When is chemical peel recommended for melasma?

Melasma causes brown or grey-brown patches, often on the cheeks, forehead, nose, or upper lip. A peel can reduce some surface pigment, but irritation may stimulate more colour, especially in skin that darkens after inflammation. The clinician therefore considers the pattern, skin tone, previous reactions, pregnancy or breastfeeding status, and current products before choosing a peel.

Peels are generally an add-on rather than the only measure. A stable routine that limits ultraviolet and visible-light exposure is central, and any active dermatitis or recent tanning may postpone treatment.

Bring a list of skincare products and medicines, including lightening agents, retinoids, and exfoliating acids. Do not start or stop prescription treatment without advice. Avoid intentional tanning and tell the clinic about recent waxing, threading, laser treatment, sunburn, or a history of cold sores.

After a peel, use only the recommended gentle cleanser and moisturiser until the surface settles. Apply sunscreen as directed and use physical shade where possible. Do not pick flakes or judge the final colour while the skin is irritated; schedule review so the plan can be adjusted if pigment returns or sensitivity develops.

Contact the clinic for severe burning, increasing swelling, extensive blistering, weeping, pus, or pain that is worsening rather than settling. Seek urgent help if facial swelling affects breathing or eyesight. A single dark patch that changes quickly, bleeds, or crusts should be assessed as a skin lesion, not assumed to be melasma.

Ask whether your melasma is calm enough for a peel, what preparation reduces the chance of irritation, how light exposure will be managed, and which products must be paused. Clarify how progress will be reviewed and what to do if the patches darken after treatment.