Key takeaways
- In melasma, the pigment-producing cells (melanocytes) become hyperactive and produce more pigment (melanin).
- Creams, lasers and serums clear pigment that is already made. They do not calm the hyperactive pigment-producing cells.
- Hence pigmentation returns once treatment is stopped. This is why we should control triggers as well.
Melasma is a common pigmentation condition that causes brown patches on the cheeks, forehead and upper lip, triggered by sun, heat and hormones.
The story of melasma is almost the same for every patient. The spots usually fade nicely on a cream or serum. Once they stop applying it, the pigmentation comes back, even worse and darker than before. You may think the cream has failed, but in reality this is exactly how melasma behaves. Once you understand it, you'll be able to control the pigmentation better.
What switches the pigment machinery on?
- Sunlight and visible light. Including light through windows, tubelight and screens.
- Heat. Commonly kitchen stove heat and the hot climate outdoors.
- Hormones. Pregnancy, thyroid issues, irregular cycles, hormonal pills.
- Inflammation and damage to skin. Using harsh scrubs can make it worse.
This is why melasma is stubborn in Ahmedabad. We get six to eight months of strong sun and heat, and most of us commute in it.
What can I do to calm it?
- Sunscreen is essential. Use it 20 minutes before stepping out. Reapply if you are out past midday.
- Heat cover. Wear a scarf or thick cotton (or better, UPF rated clothing) while outside. Stand back from the kitchen stove or grill.
- Gentle procedures. Dermatologist-approved peels or low-fluence laser toning suited for your skin. Aggressive settings used by unqualified laser operators can make the pigmentation rebound.
- A check for other causes. Thyroid issues, hormonal fluctuations and vitamin deficiency should be checked in stubborn, widespread pigmentation.
What to expect?
- First visible change after 1 to 2 months.
- Real difference in 3 to 4 months.
What ruins results?
- Stopping sun protection once the skin looks clear.
- Switching creams every few weeks because something stronger was promised online.
Book a consultation
Have pigmentation that keeps returning? A consultation sorts out which type it is before anything is prescribed.
Medical disclaimer. This article is for general education only. It is not a substitute for a consultation and examination by a qualified doctor who knows your medical history. Do not start, stop or change any medicine without medical advice.