Melasma is a common skin condition that involves chronic and relapsing hyper-pigmentation. It is extremely common in Indians, occurring both in females and males, though there is a higher incidence in females.

It occurs as bilaterally symmetrical and well-demarcated brown patches on the areas of cheeks, nose, jawline, around the upper lip.

These are the patterns of Melasma depending on their location

  1. Malar pattern – here the pigmentation is seen on nose and malar area
  2. Mandibular pattern – seen around the jawline
  3. Centrofacial pattern – seen on forehead, nose, cheeks and upper lips.

Melasma is due to increase in the amount of pigment melanin in your skin and the various causes that can lead to this are:

  • Sun exposure – Exposure to UV rays increases the melanocyte production in the skin which leads to increase in the pigment melanin. There is also an increase in free radical damage on UV exposure.
  • Birth control pills – This is due to imbalance in levels of estrogen and progesterone hormones in the body.
  • Genetic predisposition – Family history is an important risk factor for developing melasma. Some studies have indicated 55–64% of patients with this condition have a positive family history.
  • Other Medications that can lead to melasma are Anti seizure medications, Anti psychotics, Anti malarials, Amiodarone, Cytotoxic drugs/ chemotherapeutics, Phenytoin, NSAIDS (Non – steroidal anti-inflammatory drugs), Tetracyclines.
  • Thyroid disorders
  • Hormone replacement therapy - Can lead to melasma due to changes in hormonal balance. Also, there are more chances of developing melasma in post menopausal women getting progesterone during hormone replacement therapy than estrogen.
  • Pregnancy – blotchy spots of darker skin appear, a condition known as chloasma or mask of pregnancy.
Different options for treatments are available which depends on the suitability and type of pigmentation.

Melasma presentation can be of 3 different types

Types of Melasma

  1. Epidermal Melasma - characterized by well defined patches of dark brown color, which have symmetrical presentation on both sides of the face. They become pronounced under black light and respond to good medical therapy and chemical peeling treatment.
  2. Dermal Melasma – characterized by light brown to bluish patches. There is no change in color under black light. Respond to medical treatment is tougher
  3. Mixed Melasma – in this there is combination of bluish and dark brown patches, mixed marking under blue light. Partial response to treatment.


With such great variations in presentation, Melasma Treatment at our clinic is customized to each patient. Dr. Neha Sharma, the best dermatologist in Gurgaon, believes in first identifying the cause, eliminating the triggering factors, figuring out the type of melasma and then proceeding to the treatment which would suit your skin type

Different options for treatments are available which depends on the suitability and type of pigmentation.

There are available options such as:

  • Chemical peelsaim to uniform the skin.
  • Laser techniqueby employing the use of lasers to treat vascularity and pigmented lesions. The laser procedure is performed by emitting controlled light energy to the treatment area.
  • Instant Power radiancehelps in faster resolution
  • Active ingredients in the form of topical creams for pigment suppression.

Following precautions can go a long way to minimize recurrences:

  1. Limiting sun-exposure.
  2. Using a medicated sunscreen.
  3. Wearing a hat when outside.


Sun exposure is the main cause of melasma. Other causes include Pills for birth control, pregnancy, and hormone therapy, few anti anxiety medications and thyroid disorders.

Sunscreen, limiting sun exposure form the main basis of treatment. Various topical preparations like kojic acid, alpha arbutin, glycolic acid, hydroquinone, azelaic acid, retinoids when used in right concentrations help in curing pigmentation. Chemical peels, Instant power radiance and LASERS help in faster and better resolution of pigmentation.
Daily sunscreen use, limiting sun exposure and outdoor hats (broad-brimmed hats help keep rays off vulnerable parts of the face) can prevent melasma from spreading. Also, any other underlying cause like medications or hormones, needs to be addressed.
Yes, melasma can be treated and it can go away though complete clearance requires effort and strict precautions. Topical medications, Chemical Peels, Microdermabrasion and LASER are various options that your doctor can recommend depending on the pigmentation.
Microneedling alone or used in combination with vitamins and antioxidants can cause lightening of pigmented spots. Multiple sessions may be required.
Yes, stress can aggravate acne. Stress activates propriomelanocortin gene which prompts the skin to produce more pigment. Our bodies also interprets lack of sleep as stress so even this can aggravate melasma.

If the melasma occurred because of hormonal changes like those in pregnancy or due to birth control pills, it will fade after stoppage of the pills or after deliver.

While in other cases melasma can be quite stubborn and may last for years. In some cases, it can be permanent as well. If the discoloration does not fade away then it would be better to seek treatment.

Although melasma is a chronic disorder with periodic ups and downs, it does go away. Correct and early treatment helps in faster resolution. Also, the exact cause should be ruled out.


Medical and Cosmetic Dermatologist and well renowned as the Best Dermatologist in Gurgaon, has formerly practised in prestigious Hospitals such as VMMC & Safdarjung Hospital (New Delhi) and All India Institute of Medical Sciences (AIIMS, New Delhi). She has done teo superspecializtions - Fellowship in LASERS and Dermatology from National Skin Centre , Singapore and Fellowship in Aesthetic Dermatology from Bangkok. She has a total experience of 11 years and has treated over 20000 patients.
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