How To Treat Melasma, According To The Top Skin Experts

Photographed by Sarah Harry-Isaacs
While most pesky skin conditions like acne and eczema are equal opportunity offenders, melasma is a special kind of joy that’s reserved mostly for women. It's estimated that 90% of people who suffer from melasma are women, according to the British Association Of Dermatologists. What's more, many don't even realise they have it — which can make things worse with mistreatment.
"Melasma affects the skin of the face with irregular brown and grey-brown areas of discolouration," dermatologist Michael Swann, MD explains. "The cheeks, nose, forehead, chin and upper lip are most commonly affected." Like all skin issues, it can range from light to severe — a few patches or spots above the upper lip to a full face of discolouration. Dr Anjali Mahto, consultant dermatologist and author of The Skincare Bible: Your No-Nonsense Guide To Great Skin, adds that melasma is more common in Asian and Mediterranean skin.
Facialist Kate Kerr pinpoints pregnancy and the contraceptive pill as just a couple of melasma triggers, due to a surge of hormones, while the British Skin Foundation points out that exposure to UV light from the sun and the use of sunbeds can also trigger melasma or make it worse.
But what can you do about it? And how do you prevent it from multiplying this summer without avoiding pool and park days? We checked in with the experts.
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What is melasma?

Understand What Melasma Is — & Isn't

Los Angeles dermatologist Annie Chiu, MD describes melasma as "chronic hyperpigmentation of the skin occurring in patches on the face." She credits sun exposure and hereditary predisposition as major culprits, as well as hormonal changes, but adds that the causes range. "Most commonly an increase in oestrogen either through pregnancy or birth control pills," she says, noting that darker skin tones are affected more frequently. Google melasma and you'll see exactly what we're talking about.

One more rumour to bust: melasma is not the same as freckles. "The pigmentation in melasma is much deeper in the skin than more common sun spots, aka 'lentigenes' or freckles," Dr Swann says. "This deposition of pigment deeper in the skin means the resulting colour that we see with our eye doesn't match normal skin tones. It also makes the pigment harder to treat, so prevention is actually much more effective than treatment."

Sun exposure also exacerbates the issue. "Studies have shown melasma is triggered not only by UV exposure, but can also be worsened by infrared energy, which is felt as warmth," she says. Suffice to say, it's impossible to cut out everything that could be causing melasma, so let's talk about slowing it down instead.
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How do I avoid it?

Sunscreen Is A Must

You guessed it: SPF, SPF and more SPF. "The single most important thing you can do for your skin is to protect it from the sun," celebrity aesthetician Shani Darden told us. "Sun exposure ages your skin and is extremely hard to reverse later in life," so apply a sunscreen with a minimum of SPF 50 daily.

Chiu agrees and suggests an especially strong, broad spectrum sunscreen. "Everyday use with regular reapplication is crucial to the control of melasma," she says.

Dr Swann agrees with Dr Chiu, stating that it's not just sunlight you have to worry about. "Melasma may be more linked to UVA or infrared light and heat than it is to UVB," he says. Moral of the story: Liberally apply a broad spectrum SPF every day for extra protection. Dr Swann recommends any formula from Elta MD.

Next, stay cool and learn to love big hats and shade. Baking in the sun and even hot yoga can trigger melasma, our experts say.
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"This provides protection from the sun with mattifying perks," says London-based consultant dermatologist, Dr Justine Kluk. "It has a gel-cream texture, contains salicylic acid which provides anti-shine and anti-blemish properties and it’s non-comedogenic so the formula is unlikely to clog pores."
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Founder of Black Skin Directory, Dija Ayodele rates this sunscreen for its "high UVA and UVB protection", clear, streak-free formula and "smooth, matte, invisible finish".
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"Choosing the correct sunscreen for your skin largely comes down to personal preference," explains Dr Anjali Mahto, consultant dermatologist and author of The Skincare Bible: Your No-Nonsense Guide To Great Skin, "but my personal favourite is Heliocare 360 Gel Oil-Free SPF 50."
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How do I get rid of it?

Pick The Right Skincare Products

London-based consultant dermatologist Dr Justine Kluk suggests looking at melasma as a long-term condition. Even though there are a number of things you can do to help alleviate melasma, very frequently, it does come back.

"Effective treatment of melasma requires adhering to a skincare regime with 'superscreens', pigment-decreasing ingredients and behaviour modification," Chiu adds. That is: seeking shade when outdoors, and avoiding too sunny or too hot environments. SPF? Check. Big hats and sunnies? Check check. An affinity for shade? Working on it. The last step? Finding the right ingredients to help lessen the discolouration at home.

Darden and Chiu both recommend at-home peel pads, such as Dr. Dennis Gross' formula and Murad's options, respectively. You can also add a skin lightener to temper the issue, such as hydroquinone which is only available on prescription from a qualified dermatologist. Also look for exfoliating ingredients like kojic acid and alpha arbutin, Dr Swann says, while Dr Kluk recommends either azelaic acid or a vitamin C-based serum to help regulate pigmentation.
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"This product is a potent combination of essentially melanin inhibitors, niacinamide and exfoliating acids," says Dr Ewoma Ukeleghe, founder of SKNDOCTOR. These ingredients actually target pigmentation on a cellular level by interfering with the hyperpigmentation process."
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"This is an advanced, clinically proven product with a highly effective combination of ingredients," says facialist, Chelseé Lewis. "They work together to increase cell turnover, therefore diminishing the appearance of skin discolouration. The addition of vitamin E also protects skin from further environmental damage."
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"This exfoliating serum is a great product for reducing discolouration caused by sun exposure, hormonal changes and the ageing process, which can sometimes result in dark spots and patches," says Dr Jonquille Chantrey, aesthetic surgeon and international beauty lecturer.
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Vitamin C

A stable vitamin C serum is another step, applied in the morning after cleansing and before SPF, Chiu says, noting that SkinCeuticals C E Ferulic, £135, is the "gold standard".
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Supercharged with vitamin C, this silky beauty editor-approved serum boosts skin radiance and plumpness without irritation.
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Dr Mahto also suggests opting for a vitamin C serum combined with vitamins E and ferulic acid, such as Timeless Skincare 20% Vitamin C + E Ferulic Acid Serum.
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What about professional treatments?

Want to take it a step further? Experts note that a professional chemical peel and/or laser treatment can jumpstart results but be wary, because "many lasers can actually worsen melasma given the heat exposure," Dr Chiu says. (She recommends the "cautious use of limited lasers like the Clear and Brilliant Permea fractional laser.")

Kate Kerr adds: "Melasma is very tricky to treat so if it is purely melasma and there is no other sun damage or pigmentation, I would always refer a client to a specialist. As melasma tends to be a deeper issue, medical grade ingredients should always be used. I would always recommend seeing a dermatologist, although this isn’t suitable for everyone as there’s a lot of downtime and it’s expensive." If you do decide to seek help from a dermatologist, always make sure they are qualified by searching their name on the General Medical Council register.

Talking to your doctor about a lower dose of oestrogen in your birth control or adding a topical, prescription-strength hydroquinone for a few weeks (too much can make things worse) is also helpful. And remember, daily, religious use of broad spectrum SPF is important.

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