Melasma: causes, care and treatment options

Melasma causes symmetrical brown or grey-brown patches, most often on areas of the face exposed to light.

It is a pigment condition rather than an infection or a cancer. Patches often appear across the cheeks, forehead, nose, upper lip, or jawline. The colour can sit at different depths in the skin, which helps explain why the response to treatment varies from person to person.

Dark Patches On Skin and Uneven Skin Tone are very common presentations of melasma. The patches are usually flat, with no scale or open wound, and often mirror one another on the face. Melasma itself is not usually painful or itchy; a new rash, marked irritation, or a changing raised lesion needs a separate assessment.

Melasma reflects increased pigment production in response to several influences. Sunlight and visible light can deepen existing patches. Heat, hormonal changes, pregnancy, some hormonal medicines, genetics, and irritation from unsuitable skin products may contribute. Different triggers can matter at different times for the same person.

Patches can become darker after light exposure or hormonal shifts and may fade when triggers settle. The condition can recur, including after an initially good response to treatment. A steady routine that limits triggers is therefore part of management, rather than something used only during a treatment course.

Melasma is more likely in people with a personal or family tendency to pigment changes, in those exposed to strong daylight or heat, and during periods of hormonal change. Skin that tans readily may be particularly prone to visible discolouration after irritation. These factors guide prevention; they do not determine who will develop the condition.

Diagnosis is usually based on the distribution and colour of the patches, your medical history, and a close skin examination. A dermatologist may use a specialised light or magnification to help distinguish superficial from deeper pigment. They may also consider other causes of facial discolouration, particularly if the pattern is unusual or a patch has changed quickly.

Treatment often combines strict light protection with prescription or clinician-guided pigment treatments. Topical medicines can reduce pigment production or increase skin-cell turnover. Some people may be offered oral medicine after an individual safety assessment. Procedures such as peels, lasers, or microneedling need careful selection because inflammation can worsen pigment in susceptible skin.

Choose gentle cleansing and moisturising products that do not sting, and introduce active treatments exactly as directed. Make sun protection a habit before driving, walking outdoors, or sitting near strong daylight. If a product causes burning, swelling, or peeling, pause it and contact the clinician who recommended it instead of trying to push through irritation.

Overly strong products, frequent exfoliation, or unsuitable procedures can trigger inflammation and post-inflammatory darkening. Some prescription treatments are not appropriate during pregnancy, breastfeeding, or with certain health conditions. Tell the clinician about pregnancy plans, medicines, clotting history, and previous reactions before starting a new treatment.

Consistent broad-spectrum sun protection, shade, a hat, and avoidance of skin irritation can reduce the triggers that make patches more noticeable. Reapply sun protection according to the product instructions when you are outdoors. Review hormonal medicines with the prescriber if you think they coincide with pigment changes; do not stop prescribed medicine on your own.

See a dermatologist when facial patches are new, spreading, distressing, or not responding to a careful routine. Specialist assessment is also useful before peels, lasers, or oral pigment treatments. Bring the products you use or photographs of their labels, as this can reveal a possible irritant or a treatment that should not be combined with another.