DYNAMIC LINES

Botulinum toxin A is a medical treatment for facial lines and wrinkles. It is classified as an injectable muscle relaxant. The different forms of purified botulinum toxin A include:

• BOTOX^Ⓡ (onabotulinumtoxinA) from Allergan
• Dysport^Ⓡ (abobotulinumtoxinA) from Galderma
• Xeomin^Ⓡ (incobotulinumtoxinA) from Merz

Botulinum toxin is a neuromuscular blocking agent and causes temporary paralysis of the injected muscle by preventing the release of acetylcholine from motor nerve terminals. By blocking nerve activity in the muscles, botulinum toxin causes a temporary reduction in muscle activity, and hence is used to block muscle movement in areas that contribute to wrinkles.

It is commonly used in the upper face, in locations such as the forehead and between the brows to soften frown lines. Unlike filler, botulinum toxin only impacts muscle movement and has no effect on filling deep wrinkles that have already formed. Therefore, the treatment can be combined with filler injections to further improve overall appearance.

INDICATIONS:

Common indications for botulinum toxin:

• Forehead creases
• Frown lines
• Crow’s feet
• Infraorbital Rhytides
• Eyebrow lift
• Nasal wrinkles
• Nasal flare
• Nasal tip elevation
• Gingival show
• Vertical lip lines (Perioral rhytides)
• Marionette lines
• Mental crease & cobblestone chin
• Masseteric Hypertrophy
• Vertical neck bands (Platysmal Bands)
• Excessive sweating (Hyperhidrosis)

As there is significant variability in shape and function of many target muscles, even between individuals within one population, individualised, tailored treatment is essential to achieve an ideal cosmetic outcome. The treatment strategy should be based on muscle mass, muscle shape, pattern of muscle activity and what is aesthetically appropriate in the context of overall facial structure. As the NSC-DSS botulinum toxin Certificate of Competency (COC) trainer, Dr Angeline Yong strongly believes in and advocates a tailored, customised approach, always adjusting dosages according to the individual’s muscle activity and muscle mass.

PROCEDURE:

• A topical numbing agent is applied on the area
• The botulinum toxin is directly injected into affected muscles with a fine 30-gauge needle
• Number of injections/units used depends on the areas needing treatment
• Treated muscles weaken over the next week with visible results

Botulinum toxin is expected to lessen facial lines for a period of several months to yield a relaxed natural look. Treatment can be repeated once the effect has worn off.

FACIAL AUGMENTATION

Designed to fill in the volume the face has lost over time due to aging, fillers most commonly include, a natural protein known as hyaluronic acid (found in and under our skin) injected into areas suffering from volume loss, or static lines. Fillers may also help stimulate the production of collagen.

As the areas on the skin are filled up, the skin “plumps up,” and wrinkles become less obvious. The most common substance injected is hyaluronic acid gel. It is safe and poses minimal risks to the skin when injected by a well-qualified and trained professional. Fillers can also be used for non-surgical cosmetic enhancement such jawline and chin augmentation.

Each product line includes different formulations and densities to treat different areas. Typically denser fillers are injected deeper into the skin while lighter fillers are injected for fine lines and areas such as the lips and tear troughs.

Common indications for fillers:

UPPER FACE

• Static deep glabellar rhytides
• Static forehead “worry lines” rhytides
• Temporal augmentation

MID FACE

• Tear trough
• Nasal augmentation
• Nasolabial folds
• Distensible scars (e.g. acne scars)
• Fat atrophy of the cheek

LOWER FACE

• Lip augmentation (Contour & profile)
  • Volume enhancement
  • Vermillion border enhancement
  • Philthral crest definition
• Marionette lines
• Lip rhytides
• Chin augmentation
• Jawline enhancement and augmentation

OTHER AREAS

• Volume loss at the back of the hands

A range of FDA-approved fillers from Juvederm, Restylane, Belotero and Profhilo (New*) are used at Dr Angeline Yong Dermatology to achieve optimal results tailored specifically for each individual’s needs.

PROCEDURE:

• A topical numbing agent is applied
• Filler is injected into the area requiring treatment
• The area is gently massaged to spread the product
• Number of injections/product used is based on the extent of repair or enhancement desired

Latest filler products contain lidocaine (an anaesthetic), making patients more comfortable during and after procedure. Results are usually contemporaneous with treatment, lasting from 6-12 months on average, depending on the type of filler used and location it is injected into.

