Medicines for Melasma

What it is

Melasma (also called chloasma when it occurs in pregnancy) is a common skin condition causing brown or grey-brown patches of increased pigmentation, usually on the face — typically on the cheeks, forehead, bridge of the nose, upper lip and chin, often in a fairly symmetrical pattern. It happens when the pigment-producing cells in the skin make too much pigment in these areas. It is harmless and causes no physical symptoms, but it can be cosmetically bothersome. Melasma is much more common in women and in people with darker skin tones. Its main triggers are sun exposure (ultraviolet light stimulates pigment production, and is the biggest driver) and hormonal factors — it commonly develops or worsens during pregnancy (hence "the mask of pregnancy"), and can be linked to hormonal contraception or hormone treatments. Because it is strongly influenced by sunlight, it often worsens in summer and improves in winter, and it can be persistent and prone to returning, particularly with continued sun exposure. While melasma is harmless, understanding its triggers — especially the central role of sun protection — is key to managing it.

How it is treated

The cornerstone of managing melasma is sun protection, because sunlight is the main driver of the pigmentation, and without good protection other treatments are much less effective and the melasma tends to return. This means daily use of a high-factor, broad-spectrum sunscreen (protecting against both UVA and UVB, and ideally also visible light, which can also trigger melasma — tinted mineral sunscreens can help here), reapplied regularly, along with physical measures such as wide-brimmed hats and seeking shade. Where a hormonal trigger is identified (such as hormonal contraception), reviewing this with a doctor may help, and melasma related to pregnancy often fades over the months after the birth. Beyond sun protection, treatments to lighten the pigmentation may be used, guided by a doctor or dermatologist — such as prescribed skin-lightening creams (sometimes combinations) and other approaches; these can help but need to be used carefully and alongside strict sun protection, and results can be gradual and prone to relapse. It is worth being cautious about some cosmetic treatments, as certain procedures can sometimes worsen melasma. Patience and realistic expectations help. The reassuring message is that melasma is harmless, and that diligent sun protection is the single most important and effective measure — both to improve it and to prevent it returning — alongside careful use of lightening treatments where wanted.