Melasma is a common skin condition characterized by dark, irregular patches that usually appear on sun-exposed areas of the face, such as the cheeks, forehead, nose, and upper lip. It is more common in women than men and often develops during periods of hormonal change, such as pregnancy or while using hormonal medications. Although melasma is harmless and does not cause physical discomfort, it can have a significant emotional and psychological impact. Treating melasma can be challenging, but with a combination of approaches, its appearance can often be improved.
One of the most important aspects of melasma treatment is sun protection. Ultraviolet (UV) radiation is a major trigger and worsening factor for melasma. Daily use of a broad-spectrum sunscreen with a high SPF, even on cloudy days, is essential. Physical (mineral) sunscreens containing zinc oxide or titanium dioxide are often recommended because they block both UVA and UVB rays. Wearing wide-brimmed hats and avoiding peak sun hours further helps prevent darkening of existing patches and the formation of new ones.
Topical treatments are usually the first line of therapy. These include skin-lightening agents that reduce excess pigment production. Hydroquinone is one of the most commonly used ingredients and works by inhibiting melanin formation. Other alternatives include azelaic acid, kojic acid, niacinamide, and vitamin C. Retinoids, such as tretinoin, are often combined with these agents to increase skin cell turnover and enhance penetration. Combination creams, prescribed by dermatologists, can be particularly effective but must be used carefully to avoid irritation.