Melasma is a chronic pigmentation disorder characterized by brown or gray-brown patches that appear symmetrically on the face, most commonly on the cheeks, forehead, upper lip, and nose. It’s notoriously difficult to treat because it involves complex interactions between multiple factors including hormones, UV radiation, heat exposure, genetics, and inflammation. Unlike simple sun spots that involve localized melanin deposits, melasma results from melanocyte hyperactivity triggered by various stimuli, making it prone to recurrence. The condition often extends into deeper skin layers where pigment is harder to reach, and treating it too aggressively can cause inflammation that actually worsens the problem. At Estelaza Clinic, we address these challenges through comprehensive melasma treatment protocols that target multiple pathways simultaneously while avoiding triggers that cause flare-ups.

Melasma treatment requires patience and realistic expectations. Most patients begin noticing initial improvement within four to eight weeks of starting comprehensive treatment, but significant, stable results typically develop over three to six months. Some stubborn cases may require longer treatment periods of nine to twelve months before optimal improvement is achieved. The timeline varies based on factors including whether your melasma is epidermal, dermal, or mixed (deeper pigment takes longer to respond), how long you’ve had the condition, your skin type and tone, how consistently you follow treatment protocols, and how well you protect your skin from triggers. At Estelaza Clinic, we monitor your progress closely and adjust treatments as needed to ensure steady improvement. Remember that melasma treatment in Dubai requires ongoing maintenance even after initial improvement to prevent recurrence.

Melasma develops from a combination of triggers rather than a single cause. Primary factors include hormonal influences from pregnancy, birth control pills, or hormone replacement therapy, which is why women are far more affected than men. Sun exposure is both a trigger and aggravating factor, as UV radiation stimulates melanocyte activity. Heat exposure, independent of UV, can also trigger melasma, making Dubai’s climate particularly challenging. Genetic predisposition plays a significant role, with melasma being more common in people with medium to darker skin tones, particularly those of Latin American, Middle Eastern, South Asian, and Asian descent. Those most at risk include pregnant women, women taking hormonal contraceptives, people with family history of melasma, individuals with skin types III-VI on the Fitzpatrick scale, and those living in sunny climates like Dubai. Understanding your specific triggers helps us create more effective melasma treatment plans.

Melasma is considered a chronic condition rather than one that can be permanently cured. However, this doesn’t mean you’re destined to live with dark patches forever. With proper melasma treatment, most patients achieve significant improvement or even complete clearance of visible patches. The challenge is that melasma tends to recur when exposed to triggers like sun, heat, or hormonal changes. Think of melasma like a chronic condition that can be managed effectively but requires ongoing care. At Estelaza Clinic, we help patients achieve dramatic improvement and then maintain those results through appropriate maintenance protocols. Many patients enjoy years of clear skin with proper sun protection and periodic maintenance treatments. Some cases of melasma, particularly pregnancy-related melasma, may fade on their own after hormonal levels normalize, though this can take many months to years. The key is viewing melasma treatment as long-term management rather than a one-time cure.

Melasma treatment options are limited during pregnancy and breastfeeding due to safety concerns with certain medications and treatments. Most prescription topical treatments, including hydroquinone and retinoids, are not recommended during pregnancy or nursing. Oral medications like tranexamic acid are also avoided during these periods. However, safe options do exist. At Estelaza Clinic, we can recommend mineral-based sunscreens that are pregnancy-safe, gentle vitamin C serums and azelaic acid formulations, certain mild chemical peels after careful consideration, and comprehensive sun and heat protection strategies. Many women choose to wait until after breastfeeding to begin aggressive melasma treatment, focusing instead on prevention and protection during pregnancy and nursing. The good news is that pregnancy-related melasma sometimes fades gradually on its own after delivery once hormones normalize, though this can take six months to several years. We can create a safe management plan during pregnancy and a comprehensive treatment plan for after you’ve finished breastfeeding.

