An acquired, symmetrical hypermelanosis driven by ultraviolet and visible light, hormonal influence and dermal inflammation. Clearance is achievable; holding it is the difficulty.
Book an assessment →Melasma is a long-term pigment condition that causes symmetrical brown or grey-brown patches on the cheeks, forehead, nose and upper lip. Sunlight, visible light, hormones and low-grade inflammation in the skin all drive it, so it can be lightened and controlled but tends to return. Treatment combines strict sun protection, prescription medicines and gentle laser.
Melasma skin shows solar elastosis, increased dermal vascularisation, raised mast cell counts and an altered basement membrane alongside active melanocytes — which is why pigment sits deeper than it should.
A sunspot is a discrete bounded lesion. Post-inflammatory pigmentation follows an identifiable injury. Melasma is symmetrical, patterned and persistent — and the three are not treated alike.
Fitzpatrick type, epidermal versus dermal versus mixed depth, a vascular component, hormonal and medication history, and what photoprotection is realistically in place.
Low-fluence 1064 nm laser toning, topical tyrosinase inhibitors, and oral options where appropriate — used together, because recurrence is high when laser is used alone.
Pregnancy, the postpartum period, recently changed hormonal medication and unmodified sun exposure are reasons to wait or begin with non-procedural components only.
The first visit establishes the depth of the pigment, whether there is a redness component, and what is driving it: hormones, sun habits, heat exposure, skincare irritation or medication. A plan that leaves these unaddressed tends to fail even when the laser is well chosen.
Laser at IN Eternity Clinic is used at low energy as part of a combination, not on its own. Reviews of melasma treatment consistently describe combination therapy and photoprotection as the basis of management. The treatment plan itself is set out on the melasma treatment in Singapore page.
Change is gradual, often over several months. Flares after holidays, heat or stopping sunscreen are common and are not a sign the plan has failed. Maintenance is part of the plan from the start.
“Melasma is managed, not erased. A plan that only targets the pigment, and not what keeps producing it, tends to fail.”
An acquired, symmetrical hypermelanosis driven by ultraviolet and visible light, hormonal influence and dermal inflammation. Clearance is achievable; holding it is the difficulty.
A sunspot is a discrete bounded lesion. Post-inflammatory pigmentation follows an identifiable injury. Melasma is symmetrical, patterned and persistent — and the three are not treated alike.
Fitzpatrick type, epidermal versus dermal versus mixed depth, a vascular component, hormonal and medication history, and what photoprotection is realistically in place.
Pregnancy, the postpartum period, recently changed hormonal medication and unmodified sun exposure are reasons to wait or begin with non-procedural components only.
No treatment removes the tendency. Melasma can be lightened and kept under control, but it can return with sun, heat or hormonal change, so maintenance continues.
Usually weeks to months rather than days. Sun protection and topical treatment work slowly, and low-energy laser is spaced over a course, so progress is reviewed against photographs taken at the start.
Every assessment at IN Eternity Clinic is carried out personally by Medical Director Dr Sin Yong at 9 Scotts Road, #12-01 Pacific Plaza. If the honest answer is that treatment should wait, you will be told that.
WhatsApp the clinic →Melasma is described in two ways: by pattern and by depth. The pattern is where it sits — centrofacial (forehead, nose, upper lip and central cheeks), malar (the cheekbones) or mandibular (along the jaw). The depth is where the extra pigment lies: epidermal melasma is light brown with sharper edges, dermal melasma is greyer and blurred, and most people in Singapore have a mixed picture.
Depth matters because pigment near the surface responds to topical treatment more readily, while dermal pigment is slower and more prone to rebound. Dr Sin Yong uses dermoscopy and the history to judge depth, and also checks for look-alikes that are common in Asian skin, such as Hori’s naevus (grey-blue dots on the cheekbones) and post-inflammatory marks, which are treated differently.
Pigment cells and the small blood vessels in melasma skin carry receptors for oestrogen and progesterone. When those hormones rise, the cells are pushed to make more melanin and the skin’s support layer releases signals that keep them active. That is why melasma so often begins in pregnancy (“the mask of pregnancy”), after starting a combined oral contraceptive pill, or during hormone therapy.
Pregnancy-related melasma may fade partly over the year after delivery, but it often does not clear completely. During pregnancy and breastfeeding, treatment is limited to sun protection and a few topicals considered appropriate at that time; lasers and oral medicines wait. See treatments in pregnancy and breastfeeding.
If melasma started with a contraceptive pill, it is worth discussing alternatives with the doctor who prescribed it — but no medication should be stopped without advice. Men develop melasma too, usually with a strong family history and heavy sun exposure, and the same principles apply.
Singapore sits almost on the equator, so the UV index regularly reaches the “extreme” band around midday throughout the year. There is no low season for melasma here. Visible light and long-wave UVA also deepen pigment in darker skin types and pass through car and office windows, which is why people who “never go out in the sun” still see melasma darken.
