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Melasma is one of the most challenging pigmentary concerns seen in Singapore. It appears as brown or greyish patches on the face and is influenced by sun exposure, heat, hormones and genetics.
Unlike simple dark spots or freckles, melasma tends to fade, recur and fluctuate over time, which is why it requires careful, long-term management rather than a quick fix.
This page explains what melasma is, the different types of melasma, why it is difficult to manage, how Q-switched and Pico laser categories fit into melasma care, and what a doctor-guided treatment and maintenance plan in Singapore may look like.
Melasma is a chronic pigmentary condition where melanocytes (pigment-producing cells) become more active and sensitive.
Instead of forming isolated spots, melasma shows up as diffuse patches, often on both sides of the face in a roughly symmetrical pattern.
It is more common in individuals with medium to darker skin tones and in climates with strong sunlight and high heat, such as Singapore.
Melasma is most commonly seen in these areas:
Because melasma is influenced by internal factors such as hormones and heat, as well as external factors like UV exposure and irritation, it often behaves in a “two steps forward, one step back” pattern.
This is why doctors emphasise long-term care over one-off aggressive treatments.
Understanding the type of melasma helps doctors decide how cautious they need to be and which treatment categories may be appropriate.
This refers to melasma where more pigment is located in the epidermis (the top layer of the skin). It usually looks light to dark brown.
Epidermal melasma may respond relatively better to topical brightening agents and gentle procedures, provided the skin barrier remains calm.
In dermal melasma, more pigment sits deeper in the dermis. It can have a grey or bluish tinge and tends to be more persistent.
Dermal melasma typically requires longer-term maintenance, and doctors may be more cautious with heat or irritation.
Mixed melasma is the most common pattern in practice. It contains both epidermal and dermal components.
This means a combination approach is usually considered, with careful layering of skincare, sun protection and, where suitable, laser categories such as Q-switched lasers.
Many people in Singapore call any dark mark “pigmentation”, but different pigmentary concerns behave differently and respond differently to treatment.
Melasma is not the same as freckles, sunspots or post-inflammatory hyperpigmentation (PIH).
| Condition | How It Looks | Common Causes | Behaviour Over Time |
|---|---|---|---|
| Melasma | Larger, diffuse patches on cheeks, forehead, upper lip or jawline. | Hormones, UV, heat, genetics, skin irritation. | Fades and returns; very sensitive to triggers. |
| Freckles | Small, scattered brown spots. | Mainly UV exposure and genetics. | Darken in sun, lighten with reduced exposure. |
| Sunspots / Age Spots | Isolated dark marks or patches. | Cumulative sun damage over time. | Usually stable once formed. |
| PIH (Post-Inflammatory Hyperpigmentation) | Marks left after acne, rashes or irritation. | Inflammation and skin injury. | Can slowly fade; not primarily hormonal. |
These differences matter because melasma is both hormone- and heat-sensitive.
Approaches that work well for sunspots or freckles may not be appropriate for melasma, especially if they are too strong or cause inflammation.
Melasma is often described as “stubborn” for a few reasons:
Because of these factors, melasma is usually managed rather than “cured”. The focus is on gradually improving the appearance and keeping it as stable as possible with long-term habits.
Most doctors take a layered and cautious approach to melasma. The goal is to calm the skin, regulate pigment activity and reduce triggers, rather than relying on a single strong procedure.
A typical doctor-guided melasma plan may include:
There is no single “best” treatment for melasma. Instead, doctors usually combine several approaches and adjust them over time.
The mix depends on the type of melasma, skin sensitivity, existing skincare routine and individual goals.
Common treatment categories that may be considered as part of a melasma care plan include:
| Treatment Category | What It Focuses On | Typical Role in Melasma Care | Key Considerations |
|---|---|---|---|
| Topical Pigment Regulators | Support pigment regulation and brighten uneven tone. | Often used as first-line and for maintenance. | Must be selected carefully based on skin tolerance. |
| Chemical Peels | Exfoliate surface layers to improve dullness and uneven tone. | May be considered in selected cases, especially surface pigmentation. | Not all peel strengths and types are suitable for melasma-prone skin. |
| Q-Switched Laser | Delivers very short pulses of light energy to target pigmentation. | Often used at gentle settings for pigmentation concerns, including melasma. | Settings and frequency must be tailored to each individual. |
| Pico Laser | Delivers ultra-short pulses for pigment fragmentation. | Commonly discussed for tattoos and some pigmentary concerns. | Not automatically better for melasma; suitability must be assessed. |
| Brightening Facials (Non-medical) | Hydrate, soothe and improve surface radiance. | Supportive role for skin health and comfort. | Do not directly address deeper or hormonally influenced pigment. |
For many patients, a combination of gentle topical care, strict sun protection and carefully selected laser categories will be used at different phases of their melasma journey.
