Melasma is a common form of hyperpigmentation causing symmetrical brown or greyish-brown patches on the skin. It most often appears on the cheeks, forehead, bridge of the nose, upper lip and chin, though it can occasionally affect sun-exposed areas such as the forearms and neck.
It is not harmful, and it is not contagious, but I see patients every week who find it genuinely distressing. It tends to sit right in the middle of the face, which makes it hard to hide with a fringe or a scarf the way you might with pigmentation elsewhere, and that visibility is often what brings people through our door rather than the pigmentation itself.
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We do not fully understand why some people develop melasma and others do not, but we do know that it involves the pigment-producing cells in the skin, the melanocytes, going into overdrive and producing excess melanin. A few things are strongly associated with it:
One thing I always say to patients: melasma is a condition you manage rather than one you switch off. Even after excellent clearance, it can return if sun protection lapses or hormones shift again. I would rather tell you that honestly at the first consultation than have you disappointed six months later.
Our consultations are in-depth and tailored to you, creating a bespoke treatment plan catering to all of your concerns.
ConsultationThere is no single treatment that clears melasma on its own, and I am always a little wary of anyone who promises otherwise. What works is a combination approach, built around three things:
Strict, year-round sun protection. This is not optional and it is not just for summer. I ask patients to wear a high-factor, broad-spectrum SPF every single day, rain or shine, and to reapply it properly. This one habit does more for melasma than any product or procedure we offer.
Addressing triggers where possible. If a hormonal medication is contributing, that is a conversation to have with your GP or gynaecologist, alongside what we can offer in clinic.
Targeted treatment in clinic, which may include:
I tailor this combination to your skin type, your triggers and how your skin has responded to anything you have tried before. Melasma is notoriously stubborn in darker skin tones, and treating it too aggressively can make things worse rather than better, so I would always rather go slightly slower and get it right.
Every consultation is in-depth and built around you. We will look at your skin, talk through your history and likely triggers, and put together a realistic treatment plan with honest expectations about timescale and results.
A chemical peel is a chemical exfoliation specifically tailored to suit your skin’s needs. It rejuvenates the complexion, restores glow and lustre to the skin and helps to improve the skin’s overall health and appearance.
