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Skin concern
Brown patches on the face that appear with sun exposure, pregnancy or the pill. Here we explain how to recognise it, why it happens and what the clinic can do for you.
Reviewed by Dr Michelle Campagnoli, clinical director
How to recognise it
Many people confuse melasma with freckles or sun spots. The difference lies in the shape, the symmetry and what makes it worse.
Tick what you recognise
Tick the signs you recognise in your patches. This is not a diagnosis, it is only meant to give you an idea.
You recognise some signs. It could be melasma or another type of patch. Only a medical assessment can say for sure.
Several signs match melasma. An assessment consultation is worthwhile to confirm it and choose the way forward. Only a medical assessment confirms the diagnosis.
Book an assessment consultationOnly a medical assessment can confirm. Patches that grow quickly, bleed, are raised or change colour should be seen by a doctor as soon as possible, as they may not be melasma.
Forehead. Patches in the centre and at the sides of the forehead, near the hairline.
Cheekbones. The most commonly affected area: the cheeks and temples, almost always on both sides.
Above the lip. A «moustache»-shaped patch over the upper lip is very characteristic.
Jawline. The least common pattern: patches along the jaw, more usual in more mature skin.
Why it happens
Melasma develops when the cells that give skin its colour produce too much pigment in one area. There is almost always more than one cause at play. Choose one to see what makes it worse and what helps.
Sunlight wakes up the cells that give skin its colour, and very little is enough. Sun outdoors, sun coming through a window and the visible light from some screens can keep the patches active.
Unprotected sun, especially at midday, and sun protection only in summer.
Tinted sunscreen every day, a wide-brimmed hat and shade.
Female hormones stimulate pigment production. That is why melasma is more common in women and often starts during pregnancy, with the pill or with another hormonal treatment.
Hormonal changes combined with sun exposure.
Talking to the doctor who manages your medication, without stopping it on your own, and protecting your skin from the sun.
People with relatives who have melasma are more likely to develop it. It is also more common in olive or medium skin tones, which have more active pigment cells.
You cannot choose it, but it explains why the patches come back easily.
Constant prevention and regular follow-up appointments.
Heat and inflammation of the skin stimulate pigment production. Aggressive treatments done without supervision can irritate the skin and leave the patches even darker.
Saunas, direct heat on the face, strong scrubs and «whitening» products used on your own.
Calm, moisturised skin, and treatments always decided by the doctor.
Pregnancy and the pill
When melasma starts during pregnancy, with the pill or with another hormonal treatment, some special care is needed. It is the same melasma, but with a course of its own.
When it appears. Often during pregnancy, from the second trimester, when hormone levels are higher.
Does it go away after the birth? In many women it fades over the following months, but it may stay. It is not worth waiting without protecting your skin.
Treatments. Some are not suitable during pregnancy or breastfeeding. The doctor explains what you can expect and when to start.
What you can already do. Tinted sunscreen every day, a wide-brimmed hat and shade.
When it appears. Weeks or months after starting the pill, the patch, the ring or another hormonal treatment.
Do not stop on your own. The decision belongs to the doctor who looks after your medication, who will go through the alternatives with you.
The patches can still be treated. With a plan from the doctor and sun protection, even if you keep the method you use.
Mention it at your consultation. If the patches appeared after a new treatment, tell us: it helps to choose the way forward.
Are you pregnant, breastfeeding or on the pill? Say so when you book your consultation, so the doctor can adapt the plan.
Book an assessment consultationWhat the clinic can do
These are the treatments we offer for melasma and for patches that insist on staying. You do not choose by name: the doctor proposes the way forward after seeing your skin.
Clinical indication
For melasma and persistent pigmentation that resist ordinary treatments. It is an intensive solution, with close follow-up.
Suitable when
you have already tried to treat the patches without success.
Find out more→
Depigmentation method
One of the best-known depigmentation methods. It tackles the patches and evens out skin tone, with treatment at the clinic and continuity at home.
Suitable when
the patches call for a more even skin tone.
Find out more→
Peels and regeneration
Intense skin renewal, to treat marked skin damage and stubborn patches.
Suitable when
the patches come with other sun damage.
Find out more→
Technology
Light applied to a photosensitiser, to regenerate the skin and treat patches and signs of ageing.
Suitable when
your skin also needs regeneration.
Find out more→
Regeneration
Vitamins, minerals and other active ingredients applied in the dermis, to nourish the skin and treat patches.
Suitable when
you want to nourish the skin at the same time.
Find out more→Why is there no single «right» treatment for everyone? Melasma has more than one cause and every skin reacts differently. That is why the plan is tailored to you, and results are gradual and need maintenance.
What the journey looks like
No treatment starts without an assessment consultation with the doctor. This is how it works.
The doctor examines your skin, asks about your history, your medication and your sun exposure, and confirms that it is melasma.
She explains the options, what to expect and how long it may take, and chooses the most suitable way forward with you.
You have the treatment at the consultation and receive clear instructions for the following days, with the right products for your skin.
We look at your skin again, adjust the plan and agree on maintenance, because melasma tends to return without protection.
Day to day
Even with the best treatment, everyday habits decide a good part of the result. These are the steps that matter most.
The golden rule
In winter too, and indoors. Outdoors, reapply every two hours. It is the habit that matters most for the result.
Tinted filters also block visible light, which can keep the patches active.
In practice: apply it in the morning, even on cloudy days and indoors, in a generous amount on the face and neck.
Protection wears off with sweat, touch and time. Reapplying keeps the shield in place.
In practice: a sunscreen stick or powder with an SPF filter is easier to reapply over make-up. Reapply after swimming or sweating, too.
It reduces direct sun on the face, especially during the hottest hours.
In practice: choose the shade between 11am and 4pm, when the sun is strongest, and wear sunglasses to protect the skin around the eyes as well.
Every step of the plan is there to protect the result of the treatment.
In practice: use only the products the doctor has recommended, in the right order, and keep going to your follow-up appointments even when the patches have already become lighter.
Even a few minutes can darken the patches, especially in the weeks after a treatment.
In practice: avoid tanning and the hottest hours of the day, and remember that the sun also comes through car and window glass.
Heat stimulates the pigment cells. Saunas, intense steam and an open fire close to the face make the patches worse.
In practice: avoid very hot baths and showers on the face, and staying close to sources of heat, such as the oven or the fireplace.
Acids and strong scrubs irritate the skin and can leave the patches even darker.
In practice: before trying a new product, ask the doctor: what brightens one person’s skin can irritate another’s.
The decision about hormonal medication belongs to the doctor who looks after you. Talk to them first.
In practice: if the pill or other hormonal medication seems to be linked to the patches, talk to the doctor who looks after you, who will go through the alternatives with you.
Who will look after you
At Luxmed, the first step is always an assessment consultation with Dr Michelle Campagnoli. She is the one who looks at your skin, confirms the diagnosis and draws up the plan with you, taking her time and never rushing.
Facial aesthetics
One of the most common pigmentation disorders and one of the hardest to treat. The causes, the most common myths and the treatment and prevention options.
Read the article →
Facial aesthetics
What differs from ordinary sunscreen, which shade to choose and how often to reapply to protect your patches.
Read the article →
Facial aesthetics
Why it appears, whether it clears after birth and what care you can start now, even before any treatment.
Read the article →Other skin concerns
Book a consultation
Choose how you prefer to get in touch. We will arrange the assessment consultation with Dr Michelle Campagnoli.
New Life Miraflores, Algés · Office Center, R. Santa Teresa do Menino Jesus n.º 6, 9.º C, 1495-048
Your details are used only for this contact. Any treatment depends on a prior medical assessment.
Sometimes it fades when the cause goes away, for example after pregnancy or when stopping the pill. But in many people the patches stay, and the sun keeps darkening them. That is why it is worth having it assessed and treated, rather than waiting.
It is a condition that can be managed, but it tends to come back. The aim of treatment is to lighten the patches and maintain the result, with daily sun protection and follow-up appointments.
Improvement is gradual: it is usually noticeable after a few weeks and continues over the following months. The pace depends on how intense the patches are, your skin and the care you keep up. The doctor can give you a more concrete idea at the assessment.
It depends on the treatment. Some require you to avoid the sun for longer, and others can be done with extra precautions. The doctor will tell you the best time of year for your case.
Some treatments are not recommended at these stages. If you are pregnant or breastfeeding, tell us as soon as you book. Sun protection is always important and can be started right away.
The price depends on the plan chosen, so it is given at the assessment consultation, after the doctor has seen your skin. Discomfort varies from person to person and from treatment to treatment. Redness and peeling are common in the following days, and the doctor will explain what to expect before you start.
In many women it fades in the months after the birth or after breastfeeding ends, but in others it stays. If the patches persist, the doctor assesses them and suggests the right way forward.
Do not stop the pill on your own. The decision belongs to the doctor who looks after your medication, who will go through the alternatives with you. In the meantime, tinted sunscreen every day and the doctor’s assessment help to keep the patches under control.
No. Freckles are small, isolated dots that appear very early in life and fade in winter. Melasma forms larger, symmetrical patches in well-defined areas of the face, and has a lot to do with hormones.
As soon as the patches bother you, and without delay if a patch grows quickly, bleeds, is raised or changes colour. The earlier it is assessed, the simpler the plan usually is.
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The assistant does not give diagnoses or replace a consultation. The plan and cost of any treatment are set at the medical assessment.