Melasma is one of the most persistent and misunderstood skin concerns. It often appears as symmetrical patches of pigmentation on the face, most commonly the cheeks, forehead, and upper lip. While it isn’t harmful, it can be frustratingly resistant to treatment. The good news? With the right routine, a little patience, and professional guidance, melasma can be managed.
What Exactly Is Melasma?
Melasma is a chronic form of hyperpigmentation. It’s triggered by a combination of hormonal factors, UV exposure, genetics, and inflammation, often flaring during pregnancy, while using hormonal contraception, or following sun exposure.
Unlike sunspots or post-inflammatory pigmentation, melasma can affect deeper layers of the skin. It’s especially common in women and those with medium to deep skin tones.
Why It Happens and Why It’s So Stubborn
Melasma develops when pigment-producing cells (melanocytes) go into overdrive. Triggers include sun exposure, heat, hormones, and skin irritation. The pigment can sit in the upper (epidermal) layer of the skin, the deeper (dermal) layer — or both, which is part of what makes it so difficult to treat.
Melasma is difficult to treat because many mechanisms are involved in addition to very active pigment cells,” explains Professor Firas Al-Niaimi, Consultant Dermatologist. “There are structural changes and a vascular element too, along with receptors that are highly sensitive to sunlight. All these factors combined make treatment a challenge.
It’s also difficult because it can affect different layers of the skin — the epidermis, the dermis, or both,” adds Dr. Sina Ghadiri, Consultant Dermatologist and Founder of Sinaesthetics. “Dermal melasma is especially stubborn, and with its complex triggers — from hormones to UV to genetics — it often comes back even after treatment. That’s why long-term management is key.
What Actually Works
There’s no one-size-fits-all approach to melasma. Treatment depends on severity, skin type, and how deep the pigment sits. That said, many dermatologists take a layered approach, combining topical treatments, sun protection, and sometimes in-office procedures.
Powerhouse Ingredients
Tranexamic acid (TXA)
A rising star in the pigmentation space, TXA calms inflammation and helps disrupt the pathways that lead to excess melanin.
Try:
Allies of Skin Tranexamic & Arbutin Advanced Brightening Serum
A potent blend that pairs TXA with arbutin, niacinamide, and centella to fade discoloration and support skin resilience.
Where to buy: uk.allies.shop
Azelaic acid
A gentle, multi-tasking acid that brightens uneven tone while calming redness — perfect for sensitive skin types.
Try:
SkinCeuticals Phyto A+ Brightening Treatment
A gel-cream formula featuring 3% azelaic acid and alpha arbutin, balanced with botanical extracts to soothe and calm. A top-tier choice for sensitive, melasma-prone skin
Where to buy: my-origines.com
Vitamin C (Ascorbic Acid)
A hero antioxidant that brightens, fights free radicals, and boosts the efficacy of SPF. It’s particularly effective for melasma when paired with sunscreen.
Try:
iNNBeauty Project Green Machine Serum
A plant-based vitamin C blend that combines ascorbic acid with nourishing greens like moringa and broccoli seed oil for a brightening punch without irritation.
Niacinamide: A longtime derm favourite for good reason. It reduces inflammation, balances sebum, and reinforces the skin barrier — all crucial for melasma-prone skin.
Try:
Paula’s Choice 10% Niacinamide Booster
A lightweight, targeted formula perfect for layering.
Where to buy: paulaschoice.co.uk
Retinoids
These vitamin A derivatives boost cell turnover and fade pigment — but should be introduced slowly to avoid irritation.
Try:
Medik8 Crystal Retinal 3 or 6
A clinically respected retinoid that’s effective without the usual dryness.
Where to buy: spacenk.com
Smart blends of actives
If you want a one-and-done solution, consider multi-ingredient serums that hit several targets at once.
Try:
Dr. Idriss Major Fade Hyper Serum
Created by NYC dermatologist Dr. Shereene Idriss, this brightening cocktail includes TXA, niacinamide, glycolic acid, and licorice root to tackle melanin production at multiple stages.
Where to buy: dridriss.com
Topical treatments like hydroquinone, tretinoin, azelaic acid, or specialised triple-combination creams can be very effective,” says Dr. Ghadiri, “but they should always be used under professional guidance. For tougher cases, we may explore options like peels, microneedling, or laser — though these require careful selection and must be administered with caution to avoid worsening pigmentation.”
Treatment choice also depends on severity,” adds Professor Al-Niaimi. “Moderate to severe melasma often requires in-office intervention, while milder forms may respond to over-the-counter options — though long-term topical maintenance is essential for everyone
The Non-Negotiable: Sunscreen
No treatment plan for melasma will work without sun protection. Full stop. Melasma is uniquely sensitive to both UV radiation and visible light, which makes daily sunscreen not just helpful, but essential.
Melasma-prone skin reacts not only to UVB rays (which burn) and UVA rays (which age), but also to visible light, especially blue light which can worsen pigmentation in medium to deep skin tones. Even heat alone, whether from the sun or steamy environments, can cause flare-ups. That’s why sun protection isn’t just for summer or sunny days, it needs to be part of your everyday routine.
The ideal sunscreen for melasma is a broad-spectrum SPF 30 or higher, worn every day as the final step in your morning skincare routine. Many dermatologists recommend mineral formulas (with zinc oxide or titanium dioxide) because they tend to be gentler and less likely to irritate already sensitive skin. Tinted sunscreens are especially helpful for deeper complexions, as they contain iron oxides, which help block visible light, another sneaky melasma trigger.
Since melasma is highly sensitive to sunlight, with many receptors activated upon sun exposure, sunscreen is a cornerstone of treatment,” says Professor Al-Niaimi.
Dr. Ghadiri agrees: “Sunlight stimulates melanocytes to produce more pigment, making melasma worse. A high-factor, broad-spectrum sunscreen is essential — not just to prevent flare-ups but to support any other treatments you’re using.
What Doesn’t Work
Melasma isn’t a condition you can exfoliate, laser, or DIY away — and in many cases, the wrong approach can actually make it worse. Some of the most commonly tried treatments do more harm than good, particularly if they cause irritation or heat up the skin.
Home remedies, for example like applying lemon juice or vinegar are far too harsh and just don’t work. These ingredients can burn or inflame the skin, leading to more pigment rather than less. The same goes for aggressive exfoliation: scrubbing or overusing acids can damage the skin’s barrier and trigger a rebound in melanin production.
Even some professional treatments come with risks. IPL (Intense Pulsed Light), often marketed for pigmentation, is generally not recommended for melasma. It generates heat, targets surface pigment only, and can worsen the condition, especially in medium to deep skin tones.
Hydroquinone, while considered a gold-standard treatment, should never be used without supervision. Long-term or unsupervised use can lead to sensitivity, uneven tone, or in rare cases, a condition called ochronosis, a greyish discolouration that’s extremely difficult to treat.
Lasers are another area to approach cautiously. Not all lasers are suitable for melasma, and some can make things significantly worse. Only specific low-energy devices, like pico or thulium lasers should be considered, and always in expert hands.
In short: more isn’t better. The most effective melasma treatments are consistent, gentle, and grounded in long-term care — not quick fixes.
Here’s the truth: melasma isn’t curable, but it is manageable. The goal isn’t perfection but progress: fewer flares, more even tone, and skin that feels calm and under control. Melasma treatment is a long game. But with the right tools and a good SPF you can absolutely keep it in check.
