When to worry about uneven skin tone with melasma

Melasma is a pigment condition that commonly creates tan, brown, or grey-brown patches on areas such as the cheeks, forehead, upper lip, and jaw. Most people with Melasma notice uneven skin tone, often with fairly similar areas on both sides of the face. Sunlight and visible light can deepen the colour, and hormonal changes or heat may contribute for some people. Similar-looking pigmentation can have other causes, so location and pattern are useful clues rather than a diagnosis.

Use shade, a hat, and daily broad-spectrum sunscreen, then reapply as directed when outdoors. Choose gentle, non-irritating products and stop any product that causes burning or a rash. Take photographs in similar lighting so gradual changes are easier to describe. A dermatologist can discuss prescription options or procedures after considering your skin tone, pregnancy or breastfeeding status, medicines, and the risk of irritation or darker marks.

Arrange an appointment if the colour continues to change despite protection, returns after treatment, causes persistent irritation, or does not follow a symmetric patch pattern. Seek prompt assessment for a spot that grows quickly, develops several colours, crusts, bleeds, becomes painful, or differs clearly from nearby marks. Do not use strong lightening products on a suspicious or broken area before it has been examined.

Does the pattern fit melasma or another pigment condition? Which sunscreen and treatment are suitable for my skin and current medicines? How should I respond if a patch becomes irritated or darker?