Melasma and facial pigmentation: why it happens and how it's managed
Brown or grey-brown patches on the cheeks, forehead, or upper lip — symmetrical on both sides of the face — are the classic picture of melasma. It’s one of the most common pigmentation concerns in Indian skin, and one of the most misunderstood: there’s no overnight fix, but with the right plan it can be managed well.
Why melasma happens
Two forces drive it, usually together:
- Sunlight. UV exposure stimulates the pigment-producing cells (melanocytes) in the skin. Melasma almost always appears on the most sun-exposed areas of the face, and worsens after time outdoors.
- Hormones. Pregnancy (when it’s often called the “mask of pregnancy”), birth-control pills, and other hormonal changes can trigger melasma in people who are predisposed. Pregnancy-related melasma often fades in the months after delivery as hormones settle.
Genetics load the dice — melasma frequently runs in families and is more common in medium and darker skin tones.
The non-negotiable foundation: sun protection
No treatment for melasma succeeds without daily sun protection, because even brief unprotected exposure re-stimulates the pigment. That means:
- A broad-spectrum sunscreen every morning, rain or shine, indoors-by-the-window included
- Reapplication when outdoors for long periods
- A wide-brimmed hat or scarf and shade during peak hours
- Being aware that heat, not just sunlight, can aggravate melasma for some people
What dermatologists can offer
After confirming the diagnosis (a few other conditions mimic melasma), treatment is built in steps:
- Topical treatments that regulate pigment production — prescription creams used under supervision, since some need careful, time-limited use
- Chemical peels as an add-on for resistant pigment
- Laser and light-based treatments in carefully selected cases — with caution, because the wrong settings can worsen pigmentation in Indian skin
Expect gradual lightening over months, and a maintenance plan — melasma has a tendency to return if sun protection lapses.
When to see a dermatologist
- New or spreading facial pigmentation, to confirm what it actually is
- Melasma that hasn’t improved with consistent sunscreen use
- Before trying strong “fairness” or steroid-containing creams from a pharmacy — unsupervised use of these is a common cause of skin damage we see
Dr. Rampal Ortho & Skin Clinic in Jacobpura, Gurugram treats melasma and pigmentation with Dr. Mukesh Rampal. To ask about pigmentation treatment, call or message +91 93104 57590.
This article is general health information and is not a substitute for a consultation with a qualified doctor.