What Is Melasma?
Melasma is a chronic pigmentation disorder characterised by symmetrical brown or grey-brown patches on sun-exposed skin — most commonly the cheeks, forehead, upper lip, and chin. It predominantly affects women (90% of cases) and is particularly common in individuals with darker skin tones (Fitzpatrick types III–V) — making it highly prevalent among Singapore's ethnic Chinese, Malay, and Indian populations.
Melasma occurs when melanocytes (pigment-producing cells) become hyperactive in response to UV exposure, hormones, and heat. It is classified as epidermal (superficial — responds better to treatment), dermal (deeper — more resistant), or mixed (most common).
Treatment Options for Melasma
| Treatment | How It Works | Cost (SGD) |
|---|---|---|
| Daily SPF50+ Sunscreen (PA++++) | Non-negotiable foundation of all melasma treatment. Broad-spectrum mineral + chemical hybrid. Must be reapplied every 2–3 hours. | $30–$100/month |
| Topical Hydroquinone (2–4%) | Gold standard depigmenting agent. Bleaches melanin by inhibiting tyrosinase. Used in 3-month cycles to avoid ochronosis. | $50–$120 (Rx) |
| Triple Combination Cream (Tri-Luma) | Hydroquinone + tretinoin + fluocinolone acetonide. Most effective topical for melasma. Prescription only. | $80–$150 (Rx) |
| Tranexamic Acid (oral) | 250mg twice daily. Reduces UV-stimulated melanocyte activity. Strong evidence in Asian skin. Safe long-term use. | $30–$80/month |
| Tranexamic Acid (IV/topical) | IV: higher concentration; microinjection protocols. Topical serums available OTC. | $100–$400/session (IV/injection) |
| Q-Switched Nd:YAG Laser (Low Fluence) | Toning protocol (Spectra/MedLite): low energy, 4–6 sessions every 2–4 weeks. Reduces melanin without inducing PIH. | $200–$400/session |
| Pico Laser (fractional settings) | Ultra-short pulses; good for mixed-type melasma with less risk of PIH. Requires experienced operator. | $400–$800/session |
| Chemical Peel (glycolic, TCA low%) | Superficial peels accelerate cell turnover and depigmentation. Add-on to topicals and laser. | $150–$400/session |
See our researched shortlist: subspecialty focus, credentials and clinic websites, checked against public records.
View the shortlist →Melasma is extremely prevalent in Singapore due to a combination of factors: UV exposure (Singapore sits near the equator, 1°N), predominantly Asian skin types (Fitzpatrick III–V) which have more active melanocytes, hormonal influences (oral contraceptives, pregnancy), and heat. An estimated 40% of women of childbearing age in Singapore have some degree of facial hyperpigmentation.
Melasma is notoriously difficult to treat and requires a multi-modal approach. The gold standard is: (1) strict broad-spectrum SPF50+ sunscreen daily, (2) topical triple combination cream (hydroquinone + tretinoin + steroid — Tri-Luma), (3) tranexamic acid (oral or topical), and (4) low-energy Q-switched Nd:YAG laser (Spectra peel). No single treatment is curative — maintenance is essential.
Pico lasers (PicoSure, PicoWay, PicoPlus) are increasingly used for melasma with promising results in many patients. They work by targeting melanin pigment with ultra-short pulses, causing less thermal damage than traditional Q-switched lasers. However, melasma can paradoxically worsen with aggressive laser treatment (post-inflammatory hyperpigmentation). Low-fluence, fractional pico settings by an experienced dermatologist are key.
Dermatology consultation: $100–$200. Topical treatments (tri-combination cream, tranexamic acid): $80–$200/month. Q-switched or Pico laser: $200–$600/session (4–8 sessions recommended). Chemical peels: $150–$400/session. Oral tranexamic acid: $30–$80/month. Budget $1,000–$3,000 for an initial 3–6 month treatment course.
Melasma cannot be permanently removed — it is a chronic condition that requires ongoing management. UV exposure, hormonal changes, and heat can trigger recurrence even after successful treatment. Maintaining daily SPF50+ sunscreen use is non-negotiable for long-term control. Regular maintenance treatments (laser, topicals) help sustain improvements.