01Foundation
Medical-Grade SkincareThe foundation. Specific products are discussed in consultation, not advertised here.
Hormonal, Recurrent, and Worth Treating Carefully
Melasma
Hormonal pigmentation that returns under hormonal triggers and UV exposure. Aggressive laser is not first-line.
Your Concerns
What Is It?
Melasma is hormonal pigmentation that affects the cheeks, forehead, and upper lip — most often in women, often appearing or worsening during pregnancy, after starting hormonal contraception, or alongside perimenopausal change. Unlike other pigmentation, melasma is recurrent: it returns under hormonal triggers and UV exposure even after successful treatment. At 23MD, melasma is approached more conservatively than other pigmentation. Daily broad-spectrum SPF is the non-negotiable foundation. In Dubai, our clinical team leads this work.
Recommended Pathway
Treatments for Melasma
The treatments our doctors most often recommend for this concern. Your consultation confirms the right combination and sequence for you.
02Daily Essential
Broad-Spectrum SPF with Iron OxidesThe single most important intervention. Mineral SPF that blocks visible light, not just UV. Discussed in consultation.
05Energy-Based
Selective DevicesUsed very selectively. Aggressive laser is NOT first-line — the risk of rebound (pigmentation returning worse than before) is real, particularly in skin of colour.
Unsure which pathway suits you?
Not sure which treatment is right for you?
23MD DigitalSkin Expert
Upload a photo and receive a personalised skin assessment with treatment recommendations from our doctor-led protocols.
Analyse My SkinCommon Causes
What Could Be Causing It
Hormonal
Pregnancy, hormonal contraception, hormone therapy, perimenopausal shifts.
UV Exposure
Even brief sun exposure can trigger or worsen melasma.
Visible Light
Sunlight through windows, screens, indoor lighting can drive melasma in some patients.
Heat
Chronic heat exposure (e.g. cooking, hot climates) may contribute.
Inflammation
Friction, irritation, aggressive treatments can worsen the picture.
FAQs
Your Questions, Answered
Melasma is hormonally driven and recurrent — it can return even after successful treatment. Other types of pigmentation (sun damage, post-inflammatory hyperpigmentation, lentigines) have different drivers and behave differently. The treatment approach is different, which is why classifying it matters.
Honest answer: melasma is managed, not cured. With consistent SPF, the right skincare, and selective treatments, it can be substantially lightened and maintained — but the hormonal and UV triggers remain. Expectation-setting is part of the consultation.
Hormonal influence is the most common driver, but UV and visible light are the most common triggers for flare. Melasma rarely appears without some hormonal context, even if subtle.
Aggressive laser can produce paradoxical worsening — pigmentation rebounding darker than before — particularly in skin of colour. The 23MD approach is conservative for this reason. When energy-based treatment is appropriate, the device, depth, and settings are selected carefully.
With caution. We lead with skincare, sun protection, and conservative interventions before any energy-based treatment is considered. For most patients, that's the appropriate first phase.
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Medically reviewed by Dr Suha Kersh, MB BCh BAO LRCP&SI, MRCPsych, GMC-registered since 1992.
