What should you know about dermoscopy of melasma?

A dermatologist places a dermatoscope over the skin to magnify details that are difficult to see with the naked eye. With melasma, the view can help show whether colour is mainly within the upper skin layers or appears deeper, and whether pigment follows a fairly even facial pattern or has mixed features. It can also help separate melasma from look-alike conditions such as post-inflammatory darkening or a pigmented mole. Dermoscopy does not by itself prove a diagnosis or explain every cause of facial pigmentation.

Attend with clean skin if your clinic requests it, and tell the clinician about recent sun exposure, irritation, pregnancy, medicines, and products used on the area. The examination is usually performed during a skin consultation and does not require a cut or injection. Your clinician may combine the dermoscopic view with a history and direct examination before suggesting pigment care. Protecting the face from ultraviolet and visible light, avoiding unnecessary irritation, and following the recommended routine can support the assessment and treatment plan.

Arrange a dermatology review for facial pigmentation that is new, changing, itchy, bleeding, crusting, painful, or different from the surrounding patches. Seek prompt assessment if one spot becomes noticeably darker or develops an irregular border. These features do not identify a particular diagnosis on their own, but they deserve direct examination rather than self-treatment. A changing solitary mark may need a different assessment from a broad, symmetrical pattern of melasma.

Ask whether the pattern fits melasma, which skin layer seems most involved, what other diagnoses were considered, and how progress will be monitored. You can also ask whether a dermatoscope is needed at follow-up and which ingredients or procedures could worsen irritation or darkening.