Melasma Dark Spots on the Face: What to Know

Melasma often appears as fairly even brown or grey-brown patches on areas exposed to light, including the cheeks, forehead, nose, and upper lip. It is a condition that presents with facial pigmentation; the presence of a dark spot does not by itself identify the cause. Post-inflammatory hyperpigmentation may follow acne, eczema, burns, or an injury. Sun spots and tinea versicolor have different patterns and treatment needs.

A clinician considers the shape, scale, texture, distribution, timing, medicines, hormonal context, and recent inflammation. This helps separate melasma from other conditions before a peel, brightening treatment, or laser is considered.

Photograph the area in steady lighting and note when it began, whether it changes with sun exposure, and whether any rash or irritation came first. Use gentle cleanser and moisturiser, avoid picking or aggressive exfoliation, and protect exposed skin from sunlight. These measures help limit extra pigment while the cause is clarified.

Once melasma is confirmed, options may include a tailored topical routine, chemical peel, skin brightening treatment, or picosecond laser treatment. The choice depends on skin sensitivity and pigment depth, and treatment should be adjusted if inflammation appears. A gradual plan is safer than chasing rapid lightening with repeated irritation.

Book an assessment for a new or changing mark, especially if it is raised, scaly, crusted, bleeding, painful, persistently itchy, or clearly unlike nearby patches. Seek prompt care for sudden widespread pigment change or a reaction after treatment. Cosmetic lightening should wait until a clinician has considered these features.

Ask what features support melasma, what alternatives should be excluded, and whether the pigment seems close to the surface or deeper. Discuss suitable sunscreen, preparation before a procedure, the chance of post-treatment darkening, and how progress will be reviewed.