Dr Vanessa Phua used to be an ophthalmologist performing complicated eye surgery. But for the past 14 years, she's been applying her gift of precision to aesthetic laser skin treatments. She shares with us what the new ones are, the right time to do them and if anyone will be able to tell.
1. What does a laser treatment do?
VP: Lasers generate invisible light energy that can span hundreds to thousands of nanometres (a nanometre is one billionth of a metre). Lasers can treat a variety of skin problems, from acne, rosacea, eczema and hyperpigmentation to skin-renewal concerns and even hair and tattoo removal. There’s no such thing as one-laser-fits-all. I adjust the laser wavelengths based on the patient’s skin condition – the longer the wavelength, the deeper the laser penetration into skin.
2. What’s an Asian skin-friendly laser?
VP: The Enlighten Picosecond is more suitable for Asian skin because it prevents hyperpigmentation from coming back. It’s a green laser emitting low energy, which makes it more protective. It won’t injure the surrounding skin. So it’s safer for those with deeper skin tones who are more likely to suffer burns from traditional laser machines which target the entire face instead of areas with pigmentation problems.
3. Is laser treatment a good intro to aesthetic treatments?
VP: It’s a good start as it can work on all skin concerns. There are two categories of lasers. Non-ablative lasers – such as ND:YAG, Enlighten Picosecond, and Dual Yellow Copper Bromide – are more commonly used on younger skin to even out skin tone, smooth roughness, treat acne scars, enlarged pores and superficial pigmentation, and reduce fine lines. Ablative lasers – such as those used in fractional skin resurfacing – are suitable for people in their late 40s and beyond who require more skin tightening and lifting, and want to treat deep wrinkles.
4. When can one start using laser treatments?
VP: Someone as young as a 16-year-old with acne can start such treatments. And the signs of ageing become more obvious from your mid-20s, so a preventive approach is better than a reactive one. Treat problems such as fine lines, the appearance of enlarged pores, uneven skin tone, dullness and roughness before they become more prominent and deep-set.
5. Can it ever be too late for lasers?
VP: There’s no such thing. My oldest patient is 81 years old, and she only started seeing me when she was 67. Pigmentation problems were her main concern, so I started her on lasers to treat her melasma and superficial sun spots. We did all the aesthetic procedures in a way that wouldn’t show up as major changes on her face. Her skin is currently brighter and more even-toned, with fewer visible wrinkles.
6. What does a typical course of laser treatments entail?
VP: Treatments are done at least once a month over a six-month duration if we’re dealing with acne and long-term melasma caused by hormonal disturbances.
7. Is there a waiting period between treatments?
VP: Laser treatments are generally done once in three to four weeks, as the skin needs that amount of turnover time.
8. How much can I expect to pay?
VP: It’s about $500 a month on average, but take into consideration other expenses such as skincare, boosters and add-on treatments too, subject to your skin type.
9. What should I expect to see after the first session, and by the end of the course?
VP: Generally, after the first session, you can expect your skin tone to be more even, dull areas to be slightly reduced, and an overall brighter complexion. By the end of the course, you can expect a minimised appearance of pores, acne scars and dark spots, controlled oil production, and better skin radiance.
10. Will lasers fix my skin permanently?
VP: Skin will age, and it will revert to showing the normal signs of ageing if you go completely laser-free. The treatments can be once every two or three months, but you’ll need to commit to lifetime maintenance for healthy-looking skin.
11. Can people tell if I’ve had it done?
VP: Not with a skilled and experienced doctor. It might take an average of three to five days for your skin to heal and for the redness to subside if you have just done an ablative laser treatment, but after the downtime, the results are very natural.
12. Does it make my skin thinner?
VP: That’s a misconception. In fact, your skin becomes healthier and more resilient since laser treatments encourage skin to produce more collagen.
13. Is there such a thing as overdoing it?
VP: If you overdo it, your skin might not have time to recover and may become sensitive, which could possibly give rise to other pigmentation issues. But an experienced doctor will not go overboard with the laser wavelength.
14. What about the pain and discomfort?
VP: For patients undergoing more intense laser treatments, we apply a topical anaesthetic cream. Other times, we use a cold compress to help reduce discomfort, but most laser treatments generally do not require any form of numbing.
15. Should I exfoliate my skin pre-treatment?
VP: I usually advise my patients not to exfoliate for at least one week before the treatment. This is because exfoliating causes the skin to be more sensitive to the laser, which means you might feel the sensation of heat slightly more than you usually would.
16. What about when I’m on my period?
VP: It won’t negatively affect the outcome of the treatment, but some women may be more sensitive to heat-induced pain during this time.
17. Do I really have to avoid outdoor activities or sun exposure post-laser?
VP: Yes, and it is even more crucial for you to do so if you’ve just completed a fractional skin resurfacing laser treatment, which treats more severe skin damage and wrinkling by removing microscopic columns of skin while leaving the surrounding tissue untreated. This prompts the body’s natural healing process to create new, healthy collagen to replace the removed columns of skin. This ablative treatment leaves skin especially raw and vulnerable, so it is highly recommended that you avoid swimming, diving and overexposure to the sun for at least two weeks.
Dr Vanessa Phua is based at The Chelsea Clinic, #05-08A Wheelock Place.