Skin & Complexion
Patchy brown or grey-brown facial pigmentation often influenced by hormones, sunlight and heat.
Physician-led assessment · individualized care · Vancouver clinic
Understanding Melasma and Uneven Pigmentation
Melasma is a common pigmentation condition that causes brown or grey-brown patches on the face, most often on the cheeks, forehead, bridge of the nose, upper lip and jawline. It is usually linked to sun and heat exposure, hormonal changes such as pregnancy or hormone-containing medications, and a genetic tendency, and it often appears symmetrically on both sides.
Melasma is not harmful to health, but that does not make its impact minor. It can be persistent, hard to control, and prone to returning after it settles, so care centres on reducing visible pigment, limiting known triggers, protecting the skin barrier, and setting realistic expectations for long-term control.
Melasma is not a sign of poor hygiene or inadequate skincare. It is a complex condition influenced by light exposure, genetics, hormones, inflammation, vascular factors and skin type, and these differ from one person to the next.
Causes and Contributing Factors
Melasma is more complex than excess surface pigment alone. Several processes can be involved, and their relative contribution differs from one person to the next.
Pigment-producing cells in melasma-affected skin tend to be more active, releasing more melanin into the surrounding skin.
Sunlight is the strongest external driver. Ultraviolet light stimulates pigment production, and visible light, including daylight and the light from screens, can also worsen melasma, particularly in richer skin tones.
Melasma often runs in families, suggesting that inherited differences in how the skin responds to light and other triggers can increase a person’s susceptibility.
Hormonal changes during pregnancy and the use of some hormone-containing medications, including oral contraceptives, can trigger melasma in susceptible individuals.
Long-term sun exposure can alter the skin’s supporting tissue and the boundary between its outer and deeper layers, changes that may help sustain melasma.
Studies have identified inflammatory signalling and altered skin-barrier function in melasma-affected skin, although their precise roles in the condition are still being investigated.
Some melasma patches have increased numbers or prominence of small blood vessels, and signals from these vessels may contribute to pigment-cell activity.
Skincare products or procedures that irritate the skin can worsen pigmentation or cause additional post-inflammatory darkening, making careful product selection and treatment planning important.
Because melasma can resemble other pigmentation conditions, a professional assessment helps confirm the diagnosis and guide appropriate treatment and at-home skincare.
References and Further Reading
Signs and Symptoms
A few features help tell melasma apart from other causes of facial pigmentation:
Assessment
Because several conditions can cause facial pigmentation, an assessment first confirms that it is melasma, then looks at what is driving it:
Treatment Options
These are some of the options connected to this concern. The appropriate plan depends on assessment, suitability, and your goals.
Melasma is managed with an individual plan rather than a single treatment, and daily protection from ultraviolet and visible light is the foundation of any approach. The options below are some of what the clinic may consider. The right combination is decided after an in-person assessment, and no treatment can guarantee complete or permanent clearance.
For melasma specifically, any device is used cautiously and alongside daily light protection and topical care, never as a stand-alone cure, because heat and overly aggressive treatment can worsen pigment or trigger post-inflammatory hyperpigmentation. The best next step is a consultation, where your skin is assessed and a suitable plan is discussed. You can also see the fuller picture on our Pigmentation & Sun-Damage Treatment page.
Uses selected laser and light-based wavelengths, guided by assessment, to help address excess pigment, sun damage and uneven skin tone.
A controlled chemical solution that encourages renewal of the skin's surface and helps concerns such as uneven pigment, post-acne marks or rough texture.
For the fuller picture, explore the treatment pages above or discuss the options during a consultation.
The best sun-protection routine is the one you will actually use every day:
Daily protection reduces triggers but cannot guarantee complete clearance or prevent every recurrence.
Melasma is generally managed as a chronic, relapsing condition: treatment may reduce visible pigment without eliminating the underlying tendency to produce it. Recurrence can be influenced by renewed ultraviolet or visible-light exposure, hormonal changes or pregnancy, certain medications, skin irritation or inflammation, stopping maintenance care, and individual genetic and biological factors. For this reason, management is usually ongoing rather than a one-time fix, and a maintenance plan is often needed after the initial treatment phase.
A responsible treatment plan sets out what change may reasonably be possible, how long it may take, and the possibility of an incomplete response, along with the risk of irritation or pigment worsening, any procedure-specific downtime and risks, the likelihood of recurrence, the importance of continued light protection, the role of maintenance care, and when treatment should be changed or stopped. No treatment can guarantee complete clearance or permanent prevention of recurrence.
Sources referenced in developing this page. Links open in a new tab.
Medical Assessment
Seek professional assessment when pigmentation:
Not every facial pigment change is melasma. A clinician may need to distinguish it from post-inflammatory pigmentation, medication-related pigmentation, sun-related lesions, contact reactions or other skin conditions.
Frequently Asked Questions
Hormonal changes (including pregnancy and some hormone-containing medications), sun and heat exposure, and a genetic tendency are the common contributors. Visible light and skin inflammation can also play a part.
It is most common in women during their reproductive years and is strongly linked to pregnancy and hormonal medications, though men can develop it too. It is more common in medium to darker skin tones and where there is a family history.
No. Melasma is benign and not a form of skin cancer. If a patch looks unusual, changes quickly, or does not fit the typical pattern, it should be checked to rule out other conditions.
Melasma is usually a long-term, relapsing condition. Treatment can reduce visible pigment, but the underlying tendency to produce it often remains, so ongoing maintenance is common.
Yes. Sun and heat exposure, hormonal changes, and skin irritation can all darken melasma, which is why daily protection and gentle skincare matter.
Options may include prescription topical therapy, medical skincare, carefully selected chemical peels, and light- or laser-based treatments such as PicoWay, BBL or HALO. Daily sun protection is part of every plan. Suitability is confirmed at an in-person assessment.
Change is gradual and varies from person to person. Most approaches take several weeks to a few months, and melasma usually needs ongoing maintenance rather than a single course of treatment.
Yes. Melasma may recur if triggers such as sun exposure, heat or hormonal changes continue, so continued light protection and maintenance are emphasised.
Sun protection is the foundation and is essential, but on its own it may not clear existing pigment. Protection that also addresses visible light, along with other measures, is often needed. Protection mainly helps prevent worsening and recurrence.
Sometimes. Melasma can be aggravated by heat and by unsuitable light- or laser-based treatment, particularly in darker skin tones. Any device is chosen cautiously and matched to the individual after an in-person assessment.
It is driven by ongoing triggers such as hormones, ultraviolet and visible light, and heat. Even after it improves, these can reactivate the pigment, which is why continuous sun protection and maintenance are emphasised rather than a single course of treatment.
Book an assessment if the pigmentation is new or changing quickly, appears on only one side or in an unusual pattern, is raised, itchy or inflamed, follows a new medication or hormonal change, or is causing distress. An assessment also helps confirm it is melasma and not another pigment condition.
Physician Assessment
An assessment can help clarify what may be contributing, which options may be appropriate, and what a reasonable next step could look like for you.
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Anti-Aging Medical & Laser Clinic combines medical assessment, individualized planning, physician oversight, and a broad range of treatment options in its Vancouver clinic.
Bring your questions, treatment history, and goals. Your provider can help you understand appropriate options, expected recovery, and realistic outcomes.
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