Pigmentation and melasma: what works, what doesn't
Sun spots, freckles, post-inflammatory marks and melasma look alike and behave differently. Lentigines usually clear with a well-chosen laser; melasma is a chronic, relapsing condition driven by hormones, heat and light, and the treatments that work are the ones that respect that.
About 600 searches a month in Singapore for “pigmentation treatment singapore” (Ahrefs, October 2026). 16 treatments reviewed for this concern.
What works for pigmentation and melasma?
For lentigines and freckles, Q-switched and picosecond lasers have a long track record. For melasma, the evidence favours a maintenance approach: strict broad-spectrum sun protection, topical tranexamic acid, azelaic acid, retinoids and prescription lightening agents, with oral tranexamic acid under medical supervision in resistant cases; low-fluence laser toning adds modest benefit and carries a rebound and mottling risk when overused. Peels and picosecond lasers help selected cases. Supplements marketed as whitening pills have weak evidence.
- Vetted
- Pico laser
- Established
- Niacinamide · Retinoids · Azelaic acid · Vitamin C serums · Chemical peels · Sunscreen · BBL and IPL photofacial
- Trend
- Carbon laser peel
- Caution
- Glutathione 'whitening' pills · IV drips and NAD+ · Underarm and intimate-area lightening · Laser toning for melasma
- Reviewed
- 1 October 2026 by Aesthetics International. Verdicts are editorial and unpaid.
By the numbers
- systematic review
Pooled trials showed 1064 nm picosecond treatment reduced melasma scores, while 755 nm was not superior to topical agents and was associated with post-inflammatory hyperpigmentation.
From the Pico laser review — Efficacy and safety of picosecond laser for the treatment of melasma: a systematic review and meta-analysis., Lasers Med Sci, 2023. PMID 36897459.
- systematic review
Twenty-one studies including 11 randomised trials support Polypodium as an adjunct in photoageing, photodermatoses and melasma with a good safety profile.
From the 'Oral sunscreen': Polypodium and astaxanthin review — The Utility of Oral Polypodium Leucotomos Extract for Dermatologic Diseases: A Systematic Review., Journal of Drugs in Dermatology, 2025. PMID 40196953.
- systematic review
Low-fluence 1064 nm picosecond treatment reduced melasma scores in pooled trials, while 755 nm offered no advantage over topical agents and caused post-inflammatory darkening.
From the Laser toning for melasma review — Efficacy and safety of picosecond laser for the treatment of melasma: a systematic review and meta-analysis., Lasers Med Sci, 2023. PMID 36897459.
Three figures from the studies cited across this concern's reviews, chosen for study quality rather than for agreement with the verdicts.
“For lentigines and freckles, Q-switched and picosecond lasers have a long track record.”
Every treatment reviewed for pigmentation and melasma
Ordered by verdict, then by how often people search for each. Open any review for the studies, what people are saying and who it suits.
- Pico laserThe variable that matters is depth, not brightness, and pigment already deposited is only half the problem; the inflammation producing it is the other half.Vetted
- NiacinamideIt will not change a face, but it makes everything else in the routine easier to tolerate, which is worth more than most hero ingredients deliver.Established
- Retinoids: retinol, retinal and prescription retinoidsThe mistake is not choosing the wrong retinoid; it is quitting in week three.Established
- Azelaic acidFor the Singapore face that is red, bumpy and marked all at once, it is often the first thing we reach for before any device.Established
- Vitamin C serumsThe serum works in the morning under sunscreen; the bottle that has gone the colour of tea is a different product from the one you bought.Established
- Chemical peelsThe result is written in the depth and the priming, not in the brand on the bottle.Established
- Sunscreen: Korean formulas, mineral vs chemicalThe filter debate is a texture debate in disguise: the sunscreen that works is the one you will put on again at lunchtime.Established
- BBL and IPL photofacialThe light is broad and so is the risk: fair skin gets a photofacial, tanned skin gets a burn, and the marketing about genes is a footnote.Established
- Topical tranexamic acidIt treats the inflammation that makes melasma, which is the half of the problem lasers cannot touch.Promising
- 'Oral sunscreen': Polypodium and astaxanthinThe pill raises your threshold for damage a little; the cream and the hat do the work.Promising
- Clear + Brilliant and MoxiTreating pigment early is sensible; calling it prevention is a story the evidence has not yet told.Promising
- Carbon laser peelA trend with a good show. The carbon flash is theatre; the modest surface effect is the laser toning underneath, which can be done with or without the mask. Enjoy it as a facial; plan skin with something that reaches the dermis.Trend
- Glutathione 'whitening' pillsA small, temporary shift in a melanin index is not a reason to take a daily pill of unknown long-term consequence — and the drip version is a reason to leave the clinic.Caution
- IV drips and NAD+Nothing in a drip lifts, resurfaces or tightens, and 'whitening' infusions carry risk for no reliable benefit.Caution
- Underarm and intimate-area lighteningLaser hair removal and less friction do most of the work; 'whitening' is marketing.Caution
- Laser toning for melasmaPigment already deposited is a deposit; inflammation is what keeps producing it. R2 Glow exists because turning the energy up feels like progress and often triggers rebound.Caution
Vetted protocols for pigmentation and melasma
Protocols that pass the Aesthetics International standard and address this concern. A protocol is a plane, a sequence and a set of endpoints — not a device.
Questions
Can melasma be cured?
Is pico laser good for melasma?
What is the first-line treatment for pigmentation?
Do whitening pills or glutathione drips work?
Have a question about pigmentation and melasma?
Ask us — or ask to be matched with a practitioner in Singapore who follows evidence-based treatment. What suits you is decided at an in-person assessment, not by a page.
WhatsApp +65 8023 7170Suggest a treatment to review
Physicians, manufacturers and readers can propose a treatment for review. Reviews are editorial and are not paid for.
[email protected]