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Freckles or dark patches on your cheeks?


FrecklesBlotchy skin is a common complaint in Asian country.

What are the causes?

Cumulative sun damage causes premature aging and pigment formation, this result in sun and age spots. Some people are genetically predisposed to pigmentation like freckles, while melasma ( “the mask of pregnancy”) is due to hormonal changes. Another unique feature of Asian skin is post inflammatory hyperpigmentation in which the skin darkens after injury from, for example, too strong an acid peel. I encounter these conditions daily in my practice.

Any treatment?

Some doctor would need to assess with their patient and discuss the possible options and outcomes. Using a good sunblock will definitely prevent worsening of the pigmentation. You can use creams — a good start although the results are slow. I usually use Photo-rejuvenation which involves an energy source either from light or laser to fragment the pigment under the skin without burning the outer skin layer. Hence, there is no reddening, pain or downtime.

Lightening of the pigment can be noticed within a week but results vary from 20%-80% depending on the individual. Consistent use of creams and sun-block will improve the final outcome. The results, though never perfect, are about as good as what medical technology can offer. That’s probably why we get many new patients by way of recommendation.

How has it affected your treatment of pigmentary disorders?

When first started aesthetic practice, treatment options were limited to just creams, chemical peels and microdermabrasion. Some lightening could be seen after a few months. Technology has improved tremendously and I have been using a combination of mild burning ablative lasers and non-burning non- ablative lasers with much better results.