Melasma: Causes, Symptoms & Treatment Solutions at Skindepth Dermatology

Melasma is a common pigmentation concern we see at Skindepth Dermatology, it is also one of the most misunderstood. Melasma often appears as symmetrical patches of brown or grey/brown pigmentation across the cheeks, forehead, upper lip, and/or jawline.

It is a chronic and relapsing condition influenced by multiple internal and external triggers. Because it can fluctuate, darken quickly and respond differently from one person to the next, melasma requires a thoughtful, layered and individualised treatment plan.

What Exactly Is Melasma?

Melasma is traditionally described as a pigment disorder driven by overactive melanocytes which are the skin cells responsible for producing melanin. However research over the last decade has shown that it’s not just a pigment problem. Melasma also has a vascular component, meaning there is increased blood vessel activity underneath the pigmentation. This vascularity can make the pigment appear darker, more stubborn and more reactive.

This is why the best results come from treating both the pigment and the underlying vascular contribution. If the vascular component isn’t addressed, pigmentation may keep rebounding or resist improvement.

Why Does Melasma Occur?

Melasma is a multifactorial condition and often linked to:

• Hormonal fluctuations – pregnancy, contraceptive pills, hormonal IUDs, perimenopause and hormone therapies can all trigger melasma.
• UV and visible light exposure – the biggest external trigger.
• Heat and inflammation – even without sunburn, heat can worsen melasma.
• Genetics – a family history can increase risk.

Because hormones play such a significant role, some patients may benefit from support outside of skin treatments with an endocrinologist or naturopath to discuss hormone management. 

Preparing the Skin: A Crucial First Step for Melasma Treatment

Melasma responds best when the skin is prepped properly. Jumping straight into clinical treatments without preparation can lead to an increased risk of adverse events, rebound pigment or compromised results.

1. Sun Protection (Non-Negotiable)

A broad-spectrum SPF50+ every single day is essential. UV radiation is the number one trigger for melasma - but visible light and heat also matter. For this reason, a tinted physical sunscreen is ideal. The iron oxides provide a barrier, offering better reflection, less absorption and superior protection for pigment-prone skin.

2. Tyrosinase Inhibitors

These ingredients slow down the enzyme (tyrosinase) responsible for pigment production. 
Common tyrosinase inhibitors include:

• Azelaic acid
• Kojic acid
• Arbutin
• Vitamin C
• Niacinamide

At Skindepth, we also use Mela Cream, a professional-strength depigmenting cream designed specifically for melasma to gently but effectively regulate pigment formation.

3. Hydroquinone (When Appropriate)

Hydroquinone is still considered the gold standard for stubborn melasma, but it must be used short-term, carefully, and under professional guidance due to the risk of rebound pigmentation if misused. It may be prescribed by one of our dermatologists where appropriate, usually as part of a structured treatment plan. 

In-Clinic Melasma Treatment in Melbourne

Once the skin barrier is prepped and protected, we can begin targeted treatments. At Skindepth Dermatology, we offer several options depending on the specific presentation of your melasma. A few examples include: 

1. Express Laser Facial

This treatment combines:

• Express Laser toning to break down pigment
• A chemical peel to brighten and refine the skin

Because this treatment works gently and gradually, it avoids the inflammation that can worsen pigment.

2. Laser Toning

Laser toning targets pigment at deeper layers using repetitive, low-energy passes. Multiple sessions are required for best results.

3. Mela Peel

This controlled chemical peel is designed specifically for pigmentation disorders. It works to:

• Accelerate cell turnover
• Reduce surface pigment
• Prevent new pigment formation

Because it doesn’t generate excessive heat, it is a safe option for melasma-prone skin.

Why Treat the Vascular Component First?

Melasma has a vascular component and treating the blood vessels first can dramatically enhance results. Vascular laser treatments with conservative parameters can calm underlying inflammation, reduce redness, and create a more stable base before pigment reduction therapies begin. This leads to more consistent and longer-lasting outcomes.

Why Personalisation Matters?

Every melasma case is different. Some people have mainly superficial pigment; others have deeper pigment. Some have strong hormonal triggers; others are more vascular-dominant or UV-driven.

Because melasma behaves differently on every skin, the most important step is booking a consultation with one of our dermal clinicians. We assess your:

• Skin type and Fitzpatrick classification
• Melasma triggers (hormonal, UV, heat, etc.)
• Lifestyle factors (occupation, hobbies, skincare routine)
• Medical history (medications, health conditions)
• Treatment goals and expectations
  

This comprehensive assessment allows us to create an individualized treatment plan tailored specifically to you.

Book Your Melasma Consultation at Skindepth Dermatology

If you're ready to start your skin journey and learn more about personalized melasma treatment options, we would love to help you. Book a consultation at Skindepth Dermatology and let's create a plan designed specifically for your skin. 

Frequently Asked Questions

What causes melasma?

Melasma is caused by a combination of factors including hormonal fluctuations (pregnancy, birth control, menopause), UV and visible light exposure, heat, inflammation, and genetic predisposition. The condition involves both overactive pigment-producing cells and increased blood vessel activity.

Can melasma be cured permanently?

While melasma can be effectively treated and significantly improved, it's considered a chronic condition that can recur with triggers like sun exposure or hormonal changes. However, with proper treatment and maintenance, many patients achieve long-lasting results and can manage flare-ups effectively.

How long does melasma treatment take?

Most melasma treatment plans take 3-6 months for initial improvement, with maintenance treatments ongoing. The preparation phase (4-8 weeks) is crucial before active treatments begin. Individual results vary based on melasma severity, depth, and patient compliance with sun protection and skincare.

Is melasma dangerous?

Melasma is not dangerous or harmful to your health, it's a cosmetic skin condition. However, it can significantly impact self-esteem and quality of life. Some patients may want to rule out other medical conditions, which is why professional diagnosis is important.

Can melasma go away on its own?

Melasma rarely goes away on its own without treatment. However, melasma that occurs during pregnancy (pregnancy mask) may fade after delivery, though it often requires treatment to fully resolve. Most cases require professional intervention for significant improvement.