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updated 11 Dec 2011, 15:34
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Sun, Dec 11, 2011
Urban, The Straits Times
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Spot the difference
by Karen Tee

It is no fun being able to connect the dots - those pesky sun spots, pimple scars and other blemishes that make life so unfair.

'Every woman wants even, spotless, flawless skin,' says Dr Yeak Hwee Lee, medical director of Singapore Aesthetic Centre at Novena Medical Centre.

'Even if it is just one spot, she will want to treat it.'

The number of patients seeking whitening treatments at the centre has risen by about 20 per cent annually since 2007, she says.

That is despite the cost - one session of intense pulsed light (IPL) treatment, a popular skin rejuvenation and spot removal process, starts from $350.

If that is beyond your budget, good news: This is the month when the newest crop of whitening potions hit the shelves.

This year, cosmetic brands are going on the offensive.

For instance, Biotherm's new White D-Tox (Bright Cell) Ultra-Whitening Serum ($125) contains a pea extract called phyto code seed, which its scientists say will prevent melanin from darkening so that spots will not form. Melanin is a pigment that dark spots are made of.

'Why wait for dark spots to happen when you can correct the problem right from the source?' says Elle Suebjaklap, Biotherm's product manager.

Nearly every major brand, including Estee Lauder, Clinique and Shu Uemura, has launched spot erasing or reducing potions over the last three months. These products boast ingredients that target melanin clusters to lighten them.

Instead of potions that promise to lighten overall skin tone, brands now have spot zappers in the form of serums or spot correctors that target darker skin patches.

For example, Shiseido's new White Lucent Intensive Spot Targeting Serum ($159) contains a whitening ingredient called m-Tranexamic Acid which targets age spots, darkened pores and acne marks.

For the Japanese beauty giant, a pioneer of whitening skincare, sales of this category make up about 30 per cent of its total sales in Singapore. During the first weekend of the serum's launch in January, one bottle was sold every six minutes.

Indeed, the whitening sector has always enjoyed brisk sales given 'Asian women's concerns on skin clarity and brightening', says Grace Ban. She is the president of the Singapore Association of Perfumes and Cosmetics Distributors (APCD) and also the managing director of Estee Lauder Singapore.

APCD figures for prestige department store brands showed that sales of whitening products made up 14 per cent of the skincare market here last year - second only to anti-ageing potions, which make up 27 per cent.

Last year, $21 million worth of whitening products were sold, an increase of 3.1 per cent over 2008.

Nielsen Singapore, which tracks sales of brands sold in supermarkets and personal care stores, reports a 25 per cent jump in sales of whitening products from 2008 to 2009.

While brands say their newest formulations will give you better and faster results, doctors say the reality might not be so clear.

Cosmetic companies constantly try to improve in terms of new ingredients and mode of delivery, notes Dr Eileen Tan, a dermatologist at Eileen Tan Skin, Laser and Hair Transplant Clinic at Mount Elizabeth Medical Centre.

'However, because some of the ingredients are rather new and insufficient studies are conducted to determine their efficacy, probably only time can tell if the innovation has some science to it,' she says.

Dermatologists and aesthetic doctors also report that more patients are seeking treatment to lighten pigments such as sun spots, freckles and melasma.

A check with five clinics showed that they are seeing a jump of up to 20 per cent every year in the number of patients seeking whitening and scar removal treatments.

But not all spots are created equal. Some, like scars, can fade away with a little tender loving care while others, such as freckles, are determined by genes and might not be removed completely even with laser treatments.

It is also likely that the spots will recur even if they are removed.

Before you decide on how to banish your blemishes, work out what kind of spot you have with our guide.

Sun/Age Spots

What: Brown, irregularly shaped patches that vary in size, ranging from tiny specks to 1cm-wide spots.

They can appear anywhere on the face.

Cause: Overexposure to the sun. Ultra-violet B rays from the sun activates the melanocytes (pigment forming cells) into producing excess melanin pigments.

When the pigments gather on the surface of the skin, they form dark clusters.

These sun spots are also termed age spots as with age comes increased exposure to the sun.

They are also called liver spots because of their colour.

Treatment: Whitening products can help to lighten sun spots if they are applied consistently for at least two to three months, but they will not get rid of them completely.

Cosmetic products are most effective on light, newly developing spots, says Dr Yeak Hwee Lee, medical director of Singapore Aesthetic Centre.

