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Melasma is a common pigmentation concern in Singapore, often presenting as brown or greyish patches on the cheeks, forehead, upper lip, or jawline. While not harmful, it can be persistent and challenging to treat. As aesthetic doctors, we frequently see patients frustrated by stubborn melasma that does not improve with over-the-counter products.

This guide explores the medically proven melasma treatment options available in Singapore — from topical therapies and oral supplements to advanced lasers and procedural treatments — and explains how we approach each case with a personalised, doctor-led plan.

Melasma

Understanding the Causes and Types of Melasma

Melasma is a complex pigmentation disorder commonly seen in women, particularly in sun-rich environments like Singapore. It appears as symmetrical patches of brown, grey, or tan pigmentation, typically on the cheeks, forehead, nose bridge, upper lip, and jawline. While melasma is not medically harmful, its visible nature can cause significant emotional distress and self-consciousness.

What Causes Melasma?

The exact cause of melasma is multifactorial, but it is strongly influenced by the following triggers:

  • UV and Visible Light Exposure: Ultraviolet (UV) radiation is one of the most important factors in melasma development. Prolonged or cumulative sun exposure stimulates melanocytes (pigment-producing cells) to produce excess melanin, leading to pigmentation.
  • Hormonal Fluctuations: Melasma is closely linked to hormonal changes. It often develops during pregnancy (referred to as chloasma or "the mask of pregnancy") and can also occur with the use of oral contraceptives or hormone replacement therapy.
  • Genetic Predisposition: A family history of melasma increases one’s risk, suggesting a genetic susceptibility to pigment cell overactivity.
  • Heat and Infrared Light: Heat exposure, even without direct UV radiation, can stimulate melanocyte activity and worsen melasma. Everyday activities such as prolonged cooking near stoves, using steam rooms or saunas, and even certain aesthetic procedures that generate significant heat — such as some radiofrequency (RF) treatments — may contribute to melasma flare-ups. Additionally, frequent use of at-home anti-aging LED masks, especially those emitting infrared wavelengths, may inadvertently aggravate pigmentation in susceptible individuals.
  • Certain Medications and Skincare Products: Some medications, such as anti-seizure drugs, and irritating skincare products may trigger or worsen melasma in predisposed individuals.

Types of Melasma

Melasma is categorised based on the depth of pigment deposition in the skin:

  • Epidermal Melasma: Pigment is located in the outermost skin layer. It appears more sharply defined and brownish in tone, and tends to respond better to topical treatments and lasers.
  • Dermal Melasma: Pigment is found in deeper layers of the dermis. It often looks bluish-grey and is more challenging to treat, as pigment lies beneath the reach of many superficial therapies.
  • Mixed-Type Melasma: The most common presentation, combining both superficial and deep pigmentation. Treatment requires a multi-modal approach tailored to the individual.

How to Tell If Your Pigmentation Is Melasma – Key Differences to Know

Not all pigmentation is the same, and correctly identifying melasma is essential to selecting the right treatment. While melasma is one of the most common pigmentation disorders seen in Singapore, it is often mistaken for other conditions such as sunspots, post-inflammatory hyperpigmentation (PIH), or freckles. Differentiating between them helps avoid unnecessary or ineffective treatments.

Common Signs That Suggest Melasma

Melasma often presents with the following features:

  • Irregular Patches: Unlike sunspots or freckles, melasma appears as large, uneven patches rather than small, isolated spots.
  • Symmetry: One of melasma’s hallmark features is that it tends to appear symmetrically — affecting both sides of the face in a mirror-like distribution, especially on the cheeks, forehead, nose bridge, and upper lip.
  • Brown or Greyish Pigment: The colour of melasma may range from light brown to ashen grey, depending on whether it is epidermal, dermal, or mixed in depth.

How It Differs From Other Pigmentation Conditions

  • Sunspots (Solar Lentigines): Typically round, sharply defined, and appear due to cumulative sun exposure with age. They are usually not symmetrical and respond well to laser removal.
  • Post-Inflammatory Hyperpigmentation (PIH): Occurs after acne, burns, or other skin trauma. PIH tends to be more localised, with a distinct onset following inflammation.
  • Freckles: Small, scattered spots that are genetically determined and darken with sun exposure. They usually appear from a young age and are more superficial.

Importance of Medical Assessment

Because different types of pigmentation respond to different treatment modalities — and melasma requires careful, long-term management — it is important to have a medical assessment by an experienced aesthetic doctor.

Why Is Melasma More Difficult to Treat Than Other Pigmentation?

