Melasma

What it is

Melasma causes even, symmetrical brown or grey-brown patches, most often on the cheeks, nose bridge, forehead, jaw and upper lip. It is common in women aged 20 to 50 and is not contagious or dangerous, but it can be persistent and affect confidence.

How it works

Melasma is a long-term pigment condition in which melanocytes in the face are more sensitive and more active than normal. Hormones, ultraviolet and visible light, and heat all switch them on. Small blood vessels and changes in the dermis also seem to send signals that keep pigment production high, which is why melasma tends to come back.

Why it matters on darker skin

Melasma is much more common in medium and darker skin tones. Pigment cells respond strongly to ultraviolet and visible light, heat and hormones (pregnancy, contraceptive pills), so patches appear and darken easily in a sunny climate like Nigeria.

Causes and triggers

Pregnancy, hormonal contraception, family history, sun and visible light (including bright indoor light and screens to a small degree), heat from cooking or saunas, and irritating skincare. It is commoner in women and in medium to dark skin tones.

What helps — and why it works

Strict daily sun protection is the foundation: a broad-spectrum SPF 30+ tinted sunscreen with iron oxides, reapplied when outdoors, plus a hat and shade. Gentle evidence-based ingredients include azelaic acid, niacinamide, vitamin C and tranexamic acid serums. A doctor may prescribe stronger treatments for a limited period. Melasma often returns, so maintenance matters. Daily tinted sunscreen with iron oxides, reapplied: visible light worsens melasma in darker skin and only tinted products block it well. Expected timeline: the foundation of any improvement; flares settle over weeks. Gentle, fragrance-free routine: irritation triggers more pigment. Expected timeline: less redness and stinging within 1–2 weeks. Azelaic acid, niacinamide or tranexamic acid products: they target different steps of pigment production and are less likely than strong bleaches to cause rebound. Expected timeline: improvement over 8–12 weeks. Doctor-supervised prescription treatment when needed: short supervised courses of combination creams can help; a doctor monitors for side effects. Expected timeline: assessed at 8–12 weeks.

What to avoid and why

Avoid bleaching creams, especially unregulated ones; they can cause ochronosis (permanent blue-black darkening) and steroid damage. Avoid aggressive peels, lasers or "home microneedling" without an experienced dermatologist, as these can worsen pigment in darker skin.

Common mistakes

• Expecting a permanent cure — melasma is controlled, not cured.
• Using strong or unlicensed bleaching creams, which cause rebound darkening and ochronosis.
• Skipping sunscreen on cloudy or indoor days.
• Aggressive peels or lasers without an experienced specialist, which can worsen it.

Building a routine that lasts

Most skin problems improve with a short routine used every day rather than many products used occasionally. A practical base is a gentle cleanser, a fragrance-free moisturiser and a broad-spectrum sunscreen in the morning, with one targeted treatment at night. Introduce one new product at a time and give it two weeks before adding another, so that if your skin reacts you know the cause. Patch-test on the inner arm or behind the ear for a few days first. Skin renews itself roughly every four to six weeks, so most treatments need two to three cycles — eight to twelve weeks — before you can judge them fairly. Photographs taken in the same light every four weeks are more reliable than memory. In the Nigerian climate, heat, humidity and harmattan all change what your skin needs: lighter gels in the humid season and richer creams in dry months are both reasonable. If a product stings for more than a few minutes, causes swelling, or leaves new dark patches, stop it. Buy from registered pharmacies or official stockists, and use the Authenticity Check if you are unsure whether a product is genuine.

Reading labels and choosing products

On the label, look first for the active ingredient and whether the product is fragrance-free and non-comedogenic. Ingredients are listed in order of amount, so an active at the end of a long list may be present only in a small quantity. Be wary of products that promise results in days, that list no ingredients, or whose label is a sticker or handwritten. Words such as 'natural', 'herbal', 'organic' and 'dermatologist-inspired' are marketing terms, not safety standards. Hydroquinone, mercury compounds (sometimes listed as calomel or mercurous chloride) and strong steroids such as clobetasol do not belong in an over-the-counter cosmetic. A real NAFDAC registration number should be printed on the pack and should match the product on the official Greenbook register. Price is not proof: counterfeiters copy expensive brands. When in doubt, ask a pharmacist, keep your receipt, and use Melanin & Me's Authenticity Check and barcode scanner as a first screen.

Questions to ask your doctor or pharmacist

Useful questions include: What do you think is causing this? Is it likely to come back, and how can I prevent it? Which products should I stop? How long before I should expect improvement, and when should I come back if it isn't better? Are there side effects to watch for? Is this treatment safe if I am pregnant, breastfeeding or for my child? Writing your questions down, bringing your products (or photos of their labels) and taking dated photos of the problem make an appointment much more useful.