How common is uneven skin tone in melasma?

Most people with melasma notice uneven skin tone as patches rather than raised spots, sores, or a change in skin texture. The colour may be light brown, deeper brown, or grey-brown, and patches often occur on the cheeks, forehead, nose, upper lip, or jawline. They are commonly similar on both sides of the face, although the pattern can vary.

Melasma can become more noticeable after sunlight or visible light exposure. Heat, hormonal changes, and skin irritation may also make pigmentation look darker in some people. The colour can fade and return over time, so a period of improvement does not necessarily mean the tendency has gone away.

Use broad-spectrum sun protection on exposed skin and reapply as directed, especially when outdoors. A hat, shade, and clothing that covers the face can add protection. Choose gentle, fragrance-free skincare when possible, because stinging or peeling products can worsen the appearance of dark patches.

A dermatologist can confirm whether the pattern fits melasma and discuss suitable treatment, such as prescription lightening medicines, procedures, or a combination. Do not use an unlabelled bleaching product or a strong steroid cream on the face without medical guidance; these can injure the skin or create new colour changes.

Arrange a skin assessment if the diagnosis is uncertain, the patches are changing quickly, or pigmentation is limited to one unusual spot. Seek prompt medical advice for a mark that bleeds, crusts, becomes painful, develops a firm or raised area, or does not resemble the surrounding patches. These features need assessment because not every change in skin colour is melasma.

Ask whether the distribution and colour of your patches are consistent with melasma, what may be triggering darkening, and which treatment is appropriate for your skin type. You can also ask how to protect your skin from sunlight and visible light, how long to try a treatment before review, and which symptoms should prompt an earlier appointment.