Melasma is widely regarded as one of the most complex and stubborn forms of facial pigmentation to manage. Unlike other pigmentation conditions that may respond well to topical creams or laser treatments, melasma is driven by deeper, more persistent biological factors — making it prone to recurrence and treatment resistance.

1. Hormonal Triggers Are Difficult to Eliminate

A key reason melasma is so difficult to treat lies in its hormonal component. Fluctuations in estrogen and progesterone levels — whether due to pregnancy, oral contraceptives, or hormone therapy — play a central role in melasma development. These internal influences are not easily removed or controlled, which is why melasma often persists despite treatment.

2. High Recurrence Rates

Even after visible improvement, melasma is notorious for relapsing. A single beach holiday with excessive sun exposure, or skipping daily sun protection, can cause pigmentation to return — sometimes more intensely than before. Because melasma-affected skin remains hypersensitive to UV and heat triggers, long-term maintenance is essential.

3. Risks of Incorrect Laser Use

While lasers can be helpful in treating certain types of pigmentation, melasma requires cautious use of laser technologies. Aggressive or inappropriate laser settings may worsen the condition or cause post-inflammatory hyperpigmentation (PIH) — especially in individuals with darker skin tones. This is why a personalised, low-energy approach is often preferred, and treatments must be adjusted based on skin response.

4. Treatment Must Be Sustained and Monitored

Unlike other pigment conditions where treatment may be curative, melasma requires ongoing care. Studies have shown that stopping treatment too early can lead to relapse. A comprehensive treatment plan — often combining topical agents, sun protection, oral supplements, and periodic in-clinic procedures — is necessary for long-term control.

Topical Creams for Melasma – Medically Proven Ingredients That Work

Topical creams are a foundational part of melasma management and are often used as first-line therapy. These formulations work by targeting different points in the melanin production pathway and by accelerating skin cell turnover to lighten dark pigmented patches more effectively. Prescription-only combinations are typically more potent than over-the-counter creams, and should be tailored to the individual’s skin condition.

Common Active Ingredients in Melasma Creams

Some of the most effective medical-grade ingredients include:

  • Hydroquinone: A gold-standard depigmenting agent that blocks tyrosinase, an enzyme needed for melanin synthesis.
  • Tretinoin (Retinoids): Promotes cell turnover and helps exfoliate pigmented skin layers.
  • Arbutin and Butylresorcinol: Natural and synthetic ingredients that inhibit melanin production with a lower risk of irritation.
  • Tranexamic Acid: Reduces vascular and hormonal triggers of pigmentation and is particularly helpful for hormonally driven melasma.

Doctor-Formulated Solutions by Dr Edwin

At our clinic, Dr Edwin has developed two targeted prescription formulations for melasma:

  • Advanced Skin Lightener
  • Pigment Focus Cream

These creams incorporate a synergistic blend of hydroquinone, tretinoin, arbutin, tranexamic acid, and butylresorcinol. They work by blocking excess melanin production and promoting skin renewal, thereby helping to clear existing pigmentation and prevent further melanin buildup. As prescription formulations, they are dispensed after a consultation to ensure suitability for each skin type.

Learn more about pigmentation creams here

Customised Laser Treatments for Melasma – Our Dual-Laser Strategy

Melasma is a complex condition that requires more than a one-size-fits-all laser treatment. At our clinic, we use a dual-laser protocol — combining the Spectra Pigment Laser and the Quadrostar Pro Yellow Laser — to achieve safe, gradual, and sustained improvements in melasma.

Spectra Pigment Laser (Q-Switched Nd:YAG)

This low-fluence laser targets deeper pigmentation using gentle pulses of laser energy to break down melanin particles. It is effective for epidermal and mixed-type melasma, and its non-ablative nature means minimal risk of skin irritation or post-treatment downtime.

Learn more about the Spectra Laser here

Quadrostar Pro Yellow Laser

This vascular laser targets the microvascular inflammation and redness often associated with melasma. By reducing superficial blood vessels and inflammation, it helps stabilise pigment activity and prevent rebound pigmentation — a key concern with melasma.

By combining both pigment and vascular lasers, we address melasma holistically: removing excess melanin while calming the underlying triggers.

Learn more about the Pro Yellow Laser here

Pico Laser for Melasma – Low-Heat Precision for Superficial Pigmentation

In addition to our core dual-laser method, we also offer Pico Laser for suitable cases — particularly those with superficial or epidermal melasma, or when a low-heat approach is preferred.

What Makes Pico Laser Unique?

