Melasma
Melasma appears as flat brown or grey-brown patches, usually across the cheeks and forehead. An interplay of factors cause the development of melasma, often with a heavy hormonal influence, which is why it is common in pregnancy and periods of hormonal change.
Melasma is a common type of pigmentation that forms symmetric patches of brown pigment on the face. Hormonal changes and sun exposure are the main triggers, and heat and visible light can make it darker. It can be managed but often recurs, so Heather Holbrook assesses your skin first and recommends a gentle, gradual plan that combines in-clinic treatment with daily sun protection.
Reviewed by Heather Holbrook, Dermal Clinician, 35 years' experience. Last reviewed October 2026.
Understanding melasma
Melanocytes are the cells that make pigment. In melasma they become overactive in patches, so some areas of skin produce more pigment than the skin around them.
Melasma is common in women and often first appears between the ages of 20 and 40. People with olive or deeper skin tones are more likely to develop it. It is sometimes called the mask of pregnancy, because pregnancy is one of the most common times for it to appear.
Signs to be aware of
What triggers melasma
Melasma rarely has a single cause. Most people have a mix of triggers, and knowing yours is a large part of managing it.
Hormones
Pregnancy and hormonal contraception are common triggers. Some women notice new or darker patches around perimenopause.
Sun and visible light
UV is the main trigger. Visible light, including bright daylight through windows, can also darken melasma, particularly in deeper skin tones.
Heat
Heat on its own can stimulate pigment. Hot environments such as saunas, and skin treatments that heat the skin, can play a part.
Genetics
Melasma often runs in families. If a parent or sibling has it, you are more likely to develop it.
Melasma can sit in the upper layer of the skin, in the deeper dermis, or in both. Deeper pigment is slower to change.
Treatments that heat or irritate the skin can trigger more pigment, so an aggressive approach may make melasma darker. For this reason Heather starts gently and builds gradually. A spot that is raised or changing is not melasma and needs a skin check with your GP.
How we can support you
Melasma is a long-term condition that is managed over time. Heather looks at the type and depth of your pigment and your likely triggers before recommending anything. Most plans pair gentle in-clinic treatment with consistent sun protection, and are reviewed as your skin responds.
If your pigmentation looks more like sun spots or general uneven tone, our Pigmentation page covers those types in more detail.
Skin renewal
Skin NeedlingFine needles create controlled micro-channels designed to support skin renewal and help active serums reach deeper. For melasma, Heather uses a conservative approach to keep the skin calm. It may be combined with Advanced Growth Factor Therapy.
In-clinic care
FacialsMedical-grade facials chosen for pigment-prone skin may help support a more even skin tone without heating or inflaming the skin.
At-home care
Sun Protection and SkincareDaily broad-spectrum SPF 50+ is the foundation of any melasma plan. Heather will also recommend at-home skincare to support your in-clinic treatments.
Frequently asked questions
What is the difference between melasma and sun spots?
Sun spots are usually small, well-defined spots on sun-exposed areas such as the face and the backs of the hands, and they build up over years of UV exposure. Melasma forms larger matching patches, usually on the cheeks and forehead, and is strongly linked to hormones. The two can appear together and are managed differently, so an assessment comes first.
Can melasma be cured?
There is no permanent cure for melasma. It can often be managed so the patches are lighter and less noticeable, although it tends to return with sun exposure or hormonal change. Daily sun protection and a long-term plan help keep it under control. Individual results vary.
Does melasma go away after pregnancy?
Melasma that appears during pregnancy may fade on its own in the months after birth, although it does not always clear fully. If you are pregnant or breastfeeding, Heather can advise on when in-clinic treatment may be suitable.
What sunscreen is best for melasma?
Use a broad-spectrum SPF 50+ every day and reapply it through the day when you are outdoors. A tinted sunscreen containing iron oxides gives extra protection from visible light, which can darken melasma. A broad-brimmed hat adds another layer of protection.
Talk to us about melasma
Book online, or call us on 0403 292 292 if you would like to talk it through first.
Book a ConsultationPerformed by Heather Holbrook, Dermal Clinician, at our Largs Bay clinic.