Pigment Removal

Introduction to Skin Pigmentation

Skin pigmentation refers to the natural color of the skin, which is determined by the amount and distribution of melanin produced by specialized cells called melanocytes. Melanin is the pigment responsible not only for the color of the skin, but also for hair and eye color. The production of melanin is influenced by genetics, hormonal changes, and environmental factors such as sun exposure. In Singapore, where the sun’s rays are strong year-round, pigmentation concerns like hyperpigmentation, melasma, and sun spots are especially common. Understanding how melanin production affects the skin and contributes to different skin tones is essential for addressing pigmentation issues and achieving a healthy, even complexion.

Causes of Pigmentation

Pigmentation issues can develop due to a combination of internal and external factors. Intrinsic causes include genetics, hormonal changes, and the natural aging process, which can lead to conditions such as melasma and age spots. Extrinsic factors, particularly UV exposure from the sun, play a significant role in triggering and worsening pigmentation concerns. Other contributors include skin injuries, inflammation, and certain medications. In Singapore’s tropical climate, the high levels of UV exposure make pigmentation issues like sun spots and hyperpigmentation especially prevalent. Identifying the underlying causes of pigmentation is crucial for selecting the most effective treatment methods, such as laser treatment for pigmentation removal, to achieve optimal results.

Pigmentation Removal Options

There are several treatment methods available for addressing skin pigmentation concerns, each suited to different types and severities of pigmentation. Laser treatment for pigmentation removal is one of the most popular and effective options, thanks to its precision and ability to target excess melanin without damaging surrounding skin. Advanced pigment lasers, such as the Pico laser and Nd:YAG laser, are commonly used in Singapore to treat a wide range of pigmentation issues, from sun spots to deeper discolorations. Other options include chemical peels and topical creams, which may be recommended for milder cases or as part of a comprehensive treatment plan. The choice of treatment depends on the type of pigmentation, skin type, and individual concerns, making it important to consult with a qualified doctor to determine the most suitable approach for skin pigmentation removal.

What is laser pigment removal?

Laser pigmentation removal treatments are non-invasive options that utilize laser energy to reduce or eliminate unwanted pigmentation in the skin. This includes sunspots, freckles, melasma, acne brown marks and other forms of hyperpigmentation. The treatment works by delivering targeted laser energy that breaks down pigment particles, which are then naturally cleared by the body’s immune system. It is a safe and effective procedure for addressing various pigmentation concerns and achieving a more even skin tone.

How Does It Work?

Our clinic uses the StarWalker MaQX laser, a state-of-the-art system equipped with both nanosecond and picosecond pulsed technology.

The StarWalker laser uses ultra-short, high-energy pulses of light to target unwanted pigmentation without damaging the surrounding skin via these two mechanisms:

• Selective photothermal effect:The laser energy is selectively absorbed by melanin (the pigment responsible for dark spots). This energy is then converted into heat which causes the pigment to break down into tiny particles. The fragmented particles are then naturally cleared away by the body’s immune system, leading to a gradual fading of the pigmentation.
• Photomechanical effect:The laser also delivers ultra-short, high-energy pulses of light to the pigmented area, causing rapid expansion and contraction of pigment particles. This leads to mechanical shattering of the pigment into tiny fragments. These small fragments are then cleared naturally by the immune system.

By utilizing advanced technology, the StarWalker MaQX laser can precisely target pigmentation located in different layers of the skin, ensuring optimal results for pigment removal and skin rejuvenation.

Why do we choose to use the StarWalker MaQX laser?

As the StarWalker MaQX combines nanosecond and picosecond pulses, it delivers both photothermal and photomechanical effects. This means:

• More effective pigment breakdown
• Reduced risk of thermal injury to skin
• Minimal downtime
• Fewer treatment sessions required
• Suitable to treat all skin types including darker skin

What conditions can be treated?

1. Unwanted tattoos (tattooed by amateur or professional)
2. Age spots/ sunspots
3. Freckles
4. Melasma
5. Post-inflammatory hyperpigmentation such as from acne/ injury
6. Hyperpigmentation birthmarks (including birthmarks caused by excess melanin; professional evaluation is important to determine the best treatment approach)

Can pigments be fully removed?

YES! In most cases, pigments can be significantly lightened or fully removed. Results vary based on factors that influence how well these pigments absorb the laser energy and how efficiently the body clears the fragmented particles.

Factors that affect complete pigment clearance:

• Depth of pigmentation (superficial pigment is easier to remove)
• Skin type (darker skin needs more cautious treatment to avoid complications)
• Cause of pigmentation (pigmentation from UV damage, hormonal, or inflammatory changes)
• Patient’s compliance to post-laser care and sun avoidance

What types of pigmentation respond well to laser treatment?

