What should you know about deep melasma treatment?

Melasma is a pattern of facial pigmentation, often affecting the cheeks, forehead, upper lip, or jaw. Deeper pigment may appear grey-brown and can be slower to change because pigment is not confined to the most superficial skin. Sunlight, visible light, heat, hormonal shifts, and irritation can all influence its appearance. A clinician may distinguish melasma from sun-damaged skin, post-inflammatory pigment, or another cause of dark patches before recommending a procedure.

Start with daily broad-spectrum sunscreen, reapplication during outdoor exposure, shade, and a hat. Use a gentle cleanser and moisturiser, and stop products that sting or cause peeling unless your clinician has specifically included them. Depending on your skin and pigment pattern, a clinician may suggest a prescription regimen or an in-clinic option. Chemical peels work at the surface, microneedling creates controlled skin channels, skin brightening treatment may target uneven colour, and laser toning uses light energy. These choices require appropriate settings and aftercare because inflammation can deepen visible pigment.

Seek assessment before treatment for a rapidly changing patch, bleeding or crusting area, persistent itch, or pigmentation with an unusual shape. After a procedure, contact the clinic for blistering, severe pain, marked swelling, pus, or worsening darkening. Do not add another exfoliant or energy treatment to irritated skin without advice.

Ask how the diagnosis was made, whether a topical plan should come first, which procedure suits your skin tone, what downtime to expect, and how relapse or post-treatment darkening will be managed.