Dr Angeline Yong is the National Skin Centre-Dermatologic Society Singapore (NSC-DSS) Certificate of Competency (COC) instructor in the domain of injectable fillers and is versatile in using injectables for various indications. As a dermatologist and dermatological surgeon, she has thorough understanding of the facial anatomy and is able to tailor the injections to your own unique facial structure and needs.

HYPERPIGMENTARY DISORDERS

FRECKLES

Freckles are small light brown flat spots on your skin, often in areas that are affected by sun exposure such as the cheeks and nose. It is usually present when young and develops with ageing and sun exposure. In most cases, freckles are harmless. It appears as a result of overproduction of melanin, which is responsible for skin and hair colour (pigmentation). Overall, freckles come from ultraviolet (UV) radiation stimulation.

HORI’S NAEVUS

A pigmentary disorder typically affecting Asian women between the ages of 30s-50s, it appears as discrete brown to grey spots across the upper cheeks. As the pigmentation is relatively deep within the skin, treatment with creams is less effective. Hori’s naevus however can be effectively treated with pigment lasers although multiple sessions are required.

MELASMA

A common skin problem that causes brown to grey-brown ill-defined patches, usually on the face, Melasma is a predominant issue amongst Asians, with women being more commonly affected than men.

Typically appearing on cheeks, forehead, chin, and above the upper lip, it can also be found on other parts of the body that get lots of sun, such as the forearms and neck.

Melasma results from the complex interplay of genetic, hormonal and UV factors; hence deterioration is often reported after sun exposure, during pregnancy (known as the mask of pregnancy), and the use of oral contraceptives.

It is difficult to treat, as recurrence and relapse rates are high. Adequate sun protection along with a combination of various modalities which includes topical lightening creams, chemical peels, intense pulsed light, low-fluence pigment lasers and oral medications can be used for treatment.

SOLAR LENTIGINES

Lentigines are brown, flat lesions with a clearly defined edge. The most common type, solar lentigines, occurs during middle age as a result of sun damage. Most often found on face and hands, it is larger and more defined than freckles. Some lesions may slightly thicken over time.

Solar lentigines are caused by exposure to ultraviolet radiation from the sun. It is common in people over the age of 40, but younger people are also susceptible. It happens when UV radiation causes pigmented cells called melanocytes in the skin to multiply. Solar lentigines are harmless and do not turn malignant. It can be left untreated or can be removed for aesthetic reasons.

Prevention is possible through regular usage of a broad-spectrum sunscreen and sun protection. It can be treated with lightening creams, intense pulsed light therapy or pigment lasers.

LIQUID FACELIFT

Designed to fill in the volume the face has lost over time due to aging, fillers most commonly include a natural protein known as hyaluronic acid (found in and under our skin) injected into areas suffering from volume loss, or static lines. Fillers may also help stimulate the production of collagen.

A range of FDA-approved fillers are available at Angeline Yong Dermatology which includes:

• Juvederm from Allergan
• Restylane from Galderma
• Belotero from Merz
• Profhilo from IBSA (New*)

As the areas on the skin are filled up, the skin “plumps up,” and wrinkles become less obvious. The most common substance injected is hyaluronic acid gel. It is safe and poses minimal risks to the skin when injected by a well-qualified and trained professional. Over time, the body slowly uses up the protein gel and completely recycles it to produce essential components like skin and hair.

Each product line contains different formulations and densities to treat different areas. Typically, denser fillers are injected deeper into the skin while lighter fillers are injected for fine lines and areas such as the lips and tear troughs. Certain hyaluronic acid fillers are also used for skin hydration.

INDICATIONS:

Common indications for fillers:

Upper face

• Static deep glabellar rhytides
• Static forehead “worry lines” rhytides
• Temporal augmentation

Midface

• Tear trough
• Nasal augmentation
• Nasolabial folds
• Distensible scars (e.g. acne scars)
• Fat atrophy of the cheek

Lower Face

• Lip augmentation (Contour & profile)
  • Volume enhancement
  • Vermillion border enhancement
  • Philthral crest definition
• Marionette lines
• Lip rhytides
• Chin augmentation

Other areas

• Volume loss at the back of the hands

Other indications

• Skin hydrating boosters are also used to improve the moisture-levels in your skin

Juvederm, Restylane and Belotero are used at Angeline Yong Dermatology to achieve optimal results tailored specifically for each individual’s needs.

