What should you know about stubborn melasma?

Melasma is increased pigment in characteristic facial patterns, commonly across the cheeks, forehead, upper lip, or jawline. Sunlight and visible light can deepen it, while hormonal changes, heat, and skin irritation may contribute. Colour can sit at different depths, so patches may respond unevenly. Persistent facial darkening should be assessed rather than assumed to be melasma, because other causes can look similar.

Use broad-spectrum sunscreen and physical light protection such as a hat, while limiting avoidable heat and friction. Keep cleansing and moisturising gentle. A dermatologist may recommend a pigment treatment, chemical peel, microneedling, or laser toning after considering your skin tone, depth of pigment, and tendency to darken after irritation. Introduce one active plan at a time and stop products that burn or inflame the skin.

Arrange an assessment when patches appear suddenly, change in shape or colour, affect one unusual area, itch or bleed, or fail to match the usual pattern of melasma. Seek advice before a procedure if you are pregnant, breastfeeding, using irritating products, or have previously developed dark marks after skin injury.

Ask whether the pattern fits melasma or another cause of dark patches, which light protection is suitable, and how to reduce the chance of post-treatment darkening. Discuss the expected course, maintenance plan, and what to do if irritation occurs.