Melasma: why those spots appear and how they're treated

Melasma is one of the most common dermatology consultations, especially in women. They are brown or grayish patches, usually symmetrical, that appear on the cheeks, forehead, upper lip or chin. It does not hurt or itch, but it weighs heavily on those who have it. The good news: it can be controlled; the realistic part: it takes consistency.

Why it appears

Melasma arises when the pigment-producing cells (melanocytes) make too much melanin in certain areas. Several triggers usually add up:

• Sun and visible light: the number-one factor. UV radiation and blue light activate pigmentation.
• Hormones: pregnancy (the so-called "mask of pregnancy") and contraceptives favor it.
• Genetic predisposition and skin phototype.
• Heat and some irritating cosmetics or procedures.

How it's treated

The approach is stepwise and personalized. It usually combines topical depigmenting agents prescribed by the dermatologist, a gentle routine that does not irritate, and —in selected cases— procedures such as peels or specific lasers, always cautiously: an overly aggressive treatment can worsen melasma instead of improving it.

Realistic expectations

Melasma is controlled, not always fully "erased," and it tends to return if you let your guard down with the sun. That is why the goal is to lighten it significantly and keep it in check. A tailored plan, with follow-up, makes all the difference compared to trying random products.

If you have spots that worry you, the first thing is to correctly identify what type they are. A dermatology assessment defines the right treatment for your skin.