Pigmentation problems on the face are common in Asians and can cause significant cosmetic concern. Most pigmentation problems appear during middle age. They occur as part of the natural aging process of the skin. However, excessive sun-exposure can speed up the development of pigmentation problems. There are many skin care products in the market that have some whitening effect. Some of the common ingredients that have whitening properties include Vitamin C, Niacinamide, Arbutin, Kojic acid and Liquorice. If the pigmentation problem is very mild, the use of such whitening products, together with regular use of sunscreens will be helpful. When dealing with more stubborn pigmentation problems, stronger, medical-grade whitening creams are much more effective. In addition, procedures such as chemical peels, intense pulsed light and pigment lasers are very useful in the treatment of stubborn pigmentation. For best results, combination treatment is often required.

There are different types of pigmentation problems, and their treatment may vary slightly. We discuss a few of the more common pigmentation problems below.

Freckles are small light brown spots which are usually found on the cheeks of fair-skinned individuals. They can also occur on the rest of the face and body. They tend to appear at a young age and typically darken after sun exposure. If treatment is desired, freckles can be lightened with regular use of sunscreens, whitening creams, intense pulsed light or pigment lasers.

Lentigenes are small brown spots on the face which tend to appear during middle age. They can be lightened with topical treatment, chemical peels, intense pulsed light and pigment lasers.

Melasma is an extremely common pigmentation problem amongst Asian adults. They present as brown patches on the cheeks and can also occur on the forehead. It is well known to develop during pregnancy or when a person is taking oral contraceptive pills, due to the stimulation of melanocyte acitivity by hormones . Melasma can be effectively lightened with certain topical whitening creams and sun protection. However, complete permanent clearance is difficult to achieve. Chemical peels, intense pulsed light and pigment lasers can be used in conjunction with topical treatments to further enhance lightening and to maintain a clear complexion.

Hori’s nevi
Hori's nevi is a pigmentation problem which is unique to people of Oriental descent. They appear as bluish-grey spots on the cheeks, usually during early adulthood. About 50% of cases affected have other family members having a similar problem. As the pigmentation in Hori's nevi lie very deep in the skin, topical treatments are usually ineffective. Pigment lasers are effective in the treatment of Hori's nevi. However, multiple sessions are usually required.

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