Pigmentation

Cosmetic Services
Skin Pigmentation

Facial pigmentation is one of the most common reasons for seeking a skin consultation. This is especially so in Asia where the quest for porcelain clear skin has fueled the development of many products and treatments. Given the plethora of creams and therapies available in the marketplace, a person can be excused for wondering if there is a need to see a dermatologist at all.

What value can a dermatologist add?

There are 3 main areas in which a dermatologist can add value:

  1. Accurate Diagnosis – Pigmentation is a complex problem and not all pigment conditions are treated in similar fashion. It is often not uncommon for patients to have more than one type of pigment disorder. The key then, to optimizing treatment outcomes is to have a good match between the treatment modality and the pigment disorder. This is where effective and efficient outcomes hinge on an accurate diagnosis.
  2. Assessment of Skin Type – Every treatment be it a cream, tablet or procedure has its inherent risk. Aside from diagnosing the pigment disorder, a dermatologist is able to evaluate the patient’s skin type. This reduces the incidence of adverse reactions be it allergy or irritant reactions from creams or aggravation of the pigmentation from treatment procedures.
  3. Adopt a Holistic Approach – Treatment of pigmentation is not just about prescribing a medication or performing a procedure. Often, patients are ignorant of the fact that certain lifestyle habits, medications they are taking or skin care products they are using are in fact the cause of their pigmentation or are compromising the results from treatment.

    This is where a dermatologist, through an evaluation of the patient’s medical history and a screening of the patient’s skin care routine, can educate the patient on how to get the most out of their treatments.
There are many pigmentary disorders, both genetic and acquired.

Specialist Skin Clinic Provides Customized & Targeted Treatment Plans – Call 6734 1411 To Enquire Today.

What are the different types of pigmentation?

There are many pigmentary disorders, both genetic and acquired. The most common ones include melasma, freckles, lentigos, postinflammatory hyperpigmentation (PIH) and Hori’s nevus.

  • Melasma – Presents as a diffuse brown and/or grey pigmentation on the forehead and cheeks. It occurs more frequently in women than men and is caused by genetic factors, hormonal changes and sun exposure. It is often encountered in pregnancy or with oral contraceptive use.
  • Freckles and Lentigos (Liver Spots) – These present as distinct, polka dot like spots on the cheeks and nose. Freckles are often light brown in color and are more often seen in fair-skinned individuals, both children and adults alike. They may fade with sun avoidance. Lentigos are generally bigger and more clearly defined spots. They are seen in adults following years of sun damage and persist despite further avoidance of sun exposure.
  • Post-inflammatory Hyperpigmentation (PIH) – As the name suggests, this occurs following injury or inflammation in the skin. The commonest cause on the face is post-acne pigmentation. Individuals of darker skin tones are more susceptible.
  • Hori’s Naevus – Presents as brown or blue grey spots on one or both cheekbone areas. It has a predominance in females of Asian descent.
Topical treatments for pigmentation

Broad spectrum sunscreens are the cornerstone of treatment for skin pigmentation include:

  • Combination cream containing tretinoin, hydroquinone and a low potency steroid – the gold standard for lightening melasma.
  • Antioxidant serums containing Vitamin C and E.
  • Topical tranexamic acid. The tablet form is used in severe melasma
  • Others – kojic acid, azelaic acid, niacinamide.
Procedures for treating pigment disorders

Hori’s nevus, freckles and lentigos respond only to procedures. Procedures may augment and hasten the lightening effect of creams in the treatment of melasma and postinflammatory hyperpigmentation.

  • Laser and Light Treatment – Pigment lasers like the Medlite C6 and the AlexTriVantage lasers are effective for freckles, lentigos and Hori’s naevus. The Medlite laser can also be used to treat PIH that is slow to clear and used with caution in melasma. Intense pulse light (IPL) is not effective for Hori’s naevus.
  • Microdermabrasion – The Silkpeel is a low impact treatment with minimal side effects that facilitates lightening of melasma and PIH. It is not effective to remove freckles, lentigos or Hori’s nevus.
Our Dermatologists
Our team of dermatologists with a combined experience of more than 60 years provides a complete range of professional dermatological services to manage all varieties of skin problems affecting the skin, hair and nails and also sexually transmitted infections. They are equally adept at performing skin surgery and laser procedures.
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