Pigmentation is the skin concern I see most often in Singapore, and the one most often treated the wrong way. Freckles, age spots, melasma, brown acne marks and Hori’s naevus all look like brown patches. They sit at different depths, have different causes and need different treatment. A laser setting that clears an age spot in one session can make melasma darker. So I name the pigment first, and the pigment decides the treatment.
This page covers how I tell the types apart, which pigmentation treatment I use for each one, how many sessions it takes, what it costs and how I keep the risk of darker patches low on Asian skin.
Key points
- Pigmentation treatment works when it is matched to the type of pigment
- Age spots and freckles usually clear with 1 to 3 laser sessions
- Melasma is controlled, not cured, and starts with sunscreen and creams
- Brown acne marks fade with creams and time, with laser for marks that stay
- Hori’s naevus sits deep and needs 6 to 10 or more sessions
- On Asian skin I use lower energy and more sessions to avoid darker patches
Pigmentation treatment in Singapore, what I use for each type
| Pigment | First treatment I use | Usual course |
|---|---|---|
| Age spots and sun spots | Pico or Q-switch laser | 1 to 3 sessions |
| Freckles | Pico or Q-switch laser, then sunscreen | 1 to 3 sessions, top-ups in later years |
| Melasma | Tinted sunscreen and prescription cream, then low-energy laser | Months, then maintenance |
| Brown acne marks | Creams, sunscreen, then pico laser if they stay | 3 to 6 laser sessions |
| Hori’s naevus | Pico or Q-switch laser at 1064 nm | 6 to 10 or more sessions |
| Uneven tone and sun damage | Fraxel 1927 or Fraxel 1550 | 3 to 5 sessions |
Most people come in with more than one type. A woman in her forties often has age spots on the cheeks, melasma on the upper lip and a few old acne marks on the jaw. I treat each one on its own terms, often in the same visit.
Types of pigmentation I see in Singapore, and how I tell them apart
| Type | What it looks like | How deep it sits | What drives it |
|---|---|---|---|
| Age spots (solar lentigines) | Flat, sharp-edged brown spots on the cheeks, temples and hands | Surface | Years of sun |
| Freckles | Small, light brown dots that darken in the sun | Surface | Sun and genes |
| Melasma | Matching brown or grey-brown patches on the cheeks, forehead and upper lip | Surface, deep or both | Hormones, heat, visible light, sun and genes |
| Brown acne marks (PIH) | Flat brown marks where a spot or rash used to be | Surface, or deeper if the inflammation was deep | Inflammation in skin that tans easily |
| Hori’s naevus | Grey-blue or grey-brown dots across both cheekbones, often from the twenties | Deep | Genes, common in East Asian women |
| Pigment-type dark eye circles | Brown shadow under the eyes | Surface and deep | Rubbing, allergy and genes |
I examine every patch under a dermatoscope and a Wood’s lamp. The dermatoscope shows the pattern of the pigment. The Wood’s lamp shows whether melasma sits near the surface or deeper down. Any spot that is raised, growing, changing colour or bleeding is checked as a possible mole or skin cancer before anyone talks about a laser. I cover moles on my mole removal page.
Age spot removal in Singapore
Age spots, also called sun spots or solar lentigines, are the easiest pigment to clear. The pigment sits in a tight cluster near the surface, so a short pulse of laser light breaks it up and the body clears it over the next few weeks.
I use the 532 nm wavelength on the Picoplus or the Q-switch laser for most age spots. The spot turns grey straight after the pulse, darkens into a fine crust over 3 to 7 days and then flakes off. Most spots clear in 1 or 2 sessions about 4 weeks apart.
In a study of Asian patients treated with a 532 nm picosecond laser, 18 of 20 had moderate to marked improvement 12 weeks after treatment. A 2025 review of 41 clinical trials found lasers worked better for age spots than creams, peels or freezing.
Age spots on the hands and arms clear the same way, but heal more slowly than the face. New spots form with new sun, so daily sunscreen keeps the result.
How can I remove age spots? With a pigment laser, after the spot has been checked under the dermatoscope. Creams lighten age spots a little but rarely clear them. Home peels and freezing pens risk burns and pale marks.
Freckles pigmentation treatment
Freckles are lighter and more scattered than age spots, and they darken each time the skin sees sun. I treat them with the same 532 nm wavelength at a lower energy, often across the whole cheek in one session rather than spot by spot.
Most freckles fade well after 1 to 3 sessions. Because freckles are partly genetic, some return over the years. A top-up session every year or two, with sunscreen every day, keeps them light.
I do not treat freckles on a tan. Tanned skin has more pigment around the freckle, so the laser energy goes into the wrong place and the risk of a darker patch afterwards goes up. I ask patients to keep out of the sun for 4 weeks before a freckle session.
