Introduction
It would be utterly embarrassing and awkward to raise your hand only to have people notice that your underarms are darker than the rest of your skin. Having darkened underarms can make you self-conscious. It might even stop you from wearing your favourite sleeveless tops or bathing suits in public.
However, with the help of underarm whitening, the procedure can help lighten darkened armpits, restore your confidence and allow you to wear any outfits that you want!
Read on to find out more about underarm whitening.
What is underarm whitening?
Underarm whitening uses various methods such as lasers and creams to lighten the underarm. These methods cause the dark pigments to fade and it works to restore the colour of the underarm back to the individual's original skin tone.
What causes the darkening of underarms?
There are many reasons for the darkening of underarms, such as irritants, lack of exfoliation and certain medical conditions. Some causes of darkening underarms include:
- Acanthosis nigricans (AN)
AN is a common cause of dark underarms. It is a medical condition characterised by dark, coarse and thickened skin around the underarms, groin, elbow and neck areas. AN is linked to obesity and diabetes and has a prevalence rate of 7-74%, depending on factors such as age, race and degree of obesity, which play a part in the prevalence of AN. [1]
- Chemical irritants
Chemical irritants such as deodorant, antiperspirants or products containing fragrance can result in dark underarms as they can irritate the skin, leading to increased melanin production and hyperpigmentation [2]. Melanin is a brown pigment in our skin, and a large amount of melanin will result in darker skin colour.
- Shaving or waxing
Shaving or waxing can cause irritation and abrasion to the skin, which causes it to be thicker. It also leads to increased melanin production and hyperpigmentation [3], resulting in darkened underarms.
- Erythrasma
Erythrasma is a bacterial infection that affects the skin folds under the arms, the groin area and between the toes, resulting in pink or brown patches appearing on the skin [4].
- Lack of exfoliation
The lack of exfoliation leads to the accumulation of dead skin cells over time. This can cause ingrown hair, which results in the darkening of the area over time [5].
- Post-inflammatory hyperpigmentation
Incorrect use of lasers such as underarm hair removal using intense pulsed light (IPL) can result in trauma to the skin and stimulate melanin production [6]. This causes the underarms to look darker.
- Abnormalities in hormone levels
Imbalance of hormone levels such as progesterone and estrogen results in the production of melanocytes and melanin, contributing to the darkening of the skin in areas such as the underarms.
What are the types of underarm whitening treatments in Singapore?
There are many types of treatments available to help whiten underarms, such as:
- Topical creams:
Most topical creams contain hydroquinone, azelaic acid, corticosteroids and tretinoin to lighten dark underarms. However, the long-term use of hydroquinone can be toxic. They cause irritation and post-inflammatory hyper- or hypopigmentation, resulting in its ban in many countries [7].
An alternative is using creams containing cysteamine instead, which has been shown to be effective in lightening dark underarms as well [8]. Cysteamine also has milder, reversible side effects such as a burning sensation or irritation that resolve by itself when application stops. Furthermore, cysteamine is safer and better tolerated by its users [9].
- Chemical peeling:
Chemical peeling is a cosmetic procedure whereby a chemical solution is applied to the skin to remove the top layer. The top layer is then allowed to regrow.
Chemical peels have shown to be useful in removing unwanted melanin that are causing the dark underarms. The skin that grows back after the chemical peel would be lighter, more similar to that of the surrounding skin. [10]
- Microdermabrasion:
Microdermabrasion helps to whiten your underarms by using an applicator with an abrasive surface to gently remove the thickened and darkened skin.
- Laser therapy:
Laser therapy has been used to treat many dermatological conditions involving pigmented skin, such as melasma and post-inflammatory hyperpigmentation. It has proved to be effective in removing dark pigments and lightening the skin. [11] Laser hair removal can also permanently remove hair, which decreases the chances of underarm darkening.
How does underarm whitening by laser work?
