On the surface, the terms Hyperpigmentation and Melasma are interchangeably used — however, these skin conditions are different and are often confused with each other because of their similarities in appearance and symptoms. In fact, Melasma is a form of hyperpigmentation.
If you suffer from this skin condition or the like, it may be good to understand how they differ and their causes, so that you can find the right treatment for your skin and, hopefully, reverse their effects.
According to medical studies and expert observations, hyperpigmentation has been generally observed to be the darkening of areas of the skin. Hyperpigmentation often stems from acne and you may also develop it even after your acne breakout or pimples heal. The discolouration of your skin may be temporary but it can also be near-permanent.
Pigmentation affects the natural colour of your skin. Our skin appears in the natural colour that we are born with from a pigment called melanin. Special cells in our skin are in charge of melanin production. When these skin cells become unhealthy or damaged, melanin production is affected. 
Pigmentation usually appears as a dark patch and this has been medically classified as post-inflammatory hyperpigmentation. Nonetheless, there are no harmful side effects. They may appear as birthmarks, freckles and liver spots. It is usually tan, brown or dark brown in colour. These dark spots may darken with increased sun exposure, especially without sunscreen.
Vitamin C has been deemed as one of the most important products in any skincare routine. It’s packed with antioxidants and ingredients that even out skin tone. It also reduces the appearance of scarring by encouraging collagen production. A 2019 scientific report found that Vitamin C at levels from 3 to 10% are one of the quickest long-term solutions for managing hyperpigmentation. 
Vitamin C can be applied mostly through serums. It is also included in some brightening creams and sunscreens. Ideally, it should be applied once daily after cleansing and moisturising.
Retinoids are also known as Vitamin A and they are just as powerful (if not, more) as Vitamin C. Mainly used to treat signs of ageing, they also double up as solutions to treat acne and hyperpigmentation.
A 2016 study which took place for 24 weeks learnt that 4% hydroquinone and 1% retinol treatment significantly improved photodamage and melasma, which are 2 types of hyperpigmentation, in participants. 
Retinol products of up to 2% can be purchased over the counter at most pharmacies. However, you should consult a dermatologist if you would like to use retinol products of a higher concentration.
For retinol to work without any harmful side effects, incorporate it once or twice weekly into your skincare routine.
Known as the most popular and strongest AHA (alpha hydroxy acid), the sugar cane derived glycolic acid exfoliates and thickens skin as well as prevents acne and fades dark spots. It also adds another strong barrier in the skin layers which enable the skin to be thickened. Though found mostly in professional chemical peels, it is also an active ingredient in many face washes, moisturisers and serums.
Most products usually contain about 8-30% of glycolic acid. While some may find this concentration mild, it is not typically recommended to use more than 30% once or twice a week to avoid irritation or harmful side effects.
Similar to the application of retinol, it is vital to apply glycolic acid gradually by working your way upwards. Regardless of skin type, glycolic acid is guaranteed to make your skin more sensitive to the sun.
Melasma has been identified as a sub-category of hyperpigmentation. Due to one of the main causes of Melasma being hormonal changes, treating it can be much more challenging as compared to other hyperpigmentation issues. This is due to difficulties in altering the body’s hormonal composition.
This chronic pigmentary skin disorder mostly affects women of Southeast Asian descent as well as patients living close to the equator. Melasma is also known as chloasma.
Physically, melasma presents itself as a mild and faint discolouration of the face before it darkens. Melasma patches may vary in size and distribution. Usually, they tend to develop at a gradual pace depending on the person.
For patients who are pregnant, these patches may gradually disappear a few months after pregnancy. However, this does not always happen. Patients whose melasma patches are not disappearing may want to consider undergoing treatment to remove the patches.
According to experts, the pathology of melasma is complex due to its combination of both extrinsic and intrinsic factors with the inclusion of genetic susceptibility. Studies have shown that excessive UV damage and exposure may aggravate the condition and cause further harm.  Melasma may also complicate the process of post-inflammatory hyperpigmentation, which is caused by damage to the skin such as chemical peels or allergic reactions to certain facial creams.
Studies have also shown that melasma disproportionately affects more women who have darker skin, higher oestrogen sensitivity or are facing excessive stress. While this fact is not one hundred percent verified, melasma may also be caused by the overstimulation of melanocytes when the skin is under heavy exposure to ultraviolet light (UV) from the sun, which is especially common in tropical countries such as Singapore.
The most at risk of developing melasma are:
The condition may appear to be more insidious than others and is also sometimes called the “mask of pregnancy” due to it being a common occurrence among pregnant women. Despite this, women who are not pregnant and men may also develop melasma.
There are three different types of Melasma:
Even with the perfect skincare routine, it may not be sufficient to get rid of melasma patches. One way to fix this is by using only safe skincare products which do not include harsh chemicals or ingredients that easily dry out or burn your skin. Certain cosmetics may include compounds that are inherently harmful to us in the long run. It is also a common mistake made by most individuals to use skin lightening products in hopes of lightening the melasma patches. Most medical professionals warn against using such skin lightening products as they are mostly ineffective and may lead to oral and kidney complications. Most of these skin lightening products may also not be FDA approved.
Individuals with melasma may notice that their condition may worsen after being exposed to the sun for long periods of time. Melasma pigments tend to flare up due to the combinatorial effect of ultraviolet (UV) rays, light and heat being able to accelerate the development of pigmentations.
Working with topical treatments is one of the easiest treatment methods for most individuals as most of these products can be purchased over-the-counter. Combining the use of various creams and medications may reduce the intensity of the dark spots and each medication may potentially maximise each other’s skincare purpose.
Hydroquinone is one of the more popular skincare options and may be combined with other medications such as tretinoin and steroids. The combination of these topical treatments helps to inhibit melanocytes from overproducing melanin. Other solutions such as oral tranexamic acid may also be used to inhibit melanin production. However, this needs to be prescribed by a medical professional.
Professional chemical peels are highly effective due to the combination of several chemical compounds which are used to make the surface layer of the skin blister. Eventually, the chemical peel peels off to reveal a new and more supple layer underneath the skin.
At Cambridge Therapeutics, we offer a wide variety of treatments for various skin concerns. Sylfirm is a revolutionary technology developed in Silicon Valley, treats melasma, redness, fine lines, brightens skin tones, tightening pores, acne scars and skin rejuvenation.
Sylfirm utilises repeated ultra-short pulses (RP) which react only to abnormal blood vessels and tissue membranes. Tiny electrodes generate a powerful electromagnetic field of energy that safely and effectively penetrates the dermal layer. SMART technology selectively treats abnormal skin vessels such as Melasma improved skin tone, clearer and more radiant-looking skin.
Unlike other laser treatments, Sylfirm is safe on tanned and darker skin tones as it targets the dermis and minimises thermo stimulation on the epidermis.
Patients who have undergone or are undergoing the Sylfirm treatment have reported that they experience little to no pain. However, this also depends on external factors such as the patient’s melasma condition.
Results can be observed post-treatment after a single session. For better results, a program of 5 or more planned sessions may be suggested. This, however, depends on the patient’s needs. It is important to communicate both your needs and desires with your doctor, so that they may craft a treatment that best suits you.