Melasma treatment in Singapore, controlled step by step
Why melasma is not treated like a freckle
A freckle or an age spot is a stable deposit of pigment. Melasma is an active process. The pigment cells are overactive, driven by hormones, heat and light, and the skin beneath has more small blood vessels than normal. Heat and sun both switch it on, which is why melasma flares in the Singapore sun and after hot yoga.
If melasma is treated with the high laser energy used for an age spot, the overactive cells make more pigment. This is the rebound people describe as “the laser made it worse”. So I build melasma treatment around sunscreen and creams first, with low-energy laser added as one part of the plan, never as the whole plan.
The order I follow for melasma
- Name the type. The Wood’s lamp shows surface, deep or mixed melasma. Mixed melasma takes longer because creams do not reach the deeper part.
- Tinted sunscreen and cream for 2 to 3 months. Most patients see useful lightening with this alone, and the response tells me whether a device is needed at all.
- Add low-energy laser toning. If the response stalls, I add monthly pico or Q-switch toning at 1064 nm. I never laser tanned, inflamed or untreated melasma.
- Add tranexamic acid or microneedle RF for stubborn melasma. Oral tranexamic acid after screening, or tranexamic acid delivered through microneedling.
- Maintenance. Cyspera or a lower-strength cream, tinted sunscreen and toning every 1 to 2 months if needed.
- Stop and check. A treated patch that darkens for a few days is expected. A patch that keeps darkening after a week is not, and I pause treatment.
Low-energy toning works but has limits. In one Asian study, five weekly sessions gave clear lightening, yet a few patients developed pale mottled spots or rebound, and the melasma came back in every patient once treatment stopped. This is why I space toning to the skin’s response and always pair it with creams. More on the laser side is on my pico laser vs Q-switch laser page.
Brown acne marks and post-inflammatory hyperpigmentation treatment
Post-inflammatory hyperpigmentation (PIH) is the flat brown mark left after a pimple, eczema, an insect bite or a procedure. It is very common in Singapore because skin that tans easily also marks easily.
PIH fades by itself in most people, but it can take 6 to 12 months or longer. I speed it up in this order.
- Treat the acne or rash first, because new spots make new marks
- Sunscreen every day, because sun keeps the marks dark
- A prescription cream, often a retinoid or azelaic acid, sometimes hydroquinone for a short course
- Superficial peels as an add-on
- Low-energy pico laser for marks that have not faded after 3 to 6 months
Brown marks are not the same as red marks or scars. Red marks are blood vessels and need a vascular laser. Scars are a change in texture and need resurfacing. I cover these on my brown acne marks page, my red acne marks page and my acne scar treatment guide.
Hori’s naevus and deeper pigment treatment
Hori’s naevus is a speckled grey-blue or grey-brown patch across both cheekbones. It is often mistaken for melasma, but the pigment sits much deeper in the skin and creams do not reach it.
I treat Hori’s naevus with the 1064 nm wavelength on the pico or Q-switch laser, at a higher energy than melasma toning, every 6 to 8 weeks. Most patients need 6 to 10 sessions or more. The pigment fades in stages, and the face often looks a little darker for a few weeks after each of the first sessions before it lightens.
In a series of 110 patients in China, results improved with more sessions, and about 1 in 10 patients had temporary darkening along the way. When Hori’s naevus and melasma sit together, I calm the melasma first with creams before I treat the deeper pigment.
Pigmentation creams in Singapore, from hydroquinone to Cyspera
Which skin care is best for pigmentation? The best skincare for pigmentation is a tinted sunscreen every morning and the right active cream at night. Which cream depends on the type.
Hydroquinone and triple cream
For melasma, hydroquinone and triple-combination cream (hydroquinone, a retinoid and a mild steroid) are still the best-studied creams. I prescribe them as a supervised course of up to 6 months, not open-ended. In Asian patients, triple cream cleared or nearly cleared melasma in about 2 out of 3 people at 8 weeks, against about 2 out of 5 with hydroquinone alone.
Cysteamine cream (Cyspera)
Cyspera is the hydroquinone-free cream I use for the long maintenance phase. It goes on for 15 minutes a day, then is washed off. After the first 16 weeks it is used twice a week, and it is safe to continue long term. In a placebo-controlled trial it lowered melasma severity clearly more than placebo after 4 months. In my experience it works better combined with pico or Q-switch laser than alone. Cyspera is S$270 for a 50 ml bottle. I cover it in detail on my Cyspera page.
Tranexamic acid
Tranexamic acid works on the blood vessel and signalling side of melasma. I use it as a cream, through microneedling, or as a tablet after screening for clotting risk. In a trial of oral tranexamic acid, melasma improved by about half against a small change on placebo, but some of the gain was lost 3 months after stopping. Reviews of many trials show the same pattern, which is why I plan maintenance from the start.
