Understanding melasma: Causes, symptoms, and treatment options

Melasma is a common skin condition characterised by the appearance of dark, irregular patches on sun-exposed areas of the face. While it can affect anyone, it is most frequently seen in women, particularly during reproductive years, and in individuals with medium-to-darker skin tones. Although melasma is harmless from a medical standpoint, its impact on appearance can affect self-confidence, making understanding and managing the condition especially important.

The exact cause of melasma is not fully understood, but several factors are known to contribute. Sun exposure is the most significant trigger, as ultraviolet (UV) radiation stimulates pigment-producing cells called melanocytes. Hormonal fluctuations also play a major role, which is why melasma is common during pregnancy, when using birth control pills, or during hormone therapy—earning it the nickname “the mask of pregnancy.” Genetics, certain medications, and skin irritation from harsh skincare products can also worsen the condition.

Melasma typically appears as symmetrical, brown or gray-brown patches on the cheeks, forehead, upper lip, and chin. Because it develops gradually and does not cause pain or physical discomfort, many people may not notice it until the pigmentation becomes more prominent.

Treatment focuses on reducing pigmentation and preventing new patches from forming. Dermatologists often recommend topical therapies such as hydroquinone, retinoids, azelaic acid, or tranexamic acid. Chemical peels, microneedling, and laser treatments may be used for more stubborn cases, though they must be approached carefully to avoid worsening pigmentation—especially in darker skin tones. Sun protection is essential for anyone with melasma; daily use of broad-spectrum sunscreen, along with wearing hats and seeking shade, can help prevent flare-ups.

While melasma can be persistent, it is manageable with a consistent, gentle skincare routine and proper medical guidance. With patience and protection from the sun, many people see significant improvement over time.