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Melasma Diagnosis and Treatment in London

Melasma is a common skin condition that causes brown or grey-brown patches, usually on the face. It is strongly linked to sun exposure, hormonal changes, and skin type. Though harmless, it can cause cosmetic concern and affect confidence. At Skinhorizon Dermatology London, we provide expert diagnosis and advanced treatments to help reduce pigmentation and restore an even skin tone.

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Melasma at a Glance

What is melasma?	A chronic pigmentation disorder causing brown or grey patches, most commonly on the cheeks, forehead, nose, and upper lip.
What are the symptoms of melasma?	Irregular, symmetrical patches of hyperpigmentation on sun-exposed areas, usually without itching or pain.
Who gets melasma?	Most common in women of childbearing age, people with darker skin types, and those exposed to sun or hormonal changes.
What causes melasma?	Triggers include sun exposure, pregnancy (chloasma), oral contraceptives, hormone therapy, and genetic predisposition.
Is melasma dangerous?	Melasma is harmless and not cancerous, but it can be persistent, cosmetically distressing, and resistant to treatment.
How is melasma diagnosed?	Usually by clinical examination, Wood’s lamp, and occasionally dermoscopy to assess depth of pigmentation.
How is melasma treated?	Combination of strict sun protection, topical creams (e.g. hydroquinone, retinoids, tranexamic acid), chemical peels, and laser treatments.
Can melasma be prevented?	Not always, but consistent daily sun protection and avoiding unnecessary hormonal triggers can reduce risk.

Understanding Melasma

Melasma is a form of acquired hyperpigmentation where patches of darker skin develop due to increased melanin production. It most often affects the face and is influenced by a combination of genetic, hormonal, and environmental factors. Melasma tends to be chronic and may fluctuate in intensity over time.

Causes of Melasma

Melasma develops when melanocytes (pigment-producing cells) are over-stimulated. Triggers include:

Sun exposure: UV and visible light stimulate melanin production.
Hormonal influences: Pregnancy (chloasma), contraceptive pills, and hormone replacement therapy.
Genetics: Family history and darker skin types increase risk.
Drugs and cosmetics: Photosensitising medications or irritating skincare products.
Other factors: Thyroid disease and stress may contribute in some cases.

Symptoms of Melasma

Melasma typically presents as:

Flat, brown or greyish patches on the face (cheeks, forehead, nose, chin, upper lip)
Symmetrical distribution on both sides of the face
Patches may darken with sun exposure or pregnancy
Harmless and not itchy or painful, but often cosmetically distressing

Melasma Diagnosis

Melasma is diagnosed clinically by a dermatologist. Useful tools include:

Wood’s lamp: Helps differentiate superficial (epidermal) from deeper (dermal) pigmentation.
Dermoscopy: Provides detailed assessment of pigmentation patterns.
Skin biopsy: Rarely needed, only if diagnosis is uncertain.

Melasma Treatment and Management

While melasma is difficult to cure permanently, a tailored combination approach helps control and improve pigmentation:

Sun protection: Broad-spectrum SPF 30–50 daily, hats, and avoiding direct sunlight.
Topical creams: Hydroquinone, retinoids, azelaic acid, kojic acid, or tranexamic acid formulations.
Oral therapies: Low-dose tranexamic acid under specialist supervision.
Procedures: Chemical peels, microneedling with serums, and fractional lasers may be used for resistant cases.
Maintenance: Ongoing skincare, sun protection, and avoiding triggers are essential to prevent relapse.

Living with Melasma

Melasma often fluctuates, improving in winter and worsening in summer. Patients benefit from consistent sun protection, medical skincare, and realistic expectations. Emotional support may also help, as melasma can impact self-esteem and quality of life.

Your first visit — what to expect

History: Review of symptoms, onset, hormonal factors, medications, and sun exposure.
Examination: Facial mapping of pigmentation patterns.
Investigations: Wood’s lamp or dermoscopy if needed.
Management plan: Personalised treatment combining skincare, medical creams, and in-clinic procedures.
Follow-up: Monitoring progress and adjusting treatments for best outcomes.

Reviewed by: Dr Mohammad Ghazavi, Consultant Dermatologist
Skinhorizon Clinic, 4 Clarendon Terrace, Maida Vale, London W9 1BZ
Last reviewed: 22 August 2025

Struggling with facial pigmentation? Skinhorizon London offers expert diagnosis and advanced melasma treatments to restore skin clarity and confidence.

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Melasma FAQs

Is melasma the same as freckles?

No. Melasma causes larger, symmetrical patches of pigmentation, while freckles are small, scattered spots that darken with sun exposure.

Can melasma go away on its own?

Melasma may fade after pregnancy or when hormonal triggers stop, but it often persists and requires treatment plus sun protection.

Is melasma linked to skin cancer?

No. Melasma is not cancerous and does not increase the risk of melanoma. However, it should be distinguished from other pigmentation conditions.

What is the most effective treatment for melasma?

A combination of sun protection, prescription creams, and procedures like chemical peels or fractional laser is most effective. Results vary by skin type.

Can men get melasma?

Yes, although less common, melasma also affects men, particularly with sun exposure or genetic predisposition.

Disclaimer: The information above is provided for general education only and should not be taken as medical advice for any individual case. A consultation with a qualified healthcare professional is required to assess suitability, risks, and expected outcomes.

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