Melasma is a common form of hyperpigmentation that appears as brown or gray-brown patches, usually on the cheeks, forehead, upper lip, or chin, and is triggered mainly by sun exposure and hormones. It is a chronic, manageable condition — the goal of treatment is to fade pigment and prevent flare-ups rather than a one-time cure.
What causes melasma?
Melasma develops when pigment-producing cells (melanocytes) become overactive. The most common triggers are ultraviolet and visible light, heat, and hormonal changes (pregnancy, birth control, or hormone therapy). Because these triggers are ongoing, melasma tends to recur, which is why daily sun protection is the foundation of any plan.
How is melasma treated?
A physician-directed plan is usually layered and gradual:
- Rigorous sun protection — broad-spectrum SPF (ideally with iron oxides for visible-light protection) and sun avoidance.
- Topical therapy — pigment-balancing and brightening ingredients such as hydroquinone, retinoids, azelaic acid, vitamin C, and tranexamic acid, tailored to your skin.
- In-office procedures — carefully selected chemical peels and, in appropriate cases, specific light or laser treatments. These must be chosen cautiously, because aggressive or poorly matched devices can worsen melasma.
Why professional guidance matters
Melasma is easy to aggravate. A physician assessment matches treatment to your skin type and triggers, sequences therapies safely, and sets realistic expectations — steady, gradual lightening with maintenance to keep it under control.
Frequently asked questions
Can melasma be cured?
It is best described as controlled rather than cured; consistent treatment and sun protection keep it faded.
Does sunscreen really matter for melasma?
Yes — sun and visible light are the leading triggers, so daily broad-spectrum protection is essential.
Can lasers fix melasma?
Sometimes, but only carefully selected settings; the wrong laser can make melasma worse, so it should be physician-directed.
Physician-reviewed educational overview. At MD Laser & Cosmetics in San Mateo, melasma and pigmentation treatment is performed by Dr. Susan Lin, M.D., serving patients within a ~25-mile radius including Burlingame, Foster City, Belmont, San Carlos, Redwood City, Millbrae, Palo Alto and the greater Peninsula. This page is educational and not a substitute for a medical consultation.
References: American Academy of Dermatology – Melasma. For guidance specific to you, consult a physician.