What should you know about melasma on African American skin?

Melasma can appear as brown, grey-brown, or deeper patches on the cheeks, forehead, upper lip, or other exposed areas. In richly pigmented skin, inflammation from acne, eczema, burns, rubbing, or harsh products may leave post-inflammatory darkening alongside melasma. Colour alone cannot confirm the diagnosis. The clinician should consider texture, distribution, recent irritation, medicines, pregnancy or hormonal changes, and sun or visible-light exposure.

Choose fragrance-free, gentle skincare and protect exposed skin from sunlight and visible light with sunscreen, shade, and clothing where practical. Stop scrubbing and avoid unregulated bleaching products. Treatments should be introduced carefully, with attention to irritation and uneven colour. A dermatologist may discuss prescription care or skin brightening treatment; chemical peel, microneedling, and laser toning should be selected and performed by an experienced professional familiar with deeper skin tones.

Arrange an assessment for a new or changing patch, especially if it is raised, scaly, painful, bleeding, crusted, or persistently itchy. Seek advice when darkening follows a procedure or product and continues after the irritation settles. A careful diagnosis helps prevent treating the wrong condition or adding avoidable inflammation.

Ask how your skin tone affects treatment choice, whether a test area is appropriate, and how irritation will be prevented. Discuss the difference between melasma and post-inflammatory pigment, when to expect visible change, and what to do if the area becomes darker.