While melasma shares the common feature of skin darkening with other pigmentation conditions, it has distinctive characteristics. Melasma appears as symmetrical brown or gray-brown patches typically on both sides of the face, is triggered by hormones, sun, and heat rather than just sun damage, tends to be chronic and recurrent rather than stable, and often extends into deeper skin layers making it harder to treat. Sun spots or age spots are usually smaller, more isolated spots that result from cumulative sun damage, appear on sun-exposed areas including hands and chest, are typically epidermal (surface-level) and easier to treat, and don’t have hormonal triggers. Post-inflammatory hyperpigmentation develops after skin injury, inflammation, or acne, matches the shape of the original injury, and gradually fades over months without treatment. At Estelaza Clinic, we use advanced diagnostic tools including Wood’s lamp examination to differentiate melasma from other pigmentation types, ensuring you receive the most appropriate melasma treatment for your specific condition.

There is no single “best” melasma treatment that works for everyone, which is why combination therapy typically delivers superior results. The most effective approach at Estelaza Clinic combines triple combination topical cream (hydroquinone, tretinoin, corticosteroid) as the foundation, low-energy laser therapy or chemical peels performed regularly, tranexamic acid either topically, injected, or orally for stubborn cases, and strict sun and heat protection protocols. This multi-pronged approach addresses melasma through multiple mechanisms simultaneously. In terms of speed, some patients see initial improvement within weeks from chemical peels or laser treatments, but sustainable results require consistent treatment over months. Topical treatments work gradually but provide the foundation for lasting improvement. Tranexamic acid has shown impressive results in clinical studies and may work faster than topicals alone. The fastest approach is actually the comprehensive one, using multiple treatments that work synergistically rather than relying on any single modality. Our melasma treatment in Dubai is customized based on your specific case for optimal speed and efficacy.

Yes, inappropriate laser treatment can absolutely make melasma worse, which is why choosing an experienced provider is essential. Aggressive laser treatments that generate excessive heat or inflammation can trigger post-inflammatory hyperpigmentation and rebound melasma that’s darker than the original condition. This is especially problematic in darker skin types that are more prone to melasma in the first place. However, when performed correctly using appropriate techniques, laser therapy can be highly effective for melasma. At Estelaza Clinic, we use conservative approaches including low-fluence laser toning, Q-switched lasers at sub-therapeutic settings, appropriate cooling to prevent heat buildup, and gradual treatment protocols rather than aggressive single sessions. We also carefully assess your skin type, melasma depth, and individual risk factors before recommending laser treatment. For some patients, we may avoid lasers entirely and focus on chemical peels, topicals, and other modalities instead. Our priority is always improving your melasma safely without triggering worsening.

Preventing melasma recurrence requires lifelong vigilance and commitment to protective measures. At Estelaza Clinic, we provide comprehensive prevention strategies that include strict sun protection with broad-spectrum SPF 50+ sunscreen every single day regardless of weather or season, reapplication every two hours when outdoors, physical protection through hats, sunglasses, and sun-protective clothing, and seeking shade during peak sun hours. Heat protection is equally important, so avoid saunas, hot yoga, and prolonged heat exposure, use cooling facial mists in hot weather, and stay in air-conditioned environments when possible. Maintain your skincare routine with gentle, medical-grade products that support even skin tone, and continue using maintenance topicals as prescribed even when melasma is clear. Consider periodic maintenance treatments such as quarterly chemical peels or laser sessions. Manage hormonal factors by discussing contraceptive options with your physician if birth control triggered your melasma. Monitor your skin regularly and address any darkening immediately before it progresses. With proper prevention, most patients maintain their results for extended periods.

Yes, melasma treatment can be effective across all skin types, but treatment approaches must be carefully tailored to your specific skin tone. Darker skin types (Fitzpatrick types IV-VI), which are most prone to melasma, require special consideration because they’re also more susceptible to post-inflammatory hyperpigmentation from aggressive treatments. At Estelaza Clinic, our dermatologists have extensive experience treating melasma in the diverse Dubai population, including Middle Eastern, South Asian, Asian, and African skin tones. We customize treatment parameters including using lower laser energy settings for darker skin, choosing gentler chemical peel formulations, carefully selecting topical concentrations to minimize irritation, and conducting test spots before full treatment when appropriate. We also adjust treatment frequency and intensity based on how your skin responds. Some treatments that work well for lighter skin may not be suitable for darker tones, and vice versa. Our expertise in treating melasma across all skin types ensures you receive safe, effective melasma treatment in Dubai regardless of your ethnic background or skin tone.