Clear And Unbiased Facts About MELASMA (Without All the Hype)

Melasma is a skin condition that causes brown or grey patches to appear, usually on the face. Most commonly appearing on the cheeks, nose, forehead, and chine. Melasma appears more commonly in women, particularly during pregnancy, gaining the nickname “the mask of pregnancy”. 

I had the pleasure to chat with Fiona from the Harley Street Emporium in a Live Instagram session where we talked about Melasma facts, giving clear and unbiased answers about its causes and its treatments. I also answered some of the most popular questions regarding this skin condition.

Check out all the questions we addressed during the Live Instagram talk below.

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Pigmentation: Unbiased Melasma facts

1)There are a lot of different types of pigmentation what is melasma and how does it differ from other types?

It differs by:

  • The Cause  
  • The way it behaves 
  • The shape (what dermatologists call clinical features)

The difference between Melasma and other pigmentation such as photodamage, sun damage or post-inflammatory pigmentation is that melasma is hormonally induced. This happens because of multiple reasons and triggers in comparison to post-inflammatory pigmentation which follows inflammation from scars, burns or acne which is usually deeper pigmentation than melasma. Sun damage is sun-induced and it can appear as freckles and blotchiness on your face, hands and feet it looks different. Melasma has specific typical features that allow dermatologists to identify it as melasma straight away.

2) Are there any other symptoms that come with melasma such as red, itchiness? How would somebody differentiate it themselves if somebody so something appears differently on their face?

No there are no symptoms with melasma but there are typical locations that it appears in. If your skin is burning, itchy or stinging – this is not melasma. 

3)Where does it normally appear?

Melasma typically appears on the cheeks, upper cheeks, nose, upper lip and forehead which are the main classical melasma areas. It has been reported to occur elsewhere other than the face but in very extremely rare situations. So I would say 99.9% of the time, melasma will appear on the face. 

Melasma looks like a mask on your face. That is why it is also called the mask of pregnancy or chloasma when it happens during pregnancy

4) Does it come on suddenly or does it progress during a period of time?

It could be sudden especially with pregnancy or when taking contraceptive pills. In some cases, it might appear gradual however I find that most patients come to me and say that their pigmentation appeared suddenly. 

5) What are melasma triggers?

Then Sun, sun, and sun! Also, pregnancy and contraceptive pills 

6) You mentioned that pregnancy and taking the contraceptive pill as two triggers would HRT also affect it as well?

Yes HRT can also affect it. 

 7)Could blue lights from your lamps, mobile or tv screen be a trigger?

This is controversial. But what we do know for sure is that if you are prone to getting pigmentation, then blue light could worsen or be a trigger.

8) Can it be cured or is it a matter of keeping it under control?

Melasma can recur and needs maintenance treatment and strict avoidance of sun by using sunscreen regularly.

9) Is melasma hereditary?

No, Melasma is not hereditary.

10) Would skin lightening products be something worth using as a treatment? 

Yes, Melasma is treated with lightening creams. 

11) What are the different treatment options available for people who suffer from this disease? 

  • Prescription creams 
  • Chemical peels  
  • Combination treatments including peels and creams 

A popular chemical peel for the treatment of pigmentation is the Dermamelan Peel. If you want to learn more about chemical peels and which peel could be right for you – download our free chemical peel guide.

12) Hydroquinone, which is a prescription medicine can be bought online, what would you say are the dangers of using that without consulting a doctor? 

Hydroquinone can cause sometimes skin irritation and can also worsen the pigmentation if used excessively in darker-skinned individuals, it is also not safe for use during pregnancy and breastfeeding, and will not work alone in lightening the melasma.

13) Intravenous (IV) drips to lighten the skin – is this something you would recommend?

Not at all. they are very dangerous and have in some cases caused death, and they are not an approved treatment for melasma.

14) Chemical peels and acid peels – which ones do you think are good to get rid of melasma?

Chemical peels are acids, there is no difference between the two.

15) Can deficiencies in iron or vitamin D worsen the condition?

 Those deficiencies are not directly related.

16) Does melasma affect more people with lighter skin or darker skin or is it indiscriminate? 

It can affect both.

17) What sort of damage can be done if you use the wrong kind of peel for melasma?

Chemical peels are extremely dangerous and must only be done by experienced doctors. Using the wrong peel or not being carefully monitored after the peel, can cause burns and permanent scarring.

18) Is there a way to treat hormonal imbalance if that affects your melasma?

Yes of course. You can consult with your gynaecologist or endocrinologist to treat any hormonal imbalance, but you would still need to treat the melasma. 

19) Are there any new treatments on the market with good results to treat melasma?

The mainstay of treatment is chemical peels and prescription creams that bleach the pigmentation, peel the outer layer of the skin and dampen the hyperactive melanocytes. Dermamelan treatment gives excellent results in melasma.

20) Do skin hydration injections work for melasma?

Not at all

21) Can melasma be treated with laser?

Usually not. There are the newer picosecond lasers that are showing promising results in difficult to treat melasma.

22) How long does it take during the treatment of melasma to see results? 

Depends on the depth of melasma, the deeper it is the longer it takes. it takes a few months to see final results and sometimes up to a year. 

23) Which type of sun cream is good for melasma?

There are many good sunscreen brands out there but opt for the medical range ones you can buy from a pharmacy and choose the high spf ones 30 and above.

24) Is Obagi the best skincare for melasma?

It is excellent. Obagi nuderm is one of the best treatments for melasma but has to be prescribed by a specialist experienced in it and to teach the patients how to overcome the initial downtime of redness and peeling. 

25) Is there a similar product (like Obagi) that the average person can afford?

Yes, we can prescribe generic creams which are much cheaper.

26) What makes one type of melasma deep while another superficial – do we know?

No, we don’t. It depends on where the pigment is deposited in the skin. Deep melasma tends to be more common in darker-skinned individuals because they have more melanocytes to start with.

27) Do you see children with melasma?

Extremely rare to see children with melasma.

28) Is over the counter or drinking collagen recommended for melasma?

Not at all. It is useless and just commercial.

29) Is there anything else that people should know about melasma?

You don’t have to suffer from melasma. It can be treated and effective treatments exist so you don’t need to live with it. 



You can also watch Instagram live to hear in details all the unbiased melasma facts that were discussed in the Live.


Clear And Unbiased Facts About MELASMA Instagram live