Melasma is one of the most frustrating skin concerns we treat — partly because it is so visible, and partly because the wrong treatment can make it dramatically worse.
What exactly is melasma?
Melasma is the appearance of symmetrical brown or grey-brown patches, usually across the cheeks, forehead, upper lip and bridge of the nose. It is far more common in women, particularly Indian women in the 25–55 age group.
Why it happens
Three factors typically combine: genetic predisposition, hormonal triggers (pregnancy, oral contraceptives, hormonal IUDs), and sun exposure — both UV and visible light.
What NOT to do
Avoid steroid-based fairness creams sold at general stores. They cause rebound darkening, skin thinning and a condition called steroid-induced rosacea that is far worse than the original melasma.
What works
A dermatologist-led plan combining sunscreen with iron oxide (for visible-light protection), topical agents like tranexamic acid or modified Kligman's formula, monthly chemical peels, and in some cases low-fluence Q-switched laser toning.
Realistic expectations
Melasma is *managed*, not cured. With consistent care most patients see 60–80% improvement in 3–6 months and maintain it long-term with sunscreen and a maintenance topical.
Frequently asked questions
Melasma is a common skin condition that causes brown or grey-brown patches on the face, especially on the cheeks, forehead, nose, and upper lip. It is often triggered by sun exposure and hormonal changes.
Melasma can be caused by multiple factors including sun exposure, hormonal fluctuations, pregnancy, birth control pills, genetics, thyroid disorders, and certain skincare products.
Melasma is usually a chronic condition, but it can be controlled effectively with proper treatment, sun protection, and maintenance skincare.
Yes. UV rays and even visible light can stimulate excess pigment production, making melasma darker and more noticeable. Daily sunscreen use is essential.
Yes. Melasma commonly develops during pregnancy due to hormonal changes and is sometimes called the "mask of pregnancy."
Melasma is not dangerous or contagious, but it can affect self-confidence and quality of life due to its cosmetic appearance.
A dermatologist usually diagnoses melasma through clinical examination. In some cases, Wood's lamp examination may help assess pigment depth.
Treatment options may include topical creams, chemical peels, laser treatments, oral medications, and customised pigmentation management plans depending on the severity.
Melasma can improve significantly with treatment, but recurrence is common if sun protection and maintenance care are not followed consistently.
Broad-spectrum sunscreens with SPF 30 or higher, preferably containing iron oxides for visible light protection, are generally recommended for melasma-prone skin.
Home remedies may provide temporary improvement in some cases, but improper use can irritate the skin and worsen pigmentation. Dermatologist-guided treatment is safer and more effective.
Stress may indirectly worsen melasma by influencing hormonal balance and skin inflammation in some individuals.
Yes. Although more common in women, melasma can also affect men, especially those with frequent sun exposure or genetic predisposition.
Visible improvement may take several weeks to months depending on the depth of pigmentation, treatment type, and adherence to sun protection.
Daily sunscreen use, avoiding excessive sun exposure, wearing protective clothing, and following maintenance skincare can help reduce recurrence.