Clinical Dermatology

Melasma Treatment

Melasma is a manageable but often recurring condition -- honest, sustained treatment works better than chasing a quick fix.

Book a Melasma Consultation

Noticing symmetric brown patches on your face?

Melasma typically appears as symmetric brown-to-grey patches on the cheeks, forehead, or upper lip. An evaluation confirms the diagnosis and distinguishes it from other forms of pigmentation.

Already diagnosed and looking for a management plan?

If you know you have melasma and it's not responding to over-the-counter products, we'll build a realistic, sustained treatment and prevention plan around your specific pattern.

Melasma is a common form of facial pigmentation that typically appears as symmetric brown-to-grey-brown patches, most often on the cheeks, forehead, upper lip, or chin. It’s driven by a combination of genetic susceptibility, hormonal factors (which is why it’s common during pregnancy and with certain hormonal medications), and sun or even visible light exposure, which makes it considerably more stubborn and recurrence-prone than most other forms of pigmentation.

We treat melasma honestly as a chronic, manageable condition rather than something with a one-time cure. Patients who understand this from the outset tend to have better long-term results than those expecting pigmentation to disappear permanently after a single treatment course.

What to Expect at Your Visit

We examine the pattern and, where useful, depth of pigmentation, and take a history covering pregnancy, hormonal medications, sun exposure habits, and any prior treatments tried. This helps confirm the diagnosis and rules out other causes of facial pigmentation that would need a different approach.

Treatment Approach

Topical combination therapy, using prescription-strength agents over an extended period, forms the backbone of melasma treatment. Chemical peels can be added carefully, since overly aggressive peeling can worsen melasma in some patients rather than help it — peel selection is more conservative here than for other pigmentation types.

Strict, daily sun protection isn’t optional guidance for melasma — it’s a core part of treatment, since UV and even indoor visible light exposure are established triggers for flares. Skipping this step routinely undoes months of otherwise effective treatment.

Setting Realistic Expectations

Melasma responds to treatment, often significantly, but it is prone to recurrence — particularly with sun exposure, pregnancy, or hormonal changes — and many patients need periodic maintenance treatment over the years rather than a single resolved course. We set this expectation clearly at your first visit so treatment decisions are made with the full picture, not a false promise of permanence.

How We Evaluate

Skin examination under Wood's lamp where useful for depth assessment
Assessment of triggers: sun exposure, hormonal factors, pregnancy, certain medications
Distinguishing melasma from other causes of facial pigmentation

Treatment Options

Topical Combination Therapy: Prescription topical regimens, often combining multiple active ingredients, used consistently over an extended period.
Chemical Peels: Carefully selected peels as an adjunct to topical therapy, chosen to avoid triggering further pigmentation in melasma-prone skin.
Strict Sun Protection Protocol: A non-negotiable component of melasma management -- UV and even visible light exposure are major triggers for flares and recurrence.

Conditions We Manage

Condition

Melasma

Frequently Asked Questions

What causes melasma?

Melasma is driven by a combination of genetic susceptibility, hormonal factors -- which is why it's common during pregnancy or with hormonal medications -- and sun or visible light exposure, which makes it more stubborn and recurrence-prone than most other pigmentation.

Is melasma permanent?

Melasma responds to treatment, often significantly, but it's prone to recurrence, particularly with sun exposure, pregnancy, or hormonal changes. We treat it as a manageable, chronic condition rather than promising a one-time permanent cure.

Is melasma related to pregnancy?

Yes, hormonal changes during pregnancy are a well-recognized trigger for melasma, sometimes called the "mask of pregnancy." It often persists after delivery and benefits from evaluation and a sustained management plan.

Does melasma come back after treatment?

It can, particularly with sun exposure, pregnancy, or hormonal changes. Many patients need periodic maintenance treatment over the years rather than a single resolved course, which we explain clearly at your first visit.