• Sunspots/ age spots (solar lentigines)
• Freckles
• Post-inflammatory hyperpigmentation (PIH) from acne or skin injury
• Pigments that are usually superficial and absorb laser energy well

Conditions that are more challenging to treat with lasers:

Melasma

This deeper, hormonally driven form of pigmentation is prone to recurrence and may not be completely removed with laser treatment alone. While lasers can significantly improve melasma, a comprehensive, multimodal approach is essential for effective and long-lasting results. This typically includes a combination of lasers, skin rejuvenation treatments, proper skincare, and strict sun protection to address the condition at its root.

Dermal melanocytosis (Hori's nevus / Nevus of Ota)

This type of pigmentation lies deep in the dermis layer of the skin, making it more difficult for the laser energy to reach and effectively break down the pigments compared to superficial pigmentation. As a result, more treatment sessions are typically required to achieve significant lightening or complete removal.

Number of laser sessions required:

Superficial pigmentations often begin to lighten after just 1–2 laser sessions and typically require 4–6 sessions for complete removal.

Deeper pigmentations such as Hori’s nevus or nevus of Ota generally require more treatments, often around 10–15 sessions to achieve optimal results. The exact number of sessions varies depending on the type, depth, and density of the pigmentation, as well as the individual’s skin response and treatment adherence.

Interval: 4–6 weeks apart

Contraindications: (if unsure, always check with doctor)

1. Pregnancy
2. Active skin infection
3. Signs of sun injury
4. Wound

Downtime: Mild redness and swelling may occur in the treated area for 3–5 days, followed by temporary darkening of the pigment as part of the normal healing process. In most cases, the treated pigmentation heals within one week.

Possible complications from laser pigmentation treatment:

While laser treatments for pigmentation are generally safe and effective when performed correctly, some risks and side effects can occur, especially if the skin is not properly assessed or cared for after treatment.

1. Post-inflammatory hyperpigmentation (PIH)
   • More common in darker skin types (Fitzpatrick IV–VI)
   • Treated area appears temporarily darker
   • Often improves over time with topical treatment and additional care
2. Hypopigmentation
   • Loss of pigment in the treated area due to thermal injury to melanocytes
   • May be temporary or permanent ‍
3. Scarring (Rare)
   • Usually associated with improper laser technique or in individuals with a tendency for keloid scarring ‍
4. Recurrence of pigmentation
   • More common in melasma which is hormonally influenced and prone to relapse without strict sun protection and ongoing maintenance

How to minimize risk from laser treatment?

• Choose a qualified medical aesthetic practitioner with experience in laser pigment removal treatments.
• Ensure a proper skin assessment is done before treatment, as different types of pigmentation may require specific approaches for effective pigmentation removal treatment.
• Follow all aftercare instructions after the procedure, including sun avoidance and diligent use of sunscreen, especially after pigmentation removal treatment.

Adhering to post-care guidelines after the procedure is essential to optimize results and minimize complications.

Pre-procedure:

1. Photo documentation
2. Detailed consultation with doctor to determine the laser treatment plan
3. Face is cleaned and topical numbing cream applied for 30 mins
4. Obtain written consent

Post-procedure:

1. Apply topical healing cream on the treated area, followed by moisturizer and SPF 50 sunscreen
2. Post-procedure advice:
   • Apply SPF 50 broad spectrum sunscreen at least twice a day
   • DO NOT touch, scratch, or rub the treated area for 48 hours or till the skin is completely healed to prevent irritation or infection
   • Be gentle when washing your face and applying skincare products
   • Avoid skincare ingredients such as retinol, Vitamin C, exfoliating products (facial scrub/AHA/BHA) for 1 week
   • Avoid excessive sun exposure for 1 week
   • Avoid facial procedures and energy-based aesthetic treatments such as laser, radio frequency, HIFU, BBL, IPL for 2 weeks

Prevention and Maintenance

Maintaining healthy skin pigmentation and preventing future pigmentation concerns requires a proactive approach. Consistent sun protection is essential—this includes using broad-spectrum sunscreen daily, wearing protective clothing, and minimizing direct sun exposure, especially during peak hours. Incorporating skincare products with ingredients like vitamin C, retinoids, and niacinamide can help support an even skin tone and reduce the risk of new pigmentation forming. After undergoing laser pigmentation removal, following your doctor’s aftercare instructions and maintaining regular check-ups can help preserve results and address any emerging pigmentation issues early. By prioritizing prevention and maintenance, you can keep your skin looking healthy and radiant while minimizing the need for repeated laser treatments.

Choosing the Right Doctor

Selecting the right doctor is a crucial step in achieving safe and effective results for skin pigmentation concerns in Singapore. Look for a medical professional with specialized experience in laser treatment for pigmentation removal and a strong track record in treating various skin types and pigmentation conditions. The use of advanced technology, such as the Pico laser and Nd:YAG laser, is also important for achieving optimal outcomes. A qualified doctor will conduct a thorough assessment, recommend a personalized treatment plan, and provide guidance on aftercare to ensure the best possible results. By choosing an experienced practitioner, you can feel confident that your pigmentation treatment is tailored to your unique needs and performed with the highest standards of safety and care.

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