe cases, medical-grade creams and sunscreen are usually sufficient.
Medical grade creams like hydroquinone, tretinoin or combinations, are very effective for treating melasma. These doctor-prescribed creams need to be monitored for side effects like redness, itching and stinging of the skin. Lightening of melasma is expected after 5 - 7 weeks of treatment.
Topical creams generally cost from $60 to $180. Good sunscreens (SPF 30-50, PA+++) cost about $50 - $100.
How is more severe melasma treated?
Lasers are often the next line of treatment for more severe melasma cases. Other modalities that may be used to treat more severe melasma include chemical peels or oral tranexamic acid.
Generally, patients see good results after 3 - 8 laser sessions, with 4 - 6 sessions being the usual range. Each session is about 15 minutes long, and the full program might take 2 - 3 months.
That sounds rather long, but on the upside, lasers used to treat melasma usually do not have any downtime.
The cost of laser pigmentation treatment in Singapore for more persistent melasma ranges from $1500 - $2800.
The final cost depends on 2 main factors:
- The clinical experience of your doctor
- The number of laser sessions you require
How is post-inflammatory hyperpigmentation treated?
Generally, the above mentioned treatment modalities for melasma (ie. topical medical creams, chemical peels and lasers) can also be applied to post-inflammatory hyperpigementation.
Since the treatment methods are so similar, much of the effectiveness comes down to the doctor’s skill and experience.
How is seborrehic keratosis or “pigmentation bumps” treated?
Pigmentation bumps are usually removed using electrocautery or through ablative laser surgery.
Treatments (about 10 to 20 mins) are done on numbed skin, with about 1-2 sessions needed.
Despite the scary names, the process is actually quite straightforward and almost pain-free with the help of numbing creams.
Slight downtime of 3 - 7 days is expected for the post procedural wounds to heal, but the good news is that you can expect almost instant results right after.
Treatment for pigmentation bumps in Singapore costs about $300 to $1000.
How are freckles and solar lentigos treated?
Many clinics in Singapore immediately recommend a laser package when they see a patient with freckles and solar lentigos.
But do you know they can also be treated with simple, topical medicated creams such as hydroquinone?
Always ask your doctor for this option before signing up for any laser package.
For more persistent cases, lasers like the Q-switched Nd:Yag laser can be used. This will carry a downtime of around 1 week due to the dry scabs that form.
It usually takes 2-3 sessions of lasers over 2 to 3 months to see good results. Cost-wise, you can expect to spend around $800 to $1600.
If you ONLY have freckles or solar lentigos, you can also consider Intense Pulsed Light (IPL) devices. It’s cheaper ($100-200) and usually takes the same number of sessions as medical-grade lasers.
If you are NOT SURE what kind of pigmentation you have, or if there are mixed or deep pigmentations, it would be advisable to see a doctor instead.
Medical grade lasers (eg Q-switched lasers) are much more effective at clearing a comprehensive range of pigmentations compared to IPLs.
This leaves us with THE hardest type of pigmentation to treat - Hori’s naevus!
Hori’s naevus are deep pigmentations, so the nature of it alone already rules creams out as an effective treatment. You WILL have to undergo lasers for this.
Redness and swelling post-treatment usually lasts for a few days.
Compared to other pigmentation types, Hori’s naevus can be tougher to treat, so 3 - 10 sessions of lasers might be needed.
It also takes about 3 to 10 months (!!!) to see really good results. Don’t be disheartened if your condition doesn’t improve immediately.
Pick a doctor you trust and STICK WITH HIM OR HER. Constantly switching doctors will NOT help your case!
The treatment cost varies depending on the severity, but most patients do not spend more than $3000.
How much improvement should you expect after pigmentation treatment?
Generally, you can expect visible improvements of about 50% - 90%, depending on the type and severity.
This means that if you have an extremely severe case of pigmentation, it’d be wiser not to expect completely clear, smooth skin after the treatment program.
I cannot stress this point enough, but your compliance to the doctor’s instructions is CRUCIAL in getting the best results.
Will your pigmentation problem recur after treatment?
Hori’s naevus do not recur so readily once treated, while PIH should not recur unless there are further skin injuries or inflammation.
On the other hand, pigmentation aggravated by sun exposure (especially freckles, solar lentigo, melasma) tend to recur if there’s insufficient post-treatment maintenance.
In such cases, adhering to the doctor’s post treatment instructions and having a good skincare regime (sunscreen and sun protection measures) are imperative to sustaining long term results.
Good sunscreen is very important and worth paying $50-$100 for!
How to prevent your pigmentation from worsening
The sun is the biggest culprit when it comes to worsening pigmentation problems.
Listen to your doctor’s pre and post care advice carefully, and adhere to the recommended skincare regime.
Here are some quick tips for sun protection measures:
- Look for a sunscreen that is labelled as SPF 30 - 50. Anything more is excessive.
- It should also be labelled as “PA+++”, or “broad spectrum coverage for Ultraviolet-A &B”
- Sunscreen should also be used even when you are indoors, or during cloudy days.
3 money-saving tips for pigmentation treatment in Singapore
Generally speaking, there are no government subsidies for pigmentation treatments in Singapore, but you can save on costs with the following three tips:
Tip 1: Check if you really need laser treatment
Simply ask your doctor if you need lasers. PIH, melasma, solar lentigos and freckles often respond well to topical creams.
If the pigmentation is not too serious, topical creams alone can often get the job done. We’re talking about big savings here ($300 creams vs. $2,200 lasers)!
Tip 2: Pay for results instead of technology
Another aspect is the cost of technology. While conventional lasers like the Q-switched Nd:Yag can still be very effective as a pigmentation treatment, aesthetics is an industry that thrives on marketing the newest and latest technology.
Being "new and trendy", such lasers obviously cost more to bring in, and clinics charge higher prices for them. Paying for a hyped up, new laser can potentially cost you $3,000 EXTRA for a 5-session package in Singapore!
However, there is no guarantee that new lasers do a better job, as ultimately, results depend very much on the experience of the performing doctor.
Tip 3: Ask your doctor these 3 questions
Finally, I'd suggest for you to send in an enquiry to a few trusted doctors to get a variety of opinions, and ask these questions before signing up for any treatment:
- How many patients have you treated for this SPECIFIC pigmentation condition (eg. melasma, solar lentigos etc)?
- Do you have a before/after album of patients who have been successfully treated?
- Are there OTHER treatment options besides lasers?
Experienced doctors will be able to provide appropriate advice and insights, so going to the RIGHT doctor can save you a lot of money and disappointment.
Dr David Ng C H has a deep passion and long career in treating skin and aesthetics issues eg.pigmentations, acne and anti-ageing. He strongly believes in a holistic approach to treatments and achieving the best results for his patients. Apart from discussing medicine, he is an avid foodie and would travel near and far with his family to gratify his appetite on weekends.
- Del Bino, S., Duval, C., & Bernerd, F. (2018). Clinical and Biological Characterization of Skin Pigmentation Diversity and Its Consequences on UV Impact. International journal of molecular sciences, 19(9), 2668.
- Bonilla, C., Ness, A. R., Wills, A. K., Lawlor, D. A., Lewis, S. J., & Davey Smith, G. (2014). Skin pigmentation, sun exposure and vitamin D levels in children of the Avon Longitudinal Study of Parents and Children. BMC public health, 14, 597.