Lasers help to whiten your underarms by delivering pulses of high-intensity laser energy at specific wavelengths between 630 and 1100nm through the skin to selectively destroy melanin pigments, which are responsible for darkened underarms [11].
With the help of the laser, melanin pigments are broken down into small pigments and will then be flushed out of the body via our lymphatic system over a few weeks. The heat from the lasers can also stimulate collagen production, resulting in an improvement in skin laxity and firmness.
There are many different types of lasers available in the market that are used in underarm whitening. These lasers typically differ in the wavelength emitted and the depth of skin the laser passes through.
Examples of lasers that have been commonly used in underarm whitening include:
- Nd:YAG lasers (1064nm)
- Quality-switched (QS) Ruby laser (694nm)
- QS Alexandrite laser (755nm)
- Pulsed dye laser (590nm)
- Diode laser (805nm)
- Picosecond lasers
Some clinics prefer to use a combination technique for underarm whitening, by using multiple lasers to break down the melanin pigments, as well as prescribing topical medications.
What are combination laser treatments for underarm whitening?
Clinics that offer a combination approach for underarm whitening usually use technology that consists of multiple lasers. Depending on the patient’s skin type and problems faced, one or more technologies may be combined to achieve the best results [12].
Examples of such technologies include [13]:
- BLEND consists of a variety of non ablative lasers and can be tailored according to the patient’s specific skin type. It effectively treats pigmentation with no downtime.
- PERFECT is a combination fractional laser treatment that delivers different laser beams divided into thousands of microscopic treatment zones, targeting only a fraction of the skin at a time. This laser works on pigmented areas on both the epidermal and dermal layer of the skin, improving the appearance of darkened underarms [14].
- Fotona v3 redness laser is a long-pulsed laser emitting energy at wavelengths of 532 and 1064nm. This laser is well absorbed by haemoglobin and improves general redness and visible blood vessels. [15]
Is a combination approach better for underarm whitening?
Using a combination approach is more effective than just using a single laser as pigmentation tends to occur at various levels of the skin (epidermal, superficial dermal and deep dermal). This means that using a laser that emits laser energy at a single wavelength is not going to be as effective in getting rid of your pigmentations — you may require several treatments before visible results!
Furthermore, apart from poor results, customers who use a single laser treatment approach usually experience more side effects. Studies have shown that when a single laser treatment approach is used excessively, there is a risk of developing macular hypopigmentation (patches of pale skin that are lighter than the surrounding skin) [16].
Combining several lasers to perform underarm whitening ensures that the treatment is tailored based on the customer’s underarm condition and skin type, to effectively lighten pigmentation, allowing the underarm to be whitened quickly and with few side effects.
Although combining several lasers together may sound time-consuming and complex, the entire procedure takes only 15-20 minutes and the downtime is also shorter than single laser treatments [13]. This is because there is minimum damage done to skin layers that are unaffected by pigmentation.
What can I expect during an underarm whitening treatment in Singapore
Before the start of the treatment, your aesthetic doctor will examine your underarms to determine your specific skin type and skin condition. This will help them in deciding which lasers to use during the treatment.
You will then be led to the treatment room, where your underarms will be cleansed to remove any dirt. Topical anaesthesia will also be applied to your underarms to help minimise discomfort you may feel during the procedure. A pair of eye goggles will be given to help protect your eyes from the laser during the procedure.
Once you are ready, your doctor will start the underarm whitening treatment. There is little to no pain involved in treatment, just a slight discomfort that feels like a warm, tingly sensation. The treatment is expected to take about 15-20 minutes.
After the treatment, a cooling mask will be applied to your underarms to help soothe your skin. You will be able to leave after your doctor provides you with some aftercare tips. The downtime is minimal, so you will be able to return to your normal daily activities after.
Is there any downtime after underarm whitening treatment?
There is minimal downtime following an underarm whitening treatment. Common side effects include:
- Mild redness
- Swelling
- Sensitive skin
These symptoms should subside within 3-5 days. However, most redness and swelling typically last only several hours [13].
