Is melasma safe in skin of colour?

Melasma appears as flat brown, grey-brown or tan patches, often on the cheeks, forehead, upper lip and jawline. In skin of colour, pigment cells can respond strongly to sunlight, visible light, inflammation and irritation. That can make patches more noticeable and can leave temporary darkening after spots or procedures have healed. Melasma itself is not an infection and does not usually damage the skin, but a changing, raised, bleeding or crusted mark should not automatically be labelled melasma.

Use shade, a hat and clothing that covers exposed areas, then apply broad-spectrum sunscreen as directed. A tinted product containing suitable visible-light protection may be useful for some people; a clinician can help choose one that matches your skin. Keep cleansing and moisturising gentle, and stop products that sting or burn. Before a peel, laser, light treatment or strong fading cream, ask a dermatologist experienced with your skin tone about settings, test areas and the possibility of post-inflammatory darkening. Slow, steady improvement is safer to plan for than aggressive treatment.

Arrange a dermatology review when facial patches persist, recur, spread or are difficult to distinguish from another condition. Seek prompt assessment for a single mark that changes shape or colour, becomes raised, bleeds, ulcerates or develops a persistent crust. Get urgent help for rapidly spreading redness, swelling, blistering or severe pain after a product or procedure. Bring the products you use and describe any previous reaction or darkening after injury.

How confident are you that these patches are melasma? Which protection helps with both ultraviolet and visible light? What is the risk of darkening with the proposed treatment for my skin tone? Would a small test area or a gentler starting plan be appropriate?