How to Treat Melasma — The Honest Guide
Melasma is hormonal pigmentation that doesn't respond to standard pigmentation treatments. The protocol below is what dermatologists prescribe — and it's a slow process.
If you only read one paragraph.
Daily SPF 50 mineral, tranexamic acid 3%, vitamin C, gentle retinoid, and address hormonal triggers. 6-12 month timeline. Avoid harsh treatments — they make melasma worse.
The full method.
- Switch to mineral SPF 50, daily. Chemical SPFs don't block visible light, which is a major melasma trigger. Mineral (zinc oxide) is essential.
- Add tranexamic acid 3% (The Ordinary). Reduces melanin transfer. The most-evidence-based topical for melasma.
- Vitamin C every morning. L-ascorbic 10-20%. Brightens overall, gentle on melasma.
- Niacinamide 5-10% twice daily. Reduces melanin transfer.
- Retinol 0.025%, slow build. Higher percentages can trigger flares. Build slowly — 2 nights weekly to start.
- Address hormonal triggers. Pregnancy, oral contraceptives, hormone replacement therapy. Discuss with your GP.
- In-clinic: Cosmelan or Pico laser only with specialist supervision. Aggressive treatments can worsen melasma. Only with a dermatologist who specialises in pigmentation.
What to avoid.
- Using chemical SPF only (visible light triggers melasma).
- Aggressive scrubbing or peels (worsens melasma through inflammation).
- DIY hydroquinone (can cause permanent darkening if misused).
- IPL laser (often makes melasma worse, not better).
- Stopping treatment when melasma fades (returns within 4-6 weeks of sun exposure).
Common questions.
Will melasma ever fully fade?
Often yes, with consistent treatment over 12-18 months. But it's prone to recurrence with sun, hormones, or pregnancy. Prevention is lifelong.
Should I see a dermatologist?
Yes, especially if topicals don't show improvement at 16 weeks. Melasma needs specialist supervision — non-specialist procedures often worsen it.
Does diet affect melasma?
Limited evidence. Some clients see improvement with anti-inflammatory diets. Stress and inflammation are real triggers.
Can I use IPL or fractional laser for melasma?
IPL often makes it worse. Fractional laser can help with specialist supervision but risks rebound. Pico laser is the most-evidence-supported.
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