It is important to identify the type of pigmentation you have in order to get a safe and effective skin pigmentation treatment. Fortunately, there aren’t 50 types of pigmentation conditions. Pigmentation can essentially be grouped into three main classifications – Epidermis, Dermis & a mix of both.
The skin is made up of two main layers. The epidermis and the dermis. The epidermis is the outer layer of these two main layers. Epidermal pigmentation includes freckles, sun spots, and age spots. Epidermal pigmentation can be identified as light to medium brown spots with well-defined margins.
Dermal pigmentation includes conditions such as post-inflammatory pigmentation (pimple marks/chicken-pox marks), hori’s nevus, nevus of ota, etc. It looks hazier under the skin compared to epidermal pigmentation. They do not have well-defined margins and are usually slightly lighter in colour.
A good example, and also one of the most common pigmentation problem faced by women is melasma. Melasma are either epidermal, dermal, or a mix of both. It takes a longer time to treat a mixture of both epidermal and dermal pigmentation.
Can pigmentation be treated with topical creams and facials?
Certain types of pigmentation are sometimes treated at facial salons, or by using topical creams alone. However, lasers remain the most efficient remedy when properly done by a doctor.
Superficial pigments such as epidermal pigmentation can be slightly reduced with facials or creams that has acids or certain chemicals. For example, Retinol helps skin cells to turn over faster, which causes lightening of superficial pigmentation. Certain creams (Hydroquinone) thins the surface of the skin. For most cases, pigmentation only appears to be lighter as the skin is temporarily brightened. Hence, it takes longer using just cream instead of using lasers or a combination treatment. Lasers targets and breaks down pigmentation deeper than creams can reach. Your mileage may vary for topical creams and facials, especially if you are not sure what pigmentation you have. This is why topical treatments may not work for everyone.
Treating pigmentation, especially dermal pigmentation, with a typical cream is akin to removing a tattoo with a cream or facial treatment. Tattoos are ink pigmentation purposely deposited in the dermal skin layer, and most effectively removed by lasers.
Lasers can safely and effectively treat both epidermal and dermal pigmentation with lasting results. Epidermal pigmentation requires a laser with a shorter wavelength such as the ProYellow laser (577nm) and dermal pigmentation requires a laser with a longer wavelength such as the popular Q-switched laser (1064nm).
Creams (Hydroquinone) and serums like SkinCeuticals’ Discoloration Defense work by controlling pigmentation production. Cyspera’s Cysteamine cream can reduce the appearance of existing pigmentation.
How many sessions do I need, and how much will it cost to treat my pigmentation?
On average, epidermal pigmentation takes between 4-5 sessions to treat, and dermal pigmentation takes between 6-8 sessions. Patients with a mix of both epidermal and dermal pigmentation might require slightly more sessions.
Laser sessions do not have to cost an arm or a leg. They typically average around $180 – $480 per session, depending on the type of laser. Make sure you go to a doctor who can correctly identify the kind of pigmentation you have, and recommend a suitable pigmentation removal treatment.
What should a proper laser treatment be like? Why are there clinics that offer laser treatments at such a low price point?
A proper laser treatment takes between 15 – 20mins, and is done once every 3 – 4 weeks.
There are clinics which offer low cost / ‘cheap’ laser treatments. These treatments are usually not tailored to your specific needs, (standard laser settings, low power and only at one wavelength), and are shorter in duration (1 – 2 minutes each treatment session). They also need to be done more regularly (up to 3 – 7 times a week) to be as effective as a single treatment.
This accumulates, and you end up spending more time and money on treatments.
The is an increased risk of side-effects when you get multiple sessions of shorter laser treatments over a shorter period of time. These side-effects include hypo-pigmentation (white patches on the skin) and hyper-pigmentation (darker pigments due to over-stimulation of the skin).
Unfortunately, sunscreen isn’t everything. Sunscreen is extremely important, but it still does not block out 100% of UV rays. UV damage can accumulate over time, and cause pigmentation to surface.
Hormonal changes can also cause pigmentation to surface. This is why pigmentation is 3 times more common in women than men! Pigmentation has a higher chance of occurring when a woman is pregnant or undergoing menopause.
Genes play a part in pigmentation formation – you are more likely to have pigmentation if it runs in your family.
Wear it everyday.
Will lasers thin my skin?
This is one of the most common questions Mizu gets. Non-ablative lasers (Q-Switched, ProYellow Lasers) used to treat pigmentation do not thin the skin. In fact, these lasers actually help thicken and strengthen the skin. Heat and mechanical effect from these lasers help stimulate superficial collagen production and makes the skin thicker and feels firmer.
The right laser treatment not only treats pigmentation – it also brightens, cleanses, and tones skin at the same time.
Will my pigmentation come back?
Just like a tattoo, pigmentation do not reappear after treatment. However, new pigmentation can still form over time due to various reasons such as hormonal changes or sun damage. It is therefore important to maintain a good regime to prevent new pigmentation from forming. This regime can include both maintenance laser treatments and skincare products.
Still have questions? We’d love to clarify your doubts, and have you at a trial to experience how lasers can work for you. If you are unsure of how to identify your pigmentation type still, Dr. YZ Tan can do that for you during a consultation as well.