Melasma
Melasma is a common chronic pigmentary condition that causes symmetrical brown or grey-brown patches on the face. It most commonly affects the cheeks, forehead, upper lip and chin, and is particularly common in women and individuals with darker skin types. While melasma is harmless, it can be persistent and may recur over time.
Unlike freckles or sun spots, melasma is influenced by a combination of hormones, sun exposure, genetics and inflammation. Successful management often requires a long-term approach that combines sun protection, medical skincare and carefully selected treatments.
The Science Behind Pigmentation
What Causes Pigmentation?
Skin colour is determined by melanin, a natural pigment produced by specialised skin cells called melanocytes.
Pigmentation occurs when there is an abnormal distribution of melanin. This can occur over different parts of the Melanin Synthesis Pathway.
Melanin production may increase in response to:
Sun exposure
Visible light
Heat
Hormonal influences
Inflammation
Certain medications
Genetic predisposition
What Is Melasma?
Melasma is a disorder of increased pigmentation in which the skin produces excess melanin, resulting in patches of darker skin. It is a complex pigmentary disorder with multiple contributing factors.
Increased melanin production
Visible blood vessels
Overactive melanocytes
Skin barrier dysfunction
Chronic ultraviolet (UV) exposure
Chronic low-grade inflammation
These factors help explain why melasma may recur even after successful treatment.
What Causes Melasma?
Melasma is a multifactorial condition, meaning that several factors often contribute simultaneously.
Sun Exposure or Visible Light
Such as high energy blue light
Where Does Melasma Occur?
Melasma most commonly affects:
Cheeks
Forehead
Upper lip
Chin
Less commonly, it may affect:
Neck
Forearms
The pigmentation is usually symmetrical on both sides of the face.
Why Is Melasma Different From Other Pigmentation?
Melasma differs from many other pigmentary conditions because it is a chronic disorder rather than a simple accumulation of pigment.
Unlike sun spots, melasma often involves:
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Epidermal pigmentation
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Increased vascularity
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Dermal pigmentation
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Chronic inflammation
For this reason, treatment often requires multiple approaches rather than a single procedure. There is no cure for melasma and maintenance treatments are usually required to prevent recurrence.
Treatments for Melasma
Medical Therapy
Prescription topicals or oral medications form the foundation of melasma management.
Depending on individual assessment, medical treatments aim to:
Reduce melanin production
Improve skin turnover
Support skin barrier function
Reduce oxidative stress
Daily sunscreen remains essential to minimise recurrence.
Adjunct Treatments For Melasma
Cosmelan® and Dermamelan® are doctor-supervised depigmentation programmes that target multiple biological pathways involved in melasma, rather than simply removing existing pigment. Through a combination of depigmenting agents, antioxidants and skin-renewing ingredients, they help regulate melanocyte activity, reduce melanin production, minimise oxidative stress and inflammation, and promote the gradual removal of pigmented skin cells through epidermal renewal.
Unlike laser treatments, they do not rely on thermal energy, making them a valuable treatment option for selected patients with melasma and those at higher risk of treatment-induced post-inflammatory hyperpigmentation.
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Can Melasma Be Permanently Cured?
Melasma is generally considered a chronic condition and cannot be permanently cured.
While treatment may improve pigmentation, recurrence is common because the underlying triggers often remain present.
Long-term management focuses on:
Sun Protection
Appropriate Skincare
Maintenance treatment where appropriate
Reducing known triggers
How Can I Prevent Melasma From Returning?
Although recurrence cannot always be prevented, the following measures may reduce the likelihood of relapse:
Apply broad-spectrum sunscreen every day
Reapply sunscreen during prolonged outdoor activities
Wear hats and seek shade
Avoid excessive heat exposure where possible
Treat inflammation early
Maintain a consistent skincare routine
Follow maintenance recommendations after treatment
When Should You Seek Medical Advice?
Medical assessment may be beneficial if:
Pigmentation develops suddenly
Pigmentation worsens despite skincare
Pigmentation is affecting quality of life
The diagnosis is uncertain
Previous treatments have been unsuccessful
A careful assessment helps determine whether the pigmentation is melasma or another pigmentary condition requiring a different treatment approach.
Melasma FAQs
*This information is for educational purposes only and is not intended as a substitute for medical advice. We recommend a clinical consultation for a plan tailored to your unique anatomy.*