But creams would not lighten very dark spots because these have more pigments and may be too deep in the skin to be erased by cosmetics alone, she adds.

Medical options include intense pulsed light (about $350 per session) and laser (about $400 per session) treatments.

Five sessions of either are usually needed to remove the spots.

Removing existing spots does not mean that new ones will not form though. Be sure to wear sunblock to prevent more spots from appearing.

Melasma

What: Brownish grey patches that sometimes form a net-like spread on the cheeks, temples, forehead or across the nose.

Cause: The exact cause of melasma, which is more prevalent in women than men, is not known.

However, genetic make-up, hormonal changes caused by pregnancy or oral contraceptive pills, as well as over-exposure to the sun can induce and aggravate melasma, says DrKhoo.

Treatment: If melasma is caused by pregnancy, the patches will usually three to four months after delivery.

Otherwise, melasma can be hard to treat.

Creams which contain ingredients such as hydroquinone, azaleic acid and retinoids may help to lighten the marks but will not remove them.

Other lightening ingredients include kojic acid, vitamin C and mulberry extract.

Doctors recommend chemical peels (about $100 per session) or intense pulsed light treatment of four to six sessions to lighten or clear the pigments.

Laser treatment is sometimes used as well.

However, Dr Khoo says this should be used as a last resort as lasers can sometimes cause post-inflammatory hyperpigmentation.

Melasma may still recur after these treatments.

 

Dark Eye Circle

What: Bluish-black patches around the eyes that create the appearance of 'panda eyes'.

Cause: The exact cause is not known but is believed to be due to a combination of factors including genes, poor blood circulation that causes blood to accumulate in the eye area, as well as pigmentation, says Dr Lawrence Khoo, a dermatologist with Dermatology Associates in Paragon.

As the skin around the eyes is thin and contains little fatty tissue, discoloration is often accentuated.

Frequent rubbing of the eyes can also lead to hyperpigmentation when the pigment cells are stimulated into producing more melanin, says dermatologist Dr Eileen Tan. Fine blood capillaries may also break and cause darkening.

Treatment: If your dark eye circles are caused by hyperpigmentation (where melanin accumulates under the eyes), whitening creams may help lighten their appearance.

Otherwise, pigment laser treatments, which cost about $500 per session, can help. About four to six sessions are needed but panda eyes may recur.

Scars

What: Brown or reddish marks on the surface of the skin.

Causes: Aggravations to the skin such as pimples, cuts and insect bites can leave dark marks.

Known as post-inflammatory hyperpigmentation, such scars are more commonly seen in Asians as they have more melanin in their skin compared to Caucasians.

When skin cells are damaged by aggravations such as acne or bites, the pigment cells respond by overproducing melanin, resulting in the formation of dark patches when the wounds heal.

Treatment: Scars usually fade over time so if you are patient, you can leave them alone, says Dr Yeak Hwee Lee, medical director of Singapore Aesthetic Centre.

The fading process can be sped up with the use of whitening creams. In fact, scars are the easiest forms of pigments to get rid of, as long as they are light and on the surface of the skin.

In deeper scars, where the pigments are found below the skin's surface, aesthetic treatments like intense pulsed light or laser are needed.

Up to five sessions may be required, depending on the severity of the scar.

 

Freckles

What: Tiny flat circular spots the size of pinheads common on cheeks, nose, shoulders and arms.

Causes: Typically determined by genes. Exposure to sunlight also triggers cells to make more melanin or skin pigment, which darkens existing freckles and causes more to form.

Treatment: As with all other forms of pigmentation, prevention is better than cure, so slather on sunscreen of at least SPF 30 before you go out. If you are out in the sun, try to reapply sunscreen every two hours.

Those with light brown spots may see a slight lightening with cosmetic whitening creams. However, they are unlikely to disappear completely.

Look for ingredients including tretinoin, retinol and hydroquinone (available by prescription only), says

Dr Eileen Tan of Eileen Tan Skin, Laser and Hair Transplant Clinic at Mount Elizabeth Medical Centre.

She warns that exposure to sun is likely to cause the freckles to reappear.

Those with darker freckles can try chemical peels (from $100 per session), intense pulsed light (from $350 per session) or laser treatments (from $400 per session) but be prepared to see them recur. About three to six sessions are required.

[email protected]

This article was first published in Urban, The Straits Times.

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