PROCEDURE:

• A topical numbing agent is applied
• Filler is injected into the area requiring treatment
• The area is gently massaged to spread the product
• Number of injections/product used is based on the extent of repair or enhancement desired

The latest filler products contain lidocaine (an anaesthetic), making patients more comfortable during and after the procedure. Results are usually visible contemporaneously with most filler treatments, and last from 6-12 months on average, depending on the type of filler used and location it is injected into.

MASSETER REDUCTION

Botulinum toxin A is a medical treatment for facial lines and wrinkles. It is classified as an injectable muscle relaxant. The different forms of purified botulinum toxin A include:

• BOTOX^Ⓡ (onabotulinumtoxinA) from Allergan
• Dysport^Ⓡ (abobotulinumtoxinA) from Galderma
• Xeomin^Ⓡ (incobotulinumtoxinA) from Merz

Botulinum toxin is a neuromuscular blocking agent and causes temporary paralysis of the injected muscle by preventing the release of acetylcholine from motor nerve terminals. By blocking nerve activity in the muscles, botulinum toxin causes a temporary reduction in muscle activity, and hence is used to block muscle movement in areas that contribute to wrinkles.

It is commonly used in the upper face, in locations such as the forehead and between the brows to soften frown lines. Unlike filler, botulinum toxin only impacts muscle movement and has no effect on filling deep wrinkles that have already formed. Therefore, the treatment can be combined with filler injections to further improve overall appearance.

INDICATIONS:

Common indications for botulinum toxin:

• Forehead creases
• Frown lines
• Crow’s feet
• Infraorbital Rhytides
• Eyebrow lift
• Nasal wrinkles
• Nasal flare
• Nasal tip elevation
• Gingival show
• Vertical lip lines (Perioral rhytides)
• Marionette lines
• Mental crease & cobblestone chin
• Masseteric Hypertrophy
• Vertical neck bands (Platysmal Bands)
• Excessive sweating (Hyperhidrosis)

As there is significant variability in shape and function of many target muscles, even between individuals within one population, individualised, tailored treatment is essential to achieve an ideal cosmetic outcome. The treatment strategy should be based on muscle mass, muscle shape, pattern of muscle activity and what is aesthetically appropriate in the context of overall facial structure. As the NSC-DSS botulinum toxin Certificate of Competency (COC) trainer, Dr Angeline Yong strongly believes in and advocates a tailored, customised approach, always adjusting dosages according to the individual’s muscle activity and muscle mass.

PROCEDURE:

• A topical numbing agent is applied on the area
• The botulinum toxin is directly injected into affected muscles with a fine 30-gauge needle
• Number of injections/units used depends on the areas needing treatment
• Treated muscles weaken over the next week with visible results

Botulinum toxin is expected to lessen facial lines for a period of several months to yield a relaxed natural look. Treatment can be repeated once the effect has worn off.

MOLE REMOVAL

Prior to any decision made about mole removal, a trained dermatologist should be consulted to examine all moles and ensure they are harmless before treatment is carried out. Laser treatment should not be used to treat any suspicious moles. Benign moles however can be treated with lasers for cosmetic removal. Surgical removal is sometimes also used to remove harmless moles. If the mole is however deemed suspicious and requires further evaluation, your dermatologist will usually suggest a surgical removal and will send it for further histological examination.

The different treatment options for mole removal will be discussed in detail with you and a decision can be made based on the location, type of mole and patient preference.

Treatment Options for Mole Removal

Both laser and surgery can be used to remove moles for cosmetic reasons. Laser involves the use of laser light to target and remove the mole cells. Surgery involves cutting out the mole, closing the wound with fine stitches, with the end result being a small scar that fades over time.

For flat moles, our pigment laser has been used to successfully remove them without scarring in a large majority of patients. Most flat brown moles will require 1-2 treatments. This can be done as a simple, quick procedure in less than 5 minutes.

