What are the causes and best treatment for brown facial pigmentation in Singapore?
I have a circular stubborn brown mark on my face which has been there for 3 years. I have done several q switch lasers and fracitional co2 lasers with very little improvement. Now, not only the brown mark is there but there are also some white spots. Would you be able to recommend me a good clinic or a good dr who is able to provide a solution for my problem. I have been to several clinics with no luck.
The most important part of treatment pigmentation is first a correct diagnosis by an experienced doctor.
Freckles are mainly due to genetic predisposition and though it is easily removed, will certainly return when your skin is exposed to the sun so sunblock and sun avoidance is so important.
Lentigens or sunspots occur in sun exposed area of face and body and is due to photodamaged of underlying skin. Under special photograph filters, once can easily notice a vascular abnormality under the pigments. To successfully treat lentigines, I will suggest using the Excel V laser which reverses some of the photodamage. If the lentigene is very faint, sometimes a touch up with Picosure laser can blast the small pigments into really fine particles for the body to clear easily.
Some pigmentations such as Adult bilateral naevus of ota macules (ABNOM) are deep in skin and will need multiple sessions with a highly powered laser for best results.
Melasma is often under-diagnosed. If there is underlying melasma of the skin, fractional lasers can sometimes make the melasma worse.
There are many types of pigmentations and many different ways to achieve a good outcome. Please consider going to a doctor experienced with pigment treatments for a better outcome.
Circular brown marks on the face can be due to different skin conditions and the treatment response depends on what the underlying cause is. Some conditions eg. solar lentigines are laser responsive while other types of pigmentation may be less responsive to laser treatment. The background skin type may also influence the types treatment that can be used.
I would advise seeking treatment with a dermatologist to determine the exact cause of the pigmentation so that a proper diagnosis can be made and the appropriate treatment given.
The most important step in all pigmented conditions is to get the diagnosis right as different pigmented conditions will require different treatment options. Even with the same laser, different laser settings are employed for different pigmented conditions. An examination will therefore be pertinent for your case.
As for the white spots, if they had started to occur after the multiple treatments of laser that you have had, then I would be prudent in subsequent laser sessions as your pigment cells in these areas have already been damaged thereby producing these white spots (ie. no pigment cells = no pigment = white spots).
Hope that helps.
All the best!
I am quite concerned about your white spots appearing around your brown mark.
It sound like you have done several laser treatments over the years. Pigment cells may have been damaged and unfortunately, no pigments = white spots as Dr Ho rightfully pointed out.
To me, you would need to seriously consider stopping laser treatments. I would suggest antioxidants to help with your brown spot and nothing more invasive.
Hope this helps!
Pigmentations are common skin problems especially in the Asian skin types, and they can be treated well.
For your case, I would recommend stopping further laser treatments for the time being since there are already associated white spots developing with your brown mark.
Next, let an experienced doctor diagnose what exactly is that stubborn brown mark on your face. Is it solar lentigo, freckles, or something else? From there, the doctor should be able to advise you on the most appropriate treatments and prevention measures.
Depending on the type and severity of pigmentations, topical creams with sun protection measures alone can be sufficient to treat the pigmentations, so you may not even need laser treatments.
I have actually included photos of the various types of pigmentations commonly seen in my clinical practice. You can read more about them in my "Ultimate Guide to Pigmentation Treatment in Singapore".
Hope this helps!
Dr David Ng C H