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What Is Melasma?

Melasma is a common skin condition characterized by dark, discolored patches that typically appear on the face. These patches are often symmetrical and most commonly found on the cheeks, forehead, upper lip, and chin. Melasma is caused by an overproduction of melanin—the pigment that gives skin its color—and is often triggered by sun exposure, hormonal changes (especially during pregnancy or with birth control), genetics, and certain medications. Though melasma is not harmful, it can be emotionally distressing due to its appearance.

How Is Melasma Diagnosed?

A dermatologist usually diagnoses melasma by examining the affected areas of the skin. In some cases, a special light called a Wood’s lamp may be used to determine how deep the pigmentation goes. In rare situations where diagnosis is unclear, a skin biopsy might be performed to rule out other conditions that mimic melasma. Accurate diagnosis is essential to choosing the most effective treatment plan.

What Are the Treatment Options for Melasma?

The first and most important step in melasma treatment is sun protection. Daily use of broad-spectrum sunscreen with SPF 30 or higher is crucial, as UV exposure can worsen pigmentation. Topical creams containing hydroquinone, tretinoin, corticosteroids, or a combination of these ingredients are often prescribed to lighten the dark patches. Other agents like azelaic acid, kojic acid, or tranexamic acid may also be used, especially for individuals with sensitive skin or those who cannot tolerate hydroquinone.

Can Procedures Help Treat Melasma?

When topical treatments are not sufficient, dermatological procedures can be effective in reducing melasma. Chemical peels, using mild acids such as glycolic or salicylic acid, help exfoliate the skin and lighten pigmentation. Microdermabrasion gently removes the top layers of the skin to reduce dark patches. Laser therapies, such as low-energy fractional lasers or intense pulsed light (IPL), may be used cautiously in stubborn cases. However, these should only be done by experienced specialists, as some aggressive treatments can worsen melasma if not handled correctly.

How Long Does It Take to See Results?

Melasma treatment requires patience, as improvement is gradual. With consistent use of topical therapies and diligent sun protection, visible changes may begin to appear after 4 to 8 weeks, with more significant fading over 3 to 6 months. Results from procedures like chemical peels or laser therapy may be faster but also carry a risk of temporary irritation or rebound pigmentation if sun exposure isn’t avoided afterward.