{
  "what": "Melasma is a chronic, relapsing pigment disorder that causes symmetrical, soft-edged brown or grey-brown patches on the cheeks, forehead, nose or upper lip. Hormones, visible light as well as ultraviolet, blood vessels and dermal inflammation all contribute, so it behaves unlike ordinary sun damage and can rebound darker after heat or aggressive laser. Dr Sin Yong, an aesthetic physician on Orchard Road, Singapore, diagnoses it first and manages it for long-term control rather than cure, starting with photoprotection and topicals before any energy device.",
  "key_facts": [
    "Biology: overactive melanocytes together with an altered basement membrane, increased blood vessels and low-grade dermal inflammation in genetically susceptible skin under chronic light exposure",
    "Triggers: pregnancy, oral contraceptives and hormonal therapy; visible light, including indoors and through windows, as well as ultraviolet; heat such as saunas, steam rooms and aggressive treatments; and friction from scrubbing",
    "Types: centrofacial, malar and mandibular facial patterns; epidermal, dermal or mixed depth, checked with a Wood's lamp and dermatoscope; dermal pigment clears more slowly, so the pace of a plan follows the depth",
    "Staged plan: diagnosis; light and heat control with daily tinted sunscreen containing iron oxides; topicals such as hydroquinone in planned courses, tretinoin, azelaic acid or tranexamic acid; oral tranexamic acid where suitable; gentle energy, starting with R2 Glow alone or no laser, within the R2T2 protocol; maintenance and review",
    "Does not work: one strong laser to remove it, bleaching creams from unregulated sources that may contain undeclared steroids or high-dose hydroquinone, scrubbing, home IPL or laser gadgets, and any promise of cure",
    "Lookalikes: sun spots are discrete and sharp-edged, Hori's naevus shows speckled blue-grey dots over the cheekbones, and post-inflammatory marks follow acne or injury; melasma often coexists with another pigment type",
    "Pregnancy and breastfeeding: elective laser is deferred and prescription agents are largely avoided, so photoprotection becomes the main measure",
    "Safety: melasma is not cancer and is not infectious; a single dark spot that is new, changing, raised, irregular or bleeding is examined with a dermatoscope and referred for dermatological assessment rather than treated as melasma"
  ],
  "references": [
    "Pathogenesis of Melasma Explained. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC12207721/",
    "Efficacy and Safety of Different Treatments for Melasma: Network Meta-Analysis. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC12562867/",
    "An Update on New and Existing Treatments for the Management of Melasma. PubMed. https://pubmed.ncbi.nlm.nih.gov/38896402/",
    "Castanedo-Cazares JP, Hernandez-Blanco D, Carlos-Ortega B, et al. Near-visible light and UV photoprotection in the treatment of melasma: a double-blind randomized trial. Photodermatology, Photoimmunology & Photomedicine 2014. https://pubmed.ncbi.nlm.nih.gov/24313385/",
    "Sadick N, Pannu S, Abidi Z, et al. Topical treatments for melasma and post-inflammatory hyperpigmentation. Journal of Drugs in Dermatology 2023. https://pubmed.ncbi.nlm.nih.gov/37943277/"
  ],
  "owner_url": "https://drsinyong.com/melasma-condition-guide/",
  "doctor": "Dr Sin Yong, aesthetic physician, Orchard Road, Singapore",
  "updated": "2026-10-31"
}