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
Maybe it showed up during pregnancy, or after a sunny summer: brownish patches across your cheeks, forehead or upper lip that makeup never quite covers. Melasma is very common, and if you've been frustrated by how stubborn it can be, you're not alone.
Melasma causes brown or grey-brown patches on the face, most often on the cheeks, forehead, bridge of the nose, upper lip and jawline, usually on both sides. It's linked to sun and heat, hormonal changes such as pregnancy or hormone-containing medications, and a genetic tendency. It isn't harmful to your health, and it isn't a sign of poor skincare. It's a complex condition shaped by light, genetics, hormones, inflammation, small blood vessels and skin type.
With the right mix of gentle skincare, daily light protection and carefully chosen treatment, melasma can fade noticeably and stay calmer over time.
Causes and Contributing Factors
Melasma involves more than surface pigment. Several processes can be involved, and their 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 darken 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 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, and their exact roles are still being studied.
Some melasma patches have more prominent small blood vessels, and signals from these vessels may contribute to pigment-cell activity.
Products or procedures that irritate the skin can deepen pigmentation or cause post-inflammatory darkening, which is why careful product selection and treatment planning matter.
Because melasma can resemble other pigmentation conditions, a professional assessment confirms the diagnosis and guides 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
Several conditions can cause facial pigmentation, so we first confirm it's melasma, then look at what's driving it. You'll meet our senior laser technicians or cosmetic health and skincare advisors, with our physicians confirming the diagnosis and prescribing topical therapy where it suits you.
Cosmetic consultations are complimentary.
Prevention and Ongoing Care
At-home care is where melasma control happens day to day. A tinted, broad-spectrum sunscreen with iron oxides every morning, a gentle cleanser, a barrier-supporting moisturizer and pigment-directed ingredients chosen for your skin all help keep patches lighter and calmer between visits. Our team can build a routine around your skin, and our professional skincare is available in our online shop.
Treatment Options
These are some of the options connected to this concern. The appropriate plan depends on assessment, suitability, and your goals.
Melasma responds well to a personal plan that combines a few approaches, with daily protection from ultraviolet and visible light as the foundation.
Laser settings are chosen gently and always paired with light protection and topical care, because melasma is sensitive to heat. Ongoing maintenance keeps results steady, and your plan adjusts as your skin responds.
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'll use every day:
Daily protection is one of the most powerful things you can do to keep melasma calm.
Melasma is managed as a long-term condition: treatment reduces visible pigment, and the skin's tendency to make it remains. Pigment can return with renewed ultraviolet or visible-light exposure, hormonal changes or pregnancy, certain medications, skin irritation, pausing maintenance care, and individual genetic factors. That's why care continues after the first treatment phase, with a maintenance plan built around your skin and the seasons.
Your plan sets out the change that's realistic for your skin, how long it may take, how we'll protect your skin from irritation, any downtime for the options you choose, and how maintenance and light protection keep results steady. We review your progress along the way and adjust the plan as your skin responds. Individual results vary.
Sources referenced in developing this page. Links open in a new tab.
Medical Assessment
See a doctor when pigmentation:
Our physicians can tell melasma apart from post-inflammatory pigmentation, medication-related pigmentation, sun-related lesions, contact reactions and other skin conditions.
Frequently Asked Questions
At our clinic, melasma plans combine prescription topical therapy, medical skincare, carefully selected chemical peels and, where a laser suits your skin, PicoWay. Daily protection from ultraviolet and visible light is part of every plan. We'll confirm which options suit you at your consultation.
Melasma is sensitive to heat, especially in medium to darker skin tones, so any laser is chosen carefully and matched to your skin type. PicoWay's ultra-short, low-heat pulses are why it's the laser we use when a laser suits melasma. Some plans start with topical care and peels first, and we'll explain the reasoning for your skin.
Melasma is a long-term condition, so triggers like sun, heat and hormonal change can bring pigment back. Steady light protection and a simple maintenance plan keep it calmer over time. We'll set up that maintenance with you so your results stay as steady as possible.
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.
Visit Our Clinic
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.
Make an Appointment
Use our consultation form below and the clinic can guide you toward the appropriate starting point.
