Melasma is the pigmentation problem people most often misdiagnose in themselves, and treating it as if it were ordinary sun spots is why so many routines fail. Here is what it actually is and what the evidence supports.
What melasma is
Melasma is a form of hyperpigmentation that appears as symmetrical patches, usually on the cheeks, forehead, upper lip and bridge of the nose. The patches are typically larger and more diffuse than individual sun spots, with less defined edges.
It is driven by overactive melanocytes, the cells that produce pigment. What sets melasma apart from other dark spots is that hormones play a central role alongside UV exposure, which is why it is far more common in women, frequently starts during pregnancy or after starting hormonal contraception, and often does not respond to treatments that work well on sun damage.
How to tell it apart from other dark spots
Melasma: symmetrical, patchy, blurred edges, cheeks and forehead, often appeared during pregnancy or a hormonal change, worsens noticeably in summer.
Sun spots (solar lentigines): small, distinct, well-defined edges, scattered rather than symmetrical, appear on areas with the most cumulative sun exposure.
Post-inflammatory hyperpigmentation: appears exactly where a spot, cut or irritation was, and follows the shape of the original injury. If that describes your marks, our guide to dark marks after acne is the more relevant read.
The distinction matters because melasma is the most stubborn of the three and the most prone to rebound.
What triggers and worsens it
- UV exposure. The single largest driver. Even incidental daily exposure walking to a car is enough to sustain it.
- Visible light. Melasma is one of the few pigmentation conditions where visible light, including light from screens and indoor lighting, appears to contribute. This is why tinted mineral sunscreens containing iron oxide are often recommended over clear chemical ones.
- Heat. Independent of UV. Cooking over a stove, hot showers, saunas and hot climates can all aggravate it.
- Hormones. Pregnancy, combined oral contraceptives, and hormone therapy.
- Irritation. Aggressive scrubs, strong peels and over-exfoliation can trigger inflammation that makes melasma worse rather than better.
What actually helps
Sun protection, first and non-negotiable. Broad-spectrum SPF 30 or higher, applied daily regardless of weather, reapplied through the day. Tinted mineral formulas with iron oxide give additional visible-light protection. Nothing else on this list works if this is skipped, and this is where most people fail.
Topical actives with evidence. Azelaic acid, niacinamide, vitamin C and tranexamic acid all have supporting research for melasma. Hydroquinone remains the most studied prescription option but is regulated differently across markets and is not intended for indefinite use.
Gentle, consistent routines. Melasma responds poorly to intensity. A mild routine followed for a year outperforms an aggressive one abandoned after six weeks because it caused irritation. If you are building one, the graduated soap sequence is designed to escalate slowly rather than all at once, which suits melasma-prone skin better than a single strong product.
Professional treatment. Dermatologists have options including prescription combinations and carefully selected laser or peel protocols. Lasers are a double-edged tool here: the wrong setting can worsen melasma significantly, so this is not the place to bargain hunt.
Where oral supplements fit
Being straightforward, since we sell them.
Oral antioxidants including glutathione are, at best, a supporting element for melasma rather than a treatment for it. The clinical evidence for oral glutathione on pigmentation generally is mixed, and evidence specific to melasma is thinner still. Melasma is hormonally driven in a way that a general antioxidant does not directly address.
If you decide to add one as an adjunct alongside daily sun protection and appropriate topicals, Ultima is the formula in our range weighted toward skin tone, and Protect is a single-ingredient antioxidant at the lowest price point in the range. Neither is a substitute for sunscreen or for a dermatologist, and anyone marketing a capsule as a melasma cure is overselling.
A realistic timeline
Melasma is managed, not cured. Expect months rather than weeks, and expect it to fluctuate seasonally, typically worsening through summer and improving in winter.
Relapse after successful treatment is common, particularly if sun protection lapses or the hormonal driver remains. That is not a sign the treatment failed. It is the nature of the condition.
What to stop doing
- Scrubbing the patches. Physical exfoliation on melasma tends to inflame and worsen it.
- Stacking multiple strong actives at once hoping to accelerate results.
- Switching products every three weeks. You cannot assess anything on that timescale.
- Skipping sunscreen on cloudy days or indoors near windows.
If it started during pregnancy
Melasma that appears during pregnancy frequently fades in the months after birth, and supplements are not appropriate during pregnancy or breastfeeding. See our guide on glutathione in pregnancy for what is safe to do in the meantime.
When to see a dermatologist
See a professional if the patches are spreading, if six months of consistent sun protection and over-the-counter actives have produced nothing, or if you are unsure whether what you have is melasma at all. Getting the diagnosis right determines whether the next year of effort is aimed at the correct target.