Many Singaporeans experience skin pigmentation problems throughout their lifetime. Pigmentation refers to the discolouration of the skin. One of the major causes of skin pigmentation is sun damage and typically affects the parts of the body that are frequently over-exposed to the sun’s UV rays.
In addition, certain medications and skin care products can also cause your skin to darken or develop patches of discoloured surfaces and most of the time becomes a cosmetic issue for a lot of people.
If you have been experiencing skin pigmentations problems and want to know how to get rid of them, this article will help you understand the most common skin pigmentation problems of Singaporeans, what causes these problems, the effective treatments for each skin issues and bonus practical tips on how to lessen the condition.
Melasma is one of the most common skin pigmentation problems for Singaporeans, especially with women. Melasma usually appears as brown to grey-brown patches on the face but can appear on other parts of the body such as the neck and forearms. On the face, the most common parts where melasma patches are on the:
- Nose bridge
- Above the lips
Melasma is more common on women than men, particularly because it often appears during pregnancy. The increased production of hormones such as estrogen during pregnancy trigger the appearance of melasma.
90% of people who get melasma are women, and it is more common for people with darker skin. If you are related to someone who has melasma, then there’s a high chance that you have it too or will develop it in the future.
The exact causes of melasma are unknown. It is widely accepted that melanocytes (colour-producing cells in the skin) producing too much melanin is what influences the appearance of melasma.
The following events can trigger the appearance of melasma patches on your skin:
- Exposure to UV light from the sun – Even the smallest amount of ultraviolet (UV) light can trigger your melanocytes to produce more melanin. This is why melasma is a lot more common during the summer season.
- Hormonal changes, especially during pregnancy – Melasma is common among pregnant women, and the main culprits are the various hormonal changes that happen inside a pregnant woman’s body. Melasma on pregnant women is called chloasma or the “mask of pregnancy”. Melasma can also be triggered by birth control pills and hormone replacement drugs.
- Skin care products that irritate your skin – Sometimes your skin is incompatible with a couple of skin care products. These products can irritate your skin and can make your melasma worse.
Dermatologists recommend the following tips to lessen the effect of melasma on your skin:
- Using sunscreen regularly – Since UV light from the sun is the most common trigger of melasma, one reliable way to prevent melasma from getting worse is by the application of sunscreen to your skin. If you sweat or go swimming, remember to reapply sunscreen before you go out under the sun again. Choose a sunscreen that contains zinc oxide or titanium dioxide with an SPF of 30 or more to maximize your skin’s protection against UV radiation.
- Wearing shades and sun-protective clothing when outside – Wearing sunscreen isn’t enough to protect your skin from the sun’s harmful UV radiation. If possible, also wear a wide-brimmed hat and sunglasses whenever you expose yourself under the sun.
- Use gentle skin care products – Strong skin care products can irritate and worsen your melasma. It is recommended to use only gentle products that don’t sting or burn.
Over time, melasma patches can disappear especially for those that are triggered by hormonal changes through pregnancy or birth control pills. As soon as your hormone levels return to normal, melasma patches will also usually fade.
If the patches don’t go away, there are a few options you could consider for treatment:
- Hydroquinone – Hydroquinone is a topical skin-bleaching agent that is the recommended first line of treatment for melasma. It works by interfering with the melanin production of the melanocytes. Hydroquinone can be purchased from your pharmacy as a cream, emulsion, gel, lotion or solution. Higher concentrations require a dermatologist’s prescription.
- Tretinoin – Tretinoin belongs to a class of medicine called retinoids, and it is mainly used for treating acne. It has been shown to be moderately effective against melasma.
- Corticosteroids – These are a class of medication that are used to treat rashes and asthma. Research has found though that using corticosteroids with tretinoin is effective in treating melasma.
- Chemical peels or dermabrasion – If topical medicine fails in treating your melasma, your dermatologist may advise you to undergo a procedure such as a chemical peel. Ensure that you choose a doctor or clinic that is trusted.
Laser Pigmentation Treatments
Laser treatments are one of the best ways to treat melasma as it is very quick (about 15 minutes per session) and non-invasive.
They work by changing the structure of the melanin on your skin. This will actually cause your patches to look darker than before, but there’s no need to worry. Your immune system will think that the melanin particles are foreign objects and will start dissolving them. A few days after treatment, your melasma patches will eventually scab and flake off your skin.
Usually, it takes about 4 to 5 sessions of laser treatments to achieve the best results. In Singapore, the laser pigmentation treatments cost around $1400 to $3000.