Retinoids, azelaic acid, niacinamide and vitamin C
These support every plan. Retinoids speed up the turnover of pigmented surface cells. Azelaic acid and niacinamide calm pigment cells and are gentle enough for sensitive skin. Vitamin C protects against sun damage. None of these is used in pregnancy without checking with me first, and hydroquinone, retinoids and Cyspera are avoided in pregnancy.
Tinted sunscreen, the pigmentation treatment that holds the result
Visible light darkens melasma as much as UV does, and a clear sunscreen does not block visible light. A tinted SPF 50 PA++++ sunscreen with iron oxides is part of every pigmentation plan I write. In a trial, adding iron-oxide tint to an SPF 50 sunscreen gave clearly better melasma lightening over 8 weeks than UV protection alone.
I apply it in the morning and again at lunch if I am outdoors. A hat and shade matter as much in Singapore, where the sun is strong all year. I would rather not start a laser or a peel if daily sunscreen cannot be kept up, because the result will not last.
Pigmentation treatment price in Singapore
How much does it cost to laser off hyperpigmentation? At my practice, pico laser is S$350 a session, S$1,600 for 5 sessions and S$2,800 for 10 sessions. The full price list is below.
| Treatment | Price at my practice | Usual course |
|---|---|---|
| Pico laser | S$350 a session, S$1,600 for 5 sessions, S$2,800 for 10 sessions | Age spots 1 to 3, acne marks 3 to 6, Hori’s 6 to 10 or more, melasma 5 to 10 then maintenance |
| Q-switch laser | From S$1,100 for 5 sessions, or from S$2,000 for 10 | 4 to 6 sessions, 2 to 5 weeks apart |
| Fraxel laser | From S$1,000 a session | 3 to 5 sessions, 2 to 4 weeks apart |
| Superficial chemical peel | S$200 a session, course S$800 to S$1,200 | 4 to 6 sessions |
| Cyspera cream | S$270 for 50 ml | 16 weeks daily, then twice a week |
| Microneedle RF with pico | Quoted after assessment | Monthly course |
| Lorient Element skin booster | Quoted after assessment | Course a few weeks apart, then maintenance |
| Exosome serum after laser | Quoted after assessment | Added to laser sessions |
| Prescription creams | Quoted at consultation | Up to 6 months for hydroquinone |
Prices are before GST. Across Singapore, laser pigmentation treatment is advertised from about S$200 to S$600 a session. The real difference between clinics is the number of sessions quoted and whether melasma is treated with gentle toning or with the high energy that causes rebound. I give a written plan with the session count before treatment starts.
Chemical peels for pigmentation on Asian skin
A superficial peel with salicylic, glycolic or lactic acid lifts surface pigment and evens skin tone. I give it as 4 to 6 sessions, 2 to 4 weeks apart. On Asian skin I keep peels light. A peel deep enough to injure the deeper skin causes the very inflammation that leaves brown marks.
Peels work best for brown acne marks, dull uneven tone and as an add-on for melasma. They do not clear Hori’s naevus or deep age spots. More detail is in my chemical peel guide.
Laser pigmentation treatment, pico, Q-switch and Fraxel
Pico laser
A pico laser breaks pigment with very short pulses and less heat than older lasers, which matters on darker skin. I have three pico platforms, Picocare, Picoplus with all its handpieces and the Helios 785, all with Pico MLA. I choose the wavelength by pigment, 532 nm for age spots and freckles, 1064 nm for melasma toning and Hori’s naevus. Prices, platforms and session counts are on my pico laser page.
Q-switch laser
The Q-switch Nd:YAG uses longer nanosecond pulses. It is still effective for age spots, Hori’s naevus and melasma toning, and I use it where a patient has responded well to it before. The protocol is on my Q-switch laser page.
Fraxel 1927 and Fraxel 1550
Once the darker spots are cleared, I use the Fraxel 1927 nm thulium laser, which some call the BB laser, to refine uneven tone and fine sun damage. It treats tiny columns of pigmented surface skin that are replaced by evenly coloured skin over the next weeks. The Fraxel 1550 nm reaches deeper and suits pigment mixed with texture and fine lines. I use low density on Asian skin, because higher density and poor cooling raise the risk of brown marks afterwards. More is on my Fraxel laser page.
Microneedle RF, Lorient Element and exosomes for stubborn pigmentation
Microneedle fractional radiofrequency
For stubborn or mixed melasma, microneedle fractional radiofrequency heats the deeper skin through insulated needles. It spares the surface pigment cells that rebound after a laser, and the tiny channels it opens help tranexamic acid and other actives get in. I combine it with pico laser when melasma has stalled on creams and toning.
