Tag Archive: freckles

Brightening dark spots

December 25, 2018

Struggling with dark spots? To treat them, you first have to know the kind of pigmentation you have.

Melasma

Melasma is characterized by irregular brown patches on the skin and can typically be found on the forehead, upper lip, nose and the chin. Melasma is the result of an overproduction of melanin (the pigment that gives colour to our skin, hair and eyes).

Excessive sun exposure is one of the greatest contributors to melasma as melanin-producing cells are easily stimulated by UVA and UVB rays. Pregnancy, hormone treatments and genetic predisposition are other causes.

Postinflammatory hyperpigmentation (PIH)

PIH is the result of your skin’s melanin-inducing response to inflammation or injury, and appears at the injured site as a dark brown macule or patch. Such markings usually fade within a few months with appropriate treatment. However, the brown spots may darken or spread if not addressed. Sun exposure may also worsen PIH.

 Skin conditions that can cause the above inflammation include acne vulgaris, atopic dermatitis (eczema) and psoriasis (red, flaky skin patches).

Freckles

Freckles, also known as ephelides, are harmless small pigmented spots that are frequently found on the face, arms, neck and chest. Freckles are brown due to a diffusion of melanin into skin cells.

In winter, the activity of melanin-producing cells slows down. When exposed to UV radiation in sunlight, melanin-producing cells pick-up. As a result, freckles fade slight in the winter and darken in summer. Often, freckles partially disappear with age.

Genetics contribute to the formation of freckles. They are frequently observed in fair-skinned individuals, especially those with red hair.

Solar lentigo

Solar lentigines are harmless patches of darkened skin that are generally larger than freckles and have well-defined edges. They are caused by an accumulation of sun damage that leads to an increase in the number of melanin-producing cells and subsequent accumulation of melanin.

Solar lentigines are also associated with increased age. While freckles generally disappear over time, untreated solar lentigines are likely to persist indefinitely.

Treatments

For all dark spots, start by avoiding the sun and applying a sufficient amount of sunscreen every two hours. Use a lightweight sunscreen like Dr. TWL’s SunProtector™, which is dermatologist-formulated for the humid climate.

For melasma, consider a combination of topical therapies (outlined below) and chemical peels. Lasers should be considered last.

For PIH, first treat and prevent the skin condition triggering the inflammation. Then use topical treatments followed by chemical peels and lastly, laser and light treatments.

For freckles, use topical or laser/light therapies.

For solar lentigines, use ablative therapy with cryotherapy. Subsequent treatment options include topical agents and laser therapy.

Bleaching agents

 Bleaching agents are often used to inhibit melanin synthesis. The most commonly prescribed ones are hydroquinone, azelaic acid and kojic acid.

Hydroquinone inhibits the production of melanin by binding to tyrosinase, the enzyme responsible for the first step in melanin production.

Azelaic acid acts on abnormal melanin-producing cells but leaves the healthy ones untouched, ensuring optimal melanin levels.

Kojic acid binds to copper, which is required by melanin-producing cells.

Retinoids

Topical retinoids are often used in combination with bleaching agents. Retinoids target pigmentation issues by inducing the death of melanin-producing cells, accelerating turnover of new skin cells and inhibiting the enzyme tyrosinase.

Chemical peels

Chemical peels refer to the process of applying acids to the skin to destroy the outer skin layers. They accelerate the process of exfoliation by sloughing off dead layers of older skin and promoting smoother layers of new skin.

Superficial and medium depth peels are effective in treating pigmentation concerns. These peels differ in the depth of skin resurfaced. Superficial peels target only the surface skin layer while medium peels target the next layer.

To successfully achieve significant depigmentation, a patient needs to undergo at least 3 to 4 repeated peels. Common acids employed are glycolic acid, salicylic acid and lactic acid.

Laser and light treatments

Lasers are notably successful with solar lentigines, but less so with melasma and PIH. Such treatments damage the skin to stimulate growth of new skin cells.

To treat solar lentigo and freckles, use IPL, Q-switched lasers and fractional lasers.

