Melasma pathology: what to know

Melasma begins with increased activity in pigment-producing cells. These cells make more melanin, the substance that gives skin its colour, and transfer it into nearby skin cells. Pigment may sit closer to the surface or extend deeper, which affects how the patch looks and how it responds to treatment. Light can stimulate pigment activity; hormonal signals, heat, and inflammation may add to that response. The result is usually a flat, uneven area rather than a growth.

Daily broad-spectrum sunscreen, shade, and physical coverage reduce light signals that can maintain pigment. Gentle products help avoid inflammation, while treating acne, eczema, or irritation can remove another trigger. A dermatologist may choose topical treatment based on the colour and depth of the pigment. Procedures including Chemical Peel, Microneedling, Skin Brightening Treatment, or Laser Toning can be considered selectively, since skin injury may temporarily increase pigment in some people.

Seek assessment for a patch that is raised, crusted, bleeding, painful, persistently itchy, or rapidly changing, because those features are not typical of a simple flat pigment pattern. Arrange a review if several products have caused burning or if a procedure has led to worsening colour. A clinician can examine the skin and decide whether another diagnosis needs investigation.

Ask whether the pigment appears superficial or deeper, which triggers are most relevant in your case, and how to protect the skin from both outdoor and incidental light. Discuss expected irritation, preparation, and follow-up before starting a peel, needling treatment, or laser-based option.