Over the course of so many years treating pigmentations, I’m surprised to find that common myths and misconceptions are STILL circulating around even till today. Many patients frequently come to me with these questions:
“Doc, I have tried all sorts of skincare products out there, but they just don’t work at all. Are you sure your cream works?”
“Doctor I don’t want to do lasers! I heard lasers will have a lot of side effects!”
“Wow your treatments are so expensive. Beauty salon is so much cheaper!”
Allow me to debunk all these myths (hopefully once and for all) so you can avoid wasting money, time and effort on “treatments” that don’t work. And hopefully, go for the ones that actually do.
Pigmentation is very treatable in most cases, but only under the correct diagnosis and suitable treatment strategies devised by experienced doctors.
No you don’t, at least not all the time. In fact, I recently wrote an entire article discussing this misconception. Sure, many clinics and beauty spas heavily advocate the use of lasers as a “one-stop” solution to treating all sorts of pigmentations but this is INCORRECT.
Very often, alternative treatment methods like topical medicated creams (eg hydroquinone) can treat conditions such as melasma, post-inflammatory hyperpigmentation (PIH) and sometimes even freckles and solar lentigos very well. Coupled with adequate sun protection measures, you’ll be surprised to find how effective this simple combination is in treating light pigmentations.
What this means is that you can possibly avoid the hassle of lasers and instead see results from the more affordable medicated creams. Having said so, you might still need lasers for more stubborn or deep pigmentations e.g. Hori’s naevus.
This misconception stems from the fact that there are actually many different lasers on the market. The ones that actually “peel” your skin (causes minute flaking of the outer skin) are actually ablative lasers (e.g. CO2 fractional lasers for acne scars resurfacing). Even so, the skin will heal completely back to its full thickness after treatment anyway.
In contrast, lasers that are commonly used to treat pigmentations work by a different science. These lasers, like the Q-Switched Nd:Yag laser are non-ablative, so it does not “peel” your skin or affects the skin thickness at all.
Not true. Medical Lasers nowadays have improved so much to be even more effective, with lesser pain and downtime. In fact, certain pigmentations like melasma do not even require high power laser settings nowadays. So why does this misconception exist?
Because inappropriate and inexperienced use of lasers, especially with unnecessarily high power settings and close intervals, CAN at times lead to complications like PIH or confetti hypopigmentations (scattered white spots in the skin that can last for YEARS).
For instance, I would NOT advise doing frequent laser toning (with Q-Switched Nd:Yag) at a short interval of every week, not to even mention few treatment sessions within a week!
Personally, I design my own pigmentation laser and treatment protocols to ensure maximal effects, comfort and safety, especially so for patients with SENSITIVE and DARKER SKIN TYPES.
PIH (darker spots) on the left and Hypopigmentations (whiter spots) on the right.
Pigmentations (especially melasma and freckles) sometimes do recur even after successful treatments. But it has nothing to do with finishing your laser treatments. Constant exposure to the sun and hormones CAN cause pigmentations to recur BUT you can prevent this from happening.
Ensure you maintain with sunscreen and adopting sun protection measures, in order to have long-term sustainable results. Also, non-compliance with sun protection measures and doctor’s instructions during treatment will definitely affect the pigmentation results.
Lasers can only clear your pigmentations. It’s down to your own diligent care to prevent recurrence.
The analogy is like weight loss. Once you have achieved the desired weight loss, you have to do your own regular maintenance of a healthy balance of exercise and dieting to have sustainable results. Otherwise weight gain can recur.
Do the right thing; first clear your pigmentations then prevent recurrence by taking care of your skin.
Having the latest laser technology does NOT guarantee results. Of course, new technology can be very helpful but to see success in treatments, these factors are even more important:
All these can only be achieved with vast clinical experience in treating pigmentations.
I have personally seen very experienced doctors who have used conventional models of laser equipment and getting near to perfect results. Yet, I have seen others using the latest laser technology, getting no results or even complications still.
Having the fastest Ferrari sportscar does not automatically bring you the F1 Championship trophy, as the car must be driven by an equally matched professional experienced driver. Otherwise, the driver may just crash the car.
I feel that this myth needs to be clearly dispelled.
Some over-the-counter products (OTC) can be very useful for pigmentation prevention (especially sunscreen) and skincare maintenance. However, OTC products should not be confused with medical-grade creams which are formulated scientifically to treat pigmentations, which are essentially diseases of the skin.
For instance, the medicated cream Hydroquinone, is scientifically known to inhibit pigmentation production in the skin.
Medical creams have to undergo rigorous clinical studies to prove its efficacy to TREAT pigmentations. They are also ONLY allowed to be prescribed by a certified doctor.
OTC products are meant to be sold to the mass market, so they cannot be made too potent, unlike medicated creams.
There is a HUGE difference between a “spa grade laser” and a medical-grade laser. In Singapore, only certified doctors are able to operate medical grade lasers. Beauty salons commonly use devices like spa grade Intense Pulsed Light (IPL) to treat various skin issues including pigmentations.
IPLs are often confused by patients to be “lasers”. However, such IPLs are NOT lasers in terms of how they work so their results are thus not on par with medical grade lasers.
Medical grades lasers (eg Q-switched Nd:Yag laser) are scientifically proven and clinically designed to deal with tough pigmentations like Hori’s naveus, freckles and solar lentigo etc.
Now here’s the reality. Patients DO NOT actually have to spend so much money on seeing an experienced doctor in Singapore for pigmentation treatments to see good results. In fact, most pigmentation patients only spend about $200-$350 for topical creams and, if required, $1000-$3000 for medical lasers at a clinic, depending on the type and severity of pigmentations.
This is a very reasonable figure if you want to see REAL clearance of your pigmentations.
Speaking from years of interaction with patients, QUITE SHOCKINGLY, I have actually come across patients who had previously spent more than $10,000 for pigmentation treatments at non-medical skincare and beauty service providers (eg beauty spas, facial salons), but not getting the desired results.
Don’t be mistaken though, some of these entities are actually very good for skincare maintenance or milder skin issues, but pigmentations is a skin disease that needs to be addressed by doctors.
So if you want to see good results based on clinical treatments for pigmentations that are value for money, go straight to an experienced doctor instead.
You can also email me at:
Dr David Ng C H
I’ve devoted over a decade of my medical career towards treating melasma. Many patients approach this particular skin pigmentation completely wrong. I know how this skin condition, while seemingly superficial or “not a big deal”, can take a huge toll on the...Read More
A Note to Readers: Dr. David Ng C. H. is proud to be the original author of this article, which was first published on 12th May 2018. Content is distilled from more than 15 years of his clinical experience in pigmentation treatments in Singapore. This current article is an updated version by Dr David Ng […]Read More
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