Melasma is a chronic condition that can be controlled very well but not permanently cured. With the right plan — strict sun protection plus topical or in-clinic treatment — the patches can fade substantially, but they tend to return if triggers like sun and hormones are not managed. Think of it as a condition you manage long-term rather than a one-off fix, which is why maintenance and daily sunscreen matter as much as the treatment itself.

The two biggest triggers are sunlight and hormones. Ultraviolet and even visible light stimulate the pigment cells, while hormonal shifts from pregnancy, oral contraceptives or hormone therapy switch pigment production on. Heat, certain skincare that irritates the skin, and a family history also contribute. Because sun and heat are major drivers, melasma is especially common and stubborn in Pakistan's climate.

Pregnancy-related melasma (sometimes called the mask of pregnancy) does fade for some women in the months after delivery, particularly once hormones settle. For others it persists and needs treatment. In either case, daily broad-spectrum sunscreen from early on gives the skin the best chance of clearing and helps prevent it from deepening.

Laser can help melasma but must be used cautiously on darker skin. Aggressive or incorrectly chosen laser settings can actually worsen melasma or trigger rebound pigmentation and post-inflammatory hyperpigmentation in Fitzpatrick III–VI skin. That is why melasma is never treated with laser as a first step at Skin Bliss — sun protection and topicals come first, and any laser or energy treatment is conservative, test-patched and doctor-supervised.

There is no single best treatment — melasma responds best to a layered approach. The foundation is rigorous daily photoprotection. On top of that, dermatologists use topical depigmenting agents, gentle chemical peels, and in selected cases oral or topical tranexamic acid or conservative pigment lasers. The right combination depends on how deep the pigment sits and your skin tone, which Dr. Sania Khan assesses at consultation.

It is the single most important part of managing melasma — no treatment works well without it. Melasma is driven by light, so a broad-spectrum sunscreen (ideally SPF 50+, reapplied through the day, and tinted/iron-oxide formulas that also block visible light) is essential every day, even indoors near windows and on cloudy days. Skipping sunscreen is the most common reason melasma treatment fails or relapses.

Yes, melasma commonly recurs, especially with sun exposure or hormonal changes. This is normal for the condition and not a sign that treatment failed. Ongoing maintenance — daily sunscreen, periodic topical use and occasional top-up sessions — keeps it under control. Setting this expectation up front is part of a responsible treatment plan.

Yes. Although melasma is far more common in women, men account for a meaningful share of cases, usually driven by sun exposure and genetics rather than hormones. The assessment and treatment approach is the same, with sun protection as the foundation.

Melasma improves gradually. Most people begin to see the patches lighten over 8–12 weeks of consistent treatment and sun protection, with continued improvement after that. Deeper (dermal) pigment is slower to respond than surface (epidermal) pigment. Patience and consistency give far better results than aggressive shortcuts, which can backfire on darker skin.

Oral tranexamic acid is used for stubborn melasma and can be effective, but it is a prescription medicine that must be assessed and monitored by a doctor, as it is not suitable for everyone (for example, people with certain clotting risks). At Skin Bliss it is only ever considered after a proper medical assessment by Dr. Sania Khan — never bought or self-dosed over the counter.