To treat melasma and PIH (and only after topical therapy and chemical peels), try fractional radiofrequency, Q-switched or picosecond lasers, high-fluence/high-density non-ablative lasers, pulsed dye lasers, IPL, microneedling, and spot liquid nitrogen treatment.

If you are considering laser or light treatment, be sure to first consult an accredited dermatologist to recommend suitable treatments for the skin condition you are experiencing.

Cosmeceuticals

Patients who are not ready to commit to laser treatments can consider cosmeceuticals. These are cosmetic products with bioactive ingredients that are scientifically proven to deliver results to the skin. Active ingredients that fight dark spots include vitamin C and niacinamide. As a powerful antioxidant, Vita C GOLD™ Serum can help fade dark spots on your face and neutralise some of the free radicals that damage your skin. Niacinamide, found in Radiance Fluide™ Hydrating Emulsion, helps to brighten skin by reducing the amount of melanin.

© 2018 TWL Specialist Skin and Laser Centre. All rights reserved.
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Meet with Dr. Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.
To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.

Best Dermatologist’s Guide to Chemical Peel Treatments

October 13, 2017

What is a Chemical Peel?

A chemical peel treatment is designed to improve the appearance of the skin by gently stimulating the top layer of skin cells known as the epidermis by applying a solution composed of fruit derived acids such as alpha-hydroxy acids, glycolic acid, lactic and salicylic acid. This stimulates the skin to regenerate, to be smoother and less wrinkled.

Who is Chemical Peel for?

Chemical peels are helpful for acne prone as well as normal skin, as a regular form of anti-ageing treatment to maintain one’s youthful appearance. In general, patients with fairer skin and lighter hair are ideal candidates. However, depending upon the type of skin problem encountered, darker skinned patients may also experience good results. If you are looking to minimise or eliminate the lines around your eye or mouth area, wrinkles that are caused by sun damage, aging and hereditary factors, aging spots, mild scarring, certain kinds of acne, skin pigmentation such as sun spots, age apots, liver spots, freckles or splotching due to the consumption of birth control pills or dull skin texture and colour, chemical peels are effective treatment methods. It is also good to note that chemical peeling can also be seen as a cost-effective solution for those who are currently undergoing other treatment modalities such as lasers for a skin rejuvenation purposes. Chemical peels are also more beneficial than beautician facials, in terms of skin rejuvenation and as an adjunct to acne treatment.

What should I know about Chemical Peels?

Chemical peels were developed and should be performed by a dermatologist, rather than an aesthetician or a beautician. Find out more about what a dermatologist is here. A thorough evaluation is imperative before embarking upon a chemical peel. In Singapore, if you are not a medical doctor, you will not have access to prescription strength chemical peels which actually work. Hence, it is not recommended to visit beauty parlors or aestheticians who offer chemical peels that either may be dangerous (it should only be performed under medical supervision) or provide not much benefit.

After a chemical peel, one’s skin is also temporarily more sensitive to the sun. It is pertinent to avoid overexposing the areas that have been treated with chemical peels to the sun as the new skin is fragile and more susceptible to complications. It is advised to protect your skin from the sun with an application of sunscreen and minimising direct contact with the sun by wearing hats or seeking shade with umbrellas.

To prevent any side effects, visit an accredited dermatologist for your chemical peels. Dermatologists will prescribe the proper follow-up care to reduce the tendencies of skin discolouration.

What to expect during a Chemical Peel?

The eye area is protected during the chemical peel and skin is first thoroughly cleansed to remove excess oils. During the procedure, one or more chemical solutions such as glycolic acids are used. As the chemical solution comes into contact with the skin, most patients would experience a warm sensation which lasts about three to seven minutes. Depending on the indication for the peel,  the dermatologist will select the proper chemical peel agent and apply the selected solution to  the skin. As these applications produce a controlled environment whereby a small amount of damage is induced on the skin, to trigger off new collagen formation.

What to expect after a chemical treatment?

Patients usually experience a reaction similar to a sunburn. There generally is no downtime beyond  superficial peeling of the skin which presents as redness and mild flaking. See your skin become less greasy, more radiant and healthy after your first peel!

© 2017 twlskin.com. All rights reserved.

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Meet with Dr. Teo Wan Lin, accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.

To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.