Conditions

Melasma

Melasma is a common pigmentation condition causing symmetrical brown or grey-brown patches, most often on the face. It's notoriously stubborn to treat and can be frustrating to live with, but with the right combination of daily sun protection, medical treatment, and — where appropriate — professional cosmetic treatment, it can be significantly improved and well managed.

What causes melasma?

Melasma develops from a combination of factors:

  • Hormonal changes — including pregnancy (sometimes called the "mask of pregnancy"), the contraceptive pill, hormone replacement therapy, and menopause
  • UV and visible light exposure — the primary trigger and the reason melasma so often worsens with sun exposure, even from everyday incidental exposure through windows or on overcast days
  • Heat and inflammation — which can worsen melasma independently of light exposure
  • Genetics — a family history of melasma increases the likelihood of developing it

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What medical treatments are available for melasma?

Daily, consistent sun protection is the foundation of every melasma treatment plan — without it, other treatments are far less effective and melasma tends to return. Medical treatment options include:

  • Broad-spectrum SPF 50+ sunscreen — ideally a tinted, physical (mineral) sunscreen, since melasma is also triggered by visible light, which chemical sunscreens alone don't fully block
  • Tyrosinase inhibitors — topical ingredients such as azelaic acid, vitamin C, and niacinamide, which reduce pigment production
  • Hydroquinone — a more potent skin-lightening treatment used short-term and under professional supervision, given the risk of irritation or rebound pigmentation with prolonged use
  • Prescription combination creams — combining several active ingredients for a stronger effect in more resistant cases
  • Oral Medication: Tranexamic Acid is thought to help melasma via the vascular pathway, but needs to be prescribed with caution in those with blood clot history,

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Common questions

Frequently asked questions

What cosmetic treatments are available for melasma?
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Alongside medical treatment, a range of in-clinic cosmetic treatments can help improve melasma, available at Skindepth Cosmetic, our dedicated cosmetic clinic:

  • Chemical peels — including peels containing salicylic, lactic, or pyruvic acid, and combination peels formulated specifically for pigmentation, which can help lift stubborn or deeper pigment
  • Laser toning — a series of low-energy laser passes designed to gently target deeper pigment over time
  • Vascular laser treatment — addressing the underlying blood vessel activity that contributes to melasma, often used alongside pigment-focused treatments

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What are the risk factors for melasma?
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Melasma develops from a combination of factors:

  • Hormonal changes — including pregnancy (sometimes called the "mask of pregnancy"), the contraceptive pill, hormone replacement therapy, and menopause
  • UV and visible light exposure — the primary trigger and the reason melasma so often worsens with sun exposure, even from everyday incidental exposure through windows or on overcast days
  • Heat and inflammation — which can worsen melasma independently of light exposure
  • Genetics — a family history of melasma increases the likelihood of developing it

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Can laser treatments make melasma worse?
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Melasma requires a careful, expert approach to cosmetic treatment: pigmentation conditions can worsen with laser and energy-based treatments if the wrong technique or settings are used, which is why treatment planning and selection between peels and laser should always be guided by an experienced practitioner rather than approached as a generic pigmentation treatment. Your dermatologist can advise whether cosmetic treatment is appropriate for your melasma and refer you to Skindepth Cosmetic for the right in-clinic approach alongside your medical treatment plan.

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