What are the main causes of melasma?

Melasma, a common skin condition characterised by dark, discoloured patches on the skin, particularly on the face, affects millions worldwide. This hyperpigmentation can cause significant distress, especially since it often appears in highly visible areas. Understanding the root causes of melasma is crucial for managing and preventing it.

In this article, we delve into the primary factors contributing to melasma and discuss treatments available in Singapore, including laser and microneedling.


One of the key contributors to melasma is genetics. Studies have shown that a family history of melasma can significantly increase an individual’s likelihood of developing the condition. Melasma is more prevalent among certain ethnic groups, notably those with darker skin tones, including Asians, Hispanics and those of Middle Eastern descent.

Genetic factors influence the activity of melanocytes, the cells responsible for pigment production in the skin. In individuals prone to melasma, these cells are more sensitive and reactive, leading to excessive melanin production when exposed to certain stimuli. This increased melanin production results in the characteristic dark patches of melasma.

UV exposure

Ultraviolet (UV) exposure is a well-documented trigger for melasma and is perhaps the most significant environmental factor. UV rays from the sun stimulate melanocytes to produce more melanin as a protective response. For those with a predisposition to melasma, this response is exaggerated, leading to hyperpigmented areas on the skin.

UV exposure does not just include direct sunlight. Reflected UV rays from surfaces like water, sand, and even buildings can also contribute to melasma. Even brief periods in the sun without adequate protection can exacerbate the condition, making consistent sun protection essential for individuals prone to melasma.


Melasma often accompanies pregnancy. So much so that melasma is referred to as “the mask of pregnancy”. Hormonal changes during pregnancy, particularly increased levels of estrogen and progesterone, can stimulate melanocytes, leading to hyperpigmentation.

During pregnancy, the skin becomes more sensitive to sun exposure, and the hormonal fluctuations can enhance the skin’s pigmentation response. This is why many pregnant women experience dark patches on their faces, especially on the forehead, cheeks, and upper lip.

Melasma triggered by pregnancy often fades after childbirth as hormone levels stabilise. However, for some women, the condition can persist, especially if additional factors like sun exposure continue to stimulate melanin production. It’s essential for pregnant women to practise diligent sun protection to minimise the development or worsening of melasma.

Hormonal therapies

Hormonal therapies, such as birth control pills and hormone replacement therapy (HRT), can also contribute to the development of melasma. These treatments often involve oestrogen and progesterone, which, as with pregnancy, can stimulate melanocytes to produce more melanin, leading to hyperpigmentation.

The link between hormonal treatments and melasma underscores the sensitivity of melanocytes to hormonal changes. Women who take these therapies are at a higher risk of developing melasma, especially if they have other risk factors such as a genetic predisposition or significant sun exposure.

To manage melasma induced by hormonal therapies, individuals may need to discuss alternative treatments with their healthcare provider or enhance their sun protection measures to prevent further pigmentation.


Certain cosmetics and skin care products can also trigger or exacerbate melasma. Ingredients in some products, particularly those that are photosensitizing, can make the skin more susceptible to UV damage, leading to hyperpigmentation.

Fragrances, certain chemicals, and even some natural ingredients can cause a phototoxic reaction when exposed to sunlight. This reaction can increase melanin production in the skin, leading to the development or worsening of melasma. Additionally, harsh skin treatments like chemical peels and microdermabrasion, if not done correctly, can irritate the skin and provoke pigmentation issues.

People prone to melasma should be cautious about the products they use and look for non-comedogenic, fragrance-free, and gentle formulations. Patch testing new products can also help avoid reactions that might exacerbate melasma.

Can you prevent melasma?

Preventing melasma is challenging, especially for individuals with a genetic predisposition or those exposed to hormonal changes. However, certain measures can significantly reduce the risk and severity of melasma.

Sun protection

Consistent and comprehensive sun protection is the most effective way to prevent melasma. This includes using broad-spectrum sunscreen with an SPF of 30 or higher, wearing wide-brimmed hats, and seeking shade whenever possible. It’s also crucial to apply sunscreen regularly, especially after swimming or sweating, to maintain its protective effects.

Avoiding triggers

Identifying and avoiding potential triggers is another key preventive measure. For individuals on hormonal therapies, discussing alternatives with a healthcare provider may be beneficial. Additionally, choosing skincare products carefully to avoid photosensitizing ingredients and harsh treatments can help prevent the onset of melasma.

Antioxidants and skin care

Incorporating antioxidants into the skincare routine can help protect the skin from oxidative stress, which contributes to melasma. Products containing vitamin C, niacinamide, and other antioxidants can reduce inflammation and protect the skin from UV damage, thereby minimising the risk of melasma.

Healthy lifestyle

Maintaining a healthy lifestyle, including a balanced diet and adequate hydration, supports overall skin health and can help mitigate factors contributing to melasma. Stress management and sufficient sleep also play a role in maintaining hormonal balance and preventing skin issues.

Why skincare products may not be enough to remove melasma

While numerous skincare products claim to treat or eliminate melasma, their effectiveness can vary significantly, and many may not provide satisfactory results.

Here’s why:

Limited penetration

Most over-the-counter skin care products lack the ability to penetrate deeply enough into the skin to affect the melanocytes responsible for melasma. Melasma often affects the dermal layer, which is deeper than the epidermis that most topical products target. Therefore, products that only treat the surface of the skin are often ineffective for melasma.

Inadequate ingredients

Many products marketed for melasma contain ingredients that are not potent enough to address the condition. Ingredients like hydroquinone, retinoids, and azelaic acid have shown efficacy in treating melasma, but they often require higher concentrations and prolonged use under the guidance of a dermatologist. Over-the-counter products may contain these ingredients in lower, less effective concentrations.

Need for professional treatment

Melasma often requires professional treatments such as laser and microneedling treatment.

Yellow laser therapy

At DermAlly, we use yellow laser for melasma. This treatment specifically targets melanin, the pigment responsible for the characteristic dark patches of melasma. When the laser energy is absorbed by melanin, it heats and breaks down the pigment, which is then gradually eliminated by the body’s lymphatic system.

Additionally, yellow laser therapy targets blood vessels, reducing inflammation and addressing the vascular component of melasma that can exacerbate pigmentation. This dual action makes it highly effective for treating melasma, especially in individuals with darker skin tones who are more prone to hyperpigmentation.


We also use Sylfirm for melasma. This treatment involves delivering controlled radiofrequency (RF) energy through microneedles into the deeper layers of the skin, stimulating the production of collagen and elastin and promoting natural healing.

This process helps to reduce melanin levels and improve skin health. Simultaneously, the PEMF technology targets abnormal blood vessels and pigment-producing cells without affecting the surrounding tissues, effectively reducing hyperpigmentation and preventing its recurrence.

Melasma treatment in Singapore

Understanding the various causes and contributing factors of melasma is crucial for effective management and prevention. While skincare and some preventive measures can play a role, it’s often crucial to get professional advice and treatment for the best results.

Whether you’re dealing with stubborn melasma or seeking a comprehensive skin rejuvenation, Our skin specialist at Dermally is ready to tailor a personalised treatment plan that meets your needs.

Book a consultation with us now.

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