What should you know about early melasma?

Melasma appears as flat brown, grey-brown, or tan patches, often on the cheeks, forehead, upper lip, nose, or jaw. It is not an infection and usually does not cause pain or itch. The colour reflects increased pigment activity in the skin and may be influenced by sunlight, visible light, heat, hormonal changes, or irritation. A clinician may diagnose it by examining the pattern and skin surface; other causes of dark patches can look similar.

Use broad-spectrum sunscreen as directed, reapply when outdoors, and add shade, a hat, or other physical protection. Choose gentle, fragrance-free skincare and stop products that sting or inflame the skin. A dermatologist can discuss prescription pigment treatments or procedures such as a chemical peel, microneedling, skin brightening treatment, or laser toning. Procedures can irritate some skin types and may worsen pigmentation, so treatment should be selected and tested carefully.

Arrange an assessment if a new patch is one-sided, raised, scaly, bleeding, itchy, or changing in shape, because those features are less typical of uncomplicated melasma. Seek care for sudden widespread pigmentation, pigment around the eyes with swelling, or a reaction after a cream or procedure. A clinician can distinguish melasma from other dark patches and identify an irritant or medicine that may be contributing.

Ask whether the pattern fits melasma, what may be triggering it, and which daily products are least irritating. Discuss pregnancy, breastfeeding, hormone medicines, and your tendency to develop dark marks before starting treatment. If considering a procedure, ask about test areas, downtime, the risk of post-inflammatory darkening, and how progress will be judged.