Melasma (Hormonal pigmentation/chloasma)
Melasma is a common skin condition that causes brown or grey-brown patches, most often on the face—particularly the cheeks, forehead, nose, and upper lip. It occurs when pigment-producing cells in the skin (melanocytes) become overactive, usually triggered by sun exposure, hormonal changes (such as pregnancy or oral contraceptives), and certain skincare products. While melasma is not harmful, it can be distressing for those affected. Fortunately, there are effective treatments available.
Melasma is an acquired disorder of hyperpigmentation characterised by symmetrical, irregularly bordered brown to grey-brown macules and patches, most commonly affecting sun-exposed areas of the face such as the cheeks, forehead, upper lip, and chin. It is a benign condition but often chronic and relapsing.
Melasma develops due to overactivity of melanocytes, the pigment-producing cells of the skin, leading to excess melanin production and abnormal pigment deposition within the epidermis, dermis, or both. This melanocyte hyperactivity occurs without an increase in melanocyte number and results in visible darkened patches of skin.
The Science Behind It
The pathogenesis of melasma is multifactorial. Key triggers include ultraviolet and visible light exposure, which directly stimulate melanin production and induce cutaneous inflammation that further exacerbates pigmentation. Hormonal influences—such as pregnancy, oral contraceptive use, and hormone replacement therapy—play a significant role, as do genetic predisposition and certain medications or topical products.
Individuals with darker skin types are more susceptible due to naturally higher baseline melanocyte activity. Emerging evidence also suggests that vascular changes, increased blood vessel signalling, and skin barrier dysfunction contribute to the development and persistence of melasma.
Effective management requires a multimodal, long-term approach, including strict photoprotection, topical pigment-modifying agents, and carefully selected procedural treatments. Given the risk of post-inflammatory hyperpigmentation, particularly in skin of colour, treatment should be guided by clinicians experienced in managing pigmentary disorder.
What are the best lasers for Melasma?
Laser treatments are considered a third-line option in the management of melasma and are typically reserved for patients whose pigmentation has been resistant to, or has failed to adequately respond to, conventional therapies such as topical agents and systemic treatments. Lasers do not cure melasma. Rather, they may help improve pigmentation in carefully selected cases by targeting excess melanin and, in some instances, associated vascular components. Treatment is often performed using conservative settings to minimise the risk of post-inflammatory hyperpigmentation, particularly in darker skin types.Optimal outcomes usually require a combination approach, with laser therapy used alongside ongoing topical treatments, strict photoprotection, and long-term maintenance strategies. Recurrence is common, and patients should be counselled that repeat treatments and sustained skincare regimens are often necessary to maintain improvement over time.
Treatment at a Glance
| Treatment Type | Number of Sessions | Procedure Time | Typical Recovery |
|---|---|---|---|
| Picosecond laser | 2 - 5+ sessions | 10 - 30 minutes | 3 - 5+ days |
| Biomodulator / Biostimulator Injections | 3 sessions - every 3-4 weeks, for 3 months | 30 minutes | Slight redness and swelling for 48 hours |
Frequently Asked Questions
Persistent pigmentation is usually due to one or more of the following factors:
- Insufficient sun and visible-light protection UV and visible light are major drivers of pigmentation. If sunscreen is not the correct type, amount, or reapplied often enough, pigmentation will continue to flare—no matter how much treatment you do.
- An incomplete or unbalanced treatment plan Melasma and other pigment conditions often require a combination of treatments (lasers, medical creams, peels). Relying on a single treatment is rarely effective.
- Ongoing underlying inflammation Conditions like acne can continuously trigger post-inflammatory pigmentation. If inflammation isn’t treated, pigmentation will keep returning.
- Incorrect diagnosis There are over 150 causes of pigmentation. If the underlying type is misdiagnosed, even the best treatments may not work. Accurate diagnosis is the critical first step.
Important ACC & Treatment Disclaimer
ACC funding eligibility is determined by the Accident Compensation Corporation on a case-by-case basis. Approval is dependent on injury acceptance, clinical indication, and ACC policy at the time of application. Not all treatments offered at Scars & Lasers are ACC-funded. Private fees may apply for unfunded components of care.
Learn more about ACC IncidentsElevating melasma treatment through precision pigment correction and advanced dermatologist-directed skin restoration.
Book Your Consultation
Take the first step towards healthier skin. Leave your details below and our friendly team will be in touch to secure your appointment.