Pico Laser delivers ultra-short bursts of laser energy in picoseconds, creating a photoacoustic effect rather than a photothermal one. This means melanin is shattered with minimal heat, reducing the risk of inflammation or post-inflammatory hyperpigmentation (PIH).

When We Use Pico Laser

Pico Laser is typically incorporated as part of a multimodal protocol, not used in isolation. It is especially useful for:

  • Patients with sensitive skin or heat-reactive melasma
  • Cases that have plateaued with conventional lasers
  • Those seeking a gentler alternative to maintain or refine results

Learn more about the Pico Laser here

Dr Edwin carefully selects the appropriate laser or combination based on skin type, pigmentation depth, and treatment response — ensuring each patient receives a tailored and safe solution.

Oral Medication for Melasma – How Tranexamic Acid Helps

In recent years, oral tranexamic acid has emerged as a promising adjunct treatment for moderate to severe melasma. Originally used to reduce bleeding, tranexamic acid has been found to inhibit the plasminogen pathway, which indirectly affects melanin production triggered by UV exposure and hormonal activity.

How Tranexamic Acid Works for Melasma

Melasma is not just a surface-level skin issue — it is deeply influenced by vascular and hormonal pathways. Tranexamic acid works by:

  • Blocking the UV-induced melanogenesis pathway: Reduces pigment production triggered by sun exposure.
  • Suppressing vascular endothelial growth factor (VEGF): Addresses the blood vessel component often seen in melasma.
  • Interfering with hormonal signals that stimulate excess pigment production.

Doctor-Led Use of Oral Tranexamic Acid

At our clinic, oral tranexamic acid may be recommended as part of a combination treatment plan for suitable patients. It is typically prescribed at a low dose and taken over a 3- to 6-month period, depending on the severity of pigmentation and patient response.

It is important to note that oral tranexamic acid is not suitable for everyone. It is contraindicated in individuals with a history of blood clots or cardiovascular conditions, which is why a full medical assessment is essential before starting treatment.

Sun Protection – A Critical Component in Melasma Treatment

Effective sun protection is paramount in managing melasma. Ultraviolet (UV) radiation, visible light, and environmental pollutants are significant triggers that can exacerbate pigmentation. Therefore, comprehensive protection against these factors is essential to prevent melasma flare-ups and recurrence.

Topical Sunscreen: Crystal Tomato® Beyond Sun Protection

At our clinic, we recommend Crystal Tomato® Beyond Sun Protection, a premium sunscreen that offers extensive defense against various environmental aggressors. Its key features include:

  • Broad-Spectrum UV Protection: With an SPF of 79 and a PPD rating of 17+, it provides robust protection against both UVA and UVB rays, which are known to worsen melasma.
  • Blue Light Defense: Clinically proven to shield the skin from 54.1% of High Energy Visible (HEV) light, commonly emitted by digital screens and indoor lighting, which can contribute to pigmentation.
  • Anti-Pollution and Infrared Protection: Formulated to combat environmental pollutants and infrared radiation, both of which can induce oxidative stress and pigment production.
  • Antioxidant-Rich Composition: Contains ingredients like Ectoin, Bisabolol, and Pongamia Pinnata Seed Extract, which help soothe the skin, reduce inflammation, and prevent oxidative damage.
  • Skin Hydration and Lightening: Clinical studies have demonstrated a 32% increase in skin moisture after 27 days of use, along with skin lightening benefits, enhancing overall skin health.
  • User-Friendly Texture: Its lightweight, non-greasy, and dry-touch formula ensures comfortable wear, making it suitable for daily use under makeup.

Application Guidelines

For optimal protection:

  • Apply Generously: Use approximately 1.5 to 2 cm of the product to cover the face and neck adequately.
  • Reapply Regularly: Reapplication is recommended every 2 to 3 hours, especially after sweating, swimming, or towel drying, to maintain effective protection.
  • Final Skincare Step: Apply sunscreen as the last step in your skincare routine, before makeup application.

Incorporating a high-quality sunscreen like Crystal Tomato® Beyond Sun Protection into your daily regimen is a proactive step towards managing melasma effectively and maintaining overall skin health.

Learn more here

Oral Sun Protection Supplements – Treating Melasma Management from Within

Incorporating oral sun protection supplements can be a valuable adjunct in the comprehensive management of melasma. These supplements work systemically to bolster the skin's defense against ultraviolet (UV) radiation and oxidative stress, both of which are significant contributors to melasma development and exacerbation.

