The Ultimate Guide To Pigmentation Treatment In Singapore (2020)

Guides
Dr Justin Boey

"Doctor with interest in Aesthetics and Lasers"

Pigmentation treatments are one of the most popular procedures 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. 

Despite how prevalent the issue is, readers tend to be misinformed on how aesthetic doctors and dermatologists can best treat 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!

Your diagnosis will determine which pigmentation treatment is most suitable

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. The treatment should always start with an accurate diagnosis from a trained doctor. This will ensure success and safety throughout the whole procedure!

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.

It might be difficult for a layperson to determine the diagnosis. 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.

Based on my experience, most cases of skin pigmentation will require a combination of:

  • Lasers
  • Medical-grade creams
  • Sun protection and avoidance

Common types of pigmentation in Singapore

1. Freckles

asian woman with freckles on cheeks and nose

Freckles are termed as:[1]

  • tiny light brown spots on the cheekbones and nose
  • often in younger people

2. 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:[2]

  • blotchy patches of light-to-dark brown discolouration
  • 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

3. Post-Inflammatory Hyperpigmentation (PIH)

closeup on woman 

Post-inflammatory hyperpigmentation is often found in darker skin types and has the following features: [3]

  • discoloured 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

4. 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[4]

  • light brown or black spots on the face
  • rough in texture and is slightly elevated from the face
  • found in elders and especially those with a family history of seborrheic keratosis

5. Solar Lentigo

solar lentigo formed on elders arms

A condition commonly found in elders and is caused by prolonged exposure to UV radiation. [5]

  • single or a few dark spots on the face
  • round in shape and uniform in colour

6. 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: [6]

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

Can you tell the difference?

Don’t they look almost similar to each other?

There are also other reasons that can complicate the diagnosis of your skin condition.

Did you know that you can have more than 1 type of pigmentation? For instance, you may be suffering from Melasma and Hori's naevus at the same time!

Different forms of pigmentation require different types of lasers and creams. As such, you should always seek medical assistance from a doctor or dermatologist!

How effective are over-the-counter pigmentation creams?

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. 

 

Treatment of mild melasma

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.

Treatment of severe melasma

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. Your doctor's clinical experience
  2. The type of laser (Pico Lasers, which are one of the latest lasers tend to be more expensive)
  3. The required number of laser sessions tailored to your condition

 Also read: A Complete Guide To Pico Lasers In Singapore

Treatment of post-inflammatory hyperpigmentation

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. 

Treating seborrheic keratosis or “pigmentation bumps”

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.

Treatment for freckles and solar lentigo

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

That said ...

Do you know that topical agents like hydroquinone can treat freckles and solar lentigos?

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 broad and diverse range of pigmentation issues. 

Treating Hori's naevus - leave it to the professionals!

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 discouraged 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 continue with the same doctor throughout as constantly changing 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.

What results you should expect after starting a course of 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.

Is it possible for pigmentation to 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 protect your skin from pigmentationillustration 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.

Savvy tips to getting 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 skincare 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 or dermatologist 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 a medical 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.  

References

1. 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

2. 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

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