From uneven skin tone, stubborn dark patches, and spots that seem to linger long after acne has healed, pigmentation is one of the most common skin concerns we see in the clinic. Whether caused by sun exposure, inflammation or hormonal fluctuations, pigmentation can affect your skin’s clarity and radiance, leaving you looking more tired or aged than you feel.
Pigmentation refers to the discolouration of the skin caused by the overproduction of melanin, the pigment responsible for the colour of our skin, hair and eyes. This excess melanin can appear as dark spots, patches, or contribute to a general uneven skin tone.
Understanding the type and depth of pigmentation is key to effective treatment. At Mizu, we often categorise pigmentation into the two primary layers of the skin: epidermal (superficial) and dermal (deep). Our VISIA analysis helps pinpoint the pigment depth for precise treatment planning.
This type of pigmentation affects the more superficial layer of the skin, the epidermis, and often appears as well-defined, flat brown spots. Because the pigment is located closer to the skin surface, these are generally easier to treat.
Freckles: Small, scattered brown spots with distinct borders, often seen in fair-skinned individuals. They tend to become darker with sun exposure and can lighten with adequate sun protection
Sun Spots (Solar Lentigines): Caused by cumulative UV damage, these are larger, darker patches that typically appear on sun-exposed areas like the face, hands and décolletage. These also darken with sun exposure but are less likely to fade with sun protection.
Dermal pigmentation lies deeper in the skin (dermis) and tends to present as a greyish, bluish or dark brown discolouration, often with less distinct borders. Because the pigment is embedded deeper, this form of pigmentation is often more challenging to treat and may require longer-term management with specialised lasers and doctor-prescribed skincare or medication.
Post-Inflammatory Hyperpigmentation (PIH): Often occurs after skin trauma or inflammation, such as acne, eczema, insect bites or certain procedures. It is more common in individuals with darker skin tones.
Hori’s Nevus: A form of acquired dermal pigmentation that appears as bluish-grey patches on the cheeks. It is especially common among Asian women and typically appears in adulthood.
Nevus of Ota: A congenital pigmentation disorder resulting in bluish discolouration around the eye area. Unlike Hori’s Nevus, this is usually present from birth or early childhood.
Some pigmentation conditions involve both the epidermis and dermis, making them more complex to treat. These types usually appear as diffuse brownish patches with uneven borders and can fluctuate in intensity depending on sun exposure and hormonal influences.
The most common example of mixed pigmentation is melasma. Often triggered by hormonal changes (e.g. pregnancy, oral contraceptives), melasma is more common in women and usually appears bilaterally on the cheeks, forehead, upper lip and jawline. It can be stubborn and prone to recurrence.
For best results, treatment of melasma can include a combination of topical skincare, oral medication and pigmentation laser where appropriate.
Pigmentation refers to the discolouration of the skin caused by the overproduction of melanin, the pigment responsible for the colour of our skin, hair and eyes. This excess melanin can appear as dark spots, patches, or contribute to a general uneven skin tone.
Understanding the type and depth of pigmentation is key to effective treatment. At Mizu, we often categorise pigmentation into the two primary layers of the skin: epidermal (superficial) and dermal (deep). Our VISIA analysis helps pinpoint the pigment depth for precise treatment planning.
This type of pigmentation affects the more superficial layer of the skin, the epidermis, and often appears as well-defined, flat brown spots. Because the pigment is located closer to the skin surface, these are generally easier to treat.
Freckles: Small, scattered brown spots with distinct borders, often seen in fair-skinned individuals. They tend to become darker with sun exposure and can lighten with adequate sun protection
Sun Spots (Solar Lentigines): Caused by cumulative UV damage, these are larger, darker patches that typically appear on sun-exposed areas like the face, hands and décolletage. These also darken with sun exposure but are less likely to fade with sun protection.
Post-Inflammatory Hyperpigmentation (PIH): Often occurs after skin trauma or inflammation, such as acne, eczema, insect bites or certain procedures. It is more common in individuals with darker skin tones.
Hori’s Nevus: A form of acquired dermal pigmentation that appears as bluish-grey patches on the cheeks. It is especially common among Asian women and typically appears in adulthood.
Nevus of Ota: A congenital pigmentation disorder resulting in bluish discolouration around the eye area. Unlike Hori’s Nevus, this is usually present from birth or early childhood.
Dermal pigmentation lies deeper in the skin (dermis) and tends to present as a greyish, bluish or dark brown discolouration, often with less distinct borders. Because the pigment is embedded deeper, this form of pigmentation is often more challenging to treat and may require longer-term management with specialised lasers and doctor-prescribed skincare or medication.
Some pigmentation conditions involve both the epidermis and dermis, making them more complex to treat. These types usually appear as diffuse brownish patches with uneven borders and can fluctuate in intensity depending on sun exposure and hormonal influences.
The most common example of mixed pigmentation is melasma. Often triggered by hormonal changes (e.g. pregnancy, oral contraceptives), melasma is more common in women and usually appears bilaterally on the cheeks, forehead, upper lip and jawline. It can be stubborn and prone to recurrence.
For best results, treatment of melasma can include a combination of topical skincare, oral medication and pigmentation laser where appropriate.
Pigmentation can be caused or aggravated by a number of intrinsic and extrinsic factors. These include:
Acne, insect bites, eczema or even aggressive skincare treatments can lead to PIH.
