Melasma: Understanding and Treating Stubborn Skin Pigmentation

Melasma: Understanding and Treating Stubborn Skin Pigmentation

By Dr. Heather Jenkins, Cosmetic Physician | Expert in Melasma Treatment | 20 Years of Experience | Medical Director The Skin Lab Brisbane

Have you noticed dark, patchy areas appearing on your cheeks, forehead, or upper lip? You may be experiencing melasma, a common but often frustrating skin condition that affects people of all skin types.

As a cosmetic physician with 20 years of experience treating melasma using multiple modalities, I have seen firsthand how this condition impacts self-confidence and skin health. At The Skin Lab Brisbane, we take a comprehensive and personalised approach to melasma treatment, combining the latest medical research with cutting-edge technology to deliver proven, long-term results.

In this guide, we’ll break down what melasma is, its causes, and the most effective treatments available to help you regain clear, even-toned skin.

What is Melasma?

Melasma is a chronic pigmentation disorder that presents as dark, irregular patches on the face, commonly affecting the cheeks, forehead, nose, and upper lip. While it is often linked to hormonal changes—including pregnancy, birth control, and hormone therapy—melasma can also affect men and those who are not pregnant, making the outdated term “mask of pregnancy” less relevant for many sufferers.

This stubborn pigmentation occurs due to excess melanin production, often triggered by a combination of hormones, sun exposure, and genetics. While melasma is not harmful, it can be difficult to treat and requires a targeted, professional approach for the best results.

Recognising Melasma Symptoms: What to Look For

Early detection is key to effective melasma management. If you experience the following symptoms, seeking expert advice can help you get started on the right treatment plan:

• Dark, discoloured patches that develop gradually
• Symmetrical pigmentation appearing on both sides of the face
• Commonly affected areas include the cheeks, forehead, bridge of the nose, and upper lip
• Pigmentation varies from light brown to dark brown or bluish-gray
• Worsens with sun exposure due to UV-induced melanin production

At The Skin Lab Brisbane, we use advanced diagnostic tools, including specialised photography and wood’s lamp examination, to determine the depth of pigmentation, ensuring we tailor the most effective treatment plan for each individual.

Why Melasma is More Common in Australia

Melasma can occur anywhere, but living in Queensland significantly increases your risk due to intense year-round sun exposure.

• Australia has some of the highest UV levels in the world, and Queensland ranks among the most sun-exposed regions.
• UV rays trigger and worsen melasma by stimulating melanocytes, the pigment-producing cells in the skin.
• Even brief sun exposure—such as walking to your car or sitting by a window—can reactivate melasma, making prevention a key part of treatment.

Because of our extreme UV conditions, effective melasma management in Brisbane requires daily, high-protection sunscreen use alongside targeted treatments.

What Causes Melasma? The Science Behind Skin Pigmentation

Melasma is a complex condition with multiple contributing factors. Understanding these can help prevent worsening symptoms and guide treatment decisions.

• Hormonal changes – Pregnancy, oral contraceptives, and hormone replacement therapy can trigger melasma by stimulating melanin production.
• Sun exposure – Queensland’s high UV levels make sun-induced melasma particularly common here. UV rays stimulate melanocytes, leading to persistent and worsening pigmentation.
• Genetics – A family history of melasma increases the likelihood of developing it.
• Skin type – Those with darker skin tones (Fitzpatrick types III-VI) are more prone to melasma due to higher melanin levels.
• Heat and inflammation – High temperatures, including saunas, hot yoga, and certain cosmetic treatments, can worsen melasma by stimulating pigment-producing cells.

Best Treatments for Melasma: The Skin Lab Brisbane’s Expert Approach

As melasma is notoriously difficult to treat, a multi-modal approach—combining topical skincare, in-clinic treatments, and long-term prevention—delivers the best outcomes for melasma treatment.

1. Topical Treatments: First-Line Defence Against Melasma

Medical-grade skincare is essential in controlling melasma. We recommend:

• Triple combination therapy – The gold standard for melasma treatment, combining hydroquinone, tretinoin, and corticosteroids for maximum efficacy.
• Hydroquinone – A powerful melanin inhibitor that helps lighten pigmentation.
• Tranexamic acid – A breakthrough treatment shown to interrupt pigment formation at a cellular level.
• Niacinamide & Vitamic C – Antioxidants that brighten the skin and prevent further pigment formation.

2. Advanced Laser and Energy-Based Treatments for Stubborn Pigmentation

At The Skin Lab Brisbane, we specialise in laser treatments designed specifically for melasma, ensuring safe and effective results:

• Pico Laser – Uses ultra-short pulses to break down pigment without overheating the skin, making it safer for melasma-prone individuals.
• CO2 CoolPeel – A fractional CO2 laser that resurfaces skin, reducing stubborn pigmentation with minimal downtime.
• MOXI Laser – A gentle, non-ablative laser that targets pigmentation and improves overall skin tone without excessive heat.

Not all lasers are suitable for melasma. Heat-based treatments and some lasers can worsen pigmentation if not used correctly, which is why expert guidance and melasma treatment planning is essential.

3. Prescription Medications: Internal Treatment Options

In resistant cases, oral and prescription treatments may be recommended:

• Oral tranexamic acid – Reduces melasma severity by targeting the vascular component of pigmentation.
• Prescription retinoids – Help increase cell turnover, promoting faster pigment reduction.

How to Prevent and Manage Melasma Long-Term

Even with treatment, melasma requires ongoing maintenance to prevent recurrence. These strategies can help:

• Daily sun protection – Apply a broad-spectrum SPF 50+ sunscreen every morning. Reapply every two hours when outdoors.
• Avoid heat exposure – Minimise time in saunas, steam rooms, or excessive heat that can trigger pigmentation.
• Use gentle skincare – Overusing harsh scrubs and irritating products can worsen melasma by increasing inflammation.
• Regular maintenance treatments – Periodic laser sessions, chemical peels, or prescription and cosmeceutical grade skincare can help keep melasma under control.
• Monitor hormonal triggers – If birth control pills worsen melasma, discuss alternative options with your doctor.

Your Next Steps: Book a Consultation at The Skin Lab Brisbane