For raised moles, either laser or surgical removal can be performed. The advantage of a surgical approach is that recurrence is very rare as the entire mole including the deeper component is excised. However, there will be a linear scar. Lasers can also be used to remove raised moles safely and effectively. Depending on whether the moles are flesh coloured or pigmented, one or a combination of two different lasers may be required.

With our range of lasers and surgical facilities, we are able to remove moles effectively and safely on the same day. A thorough assessment and discussion is essential prior to you making your decision.

NON-SURGICAL BROWLIFT & RESHAPING

Botulinum toxin A is a medical treatment for facial lines and wrinkles. It is classified as an injectable muscle relaxant. The different forms of purified botulinum toxin A include:

• BOTOX^Ⓡ (onabotulinumtoxinA) from Allergan
• Dysport^Ⓡ (abobotulinumtoxinA) from Galderma
• Xeomin^Ⓡ (incobotulinumtoxinA) from Merz

Botulinum toxin is a neuromuscular blocking agent and causes temporary paralysis of the injected muscle by preventing the release of acetylcholine from motor nerve terminals. By blocking nerve activity in the muscles, botulinum toxin causes a temporary reduction in muscle activity, and hence is used to block muscle movement in areas that contribute to wrinkles.

It is commonly used in the upper face, in locations such as the forehead and between the brows to soften frown lines. Unlike filler, botulinum toxin only impacts muscle movement and has no effect on filling deep wrinkles that have already formed. Therefore, the treatment can be combined with filler injections to further improve overall appearance.

INDICATIONS:

Common indications for botulinum toxin:

• Forehead creases
• Frown lines
• Crow’s feet
• Infraorbital Rhytides
• Eyebrow lift
• Nasal wrinkles
• Nasal flare
• Nasal tip elevation
• Gingival show
• Vertical lip lines (Perioral rhytides)
• Marionette lines
• Mental crease & cobblestone chin
• Masseteric Hypertrophy
• Vertical neck bands (Platysmal Bands)
• Excessive sweating (Hyperhidrosis)

As there is significant variability in shape and function of many target muscles, even between individuals within one population, individualised, tailored treatment is essential to achieve an ideal cosmetic outcome. The treatment strategy should be based on muscle mass, muscle shape, pattern of muscle activity and what is aesthetically appropriate in the context of overall facial structure. As the NSC-DSS botulinum toxin Certificate of Competency (COC) trainer, Dr Angeline Yong strongly believes in and advocates a tailored, customised approach, always adjusting dosages according to the individual’s muscle activity and muscle mass.

PROCEDURE:

• A topical numbing agent is applied on the area
• The botulinum toxin is directly injected into affected muscles with a fine 30-gauge needle
• Number of injections/units used depends on the areas needing treatment
• Treated muscles weaken over the next week with visible results

Botulinum toxin is expected to lessen facial lines for a period of several months to yield a relaxed natural look. Treatment can be repeated once the effect has worn off.

At Angeline Yong Dermatology, problems are addressed using a bespoke multi-modality approach, as Dr Yong believes that no one method is perfect for everybody, and a combination of approaches may sometimes be needed to deliver the most natural, optimal outcomes. Our range of techniques includes non-surgical techniques such as botulinum toxin and high-intensity focused ultrasound (Ultherapy^TM) to deliver this non-surgically. Whether a combination of approaches is required or not depends on the needs of each individual patient.

NON-SURGICAL FACELIFT

HIGH INTENSITY FOCUSED ULTRASOUND (ULTHERAPY)

High-intensity focused ultrasound (HIFU) is a relatively new cosmetic treatment for skin tightening that some consider a non-invasive replacement for face-lifts. It uses ultrasound energy to encourage the body to produce both collagen and elastin, which results in firmer skin while maintaining a natural look.

Ultherapy^Ⓡ is the only FDA-cleared, non-invasive procedure that lifts and tightens the neck, chin and brow while also improving lines and wrinkles on the chest. It uses ultrasound energy to lift and tighten the skin naturally—without surgery or downtime. This collagen-boosting treatment uses micro-focused ultrasound energy to target the deep structural layers of the skin without disrupting the skin’s surface. It also incorporates ultrasound imaging, which allows practitioners to see the actual layers of tissue they are treating, ensuring the treatment energy is delivered to where it will be most beneficial. After treatment, the body’s tissue repair process stimulates the production of new collagen, creating a natural lifting effect.

