Melasma is a common pigmentary problem affecting the Asian skin, It usually appears as brownish patches over the cheeks although the forehead, temples, nasal bridge, upper lips and jawline may be affected as well. Melasma results from the interplay of genetic, hormonal and UV factors. Women are more commonly affected compared to men. Worsening is often reported after sun exposure, pregnancy and the use of oral contraceptives.
Melasma is challenging to treat as recurrence after initial successful treatment is high. Melasma is best controlled with the regular use of broad spectrum sunscreens, sun avoidance and lightening creams. Prescription-only combination creams may offer rapid initial clearance of the melasma. For difficult cases, chemical peeling, intense pulsed light therapy and FraxelTM laser treatments may offer additional benefits but the results are variable. Pigment laser treatment is not recommended as it may make the pigmentation worse instead.