Melasma

Melasma is a specific, hormonally-linked form of pigmentation that causes symmetrical, blotchy patches, most often across the cheeks, forehead, upper lip or chin. It’s frequently triggered or worsened by pregnancy, the contraceptive pill, hormone therapy or oestrogen fluctuations, and is made worse by both UV and visible light exposure.

Why melasma behaves differently to general pigmentation

Melasma tends to be more stubborn than sun-related pigmentation and has a strong tendency to return, particularly after further sun exposure or a hormonal change, even once it has faded. It can also sit at different depths in the skin, and deeper, dermal melasma responds to a much narrower range of treatments than surface-level pigmentation does. Treating melasma with the wrong approach, an active designed for general pigmentation rather than melasma specifically, can sometimes make it worse rather than better, which is part of why an accurate diagnosis matters more here than with most other pigmentation.

What actually helps

Daily, high-level broad-spectrum sun protection is the single most important habit for anyone with melasma, since both UV and visible light can trigger flares. Gentle, non-irritating skincare limits additional inflammation-related pigmentation building on top of melasma. For superficial or mixed-depth melasma, in-clinic options such as a structured peeling programme are sometimes used, though outcomes vary between individuals and rebound is common without strict, ongoing sun protection. Deeper melasma generally needs a more cautious, professionally guided approach rather than a standard pigmentation treatment.

When to seek professional advice

Because melasma can be difficult to distinguish from other forms of pigmentation without a proper assessment, and because the wrong treatment can worsen it, getting an accurate diagnosis before starting any active treatment is a genuinely important first step, rather than assuming any dark patch will respond the same way.