Melasma is a common skin condition that causes dark, patchy pigmentation usually on the cheeks, forehead, upper lip, and nose. While it is not harmful, melasma can affect confidence and often becomes a chronic concern if the triggers are not understood.

Common Triggers of Melasma

1. Birth Control Pills

Hormonal contraceptives are one of the leading causes of melasma. These pills contain estrogen and progesterone, which can stimulate excess melanin production and darken existing pigmentation.

Women who are genetically prone or have a history of pigmentation should consult a dermatologist before starting hormonal contraception.

2. Sun Exposure

Ultraviolet (UV) radiation is the strongest trigger for melasma. Even a few minutes of unprotected sun exposure can darken existing patches or cause new ones to develop.

To protect your skin:

• Always use a broad-spectrum sunscreen (SPF 50+)
• Reapply every 2–3 hours, especially when outdoors
• Wear wide-brimmed hats, scarves, and sunglasses for added protection

3. Hormone Treatment

Any therapy that alters hormone levels, such as thyroid treatments, menopause therapy, or infertility medications, can increase pigmentation. Hormonal fluctuations overstimulate melanocytes (pigment-producing cells), leading to brown or grey patches on the face.

4. Changes in Hormones During Pregnancy

Often called the "Mask of Pregnancy" or chloasma, melasma commonly appears during pregnancy due to elevated estrogen and progesterone levels. These hormonal changes, combined with sun exposure, can significantly darken pigmentation.

The condition may reduce after delivery, but sun exposure or stress can make it persist or worsen.

5. Heavily Chemical-Based Skin Care Products

Harsh skincare ingredients, strong fragrances, bleaching agents, and certain peels can irritate the skin. This irritation may trigger inflammation, which leads to post-inflammatory hyperpigmentation and worsens melasma.

Choose:

• Dermatologist-recommended products
• Gentle, pH-balanced cleansers
• Non-comedogenic, fragrance-free formulations

How to Manage and Treat Melasma

While melasma can be stubborn and recurrent, it is treatable with the right approach and expert guidance.

✔ Dermatologist-Prescribed Treatments

Your dermatologist may recommend medical-grade topical agents such as:

• Hydroquinone
• Kojic acid
• Azelaic acid
• Tranexamic acid (topical or oral in select cases)
• Retinoids

These ingredients help reduce excess melanin production, lighten existing patches, and improve overall skin tone when used under medical supervision.

✔ Advanced Procedures

In resistant or deeper pigmentation, in-clinic treatments can offer faster and more visible improvement:

• Chemical peels
• Q-switched laser
• Pico laser
• Microneedling and combination protocols

These procedures must always be performed by an experienced dermatologist to minimize the risk of irritation or rebound pigmentation.

✔ Daily Care & Lifestyle

Consistency is key when dealing with melasma. Daily skincare and lifestyle habits play a major role in long-term control:

• Use a broad-spectrum sunscreen every single day, even indoors
• Avoid peak sunlight hours whenever possible
• Follow a gentle skincare routine without harsh scrubs or DIY remedies
• Manage stress with relaxation techniques, sleep, and a balanced lifestyle

When to Consult a Dermatologist?

If your pigmentation is spreading, becoming darker, or not improving with basic care and over-the-counter products, it's time to consult a dermatologist for a personalized melasma management plan.

Melasma is not just a cosmetic concern—it can affect self-esteem and emotional well-being. Professional evaluation helps identify your specific triggers and design a treatment plan that is safe, effective, and tailored to your skin.

For expert treatment, you can visit:

Dr. Monica Chahar
MBBS, MD, FIDP (Germany)
Skin Décor – Skin, Hair & Laser Clinic