When to worry about dark patches on skin with melasma

Melasma causes brown or grey-brown areas, often on the cheeks, forehead, nose, upper lip, or jawline. It is commonly seen in a fairly symmetrical pattern and may become more visible after light exposure or hormonal changes. Similar-looking marks can have other causes, so a new or unusual patch should not be labelled from appearance alone.

Use broad-spectrum sun protection, shade, hats, and gentle skin care to reduce darkening from light and irritation. Avoid picking, harsh scrubs, and unprescribed bleaching mixtures. Take photographs in similar lighting and note pregnancy, hormonal medicines, new products, or recent irritation, then share this information at an appointment.

Arrange prompt assessment for a spot that is one-sided, rapidly enlarging, raised, scaly, painful, persistently itchy, crusted, or bleeding. A lesion that looks unlike the surrounding melasma also deserves review. Seek urgent care for severe swelling, blistering, or a rapidly worsening reaction after a product or treatment.

Ask whether the pattern is consistent with melasma, what might be maintaining it, and which treatment options suit your skin. Ask how to combine treatment with light protection and what changes should trigger an earlier follow-up.