SINGAPORE - Pigmentation on the face is a distressing problem to many women.

The most distressing form of pigmentation is melasma.

Melasma occurs in those who are in their 40s and beyond and usually worsens around perimenopause (the stage of a woman's reproductive life that begins several years before menopause, when the ovaries gradually begin to produce less oestrogen) and menopause. It presents itself as irregularly shaped patches of light to dark brown pigmentation.

The patches are mainly on the upper lip, nose, cheeks, forehead and sometimes on the chin and neck. In men it's usually over the cheeks and sometimes over the forehead.

It's a chronic disorder that is disfiguring to patients and medically very difficult to treat. This is why many patients would have found no difference or worsening of the pigmentation after many sessions at the beauty parlours. Melasma can get darker after treatment with Intense Pulsed Light (IPL) or any therapy involving heat and light or fruit acids if too aggressive.

Hyperpigmentation due to burns can be persistent.

Post-inflammatory hyperpigmentation, especially on tanned skin, can be very hard to clear. Uneven skin tone is common especially with Indian skin - mostly darker on the forehead and around the mouth. Hyperpigmentation can also occur around the neck, usually due to wearing a heavy gold chain.

All the three conditions are medically difficult to treat. Thus it is best to seek doctors who specialise in such treatments. Medical treatment comprises a regime of medical-grade lightening creams and/or special chemical peels designed for treating hyperpigmentation.

Avoidance of direct sun exposure is very important especially for melasma.

Dr Komathy Rajaratnam is the founder of The Lifestyle Clinic at 16-03 Camden Medical Centre, Tel: 6733-0788. Her articles in upcoming issues will deal with beauty and aesthetic issues relevant to the Indian body type.

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