- 501 Orchard Road, #04-08 Wheelock Place, Singapore 238880
- (65) 6235 4429
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- (65) 9830 0597
Melasma is a chronic pigmentation condition commonly seen in Singapore due to sun exposure and hormonal changes. VIDASKIN provides several melasma treatment options depending on severity and skin type.
Persistent brown or grey-brown patches typically appear on the cheeks, forehead, or upper lip. These changes are commonly associated with sun exposure, hormonal influences, and genetic predisposition, and may be influenced by pregnancy, oral contraceptives, or repeated skin irritation.
Although the exact cause of melasma is still being studied, medical research suggests that it involves overactivity of melanocytes, the cells responsible for melanin production.
Ultraviolet radiation can activate inflammatory pathways involving histamine, prostaglandins, and mast cells, leading to increased melanin formation.
Hypervascularity, or increased blood vessel activity, is also recognised as a contributing factor, and individuals with underlying inflammatory conditions may experience more persistent or pronounced pigmentation.
Together, these factors are thought to trigger melanocyte overactivity, resulting in the characteristic skin discolouration seen in melasma.
Melasma develops on frequently exposed skin on the face, neck and arms as blotches or spots.
Higher estrogen and progesterone levels during pregnancy is thought to trigger melasma. Melasma may start to clear on its own after birth.
Birth control pills, hormone replacement therapy, anti-seizure medications, some antibiotics, some blood pressure medications. Melasma tends to improve upon discontinuing these medications.
Cortisol produced during stress may trigger melasma.
Dysregulation of hormones by the thyroid gland can increase the risk of developing melasma. In some cases, treatment of the thyroid disorder can clear up melasma.
Genetics also plays a significant role in the development of melasma. Darker skin tones contain a higher amount of melanin and are generally more prone to developing pigmented conditions.
You may have a higher risk if you fit into these groups:
Women aged 20s to 40s: Estrogen and progesterone are thought to play a role in melasma
Medium or dark skin tones: Women of Asian, Latin, and African descent have a higher incidence of melasma
Have a blood relative with melasma: Several studies found a strong hereditary association with 48% of melasma patients reported having a blood relative with melasma in one study.
Sun Protection
Topical Medicated Creams
Hydroquinone (HQ) is the mainstay of melasma treatment. It is a prescription-only cream which disrupts melanocytic processes by destroying the membranous organelles of melanocytes. When using hydroquinone, it is essential to ensure good sun protection and avoid sunlight, as this chemical may heighten sensitivity to solar rays.
Tretinoin and hydrocortisone combination creams contain a retinoid to drive turnover and discharge of melanin within the epidermis. Hydrocortisone is an anti-inflammatory which may reduce the irritation caused by tretinoin.
Triple combination (TC) creams contain all three ingredients – hydroquinone, tretinoin and hydrocortisone. Studies show that topical triple combination cream was far more effective than HQ cream alone.
Topical Tranexamic acid inhibits melanin production through interfering with molecular processes within keratinocytes in the skin. Multiple studies in South Korea and China have verified its significant efficacy and good safety profile.
Arbutin, azelaic acid, kojic acid and ascorbic acid are gentler on the skin, but still inhibit the production of melanin.
If topical creams do not lead to meaningful improvement in melasma, clinic-based treatments may be incorporated into a personalised care plan. Chemical peels using agents such as tretinoin (retinoic acid), trichloroacetic acid (TCA), and amino fruit acids have shown encouraging outcomes in studies, and are generally considered more effective than older-generation peels such as glycolic acid when selected appropriately.
At VIDASKIN, a specialised Depigmentation Treatment may be recommended. This is a customisable, doctor-performed skin-brightening protocol designed not only to lighten existing pigment, but also to moderate melanocyte activity, which may help reduce the risk of recurrence. Based on individual skin type and pigment depth, the doctor determines the appropriate type and concentration of acids at each session.
Melasma laser treatment may also be considered to address deeper or mixed pigment patterns when performed conservatively by an experienced professional. Laser programmes allow flexibility in selecting suitable laser modalities based on skin tone and pigment characteristics, and can help lighten stubborn pigmentation that responds poorly to topical therapy alone.
When used judiciously, peels and laser treatments can support gradual improvement in recalcitrant melasma. Multiple sessions are typically required, and results vary depending on skin type and severity. Ongoing home care remains essential, including consistent sun protection and appropriate topical agents, to help maintain results and minimise recurrence.
Oral Tranexamic acid (TA) gives more significant results compared to topical creams, but rare side effects that may occur include gastrointestinal discomfort and hypomenorrhea (light periods). In one study, recurrence while taking oral TA was low (9.5% of cases). Your doctor may recommend a course of this medication as part of your treatment plan.
Recurrence is common due to external factors like sun exposure, internal hormonal changes, or inconsistent maintenance.
Continuous care and strict sun protection are essential for long-term management and maintaining results.
Patients with persistent pigmentation who have undergone professional assessment.
Most skin types can receive treatment after consultation and a thorough skin evaluation.
