Understanding melasma treatment
Melasma appears as symmetrical patches on sun-exposed areas of the face. It is more common in women, and is linked to ultraviolet and visible light, heat, pregnancy, hormonal contraceptives and a genetic tendency.
It behaves differently from other pigmentation: it relapses, it is sensitive to heat as well as light, and it can worsen with aggressive lasers or strong peels. This is why a cautious, long-term plan outperforms an intensive short one.
Treatment combines a prescribed topical regimen, strict photoprotection including visible-light cover, and in-clinic procedures added carefully. Oral adjuncts are considered in selected patients. Expect control and lightening, with periodic flares.
This may suit you if
- Symmetrical brown patches on the cheeks, forehead or upper lip
- Pigmentation that worsens in summer or after sun exposure
- Pigmentation that appeared during pregnancy or with hormonal medication
- Patients willing to maintain daily sun protection long term
What happens at the clinic
- 1
Confirming the diagnosis
Melasma is distinguished from other pigmentation by its pattern and distribution, and any aggravating factors are identified.
- 2
Topical regimen
A prescription combination is started at a strength your skin can tolerate, with instructions on how to increase or pause it.
- 3
Photoprotection
A tinted broad-spectrum sunscreen that also covers visible light is advised, along with practical shade measures.
- 4
Careful procedures
Gentle peels or low-fluence laser toning may be introduced once the skin is stable, at conservative settings and never as a first step.
Aftercare
- Daily tinted broad-spectrum sunscreen, reapplied every few hours outdoors
- Avoid direct heat exposure — cooking over flame, saunas, prolonged sun
- No aggressive scrubs, bleaching or unsupervised lightening creams
- Continue maintenance treatment even after the patches lighten
Possible side effects
- Irritation from active topicals, particularly early on
- Rebound darkening after aggressive treatment or sun exposure
- Relapse during pregnancy, with hormonal medication or in summer
- Partial response in long-standing dermal melasma