2. Solar Lentigines (Sun Spots)
A solar lentigo, also known as sun spots, is a dark skin pigmentation caused by the exposure of skin to UV light. Unlike melasma which spread around a specific area, solar lentigines are relatively larger and can be a single spot or show up randomly as multiple spots on your skin.
It might worry you that solar lentigines are large, but they are actually benign. They do indicate that you are frequently exposed to the sun, which is a risk factor for skin cancer.
As the name suggests, solar lentigines are caused by exposure to the sun’s ultraviolet radiation. They can also be caused by artificial UV light, especially if protective gear is not worn. These sunspots can also grow over time if measures are not taken to prevent their worsening.
Since the main cause for solar lentigines is sun exposure, the best way to manage them is by limiting your exposure to the sun. Wearing sunscreen and protective gear like sunglasses can help manage solar lentigines.
If your job requires you to work under artificial UV light (such as in the laboratory), always ensure that you wear protective gear and the proper safety protocol is followed.
- Hydroquinone and/or Tretinoin – There are bleaching creams available in pharmacies that contain one of or both of these agents and can help in lightening the lentigo. These are not effective in removing the lentigines though, so consider undergoing a procedure instead.
- Chemical peels – You can try undergoing a chemical peel to exfoliate and rejuvenate your skin.
- Intense Pulse Light (IPL) treatment – An IPL treatment is very similar to laser treatment in that they both utilize the heat from intense light. However, IPL uses a wider spectrum of light compared to lasers which uses a specific wavelength. IPL treatments are slightly cheaper but are also less effective than laser treatments.
To effectively treat solar lentigines, laser treatment is often utilized. Around 2 to 3 sessions (about one session per month) are recommended to achieve great results.
After a session, it takes about a week for scabs to form on the area where the solar lentigines are. These eventually fall off and reveal fairer skin beneath.
Laser pigmentation removal costs for solar lentigines are based on the size of the affected areas and range from $700 to $1800 per session.
Freckles are small, beige or brown circular spots that form on sun-exposed skin. These are common among people with fair complexion and affect all ages.
Freckles are usually the same colour for each person and are just slightly darker than your usual skin complexion. They are about 1 mm to 2 mm in diameter and can be reddish, tan, yellow, brown or black in colour.
Freckles fade away naturally when sun exposure is minimized, such as during winter. Since Singapore is a tropical country, freckles often persist throughout the year.
Freckles are caused by a combination of genetics and exposure to the sun. Due to the sensitivity to UV rays of people with fair complexions, freckles are more likely to develop. Ultraviolet light stimulates melanocytes to produce more melanin, which develops into freckles.
Similar to a lot of skin pigmentation problems, managing freckles start from limiting your skin’s exposure to the sun’s ultraviolet rays. Use sunblock and cover your exposed skin with protective clothing. Consider bringing an umbrella whenever you go outside.
- Home remedies – You can try using some lemon extract and applying it directly on your freckles. It is a strong fruit acid and is an adequate bleaching agent for lightening your skin. It won’t actually remove the freckles but will lessen the pigmentation. You can also use red onions, potatoes, cucumber and vinegar.
- Topical creams – Look for creams that contain hydroquinone or retinoids. These can help in lightening your freckles and preventing new freckles from forming.
- Chemical peel – A chemical peel exfoliates your skin and peels off areas that are damaged. For freckles, a chemical solution containing either glycolic acid or trichloroacetic acid is used that penetrates the middle layers of your skin.
A safe and trusted procedure for treating skin pigmentation problems is laser treatment. Studies have shown that laser treatments are especially effective in treating freckles.
There are different types of lasers used for treating freckles, and the type of laser used depends on the type of freckles and the skin type. The heat generated by the laser destroys the melanin in the freckle, which gets naturally removed by the body.
Important to Know
Most patients assume that lasers are the only treatment for skin pigmentation problems and all conditions are the same. Unfortunately, this is not true because although most skin pigmentation problems almost look similar, there are different types of skin pigmentation problems and each case have different causes and treatment regimen.
In addition to the three skin pigmentation problems mentioned, other cases like Post Inflammatory Hyperpigmentation (PIH), Seborrheic keratosis (“Pigmentation Bumps”) and Hori’s naevus (deep pigmentations) can be exhibited by the patient.
This is why, if you have skin pigmentation problems, always talk to your doctor first before getting any kind of treatment. Different methods of treatment are required for each condition.
To ensure safety and avoid major complications, make sure you have the right diagnosis first. A precise diagnosis by a qualified medical professional is the very first step towards effective pigmentation treatment.