What To Do About Melasma: How to Minimize Those Dark Spots

While Melasma is not considered dangerous in its own right, it is often indicative of skin damage. A surprisingly common condition, melasma has a tendency to go undiagnosed, and simply ignored.

But when melasma begins to take a toll on a person’s appearance and self-esteem, appropriate action can and should be taken. All of which prompts two equally important questions – what causes melasma, and what is the best treatment for melasma when it occurs?

Melasma treatment

What is Melasma?

Melasma is a common skin condition that appears as dark and discolored patches on the face. The most common areas of the face to be affected by melasma are the skin below the eyes, the forehead and along the upper lip. 

Melasma is typically misdiagnosed as other types of hyperpigmentation.  It requires a different set of protocols to treat than most pigmentation and should be done properly. Make sure to see the team at Lucere Dermatology & Laser Clinic to get properly diagnosed.

The level of darkness and discoloration can vary significantly – some cases being severe, while others remain practically undetectable from a distance.  Melasma occurs as the result of a hormonal imbalance, triggering the overproduction of pigment in the skin cells. As this hormonal imbalance is more likely to occur during pregnancy, the condition has been called “the mask of pregnancy” by some dermatologists.

However, melasma is by no means a condition only pregnant women are at risk of. 

What Causes Melasma?

Extensive studies have drawn links between melasma and several common causes. It’s more likely to affect pregnant women than their non-pregnant counterparts, but hormonal changes during pregnancy are not the only known melasma trigger. 

For example, switching to a new type of birth control pill has also been shown to increase melasma risk in some women. Thyroid disease can also be an underlying cause, as can excessive and prolonged stress that could lead to hormonal imbalance.

In addition, one of the biggest melasma triggers of all is exposure (or overexposure) to the sun. When the skin is exposed to the sun, its cells automatically create additional brown pigment. This pigment is the reason fairer skin tans in the sun, but is also the root cause of pigmentation issues like melasma. 

Research has shown how even moderate exposure to the sun can trigger and worsen melasma, calling for common-sense precautions to protect skin from damage. Melasma can also be caused by infrared heat and tanning beds.

How Common is Melasma?

Melasma is estimated to affect around 1% of the general population worldwide, but among higher-risk groups/populations increases to anything from 10% to 50%.

Even so, the fact that many (if not most) cases of melasma go undiagnosed makes it difficult to pinpoint an exact figure. Many people simply write off melasma as an inevitable effect of the natural ageing process, and take no direct action to address the issue. 

How is Melasma Diagnosed?

At a glance, a wide variety of hyperpigmentation problems look fairly similar.  Consequently, the only way a case of melasma can be diagnosed is with a close-up inspection conducted by a dermatologist.

Depending on the nature and extent of the melasma, clinicians may recommend a skin biopsy to determine the depth of the melanin, and to come up with an effective treatment program accordingly.

What is the Typical Clinical Course for Melasma?

It is comparatively rare for a case of melasma to go into remission on its own, but this does sometimes happen with pregnancy-related melasma over the course of time. Most cases of melasma are recurrent and/or chronic in nature, and therefore call for appropriate treatment.

Even when a case of melasma has been successfully treated, there is a possibility it will return at a later date. Some cases of melasma are difficult to treat, while others respond well to treatment and can be cleared up fairly fast.

How to Treat Melasma?

The options available for treating melasma vary from cutting-edge clinical procedures to advanced topicals to be used at home. As mentioned, make sure to see the team the team at Lucere Dermatology & Laser Clinic to get properly diagnosed. If it’s not treated properly, it can get worse.

In particular, dermatologists recommend the following as the best treatments for melasma on face skin:

Sunscreen for Melasma

Under no circumstances is it worth undergoing a program of melasma treatment if it is not complemented with the daily use of high-quality sunscreen. If your skin is not effectively protected from the sun’s rays, the pigmentation issue will continue to worsen faster than even the best treatments can address it. 

Skipping daily sunscreen will simply undo all your hard work, and make the problem even more difficult to correct than it already is. A high SPF sunscreen (ideally 50) should be applied to the affected area daily, irrespective of whether or not it is hot and sunny outdoors.

Chemical Peels for Melasma

There are also some exfoliating skincare products that can gradually help bring mild to moderate cases of melasma under control. Exfoliation works by stripping the skin of the surface layer of dead cells, which can trap excess pigment and cause the skin to appear dark and uneven.