Some medications or photosensitising agents can cause skin to react more strongly to sunlight.
A family history of pigmentation issues may increase your likelihood of developing them.
Pregnancy, oral contraceptives and hormonal therapy can trigger melasma or worsen existing pigmentation.
As we age, the skin’s ability to regulate melanin production becomes less efficient, leading to age spots or uneven tone.
UV rays stimulate melanin production, which leads to tanning and can cause persistent sunspots or melasma over time.
Treating pigmentation effectively requires a tailored approach that considers the type, severity and depth of pigmentation, as well as your skin type and lifestyle. Treatment plans may include a combination of medical-grade procedures, doctor-prescribed medication, and lifestyle recommendations to manage pigmentation safely.
While in-clinic procedures provide targeted results, pigmentation should be managed holistically for best outcomes.
Topical products can play a vital role in managing pigmentation, especially when used alongside in-clinic treatments. These may include prescription-strength or medical-grade products to suppress melanin production.
Some commonly used active ingredients include:
Hydroquinone is a well-established depigmenting agent often considered for treating hyperpigmentation. It works by inhibiting tyrosinase, an enzyme involved in melanin production. This reduces the formation of new pigment and gradually lightens existing dark spots. Hydroquinone is prescription-only in Singapore and should only be used under medical supervision. It is usually prescribed in short, controlled courses to avoid skin sensitivity or rebound hyperpigmentation.
Tranexamic acid is a popular ingredient in pigmentation treatment, particularly for melasma and post-inflammatory hyperpigmentation. It reduces melanin production by interfering with the interaction between melanocytes and blood vessels. It is often used as a topical serum or cream, but can be prescribed orally for selected patients for greater efficacy. Topical tranexamic acid is generally well-tolerated and suitable for long-term use, especially in those prone to pigmentation relapse and works well with other brightening ingredients like niacinamide, vitamin C or arbutin.
This is a non-hydroquinone-based topical treatment that is a safe, long-term option for managing stubborn pigmentation. Cysteamine is a natural antioxidant found in human cells and it works by reducing melanin synthesis through multiple pathways. It is particularly suitable for patients who cannot tolerate hydroquinone or are looking for a hydroquinone-free option. It can be used long-term for conditions like melasma or PIH, even after laser sessions. It may also be recommended as a maintenance treatment to preserve results after laser sessions.
The most common and effective way to treat and remove pigmentation is with laser treatments. Laser technologies are constantly evolving, but that doesn’t mean that older technologies are no longer as effective. There are several types of laser machines at Mizu that are used for different types of pigmentation.
The most common and effective way to treat and remove pigmentation is with laser treatments. Laser technologies are constantly evolving, but that doesn’t mean that older technologies are no longer as effective. There are several types of laser machines at Mizu that are used for different types of pigmentation. Read more
This laser is used to treat epidermal pigmentation, such as freckles, sun spots, lentigos, and age spots, as well as the epidermal pigmentation components of melasma. It can effectively reduce pigmentation with fewer side effects due to its high absorption rate by melanin and low absorption rate by other skin components. Read more
The Q-switched laser is most
suited to target dermal pigmentations. It also supports skin rejuvenation and is effective in reducing oil production, acne and pore size. Read more
With both vascular and pigment-specific settings, the Yellow Laser is suitable for superficial pigmentation like freckles, red-pigmented lesions and stubborn conditions such as vascular melasma. It also helps with acne, making it a good option for those with mixed skin concerns. Read more
This dual-wavelength, non-ablative fractional laser simultaneously emits 1550 nm and 1927 nm wavelengths to resurface and remodel the skin. It stimulates collagen while targeting melanin, making it ideal for patients who want to improve pigmentation along with skin texture and pore size. Read more
Combining microneedling with radiofrequency energy, this treatment targets deeper layers of skin, disrupting excess melanin deposits while stimulating collagen to improve texture. RF microneedling is less likely to trigger post-inflammatory hyperpigmentation, making it safe for darker skin tones. Read more
A medical-grade chemical peel exfoliates the skin surface to remove excess pigmentation and stimulate cell turnover. They are best suited for superficial pigmentation and dull skin. Read more
Pigmentation can fade with the right treatment and consistent sun protection, although some types, such as melasma or Hori’s Nevus, may require long-term management.
Melasma is often best managed with a combination of laser treatments, medical-grade topical skincare and sun avoidance. Melasma requires a personalised treatment plan as it can respond differently to treatments in different individuals.
Yes, especially if sun protection and maintenance are not followed. Ongoing care is essential to prevent recurrence.
Yes, we have a range of devices and protocols that are suitable for a wide range of skin types, including Fitzpatrick IV and above. During your consultation, our doctors will customise a safe and effective plan for your skin.
Mizu Aesthetic Clinic is led by Dr YZ Tan, who brings years of experience as a trainer of laser protocols for treating different types of pigmentation. We do not believe in a one-size-fits-all approach; instead we prioritise safety, transparency, and evidence-based solutions, ensuring that every treatment is tailored to your skin’s needs.
Take the first step towards brighter, clearer-looking skin. Schedule a personalised consultation with our medical team to discuss your pigmentation concerns and explore the best treatment options for your skin type.
This page is intended for educational purposes and does not constitute medical advice. For an accurate diagnosis and personalised treatment plan, please consult with our licensed medical professionals.
