Tag Archive: Hyperpigmentation

How To Treat Facial Pigmentation Melasma According To A Dermatologist- Do Home Remedies Work?

March 9, 2020

 

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Dr. Teo Wan Lin is an accredited dermatologist and an expert on cosmeceutical skincare research and development. She is the author of  “Skincare Bible – Dermatologist’s Tips for Cosmeceutical Skincare”  which was published July 2019 by leading bookstores Barnes & Noble, Baker & Taylor and Apple Books and available in bookstores islandwide from January 2020. She heads up Dr.TWL Dermaceuticals, a specialist cosmeceutical skincare line with evidence-based active ingredients for anti-ageing and skin health. Its subsidiaries, the Pi- Cosmeceutical Custom Makeup Lab and the Conscious Mask Bar are part of the Conscious Concept Pharmacy launched in December featuring environmentally sustainable makeup and skincare materials. In this series “Dermatologist Talks” she shares her top tips on common skincare topics. In this series of articles, she focuses on some FAQs of Melasma .

 

What is the difference between melasma and hyperpigmentation?

Pigmentation is the discoloration of the skin. Melasma and hyperpigmentation are causes of pigmentation. Melasma tends to be related to changes in hormones such as during pregnancy or after menopause. It is also closely related to genetics and sun exposure. We only use the term “hyperpigmentation” in the context of post-inflammatory hyperpigmentation as a form of scarring following inflammation. Melasma itself is also distributed differently. It tends to appear in a butterfly-like configuration over the cheeks and sometimes spreading to the forehead. It also tends to be very symmetrical, even and diffused, whereas, hyperpigmentation is usually localized to the area of previous injury.

 

Is melasma curable?

A cure would mean a one-time treatment that causes all symptoms to go away forever. Most skin conditions are treatable but the underlying root cause has to do with the amount of environmental exposure such as sun exposure in one’s lifetime, genetics, as well as other factors such as hormones.

 

Do home remedies treat melasma?

Some home remedies that have been proposed to treat melasma are quite dangerous. Apple cider vinegar has been proposed as one of the solutions as it contains acetic acid which is proven by research to be effective in lightening skin pigmentation. However, the method and form of acetic acid in apple cider vinegar only causes skin irritation, the most severe form being irritant contact dermatitis or even facial eczema and chemical burn. 

The usage of aloe vera is unlikely to be harmful. However, many aloe vera products contain certain compounds such as alcohol that helps to maintain the product in a gel form. 

The key thing to understand about these DIY remedies is that while the source and raw ingredients may contain an active ingredient, proven to lighten pigmentation in laboratory studies, it is often not in the correct form for it to be effective on the skin. It can also cause severe irritant reactions that can causes pigmentation to worsen.

 

How should one treat melasma?

For melasma to be effectively treated, you have to use a combination of therapies. To me, the most effective treatment is a combination of the use of a q-switched laser, a 1064nm laser toning device, spaced at weekly intervals, together with topicals, such as hydroquinone to help remove underlying pigmentation, and cosmeceutical skincare. The Radiancé Fluide™ Hydrating Emulsion contains oligopeptides that help reduce the hyperpigmentation while increasing the function of the pigment removing cells. The Vitá C GOLD™ Serum contains nano-formulated sodium ascorbyl phosphate, a stable and effective derivative of Vitamin C, well known for its amazing ability to treat hyperpigmentation and photoageing. 

 

 

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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.

Everything You Need to Know About Melanin & Dark Spots

July 19, 2018

 

Melanin is the culprit behind the dark spots that give us an uneven complexion. It is a brown pigment found in the basal layer of the epidermis.

This pigment is synthesised by melanocytes. The process of melanin synthesis is termed melanogenesis. Melanocytes go through different stages of maturation, becoming more pigmented at each stage.

Certain stimulants trigger a gene to produce more of tyrosinase, a copper-containing enzyme that converts tyrosine into melanin. Stimulants that activate the melanocyte include hormones, inflammation (such as acne) and external environmental conditions (ultraviolet light that causes the production of free radicals).

One simple way to reduce melanin production is to use broad-spectrum sunscreens with zinc oxide, titanium dioxide or iron oxide. These substances help block UVA and UVB light, thus impeding the stimulation of melanocytes.

