Melasma often shows up quietly and then sticks around longer than anyone would like. It can fade, darken, and shift over time, which makes it especially frustrating for people who feel like they’re doing “everything right” with their skin.
This condition is very common and not harmful, but it can be persistent. Managing melasma is usually about patience, consistency, and choosing treatments that respect how reactive the skin can be.
Chronic pigmentation condition
Cheeks, forehead, upper lip, chin, temples, nose
Controlled, even-looking skin tone over time
What Is Melasma?
Melasma is a chronic pigmentation condition that causes brown or gray-brown patches on the skin. It most commonly appears on the face, particularly on the cheeks, temples, upper lip, chin, bridge of the nose, and forehead.
Unlike isolated sun spots, melasma tends to form larger, symmetrical patches and often affects deeper layers of the skin, which is why it can be more difficult to treat.
Who it affects:
Melasma is caused by the overproduction of melanin (pigment) in certain areas of the skin. There are no physical symptoms, but it can be associated with social embarrassment and self-consciousness.
Why Melasma Develops
Melasma develops due to a combination of internal and external factors.
Sun exposure — UV light from the sun or tanning beds stimulates melanocytes to produce pigment, causing overproduction in areas of melasma. In our region of the country, most patients notice it improves in the winter and worsens in the summer. Even small amounts of sun exposure can trigger or worsen melasma.
Hormonal changes — You’ll often hear melasma called “the mask of pregnancy.” Many women notice it starts during one of their pregnancies (not always the first). Birth control pills and hormone replacement therapy may also trigger or worsen melasma.
Genetics — Family history plays a role in who develops melasma.
Skin inflammation — Inflammation can trigger or exacerbate pigmentation in susceptible individuals.
Because melasma behaves differently than other pigmentation concerns like sun spots or age spots, it requires a more cautious, specialized approach to treatment.
How Melasma Can Affect Appearance
Melasma doesn’t cause physical discomfort, but it can significantly affect how people feel about their skin.
Patients often describe:
These reactions are very common. Treating melasma isn’t about chasing perfection — it’s about improving tone while protecting the skin long term.
What to Expect During a Consultation
A consultation at Lazaderm is focused on education and long-term planning.
During your visit, your provider will:
You’ll leave with a plan designed to support improvement without overstressing the skin.
Setting Realistic Expectations
There is no cure for melasma. This is important to understand from the start.
Melasma may improve over time, especially with removal of the triggering factor — such as stopping birth control pills, delivery of a baby, or discontinuing hormone replacement therapy. But treatment is about controlling it, not eliminating it permanently.
What to expect:
The goal is clearer, more even-looking skin that can be maintained over time with consistent care.
Melasma requires a thoughtful, layered treatment plan rather than aggressive correction. A consultation allows your provider to assess pigment depth, triggers, and skin sensitivity before recommending options.
Lazaderm believes that the most important first line of defense is wearing sunblock every single day on sun-exposed areas.
Sunscreen requirements:
Important note: Some physicians believe that if you tan other areas of your body (like your legs), it may affect melasma on your face — even if your face is completely protected from sun exposure. Full-body sun protection is ideal.
Additional protection:
Topical creams play a central role in managing melasma and are often used before, during, and after other treatments.
Common topical ingredients:
Medical-grade skincare systems: We recommend either the Obagi Nu-Derm system or ZO Skin Health products for melasma management. These systems combine multiple active ingredients for comprehensive treatment.
What we avoid: Corticosteroids are sometimes included in melasma treatments, but we prefer not to use them because they can only be used for a short time — and melasma is a long-term problem requiring long-term solutions.
Certain laser and light-based treatments may be used cautiously to address melasma, depending on skin type and pigment depth.
Critical warning: It is very important that those treating melasma with lasers or light sources have a good understanding of this condition. Lasers and light treatments can make melasma worse if not done correctly.
Our approach: We always recommend pre-treating with topicals before any laser or light treatments. This helps prepare the skin and reduce the risk of rebound pigmentation.
Treatments that work well for melasma:
Not all treatments are appropriate for every patient, which is why thorough evaluation is essential before proceeding.
MOXI is a gentle fractional laser that can be effective for melasma when used appropriately.
How it works: MOXI delivers fractionated laser energy at a gentler level than more aggressive lasers, making it a safer option for pigmentation concerns like melasma when combined with proper pre-treatment.
Why it works for melasma:
Important: As with all laser treatments for melasma, pre-treatment with topicals is essential. MOXI should only be used after the skin has been properly prepared.
Because melasma is a chronic condition, maintenance is essential for preserving results.
Ongoing care includes:
If you stop your maintenance routine: If you have great control of your melasma and then stop protecting your skin from sun exposure or stop using your maintenance topicals, the melasma will likely reappear.
Think of melasma management like managing any chronic condition — consistent care produces consistent results.
If melasma is something you’ve been struggling with, a consultation can help you understand what’s happening and what options make sense for you. At Lazaderm, consultations focus on education, skin health, and realistic expectations.
