Melasma Types and Why They Matter

Clinicians may describe melasma by where patches appear: across the centre of the face, along the cheekbones or near the jawline. They may also describe pigment as epidermal, dermal or mixed, referring to its position in the skin. Surface pigment can look light to medium brown, while deeper pigment may appear grey-brown or blue-grey and can be harder to change. These labels are clinical descriptions, not separate illnesses. A Wood's lamp or another examination method may help, but the appearance alone does not identify every dark mark as melasma. Sun-damaged skin and post-inflammatory colour can look similar.

Begin with light protection, because ultraviolet and visible light can deepen several melasma patterns. Use a gentle routine and avoid repeated irritation. A clinician may select a topical pigment treatment for the pattern and depth, then assess the response before considering a procedure. Chemical peel, microneedling, skin brightening treatment or laser toning may be discussed, but the risk of inflammation differs with skin tone, sensitivity and pigment location. Deeper or mixed pigment may need a longer, maintenance-focused plan. Take clear photographs in similar lighting to help track gradual change, and do not compare your progress with someone whose pattern is different.

Seek assessment for a patch that is new, isolated, rapidly changing, raised, scaly, painful or bleeding. Arrange review if colour does not fit a typical symmetrical facial pattern or if a treatment causes prolonged redness, crusting or worsening darkening. Correct identification matters before using a peel, needle-based treatment or laser.

Ask which pattern and pigment depth you appear to have, whether another condition should be excluded, which option fits your skin tone, how progress will be assessed, and what maintenance will help limit recurrence.