Image: 123rf; An illustration of the Fitzpatrick phototype
Ever wondered if you can safely become alabaster white like your favourite K-idol, and how exactly you can get a few shades lighter? We ask dermatologist Dr Teo Wan Lin, founder and medical director of TWL Specialist Skin & Laser Centre, for her recommendations and tips on what are the skincare ingredients to look out for and what treatments can help you achieve radiant fairness without harming your skin.
Dr Teo is the founder and medical director of TWL Specialist Skin & Laser Centre. She is a Ministry of Health accredited dermatologist, specialising in both medical and cosmetic dermatology and has also developed her own dermatologist-grade cosmeceuticals – Dr.TWL Dermaceuticals.
A lot of Asian women want a fairer skin tone - is this actually possible? How much lighter can one go?
In the context of achieiving a fairer skin tone, I think it is important to define if we are talking about eliminating uneven pigmentation, or actually making one’s skin lighter in shade overall. In terms of making one’s skin tone more even and eliminating dark spots, there are different forms of pigmentation that you should know about including sun spots (solar lentigo), freckles, and other medical conditions such as post inflammatory hyperpigmentation and melasma. There are specific topical medications, lasers, as well as pills that one can use to treat these conditions.
For the case of actually getting lighter skin tone that is not natural for one’s genetically determined skin type, I do not recommend that and we can address that more later.
What are the steps to take to achieve a fairer skin tone - can we break it down into lifestyle, treatments and skincare?
To achieve a fairer skin tone, I will focus on how to enhance one’s skin health, so that you get less of the common hyperpigmentation conditions. We start off with genetics. Everyone is born with a certain skin type - the dermatological grading of this is the Fitzpatrick phototype (there are 6 phototypes, see top image). For Asians, we tend to be between type III to type V. However people of a certain skin type, for example in phototype III, can have varying amounts of skin fairness or pigmentation and this is influenced by various factors.
Lifestyle certainly plays a role, as our skin contains melanin, a light-absorbing pigment molecule that also gives our skin its color. When we are exposed a lot to the sun, we activate the melanin-producing cells, melanocytes that can cause one’s skin tone to get darker. Other lifestyle habits like smoking, exposure to pollution and stress for example, can lead to a process known as free radical generation in our skin and this can increase one’s propensity to hyperpigmentation. Unhealthy lifestyle is definitely part of factors that cause our skin to be less radiant and can also cause the skin to appear as a dull complexion with uneven skin tone.
In terms of treatment, chemical peels and lasers help to stimulate one’s skin cells, restoring it to a normal cell cycle of a younger person. Overall, this makes skin more radiant with an even skin tone and a fairer complexion, whilst also reducing the amount of skin surface irregularities. The lasers work by causing the skin’s natural cells to “eat up” areas of pigmentation - this is beneficial for those hoping to achieve more even skin tone.
Image: Instagram/drtwlderma; Dr.TWL Dermaceuticals Vita C Gold Serum, $139.10, available at drtwlderma.com.
Certain skincare ingredients have shown effectiveness for evening skin tone. For example, retinoids (which are prescription only), and oligopeptides which is what I incorporate in my skincare as it is non-irritating with potent anti-ageing properties and stimulate one’s immune cells to “eat up” pigmentation and has been proven to lighten skin tone. Vitamin C is a very powerful anti-oxidant that helps to prevent free radical cell damage, and vitamin c serums can be very effective.
Is it realistic to maintain a lighter skin tone than you're naturally born with?
Our skin tone is genetically determined and we refer to the Fitzpatrick phototype classification as mentioned previously. It is unhealthy to bleach or lighten one’s skin and remove natural melanin which has a protective function. There are ways to achieve that, but they not done by dermatologists because of the danger. The only indication for using bleaching creams will be to lighten small areas of hyperpigmentation such as sun spots or in cases of the medical condition, melasma.
To lighten one’s skin entirely is very dangerous because it can increase your risk of skin cancer as well as accelerate skin ageing. Such treatments are reserved for medical conditions such as vitiligo whereby one has lost significant amount of skin pigmentation through an autoimmune disease and is cosmetically disfiguring. In those cases, if the body surface area is involved very significantly, it can be an indication for the dermatologist to lighten the rest of the skin as well to help the overall cosmetic appearance.
What is the fastest way to lighten your skin tone naturally?
One’s skin tone often appears dark because of uneven pigmentation that has developed over the years with ageing and sun damage, as well as having dull skin. A quick in-office treatment will be a chemical peel performed by a dermatologist, using glycolic or lactic acids in combination with a laser treatment. In my clinic, we do both as part of a skin rejuvenating treatment on the same day. The result of this is usually apparent right after treatment, especially after applying the amino acid masque which contains vitamin C and various plant extracts that help to shrink pores and brighten skin tone.
Dr.TWL Dermaceuticals Amino Acid 360 Masque, $235.40, available at drtwlderma.com.
Can you share with us any controversial methods of skin lightening?
More than controversial, some alternative skin lightening methods can be dangerous. In particular, do be wary of cosmetic products that promise exaggerated or miraculous results, as recommended by the Health Sciences Authority with some recent high profile cases of illegal cosmetics. Such products may be prohibited for sale in Singapore, for example due to dangerously high levels of mercury. This toxic heavy metal is prohibited as an ingredient in skincare formulations as it can cause rashes, skin discolouration and blotching. Chronic exposure to mercury may also lead to permanent damage to the kidneys, digestive and nervous systems.
Other means of skin lightening such as intravenous glutathione treatments (injections) can be unsafe. Glutathione is an antioxidant naturally found in our cells and has skin-lightening abilities. It converts melanin to a lighter color and reduces melanin production as a whole. As with any treatments involving direct delivery to the bloodstream, additional caution should be exercised in consultation with an accredited medical professional. While glutathione has been proven safe for oral and topical treatments, we cannot say the same when it is injected into the bloodstream, given the inadequate safety data presently. Serious skin disorders, kidney dysfunction and thyroid function impairment have been reported in some cases.
Another controversial method would be lightening creams containing ingredients such as hydroquinone and retinoids (tretinoin), which can cause serious adverse reactions. Their potency means they should only be prescribed by an accredited medical professional and used under strict medical supervision.
Check out other products which you can use at home for more radiant skin: