Melasma develops when melanocytes, the pigment-producing cells within the skin, become overactive and produce excess melanin. While the exact cause is not always clear, several factors are known to trigger or worsen the condition.

Hormonal changes are one of the most common causes, which is why melasma frequently develops during pregnancy, while taking hormonal contraception or during menopause. Genetics also play a role, meaning some individuals are naturally more prone to developing the condition.

Environmental factors are equally important. Ultraviolet (UV) radiation, visible light and heat all stimulate melanocyte activity, increasing pigment production and making existing melasma darker. This explains why many people notice their pigmentation worsening during the summer months, after holidays abroad or following prolonged exposure to heat.

Inflammation can also contribute to melasma. Skin irritation, an impaired skin barrier and overly aggressive treatments may all trigger increased pigmentation, making careful treatment selection essential. Unlike many other pigmentation concerns, melasma requires a gentle, evidence-based approach that protects the skin while gradually reducing excess pigment.

Why is melasma difficult to treat?

Melasma behaves differently from many other forms of pigmentation. Rather than simply affecting the surface of the skin, it involves ongoing stimulation of pigment-producing cells, meaning pigmentation can recur even after successful treatment.

For this reason, melasma is best viewed as a condition to manage rather than permanently cure. The most successful treatment plans focus on reducing pigment production, protecting the skin from further stimulation and maintaining healthy skin function over the long term.

Because excessive heat and inflammation can worsen melasma or trigger rebound pigmentation, treatment should always be carefully selected and tailored to the individual.

Managing melasma

At NassifMD Medical Spa, every melasma treatment plan begins with a comprehensive consultation to assess your skin, understand your medical history and identify any underlying triggers. As melasma is a chronic condition, we create personalised treatment plans that combine prescription therapies, medical-grade skincare, advanced in-clinic treatments and ongoing maintenance to help you achieve the best possible results.

We offer both in-person and telephone consultations, making expert melasma care accessible wherever you are in the UK. Following your consultation, our medical team can prescribe appropriate treatments where clinically indicated, with prescription medications and medical-grade skincare delivered directly to your home for added convenience.

Prescription treatments

For many patients, prescription treatment forms the foundation of successful melasma management.

Where clinically appropriate, we prescribe Obagi® hydroquinone formulations, widely regarded as the gold standard topical treatment for melasma. Hydroquinone works by inhibiting tyrosinase, the enzyme responsible for melanin production, helping to reduce existing pigmentation while preventing the formation of new pigment. Treatment is carefully supervised by our medical team to ensure it is used safely and effectively.

For suitable patients, oral Tranexamic Acid may also be prescribed following a medical consultation. Increasingly recommended by dermatologists for persistent melasma, Tranexamic Acid works by reducing the pathways involved in abnormal pigment production. When combined with prescription skincare, it can significantly improve stubborn or recurrent pigmentation as part of a carefully monitored treatment plan.

Medical-grade skincare

Medical-grade skincare is an essential part of every successful melasma treatment plan and plays a vital role in maintaining long-term results.

Alongside prescription treatments, we carefully recommend products that protect the skin and reduce the risk of future pigmentation. Antioxidant serums help defend against environmental damage and oxidative stress, while gentle exfoliating products encourage healthy skin renewal without disrupting the skin barrier. Hydrating, barrier-supporting moisturisers also help minimise inflammation, an important trigger for melasma.

As your skin improves, your skincare programme will be reviewed and adjusted to help maintain your results safely over the long term.

Daily sun protection

Daily sun protection is one of the most important aspects of managing melasma. Research has shown that both ultraviolet (UV) radiation and visible light can stimulate melanocytes, increasing pigment production and contributing to melasma flare-ups.

For this reason, many leading dermatologists recommend using a broad-spectrum sunscreen containing iron oxidesfor patients with melasma. Unlike traditional sunscreens that primarily protect against UV radiation, iron oxides also help defend against visible light, which has been shown to worsen pigmentation and contribute to recurrence.

Our Dr Nassif Protect & Hydrate SPF contains iron oxides alongside broad-spectrum UVA and UVB protection, making it an ideal choice for patients managing melasma. Consistent daily use, even on cloudy days and throughout the winter months, is one of the most effective ways to protect your skin, maintain treatment results and reduce the risk of future pigmentation flare-ups.

In-clinic treatments

While prescription treatments and medical-grade skincare form the foundation of melasma management, carefully selected in-clinic treatments can further improve skin health and enhance overall results.

Depending on your skin, concerns and treatment goals, your personalised treatment plan may include Moxi® laser, medical-grade chemical peels, Hydrafacial® or microneedling.

Moxi® is a gentle non-ablative fractional laser that can improve overall skin quality and support pigmentation management in carefully selected patients. Medical-grade chemical peels encourage controlled skin renewal and help improve uneven pigmentation without excessive stimulation when performed as part of a tailored treatment programme.

Hydrafacial® provides gentle exfoliation, deep hydration and supports the skin barrier without excessive heat, making it an excellent maintenance treatment for melasma-prone skin. Microneedling can improve overall skin quality, stimulate collagen production and enhance the absorption of active skincare ingredients while supporting healthier skin function.

Every treatment recommendation is carefully tailored, as melasma requires a cautious approach to minimise unnecessary heat and inflammation, both of which can trigger rebound pigmentation.

Living with melasma

Melasma is a long-term condition, but with consistent treatment and maintenance, significant improvements are achievable. The best results come from combining prescription treatments where appropriate, medical-grade skincare, daily sun protection and regular professional reviews.

To help maintain your results, we recommend:

• Wearing a broad-spectrum SPF containing iron oxides every day, regardless of the weather.
• Reapplying sunscreen regularly when outdoors.
• Using medical-grade skincare consistently as prescribed.
• Incorporating antioxidant products to help defend against environmental damage.
• Using gentle exfoliating products to maintain healthy skin turnover without irritating the skin.
• Avoiding excessive heat exposure where possible, including prolonged sun exposure and high-heat environments.
• Attending regular review appointments so your treatment plan can be adapted as your skin changes.

At NassifMD Medical Spa, we understand that no two cases of melasma are the same. By combining evidence-based prescription treatments, advanced in-clinic procedures, medical-grade skincare and personalised long-term support, we help patients achieve healthier, clearer and more even-looking skin while reducing the risk of future pigmentation flare-ups.