How to prevent melasma

What can you actually prevent?

Melasma causes blotchy brown patches, usually on both sides of the face, when pigment producing cells make excess melanin, the pigment that gives skin its colour. Sunlight is a trigger you can reduce, but family history and hormones also contribute. Pregnancy, hormonal contraception and hormone replacement therapy can trigger melasma. Prevention therefore means reducing avoidable triggers, not controlling every cause. Melasma is more common in women and people who tan easily or have naturally brown skin, but protection matters across skin tones.4

How to protect your skin each day

1. 1Choose a tinted, broad spectrum, water resistant sunscreen containing iron oxides. SPF 30 is the minimum; SPF 50 or higher is a practical choice for melasma.
2. 2Apply sunscreen to all skin not covered by clothing, 15 minutes before going outside. Make protection a daily habit, including on cloudy days.
3. 3Reapply sunscreen at least every two hours when outdoors, and renew protection after swimming or sweating.
4. 4Add a wide brimmed hat, protective clothing and sunglasses with UV protection before heading outdoors. A hat with an ultraviolet protection factor, or UPF, label offers more effective protection.
5. 5Seek shade whenever possible. Avoid tanning beds and sunlamps, which can worsen melasma and interfere with treatment.

Why does the tint matter?

Visible light can worsen melasma, particularly in darker skin tones. Iron oxides help protect against visible light; an untinted sunscreen containing zinc oxide or titanium dioxide is not an equivalent substitute for that protection. Trials comparing sunscreens found better control of melasma with formulas that also protected against visible light. Choose a tint that matches your skin tone and a finish you are willing to wear regularly. Tinted sunscreen can also camouflage uneven colour, which gives one bottle two jobs without requiring a committee.135

Which skincare should you avoid?

Choose gentle, fragrance free skincare. Stop using a cosmetic product that burns or stings: irritation can darken existing spots. If a prescribed melasma treatment irritates your skin, discuss it with your dermatologist. Chemical peels and lasers are not routine prevention tools; they can worsen melasma or cause additional pigmentation and need expert selection and care.34

What if pregnancy or contraception is a trigger?

Make daily sun protection a priority during pregnancy. Research in pregnant women supports sunscreen use to reduce the risk of developing melasma. If patches started after hormonal contraception or another medication, discuss the possible trigger with the prescriber rather than stopping it yourself. Melasma sometimes fades after pregnancy ends or a triggering medication is stopped, but it can also persist for years.25

How do you keep melasma from returning?

Keep protecting your skin throughout the year, including after treatment has worked. Summer sun can bring pigmentation back. Sun protection remains part of melasma care after patches fade, so finishing treatment does not retire the sunscreen. If you use prescribed melasma medication and makeup, apply them in this order: medication, sunscreen, then camouflage makeup.24

When should you see a dermatologist?

Have new or uncertain facial pigmentation checked rather than assuming it is melasma. Sun spots are a separate condition caused by accumulated ultraviolet exposure, and some pigmented spots can resemble skin cancer. A dermatologist can identify the cause and discuss treatment if patches persist or bother you. Prevention is not a quick fading treatment: melasma treatment usually takes 3 to 12 months to show results, and longstanding patches can take longer.26