#AskADerm: Q&A with Dr. Caroline A. Chang on Melasma

Updated: Jul 12


Imagine this: you have a well-rounded skincare routine, religiously applying sunscreen, and are always careful to not spend extended hours in the sun. However, you suddenly realise that patches have mysteriously appeared on your cheeks and nose. What’s going on? Is there a way to rid these blotches?


Known as melasma, these darker facial patches are caused by the overproduction of melanin—a pigment that gives your eyes, hair, and skin its natural colour. To learn more about the skin condition, we are honored to hear from Dr. Caroline A. Chang, a board-certified dermatologist and founder of Rhode Island Dermatology Institute, the first direct care dermatology practice in Rhode Island. Dr. Chang shares her expertise in melanoma research and tackles some common questions around this pigmentation disorder.



Q1: How to get rid of melasma?


Melasma is a chronic condition. This means there is no cure for it. You can really only hope to manage it with a combination of medications and in-office treatments. If you developed melasma due to pregnancy or using birth control pills, then it is possible that the melasma may go away on its own when those factors are not present. The goal of treatment is to minimise the appearance of the hyperpigmented areas. Dr. Chang



Q2: I have melasma on my nose and upper cheeks. I've tried every topical option (peels, lasers, micro-needling, hydroquinone, just to name a few and different brands). Have I exhausted my options or should I consider it an internal issue?


All the options you listed are great treatments for melasma. Since melasma is a chronic condition, it is best to work with a dermatologist to figure out the best combination of treatments to keep the hyperpigmentation from getting darker.



Q3: Why does melasma occur? Is it due to a deficiency?


While we don’t know all the sources of what causes melasma, we know that it is sensitive to hormones such as estrogen and progesterone. Melasma may appear during pregnancy or when taking birth control pills. There is also likely a genetic predisposition to developing melasma.



Q4: How can melasma be avoided during pregnancy?


While melasma cannot entirely be avoided during pregnancy, wearing sunscreen can prevent the discoloration from getting worse during your pregnancy.



Q5: Why does my melasma spread?


Melasma is a condition that should be managed on a regular basis. Best care generally requires daily management with sun protection and lightening creams as well as occasional in-office treatments. If your melasma is spreading, it could be due to hormonal signals, increased exposure to UV light, or inadequate treatment regimen.



Q6: Is there a recommended face acid for fading melasma?


Topical treatments for melasma include creams that are used for fading hyperpigmentation that includes active ingredients such as hydroquinone, licorice extract, and kojic acid. Vitamin C is also helpful in preventing further darkening.

Chemical peels can also be done under close supervision with a dermatologist to

slowly pull the pigment from the deeper layers of the skin.



Q7: What treatments are recommended for melasma?


In addition to the topical treatments mentioned above, you can also consider in-office laser treatments to aid in pigment reduction. However, it is important to note that melasma is chronic and no single treatment is curative.



While there is no fixed cure for melasma, we hope that Dr. Chang’s helpful tips on using the right topical products and sunscreen can help to reduce and/or minimise the appearance of these unwanted hyperpigmentation patches. It is always good practice to consult a dermatologist on the right combination of treatments to use before embarking on a full-fledged regime.


Above all, we encourage you to not rush the process! There’s no need to be discouraged if you do not see instant results. With continual efforts, you’ll see a brighter and less blotchy complexion over time!






About us: We are Skintelligence, a team focused on a 'skin-first' approach to beauty through artificial intelligence. We match products to you based on your unique skin type and needs. Results are highly accurate and personalized with AI and machine learning. It's fun, convenient, and it works. Try it here.

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