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Having acne is a pretty common skin problem in Singapore. Acne affects 41% of adults since their time of adolescence, according to a recent study conducted by the National Skin Centre in Singapore. Many people who are suffering from acne face also have to contend with acne related hyperpigmentation even after the breakouts have stopped and the skin has healed. 

Hyperpigmentation

Hyperpigmentation resulting from acne is known as post-inflammatory hyperpigmentation (PIH). It is the result of excess melanin production due to skin inflammation or injury, and appears as dark patches or spots on skin that is brown, tan or red in color. The exact reason behind PIH has not been verified, but it is thought that the inflammatory cells produce cytokines that stimulate and increase melanin production. 

PIH can happen to all skin types but darker skinned people are more prone to getting PIH after the acne has subsided. To make matters worse, sun and UV light exposure exacerbates the condition and causes pigmentation to become darker and wider. 

Once a person develops PIH, early treatment and intervention is recommended to halt its progress. The earlier hyperpigmentation is treated, the faster the process of fading. Certain pigmentation may fade even without treatment, but the process can take anywhere from 6 months to a year. PIH that occurs in the deeper dermis layer of the skin is more challenging to treat. It may even become permanent if left untreated. 

The first line of defence against acne pigmentation is always sun protection. People with acne pigmentation are advised to stay out of the sun, and if that is impossible, to wear sunscreen with a sun protection factor (SPF) of 30 and above. Sunscreen should be worn indoors as well because most glass windows block out UVB rays, but not UVA rays, which has the ability to cause immediate darkening of skin pigments. 

There are also a variety of DIY or home based acne pigmentation treatments available. For instance, Vitamin C has been touted as the natural ingredient to lighten pigmentation. Vitamin C has strong antioxidant properties that can help to even out skin tone by stimulating collagen production. In comparison to lemon juice, the other popular alternative to lightening dark spots, vitamin C has a lower acidic content and is suitable for all skin types. 

Other brightening ingredients such as kojic acid, mandelic acid, azelaic acid and hydroquinone also have a similar effect. Hydroquinone is a skin lightening agent that inhibits the release of melanin and removes dark spots. Likewise, kojic acid also lightens skin tone by bleaching and works best on age spots and brown spots. Azelaic acid has anti-inflammatory benefits, hence it works well on active acne and prevents PIH. Mandelic acid is a variation of alpha hydroxyl acid (AHA) that treats uneven skin tone, acne, and even wrinkles!

However, these acids may not be suitable for sensitive skin as frequent usage can cause dryness, peeling and irritation. For azelaic acid, there is also the risk of developing hypopigmentation especially for darker skin types. Hypopigmentation refers to patches of skin that are lighter than your normal skin tone. 

If you find that DIY home routine isn’t doing anything for your acne marks, that’s because homemade masks aren’t formulated with tried and tested concentrations, hence there is always room for error. Home pigmentation treatment also has limited efficiency against deep pigmentation. 

This is where professional acne pigmentation treatment comes in. Laser treatments have a high success rate for dark spots and pigmentation. With the help of different laser treatments, it is possible to remove acne pigmentation completely. 

Laser Treatments

Laser treatments utilize beams of intense light to penetrate the skin and remove acne pigmentation. Different wavelengths and color targets different types of pigmentation. Typically for acne pigmentation, our panel of doctors at Joyre Medical & Aesthetic Clinic have found the best results with Q Switch Laser and Quadrostar Pro Yellow Laser. Unlike conventional lasers, these two lasers are able to lighten pigmentation without removing the surface skin layers. How is this done? Both Q Switch Laser and Quadrostar Pro Yellow Laser emit focused light of specific wavelengths that is absorbed by the melanin cells, causing it to fragment into tiny pieces that can be cleared away by the body. The laser light also triggers fibroblast cells in the skin to produce more collagen and ultimately growing new skin that is lighter and blends in with the rest of the skin. For this reason, both laser treatments are painless, quick and have minimal downtime.

The Pro Yellow Laser also has the advantage of targeting underlying blood vessels that supply blood to the melanin cells. In fact, Pro Yellow Laser uses yellow laser light which has the highest absorption rate for blood vessels in the body. This prevents pigmentation from occurring after treatment and it is also capable of treating deep pigmented lesions. 

It should be pointed out that acne pigmentation is not the same as acne scars. After the skin has healed from acne, it is possible to have both acne pigmentation and depressed scars. Smartxide Touch Fractional CO2 Laser is a laser treatment offered at Joyre Medical & Aesthetic Clinic that is able to treat both conditions, with its new CO2 laser technology combined with bipolar radiofrequency. Smartxide Touch is an ablative laser that removes the epidermis layer of the skin. This triggers the body’s self-healing system to kick in and start creating new collagen to heal the wound. New skin that grows back is lighter and more elastic as the bipolar radiofrequency emitted from the special spacers is able to remodel deep skin tissues, thereby creating more toned and tighter skin. 

Our doctors will usually assess your skin condition before recommending laser therapies. If your skin is not ready for laser, you might be recommended to try chemical peeling first. People with dark skin tones are also suitable for chemical peels, as this treatment effectively lightens pigmentation with fast healing periods. How it works is that acid solutions of different strengths are used to “peel” off the outer layer of the skin to allow the renewal of new, smoother and brighter skin. The acids commonly used are glycolic acid, alpha hydroxyl acid (AHA) and beta hydroxyl acid (BHA), all which are at higher concentrations than the homemade DIY face acids. 
Acne pigmentation treatment is complex and depends on your skin type and concerns. Often a combination of laser, chemical peels and fillers is needed to achieve the ideal results. If in doubt, it is always best to consult a professional. Whatsapp us at 9751 2983 to get a complimentary acne pigmentation consultation with our doctors. For more info, drop us an email at [email protected].

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