Lorient Element skin booster
Lorient Element is a brightening solution of glutathione, vitamin C, hyaluronic acid, tranexamic acid and niacinamide. I apply it after a fractional laser, plasma or microneedle RF session so it reaches the deeper skin. I use it as an add-on for melasma, brown acne marks and uneven tone, as a course a few weeks apart and then as maintenance. It is not used in pregnancy, on broken or infected skin, or in the months after isotretinoin.
Exosomes after laser
Exosome serum applied straight after a laser or microneedling session calms the inflammation that follows. On Asian skin this matters, because that inflammation is what leaves brown marks. The published evidence is still early, so I use it to shorten recovery and lower the risk of marks, not as a pigment treatment by itself.
Can pigmentation be treated permanently?
It depends on the type.
- Age spots that are fully cleared usually stay cleared. New ones form with new sun.
- Freckles fade well but can slowly return because they are partly genetic.
- Brown acne marks do not come back unless new acne or inflammation returns.
- Hori’s naevus that has cleared after a full course usually stays clear.
- Melasma is controlled, not cured. It can be lightened until it is hard to see and kept there, but it returns with sun, heat, pregnancy or the pill if maintenance stops.
So the honest answer is that most pigmentation can be removed for good, and melasma can be kept under control for good with the right maintenance.
Laser pigmentation treatment on Asian skin, keeping the risk of darker patches low
Skin that tans easily also darkens easily after a laser. My safeguards are lower energy with more sessions, the 1064 nm wavelength for deeper pigment, cooling during treatment, a test patch when I am unsure of the skin type, and sunscreen for weeks before and after.
Treated spots darken for 3 to 7 days and then flake off over 2 to 4 weeks. That is normal. A patch that spreads or keeps darkening after 1 to 4 weeks is likely post-inflammatory hyperpigmentation. When I see this, I pause and treat it with cream rather than give another laser session. More on this is in my guide to lasers on darker skin.
Common questions about pigmentation treatment in Singapore
What is the most effective treatment for pigmentation in Singapore?
It depends on the pigment. Age spots and freckles clear fastest with a pico or Q-switch laser. Melasma responds best to tinted sunscreen and a prescription cream, with low-energy laser added if needed. Brown acne marks fade with creams and time, with pico laser for marks that stay.
How much does pigmentation treatment cost in Singapore?
At my practice, pico laser is S$350 a session, S$1,600 for 5 and S$2,800 for 10. A superficial peel is S$200, a 5-session Q-switch course is from S$1,100 and Fraxel is from S$1,000 a session. Prices are before GST.
How many sessions of pigmentation treatment will I need?
Age spots and freckles usually need 1 to 3 sessions. Brown acne marks need 3 to 6. Melasma needs 5 to 10 toning sessions and then maintenance. Hori’s naevus needs 6 to 10 or more.
Can pigmentation be removed permanently?
Age spots, brown acne marks and Hori’s naevus usually stay clear once removed, though new spots can form with new sun. Freckles can slowly return. Melasma is controlled rather than cured and needs maintenance.
Which skin care is best for pigmentation?
A tinted SPF 50 sunscreen every morning, and the right cream at night. That may be hydroquinone or triple cream for a set course, Cyspera for long-term melasma care, or a retinoid or azelaic acid for acne marks.
Can laser make pigmentation worse?
Yes, if the energy is too high for the type of pigment or the skin is tanned. This is most common with melasma. I use low energy for melasma, test patches on uncertain skin types and sunscreen before and after.
Is laser pigmentation treatment safe for Asian skin?
Yes, with the right wavelength and settings. Pico lasers put less heat into the surrounding skin than older lasers. I prefer them on skin that tans easily.
How long is the downtime after pigmentation laser?
For melasma toning there is little more than mild redness for an hour or two. For age spots, the spots darken and form a fine crust that flakes off over 7 to 10 days. Make-up can usually go on the next day.
Can I have pigmentation treatment while pregnant?
I do not give laser, hydroquinone, retinoids or Cyspera in pregnancy. Sunscreen and some gentle creams are safe. Melasma often fades after the baby is born, and I treat what remains then.
Does pigmentation come back after laser?
Cleared age spots usually stay cleared, though new ones can form. Melasma returns without maintenance. Brown acne marks only return if new acne or inflammation returns.
Book a pigmentation treatment consultation in Singapore
Dr Gerard Ee consults and performs pigmentation treatment at The Clifford Clinic, 50 Raffles Place, Singapore. Consultations are by appointment. Message the clinic on WhatsApp, or call 6532 2048.
At the consultation I examine each patch under the dermatoscope and Wood’s lamp, name the type, and give you a written plan with the treatment, the number of sessions and the cost.