Maxi-White Oral Skincare Supplement

At our clinic, we recommend the Maxi-White Oral Skincare Supplement, a scientifically formulated blend of potent antioxidants designed to provide internal photoprotection and support skin health. The key active ingredients include:

  • Colourless Carotenoids: Derived from non-GMO tomatoes, these carotenoids, specifically phytoene and phytofluene, absorb UVA and UVB radiation, reducing melanin synthesis and lightening pigmentation.
  • Polypodium Leucotomos Extract: A fern-derived antioxidant that has demonstrated efficacy in protecting skin cells from UV-induced damage and reducing pigmentation. Clinical studies have shown its effectiveness in improving melasma severity when used alongside topical treatments.
  • Glutathione: A powerful antioxidant that inhibits melanin production and shifts melanin synthesis towards lighter pigments, contributing to skin lightening and overall skin health.
  • L-Cystine: An amino acid that supports glutathione synthesis, enhancing its antioxidant effects and promoting skin lightening.
  • French Maritime Pine Bark Extract (Pycnogenol®): Rich in procyanidins, this extract exhibits strong antioxidant and anti-inflammatory properties. Studies have indicated its potential in reducing melasma severity by protecting against UV-induced oxidative stress and inhibiting melanin synthesis.

Clinical Benefits

The synergistic action of these ingredients offers multiple benefits:

  • Enhanced UV Protection: By neutralizing free radicals and reducing oxidative stress, these supplements provide systemic photoprotection, complementing topical sunscreens.
  • Reduction in Pigmentation: The inhibition of melanin synthesis pathways leads to a gradual lightening of existing pigmentation and prevention of new pigment formation.
  • Anti-Inflammatory Effects: By mitigating inflammatory responses, these supplements help in reducing the risk of post-inflammatory hyperpigmentation, a common concern in melasma patients.
  • Skin Brightening and Even Tone: Regular intake contributes to a more uniform skin tone and improved skin radiance.

Usage Recommendations

For optimal results, it is advised to take the Maxi-White supplement daily, as directed. Consistency is key, and benefits are typically observed over a period of several weeks. It is important to note that while these supplements provide internal support, they should be used in conjunction with topical sun protection measures and other melasma treatments for comprehensive management.

Learn more here

Combination Treatment Strategies for Melasma – Why a Multi-Modal Approach Works Best

Melasma is not a condition that can be effectively managed with a single treatment method. Because it is influenced by multiple triggers — including hormones, sun exposure, vascular changes, and skin sensitivity — a multi-modal approach is often required to achieve optimal, long-term results.

At our clinic, Dr Edwin designs customised treatment plans that combine several clinically proven therapies, targeting both the root causes and visible signs of melasma.

Topical Creams + Oral Medication

Combining prescription creams containing hydroquinone, tretinoin, arbutin, or tranexamic acid with oral tranexamic acid helps tackle pigmentation at both the surface and systemic levels. While topical agents promote pigment fading and skin renewal, oral medication works internally to suppress hormonal and UV-triggered melanin production.

Laser Therapy + Oral Supplements

Incorporating laser treatments — such as Spectra Q-Switched, Pro Yellow, and Pico Laser — alongside oral sun protection supplements like Maxi-White enhances outcomes. Lasers break down existing pigment and reduce vascular triggers, while supplements strengthen the skin’s internal defences against UV and oxidative stress, helping to prevent new pigmentation from forming.

Sun Protection as a Foundation

A combination approach always includes both topical and oral sun protection. High-quality sunblocks like Crystal Tomato® Beyond Sun Protection are used in tandem with oral antioxidants to provide comprehensive photoprotection. This dual-layered defence is essential for preventing relapses and maintaining long-term results.

Why Combination Matters

Each treatment component addresses a different mechanism:

  • Topicals reduce pigment and increase cell turnover
  • Orals modify internal pathways and enhance UV resistance
  • Lasers break down pigment and reduce inflammation
  • Sun protection prevents triggers from reactivating melasma

This synergy ensures safer, more consistent outcomes and reduces the risk of over-relying on any single modality — particularly lasers, which may worsen melasma if used aggressively.

Frequently Asked Questions About Melasma Treatment in Singapore

Q1: What is the best treatment for melasma?
There is no single “best” treatment for melasma. The most effective approach involves a personalised combination of therapies, including prescription topical creams, oral medications like tranexamic acid, laser treatments (e.g. Spectra, Pro Yellow, Pico), and sun protection. Treatment plans are tailored based on the depth and pattern of pigmentation, skin type, and history of recurrence.

Q2: Can melasma be completely cured?
Melasma is a chronic condition influenced by hormonal and environmental triggers. While it can be significantly improved and managed, it may not be permanently cured. Maintenance treatments, sun protection, and lifestyle adjustments are essential to reduce recurrence.