The practical plan is a broad-spectrum SPF 50 sunscreen with a high PA rating, in a tinted formula: the iron oxides that give it colour help block visible light that plain sunscreens let through. Use about a quarter of a teaspoon for the face, reapply at lunchtime or before going outdoors, and add a wide-brimmed hat and shade. Heat itself can flare melasma for some people, so hot yoga, saunas and long outdoor sessions in the afternoon are worth noticing.
For a fuller guide to how heat and humidity affect skin here, see Singapore’s climate and your skin.
No single tool controls melasma, because it has several drivers at once. The plan Dr Sin Yong uses is layered: first, protection and trigger control; second, topical treatment to slow pigment production (for example azelaic acid, niacinamide or, in short supervised courses, hydroquinone, which is a prescription medicine in Singapore); third, oral tranexamic acid where suitable — also a prescription medicine, used only after screening for clotting risk such as a past thrombosis, smoking or an oestrogen-containing pill; and fourth, gentle low-fluence laser.
Laser is the last layer, not the first. Low-energy 1064 nm toning or picosecond treatment, spaced out and kept cool, helps clear pigment that is already there. Aggressive or heat-heavy settings can cause rebound darkening or white mottled spots, which is why laser alone tends to disappoint. Once the skin is lighter, maintenance continues — melasma is managed over years rather than cured.
For the details of each step see melasma treatment at IN Eternity Clinic, and for a side-by-side view read melasma laser vs tranexamic acid vs skincare.
Melasma is a common, long-lasting skin condition in which pigment cells in the face make too much melanin. It shows as flat, light to dark brown or grey-brown patches with irregular edges, usually matching on both sides of the face. The name comes from the Greek word for black; when it appears in pregnancy it is also called chloasma.
| Question | Short answer |
|---|---|
| Where does it appear? | Cheeks, forehead, bridge of the nose, upper lip and chin; occasionally the forearms |
| Who gets it? | Mostly women from their twenties to fifties, especially with Asian and other medium to darker skin; men can get it too |
| What triggers it? | Sunlight and visible light, hormones (pregnancy, the pill), heat and family tendency |
| Is it harmful? | No. It is not cancer, not infectious and not a sign of poor hygiene |
| How is it diagnosed? | By examination, often with dermoscopy or a Wood’s lamp to judge depth |
| Can it be cured? | It can be lightened and controlled, but it tends to return without ongoing sun protection |
Although melasma does not harm physical health, it can affect confidence, and it is often confused with sunspots, freckles or Hori’s naevus, which are treated differently. That is why the first step is identifying it correctly.
Sometimes it fades, especially melasma that began in pregnancy and lightens over the following year, or when a hormonal trigger is removed. More often it persists or comes and goes with sun exposure. Even after successful treatment, melasma can return, which is why sun protection and a maintenance routine continue long term. An assessment helps decide whether treatment is worthwhile now or whether to wait.
Oral tranexamic acid is a prescription medicine that reduces pigment signalling in melasma skin. It is generally well tolerated at the low doses used, but it affects clotting, so it is not given to people with a history of thrombosis, certain heart or kidney conditions, during pregnancy, or alongside some hormonal medicines without careful review. Dr Sin Yong screens for these risks before prescribing and reviews you during the course.
It can, if the settings are too strong or sessions too close together. Heat inflames melasma skin, which can cause rebound darkening or white mottled patches. That is why laser for melasma at IN Eternity Clinic is low-fluence, spaced out and always combined with sun protection and topical or oral treatment, rather than used alone to chase quick clearance.
Yes. Men develop melasma less often than women, but it behaves the same way: symmetrical patches on the cheeks or forehead that darken with sun. Family history and outdoor work or sport are common features. Treatment follows the same layered approach of sun protection, topical and oral options and gentle laser, adjusted for skin type and lifestyle.
Cost depends on the type and depth of melasma, which layers of the plan are needed (topicals, oral medicine, laser), how many laser sessions are planned and how long maintenance runs. Because melasma is managed over months, a single session price says little. Dr Sin Yong sets out the plan and its cost after assessment, before anything is booked.
No. Melasma is a pigment condition, not a cancer, and it does not spread to other people. Its effect is on appearance and confidence. A patch that is raised, very dark, changing quickly or only on one side should still be examined, because other conditions can look similar and need a different approach.
They are the same condition. Chloasma is an older term often used when melasma appears during pregnancy, sometimes called the mask of pregnancy. Pregnancy-related melasma may fade partly after delivery, but it often does not clear completely, and treatment such as laser or oral medicine waits until after pregnancy and breastfeeding.
No. Melasma is driven by light, hormones, heat and genetic tendency rather than by hygiene or the products you use. Some products can make it worse, though: harsh scrubs, irritating actives and fragranced products inflame the skin and can deepen pigment. Gentle care and daily broad-spectrum sun protection are the foundation of control.
These sources describe mechanisms and general evidence. They are not a promise of any individual result; suitability is decided at an in-person assessment.