Skin pigmentation are seen as brown or grey brown patches on the face and body. Most are benign and treatment is mainly for cosmetic indications. Some are chronic while others are self-limiting. Some skin pigmentation are birthmarks.
Melasma is a very common pigmentation seen as brown or greyish brown patches, usually on the face and occasionally on the arms. On the face, the pigmentation is usually symmetrical on both sides of the cheeks, the upper lips, nose, forehead and the chin. Melasma usually starts in the mid 30 ‘s and continues throughout middle age. It is a chronic condition and treatment needs to be continued long term. If you have melasma and desire treatment, ask Dr Joyce Lim to tailor a treatment plan for you
Causes or Triggers of melasma
- Genetic
- Sun exposure to ultra-violet and blue light
- Hormonal as seen during pregnancy (chloasma)or hormone treatment
- Heat
- Age
Treatment of melasma
- Broad spectrum sunscreen plus blue light filters
- Sun avoidance such as wearing hats, shades and UV clothing
- Prescription creams
- Oral medication
- Chemical peels
- Laser treatments
Freckles are small brown spots seen on sun-exposed skin like on the face, neck and arms. Freckles are commonly seen during childhood, in fair skinned individuals and among members of the same family. On sun exposure, freckles increase in numbers, size and colour.
Treatment of freckles
- No treatment is needed
- Broad spectrum sunscreen
- If treatment is desired, they can be removed with chemical peels, light and laser treatment
Acquired bilateral naevus of Ota like macules(ABNOM) or Hori’s naevus are dark brown spots often seen on both cheeks of individuals with melasma. They are common among Asians. ABNOM are often misdiagnosed as melasma. It is important to make the correct diagnosis as the treatment is different
Treatment of ABNOM
- ABNOM does not respond to creams
- Laser treatments
Post – inflammatory hyperpigmentation (PIH) is skin pigmentation that is seen after injury to the skin. It is commonly seen in individuals with dark skin tone as any slightest injury will trigger the numerous pigment producing cells in the skin to produce even more pigment. In dark skin persons, the colour may be more intense and lasts for a longer period of time. The pigmentation is confined to the areas of injury
Causes of post-inflammatory hyperpigmentation
- After skin injury or irritation
- After an underlying skin condition has healed
- After skin procedures like chemical peels, surgery, laser treatments
- After taking some medication
Treatment of Post-inflammatory hyperpigmentation
- Prescription creams and oral medication
- Laser treatments
If you are prone to post injury pigmentation, or PIH, let your dermatologist know before you undertake any aesthetic skin procedures
Dark eye rings are seen in children and adults and are often due to a combination of factors.
Causes of dark eye rings
- Congestion of vessels below the skin
- Pigmentation in the skin
- Post eczema (PIH)
- Hollowness due to aging. As one grows older the eye socket gets larger and the lower eyelid skin sags and this accentuates the dark rings
- Genetic predisposition. In Asians dark eye rings may appear at an early age and they get darker with age
Treatment of dark eye rings
- Treatment depends on the various causes
- Prescription creams
- Light and laser treatment
- Sometimes dermal fillers will improve the sunken eyelids and as light reflects from the skin the dark eye rings appear lighter
