What is the difference between beauty spas, medical aesthetic centres, and aesthetic clinics in Singapore?Aesthetic Medicine Skin, Hair & Nails
Dear doctors, could I please seek your opinions on suitable treatment for skin pigmentation after giving birth some time ago?
My skin is fair, and I have found these pigmentation marks on my face to be rather unsightly. I am terribly confused by all the laser treatments offered by beauty spas, medical aesthetic centres, and aesthetic clinics in Singapore.
I have seen frequent advertisements for beauty spas who claim on their websites that they use the best machines and technology. The available types of treatment also appear to be the same as that offered by clinics, but cheaper.
What does it mean when the beauty spas claim that their treatment is “doctor-designed” or “doctor-approved”? Because when I went to their outlets, the manager claimed that there was no doctor on duty.
I am worried that my pigmentation will get worse as I heard some stories from my friends who developed worse discolouration of the skin after going for a skin laser treatment. Please advise. Thank you.
Let me answer the multiple questions which are outlined above.
Firstly, for your pigmentation, I think it will be easier if you consult a doctor to see what sort of pigmentation it is. But judging from the history that it worsened after pregnancy, it may well be melasma which is patchy pigmentation in the face, primarily over the cheek area. There are various treatments available, including topical and machine-based treatments such as lasers. Risks and benefits such as rebound worsening or pigmentary hypopigmentation from over treatment should also be discussed.
As you noted from your friend, sometimes excessive or poorly administered treatments can worsen the pigmentation. In our practice, we have seen hypo pigmentation from excessive laser treatments, or worsening of pigmentation, and even facial burns.
Your second question is about the difference between beauty spas, medical aesthetic centres, and aesthetic clinics. Clinics fall under the purview of the Ministry of Health (MOH), and we are bounded by guidelines that ensure we don’t over-sell or over-promise, or use words which are promotional. This is really to ensure that clinics give the various options, explain some of the benefits/risks, and allow the patient to make their choice.
Laser treatments at clinics are done by doctors, who understand and recommend treatment protocols based on experience.
Beauty spas and medical aesthetic centres are not bound by the same MOH guidelines, which lead them to use words like “BEST”, “ONLY”, “AMAZING”, and “INSTANT in their advertisements. Unfortunately, most of these claims are un-founded, and many spas (not all) play on patients’ confidence. Huge packages are signed up for, which tend to under-deliver their promises.
Spas are primarily operated by beauticians/therapists, and what they usually provide is facial extractions and facial massages. However with the advent of machines, some of them have started doing machine treatments. Some spas purchase laser machines, which under NEA's purview should only be provided to license holders (usually doctors). I am not entirely sure what framework they get these under, maybe doctors “lending their names”? The lasers are then done by the therapists which is not appropriate in accordance to Singapore regulations.
Medical aesthetic centres I would actually call a step up from simple spas. There is the added confidence of a “medical” supervision of patients. But as long as they are not clinics, they are actually still spas in reality. Some spas hire 1-2 doctors who may lend the medical credence, but they are generally running around many branches.
There may be the occasional “lucky-hit” by patients who actually get to see the doctor for consultation, but by and large as you have experienced, “the doctor is not in” is the usual answer by the staff. Fortunately many of the medical aesthetics tend to focus on machine-based treatments, so much less harm is done. And to date, there have been very few issues of non-doctors doing fillers/injectables, as compared to overseas practices, that have arisen in Singapore.
In summary: clinics are clinics for a reason in that the doctors play a primary role in the consultation, diagnosis and follow-up of the patient, even if some of the safer treatments are done by therapists/staff. Injectables and lasers in Singapore are done by doctors, and clinics are obliged to generally toe the legislative line drawn by the Ministry of Health in advertising.
Medical aesthetic centres, in my opinion, are spas trying to gain patient confidence by adding the term “medical”, while there is little or no follow-up by the doctors (if the patients even get to see one during their treatment protocols). They also have the added advantage of not being bound by Ministry of Health rules.
Ultimately, caveat emptor, and the patient has to make their own choices on what is the best or safest option for themselves.
Hope the above helps!
A beauty spa is not a licensed clinic by the Ministry of Health.
An aesthetic clinic has a Ministry of Health licence. All that means is that a Ministry of Health licensed clinic needs to comply with the Private Hospitals and Medical Clinics Act and regulations, i.e. types of treatments offer must be evidence-based, advertisements must be factual and supported by clinical evidence, and doctors doing treatments must be certified to perform certain procedures.
So, hopefully the standard of practice and care for these clinics are enforced by the Ministry of Health. This however, does not apply to beauty spas or aesthetic centres.
As for the claims made by the beauty spas, they do not have to be supported by clinical evidence. They can be anecdotal claims of effectiveness. Many such spas are commercially-driven.
As for your facial pigmentation, you will to arrange a consultation with a doctor who is trained aesthetics or skin. There are many sorts of pigmentation that can affect the facial skin. Melasma, for example, is one that can be aggravated by pregnancy and sun exposure.
I will be happy to clarify any points if you have any questions. I hope you found the information helpful for you to make an informed decision about your prospective treatments.
Dr Benjamin Yim
A Dermatologist's Guide To Scar Removal In Singapore (2019)
Many of my patients come to my clinic seeking scar removal treatment, so I decided to put together this guide to address some of the most common...READ MORE
Six Myths About Teeth Whitening In Singapore
Ever considered teeth whitening in Singapore, especially after seeing before/after pictures when someone's teeth magically turns whiter in 15 minutes?...READ MORE