Melasma is a common skin condition causing brown or greyish-brown patches of pigmentation typically across the face (cheeks, nose, forehead, upper lip) due to excess melanin. It’s often called ‘pregnancy mask’ because it commonly appears in pregnant women whose melanin production is triggered by hormones.

Melasma develops for a few key reasons, with genetics being one of the most important. If close family members such as your parents, siblings or other relatives have experienced pigmentation as they’ve gotten older, you’re more likely to develop it too. It’s also more common in people with darker skin types. 

Melasma affects women far more often than men, largely due to its hormonal links. For some women, it does fade after pregnancy, but while it is active, wearing a high SPF, limiting sun exposure where possible and using physical protection such as hats can help prevent it from worsening.

Melasma usually appears as larger patches of discolouration rather than small individual spots. It tends to look like brown, grey or brown-grey areas that blend together, most commonly on the cheeks, forehead, nose, upper lip or jawline. Unlike sunspots or freckles, the pigment forms broader, uneven patches that can look symmetrical on both sides of the face. Because the pigment sits closer to the surface of the skin and is constantly being stimulated, it can become more noticeable with sun exposure, heat or hormonal changes.

Melasma treatment timelines vary depending on severity and the treatment chosen. Topical treatments (the first-line approach) require consistent daily use for 6-12 weeks before noticeable improvement, with optimal results at 3-6 months. Chemical peels typically require a series of 4-6 treatments spaced 2-3 weeks apart, with visible fading of melasma beginning around week 2-3 and significant improvement by 8-12 weeks. Laser treatments usually need 3-6 sessions spaced 4-6 weeks apart, with results becoming apparent within 1-3 weeks of the first treatment. The most dramatic results develop over 2-3 months as the skin renews. Results depend on melasma depth—epidermal melasma (surface-level) responds faster than dermal melasma (deeper pigment). Sun protection is absolutely critical during and after treatment; without it, melasma can worsen. Most patients require combination treatment—topical therapies plus professional treatments—for best results. Maintenance treatments are often needed to prevent recurrence, as melasma has a tendency to return.