Melasma Pigmentation Treatment Singapore: What Really Works?

Melasma is a common pigmentation issue with a variety of available treatments. It can be challenging, however, to figure out which treatment works for you. To help you, we'll break down some common treatments, sharing how long it takes to see results and the best ways to maintain your results.  

We’ll also dive into the risk factors for melasma flare-ups and help you figure out why your treatment might not be delivering the desired results. Keep reading to discover what you need to know to achieve clearer skin.

Lasers

Laser treatment is a widely used option for melasma, helping to break down stubborn pigmentation with precision. Unlike topical treatments, which work gradually, lasers can target melanin deposits directly, speeding up the skin’s natural clearing process. However, choosing the right laser is crucial—melasma can be tricky to treat, and the wrong approach may worsen pigmentation instead of improving it.

At Bay Aesthetics Clinic, we utilise two FDA-approved lasers for the treatment of Melasma: PicoSure Laser and MOXI Laser

PicoSure Laser

PicoSure Laser is a 755nm Alexandrite picosecond laser. PicoSure is a pigmentation removal laser treatment designed to address pigmentation issues with accuracy and efficiency. It utilises picosecond technology, delivering ultra-short energy pulses to target and shatter pigment (melanin) into tiny particles. The body naturally eliminates these particles, resulting in clearer, more even-toned skin.

PicoSure can treat many pigmentation types, including stubborn melasma, sunspots, freckles and tattoos. Unlike traditional Q Switch nanosecond lasers, the ultra-fast treatment speed of PicoSure (each laser pulse lasts for a trillionth of a second only!) minimises the risk of damaging surrounding skin, making it suitable for all skin types and tones.

With over 100 published clinical studies supporting the safety and effectiveness of the PicoSure Laser, the PicoSure Laser is the laser of choice for results-driven laser clinics and academic medical centres, with a strong and loyal following of satisfied patients.

Moxi Laser

Moxi Laser is a non-ablative 1927nm fractional laser. Effective and yet gentle, MOXI Laser is a pigmentation removal laser treatment that rejuvenates the skin and addresses pigmentation concerns such as melasma and uneven skin tone. MOXI Laser is a "prejuvenation" treatment because it's perfect for individuals who want to maintain youthful skin or address early signs of sun damage before they worsen.

The Moxi laser emits controlled laser energy onto the skin, creating microscopic zones of damage. This process triggers the skin's natural healing, promoting cell turnover and kickstarting the growth of fresh, healthy skin. It's effective for light sun damage, uneven skin tone, and fine lines and pores.

MOXI Laser is safe and effective for the treatment of melasma, removing 20-30% of melasma pigment in a single treatment with low risk of melasma flare. MOXI Laser is popular amongst US Celebrities such as Kim Kardashian, who describes the MOXI Laser as her “Fountain of Youth”.

Topical treatments

In clinic, laser treatments are only half of the equation, for a melasma pigment treatment plan to succeed, daily application of skin care and topical medications is necessary. Key ingredients for the treatment of Melasma pigment include: Hydroquinone, Cysteamine, Vitamin C and sunscreen.

Hydroquinone: Hydroquinone acts as a topical skin-lightening agent, typically used in prescription creams or formulations, that reduces the amount of melanin (skin pigment) produced, thereby lightening areas of darkened skin. Hydroquinone is a prescription-only medication as Hydroquinone has possible side effects including skin irritation, itching, redness, dryness, and in rare cases, a condition called ochronosis (persistent blue-black pigmentation). Typically Hydroquinone is used for 3-6 months before being stopped. At Bay Aesthetics Clinic, we prescribe compounded Hydroquinone 4% with additional mild steroid and mild retinol (following Kligman’s formula)

Cysteamine: Cysteamine is a naturally occurring amino acid derivative that reduces melanin production, lightens pigment and improves skin smoothness.

Cypera Intensive 

It is a scientifically backed cysteamine 5% preparation that is Hydroquinone-free and safe for long-term use. Apply for 10-15minutes in the morning on rested skin and wash off after. Cysteamine takes time to work, with the initial effects seen in 4-6 weeks and optimal results in 12-16 weeks of daily use.

Vitamin C (L-ascorbic acid 10-15%): Vitamin C has a potent antioxidant, pigmentation correction and anti-ageing effects. For a Vitamin C serum to be effective, it needs to contain the active form of Vitamin C known as L-Ascorbic acid, be at the correct PH of 2-2.5 and concentration of 10-15%. Vitamin C serums are light sensitive and should be stored in an opaque container in a dark and cool area. At Bay Aesthetics Clinic, we stock Skinceuticals Phloretin CF and Skinceuticals CE Ferulic. 

Sunscreen

Daily application of sunscreen is essential for patients with melasma, which is triggered by UV Exposure. The Heliocare pigment solution has a combination of physical, chemical and particulate filters UVB, UVA to achieve high broad spectrum ultraviolet coverage. In addition, daily use of oral sunscreens containing polypodium leucotomos (south american fern leaf) extract such as the Heliocare Luminance provides UV protection from within, suitable for those with busy lifestyles or outdoor activities where reapplication of topical sunscreen is not possible.

