Melasma and Dark Patch Treatment (Melasma)
Melasma is patchy dark discoloration on the face caused by hormones, sunlight, and genetics. It is treated with physician-prescribed creams and laser; it can be faded and controlled but usually not cured completely, and it requires ongoing care. At Sanambinnam Clinic (คลินิกสนามบินน้ำ), Nonthaburi.
In short: what is melasma and how is it treated?
Melasma is brown, patchy dark discoloration on the face, usually on the cheeks, forehead, nose, and the border of the lips. It is caused by hormones (such as pregnancy or birth control pills), sunlight, and genetics. Melasma usually cannot be cured completely, but it can be controlled and faded with physician-prescribed creams (such as Hydroquinone, Retinoid), Q-switched laser, or IPL — and most importantly, applying SPF 50+ sunscreen every day; otherwise the melasma can darken again.
Reviewed by Dr. Net (หมอเน็ท) · Medical license ว.56133 · Updated 2026-06
What is melasma and how is it treated?
Melasma is a skin condition with patchy darkening, usually found on the cheeks, forehead, nose, and the border of the lips. The main causes are hormones, genetics, and sunlight. Treatment uses topical creams and/or laser; the physician assesses the type and depth of the melasma first to choose a suitable method.
Who is melasma treatment suitable for?
- People with melasma on the face who want to improve it
- People with dark patches from sun exposure
- People with hormonal melasma, such as during pregnancy or while taking birth control pills
- People who want to consult a physician about caring for melasma-prone skin
Consult a physician first / Cautions
- People who are pregnant — some treatments may not be suitable, but basic care is possible
- People with active melasma inflammation — the inflammation should be treated first
- People who are breastfeeding — consult a physician before using certain creams
- People with very sensitive skin — some lasers may not be suitable
- People with a history of allergy to ingredients in melasma treatment creams
What the physician will assess
- 1 Type of melasma — epidermal, dermal, or mixed
- 2 Health history — hormones, medications being taken, pregnancy
- 3 Genetics — family history of melasma
- 4 Behavior — sun exposure, sunscreen use
- 5 Depth of the melasma — with a skin scope or visual examination
What are the main treatment options?
Creams and topical medications
The physician may prescribe creams or topical medications such as Hydroquinone, Retinoid, Acid, or other topical agents, as appropriate for each person.
Laser
Some lasers help break up excess pigment. The physician selects the type and energy that suit the type and depth of the melasma.
Ongoing care
Apply SPF 50+ sunscreen every day, avoid direct sunlight, and keep follow-up appointments as scheduled by the physician.
Timeline and expected results
| Timeframe | Expected result |
|---|---|
| First 4–8 weeks | Melasma may start to fade slightly (with cream treatment) |
| 2–6 months | More visible improvement, depending on melasma type and treatment method |
| Ongoing | Continued care is needed to prevent the melasma from coming back |
| Time per session | 15–60 minutes, depending on the treatment method |
What are the risks and side effects?
From creams / topical medications
- Dry, irritated skin
- Mild peeling (Retinoid)
- Allergic reaction to ingredients
From laser
- Redness and swelling after treatment
- Melasma may temporarily darken (post-inflammatory)
- Risk of the melasma returning without sun protection
Comparing melasma treatments
| Treatment | Principle | Suitable for |
|---|---|---|
| Creams / topical medications | Suppress pigment, gentle exfoliation | Epidermal melasma, early-stage melasma, ongoing maintenance |
| Laser | Breaks up excess pigment with light | Darker melasma, melasma not responding to creams |
| Chemical peel | Exfoliates skin layers with chemical agents | Epidermal melasma, rough skin |
| Combination care | Uses several methods together | Individual melasma cases needing results in several areas |
Frequently asked questions
Can melasma be cured completely?
Melasma is a highly fluctuating condition. It can be well controlled and improved, but it usually cannot be cured completely. Ongoing care and sun protection are essential. Treatment results depend on the type of melasma, its depth, and the factors causing it.
How is melasma different from freckles?
Melasma appears as large patchy dark areas, usually on the cheeks, forehead, nose, and the border of the lips. It is caused by hormones, genetics, and sunlight. Freckles are small scattered spots, caused mainly by genetics and sunlight.
What can melasma be treated with?
The physician may use topical creams or medications (such as Hydroquinone, Retinoid, Acid) and laser, choosing the method that suits the type and depth of the melasma. Some cases require a combination of several methods.
Can birth control pills really cause melasma?
Yes. The estrogen hormones in birth control pills are a factor that can trigger melasma. If you already have melasma, you should consult a physician about changing your contraception method or increasing sun protection.
How can the melasma coming back be prevented?
The most important prevention is applying SPF 50+ sunscreen every day, avoiding direct sunlight, wearing a hat or using an umbrella, and following up with the physician’s recommended care regularly.
A note from Dr. Net (หมอเน็ท)
"Melasma is a condition that requires ongoing care. I place great importance on assessing the type of melasma in detail before choosing a treatment, because each type responds differently to treatment. The most important thing is applying sunscreen every day, no matter which treatment is used."
— Dr. Net (หมอเน็ท), Physician at Sanambinnam Clinic
Book a melasma consultation
Sanambinnam Clinic (คลินิกสนามบินน้ำ) — 421 Ngamwongwan Road, Bang Khen, Mueang Nonthaburi, Nonthaburi 11000
Phone / appointments: 086-464-2410
The clinic is open daily, 10:30–20:00
Medical references
- Pigmentary Disorders — Melasma: A Comprehensive Update
- Thai Dermatological Society — Melasma Treatment Guidelines
- Journal of the American Academy of Dermatology (JAAD) — Melasma Treatment Guidelines
Real treatment cases selected by the physician
Melasma treatment theory must go together with real individual results. See before-and-after photos and the number of treatment sessions from real clinic cases: