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Melasma is a light to dark brown pigmentation that can appear on the forehead, cheeks, upper lip and chin of mostly woman. Melasma is caused by an increase in melanin production. It most often occurs in women over 25.

Three broad factors influence the development of Melasma:

1. Genetic susceptibility
2. Hormonal factors, like taking the Oral Contraceptive Pill and pregnancy
3. Sun exposure

Severe melasma of cheeks and forehead

There are quite a few treatment options for Melasma, but whatever treatment option is chosen the regular application of a sunblock combined with minimizing sun exposure is essential. If possible also stop the Oral Contraceptive Pill.

One good way to treat Melasma is the application of a specially mixed Hydroquinone containing cream plus good sunblock for at least one month. This is followed, if required, by treatment with an IPL or laser. The specially mixed Hydroquinone cream, if it is working well enough, can be continued for as long a the Melasma improves. The IPL or laser treatments can also be repeated.

Melasma is prone to recurrence so maintenance treatment is important. Once an acceptable level of improvement is achieved the patient must continue with sunblock during the day and a milder melanin suppressing cream, like Differin or Skinoren cream, at night.

15 thoughts to “Melasma”

  1. Hello Dr. Jean Louw
    Here is my problem, I think I have melasma I have the pigmentation on my cheeks and around the lips area and a cross the nose and is it surpose to itches a whole lot is this posiable thats this is Melasma and I do where an estrogen patch.1mg and a diabetic please help me.

    1. Dear Darnice. Melasma does not itch. So, it might be that something else is going on or that you might have Melasma plus another skin condition.

    2. Hi doctor I also have a problem with melasma on my checks and chin that is taking away my self-esteem and I went to a dermatologist then was given neoretin serum and gel cream with spf50 for the day which is doing no justice to my face and don’t know what to do anymore please help me

      1. Good day Nandi

        Chemical peels, laser and prescribed topical applications are some of the treatment options in the treatment of Melasma. It would be best to schedule an appointment with Dr Louw.

  2. Good Day Doc,

    My baby is now 7yrs old and i still have these marks in my face, just want to know

    if it’s still curable.

    Many thanks,

  3. Dear Doctor Louw

    Thank you for this service. Does laser treatment work on Indian Skin? I would like to reverse the sunburn on my skin.

  4. Hi Dr
    I am 37 yrs old,from Cpt, i have blacks marks on my both chick and on my forehead since 2005. I went to see a Dermatolist and he prescibed me a pigmentation cream that must be put in the fridge, i used it until was finished but my marks are still on my face. I then try another pigmentation creams nothing is helping me and the way i hate these marks i cant explain. I am getting married in April i would like to see my face back to normal colour is there anything that you can tell me to use that can help. Please Dr

  5. Dear Dr. Louw,

    I have enjoyed beautiful skin for the past 31 yrs until i fell pregnant last yr. I have a small patch of pigmentation on my right chick and its disturbing me a lot. I went to see a dermatologist and got a cream but the patch still wont go away. Im black, so would the laser treatment work for me? and where can i go in SA to do it? Is there anything else that i could try? Thanking you in advance for your help – Mandy

  6. Good day,

    I am a lady of 26 years old,very light in complexion. I have a problem of melasma, it started in 2007 when I was 21 years old as small spot on my left cheeck and now it appears on my both cheeck growing to the forehead. I used different facial products thinking that melasma will disappear but it is growing bigger on my face.

    what is the best treatment for melasma? which south African store(s) can i find it?

    please help me, I am tired of melasma.


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