Pigmentary disorders

Common hyperpigmentation disorders that involve the darkening of an area of skin due to increased melanin include melasma, lentigo, and post-inflammatory hyperpigmentation.

Melasma is usually caused by chronic exposure to ultraviolet radiation or a spike in hormones due to pregnancy or the use of oral contraception. It can be found at the epidermisdermal layer or mixed, depending on the location of the pigment.

A lentigo is a light or dark brown area of discoloration that can range from 1mm to 1cm across, and is caused by an increased number of melanocytes. Its outline is usually discrete, but can also be irregular. Simple lentigines arise mostly during childhood on areas not exposed to the sun. Solar (or senile) lentigines are found on the backs of hands or on the face, most commonly after middle age.

Post-inflammatory hyperpigmentation (PIH) is the skin’s response to inflammatory skin disorders. Common causes are acne and atopic dermatitis. PIH is caused by the overproduction of melanin caused by skin inflammation.

Treating hyperpigmentation

Hydroquinone: For 50 years, hydroquinone has been the gold standard treatment for hyperpigmentation. This compound inhibits tyrosinase activity, thus limiting the amount of melanin to be produced. It also alters melanosome formation, possibly degrading melanocytes.

However, prolonged use of topical hydroquinone has shown to have side effects such as ochronosis and permanent depigmentation. Ochronosis is a disorder with blue-black discoloration. As such, hydroquinone is banned in cosmetic formulations and only available through a prescription that should be carefully managed by an accredited dermatologist.

Retinoids are forms of vitamin A that can treat acnephotodamage and PIH. They have various pathways that lead to skin lightening effects, such as accelerating epidermal turnover, reducing pigment transfer and slowing the production of tyrosinase.

With common side effects being erythema, skin irritation, dryness and scaling, it is recommended to use a retinoid only under the supervision of an accredited dermatologist. Corticosteroids (steroid hormones) have anti-inflammatory abilities and are often prescribed along with retinoids to prevent excess irritation.

Arbutin is a botanically derived compound found in cranberries, blueberries, wheat and pears. Though arbutin is a derivative of hydroquinoine, it has shown to be a more controlled way of inhibiting the synthesis of melanin as it does not permanently destroy melanocytes.

Kojic acid is a naturally occurring fungal substance. Its skin-lightening ability works by inhibiting the activity of tyrosinase. However, frequent use can cause side effects of contact dermatitis or erythema (redness of the skin).

Azelaic acid is known to be effective for treating PIH and acne. Azelaic acid depigments the skin in several ways. It can inhibit tyrosinase or reduce levels of abnormal melanocytes. This means that azelaic acid does not influence normal skin pigmentation but only acts on the proliferation of unwanted melanocyte activity.  Side effects are mild and only last for a short period of time. Irritation, burning sensation or mild erythema may emerge, taking 2 to 4 weeks to subside.

Niacinamide is a derivative of vitamin B3. It works by decreasing the transfer of melanosome to keratinocytes. Niacinamide is a stable ingredient as it is unaffected by light, moisture or acids. This ingredient is often incorporated into cosmeceuticals due to its safety profile.

Vitamin C or L-ascorbic acid is a naturally occurring antioxidant that helps with skin lightening. It prevents tyrosinase from converting tyrosine to melanin. Vitamin C is also favored for its anti-inflammatory and photoprotective properties. However, L-ascorbic acid is highly unstable and rapidly oxidized. It is not used in the treatment of PIH.

Stable forms of vitamin C include magnesium ascorbyl phosphate or sodium ascorbyl phosphate. For safe and effective results, consider a dermatologist-formulated serum VITA C GOLD™ Serum,a formulation tested for bio-activity in a laboratory.

As seen above, there are various treatment options to treat common hyperpigmentation disorders. Recognizing the underlying cause for pigmentation is critical for proper treatment and choosing the best-suited therapy. Visit an accredited dermatologist for effective and safe treatments catered to your condition.

© 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.

All You Need To Know About Vitamin C

January 11, 2018

 

Vitamin C is likely to be no stranger to any of us, we see it present in plenty of fruits and vegetables like oranges, grapefruits or pineapple. Yet, it is rather new to most of us to have Vitamin C on our face. This obsession with Vitamin C could be why you are googling up on this ingredient now, and we are about to tell you.