Ultherapy^Ⓡ is a non-surgical procedure with minimal to no downtime, and the safety and efficacy of Ultherapy^Ⓡ has also been established through clinical studies with over a million treatments performed worldwide.

End results:

• Skin lifts and tones over time
• A full-face treatment takes 1 hour or longer and produces noticeable results that last 1 year or longer
• Mild redness and mild swelling immediately after treatment is experienced and this usually resolves in 1 to 2 hours

PHOTO REJUVENATION

Photorejuvenation is a treatment that uses various devices such as intense-pulsed light (IPL), lasers or light-emitting diode (LED) treatment to reduce and reverse the effects of photoaging like pigmentation, and textural changes including fine lines and wrinkles.

Treatments are typically non-invasive, have minimal side effects and usually require no recovery time. Photorejuvenation can help transform blotchy, sun-damaged skin into an even, more radiant complexion. Photorejuvenation procedures can also help reduce and treat common skin problems such as melasma, age and sun spots, rosacea, and broken capillaries.

The procedure has many benefits which includes:

• Reducing hyperpigmentation and skin redness
• Making skin more radiant and youthful
• Reducing wrinkles and fine lines
• Eliminating acne-causing bacteria to minimize the occurrences of acne breakouts

At Angeline Yong Dermatology, a full spectrum of medical grade LED, IPL, and laser devices are available for photorejuvenation, and Dr Yong will first assess your skin condition and listen to your concerns and preferences before designing a bespoke personalised treatment regime that best suits your skin condition and lifestyle.

PORE SIZE REDUCTION

Enlarged pores are a frequent concern and complaint that dermatologists face. The pathogenesis of enlarged facial pores is multifactorial, and is thought to be associated with sebum production, skin aging, and hair follicle size among other factors.

Current treatment modalities for enlarged facial pores target these various factors and include topicals such as retinoids, chemical peels, skin-plumping hyaluronic acid fillers and energy-based devices such as various lasers and radiofrequency devices. They can all work individually or synergistically to produce improvement and refinement of enlarged pores.

At Angeline Yong Dermatology, there are various modalities that can be used alone or in conjunction to achieve improvement of texture and enlarged pores. Dr Angeline Yong uses various laser options such as the Picosure focused lens array, Picoway Resolve, and the DEKA fractional CO₂ laser, to tailor a treatment plan based on your expectations, lifestyle and skin phototype. She also uses other modalities such as topicals, chemical peels and various skin boosters to achieve improvement in skin texture and refinement of enlarged pores. Prior to any treatment, Dr Yong’s bespoke approach involves an in-depth consultation and understanding of your lifestyle before partnering you in tailoring an approach that is suitable for your needs.

REJUVENATION OF DÉCOLLETAGE

The skin on the décolletage is very fragile as it produces less oil than the face, but also often receives more sun exposure, so neglecting this area can result in significant visible premature ageing. As more patients undergo facial rejuvenation procedures for a more youthful look, there is also a growing demand for rejuvenation of the décolletage (neck and chest) to achieve a more natural, seamless transition from the skin of the face to the chest. The same modalities that are used on the face to treat skin rhytides, texture, and discoloration have been used successfully in the décolletage area.

At Angeline Yong Dermatology, we use a combination of treatments tailored to your needs and individual preferences. This may include the safe and effective use of various cosmetic injectables alone or in combination with other modalities to address rhytides of the décolletage. A range of FDA-approved fillers from Juvederm, Restylane, Belotero, along with Profhilo are used to address the issues of skin laxity and signs of skin aging.

Dr Yong also utilises energy-based devices such as Ultherapy^Ⓡ for décolletage treatment. Ultherapy^Ⓡ delivers heat deep into the skin to stimulate the growth of natural collagen. Often with a single treatment, you can see your décolletage revitalized over the course of the next two to three months as collagen naturally replenishes itself and your skin gradually tightens. Individualised, customised treatment protocols are used at Angeline Yong Dermatology to achieve optimal results tailored specifically for each individual’s needs.

