Melasma: A Dermatological Perspective on Managing Persistent Pigmentation

Melasma is a chronic pigmentary disorder marked by symmetrical, patchy brown to grey-brown discolouration, primarily affecting the face. While not medically harmful, melasma can be emotionally distressing and stubborn to treat. It's most common in women, particularly those with medium to deeper skin tones, and often appears on the cheeks, forehead, chin, and upper lip. For those seeking a melasma skincare routine, long-term results depend on addressing the triggers behind melanin overproduction—namely, sun exposure, hormonal shifts, and barrier disruption—while using targeted treatments for pigmentation.

Melasma vs. Hyperpigmentation

Although often confused with post-inflammatory hyperpigmentation (PIH) or age spots, melasma pigmentation is hormonally driven, deeper-set, and more difficult to fade. It’s typically triggered by:

Hormonal changes (e.g., pregnancy, oral contraceptives)
UV and visible light exposure
Heat and inflammation
Genetic predisposition

The pigmentation usually spans both the epidermis and dermis, making treatment more complex and recurrence common.

Causes of Melasma on Face

UV Radiation: Daily sun exposure is one of the strongest triggers.
Hormonal Imbalance: Pregnancy, menopause, or birth control can provoke hormonal acne and melasma simultaneously.
Skin Sensitivity: A compromised barrier may allow more irritants to penetrate, stimulating melanocyte activity
Heat & Blue Light: Both may worsen melasma by deepening pigment

The Role of the Skin Barrier in Melasma

Supporting the skin barrier is essential for both prevention and treatment:

✔ Reduces flare-ups caused by inflammation

✔ Regulates melanocyte response to UV and hormonal triggers

✔ Allows safe use of actives like azelaic acid and tranexamic acid

✔ Improves tolerance to prescription melasma cream and exfoliants

✔ Enhances daily defence against blue light and pollution

The Ideal Skin Care Regimen for Melasma

A barrier-first, pigment-safe approach helps reduce melasma dark patches on face while preserving skin health. Here’s how:

1. Cleanser for Sensitive Skin

Use a non-stripping, pH-balanced cleanser—fragrance-free and alcohol-free—to prep the skin without irritation.

2. Best Sunscreen for Melasma

Daily sun protection is non-negotiable. Opt for a broad-spectrum sunscreen with blue light protection, preferably SPF 50+ with PA++++ rating. Mineral sunscreens are ideal for sensitive or pigment-prone skin.

3. Antioxidant and Brightening Serums

Target melanin production and inflammation with:

Niacinamide for melasma
Azelaic acid
Tranexamic acid
Licorice root extract

These help regulate pigmentation without causing further sensitivity.

4. Skin Barrier Repair Cream

Use moisturizers rich in ceramides, panthenol, and omega fatty acids. A skin barrier repair cream improves hydration, reduces redness, and prepares skin for more active treatments.

Benefits of the Right Melasma Skincare Routine

✔ Fades melasma and hyperpigmentation gradually

✔ Prevents recurrence by strengthening the barrier

✔ Shields from blue light and UV damage

✔ Minimises redness and inflammation

✔ Supports early aging skin without sensitizing

Final Takeaway

Melasma is not just about dark patches on face—it's a chronic condition that requires both patience and precision. With the right melasma treatment strategy, including high SPF, barrier-first skincare, and targeted actives like niacinamide, visible improvement is possible.

A consistent routine that prioritizes sun protection for melasma, barrier support, and inflammation control can help restore even tone—without triggering new flares.

Frequently Asked Questions

What’s the best cream for melasma and pigmentation? +

Look for creams with niacinamide, azelaic acid, or tranexamic acid combined with barrier-supportive ingredients like ceramides.

Is sunscreen really necessary indoors? +

Yes. UVA and blue light sunscreen should be worn even indoors, especially when using screens for long periods.

Can exfoliation worsen melasma? +

Yes, if overdone. Choose gentle actives like PHAs or enzyme-based exfoliants and pair with a moisturiser for dry sensitive skin.

What is the best SPF for melasma? +

A broad-spectrum SPF 50+ sunscreen for face with blue light protection is ideal. Look for physical filters like zinc oxide.

Is melasma treatable? +

Yes. While it can be persistent, melasma treatment focused on sun avoidance, skin barrier health, and clinical actives shows consistent improvement over time.