Laser and Medical Treatments for Dark Spots, Melasma and Uneven Skin Tone
Skin pigmentation concerns such as dark spots, melasma, and uneven skin tone are common, particularly in all skin types. These can be triggered by sun exposure, hormonal changes, inflammation, and ageing.
At Stephanie Ho Dermatology, we provide comprehensive pigmentation treatment, combining medical skincare, oral therapy, and advanced laser treatments for safe and effective results.
Understanding skin pigmentation
Pigmentation can occur at different stages of life:
- At birth: café-au-lait spots, naevus of Ota
- Childhood / adolescence: freckles, Becker's naevus
- Adulthood: melasma, sun spots (freckles, solar lentigines), Hori's naevus
Accurate diagnosis is essential, as some conditions—particularly melasma—can worsen with inappropriate or overly aggressive laser treatment.
Treatment approach for pigmentation
Effective pigmentation treatment requires a multi-layered approach, not just lasers.
1. Sun protection (essential foundation)
Daily sun protection is critical for both treatment and prevention.
- use broad-spectrum SPF 50+ sunscreen
- reapply regularly
- wear hats, sleeves and sunglasses
UV exposure stimulates melanin production and worsens pigmentation.
Oral antioxidants such as Polypodium leucotomos may provide additional protection against UV-induced pigmentation.
2. Medical-grade lightening creams
Topical treatments help reduce pigmentation safely and effectively. Common ingredients include:
- hydroquinone
- azelaic acid
- kojic acid
- arbutin
- retinoids (e.g. tretinoin) to increase cell turnover
For sensitive skin or long-term use:
- cysteamine
- tranexamic acid creams
These treatments:
- inhibit melanin production
- gradually lighten dark spots
- improve overall skin tone
3. Oral treatments for pigmentation
Oral therapies may be used for conditions such as melasma.
-
Oral tranexamic acid
- reduces pigment stimulation pathways
- effective for melasma when used under supervision
-
Glutathione
- antioxidant support
- may improve overall skin brightness
These are typically used as part of a combined treatment plan.
4. Laser treatments for pigmentation
Laser treatments are used to target deeper or more stubborn pigmentation. We offer a range of advanced pigment lasers, including:
- picosecond lasers
- Q-switched Nd:YAG lasers
- long pulsed Alexandrite lasers
- dual wavelength lasers
These lasers work by:
- breaking down pigment into smaller particles
- allowing the body to clear pigmentation naturally
Treatment approaches
Gentle laser treatments (no downtime)
- gradual lightening
- suitable for maintenance and busy lifestyles
Stronger laser treatments
- faster results
- may involve short downtime
Treatment choice depends on:
- type of pigmentation
- skin type
- risk of post-inflammatory hyperpigmentation
5. Combination treatments for optimal results
Many patients benefit from combining:
- pigment lasers
- medical skincare
- skin rejuvenation treatments
Combination approaches help:
- improve pigmentation
- enhance skin texture
- reduce pore size and fine lines
Important considerations
- sun protection is essential before and after treatment
- multiple sessions are often required
- results are gradual and improve over time
Your dermatologist will discuss:
- expected outcomes
- number of sessions required
- risks such as post-inflammatory hyperpigmentation
Why expert care matters
Pigmentation treatment is complex, especially in all skin types.
At Stephanie Ho Dermatology:
- your dermatologist selects and performs all your treatments
- treatments are tailored to your skin type
- appropriate lasers and settings are selected carefully
- risk of complications is minimised
Clinical expertise and publications
Dr Stephanie Ho has extensive experience in managing pigmentation disorders in all skin types and has contributed to multiple peer-reviewed scientific publications in this field.
Selected publications include:
- Ho SG, Chan HH. The Asian dermatologic patient: review of common pigmentary disorders and cutaneous diseases. American Journal of Clinical Dermatology 2009; 10(3): 153–68.
- Chan NP, Ho SG, Shek SY, Yeung CK, Chan HH. Facial depigmentation with low-fluence Q-switched Nd lasers for skin rejuvenation and melasma. Lasers Surg Med 2010; 42(8): 712–9.
- Ho SG, Yeung CK, Chan NP, et al. Management of freckles and lentigines using four different pigment lasers on Asian skin. J Cosmet Laser Ther 2012; 14(2): 74–80.
- Ho SG, Yeung CK, Chan NP, et al. 1927 nm fractional thulium fiber laser for melasma management in Chinese patients. J Cosmet Laser Ther 2013; 15(4): 200–6.
- Goh CL, Ho SG. Laser tattoo removal: A clinical update. J Cutan Aesthet Surg 2015; 8(1): 9–15.
Frequently asked questions
What causes pigmentation to worsen?
Sun exposure, hormones, and inflammation are key triggers.
How many sessions are needed?
Mild pigmentation may require 1–3 sessions, while melasma often requires ongoing management.
Are lasers safe for all skin types?
Yes, when performed by an experienced dermatologist using appropriate settings.
Book a consultation
If you are concerned about pigmentation, dark spots, or uneven skin tone, a personalised consultation is the first step.
At Stephanie Ho Dermatology, we provide customised pigmentation treatments using a combination of medical and laser therapies for safe, effective, and long-lasting results.
Contact us today to arrange your consultation.