What Is Melasma?
Melasma is a chronic skin condition that causes patches of brown, grey-brown or uneven pigmentation, most commonly on the face.
It typically appears on:
- Cheeks
- Forehead
- Upper lip
- Chin
- Jawline
It is caused by overactivity of melanocytes (pigment-producing cells), leading to excess melanin production in the skin.
Unlike sun spots or post-acne marks, melasma is more complex and often influenced by hormones, UV exposure, heat and genetics.
In clinic, I often see patients who have already tried multiple skincare products without success. The reason is simple: melasma is not just a surface-level pigmentation issue.
What Causes Melasma?
Melasma usually develops due to a combination of factors:
1. Sun Exposure
UV radiation is one of the strongest triggers. Even incidental daily exposure can worsen pigmentation.
2. Hormonal Changes
Melasma is commonly associated with:
- Pregnancy
- Oral contraceptives
- Perimenopause and menopause
- Hormone replacement therapy
3. Genetics
A family history of pigmentation increases your risk.
4. Heat and Visible Light
Heat and visible light can also stimulate melanocytes, particularly in deeper pigmentation.
Melasma vs Other Types of Pigmentation
Many patients confuse melasma with other forms of hyperpigmentation. Correct diagnosis is essential for effective treatment.
Post-Inflammatory Hyperpigmentation (PIH)
PIH develops after inflammation such as acne, irritation or skin trauma.
If you want to understand this in more detail, read:
Post-Inflammatory Hyperpigmentation Explained: Causes, Treatment & Prevention
If pigmentation is persistent, it may not be melasma alone.
Read more:
Why Isn't My Hyperpigmentation Fading?
Understanding Hyperpigmentation
A full breakdown of pigmentation types:
Hyperpigmentation: Causes, Types & Doctor-Recommended Treatment Guide – Villa Skincare
Managing Pigmentation at Home
Practical skincare guidance:
Managing Hyperpigmentation at Home
What Does Melasma Look Like?
Melasma typically appears as:
- Symmetrical patches on the face
- Brown or grey-brown discolouration
- Flat, non-raised pigmentation
- Gradual onset over time
It often worsens with sun exposure and may fluctuate with hormonal changes.
Why Is Melasma So Difficult to Treat?
Melasma is considered one of the most challenging pigmentation conditions because:
- It exists in multiple layers of the skin
- It is hormonally influenced
- It is triggered by UV and heat exposure
- It has a high recurrence rate
This means treatment must be long-term and consistent rather than short-term.
The Most Effective Treatments for Melasma
1. Daily High-Protection SPF (Essential)
If there is one non-negotiable step, it is sunscreen.
A broad-spectrum SPF 50+ helps prevent:
- Pigment worsening
- Treatment relapse
- UV-induced stimulation
View recommended SPF products
2. Medical-Grade Skincare
Key ingredients that support melasma management include:
- Vitamin C (brightening + antioxidant protection)
- Retinoids (cell turnover support)
- Azelaic acid (pigment reduction + calming)
- Niacinamide (reduces transfer of pigment)
- Tranexamic acid (targets stubborn pigmentation pathways)
Explore medical-grade skincare
3. Retinoids
Retinoids improve:
- Cell turnover
- Skin texture
- Pigment dispersion over time
They are often a cornerstone in long-term pigmentation management.
Shop Retinol & Retinal products
4. Tranexamic Acid
Tranexamic acid is increasingly used for stubborn pigmentation, particularly melasma.
It works by reducing pigment signalling pathways in the skin and can be used topically or under medical supervision in stronger protocols.
Prescription Treatment: Hydroquinone & Obagi Nu-Derm
For more persistent melasma, prescription-based treatment may be required.
Hydroquinone
Hydroquinone is one of the most effective pigment-inhibiting agents available. It works by reducing melanin production and is often used in structured treatment cycles under medical supervision.
Obagi Nu-Derm System
One of the most established prescription skincare systems for pigmentation is the Obagi Nu-Derm System.
It is designed to:
- Reduce hyperpigmentation
- Improve skin turnover
- Support long-term pigment control
Obagi systems are often used in structured clinical protocols for melasma management and require professional guidance to ensure safe and effective use.
Explore Obagi range
What Treatments Can Make Melasma Worse?
Some treatments may worsen melasma if not used correctly:
- Aggressive exfoliation
- Overuse of acids
- Unsupervised laser treatments
- Heat-based procedures in sensitive skin
This is why correct diagnosis and treatment planning is essential.
My Clinical Approach to Melasma
In clinic, I assess several key factors:
- Skin type and tone
- Depth of pigmentation
- Hormonal influences
- Previous treatment history
- Lifestyle and sun exposure
Treatment plans may include:
- Medical-grade skincare routines
- Prescription hydroquinone cycles
- Obagi Nu-Derm programmes
- Barrier repair strategies
- Long-term maintenance plans
Melasma management is not about quick fixes it is about structured, long-term control.
Can Melasma Be Cured Permanently?
Melasma is generally considered a chronic condition.
However, with the right treatment plan, it can be:
- Significantly improved
- Long-term controlled
- Made far less visible
Maintenance is key to preventing recurrence.
When to Seek Professional Help
You should consider a consultation if:
- Your pigmentation is not improving
- It keeps returning after treatment
- You are unsure of the diagnosis
- It is affecting your confidence
A correct diagnosis is essential before starting any treatment plan.
Book a Melasma Consultation
Melasma can be frustrating and persistent, but with the right diagnosis and treatment plan, significant improvement is possible.
At Villa Skincare, I offer personalised consultations to assess your skin and create a tailored treatment plan that may include medical-grade skincare and prescription options where appropriate.
Book your consultation here
Written By
Dr S Ahmed | Villa Skincare
Updated June 2026