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Melasma is a benign pigmentary disorder that typically affects women between the ages of 30 and 50. It is characterised by brown or greyish-brown patches of pigmentation that appear on the face, most commonly on the cheeks, nose, forehead and upper lip.
Although melasma generally isn’t harmful, it can greatly affect an individual’s self-esteem and quality of life. Multiple factors lead to the development of melasma, including family history, darker skin types, sun exposure, hormonal changes (pregnancy or oral contraceptives) and certain medications.
Melasma is a long term condition that is challenging to treat, with the condition often relapsing. The goal in melasma treatment is to achieve remission of the melasma and a good cosmetic outcome.
The key with melasma treatment is to avoid triggering melasma flare ups, which may occur due to exposure to sunlight (UV radiation, visible light, infrared light and heat). This is achieved with strict sun avoidance and daily usage of UV protection (topical sunscreen, oral sunscreen, protective clothing).
Melasma requires a combined treatment approach, involving the use of topical medications, oral medications, skincare, lasers and injectables. The possible treatment options include:
Lasers have an important role to play in Melasma treatment. Lasers work using targeted light energy to reduce the excess pigment produced by melanocytes (pigment producing cells), without damaging the surrounding tissues.
PicoSure is a 755nm Alexandrite picosecond pigment laser that targets pigment in the skin, shattering pigment into dust like particles that are gradually cleared by the skin.
In addition, the activity of melanocytes are suppressed with repeated low fluence laser treatments1 (ie- regular laser treatments with low power settings). Apart from treating Melasma, PicoSure Laser treatments are effective for treatment of freckles, sun spots, acne scars, pores, fine lines and tattoo removal.
MOXI Laser is a 1927 nm fractional non ablative laser that targets the water in the superficial skin. MOXI Laser works by encouraging epidermal and dermal exfoliation of pigment (ie- rapid skin turnover with new skin production, shedding pigment in the old skin) and stabilising the basement membrane at dermal-epidermal junction2 (“leaky” basement membrane allows for pigment to transfer from melanocytes in the dermis to skin cells in the epidermis). Apart from treating Melasma, MOXI Laser is effective for the treatment of sun damage, fine lines, pores and acne scars.
Fractional lasers of the 1927 nm wavelength have been documented to be safe and effective for the treatment of melasma, while also achieving skin rejuvenation and improving the appearance of fine lines and sun damage.
MOXI Laser’s 1927 nm wavelength targets water in the skin (instead of pigment), making it effectively “colour blind”, which allows it to be used on all skin types, including darker skin types that are more prone to melasma flares and post-inflammatory hyperpigmentation. MOXI Laser can also be used after recent sun exposure, which is uncommon for other laser treatments that cannot be undergone right after a sun tan.
The penetration depth of the MOXI Laser, at 100-200 microns, targets the epidermis layer, which is just above the Dermal-Epidermal junction (DEJ) where the melanocytes are. This results in a lower risk of melasma flare-ups after the MOXI Laser treatment.
The MOXI Laser was not designed specifically to treat melasma. In fact, its effectiveness in treating melasma came as a surprise. It was originally designed as a resurfacing laser for skin rejuvenation, improving the appearance of fine lines, sun damage and acne scars. On top of seeing improvements in their pigmentation, melasma patients can experience improvements in their skin tone and texture.
A MOXI Laser treatment session takes about 45 to 60 minutes.
| Step 1 | Every treatment starts with a consultation with our doctor. This helps us assess your suitability for the treatment and to get a better understanding of your needs and concerns for a personalised treatment plan. |
| Step 2 | Pre-procedure photos will be taken using a 3D camera with pigment analysis to help track and monitor your treatment progress. |
| Step 3 | A topical anaesthetic, or numbing cream, will be applied to ensure that you’re kept as comfortable as possible throughout the procedure. This will take about 20 minutes. |
| Step 4 | The doctor will perform the laser treatment in your areas of concern. This will take about 10 to 15 minutes, depending on the extent of your melasma. |
| Step 5 | A 15-minute post-laser skincare treatment and LED therapy will be done to encourage healing and soothe the skin. |
The recommended treatment interval is for MOXI Laser treatment monthly for the first 3-4 months, then once every 2 months for maintenance.
Melasma patients typically see around 20% improvement in their melasma after their first MOXI Laser treatment, and 70-80% improvement after 3 to 4 MOXI Laser treatments, over a period of 3-4 months.
For optimal results, strict sun avoidance and medical therapy for melasma is required.
While the MOXI Laser has shown promising results in lightening melasma, it is not a magic bullet and melasma remains a chronic condition that needs to be treated over the long-term. Typically, good clinical outcomes can be achieved within 3 to 4 sessions, which can be maintained with creams and tablets and sun avoidance for optimal results.
Is there any downtime after a MOXI Laser treatment?
The MOXI Laser is a minimally-invasive procedure, which means you can resume office work, exercise, and apply make-up the next day after your laser treatment. Keep in mind to avoid the sun at least a week after your procedure.
You can expect 2 to 3 days of skin redness, followed by 2 to 3 days of mild skin flaking. However, this is completely normal and will subside within a few days. Results and improvements to your skin will be most significant about 2 weeks after your treatment.
Are there any risks for MOXI Laser?
As with any procedure, the MOXI Laser comes with its own set of risks, although it is well-tolerated by most.
MOXI Laser treatments are generally safe, risks include:
How should I care for my skin after MOXI Laser?
Avoid the sun for a week, apply sunblock and post laser recovery serums
At Bay Aesthetics Clinic, a detailed doctor’s consultation will assess the severity of melasma and the results of previous treatment attempts, before a personalised plan is recommended. This multimodal treatment plan is required to achieve optimal results, incorporating melasma medications, medical grade skincare and laser treatment. Results can be seen over a 4-6 month treatment period and are regularly reviewed with clinical photographs.
Bay Aesthetics Clinic is the “Home of MOXI Laser”, performing a high volume of MOXI Laser cases, recipient of the MOXI Laser Top user award 2024. Dr Bernard Tan is a recognised expert in the MOXI Laser treatment in Singapore, regularly giving talks and educating fellow medical professionals on the usage of MOXI Laser.
Melasma can be a frustrating condition with stubborn dark patches that can often be triggered by hormones or sun exposure. Thankfully, there are medical-grade treatments available, like the MOXI Laser, which helps lighten pigmentation and help you achieve rejuvenated, even-toned skin.
Take the first step and book a consultation with us for a comprehensive skin analysis and personalised treatment plan.
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