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Conditions We Treat

Pigmentation

At Livingstone Dermatology, we understand that your skin is a reflection of your health and well-being. We are committed to the latest advancements in dermatological science, and dedicated to providing you with quality care.

Overview

Blotchy, discoloured, or uneven skin tone is a common concern that can affect individuals of all skin types and ages. Known medically as hyperpigmentation, this condition occurs when certain areas of the skin produce excess melanin, the pigment responsible for skin colour, leading to darkened patches or spots.

Whether it is freckles, sun spots, melasma, or post-inflammatory hyperpigmentation (PIH), pigmentation issues can be triggered by a variety of internal and external factors. Though often harmless, these changes in skin tone can be distressing and may affect one’s self-confidence, particularly when they appear on the face, neck, or hands.

The good news? With the right diagnosis and targeted treatment plan, pigmentation concerns can be significantly improved and sometimes even reversed.

pigmentation treatment Singapore.
Uneven pigmentation can arise from sun exposure, hormonal shifts, or past skin inflammation, but many forms are treatable.

What are the types of Pigmentation?

As not all pigmentation is the same, accurate identification is essential for effective treatment. Some common forms include:

  • Freckles (ephelides) – small, light brown spots that become more prominent with sun exposure. Often hereditary and harmless.
  • Melasma – presents as symmetrical brown or greyish patches, usually on the cheeks, forehead, nose, and upper lip. Often triggered by hormones or UV exposure.
  • Periorbital hyperpigmentation – dark circles around the eyes, influenced by genetics, fatigue, or thinning skin in the eye area.
  • Post-inflammatory hyperpigmentation (PIH) – dark marks left behind after acne, eczema, injuries, or other skin trauma. More common in darker skin tones.
  • Solar lentigines (sun spots) – flat, darkened patches that appear on areas with frequent sun exposure, such as the face, hands, chest, and shoulders.

What causes Pigmentation?

pigmentation signs and symptoms Singapore.
Pigmentation can present in many forms, from subtle dark spots to widespread discolouration depending on its cause and depth.

Changes in pigmentation can develop gradually or appear suddenly, depending on the underlying cause. But some of the most common triggers are:

  • Sun exposure – ultraviolet (UV) radiation stimulates melanin production. Over time, this leads to solar lentigines (sun spots) and uneven tone, especially in sun-exposed areas.
  • Post-inflammatory hyperpigmentation (PIH) – this type occurs after skin trauma, acne, eczema, or other inflammatory skin conditions.
  • Genetics – some individuals are more prone to pigmentation issues due to inherited skin characteristics.
  • Hormonal changes – melasma, a common form of pigmentation, is often linked to hormonal fluctuations during pregnancy, oral contraceptive use, or hormone replacement therapy.
  • Underlying medical conditions – Addison’s disease, hemochromatosis, or other endocrine disorders can lead to generalised skin darkening.
  • Medications – certain drugs, including antibiotics, chemotherapy agents, and anti-seizure medications, may trigger pigmentation changes as a side effect.

What are the characteristics of Pigmentation?

Pigmentation does not always look the same from one person to another. It can range from faint patches that fade with time to stubborn, long-standing marks that worsen with sun exposure or inflammation.

Some of the common characteristics include:

  • Dark patches or spots – may appear brown, grey, or even bluish in tone, depending on the depth of melanin in the skin.
  • Flat and painless – pigmentation typically does not involve texture or pain. If a dark spot becomes raised, itchy, or bleeds, it should be examined promptly.
  • Persistent discolouration – while some pigmentation fades on its own, others remain for months or years without targeted treatment.
  • Sun sensitivity – affected areas often darken further with sun exposure.
  • Symmetry – melasma often appears symmetrically on both sides of the face, while PIH or sun spots are more randomly distributed.
  • Uneven skin tone – certain areas of the face, chest, or limbs may appear duller or darker than surrounding skin.
  • Well-defined or diffuse borders – some types, like sun spots, have clear edges, while others, like melasma, appear with blurry, spreading borders.

Who is at risk of developing Pigmentation?

Pigmentation issues can affect anyone, but some individuals are more prone than others due to genetics, lifestyle habits, and environmental exposures. The groups more at risk include:

  • Darker skin tones – melanin-rich skin (Fitzpatrick skin types IV to VI) naturally produces more pigment, which means it also responds more strongly to inflammation, injury, or irritation. This makes darker skin more susceptible to PIH, and pigmentation from acne, eczema, or even minor cuts can be more noticeable and longer-lasting.
  • Frequent sun exposure – ultraviolet (UV) radiation stimulates melanin production as a defence mechanism. Over time, repeated sun exposure leads to sun spots (solar lentigines), uneven skin tone, and can worsen existing pigmentation. Those with outdoor jobs or hobbies, or who skip sunscreen, are particularly at risk.
pigmentation risk factors Singapore.
Certain skin types, lifestyles, and medical factors can increase the risk of developing pigmentation disorders.
  • Family history of pigmentation disorders – Genetics can play a significant role in how your skin responds to sun, hormones, and injury. If your parents or siblings have melasma, freckles, or PIH, you may be more likely to develop similar conditions.
  • Women undergoing hormonal changes – hormonal fluctuations, especially during pregnancy, menopause, or while taking oral contraceptives, can trigger melasma, a form of pigmentation that affects the face. This happens when oestrogen and progesterone influence melanocyte activity, causing patchy discolouration.
  • People with acne, eczema, or other inflammatory skin conditions – inflammation in the skin triggers melanocytes to produce excess pigment as part of the healing process. This often results in PIH, which can be more severe and stubborn in individuals who pick or scratch at their skin.
  • Underlying health conditions – certain metabolic or endocrine disorders, such as Addison’s disease or hemochromatosis, can alter melanin production and distribution, leading to generalised darkening or patchy pigmentation.
  • Certain medications – some medications can make the skin more photosensitive or trigger pigmentary changes. These include antibiotics like tetracyclines, anti-seizure medications, chemotherapy drugs, and hormone therapies. Photosensitivity increases the risk of UV-induced pigmentation.
  • Inadequate sun protection habits – failing to use daily sunscreen, even during cloudy weather or indoors near windows, allows cumulative UV exposure to trigger pigmentation. Skipping reapplication, using low SPF products, or relying solely on makeup with SPF are common mistakes that contribute to pigmentation development.

