How is melasma treated?

Melasma causes darker, often symmetrical patches, commonly on the cheeks, forehead, upper lip, or jaw. Sunlight and visible light can deepen pigment, while hormones and heat may contribute for some people. A clinician first checks that the colour change is melasma rather than another cause of dark patches or sun-damaged skin.

Use broad-spectrum sunscreen, protective clothing, shade, and a hat; reapply sunscreen as directed during outdoor exposure. A dermatologist may prescribe topical pigment treatments or discuss tranexamic acid for melasma after reviewing medical history and clotting risks. Chemical peels, microneedling, or skin brightening treatment can be considered, but overly aggressive procedures may worsen pigmentation, particularly in deeper skin tones. Gentle cleansing and moisturising help the skin tolerate treatment.

Seek assessment if a patch is one-sided, rapidly changing, itchy, bleeding, scaly, or unlike your usual melasma. Arrange review when treatment causes marked burning, swelling, blistering, or darker pigment. Discuss pregnancy, breastfeeding, hormonal medicines, and clotting history before starting prescription treatment.

Is this melasma or another pigment disorder? Which light-protection routine fits my lifestyle? Would a topical medicine or tranexamic acid be suitable? How can a procedure be adjusted for my skin tone?