Have you noticed brown or grey-brown patches on your cheeks, forehead, or upper lip that seem to fade over winter and come back each summer? That pattern is typical of melasma, a common pigment condition that tends to recur. If you’re wondering why it keeps returning and what can realistically help, this guide explains how melasma differs from other dark marks, why daily light protection matters so much, and where clinic treatments may fit.
The honest answer is that melasma is usually managed rather than switched off for good. With a steady plan and realistic expectations, though, patches can often become lighter and easier to live with.
- Melasma causes flat brown or grey-brown patches, usually on both sides of the face, and it often comes back.
- Sunlight, hormones, and your genes all play a part, which is why it can appear in pregnancy or with some hormonal medicines.
- Daily broad-spectrum sun protection is the foundation of any plan, all year round.
- Irritation can darken pigment, so gentle skincare matters more than strong scrubs or home peels.
- Clinic treatments such as peels may help some people, but assessment comes first and maintenance is usually needed.
What melasma looks like
Melasma shows up as flat patches of darker skin, usually in a fairly even pattern on both sides of the face. The cheeks, forehead, bridge of the nose, upper lip, and chin are the most common areas. The patches don’t itch or hurt, and the surface feels smooth to the touch.
It’s common, and it’s seen more often in women and in people with naturally darker skin tones, although men and people of any skin tone can develop it. The British Association of Dermatologists’ patient information on melasma explains that it isn’t infectious and isn’t a type of skin cancer, and it won’t turn into one. That’s reassuring, but the effect on how you feel about your skin is still a perfectly valid reason to ask for advice.
Melasma isn’t the only cause of brown patches, though. Sun spots, freckles, and marks left behind after spots or irritation can look similar at a glance. Our guide to dark marks after spots covers post-inflammatory hyperpigmentation, which follows a different pattern and usually fades gradually on its own. You can have more than one type of pigment change at once, so a proper look at your skin matters before anything is treated.
Why it keeps coming back
In melasma, the skin’s pigment cells are more easily switched on than usual. Several things can trigger them, and they often work together:
- Sunlight. Ultraviolet and visible light both stimulate pigment, which is why patches often darken in spring and summer.
- Hormones. Melasma often appears during pregnancy, and it’s also linked with hormonal contraception and hormone replacement therapy.
- Genes. It often runs in families, so some people are simply more prone to it.
- Irritation. Harsh products and inflamed skin can make existing patches darker.
Because the tendency sits in the skin itself, treatment can lighten the patches without removing the underlying tendency. That’s why melasma so often returns after a sunny holiday or a summer with patchy protection, even when it had faded well. It isn’t a sign that you’ve done something wrong or that a treatment failed. It’s simply how the condition behaves.
Melasma linked to pregnancy sometimes fades in the months after the baby is born, and it may ease if a hormonal trigger is no longer present. Please don’t change your contraception or hormone replacement therapy to try to clear pigment without talking to your GP or prescriber first, as there may be good reasons to continue.
Light protection comes first
If one habit makes the biggest difference, it’s daily sun protection, every day of the year and not just on bright days. Ultraviolet light reaches your skin on cloudy days and through windows, and short trips outside soon add up.
The NHS advice on sunscreen and sun safety recommends a sunscreen of at least SPF30 with at least 4-star UVA protection, applied generously and reapplied regularly. Most people apply less than they think, so be generous and remember your hairline, upper lip, and the sides of your face.
Visible light can matter too, particularly for people with darker skin. Tinted sunscreens that contain iron oxides offer some protection against visible light, which untinted sunscreens don’t block well. Find a shade and texture you’re happy to wear every day, because a product that stays in the drawer won’t help.
A wide-brimmed hat, shade in the middle of the day, and sunglasses add useful protection alongside sunscreen. Make-up can help camouflage patches, but unless it carries an SPF and you apply plenty, don’t rely on it as your sun protection.
Keep your skin calm
It’s tempting to try to scrub or peel pigment away at home, but irritation tends to make melasma worse rather than better. Strong exfoliating scrubs, several acid products used together, and anything that repeatedly stings or leaves your skin red can add inflammation, and inflammation can deepen the colour.
