Melasma
Last reviewed
Melasma is a chronic pigmentation disorder causing symmetrical brown or grey-brown patches, usually on the cheeks, forehead, upper lip or chin. It's driven by sun and visible light, hormones and heat — common in Indian skin, often triggered by pregnancy or birth control. It can't be cured but is well-managed with strict sun protection, the right topicals and conservative peels.
Melasma starts as a faint shadow across the cheeks or forehead and deepens over years into a stubborn brown patch that returns each summer. It's one of the most common pigmentation disorders we see in Indian skin — and one of the most over-treated.
The single biggest cause of melasma getting worse is aggressive treatment on unstable skin. Strict sun protection, the right topicals and gentle peels — patient work over months — outperform almost any laser. We treat melasma as a long, careful relationship, not a quick fix.
How melasma shows up
- Symmetrical patches on both cheeks (malar pattern)
- Patches on forehead and bridge of nose (centrofacial pattern)
- Pigmentation across the upper lip (often mistaken for a moustache shadow)
- Patches on the jawline or chin (mandibular pattern)
- Worsening with sun exposure, heat or visible light from screens
- Occasional flares with pregnancy, hormonal contraceptives or thyroid changes
What triggers melasma
- UV and visible light — the dominant trigger; even cloudy days and indoor light through windows count
- Hormones — pregnancy (chloasma), oral contraceptives, hormone replacement therapy
- Heat — Bengaluru summers, hot yoga, cooking over a stove
- Genetic predisposition — strong family history in many Indian patients
- Inflammation from aggressive skincare or wrong-laser procedures
- Some medications, including a few antiepileptics and antibiotics
When to see a dermatologist
See a dermatologist as soon as you notice patches darkening or spreading, especially before trying any over-the-counter skin-lightening creams (many sold in India contain steroids that worsen melasma long-term). Early intervention with the right topicals plus sun-protection discipline saves years of damage.
How melasma is treated at SkinWise
Treatment at SkinWise is conservative and layered: strict broad-spectrum tinted sunscreen, prescription topicals (hydroquinone or non-hydroquinone combinations rotated carefully), gentle chemical peels on a monthly cadence, and Q-switched or pico lasers only on stable skin and only when topicals alone aren't enough. Most patients see meaningful fading in 3–6 months and need long-term maintenance to hold the result.
Services that treat melasma
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Frequently asked questions
Can melasma be cured?
Melasma is a chronic condition — it can be controlled but not permanently cured. With strict sun protection and the right ongoing routine, most patients keep it faint and stable for years. Stopping treatment usually means it returns.
Are lasers safe for melasma in Indian skin?
Only carefully, and only after topical foundation has stabilised the pigment. The wrong laser or aggressive settings on melasma in deeper skin tones almost always make it worse. We use Q-switched Nd:YAG or pico lasers conservatively, after months of preparation — never as a first-line treatment.
Does sunscreen really make that big a difference?
Yes — it's the single most important part of the plan. Visible light (not just UV) drives melasma, so we recommend tinted mineral or hybrid sunscreens reapplied every 2–3 hours. Without this, no topical or laser will hold its result.
Will my melasma worsen during pregnancy?
Often yes. Most treatments are paused during pregnancy and breastfeeding for safety; we restart a graded plan once you're past that window. Strict sun protection through pregnancy reduces how much darker the patches get.
Ready to start with a consult?
A focused 15-minute first consultation is where we slow down, map your concern and build the smallest plan that will actually move the needle. No oversell, no fixed menu.