Telling melasma apart from other dark patches
Melasma appears as blurry-edged patches, usually symmetrical, across the cheekbones, forehead and upper lip. Sun spots are smaller, sharper and scattered where light hits hardest. Post-acne marks sit exactly where a spot used to be and fade on their own over months.
The distinction matters because the approaches differ. Aggressive treatment aimed at sun spots can make melasma worse rather than better.
What drives it
- Ultraviolet light, including on overcast days, and visible light from the sun as well.
- Heat may also make it worse; the evidence is thinner than for sunlight, but it is worth avoiding where you can, for example when you cook, ride or sit near a window in a hot city.
- Hormones — pregnancy, contraception, hormonal changes — which is why it is common in women in their thirties and forties.
- Friction and inflammation, including harsh scrubs and over-treatment.
What a realistic plan looks like
Daily sun protection is the foundation and it is not negotiable in this climate. Reapplication through the day matters here because sweat removes it, and a physical barrier — a wide-brimmed hat, staying in shade at midday — does work that sunscreen alone will not. A tinted sunscreen with iron oxide also helps against visible light, which plain sunscreens do not block.
On top of that sits pigment control, usually a combination of topical work and gentler in-studio sessions spaced out over months. Progress is measured across seasons rather than weeks.
Deep or long-standing melasma, and melasma alongside hormonal treatment, sometimes needs prescription support from a hospital dermatology department alongside the topical and in-studio work. Ask about that rather than assuming one route covers everything.
What makes it worse
Strong resurfacing, aggressive heat-based devices and enthusiastic scrubbing can all rebound: inflammation itself triggers more pigment. Melasma is one of the few areas where doing less, consistently, beats doing more, occasionally.
The other reliable way to lose progress is a beach trip without protection. Plan treatment courses around your travel rather than the other way around.