Cosmelan Peel

The Cosmelan system consists of an in clinic all day peel (Cosmelan Step 1) followed by a home care regime (Cosmelan Step 2) The Cosmelan Peel is primarily used to treat pigmentary disorders such as melasma, sun spots (lentigo) and freckles. The Cosmelan peel is known for its effectiveness in treating melasma in darker skin types (Asian, Indian). In addition, the Cosmelan Peel delivers skin rejuvenation, boosting collagen levels and reducing the appearance of fine lines and wrinkles.

Oral Medications and supplements

While topical creams and laser treatments target pigmentation externally, certain oral medications can help manage melasma from within. These medications work by regulating melanin production, reducing inflammation, and addressing underlying triggers like hormonal fluctuations. They are often prescribed as part of a comprehensive melasma treatment plan, especially for stubborn or recurrent cases.

• Oral Tranexamic Acid (TA) – tranexamic acid has gained popularity as an effective oral treatment for melasma. It works by blocking pathways that trigger excess melanin production, reducing pigmentation over time. Clinical studies have shown promising results, especially for patients whose melasma is resistant to topical treatments or laser therapy. A prescription-only medication, Tranexamic acid is prescribed at 500mg once a day for 3-6 months for cases of refractory melasma. Side effects are mild, with some patients experiencing gastric irritation. 
• Skin whitening supplements - skin brightening supplements typically contain naturally sourced antioxidants such as white tomato extract or glutathione, which lighten pigmentation and brighten the skin tone by converting pheomelanin (darker pigment) to eumelanin (lighter pigment). Miriqa Skin Extra Strength (clinic exclusive) is a 2-in-1 skin whitening supplement and oral sunscreen. Combining clinically-proven ingredients such as Polypodium Leucotomos (Tropical fern leaves) and PhytoflORAL® (Tomatoes with colourless carotenoids), MIRIQA® Skin Extra Strength works synergistically to protect your skin from harmful UV rays, provides powerful Skin Lightening benefits, reducing pigmentation and brightening overall skin tone.

Injections

Injections deliver active ingredients directly into the skin, helping to regulate melanin production and improve skin tone. They are often used for stubborn or treatment-resistant melasma and can be combined with other therapies for more optimal results. Intradermal injections are performed by doctors and carry the risk of bruising, swelling and allergy.

Tranexamic Acid (TA) Injections

Tranexamic acid injections are one of the most promising injectable treatments for melasma. Unlike oral TA, which works systemically, Tranexamic acid injections deliver the medication directly into the affected skin areas, reducing pigmentation with fewer systemic side effects. Studies show that TA injections can significantly lighten melasma and prevent recurrence, especially when combined with lasers and skincare. Tranexamic acid is one of the key ingredients in the Bay Glow Skinbooster.

Polynucleotide (Rejuran) injections

Rejuran contains Polynucleotides, which are DNA fragments are extracted from salmon DNA and are over 99.9% identical to human DNA, making them highly bio-compatible with a very low risk of reactions. Rejuran works from within by stimulating a cascade of biological processes to rejuvenate the skin. This "baby skin" treatment stimulates the skin's natural regenerative abilities, improving skin health, radiance, and youthful appearance. Rejuran injections are helpful in patients with melasma, reducing skin inflammation and boosting collagen and hydration levels. Rejuran is a key ingredient in the Bay Glow Skinbooster

How Long Does It Take to See Results?

Melasma treatment requires patience, as pigmentation does not fade overnight. The timeline for visible improvement depends on the type of treatment, the severity of melasma, and individual skin response. While some treatments deliver faster results, most require consistent care for optimal fading.

Estimated Timelines for Different Treatments

• Laser Treatments – Most patients see noticeable lightening after 2 to 3 sessions, with full results developing over 2 to 6 months depending on the laser type and severity of pigmentation.
• Topical Creams – Results typically take 8 to 12 weeks with daily use. Prescription-strength creams (e.g., hydroquinone and retinol) tend to work faster than over-the-counter options, albeit with higher side effects.
• Medications – Oral Tranexamic acid can show improvement in 4 to 8 weeks
• Injections – Results may appear in 4 to 6 weeks, but multiple sessions are often needed for lasting effects.

How to Maintain Results

Treating melasma is only half the battle—keeping pigmentation from coming back is just as important. Since melasma is a chronic condition with triggers like sun exposure and hormonal changes, ongoing maintenance is key to preventing recurrence. Here’s how to keep your skin clear after treatment.

1. Sun Protection Is Non-Negotiable

UV exposure is the biggest trigger for melasma. Even minimal sun exposure can cause pigmentation to return, so daily sun protection is essential.

• Use a broad-spectrum sunscreen (SPF 50+) every day, even if you're indoors.
• Reapply sunscreen every 2 hours when outdoors.
• Wear hats, sunglasses, and protective clothing for added defence.
• Avoid direct sun exposure, especially between 10 AM and 4 PM.

2. Stick to a Medical-Grade Skincare Routine

Using the right skincare products helps maintain an even skin tone and prevents new pigmentation from forming.

