Quick Summary
- Melasma is recurrent and needs long-term control, not one-time treatment.
- Sun, visible light, heat, hormones and irritation can trigger it.
- Sunscreen is a treatment, not an optional skincare step.
- Peels and lasers help selected patients but must be conservative in Indian skin.
Call to Action: Book a consultation at Clinique Cutis, Mysore for a personalized assessment.
What Is Melasma?
Melasma causes brown or grey-brown patches, commonly on the cheeks, forehead, nose and upper lip. It is common in Indian skin and often affects women, though men can also have it. It may worsen during pregnancy, with hormonal medicines, sun exposure, heat or stress.
Patients often try multiple creams and salon treatments before seeing a dermatologist. This can irritate the skin and make pigmentation worse.
Why Melasma Is Stubborn
Melasma is not only extra pigment on the surface. It involves active melanocytes, inflammation, vascular factors, barrier dysfunction and triggers from sunlight and visible light. This is why quick bleaching or aggressive lasers can backfire.
The correct goal is control and maintenance. Some patients achieve excellent fading, but recurrence is possible if triggers continue.
Sunscreen Is the Foundation
Daily sunscreen is the most important treatment. It should be broad-spectrum and used in adequate quantity.
Reapplication is important, especially outdoors. Hats, umbrellas and shade are useful.
Visible light can worsen melasma in some patients, so tinted sunscreen with iron oxides may be recommended.
Heat avoidance also matters because cooking heat, saunas or outdoor heat can trigger flares.
Medical Skincare
Dermatologists may prescribe hydroquinone, azelaic acid, kojic acid, retinoids, niacinamide, tranexamic acid or other pigment-control agents depending on skin type and severity. These must be used correctly because irritation can worsen pigmentation.
Steroid-mixed fairness creams should be avoided unless specifically prescribed for a short controlled period.
Long-term misuse can thin skin and cause acne, redness or rebound pigmentation.
Chemical Peels
Superficial chemical peels can improve epidermal melasma and skin glow when done carefully. Peels are usually performed as a series, not one aggressive session.
Indian skin needs conservative peeling. Deep peels or poorly selected acids can trigger post-inflammatory hyperpigmentation.
Lasers and Laser Toning
Laser toning or selected pigmentation lasers may help some patients, but lasers are not the first answer for everyone. Melasma can worsen if energy settings are too high or aftercare is poor.
A dermatologist may use lasers only after preparing the skin and explaining recurrence risk. Lasers should be part of a plan, not the entire plan.
Oral Treatments
In selected patients, oral tranexamic acid or other medicines may be considered after proper history and risk assessment. These should never be self-medicated because they are not suitable for everyone.
Medical history, clotting risk, menstrual history, pregnancy plans and other medications must be reviewed.
Maintenance and Relapse Prevention
Once melasma improves, maintenance is essential. Stopping sunscreen and creams suddenly often leads to relapse. Maintenance may include sunscreen, gentle pigment-control skincare, periodic peels and trigger avoidance.
Photographs help monitor progress. Melasma treatment is a partnership between dermatologist and patient.
Call to Action: For melasma and pigmentation management, consult Dr. Shivani SR at Clinique Cutis, Mysore.
Medical note: This article is for patient education and does not replace an in-person consultation. Final treatment suitability depends on medical history, examination and doctor assessment.