The vitamin brings benefits to the skin that we love: antioxidative, photoprotective, antiaging, and anti-pigmentary effects.

Vitamin C in our body

Vitamin C is the most abundant antioxidant in human skin. Antioxidants work to reduce the damage that free radicals can bring to our skin cells. We are unable to synthesize vitamin C as we do not have the enzyme needed to do so. Even as we consume high doses of vitamin C supplements, only a small fraction of the vitamin will remain in our body and skin cells. This brings us to rely on external supplements, with topical application being the most common form.

What should the concentration of my Vitamin C be?

When choosing a Vitamin C product, you may come across the different concentrations available. Of what percentage of the Vitamin C should we be using? That really depends on the type of Vitamin C in use. Conventional Vitamin C derivatives such as Ascorbic Acid may require 10 to 20 percent to have any reasonable efficacy, and is limited inherently by the fact that higher concentrations, for instance above 20 percent, may cause irritation to the skin. On the other hand, studies have shown that a mere 1 percent concentration of Sodium Ascorbyl Phosphate – considered to be a new generation of Vitamin C derivatives, has strong antimicrobial efficacy against acne.

What are the common forms of Vitamin C?

Out of all the various forms of Vitamin C, L-ascorbic acid is conventionally recognised as one of the most biologically active molecules. This compound is likely to be found at a pH below 3.5 for greater stability and permeability. Above that, the acid becomes very unstable in aqueous solutions and is prone to immediate oxidation, turning to a brown colour when oxidized.

Other formulations of vitamin C are magnesium ascorbyl phosphate, ascorbyl-6-palmitate and sodium ascorbyl phosphate. These formulations are stable at neutral pH of 7. As a water-soluble derivative of Vitamin C, magnesium ascorbyl phosphate is more stable in water but less potent than L-Ascorbic acid.

Sodium Ascorbyl Phosphate is one of the most stable and effective forms of Vitamin C. As it will not oxidize as easily, it is a preferable choice for skin care formulations. A well-formulated product allows sodium ascorbyl phosphate to penetrate the skin epidermis without causing irritation. You may consider a dermatologist-formulated product such as Vita C Gold™ Seruma Vitamin C formulation that has been tested for bio-activity in a laboratory, for safe and effective results.

Different formulations of Vitamin C exists, and you may decide which forms would be preferable in your skincare by weighing in on the cost, potency, texture or formulation. Although the conventional L-ascorbic acid is perhaps the most potent derivative of Vitamin C, it oxidizes too quickly when exposed to oxygen to be much efficacy on the skin. One may prefer newer Vitamin C derivatives – Sodium Ascorbyl Phosphate, which are much more stable and able to deliver better efficacy even at lower concentrations.

Vitamin C helps to produce collagen

Vitamin C is required by our bodies to produce collagen, making this vitamin crucial for anti-ageing. Think of it as an anti-ageing shield your skin needs to reduce the damage your skin suffered, and also to prevent future damage. The vitamin facilitates enzymes that lead to the stability of collagen fibers. It also increases expression of collagen and synthesizes inhibitors to block enzymes from degrading collagen.

Vitamin C has anti-pigmentary effect

Vitamin C plays an important role in skin-lightening, as it inhibits an enzyme called tyrosinase. This enzyme works by converting tyrosine into melanin, so by reducing the activity of tyrosinase, our skin cells produce less melanin. 

Should I DIY my own Vitamin C serum?

According to Dr Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin and Laser Centre, she says: “Concocting your own serum of Vitamin C can be dangerous as it can lead to phytophotodermatitis, a condition where itchy blisters and reddened patches appear on the exposed skin. The redness and blistering will settle down in a few days, but it leaves pigmentation at the same sites. Phytophotodermatitis results from the action of UV radiation on a plant chemical called furocoumarins. Citrus fruits such as lemon, lime or bergamot oranges are often responsible for the reaction.”

It is best to avoid DIY recipes for Vitamin C or you may end up with rashes that scar for a long time.

© 2017 TWL Specialist Skin and Laser Centre. All rights reserved.

—–

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.