Melasma
Patches that can return, which is part of what makes them difficult.
About this concern
Melasma can appear as patches of discolouration and may recur, so medical assessment, sun protection and an individual plan are important when considering treatment. It is usually symmetrical, often on the cheeks, forehead or upper lip, and it behaves unlike most other pigmentation: it responds to sunlight and heat, it can be influenced by hormonal changes, and it has a tendency to come back after it has improved. That last point is the one most worth understanding before starting anything, because it changes what success looks like. A plan that does not include daily sun protection is working against itself, and an aggressive approach can sometimes leave the skin darker than it started. This is a condition for medical assessment rather than a cosmetic concern to be matched to a treatment from a list.
Why the causes differ
- Sun and heat exposure, including the light that reaches you indoors and through glass.
- Hormonal changes, including pregnancy and some medications.
- Your skin tone and how it responds to inflammation.
- What you have already tried, and whether anything made it worse.
- How long it has been present, and whether it has ever cleared and returned.
Questions worth asking at your consultation
- Is this melasma, or another kind of pigmentation that looks similar?
- What is a realistic result, and what happens when I stop treatment?
- Could any treatment you are considering make it darker?
- What does my daily sun protection need to look like for this to be worth doing at all?
Also worth reading
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