Q3: Is laser treatment safe for melasma?
Yes — when performed by an experienced doctor using the correct laser settings and protocols. At our clinic, we use low-fluence lasers such as Spectra and Pro Yellow, and may include Pico Laser for superficial pigmentation. Inappropriate or overly aggressive laser use can worsen melasma or cause post-inflammatory hyperpigmentation (PIH), which is why careful medical guidance is crucial.

Q4: How long does it take to see results from melasma treatment?
Results vary depending on the severity of pigmentation and type of treatment used. Most patients notice visible improvement within 4 to 8 weeks of starting combination therapy, though full results may take a few months. Consistency and adherence to a complete regimen are key.

Q5: Why does my melasma keep coming back?
Melasma often recurs due to exposure to sunlight, heat, hormonal fluctuations, or stopping treatment too early. Even short-term sun exposure, such as a beach holiday, can trigger a relapse. Long-term maintenance with sun protection and periodic treatments helps prevent recurrence.

Q6: Can I use over-the-counter products to treat melasma?
Over-the-counter lightening products may offer some benefit for very mild pigmentation but are usually insufficient for true melasma. Prescription formulations and professional treatments are typically needed to target the deeper pigment pathways effectively.

Q7: Is melasma more common in certain skin types?
Yes, melasma is more common in individuals with medium to darker skin tones (Fitzpatrick skin types III–V), especially those living in sunny climates like Singapore. These skin types are also more prone to post-inflammatory pigmentation, which is why treatments must be carefully selected.

Q8: Is oral tranexamic acid safe for everyone?
Oral tranexamic acid is generally well tolerated when prescribed and monitored by a doctor. However, it is not suitable for individuals with a history of blood clots, stroke, or certain cardiovascular conditions. A medical consultation is necessary to assess suitability.

How to Choose the Best Melasma Treatment Clinic in Singapore

Choosing the right clinic for melasma treatment can significantly impact your results — and your skin’s long-term health. Because melasma is a complex, chronic condition with a high tendency for recurrence, it’s important to seek care from a qualified aesthetic doctor who understands how to balance efficacy with safety.

Here are key factors to consider when selecting a melasma treatment clinic:

1. Doctor-Led Treatment Plans

Melasma requires medical supervision, especially when prescription medications, oral tranexamic acid, or lasers are involved. Look for clinics where treatments are conducted or closely guided by an experienced doctor — not solely by therapists or machines.

At Edwin Lim Medical Aesthetic Clinic, all melasma patients are reviewed by Dr Edwin himself, who tailors each plan according to skin type, pigment depth, and sensitivity.

2. Range of Treatment Modalities

The best melasma clinics offer a multi-modal approach, combining:

  • Prescription creams (e.g. hydroquinone, tretinoin, tranexamic acid)
  • Oral supplements and medication
  • Low-fluence laser technologies (e.g. Spectra, Pro Yellow, Pico)
  • Sun protection strategies (both topical and oral)

A clinic that offers only laser treatments or facials may not address the root causes of melasma effectively.

3. Use of Melasma-Safe Lasers

Not all lasers are suitable for melasma. The best clinics use low-energy devices designed for pigment and vascular targets — and avoid overly aggressive treatment that may worsen the condition. Ask whether the clinic offers Pro Yellow, Spectra, or Pico Lasers, and whether the doctor is experienced in using them specifically for melasma.

4. Emphasis on Long-Term Management

Melasma is not a one-time fix. A good clinic will advise you on maintenance treatments, sun protection, and how to minimise risk of relapse — not just focus on immediate clearance.

Ready to Take Control of Your Melasma?

Dr Edwin Lim has successfully treated many cases of melasma using a personalised, multi-modal approach that combines medical-grade skincare, oral therapies, and melasma-safe lasers. Whether you're dealing with stubborn pigmentation or recurring flare-ups, our clinic offers evidence-based solutions tailored to your skin type and condition.

Schedule a consultation today and take the first step toward clearer, more even-toned skin.

Contact us today at 69042218 or 96372218 to find out more!


Dr Edwin Lim

MBBS (Singapore), MRCS (Edinburgh), PgDip Practical Dermatology (Cardiff), MSc Practical Dermatology (Cardiff), Diploma in Aesthetic Medicine, (AAAM), Accredited by the Aesthetic Dermatology Educational Group (ADEG)
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This article has been medically reviewed by Dr Edwin Lim
Dr Edwin has a fond interest in Aesthetic injectable procedures such as Fillers, Skinboosters and Botox. He is passionate about enhancing one's beauty by delivering natural looking results with well placed injections.

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