Struggling with Stubborn Dark Patches? Here’s How to Manage Melasma

Written By Monika Chauhan

July is Melasma Awareness Month, a time to bring visibility to a condition that affects many, especially in the summer. Melasma is more than a cosmetic concern, it’s a chronic skin disorder that affects millions, especially women, and can be emotionally exhausting to manage without the right guidance.

If you’ve been struggling with melasma and feeling stuck, know that you’re not alone and there are options that truly work.

What Is Melasma?

Melasma causes darker patches or spots on the skin—most often on the cheeks, forehead, nose, chin, and above the upper lip. For some, it can also show up along the jawline, neck, or arms. It tends to look blotchy or freckled, and the color can vary from light brown to grayish, depending on your skin tone. Melasma usually appears on both sides of the face, and over time, smaller patches can blend into larger areas.

Why Does Melasma Happen?

While the exact cause of melasma is not known, here are a few reasons why it may happen:

  1. Sun exposure
    Ultraviolet (UV) light stimulates melanocytes (the pigment-producing cells in your skin), causing dark patches to develop or worsen.Even a small amount of sun exposure can cause melasma to return after it has faded.

  2. Hormonal shifts
    From pregnancy to birth control pills, estrogen and progesterone often spark melasma flares. That’s also why we see it more in women of childbearing age.

  3. Genetics
    Melasma is more likely if you have a family history of the condition.It’s also more common in individuals with medium to darker skin tones, such as those with Fitzpatrick skin types III to VI.

Treatment Options for Melasma

If you’ve been diagnosed with melasma, your dermatologist will likely start by prescribing topical treatments that help reduce excess pigment. Most of these are applied at home as part of your daily routine.

Here are some of the most common options:

  • Hydroquinone: Often considered the gold standard for treating melasma, hydroquinone helps lighten dark patches and even out skin tone. It’s now only available by prescription.

  • Tretinoin and a mild corticosteroid: This combination includes a retinoid to increase skin cell turnover and a steroid to reduce inflammation, both working together to help fade discoloration.

  • Triple-combination cream: A powerful formula that blends hydroquinone, tretinoin, and a corticosteroid in one prescription cream. It targets pigment, improves skin texture, and calms irritation.

  • Gentler alternatives: If your skin is sensitive or if you’re pregnant, your dermatologist may recommend non-hydroquinone options like azelaic acid, kojic acid, or vitamin C, which help brighten skin with less risk of irritation.

When Melasma Needs More Than Just Topicals

Here are a few in-office procedures that are showing promise:

  • Chemical peels: These use ingredients like glycolic acid or TCA to exfoliate the top layers of skin and reduce surface pigment.

  • Microneedling: This minimally invasive treatment uses tiny needles to create micro-injuries in the skin, which can improve tone and texture as the skin heals.

  • Laser or light therapy: Certain types of low-energy lasers or IPL (intense pulsed light) can enhance the effects of topical treatments when used cautiously and by experienced hands.

  • Platelet-rich plasma (PRP): This emerging option uses your own blood plasma, which is injected into affected areas to support skin healing and improve pigmentation.

  • Tranexamic acid (TXA): When taken by mouth, TXA works by calming inflammation and blood vessel signals that trigger excess melanin, helping fade moderate to severe melasma.

Our Top Tips for Managing Melasma

  • Wear a tinted sunscreen every day. Choose a broad-spectrum SPF 30+ that’s water-resistant. Apply it 15 minutes before going outside, and reapply every 2 hours. 

  • Find shade and wear sun-protective clothing. A wide-brimmed hat and sunglasses with UV protection go a long way.

  • Avoid tanning beds and sunlamps. These can trigger or worsen melasma.

  • Use tinted sunscreen if you have a darker skin tone. It helps protect against visible light, which can also affect melasma.

  • Stick with gentle, fragrance-free products. If something burns or stings, it’s likely making things worse.

  • Consider stopping oral birth control and use alternative methods.

  • Use makeup if it makes you feel good. There’s no shame in covering up while treatment does its work. We can help you find options that look natural and feel comfortable.

Why Melasma Awareness Month Matters

Melasma is often misunderstood as just a cosmetic issue, but in reality, it’s a chronic dermatologic condition with physical and emotional impact. Too often, patients spend years trying ineffective or irritating treatments that don’t address the root causes. Melasma Awareness Month gives us the opportunity to highlight proven, personalized solutions that can truly help.

With the right diagnosis, the right products, and the right procedures, melasma can be managed successfully and safely.

📍 Locations: Sandy Springs & Johns Creek

📞 Call us today to book your consultation!

Monika Chauhan