SKIN HYDRATION

MEDICAL GRADE FACIALS (HYDRAFACIAL ELITE)

Skin Hydration & Medical Grade Facials using HydraFacial Elite

Transforming skin health with advanced medical technology, HydraFacial is an award-winning medical-grade, non-invasive, multi-step treatment used for clearing pores and hydrating the skin.

Combining the benefits of next-level hydradermabrasion, a chemical peel and painless extractions with a special delivery of antioxidants, hyaluronic acid and peptides, this safe and effective treatment with minimal downtime takes only 30 minutes.

WHAT MAKES HYDRAFACIAL UNIQUE?

BENEFITS:

The innovative treatment is designed for all skin types, ensuring that even the most sensitive skin is able to tolerate the 30-minute procedure. Dermatologists use a combination of serums and/or customise the procedure as per individual skin conditions, requirements and patient preferences.

Some of the incredible benefits of HydraFacial include:

• Hydrated, bright, plump and clear complexion
• Reduced signs of ageing
• Reduced fine lines, wrinkles and pores
• Improved firmness, even skin tone and texture

The HydraFacial Elite has intuitive ISP technology that can be adapted to include new treatments and products as newer trends emerge. The built-in skin-imaging camera showcases clients that the treatments are working, and the photo comparison feature tracks clients’ progress with every visit. LEDs are also always ready for use as part of the treatment protocol.

ADD-ON THERAPIES:

Lymphatic Therapy

In addition, the HydraFacial Elite is a system designed to provide efficient, scientifically-backed treatments – including lymphatic therapy. This therapy improves the drainage of lymphatic fluids efficiently. The system comes with two handpieces for face and body with variable sizes. The suction drains fluids that reduces puffiness and redness of the skin. Improved lymphatic flow also enhances skin rejuvenation.

Benefits of Lymphatic Therapy:

• Decreases inflammation
• Detoxifies skin
• Removes unwanted build-up
• Optimises skin health

LED Light Therapy

The HydraFacial Elite MD system also comes upgraded with handheld LED lights. There are two handpieces for blue and red LED lights that heal and soothe the skin. Blue LED lights are used for acne-prone skin as they kill bacteria-causing acne. Red LED lights, on the other hand, are designed to reduce skin redness and signs of aging such as fine lines and wrinkles.

Benefits of LED Light Therapy:

• Reduces appearance of redness
• Decreases signs of ageing
• Targets and disrupts p. acnes bacteria
• Improves appearance of oily or congested skin

Skin hydration is not just superficial, but has to be built from the inside out for truly good, radiant skin. At Angeline Yong Dermatology, we not only use dermatologist-tested and custom-designed skin care that is suited to your skin type, but also skin hydrating injectables and medical-grade, non-invasive skin hydrating HydraFacial treatments to plump up and optimise hydration levels in your skin.

TATTOO REMOVAL

Q-switched (QS) and Picosecond laser systems can selectively destroy tattoo pigment without causing much damage to the surrounding skin. The modified pigment is removed from the skin by scavenging white blood cells and tissue macrophages. The choice of laser depends on the colour, depth and chemical nature of the tattoo ink. Amateur tattoos may take 4-6 sessions to remove, whilst professional tattoos may take 7-10 treatment sessions.

The Picosecond Nd:Yag and Alexandrite lasers, however, have revolutionised the treatment of tattoos, becoming the treatment of choice for tattoo removal due to their ability to clear the tattoo pigments faster.

Traditional Q-Switched lasers are capable of delivering nanosecond pulses. As common pigment particles used in tattoos have thermal relaxation times of less than 10 nanoseconds, the traditional Q-Switched lasers may not be the most efficient in tattoo removal. Both the PicoWay® and PicoSure® are true picosecond lasers able to generate picosecond pulses with all 3 wavelengths 532nm, 755nm and 1064nm to clear multicolored tattoos.

Picosecond lasers use ultra-short picosecond laser pulses to shatter ink particles at high pressure. The photoacoustic effect breaks tattoo inks into fine dust clouds, tinier than those fragmented by traditional nanosecond Nd:YAG and Alexandrite lasers.

