Doctor's Answers (5)
This is a very common question asked by many of my patients. As the question is rather general with no specifics regarding to the type and severity of the pigmentation I would like to offer my advice as such :
For mild pigmentation issues which is more like Dyschromia or patchy skin with open pores you can consider the following
1. Medifacials — the most popular and effective ones being Silkpeel , Hydrafacial and Oxygeneo . What they have in common is that they exfoliate the skin getting rid of the dead skin cells, infuse the skin with brightening and hydrating agents and in the case of the oxygeneo there is an element of RF skin toning as well .
2. TDD ( transdermal delivery ) devices which include iontophoresis, electrophoresis, sonophoresis , microneedling , and plasmaphoresis . What these devices have in common is that allow better penetration of active ingredients into the skin to have either brightening / whitening effects or effects on skin texture/ hydration and pores .
For pigmentation issues that are more severe you can consider the following
1. IPL or intense pulse light photofacial or photorejuvenation . In simple terms this is a light based energy device that delivers light of different wavelengths that effects changes in the skin . It is especially effective for freckles and superficial pigmentation and redness on the skin and also helps in reducing pores thus making the skin smooth and glowing .
2. Lasers that target the pigments would be generally the Q switched lasers or the newer gernerstion of Picosecond lasers . While these lasers primary target is the pigment the light energy they emit is also absorbed by the water in the skin which induces a mild thermal injury . This in turn stimulates the fibroblasts to produce new collagen as well as collagen remodeling. This will have a beneficial effect on the open pores, scars and skin texture . The Pico Genesis Laser for example has a MLA ( microlens array ) handpiece that allows the energy to be better concentrated and at a deeper penetration to allow for more effective neocollagenesis.
3, Slyfirm which is a new generation of RF microneedle device that utilises non insulated needles to deliver micro pulses of RF coagulative energy to induce changes in the basement membrane (BM ) of the skin, These changes leads to improvement in pigmentation as well as redness of the skin . Because the depth of penetration can be calibrated it can also lead to improvement in open pores and skin texture .
Hope this helps . Please discuss your expectations of the treatment outcomes with your doctor so that he / she can advice you on the best possible options for you .
Dr KK Chew
Your question resonates with a lot of readers, there are many people with the same problem! Pigmentation and pores are a source of frustration for many of my patients, both males and females alike.
First of all, the harsh sun in Singapore does not help when it comes to maintaining fair skin. Thus it is very important to apply a broad spectrum sun screen of SPF 50 and above daily, at least 30 mins before going out of your house. This helps to protect your skin from the sun's harmful rays, as well as acts to prevent further brown spots from developing.
Topical whitening agents and Vitamin C serums can help to lighten pigmentation spots to a certain degree, you will need to consult a dermatologist for prescription of medical grade creams that are effective. Topical retinoids, which are Vitamin A derivatives, can help in the lightening of brown spots and are also useful to prevent blocked pores, and this is turn helps to minimise pores.
In my practice, I find the new generation picosecond laser to be effective for lightening pigmentation on the face, and with an added brightening and toning feature, patients love the after effect of skin texture improvement, overall radiance and natural glow. A few sessions will be needed depending on the individual's condition.
Do consult an experienced dermatologist for a proper assessment and treatment plan. Cheers to a new year ahead!
Dr Ker Khor Jia
For treatments that addresses BOTH pigmentation and large pores in the same session, it would really depend on whether:
a) You will be able to accomodate downtime/ redness after the procedure
b) The type of pigmentation that you have (we will have to generalise for now as the type of pigmentation can only be determined during an examination and consultation)
Treatments will include:
1) The Spectra XT Carbon Laser Peel
This treatment targets pigmentation as well as pores. Other benefits include brightening of the skin and collagen stimulation.
There is no downtime with this procedure, is often a lunch time procedure as it is quick but yet is still able to penetrate into the deeper skin layers.
2) The BB Laser
This treatment targets pigmentation, large pores and brightens the skin. Overall texture of the skin will also be improved with smoothening of the skin.
This treatment is more effective at treating pores but there is downtime associated post-procedure.
Redness of around 3 - 5 days is to be expected.
Hope this helps.
All the best!
There are definitely treatments that are effective for both hyperpigmentation and enlarged pores . However, first and foremost, it will depend on the cause and kind of hyperpigmentation that you are having, the cause of your enlarged pores and presence of any other associated conditions like acne, as well as the extent of your hyperpigmentation.
By and large, topical therapy, injectables, lasers and radiofrequency micro-needling will be able to treat hyperpigmentation and improve skin texture e.g. enlarged pores to a certain extent.
Topical therapy will include creams that contain retinoids which will increase cell turnover, stimulate collagen and inhibiting tyrosinase activity, hence improving hyperpigmentation and reducing debris buildup in pores, resulting in improved skin texture. Chemical peels will also help to increase epidermal turnover and hence improve hyperpigmentation and skin texture.
Injectables like Rejuran(PDRN) have been shown to help with scars, pores and pigmentation through the anti-inflammatory, regenerative and reparative properties of polynucleotides.
Lasers like Picosecond lasers and Q switch Nd:YAG lasers are effective in helping to clear pigments and improve skin texture through photoacoustic and photothermal effects respectively. In my practice, I like to use the newer PicoSure laser for both treatment of pigmentation and skin texture as it has a shorter downtime and lower risks of post-inflammatory hyperpigmentation.
Lastly, pulsed radiofrequency microneedling treatments e.g. Sylfirm helps with restoration of the skin's basement membrane and ablation of small vascular lesions and abnormalities which in turn improves pigmentary conditions like melasma and can also improve skin texture.
Thanks for this great question. We get it so often!
Large pores can be due to oily skin (usually men and younger ladies) or increasing skin laxity due to age/solar elastosis.
There are so many different types of pigmentation - freckles, lentigenes, melasma.
SO first step is to get a proper assessment by an experienced dr.
I will share what we recommend for pores and highlight those treatment that may resolve certain pigmentory conditions.
Indications - For both pores due to oil dysfunction and laxity
* great for underlying melasma/sun damage
This is a gentle thulium laser (for skin rejuvenation) combined with skin care. There is no downtime. Good as a maintenance treatment.
* great for freckles and lentigenes
This is a state of the art 755nm pico (1 trillion of a second) laser that uses photo mechanical energy to stimulate skin rejuvenation from dermis. FDA approved for acne scar and skin rejuvenation. Also FDA approved for treatment of pigmentory conditions like freckles and lentigenes.
Indications - For pores due to oil dysfunction and laxity
*increases hydration and brightening of skin (not specific for any pigmentory condition)
Rejuran is from korea and increases collagen production and elasticty of the skin. The skin booster allow us to use the injector to create slight damage to the skin for controlled healing. Sometimes botox is added (off label use) to control oil dysfuntion and create further improvement of the appearance of pores. Great maintenance if you do not want multiple treatments.
Hope this lengthy reply helps!
DO NOT forget to apply sunblock generously on a daily basis! It is the single most important anti-aging product that you can use on your skin.