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Understanding Melasma

Melasma is brown or grey-brown patches on the face, often on both cheeks, the forehead or above the lip, fairly evenly on both sides. It is long-lasting, worsened by sun and hormones, and cannot be confirmed by looks alone because other marks can look similar. So the first advice is to have a dermatologist confirm it; daily sunscreen supports care but guarantees nothing.

Written by the Oliareen editorial teamDermatologist review: pendingLast updated: 6 November 2026How we write

What melasma is

In melasma the skin's pigment cells are overactive. It is far more common in women (about four women to one man) and very common in South Asian brown skin. It is not contagious and not dangerous, but it is long-lasting and can keep returning.

What can contribute

  • Sun: both UV and visible light. In one Indian study only 35% of people with melasma used sunscreen.
  • Hormones: pregnancy, birth-control pills.
  • Family tendency.
  • Heat, such as cooking over a stove, is thought to worsen it for some people.
  • Irritating products and strong peels.

What it can look like

Melasma often looks like fairly even brown patches with irregular edges on both cheeks, the forehead, the nose or above the lip, usually sparing the eyelids. Symmetry is only a clue, not a diagnosis. Acne marks, freckles, sun spots, the effects of hidden steroid creams or other pigment problems can look alike. A photo also cannot show how deep the pigment sits.

What not to assume

  • Melasma is not a tan; it cannot be scrubbed off.
  • No cream guarantees removing melasma for good; it can return with sun even after improving.
  • The goal is not to change your skin colour, only to keep the patches calm.

Common mistakes

  • Unknown "melasma creams" or "fairness creams". Tests in Bangladesh found many creams with mercury far above the safe limit, and steroid-laced creams thin the skin.
  • Sunscreen only on sunny days. Window light indoors can matter too.
  • Strong peels, scrubs and lemon: irritation can make melasma worse.
  • Using hydroquinone or steroid creams on your own.

General skincare support

  • Daily broad-spectrum SPF 30 or higher; tinted (iron oxide) if possible, which also blocks visible light.
  • Reapply every 2 hours outdoors, with an umbrella, hat or shade.
  • A gentle routine without irritation.
  • Patience: sunscreen takes at least 8 weeks to show measurable effect.

Ingredient evidence and limits

The most effective melasma treatments are prescriptions a doctor chooses. Cosmetic ingredients can support care, without guaranteed results.

  • Azelaic acid: older studies showed 20% azelaic acid performing close to 4% hydroquinone; higher strengths are usually prescription.
  • Tranexamic acid: moderate evidence on the skin; the tablet form only on a doctor's advice.
  • Niacinamide, alpha-arbutin, vitamin C: small studies; they need months of patience.

Patches very often return after stopping or with sun exposure.

When to see a dermatologist

For melasma, the main advice on this page is to see a dermatologist. The routine here only supports that.

  • At least once, to confirm, if you have brown facial patches.
  • No change after 3 months of care including sunscreen.
  • During pregnancy, or if you take hormonal medicine.
  • The patches affect your mood or confidence.

Simple routine

Morning

  1. 1
    Gentle cleanser, or just water

    If your face is not very oily after the night, water alone is fine in the morning.

  2. 2
    Light moisturiser (gel or lotion)

    Helps skin hold water; lighter textures feel better in the heat.

  3. 3
    Tinted sunscreen (iron oxides), every day

    Tinted sunscreen also blocks some visible light, which can deepen patches on brown skin.

Evening

  1. 1
    Gentle cleanser

    Lifts the day's sweat, dust and sunscreen; no scrubbing needed.

  2. 2
    An active only as a doctor advises; otherwise just moisturiser

    Irritation can worsen melasma, so do not stack actives on your own.

General education, not a diagnosis or treatment plan.

Questions people ask

Does melasma go away completely?

Sometimes it fades on its own, especially after pregnancy. For many people it is long-term and returns with sun. Treatment can improve it, without a permanent guarantee.

Why tinted sunscreen for melasma?

Tinted sunscreens with iron oxides also block some visible light, which can deepen patches on brown skin. Studies found better results than untinted sunscreen.

Is melasma the same as a tan?

No. A tan fades within weeks once you avoid sun; melasma lasts and returns. A doctor can confirm the difference.

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Sources

  1. DermNet — Melasma
  2. Sarkar R et al. Melasma update (Pigmentary Disorders Society consensus). Indian J Dermatol 2017
  3. Melasma in Indian women: clinical profile and sunscreen use. Dermatol Ther 2014
  4. Rajaratnam R et al. Interventions for melasma. Cochrane Database Syst Rev 2010 (CD003583)
  5. PRISM-ISF consensus on sunscreen use in Indian skin, 2025
  6. Baliña LM, Graupe K. Azelaic acid 20% vs hydroquinone 4% in melasma. Int J Dermatol 1991
  7. WHO — Mercury in skin lightening products (WHO/CED/PHE/EPE/19.13, 2019)