You wear sunscreen every morning, you have changed your routine more than once, and you have started to wonder whether anything holds.
It is not that the treatments you tried were wrong. It is that melasma follows heat, sun and hormones, and a routine that ignores those three can only ever fade it for a season.
At House of Aetheria, Dr. Debjani Chakraborty treats melasma with a slow, gentle plan, because on Indian skin the aggressive route often makes it worse. This guide explains why melasma returns and what helps.
The short answer
- Melasma can be controlled, but there is no cure, and it can come back.
- The main triggers are sun (including visible light), heat and hormones.
- Harsh peels or strong lasers can inflame darker skin and leave more pigment behind.
- Daily tinted sun protection and a doctor-guided plan matter more than any single procedure.
- Plan for maintenance. Results hold only while the triggers are managed.
What melasma is and what sets it off
Melasma causes darker patches, usually on the face, and it is most common in women with medium to dark skin. The American Academy of Dermatology lists hormonal change (pregnancy and birth control pills), sun, heat and genes as the main causes, and says sun is the main trigger for it coming back.
Why it keeps coming back
- The seasons. It often fades in cooler months and returns with the sun and heat, which makes a new product look like it worked.
- Hormones. Pregnancy, hormonal medicines and other hormonal changes can restart it.
- Light you do not think about. Ordinary sunscreen blocks UV. Visible light also affects melasma, and tinted sunscreen containing iron oxide helps with it.
- Stopping maintenance. Pigment that was only suppressed returns when the routine stops.
- Inflammation. Irritation from harsh products or procedures can make pigment worse.
Why aggressive treatment backfires on Indian skin
Darker skin makes pigment easily, and it reacts to irritation by making more. A peel strong enough for lighter skin, or laser settings that are too high, can cause inflammation that darkens the patches. The American Academy of Dermatology notes that darker skin needs specialised treatment to avoid irritation. That is why a slower plan, with a doctor choosing every step, tends to hold better than a dramatic first session.
What a dermatologist checks first
Your doctor asks about hormonal medicines, pregnancy, thyroid problems and everything you already use on your skin, and orders tests when they are needed. If you are pregnant, treatment normally waits until after delivery.
What helps
| Option | What it does |
|---|---|
| Daily sun protection | The foundation of every plan. Use a tinted sunscreen with iron oxide, reapply in daylight, and add a hat. |
| Prescription creams | Chosen and monitored by your doctor. Over-the-counter products should not be used for more than three to six months without review. |
| Gentle peels | Acids suited to darker skin, used gradually. Strong peels are avoided. |
| Low-energy laser toning | Gentle laser sessions spread over time, for people who suit it. Timing outside the strongest sun months helps. Our laser toning for melasma guide explains it. |
| Medicines | In some people your dermatologist may prescribe medicines after assessment. Only a doctor decides this. |
Expect a course of treatment over months, then maintenance. See also why over-the-counter serums fall short and why pigmentation returns after laser.
What to avoid
- Home peels, strong acids and scrubs on the patches.
- Changing products every few weeks, so nothing gets a fair trial.
- Going out in strong sun straight after a procedure.
- Stopping sun protection once the skin looks better.
Questions to ask a clinic
- Who decides the treatment, and will it be a dermatologist?
- Which settings or acids will you use on my skin type, and why?
- What is the plan if the patches darken after a session?
- How do we keep the result through the summer?
Read about our laser toning for pigmentation and pigmentation treatment pages.