Smaller pigments are absorbed much more efficiently, resulting in speedier elimination of the ink particles. Ultra-short bursts result in lesser thermal damage to surrounding normal tissue, leading to less erythema and swelling compared to traditional alternatives, dramatically reducing the risks of scarring.

The Procedure

• Topical numbing cream is applied onto the skin
• Laser light is beamed across the tattoo area with tattoo pigments absorbing laser energy
• Application of ice-packs or using a Zimmer cryo chiller minimises pain caused due to the laser

Once the procedure is completed, tattoo pigments aquire a silvery sheen – known as “frosting”, which lasts for 15 minutes before the tattoo returns to its original colour. Redness may appear and swelling of skin in the tattoo area is common for a few days, with fading occurring within 3-4 weeks gradually.

A series of wavelengths are required to treat multicoloured tattoos, and a single laser system is unable to remove all available inks and combinations.

At Angeline Yong Dermatology, both PicoWay® and PicoSure® lasers are used to treat a range of tattoo pigments using the 532nm, 755nm, 785nm and 1064nm wavelengths. However, certain tattoo pigments are not amenable to clearance with laser (e.g. titanium dioxide tattoos). Prior consultation with a dermatologist is imperative in determining the best tattoo removal procedure.

• Black pigment: Picosecond or QS Alexandrite or Nd:YAG
• Blue and green: Picosecond or QS Alexandrite
• Yellow, orange, red: Picosecond or QS Nd:YAG

As with other laser treatments, pigmentary and textural changes including scars may occur.

TEXTURAL IRREGULARITIES & SCARRING

ACNE SCARS

The term “scarring” refers to a fibrous process in which new collagen is laid down to heal a full-thickness injury. It affects 30% of those with moderate or severe acne vulgaris. It is particularly common in nodulocystic acne, acne conglobata and acne fulminans. Acne scars are usually the result of inflamed blemishes caused by skin pores engorged with excess oil, dead skin cells and bacteria. The pore swells, causing breakage in the follicle wall.

Scars can be classified as hypertrophic/keloidal or atrophic, and the treatment varies according to the type of scar. Atrophic scars occur when the skin heals with a net loss of collagen after the acute inflammatory process and are the most common type of acne scars. It includes boxcar scars, ice pick scars and rolling scars.

Hypertrophic and keloidal scars occur as a result of excessive collagen deposition during the healing process and occurs more commonly in darker skin types over certain sites of predilection. Sometimes a combination of various types of scars are present especially in patients with severe acne, and a combination of various modalities have to be applied to treat these scars adequately.

Additionally, traumatic scarring is a result of healing after significant injury to the skin and this may be post-surgical, or a result of mechanical or thermal injury such as burns.

UNWANTED HAIR GROWTH & HIRSUTISM

Unwanted hair and excessive hair growth due to hypertrichosis and hirsutism can be removed through laser treatments. Treatments typically require 4-6 sessions, with adequate healing time in between depending on area being treated.

The treatment involves highly concentrated light beamed into hair follicles causing the melanin pigment within the follicles to absorb the light, leading to destruction of follicles. A less painful procedure, which is much quicker than electrolysis, the lasers selectively target melanin, thereby heating up the basal stem cells in the follicle that causes excessive hair growth.

Melanin is considered the primary chromophore for all hair removal lasers currently on the market. Because of the selective absorption of laser light, only hair with colour such as black, brown, reddish-brown and dirty blonde can be removed. White hair cannot be removed by this method as it lacks the melanin pigment.

Some medical indications for hair removal include:

• Hirsutism– Hirsutism is a male-pattern of secondary or post-pubertal hair growth occurring in women. It arises in the moustache and beard areas at puberty while hair also appears in non-hirsute women in the underarm and pubic areas. Hirsute women may also develop thicker, longer hair than usual on their limbs and trunk.
• Hypertrichosis (congenital or acquired)
• Pseudofolliculitis

Suitable devices include the long-pulsed Alexandrite lasers and long-pulsed Nd:YAG laser – both of which are used at our clinic. The choice is made based on the skin type of the patient, with fairer skin types being more suited to the long-pulsed Alexandrite laser and darker skin types more suited to the long-pulsed Nd:YAG laser.

A non-laser device such as the intense pulsed light is another option.