• Brightening agents like vitamin C, and cysteamine help suppress melanin production.
• Retinoids boost skin renewal and keep pigment from settling in deeper layers.
• Hydroquinone (short-term use) and oral tranexamic acid can be prescribed for maintenance.
• Hydrating and barrier-strengthening products (like ceramides and hyaluronic acid) prevent irritation, which can worsen pigmentation.

3. Continue Professional in clinic Treatments

Periodic in-clinic treatments can help keep melasma at bay.

• Regular laser sessions (e.g., PicoSure, Moxi Laser) every month can prevent deeper pigmentation from forming.
• Skinboosters such as the Bay Glow Skinbooster promote skin hydration and brightness, containing ingredients essential for skin health 

4. Manage Hormonal Triggers

Since hormones play a role in melasma, it’s important to identify and manage potential triggers.

• If your melasma is worsened by birth control pills, discuss alternative options with your doctor.
• Pregnancy-related melasma (chloasma) often fades postpartum, but maintenance treatments can help.
• Stress management and a healthy lifestyle can help balance hormone fluctuations naturally.

5. Avoid Skin Irritation

Inflammation can trigger pigment production, so it’s important to treat your skin gently.

• Avoid harsh exfoliants, aggressive facials, or irritating skincare products.
• Stick to gentle, fragrance-free cleansers and moisturisers to maintain a healthy skin barrier.
• Treat any breakouts, rashes, or skin conditions promptly to prevent post-inflammatory pigmentation.

6. Stay Consistent & Follow Up with Your Doctor

Melasma requires long-term care, and what worked initially may need adjustments over time. Regular check-ins with your doctor ensure your treatment stays effective and tailored to your skin’s needs.

By following these maintenance strategies, you can extend the results of your melasma treatment and keep your skin looking clear, healthy, and radiant.

Melasma Flare-up–Risk Factors

Even after treatment, melasma can return when triggered by certain factors. The key culprits include:

• UV Exposure – Sunlight is the biggest trigger, stimulating melanin production. Daily SPF 50+ sunscreen and sun protection are essential.
• Hormonal Changes – Pregnancy, birth control pills, and hormone therapy can worsen melasma. If hormonal triggers are a concern, consult your doctor.
• Heat & Inflammation – Hot weather, excessive sweating, and harsh skincare can trigger pigment production. Stick to gentle, soothing products.
• Genetics & Skin Type – Those with darker skin tones or a family history of melasma are more prone to flare-ups. Long-term maintenance may be needed.
• Stress & Lifestyle Factors – Chronic stress and poor sleep can disrupt hormone balance, increasing melasma risk. Managing stress helps prevent flare-ups.

To keep melasma under control, avoid known triggers, protect your skin daily and follow the treatment protocol recommended by your doctor.

Troubleshooting: Why Didn’t My Melasma Treatment Work?

Effective melasma treatment goes beyond just one solution—multiple factors influence results. If you’re not seeing improvement, these common issues could be the cause:

1. Insufficient Sun Protection

• Even minimal sun exposure can undo progress. Daily SPF 50+ sunscreen and reapplication every 2 hours are crucial.
• Blue light from screens and indoor lighting may also contribute, so consider antioxidant-rich skincare for extra protection.

2. The Wrong Treatment Approach

• Not all melasma is the same—some cases respond better to lasers, while others need a combination of creams, oral medications, or injections.
• Deep dermal melasma is harder to treat and may require long-term management rather than quick fixes.

3. Hormonal Factors Are Still Active

• If you’re on birth control, hormone therapy, or recently pregnant, your melasma may persist despite treatment.
• In some cases, adjusting medications with your doctor’s advice can help.

4. Inconsistent Skincare & Treatment

• Melasma requires ongoing treatment. Stopping too soon or skipping maintenance steps can lead to recurrence.
• Harsh exfoliants or irritating products can cause inflammation, making pigmentation worse.

5. Not Enough Time Has Passed

• Melasma doesn’t fade overnight—it can take weeks to months to see improvement, especially for deeper pigmentation.
• Combining treatments (lasers, creams, and oral medications) often speeds up results.

If your melasma isn’t improving, consult your doctor to adjust your treatment plan and explore combination therapies for better results.

Melasma Pigmentation Removal Treatment at Bay Aesthetics Clinic and Medical Spa

While Melasma pigmentation is harmless, it can affect a person’s appearance and confidence. Unfortunately, this condition is challenging to treat, with multiple treatments necessary and results taking time. In addition, Melasma flare-ups are common during the treatment period or afterwards. How do we know? We are Melasma patients too! Dr Bernard Tan, Medical Director & Founder of Bay Aesthetics Clinic, developed Melasma pigmentation in his  30s due to excessive outdoor sports and sun exposure during his younger days. He has tried all of the abovementioned treatments (and much more!) in a bid to clear up his melasma pigmentation. So, we know what melasma treatments really work, having tried them all ourselves. We will only recommend a treatment plan with treatments we have tried before and we will be honest and upfront about the expected outcomes and timelines. Melasma treatment is a marathon and not a sprint- let’s not give up and start on the journey towards better skin!

Book a consultation with us and rediscover your confidence.