What should you know about deep melasma?

Melasma usually appears as fairly even brown, grey-brown, or darker patches on the cheeks, forehead, upper lip, or jaw. When pigment lies deeper, the colour can look more grey and may be less responsive to surface-only products. Sunlight and visible light can encourage pigment activity, and heat or hormonal changes may contribute for some people. Dark patches and uneven skin tone can have other causes, so a clinician may examine the pattern before calling it melasma.

Use broad-spectrum sunscreen as directed, reapply during prolonged outdoor exposure, and add shade, a hat, or other physical protection. Choose gentle, fragrance-free skin care and avoid picking or irritating treatments that leave the skin inflamed. A clinician may discuss prescription lightening treatment or procedures such as chemical peels, microneedling, skin brightening treatment, or laser toning. Deeper pigment needs careful selection because irritation can make discolouration more noticeable. Take photographs in consistent lighting so gradual changes are easier to judge.

Arrange assessment if pigmentation appears suddenly, changes quickly, bleeds, crusts, itches persistently, or does not follow a typical facial pattern. Seek advice before a procedure if your skin is irritated, recently tanned, or prone to dark marks after inflammation. A new or changing spot should not be assumed to be melasma.

Ask whether the colour and distribution fit melasma, how deep the pigment appears, which daily products to use, and how to reduce the chance of irritation or rebound darkening during treatment.