Facial Laser for Pigmentation
Darks Spots, Blemishes and Hyperpigmentation. You may have tried to conceal them with off the shelf products to project a clearer skin, but that’s just about it; concealment! As soon, as your make up or concealer comes off, your blemishes are still ever present, glaring back at you. On the other hand, some of you may have even tried over the counter whitening products with variable amounts of success, or even no success at all. For the more adventurous, you may have ventured into a beauty salon and tried Intense pulse light (IPL) and other treatments. The facial laser for pigmentation uses an advanced laser system to breakdown and clear away your pigmentation concerns.
Not all forms of hyperpigmentation are the same! There are a variety of dark spots, blemishes and hyperpigmentation. The timing of the appearance of the hyperpigmentation, how your blemishes are distributed, and at which layer of the skin that it resides determines what type of hyperpigmentation you may have, and correspondingly the appropriate treatment plan. Understanding the different types helps you to know your skin better and what you can do about it.
Know your Skin
Let’s get back to some basics first. The human skin houses special pigment producing cells known as the melanocyte. These melanocytes are a lifesaver, and protect the surrounding skin cells by producing the pigment, melanin. How does it transfer the melanin to the surround skin cells then? This is where it gets interesting, truly a marvel of nature. Each melanocyte has many arm-like structures (technically defined as dendrites) that it can use to reach and transfer the melanin into the surrounding skin cells. Yes, you heard that right! The skin cells are constantly interacting with each other for mutual benefit, much like having its own ecosystem. The transferred melanin protects the DNA of the normal skin cells from too much Sun damage, so your skin cells do not turn cancerous.
So, what determines your skin colour? Why is Asian skin colour darker than Caucasian skin? Do Caucasians lack pigment?Intriguingly, there is remarkable consistency in the number of pigment cells (melanocytes) across the various racial and ethnic groups. The human skin colour is determined by the type of pigment you are born with, with differing proportions and bonding patterns. There are basically 2 types of melanin, Eumelanin and Pheomelanin. Asian skin has predominantly more eumelanin which makes our skin darker compared to caucasians.
Asian Skin and Hyperpigmentation
Facial hyperpigmentation on Asian skin is very common, common enough for many to seek help in our daily practice. The Sun is not always your friend! Sun damage is a major precipitating and perpetuating factor involved in facial hyperpigmentation. Genetics, hormones, various medications and even certain medical conditions play a part and can contribute to hyperpigmentation as well. Your hyperpigmentation may also be the result of a birthmark, which may be present shortly after birth or became more apparent as you are growing up.
During consultation, and skin assessment and examination, I would often try to demonstrate the type or types of hyperpigmentation you have on your skin. We have a very interesting tool called a Wood’s lamp to help us distinguish the type of hyperpigmentation, dark spots or blemishes you have.
The various hyperpigmentation disorders on the skin, and can be generally distinguished with regards to the level involvement in the skin. Skin hyperpigmentation may occupy with the upper layer of the skin (Epidermis), the deeper layer (Dermis), or even both layers!
Freckles, and Age spots (lentigines) are examples of hyperpigmentation conditions confined to the upper skin layer (epidermis). On the other hand, Hori's nevus and Nevus of Ota occupy the deeper layer of the skin (dermis). In Melasma, both layers can be involved (epidermis and dermis), and a holistic treatment plan is required in this case.
In Asian skin, it is not uncommon to have more than one type of hyperpigmentation. For example, a 40-year-old Asian lady requesting treatment for her freckles, may show signs of early Age Spots and Melasma on the face as well.
What are Freckles?
What do Hollywood celebrities such as Lucy Liu, Julianne Moore and Lindsay Lohan have in common?
Freckles, lots of them!
If you reside in a Sunny climate such as Singapore, California or the Maldives, expect to have lots of freckles especially if you do not sun proof your skin.
Freckles are multiple small brown pigmentation that are common found on the face, back and forearms. They are due to an increase in melanin in the skin cells, and increase in colour and number due to sun exposure. While considered a benign condition, many individuals seek to have their freckles removed. The first step is the use of a regular sunblock to prevent more freckles from forming. Laser treatment for freckle removal is effective and can lead to an improvement in 1-2 sessions, however freckles can recur if the skin is re-exposed to ultraviolet radiation.
What is Melasma?
Melasma is a common skin pigmentation condition affecting many Asians. The appearance of Melasma can range from small-pigmented patches on the cheeks, to involving the forehead, nose, upper lips, and jaw line. Many factors contribute to Melasma. There may be a genetic susceptibility if there is a family history of Melasma. Melasma is commonly observed in pregnant woman, and is coined the ‘Mask of Pregnancy’.
Hormonal influence has an impact on Melasma, and women who are on hormonal treatments have a greater risk of Melasma. Sun exposure is another factor, as the ultraviolet rays can stimulate more melanin production.
The treatment of Melasma remains challenging, and is associated with a high recurrence rate. Treatment options include topical lightening agents, chemical peels and Laser treatments in refractory cases.
A novel technique developed from Korea of using a series of low energy laser (called laser toning) to break down the melanin in the skin has been performed with variable degrees of success in individuals with Melasma.
What are Sun Spots?
A sun spot (solar lentigo) is sometimes called a liver or Age spot, but it is a misnomer, as it has nothing to do with any liver disease, but gets more common as we age. It’s a completely benign condition, but can be cosmetically displeasing.
Solar lentigines are common in fair skinned individuals, and occur on sun-exposed areas such as the face, back and forearms. They are larger in size compared to freckles, and appear as oval to round flat areas of pigmentation, and can increase in size, number and colour with age and sun exposure.