Both Q-switched and Pico lasers are categories of lasers used in pigmentation care, but they are not interchangeable, and one is not automatically “better” than the other for melasma.
| Feature | Q-Switched Laser | Pico Laser |
|---|---|---|
| Pulse Duration | Nanosecond range. | Picosecond range (shorter pulses, higher peak energy). |
| Typical Use | General pigmentation and melasma in gentle settings. | Often discussed for tattoo pigment and selected pigment concerns. |
| Heat and Energy | Generally gentler; may be preferred for heat-sensitive melasma. | Higher peak energy; not always the first choice for melasma. |
| Key Considerations | Settings must be conservative and tailored for melasma. | Not necessarily “stronger is better” for melasma; individual assessment is essential. |
| Important Point | Often used as part of melasma care under medical guidance. | Although Pico lasers are widely associated with tattoo removal, this does not automatically make them the best option for melasma. |
In practice, doctors may choose Q-switched lasers in gentle, low settings for melasma because of its heat sensitivity.
Pico technology has its place for certain types of pigment, but the choice depends on the individual’s diagnosis, skin type and previous response to treatments.
Learn more about our Q-switched laser category here: Q-switched Laser.
Because melasma is chronic and easily triggered, “getting rid of it” safely usually means gradually improving and then maintaining the best possible baseline, rather than expecting it to vanish permanently.
General principles of safe melasma care include:
It may be helpful to see a doctor when:
Melasma treatment costs in Singapore vary depending on the type of treatment recommended, the number of sessions and the individual’s skin condition and goals.
A proper consultation is required before fees can be confirmed. The table below summarises typical pricing structures without listing specific figures.
| Treatment Category | Typical Pricing Structure |
|---|---|
| Doctor Consultation | Consultation fee per visit; required for assessment and planning. |
| Topical Regimen | Product-based pricing depending on formulation and duration of use. |
| Chemical Peels | Session-based pricing; frequency depends on skin type and plan. |
| Q-Switched Laser | Session-based or package-based; tailored to individual needs and response. |
| Pico Laser | Session-based or package-based; used selectively where appropriate. |
Exact costs can only be provided after a doctor has examined your skin in person and discussed suitable options for you.
As with any medical procedure or topical regimen, there may be side effects and considerations.
These can vary based on the treatment chosen and individual skin sensitivity.
A doctor will discuss the potential risks and precautions with you before starting any treatment plan.
Melasma can lighten significantly and become much less noticeable, but because the underlying tendency remains, it can return with triggers such as UV exposure, heat or hormonal changes. The focus is usually on control and maintenance rather than expecting it to never recur.
No. Pico lasers are well-known for their role in tattoo pigment fragmentation, but that does not automatically make them better for melasma. Melasma is highly heat- and energy-sensitive, so gentler Q-switched settings are often preferred. The choice depends on your diagnosis and skin type.
The number of sessions varies widely. It depends on the depth and type of melasma, the laser settings used, your skin’s response and how well triggers are controlled between sessions. Your doctor will discuss an approximate plan after assessing your skin.
It can. Melasma tends to fluctuate. Even when it improves, it may return if there is more sun, heat or hormonal change. This is why maintenance skincare and ongoing sun protection are important parts of any plan.
Sunlight is a major trigger, but melasma is usually not caused by UV alone. Hormones, heat, genetics, inflammation, and certain skincare habits can all contribute.
Some gentle over-the-counter products may support brightening, but using the wrong acids, scrubs or “whitening” products can irritate the skin and worsen melasma. If your pigmentation is persistent or spreading, it is safer to seek medical advice.
No. Post-acne marks (PIH) are linked to inflammation after acne or injuries. Melasma is hormonally and environmentally influenced and behaves differently. It often needs a longer-term, more cautious approach.
Yes. Melasma that develops during pregnancy is often called “chloasma” or the “mask of pregnancy”. It may improve after delivery but can also linger, especially if there is ongoing sun exposure.
Not necessarily. Gentle settings and appropriate laser categories can be part of melasma care, but they must be chosen and calibrated carefully. Aggressive or inappropriate laser use can worsen melasma, so medical assessment is essential.
Consistent broad-spectrum sunscreen, avoiding peak sun and heat exposure, using non-irritating skincare, and following a doctor-guided regimen are key everyday steps to keep melasma as stable as possible.
Last reviewed by Dr. Vijay Sampath on 18 Nov 2025
M.B.B.S, M.S (Gen Surg), DNB (Gen Surg), MRCS (Edinburgh)
Learn more about your doctor here: View Doctor Profile
If you are unsure whether your pigmentation is melasma, what has triggered it, or which treatment categories are suitable for your skin type, a consultation can help.
A doctor will assess your skin in person, discuss your concerns and design a melasma care plan tailored to your needs and lifestyle.
To explore doctor-guided melasma treatment options in Singapore, you may book a consultation with our clinic team.
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