A simple routine is usually a better base: a gentle cleanser, a moisturiser your skin tolerates, and daily sunscreen. If you’d like to add an active product, introduce one at a time and give it several weeks, so you can tell whether it’s helping or irritating.
Avoid skin-lightening creams bought online or from market stalls, and never use a prescription cream that was prescribed for someone else. Some unlicensed lightening products contain ingredients that aren’t allowed in UK cosmetics and can damage the skin. If a prescription cream might help you, a GP or dermatologist can assess whether it’s appropriate and explain how to use it.
Where clinic treatments fit
Once your sun protection and routine are steady, a clinic treatment may help some patches look lighter and more even. We offer a pigmentation peel designed with uneven tone in mind, and whether it suits your melasma depends on your skin type, how your skin has reacted to treatments before, and how active the pigment is at the moment.
Peels remove the outer layers of skin in a controlled way, and they carry risks as well as potential benefits. The British Association of Dermatologists lists possible side effects of peels and similar procedures, including changes in skin colour. In melasma, a treatment that’s too strong can darken patches rather than lighten them, which is why a gentle, gradual approach is usually preferred and why a stronger reaction isn’t a sign that a peel is working better.
Timing helps as well. Starting in the cooler months, when UK ultraviolet levels are lower, can make aftercare protection easier to keep up. Follow your aftercare advice closely, especially sun protection in the weeks after treatment, and don’t add home peels or scrubs between appointments.
Where melasma sits alongside other concerns, a combination of treatments may be recommended to address different concerns for a more optimal result, with a clear reason for each part. If your melasma is extensive, isn’t improving, or you’d like to discuss prescription treatment, your GP can advise and refer you to a dermatologist where appropriate.
Keeping results
Because melasma tends to return, it helps to think in two stages: lightening the patches, then keeping them lighter. Maintenance usually means year-round sun protection, a gentle routine, and sometimes occasional follow-up treatments agreed with your practitioner.
Photographs can help you judge progress fairly. Take them in the same place, with the same lighting, and without make-up or filters. Pigment can look quite different from one day to the next depending on light and recent sun exposure, so compare like with like over weeks rather than days.
If patches darken again after a summer, try not to jump straight to stronger products. Go back to the basics of protection and calm skin, and get in touch if you’d like to review your plan.
Questions about melasma
Can men get melasma?
Yes. It’s more common in women, but men can develop it too, often on the cheeks and forehead. The same principles apply: an assessment to confirm what the pigment is, daily sun protection, and gentle skincare.
Does melasma go away on its own?
Sometimes. Melasma linked to pregnancy may fade in the months after birth, and it may ease if a hormonal trigger is removed. For many people, though, it lasts for years and darkens with sun exposure, so a longer-term plan is usually needed.
Is a new dark patch always melasma?
No. Any mole or patch that’s new, changing in size, shape, or colour, bleeding, or itching should be checked by your GP rather than assumed to be pigmentation. Melasma usually appears as fairly even patches on both sides of the face, not as a single mark that keeps changing.
Can I have a peel if I’m pregnant or breastfeeding?
Tell your practitioner if you’re pregnant, trying to conceive, or breastfeeding, because some skin treatments and active ingredients aren’t recommended at these times. Pregnancy-related melasma may also settle afterwards, so sun protection and gentle skincare are often the focus until then.
Will melasma come back after treatment?
It can, and it often does, particularly after strong sun exposure. Treatment may make patches lighter, but it doesn’t remove the skin’s tendency to produce extra pigment. Ongoing sun protection gives your results a much better chance of lasting.
Should I stop my contraceptive pill?
Not without talking to your GP or prescriber first. The pill can be one factor in melasma, but it may also matter for other reasons, and a prescriber can talk you through alternatives if they’re appropriate. Don’t stop any prescribed medicine to fit around skin treatment.
Can I cover melasma with make-up?
Yes. Camouflage make-up is a perfectly reasonable choice, whether on its own or while treatment is under way. Choose products your skin tolerates, remove them gently at night, and keep wearing sunscreen underneath.
Talk to us about your pigmentation
If recurring patches are bothering you, get in touch with our Leicester team to arrange a consultation with our clinic, led by healthcare professionals. Bring a list of the products you use and let us know when the patches first appeared, and we’ll talk honestly about what might help.