How is Pigmentation diagnosed?

Skin disorders can be complex, and misdiagnosis may delay effective treatment. That’s why our dermatologists are committed to conducting a thorough skin assessment, which may include:

  • Detailed history – assessing your skin type, lifestyle, medical history, and sun exposure habits.
  • Clinical examination – evaluating the pattern, depth, and distribution of pigmentation.
  • Wood’s lamp examination – using a specialised UV light to distinguish between surface-level (epidermal) and deeper (dermal) pigmentation.
  • Skin imaging and dermoscopy – leveraging digital tools for accurate diagnosis and to track treatment progress over time.

What treatments are available for Pigmentation?

Treating pigmentation effectively requires more than a one-size-fits-all approach. The ideal treatment plan is shaped by several key factors, such as the type of pigmentation, its depth within the skin, how widespread it is, and any underlying triggers such as hormonal changes, sun exposure, or inflammation.

A personalised approach is essential. Not only does it target the pigmentation effectively, but it also minimises the risk of rebound pigmentation, skin irritation, or unintended lightening of surrounding skin. This is especially important in individuals with darker skin tones, where incorrect treatment may worsen discolouration.

pigmentation laser treatment Singapore.
From topical creams to advanced lasers, treatment options can be tailored to reduce pigmentation and restore even skin tone.

Topical Treatments

  • Hydroquinone – a skin-lightening agent that reduces melanin production
  • Retinoids – encourage cell turnover and reduce pigmentation over time
  • Vitamin C – an antioxidant that brightens skin and reduces oxidative stress
  • Azelaic acid and kojic acid – suitable alternatives for those with sensitive skin or contraindications to hydroquinone

Chemical exfoliants, such as glycolic acid, lactic acid, or salicylic acid, help remove the upper pigmented layers of skin and stimulate cell renewal. These are often used in a series for cumulative effects.

  • Pico lasers – such as the Fotona StarWalker MaQX (link to pico laser page), offer ultra-fast pulses to break down pigment without damaging surrounding skin
  • Q-switched lasers – effective for freckles and sun spots
  • Fractional resurfacing lasers – target deeper dermal pigmentation, especially for resistant cases
  • Intense Pulsed Light (IPL) – uses broad-spectrum light to fade pigment and improve overall skin tone

In some cases, oral antioxidants or tranexamic acid may be prescribed to reduce melasma and prevent recurrence.

Daily use of broad-spectrum sunscreen (SPF 50+), sun-protective clothing, and antioxidant skincare is vital to prevent recurrence and protect treatment results.

Improvements in pigmentation are typically gradual and depend on the type and depth of pigment, as well as the consistency of treatment. Epidermal pigmentation (closer to the skin’s surface) often responds more quickly, while dermal pigmentation may require longer and more intensive therapy.

With a comprehensive and consistent plan, most patients notice:

  • Brighter, clearer complexion
  • Lightening of dark spots
  • More even skin tone
  • Reduction in future pigmentation flare-ups

Book an Appointment

If pigmentation is affecting your confidence or quality of life, you do not have to live with it. With tailored, evidence-based solutions, it is possible to reduce discolouration and reclaim clearer, more radiant skin.

Schedule a consultation today and let our dermatologists at Livingstone Dermatology design a personalised treatment plan to help you achieve visible, lasting results.

pigmentation treatment Singapore.
While pigmentation may not always be fully reversible, the right combination of treatment and lifestyle changes can significantly brighten and even out skin tone over time.

Frequently Asked Questions

Is pigmentation permanent?

Not always. Superficial pigmentation often fades with the right treatment, while deeper or long-standing pigment may take longer to improve. In some cases, ongoing maintenance is needed to keep it under control.

Yes. Even after successful treatment, pigmentation can return due to sun exposure, hormonal changes, or inflammation. That is why ongoing sun protection and maintenance treatments are essential to minimise recurrence.

Daily use of broad-spectrum SPF 50+ sunscreen, avoiding direct sun exposure, and treating skin inflammation early can help prevent pigmentation from deepening or returning. A consistent skincare routine and avoiding picking at your skin are equally important.

Many patients notice visible improvements within 4 to 8 weeks of consistent treatment. More stubborn pigmentation, such as melasma or dermal PIH, may take several months to lighten significantly.

It depends on the type and depth of pigmentation. Pico and Q-switched lasers are ideal for superficial dark spots and freckles, while fractional lasers may be better suited for deeper or more complex pigmentation issues.

Yes, but it must be done with caution. Darker skin tones are more prone to post-treatment hyperpigmentation, so treatment should always be administered by dermatologists experienced in treating ethnic skin. Proper technique and tailored settings help minimise risks.

Some OTC products, such as those containing vitamin C or niacinamide, may help improve mild cases. However, more stubborn or widespread pigmentation typically requires professional evaluation and prescription-strength treatment for best results.

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