Pigmentation

What Are Pigmentation Treatments?

Pigmentation treatments aim to reduce excess melanin or remove pigment deposits using medical-grade topical agents, systemic oral therapies, and laser technologies. Treatments are tailored based on pigmentation depth (epidermal vs. dermal), skin tone (Fitzpatrick classification), and contributing factors such as hormonal imbalance, inflammation, or sun damage.

Treatment Modalities:

Topical Creams: Inhibit melanin synthesis and accelerate cell turnover.
Oral Medications: Address systemic triggers like hormonal fluctuations and oxidative stress.
Laser Therapies: Break down pigment clusters and stimulate skin renewal.

How Do Pigmentation Treatments Work?

Pigmentation therapies disrupt melanin production (melanogenesis) and accelerate pigment removal. Hydroquinone inhibits tyrosinase, a key enzyme in melanin synthesis. Retinoids boost cell turnover to shed pigmented cells. Glutathione and polypodium leucotomos act as antioxidants, reducing UV-induced oxidative stress. Tranexamic acid inhibits plasmin activity, reducing melanocyte stimulation. Lasers such as PicoWay use photoacoustic pulses to break pigment into nanoparticles, while Sylfirm X addresses vascular and dermal triggers contributing to melasma.

Key Treatments & Targeted Applications

Treatments are selected based on the pigmentation type, cause, and depth:

1. Prescription Topical Creams

Ingredients: Hydroquinone (2–4%), tretinoin, azelaic acid (15–20%)
Indications: Epidermal melasma, sunspots, PIH
Protocol: Nightly application for 3–6 months, followed by tapering
Note: Triple therapy (hydroquinone + steroid + retinoid) is gold-standard for melasma.

2. Oral Therapies

Glutathione: 500–1000 mg/day for oxidative stress reduction and skin brightening
Polypodium leucotomos: Fern extract with photoprotective and antioxidant effects
Tranexamic Acid: 250–500 mg twice daily for hormonal or vascular melasma
Protocols: 3–6 months of consistent use, with medical supervision

3. PicoWay Laser

Mechanism: Picosecond pulses (532 nm and 1064 nm) shatter melanin for lymphatic clearance
Indications: Dermal pigmentation, nevus of Ota, PIH
Protocol: 3–5 sessions, spaced 4 weeks apart

4. Sylfirm X

Technology: Dual-wave RF microneedling (pulsed for vascular targets, continuous for remodeling)
Indications: Vascular melasma, rosacea, PIH, skin laxity
Protocol: 3–6 sessions, 4–6 weeks apart

When to Consider Pigmentation Treatment

Treatment is advised when pigmentation affects appearance, confidence, or signals underlying issues. Early treatment of melasma is important to prevent worsening. Solar lentigines and PIH respond well to prompt intervention. Patients with genetic pigmentation or sun damage may also benefit from preventive or corrective care.

Common Conditions Treated:

Melasma: Hormonal pigmentation, often recurrent
Solar Lentigines: Age spots caused by UV exposure
PIH: Marks following acne, eczema, or trauma
Genetic Pigmentation: Nevus of Ota, Hori’s macules

Recommended Sessions & Recovery

Topicals

Timeline: 8–12 weeks for visible results; continued use for 3–6 months
Rotation: Cycle hydroquinone with niacinamide to avoid ochronosis

Oral Medications

Glutathione: 500 mg twice daily
Polypodium leucotomos: 1–2 capsules daily
Tranexamic Acid: 250–500 mg twice daily for up to 6 months

Lasers

Sessions: 4–6 sessions spaced 4 weeks apart
Recovery: Mild redness/swelling for 2–3 days
Post-care: SPF 50+, gentle cleansing, avoid actives

Potential Risks & Safety Measures

Treatment should be supervised by dermatologists to reduce risks:

Topicals

Hydroquinone: Risk of ochronosis with prolonged use
Management: Cycle with azelaic acid or niacinamide

Oral Therapies

Tranexamic Acid: Avoid in thrombosis-prone patients; monitor BP and clotting profile
Glutathione: Not recommended during pregnancy; may cause bloating

Lasers

Risk: PIH in darker skin tones
Management: Use low-fluence settings, pretreatment with tyrosinase inhibitors

FAQs

When will I see results from topical creams?
4–8 weeks initially; full results in 3–6 months with daily SPF 50+ use
Is tranexamic acid a permanent cure for melasma?
No. It controls triggers but recurrence is possible without maintenance
Are lasers safe for darker skin?
Yes, with low-fluence PicoWay/Nd:YAG lasers and pre-treatment stabilization
Can I combine glutathione with topicals?
Yes. It enhances outcomes when used with vitamin C and brightening agents
Best regimen for hormonal melasma?
Tranexamic acid + triple therapy cream + laser + sun protection
Post-laser maintenance tips?
Use SPF 50+, avoid hormonal triggers, continue lightening agents
Alternatives to hydroquinone?
Azelaic acid, kojic acid, niacinamide
Can I undergo treatment during pregnancy?
Avoid retinoids, glutathione, and tranexamic acid. Use azelaic acid and physical sunscreens
How does PicoWay differ from traditional lasers?
Picosecond pulses minimize heat damage, making it safer for darker skin
What does polypodium leucotomos do?
Offers photoprotection and antioxidant support to reduce pigmentation risk

Why Trust Shine Dermatology?

Shine Dermatology combines expertise with state-of-the-art technologies to provide safe, effective pigmentation solutions. All treatments comply with Singapore’s HSA regulations and are delivered by certified dermatologists.