As a doctor, I get concerned with requests from patients to do lasers for melasma treatment and pigmentation problems. Many even asked for laser treatments for melasma and pigmentation on their FIRST consultation.
Why? Patients generally believed that laser treatments cure pigmentations and melasma like magic. However, that is untrue.
Lasers are NOT always the best option for pigmentation and melasma treatment
One reason why lasers ALWAYS get pushed to patients is that they are profitable.
“Why are lasers profitable to clinics?”
For pigmentation treatments, lasers tend to be priced higher than other forms of treatment, such as topical cream. Google or make a few phone calls and you can see that they cost anywhere from $600 to $1000.
This link shows exactly how much lasers cost in Singapore.
Pushy sales staff might tell you “lasers need at least 3-5 sessions to see results”. That can easily increase your treatment cost to thousands of dollars.
It’s true that certain pigmentations require only 3 sessions to see marked improvement, while others may require 10 sessions or even more. However, something many patients DON’T KNOW is that you might not even need lasers in the first place!
Lasers are also higher in profit margin. Unlike topical treatments for melasma and pigmentation, they do not have consumable costs (e.g. syringes, production costs in creams and lotions etc). The only cost for the clinic is the machine, which is a sunk cost anyway.
The different prices between clinics is very much down to the skill of the doctor (think of the BIG price difference between seeing your HDB doctor for a sore throat VS seeing an ENT specialist in Mount Elizabeth Hospital).
“So, do lasers really treat melasma and pigmentation?”
Yes, they do. In fact, MOST OF THE TIME, they are great for a variety of pigmentation issues. For example, the Q-Switched Nd:Yag laser is excellent at treating stubborn conditions like Hori’s Naevus and Solar Lentigos etc.
However, laser is NOT ALWAYS the best method. In my previous article(click here),I mentioned about various pigmentation problems such as melasma and freckles.
Every pigmentation requires its own specific type of treatment which may or may not involve lasers.
The severity of your condition also determines whether you need laser or not.
The following is a case that I have just handled that does not require laser treatment.
Case Study #1: Melasma treatment in Singapore
Ms TA came to me with extensive patchy melasma that she’s been suffering from for many years. My experience in Melasma treatment helped me to quickly diagnose her condition. She had dark patches and spots on her cheeks and her upper lips, which would seem impossible to correct. I had reassured her that this is quite common for Asian women, especially those with darker skin types. She had scoured the internet to find treatments for pigmentation on face, but to no avail.
Melasma is a pigmentation issue caused by hormonal factors and sun exposure. Often, lasers are recommended for melasma treatment but in her case, I genuinely feel that a combination of lightening melasma cream, sunscreen and sufficient sun-protection measures is more effective. The melasma cream has medical formulation like hydroquinone, to be used daily. Some patients may get slight skin irritation with it, but most patients will still be able to use it comfortably well.
Don’t underestimate these products at treating melasma and pigmentations!
For illustration purpose only!
3 weeks later, she came back very pleased. When I showed her before/after photos to her, she was very surprised at how just topical melasma cream and sun-protection strategies improved her condition by 70%. (MOH does not allow me to show before/after photos here but interested readers can contact me to learn more).
Many clinics go straight to lasers and not bother with cream for melasma, but I believe that a gradual treatment course is necessary to see how her skin responds to the medications (e.g. hydroquinone) in the melasma cream.
These products cost her LESS THAN HALF of what she would pay for 3 sessions of lasers.
Case Study #2: Uneven skin tone and solar lentigos
Notice Mdm ZY’s uneven skin tone and patches of darkened pigmentation (solar lentigos). She spent over $10,000 on facial packages elsewhere before she came to see me.
Earlier on, I mentioned that the Q-switched Nd Yag laser is great against solar lentigos. However, in Mdm ZY’s case, I personally decided that a combination of basic lightening cream with hydroquinone, sun screening regimen and adequate sun-protect measures was sufficient for her.
By using only cream for melasma and solar lentigos, both her conditions improved significantly!
“Which treatment method should patients pick?”
These 2 case studies are examples of how non-laser treatments can be VERY effective depending on the situation.
- Find a doctor you TRUST and explore all treatment options before asking for lasers
- Seek the doctor’s opinion in treating your pigmentation condition, rather than the kind of laser he is currently using
- Always ask for before/after pictures of MULTIPLE patients with similar conditions to yours
- Seek 2-3 doctors’ opinion and see if any of them are confident in using topical treatments.
If you have any questions or need advice,
You can also email me at:
Dr David Ng C H