As with freckles, sun protection is important. Lightening creams can improve the appearance of the solar lentigo to a certain extent. Facial laser for pigmentation treatment work by selectively targeting the pigments of the lentigo, and lead to improvement in a few sessions, and can be performed safely in all skin types.
What is Hori's Nevus?
Hori’s nevus, also known as Acquired Bilateral Naevus of Ota-Like Macules (ABNOM) is a condition seen almost exclusively in Asian Chinese skin type. It typically, appears as bluish-gray flat hyperpigmentation on the cheeks, but may involve the eyelids, forehead and nose as well.
As the pigmentation in ABNOM is deeper into the skin, topical lightening creams are rarely effective to clear the pigmentation. Facial laser for pigmentation treatments penetrates deeper into the skin effectively to manage this condition. Multiple laser sessions will give better results.
What is Post-inflammatory Hyerpigmentation?
Post-inflammatory hyperpigmentation is a fairly condition seen after an injury (e.g. burn) infection, or inflammation (e.g. Acne, Eczema) to the skin. It may even occur after laser treatment when the skin is very reactive. It can be temporary lasting a couple of months before it fades away, or may become a permanent feature on your skin.
At our clinic, we commonly come across patients complaining of ‘scars’ after an Acne flare that they want removed. If you look closely, these are actually flat dark spots, and are the result of inflammation under the skin. Another frequently seen case would be a dark patch on the skin after you recover from a burn or an insect bite.
There are several treatment options to manage PIH. It may include prescription topical creams, chemical peels, or facial laser for pigmentation treatments.
Sun proof your skin against hyperpigmentation
- Wear a Sunblock daily of at least SPF 30-50 and PA +++, to protect against Ultra Violet rays (UVA & UVB).
- Forget about Sun tanning, or tanning booths. Although the bronzed look may appear appealing initially, you are actually damaging your skin, accelerating the process of aging and increasing the risk of skin cancer.
- Avoid being out in the Sun, especially mid-day sun where UV exposure is intense. Protect your self with a Hat, Sunglasses, and don long sleeve shirts. Use an umbrella! Stay in the shade where possible.
What is Facial Laser for Pigmentation?
The facial laser for pigmentation is based on a technologically advanced laser device. It uses a well known laser medium called the Nd:YAG and is capable of treating a variety of brown and red skin discolourations.
The Laser energy is highly selective to target melanin, the pigment that lies within the skin. The laser energy is delivered extremely rapidly, within one thousand-millionth of a second, to shatter the pigments.
The wavelength of the laser can be adjusted to address freckles, sun spots, melasma, tattoos, pores, skin tone, fight acne, skin redness and rosacea.
What can I expect during Laser treatment?
The first step is cleansing your skin to remove impurities before the procedure, and your eyes are then protected with the use of eyeshields.
Lasers are not painful and is well-tolerated. Numbing cream will be applied in cases where higher energy levels are used, for example when treating tattoos or birthmarks. For most individuals, with sun induced pigmentation, it is a comfortable procedure with minimal downtime.
The facial laser for pigmentation feels quite static like, and some warmth may be experienced. Some redness, and swelling is to be expected after the procedure and the effects fade shortly afterwards. A cooling mask will be applied to the skin after the laser treatment to reduce the downtime. Some crusting may form, for example if pigmentation is removed, and the use of a topical antibiotic is necessary to reduce infection and promote healing.
Sunscreens and topical bleaching agents should only be restarted once healing is complete. We advise regular use of a sunscreen (at least SPF30) in between laser sessions.
How many session do I need?
Individuals vary in the type of pigmentation, the depth and the severity of the area involved. The number of facial laser for pigmentationsession and improvement will vary among individuals. This is so, because we differ in our response to treatment and our healing capacity.
For mild cases of pigmentation, an average of 5 laser sessions is recommended. For moderate to severe cases, 5-10 laser sessions may be needed for better results.
Are Lasers suitable for darker skin individuals?
Certainly. The facial laser for pigmentation is safe under expert hands, and is effective treatment for all skin types. Dr. Ng has performed thousands of Laser procedures for a variety of skin conditions in all skin types. Compared to IPL, where there is a risk of causing burns in dark skin individuals, lasers remain the treatment of choice for dark skin individuals.
However, some conditions would require a delay in treatment, such as:
- Active skin infection or inflammation
- Recent sun tanning because this may worsen your pigmentation
Facial Laser for Pigmentation
- Advanced Nd:YAG Laser Technology
- Freckles, Sun Spots, Melasma
- Hori's Naevus
- Post-inflammatory Hyerpigmentation
- Effective for All Skin Types
- Well-Tolerated Procedure with Minimal Downtime
Pigment Focus Laser
Freckles, Sun Spots, Melasma
Effective for All Skin Types
- Vachiramon V, Panmanee W, Techapichetvanich T, Chanprapaph K. Comparison of Q-switched Nd: YAG laser and fractional carbon dioxide laser for the treatment of solar lentigines in Asians. Lasers Surg Med. 2016 Apr. 48 (4):354-9.
- Rokhsar CK, Fitzpatrick RE. The treatment of melasma with fractional photothermolysis: a pilot study. Dermatol Surg. 2005 Dec. 31(12):1645-50
- Katharine L. Ball. Arefiev, Basil M. Hantash. Advances in the Treatment of Melasma: A Review of the Recent Literature. Dermatologic Surgery. 2012;38(7):971-984