Some adverse side effects that may occur include [17]:
- Dyspigmentation
- Blistering
- Scarring
If you observe any adverse side effects or if redness and swelling do not improve, you should consult your doctor immediately.
How fast can I see results after underarm whitening treatment?
Results of underarm whitening treatment depend on a couple of factors – depth and type of pigmentation, the severity of pigmentation and individual’s skin type [13].
For patients with moderate darkening of their underarms, they would typically require regular treatments for 4-6 months before notable improvement can be seen. Proper skincare and aftercare also play a part in helping to see faster results.
Is underarm whitening safe?
Underarm whitening is considered safe and effective. There are some side effects associated with underarm whitening, such as redness, swelling or mild sensitivity. These are normal and should resolve within the day.
However, there have also been reports of adverse side effects of scarring, blisters and hyper- or hypopigmentation [17], [18]. It is important to choose a reputable clinic and a highly experienced and skilful doctor whom you can trust. This can minimise the risks of any adverse side effects or complications associated with underarm whitening treatments.
Do underarm whitening creams work? Are they safe?
Underarm whitening creams usually contain chemicals such as corticosteroids, hydroquinone and tretinoin to help lighten the skin. These creams work by inhibiting the production of melanin and results in the appearance of lighter skin colour. Underarm whitening creams are said to be successful in helping to lighten the skin.
However, studies have shown that these underarm whitening creams can result in adverse side effects such as contact dermatitis, striae, acne and infections [19]. Furthermore, creams that contain hydroquinone at concentrations greater than 2% can cause skin irritation and irreversible hyper- or hypopigmentation [20]. Hydroquinone has been banned in many countries or has been heavily regulated. [21], [22], [23]
If you are looking for a lightening cream that does not contain hydroquinone, as mentioned above, cysteamine is also effective in reducing pigmentation. It also has milder and reversible side effects such as a burning sensation or irritation that resolve by itself upon the cessation of usage. [7]
It is safer to purchase underarm whitening creams from your aesthetic doctor after they have carefully assessed your skin type. On the other hand, self-prescribed underarm whitening cream purchased online or over the counter should be avoided.
For example, Veritas Skin’s Cell-Reve Serum is an effective skin lightening cream that is gentle on the skin and suitable for sensitive skin. Cysteamine is another topical, non-hydroquinone lightening cream that can be used together with laser treatments to regulate melanin production. [13]
How can I whiten my underarms naturally?
Some may turn to cheaper and “more natural” ways to whiten their underarms. There are several natural remedies on the internet that claim to be effective in whitening our underarms. For example [24]:
- Baking soda
- Lemons
- Toothpaste and matcha green tea mixture
- Apple cider vinegar
Despite their claims, these home remedies have not been scientifically proven to be effective in helping to whiten your underarms. As everyone’s skin is different, mixtures in wrong proportions or even certain ingredients may be too aggressive for some people, which can result in unwanted skin irritation [13].
How do I prevent underarm darkening?
For those who do not have dark underarms or who wish to maintain the results of their underarm whitening treatment, there are a few ways that you can prevent your underarm from darkening. [25], [26]
- Use shaving cream while shaving.
- Avoid dull razors while shaving.
- Use deodorant with natural, active ingredients instead of those that use chemicals.
- Exfoliate regularly to prevent the accumulation of dead skin cells.
- Keep your underarms clean of sweat and dirt by showering regularly.
- Wear loose-fitting clothes.
What are the costs of underarm whitening treatments in Singapore?
The cost of underarm whitening treatments can range from $180-$1,000 per session.
It varies with the doctor’s experience and skills, clinic’s location, brand and type of technology used, as well as whether a combination of lasers is used.
Conclusion
With the effectiveness of underarm whitening treatment, ladies can be confident and free to wear sleeveless tops as they please, especially in Singapore’s sweltering heat. Find a doctor whom you can trust and of course, great care must still be taken after the treatment to ensure that results are maintained.
