Conditions · Pigment

Melasma

An acquired, symmetrical hypermelanosis driven by ultraviolet and visible light, hormonal influence and dermal inflammation. Clearance is achievable; holding it is the difficulty.

Mechanism

What is actually happening

Melasma skin shows solar elastosis, increased dermal vascularisation, raised mast cell counts and an altered basement membrane alongside active melanocytes. The disrupted basement membrane is why pigment sits deeper than it should.

The distinction

How it is told apart

A sunspot is a discrete bounded lesion. Post-inflammatory pigmentation follows an identifiable injury. Melasma is symmetrical, patterned and characteristically persistent — and the three are not treated alike.

Assessment

What is established first

Fitzpatrick type, epidermal versus dermal versus mixed depth, the presence of a vascular component, hormonal and medication history, and what photoprotection is realistically in place.

Approach

What is typically done

Low-fluence 1064 nm laser toning, topical tyrosinase inhibitors, and oral options where appropriate — used together, because reviews report recurrence as high as 81% when laser is used alone.

When treatment waits

When it is deferred

Pregnancy, the immediate postpartum period, recently changed hormonal medication, and unmodified sun exposure are all reasons to wait or start with non-procedural components only.

Full guide: melasma treatment in Singapore →

Frequently asked

What is melasma?

An acquired, symmetrical hypermelanosis driven by ultraviolet and visible light, hormonal influence and dermal inflammation. Clearance is achievable; holding it is the difficulty.

How is melasma told apart from similar conditions?

A sunspot is a discrete bounded lesion. Post-inflammatory pigmentation follows an identifiable injury. Melasma is symmetrical, patterned and characteristically persistent — and the three are not treated alike.

What is assessed before treating melasma?

Fitzpatrick type, epidermal versus dermal versus mixed depth, the presence of a vascular component, hormonal and medication history, and what photoprotection is realistically in place.

When is treatment deferred?

Pregnancy, the immediate postpartum period, recently changed hormonal medication, and unmodified sun exposure are all reasons to wait or start with non-procedural components only.

Have this assessed

Every assessment is carried out personally by Dr Sin Yong, Medical Director. 9 Scotts Road, #12-01 Pacific Plaza.

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