Exfoliating products are most effective when used in conjunction with other methods for treating melasma, such as advanced topicals.

Creams for Melasma

There is no one specific gel, cream or serum that can single-handedly reverse melasma with any real effectiveness. What works best is a combination of complementary products, each with its own unique composition and effects. Hydroquinone is a great brightening agent to help treat and prevent melasma. It works better when used in conjunction with other ingredients like retinol and sunscreen.

How to treat melasma

For the total home treatment package, the following two kits come highly recommended by professional dermatologists:

ZO Hydroquinone Program

The ZO® Hydroquinone Kit is one of the most powerful home treatment kits of its kind on the market, comprising five products that work together to combat sun damage, hyperpigmentation and skin texture damage, while quickly restoring the health of the skin.

Products included in the ZO® Hydroquinone Kit:

  • Gentle Cleanser – 60 mL / 2 Fl. Oz.
  • Wrinkle + Texture Repair – 30 mL/ 1 Fl. Oz.
  • Exfoliation Accelerator – 30 mL / 1 Fl. Oz.
  • Pigment Control Creme – 80 mL / 2.7 Fl. Oz.
  • Pigment Control + Blending Creme – 80 mL / 2.7 Fl. Oz.

Vivier Hyperpigmentation Program 2% HQ


An even more advanced solution is the Hyperpigmentation Program (2% Hydroquinone) from Vivier, which has the power to reverse several years of skin damage and make a real difference to even the most extensive pigmentation issues.

This ultra-premium home treatment kit for melasma comprises the following six products:

  • Medicated Wash – 150 mL / 5 Fl. Oz.
  • Advanced Skin Lightening Serum – 30 mL / 1 Fl. Oz.
  • Corrector 2 – 60 mL / 2 Fl. Oz.
  • Exfoliant Forte – 60 mL / 2 Fl. Oz.
  • Retinol 1% Night Complex – 30 mL / 1 Fl. Oz.
  • Sheer Broad-Spectrum SPF 45 – 90 mL / 3 Fl. Oz.

In addition to the above, research suggests that a wide variety of skincare products containing Vitamin C and antioxidants can also be great for keeping pigmentation issues under control. Vitamin C in particular has proven highly effective in reducing the appearance of hyperpigmentation and dark spots, while at the same time nourishing the surrounding tissues.

Vitamin C and antioxidants alike are renowned for their ability to restore skin’s bright, smooth and youthful glow with regular use.

How Much is Laser Treatment for Melasma?

One of the most effective clinical treatments for melasma is laser facial retexturing, which along with being safe for most skin types is also 100% non-invasive.  Over the course of several sessions, laser facial retexturing can have a remarkable impact on moderate to severe pigmentation issues – unwanted freckles, brown spots, sun damage and melasma. 

However, the best and most effective laser treatments for melasma can also be quite expensive – anything from $500 to $5,000, depending on the surface area that needs to be treated. Some clinics also offer quick 20-minute sessions to treat smaller trouble spots, which are priced at anything from $50 to $250.

Is Microneedling Effective for Melasma?

Microneedling takes a more ‘physical’ approach to the destruction of excess pigment, using fine needles to target problem areas with pinpoint precision. It is a popular choice for patients with melasma who do not respond to chemical peels or topical treatments, but is not generally recommended by dermatologists.

This is because the process naturally leads to inflammation of the skin, which itself can trigger the production and release of additional pigment.  Microneedling, therefore, has the potential to worsen the issue, resulting in a cycle of continuous treatment and further inflammation.

Procedures performed with great precision by those with extensive knowledge and experience can be effective, but microneedling in general carries risks for the treatment of melasma. 

How to Prevent Melasma

As with most things, it is much easier to prevent melasma from occurring in the first place than to treat a case that has already happened. Once again, the first line of defense against melasma will always be adequate protection from the sun’s harmful rays.

In addition, keeping your skin in the best possible condition in more general sense can also contribute to the cause.

But when melasma occurs during pregnancy (or at any other time in life), it doesn’t necessarily mean you’ve done something wrong. It may have been triggered by a completely inevitable hormonal imbalance, and have nothing to do with exposure to the sun or any other avoidable cause. 

Either way, it’s important to raise any questions or concerns you may have with your dermatologist. Some melasma products and treatments shouldn’t be done while pregnant. The earlier melasma is detected and treated, the easier it is to eradicate. See the team at Lucere Dermatology & Laser Clinic to get properly diagnosed.

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