Why is Melasma So Hard to Treat?

Melasma is a common skin condition that causes brown or gray patches to appear on the face, usually on the cheeks, forehead, nose, or upper lip. The exact cause of melasma is not fully understood, but several factors are known to contribute to its development. Although there are some known effective treatments for melasma, it is still considered difficult to treat.

Causes of Melasma

Some of the most common causes of melasma include:

Hormonal Changes

Hormonal changes in the body is the most common cause of melasma. This is why it is often referred to as the "mask of pregnancy”, as it frequently occurs in pregnant women due to the hormonal changes they experience. Hormonal changes during menopause or while taking birth control pills can also cause melasma. 

Sun Exposure

Exposure to the sun is another significant factor in the development of melasma. Ultraviolet (UV) light stimulates the production of melanin in the skin, which can lead to melasma. Individuals who spend a lot of time in the sun without adequate protection are at a higher risk of developing melasma.


Sclerosing melasma may also be hereditary. That is, people who are born to a family with melasma are more likely to develop melasma themselves if they have a family history of it.

Other factors that can contribute to the development of melasma include certain medications, such as those for epilepsy and blood pressure, as well as birth control pills. Cosmetics that irritate the skin may be included too.

Effective Treatments for Melasma

Most dermatologists will create an effective treatment plan tailored to the patient’s needs. The plan will consider skin tone, how deeply the melasma reaches into the skin, and any melasma triggers the patient may have, as aforementioned. Here are some examples of effective treatments for melasma:

Topical Creams

The most common effective topical treatments for melasma include hydroquinone, tretinoin, and corticosteroids. Hydroquinone works by inhibiting the production of melanin, the pigment that gives skin its color. Tretinoin helps to speed up the turnover of skin cells, which can help reduce the appearance of melasma. Corticosteroids can help reduce inflammation and redness associated with melasma. Topical creams with such ingredients would be able to serve as effective treatments for melasma if used consistently.

Professional Treatments for Melasma in Singapore

For a more effective treatment of melasma, a dermatologist or aesthetician may add one or more of the following to the treatment plan:

Chemical peels: An application of a chemical solution to the melasma. This can help remove excess pigment on the skin.

Microneedling: A minimally invasive procedure that creates microscopic tears in your skin. As the skin heals, it tends to have a more even skin tone.

Laser and light treatments: A treatment that, as shown by a few studies, can improve results for patients who are already applying medication to their skin and protecting their skin from the sun.

Why is Melasma So Difficult to Treat?

Melasma is a common skin condition characterized by dark and discolored patches on the skin, especially on the face. It affects both men and women, but it is more common in women, typically during pregnancy or when taking contraceptive pills.

One of the reasons why melasma is difficult to treat is because it is a chronic condition. Even after effective treatments for melasma have been done, the condition can recur. Therefore, treating melasma requires a long-term commitment from the patient, which can be difficult to maintain. Even minor amounts of sun exposure can darken or reactivate it, and it is difficult to avoid all sun exposure, especially in women in the age group most commonly affected, 25-40, who may have children with outdoor activities. Estrogen and progesterone hormones also go along with being female, something that cannot be avoided.

Melasma is also difficult to treat because its exact cause is not well understood. However, it is believed to be caused by a combination of genetic, hormonal, and environmental factors. This makes it challenging to develop a one-size-fits-all treatment plan for patients with melasma.

Another reason why melasma is difficult to treat is that it affects different layers of the skin. The pigmentation is not just limited to the top layer of the skin but also deeper layers. Therefore, topical and other effective treatments for melasma may not penetrate deep enough to effectively treat the condition.

Additionally, sun exposure can exacerbate melasma, and patients with melasma should avoid direct sunlight and wear sunscreen daily. However, even with proper sun protection, the condition can persist.

How Can I Prevent Melasma?

Use Sunscreen

One of the best ways to prevent melasma is to use sunscreen daily. Make sure to choose a broad-spectrum sunscreen with an SPF of at least 30. Apply sunscreen 20-30 minutes before you go out in the sun and reapply every two hours. This is especially important if you are undergoing or have undergone treatment for melasma.

Wear Protective Clothing

Wearing protective clothing can also help prevent melasma. Wear a wide-brimmed hat, long-sleeved shirts, and pants when you are outside in the sun. This can help minimize your skin's exposure to the sun and prevent melasma.

 Avoid direct sunlight

Avoiding the sun during peak hours (10 am to 4 pm) can help prevent melasma. If you must be outside during these hours, seek shade and wear protective clothing.

 Use Gentle Skincare Products

Using gentle cleansers can also help prevent melasma. Avoid harsh scrubs and exfoliants that can irritate your skin. Choose products that are gentle and specifically designed for your skin type.

Maintain a Healthy Diet

A healthy diet rich in antioxidants as well as avoiding trigger foods such as spicy or acidic foods will help to reduce the symptoms of this disease.

Seek Medical Treatment from Experienced Doctor

If you already have melasma, seek medical treatment. An experienced doctor can recommend various personalised effective treatments for melasma such as topical medications, chemical peels, laser therapy or a combination of these.

By taking these precautions, you can keep your skin healthy and beautiful, and preventing melasma is possible!