Melasma can persist for years or resolve more quickly once the triggering factor is removed.
Topical treatments include regimens with hydroquinone (a traditional “bleaching” cream, although not for long-term use as it may cause darkening with prolonged application), dicarboxylic acids like azelaic acid and kojic acid, mild corticosteroids, and tretinoin.
Procedural options include microneedling, chemical peels, and laser treatments; however, caution is needed with the latter two, as stronger treatments can lead to post-inflammatory hyperpigmentation if they “burn” or damage the skin.
A key strategy for managing melasma is trigger avoidance. This involves minimizing sun exposure, using mineral-based sunscreen (which blocks both UV and visible light), and coordinating care for any relevant medications or thyroid concerns with a healthcare provider.
