Confirm and document
Assess distribution, history, previous treatment and current irritation. Discuss which changes can realistically be monitored with photographs.
Service
Melasma treatment
Updated
Manage recurring pigment with a plan your skin can tolerate.
Melasma causes recurring facial pigmentation. Management usually centres on sun protection and suitable medical treatment; selected procedures may be discussed when appropriate. Laser is not an established cure and can worsen pigment. At SkinWise, the plan considers previous reactions, pregnancy or hormonal context and maintenance.
About melasma treatment
Melasma often appears as patches on both sides of the face, but examination is needed because other conditions can resemble it. Bring older photos, previous prescriptions and details of peels or lasers you have tried.
The aim is improvement with tolerable care and a maintenance plan. Relapse does not mean you caused the condition or failed treatment. Reassessing triggers, irritation and the diagnosis is more useful than repeatedly escalating procedures.
When an assessment may help
- Recurring facial patches thought to be melasma
- Darkening after a previous cream or procedure
- Advice on sun protection, prescriptions and maintenance
When to reassess or defer treatment
- A new isolated or changing lesion should be assessed separately.
- Irritated or inflamed skin may need a change of plan before a procedure.
- Pregnancy, breastfeeding, contraception and clotting history can change medicine choices.
How treatment is planned
Make sun protection practical
Discuss broad-spectrum sunscreen, shade and clothing. For melasma, a suitable iron-oxide tint may add protection against visible light from sunlight; SPF alone does not describe that protection.
Use prescriptions with supervision
Topical treatment may be selected or adjusted according to response. Oral tranexamic acid is an off-label option for selected patients and requires assessment of clotting risks and medicines; it is not routine self-care.
Consider procedures selectively
Peels and lasers can provoke pigmentation. Discuss the evidence, alternatives and recurrence risk before choosing a procedure; everyone does not need to move through a fixed ladder.
Preparing, recovering and following up
Before
Bring all brightening creams and mention pregnancy plans, contraception and any history of blood clots.
While treating
Follow the individual prescription and contact the clinic for significant irritation or unexpected darkening. Do not copy hydroquinone cycles or oral medicine doses from another person.
Maintenance
Progress and relapse vary. Agree what to continue, what to stop and when to review rather than assuming pigment is permanently cured.
Frequently asked questions
Do laptop or phone screens cause melasma?
Current limited research has not identified ordinary device exposure as a melasma hazard. It should not be equated with sunlight. Screen-brightness changes are not an established melasma treatment.
Is tinted sunscreen enough on its own?
It can be part of photoprotection, particularly when it contains suitable iron oxides. A trial supporting visible-light protection also used hydroquinone in both groups, so it does not establish sunscreen alone as a cure.
Can I take tranexamic acid myself?
No. Oral use for melasma is off-label and needs an individual risk assessment, including clotting history and medicines such as combined hormonal contraception. Ask the prescribing doctor about benefits, risks and follow-up.
Will laser stop it coming back?
Laser does not guarantee lasting clearance. Recurrence and worsening are possible, and evidence varies between devices and treatment comparisons.
Evidence behind these choices
- Melasma management: international expert consensus (2026)
Supports photoprotection and supervised medical treatment, with lasers reserved for selected resistant cases. Expert consensus does not establish one treatment sequence for everyone.
- UV and visible-light protection in melasma: randomised trial (2014)
An iron-oxide-containing sunscreen improved outcomes compared with UV-only protection while both groups also used hydroquinone. This supports suitable photoprotection, not sunscreen as a cure.
- Electronic-device blue light and skin: systematic review (2023)
The limited evidence did not identify ordinary device exposure as a pigmentation or melasma hazard. Sunlight and screen exposure should not be treated as equivalent.
- Oral tranexamic acid for melasma: Indian expert consensus (2023)
Describes off-label use in selected patients and screening for clotting risks and interacting medicines. It is not a self-treatment recommendation or a standard prescription for every patient with melasma.
Related care and reading
Conditions we treat with melasma treatment
Ready to start with a consult?
Most plans at SkinWise begin with a focused consultation. We map the concern, talk through what you’ve tried, and only then suggest what comes next — no oversell.
Plan your first visit: appointments, clinic location and what to bring.