What Causes Melasma and How Laser Treatment Can Help

Brown or gray-brown patches that remain visible despite regular skin care may be a sign of melasma. This common pigmentation condition often affects the cheeks, forehead, nose, upper lip, and chin, creating an uneven appearance across the face.

Melasma can be persistent because it is influenced by several factors, including ultraviolet exposure, visible light, hormones, genetics, heat, and skin irritation. Understanding the likely triggers is an important first step toward choosing an appropriate treatment and long-term maintenance plan.

At Everest Wellness & Aesthetics Center, patients with stubborn facial discoloration can learn more about  Hyperpigmentation Treatment    and receive a personalized evaluation based on their skin tone, pigment pattern, medical history, and previous treatments.

What is melasma?

Melasma is an acquired pigmentation condition that causes flat brown, tan, gray-brown, or darker patches to develop on the skin. It most commonly appears on sun-exposed areas of the face.

Typical areas include:

• The cheeks
• The forehead
• The bridge and sides of the nose
• The upper lip
• The chin
• The jawline
• Occasionally, the neck or forearms

Melasma often develops symmetrically, meaning similar patches appear on both sides of the face. It is generally harmless, but the visible discoloration may affect how some patients feel about their complexion.

What causes melasma?

Melasma does not usually have one single cause. It develops when pigment-producing cells in the skin create excess melanin in response to internal or external triggers.

Common contributing factors include:

• Sun exposure:Ultraviolet radiation can stimulate melanin production and make existing pigmentation darker.
• Visible light:Light beyond the ultraviolet spectrum may also contribute to pigmentation in some skin tones.
• Hormonal changes:Pregnancy, menopause, hormone therapy, and some hormonal contraceptives may influence pigment-producing cells.
• Genetics:People with a family history of melasma may be more likely to develop it.
• Heat exposure:Repeated heat may worsen discoloration in some patients, even without direct sunlight.
• Skin irritation:Harsh products, aggressive exfoliation, or unsuitable cosmetic procedures may create inflammation that makes pigmentation more noticeable.

Who is more likely to develop melasma?

Melasma can affect people of many ages and skin tones, but it is more frequently seen in women and in people whose skin naturally produces more melanin.

Factors that may increase the likelihood of melasma include:

• A family history of facial pigmentation
• Pregnancy or recent hormonal changes
• Use of certain hormonal medications
• Frequent sun exposure
• Living or working in a hot climate
• A history of pigmentation after acne or irritation
• Regular use of products that irritate the skin

Can pregnancy cause melasma?

Melasma that develops during pregnancy is sometimes called the “mask of pregnancy.” Changes in estrogen, progesterone, and other hormones may stimulate pigment production.

Pregnancy-related melasma may gradually become lighter after delivery, but it does not always disappear completely. Sun exposure can keep the pigmentation active or cause it to return.

Pregnant or breastfeeding patients should speak with a qualified healthcare provider before using prescription pigmentation products or undergoing professional procedures.

Can birth control cause melasma?

Some hormonal birth control methods may trigger or worsen melasma in susceptible patients. This may include certain pills, patches, injections, implants, or hormonal intrauterine devices.

Hormonal contraceptives do not cause melasma in every patient. Genetics, skin tone, sun exposure, and previous pigmentation history may also influence whether discoloration develops.

Patients who notice facial pigmentation after beginning hormonal contraception should discuss the concern with the healthcare professional who prescribed it.

Birth control should not be stopped or changed without medical guidance. Even after hormonal medication is changed, existing melasma may not immediately disappear and may require a separate pigmentation management plan.

Can skin care products cause or worsen melasma?

Skin care products do not always directly cause melasma, but repeated irritation may worsen pigmentation or make the skin more reactive.

Potentially irritating practices include:

• Overusing retinoids or exfoliating acids
• Combining too many active ingredients
• Using abrasive scrubs
• Applying fragranced products to sensitive skin
• Performing frequent strong peels without professional guidance
• Picking, rubbing, or scratching the skin

A gentle and consistent routine is generally more suitable for pigmentation-prone skin than frequently changing products or using aggressive treatments.

How is melasma different from sunspots?

Melasma and sunspots can both create brown areas on the face, but they often have different patterns and causes.

Melasma usually appears as larger, symmetrical patches and is commonly influenced by hormones, genetics, heat, and light exposure.

Sunspots tend to appear as smaller and more clearly defined areas caused by accumulated ultraviolet exposure. Post-inflammatory hyperpigmentation may develop after acne, injury, or irritation.

Because different pigmentation conditions may respond differently to treatment, a professional skin assessment should be performed before a laser, peel, or other procedure is selected.

How is melasma treated?

Melasma management usually requires a combination approach rather than relying on one procedure alone.

