Melasma is one of the most common skin concerns, especially among working-age individuals and those frequently exposed to sunlight. Although the brown or grayish patches on the face do not cause pain or itching, they can significantly affect confidence and appearance. Many people wonder: What causes melasma? and Which treatments actually work?
This article provides a comprehensive guide to melasma—covering its causes, types, common triggers, treatment options including creams, lasers, and modern procedures, as well as aftercare and estimated costs—helping you make informed decisions about the most suitable treatment for your skin.
Melasma is a skin condition caused by the overproduction of melanin, resulting in brown to dark brown patches on the skin. It most commonly appears on the face, especially the cheeks, forehead, upper lip, and nose.
Although often confused, melasma, freckles, and dark spots have distinct features and causes.
| Skin Concern | Characteristics | Main Causes | Common Locations |
|---|---|---|---|
| Melasma | Brown or grayish-brown patches, usually symmetrical | Sun exposure, hormones, genetics | Cheeks, forehead, upper lip |
| Freckles | Small light to dark brown spots, more visible in sunlight | Genetics, UV exposure | Face, shoulders, arms |
| Dark Spots | Dark marks left after inflammation, such as acne scars | Inflammation, wounds, sun damage | Face and body |
Occurs in the epidermis (outer skin layer). Appears as dark brown patches with clear borders. This type generally responds better to treatment compared to deeper melasma.
Located in the dermis (deeper skin layer). Appears grayish-brown or bluish-gray with blurred edges. It is more difficult to treat and usually requires medical procedures.
The most common type, combining both epidermal and dermal features. It requires a combination of treatments to achieve noticeable improvement.
Ultraviolet (UVA/UVB) rays are the primary trigger that overstimulate melanin production, making melasma appear darker and more prominent.
Hormonal fluctuations during pregnancy, oral contraceptive use, or hormonal imbalance can stimulate excessive pigment formation.
Individuals with a family history of melasma are at a higher risk of developing the condition.
Pollution, stress, lack of sleep, and skin inflammation (such as acne) may worsen melasma visibility.
Melasma is influenced by a combination of sun exposure, hormones, genetics, and environmental factors, making it challenging to control.
In types like dermal melasma, pigment is deposited in deeper skin layers, which topical creams and basic treatments cannot effectively reach.
Even after treatment, pigment-producing cells can be easily reactivated by sunlight or hormonal changes, leading to recurrence.
Melasma is a chronic condition. Consistent treatment and prevention strategies—such as daily sunscreen and proper skincare—are essential to maintain results.
Fruits and vegetables rich in vitamin C, vitamin E, and polyphenols-such as citrus fruits, berries, and leafy greens—help reduce UV-induced collagen damage and excess pigmentation.
Sources like salmon, avocado, and nuts support skin barrier function, reduce inflammation, and promote skin repair.
Drinking 1.5–2 liters of water daily helps maintain skin hydration and supports natural healing.
High-sugar foods, excessive alcohol, and smoking may trigger inflammation and increase skin sensitivity to sunlight.
Although melasma is more common in women, men can also develop it. Studies report that around 10–25% of melasma patients are male.
The causes are similar to women—mainly sun exposure and genetics. However, in men, outdoor occupations, sports activities, and lack of consistent sunscreen use are significant contributors.
Treatment approaches are similar to those for women, including depigmenting creams, laser therapy, and medical procedures. Consistent sun protection and skincare remain key to managing melasma in men.
Depigmenting agents such as hydroquinone, vitamin C, arbutin, and niacinamide can help lighten melasma when used consistently.
Laser and radiofrequency technologies like Sylfirm X Plus target abnormal pigmentation and stimulate skin rejuvenation from within.
Biostimulators such as PLLA or CaHA promote collagen regeneration, improving skin quality and reducing dullness.
Antioxidant-rich nutrition, IV drips, and strict sun protection play key roles in supporting and maintaining treatment outcomes.
Topical creams are best suited for individuals with mild or superficial melasma and are often combined with medical treatments for enhanced results.
Sylfirm X Plus uses radiofrequency microneedling technology to target abnormal melanin production while simultaneously stimulating collagen regeneration and skin repair.
Ideal for patients with stubborn or chronic melasma that has not responded well to topical creams or older laser technologies, seeking safe and natural-looking results.
Biostimulators are injectable substances, such as Poly-L-lactic acid (PLLA) or Calcium Hydroxylapatite (CaHA), that stimulate the skin’s natural collagen production to restore skin structure and quality.
Best for individuals with chronic melasma, along with signs of skin aging or fine lines, who seek natural-looking and long-lasting results.
After laser treatment, the skin becomes more sensitive to UV rays. Avoid strong sunlight and apply sunscreen with SPF 50 or higher daily.
Choose moisturizers or serums that soothe and hydrate the skin. Avoid harsh acids or retinoids until the skin has recovered.
If warmth or redness appears, gently apply a cold compress to relieve discomfort.
Use prescribed creams or medications exactly as directed to support healing and reduce the risk of post-inflammatory pigmentation.
A patient with long-standing dermal melasma underwent Sylfirm X Plus combined with topical depigmenting agents. The melasma patches gradually lightened, and the skin appeared smoother.
A patient with superficial melasma on the cheeks was treated with Skin Quality alongside strict sun protection. The skin tone became more even and brighter.
A patient with mixed melasma and signs of skin aging received Biostimulator combined with laser treatment. Results showed firmer skin with naturally lighter melasma.
Outcomes vary for each individual depending on the type of melasma and personal skin response.
Melasma is a chronic condition and cannot be permanently cured. However, it can be significantly lightened and controlled with proper treatment and prevention.
It depends on the type and severity of melasma as well as the treatment method. Multiple sessions are usually required for visible improvement.
Most procedures, such as laser or biostimulators, cause only mild discomfort or warmth. Topical anesthesia can be applied to minimize pain.
Generally, there may be mild redness for 1–2 days, but patients can continue their daily activities as usual.
Costs vary depending on the treatment type and number of sessions. Prices typically range from a few thousand to tens of thousands of THB per session.
Identify whether the melasma is superficial, dermal, or mixed in order to plan a targeted treatment approach.
There is no one-size-fits-all solution. Consulting with a qualified physician ensures a personalized treatment plan for safe and long-lasting results.