A personalized plan may include:

• Daily broad-spectrum sunscreen
• Protection against visible light when appropriate
• Professional topical pigmentation products
• Prescription treatments when medically suitable
• Gentle medical-grade chemical peels
• Carefully selected laser or light-based procedures
• A maintenance plan designed to reduce recurrence

The most appropriate option depends on the depth of the pigment, the patient's natural skin tone, previous treatment responses, and current triggers.

How can laser treatment help melasma?

Selected laser treatments deliver controlled light energy to areas containing excess pigment. The energy is absorbed by melanin and may break visible pigment into smaller particles that the body gradually clears.

Over time, this process may help treated patches appear lighter and more even. However, results vary, and laser treatment should not be presented as a guaranteed or permanent cure.

Patients interested in professional laser and light options can review  IPL & Laser Skin Resurfacing  .

Is laser treatment suitable for every melasma patient?

Laser treatment is not appropriate for every case of melasma. Pigment may be located near the skin's surface, deeper in the dermis, or in both layers.

The patient's skin tone, tanning history, sensitivity, medical history, medications, and tendency to develop post-inflammatory pigmentation must also be considered.

In unsuitable patients or when treatment settings are too aggressive, laser energy may cause:

• Temporary redness or swelling
• Skin sensitivity
• Inflammation
• Darkening of the treated area
• Lightening of the surrounding skin
• Post-inflammatory hyperpigmentation
• Recurrence or worsening of melasma

Treatment should therefore be performed only after an individualized evaluation and with realistic expectations.

Can IPL be used for melasma?

IPL uses multiple wavelengths of broad-spectrum light rather than one focused laser wavelength. It may help selected patients with superficial pigmentation, sunspots, redness, or mixed discoloration.

However, melasma can react unpredictably to heat and light. IPL is not automatically suitable for every pigmentation pattern or skin tone.

A provider must determine whether the discoloration is true melasma, sun damage, post-inflammatory pigmentation, or another condition before recommending IPL.

How many treatment sessions may be needed?

The number of sessions varies according to the selected technology, pigment depth, skin type, severity of the discoloration, and the patient's response.

Some patients may notice gradual improvement after the first few treatments, while others require a longer series or a different combination of therapies.

Sessions are often spaced several weeks apart so the skin can recover and the provider can evaluate the response before continuing.

More treatment is not always better. If irritation or darkening develops, the plan may need to be adjusted or paused.

How should you prepare for melasma treatment?

Preparation instructions depend on the procedure, but patients may be advised to:

• Avoid tanning and excessive sun exposure
• Use broad-spectrum sunscreen every day
• Avoid self-tanning products
• Pause retinoids or exfoliating products if instructed
• Tell the provider about all medications and supplements
• Discuss pregnancy, breastfeeding, or hormonal medication
• Arrive with clean skin free from makeup, lotion, and fragrance
• Report previous pigmentation changes after cosmetic procedures

Recently sunburned, tanned, inflamed, or irritated skin may not be suitable for immediate laser or light treatment.

What can you expect after laser treatment?

Temporary redness, warmth, mild swelling, or sensitivity may occur after treatment. Pigmented areas may initially look darker before gradually fading or flaking.

Patients should follow all personalized aftercare instructions, which may include:

• Using a gentle cleanser and moisturizer
• Applying broad-spectrum sunscreen daily
• Avoiding direct sun and excessive heat
• Temporarily stopping strong active ingredients
• Avoiding scratching, rubbing, or picking the skin
• Contacting the provider if irritation becomes severe

Can melasma return after treatment?

Melasma may return even after visible improvement. Laser treatment can reduce existing pigment, but it does not permanently remove hormonal, genetic, environmental, or lifestyle triggers.

Recurrence may be influenced by:

• Unprotected sun exposure
• Hormonal changes
• Pregnancy
• Certain medications
• Heat exposure
• Skin irritation
• Stopping the recommended maintenance routine

Long-term management and consistent sun protection are essential for maintaining improvement.

How can you help prevent melasma from worsening?

Daily protective habits can be as important as in-office treatment.

• Use sunscreen consistently:Apply broad-spectrum sunscreen every morning and reapply during prolonged outdoor activity.
• Wear protective clothing:Use a wide-brimmed hat, sunglasses, and shade when possible.
• Limit excessive heat:Pay attention to whether hot environments make pigmentation more noticeable.
• Avoid aggressive skin care:Use gentle products that do not repeatedly irritate the skin.
• Follow the maintenance plan:Continue recommended products and follow-up appointments even after visible improvement.

Start with a personalized pigmentation consultation

Melasma can have several causes, and the most suitable treatment depends on more than the appearance of the dark patches alone. Hormonal history, birth control use, sun exposure, skin tone, pigment depth, and previous reactions must all be considered.

Laser treatment may help selected patients, but it is usually most effective as part of a broader plan involving sun protection, professional skin care, and long-term maintenance.

Learn more about  Hyperpigmentation Treatment  ,  explore  IPL & Laser Skin Resurfacing  ,  read about the practice through  Our Story  ,  or  contact Everest Wellness & Aesthetics Center    to arrange a personalized consultation.