WHAT YOU NEED TO KNOW 

Melasma is a chronic skin condition caused by overactive melanocytes producing more pigment (Melanin) than the skin can eliminate. It is more common in women than men. 

Melasma is chronic and not curable, but it can be controlled.

What Is Melanin?

Melanin is the natural pigment that gives color to our skin, hair, and eyes. It’s made from an amino acid called Tyrosine. Tyrosine plays a critical role in the production of melanin, the pigment that helps protect our skin by absorbing ultraviolet (UV) light and converting it into heat, thereby reducing sun damage. Melanin also plays a role in camouflage, body temperature regulation, and even has antibacterial and antioxidant properties.

Melanin is produced inside specialized cells called melanocytes, which are located at the base of the outer skin layer (epidermis) and in hair follicles. Inside melanocytes are small structures called melanosomes where melanin is made. This entire process is called melanogenesis.

• Eumelanin (brown/black pigment), or

• Pheomelanin (red/yellow pigment), depending on other available molecules like cysteine.

Tyrosinase inhibition is a key strategy in melasma treatment because it slows down melanin production. 

Skin care products that contain these melanin blockers are used in treatments for all kinds of skin. Here are some Melanin blockers most commonly used in the skin care products today:

Kojic Acid, L-Arbutin, Vitamin C, Green Tea Extract, Niacinamide, AHAs - Glycolic, Mandelic, and Azelaic Acid, Retinoids, Licorice Extract, Kakadu Plum, Resveratol, Ferulic Acid and other Polyphenols.

People with higher amounts of melanin in their skin are less likely to develop skin cancer, thanks to its strong UV-blocking abilities. If tyrosine is lacking, melanin can’t be produced—this happens in conditions like albinism.

Causes of Melasma

Melasma is a complex skin condition that reflects deeper imbalances within the body. It often results from hormonal fluctuations that trigger a chain reaction involving insulin resistance, poor heat regulation, and elevated levels of proteins and unmetabolized sugars. These internal disruptions manifest externally as darkened, stain-like patches on the skin.

Pregnancy, oral contraceptives and hormonal therapies are a common cause of melasma in women.  Sometimes, increased vasculature may also contribute by amplifying inflammation and stimulating melanogenesis (the production of melanin). 

Men who spend long periods outside without sunscreen are at a higher risk of developing melasma. Hypothyroidism, hyperthyroidism, and other endocrine conditions that influence hormone levels can all lead to melasma in men.

Contribution factors for Melasma also include genetic influences (approximately 50% of affected individuals report a positive family history of Melasma).  Individuals with light to medium brown skin tones (Fitzpatrick skin types III and IV), particularly those with ancestral roots in equatorial or high sun-exposure regions, are more prone to developing Melasma. 

Hormonal Influences

Hormones may play a role in developing melasma in some individuals.

The mask of pregnancy is known to occur in pregnant women. The exact mechanism is unknown. Estrogen, progesterone, and melanocyte-stimulating hormone levels are normally increased during the third trimester of pregnancy and may be a factor.

Women with Melasma who have never been pregnant (nulliparous) may not have high levels of circulating estrogen or melanocyte-stimulating hormone (MSH)—both of which are known to trigger pigmentation. However, within the melasma-affected areas of their skin, there is an increased presence of estrogen receptors. This suggests that local skin sensitivity to estrogen may play a bigger role in Melasma than systemic hormone levels.

In addition, estrogen- and progesterone-containing oral contraceptive pills and diethylstilbestrol (DES) (a synthetic estrogen used in the past for prostate cancer treatment) can contribute to melasma.

Studies find that a woman who is postmenopausal and given progesterone may develop melasma, while those who are given estrogen alone do not; this implicates progesterone as playing a primary role in the development of melasma.

Thyroid Disease

A significant increase of Melasma has been observed in thyroid disease patients.

When the thyroid gland is not functioning properly, it can lead to other hormonal imbalances, including increased estrogen levels. This increase in estrogen can trigger the development of melasma by stimulating melanin production in the skin.

Sunlight Exposure

Extended periods of high exposure levels to UVB light can trigger extensive DNA damage. This may cause programmed cell death (or apoptosis) of affected cells in the skin, which is also the cause of ‘sunburn’. UV radiation can cause lipids peroxidation in cellular membranes, resulting in free radicals which could stimulate melanocytes to produce excess melanin.  When UV radiation causes DNA damage in skin cells (keratinocytes), it triggers a repair process involving a protein called p53. This protein activates and leads to the production of melanocyte-stimulating hormone (MSH).

Sunscreens that block UV-B radiation (290-320 nm) do not block the longer wavelengths of UV-A and visible radiation (320-700 nm), which also stimulate melanocytes to produce melanin.

Other Causes of Melasma

• Laser Treatments and Chemical peels
• Harsh cosmetics - Ingredients like alcohol-heavy toners, strong acids (especially when overused), or aggressive scrubs can sensitize the skin, making it more reactive to UV and heat—both of which are key triggers for Melasma.
• Hydroquinone - can cause permanent darkening of the skin called Ochronosis

Melasma Is More Than Skin Deep

To effectively manage pigmentation disorders like melasma, a surface-level approach isn't enough. Melasma can be triggered by emotional stress, hormonal shifts such as PMS or menopause, trauma, or even chronic low-grade inflammation.

Melasma stimulates melanocytes by the female sex hormones estrogen and progesterone, producing more melanin pigments when the skin is exposed to the sun.

Melasma is essentially an inflammatory, heat-driven condition—both in the body and in the skin. And today’s diet, rich in hidden sugars, only feeds the cycle.

Risk factors for Melasma

• Fitzpatrick III–IV skin types
• UV and visible light exposure
• Family history, pregnancy, hormonal therapy -  A thorough medical and family history is essential. A positive family history may indicate higher treatment resistance.
• Heat (causing vasodilation/inflammation)
• Endocrine disorders
• Hormonal Therapy history

Some people may show a vascular component (red or pink background in the pigmented areas). This hints that vascular involvement is not just a consequence but potentially a contributing factor. This is why vascular-targeting therapies, such as oral tranexamic acid are becoming popular in treatment of resistant  Melasma that also has a visible vascular element.

Melasma management: Topicals + Photoprotection

No two cases of melasma are alike. Melasma responds best to slow, intentional approaches that prioritize calming the skin and reducing heat. Treating from the inside out—balancing hormones, calming inflammation, improving digestion, and reducing internal heat—is key. The skin is a living, responsive organ capable of regeneration when supported correctly.

Treatments need to be customized, often blending gentle resurfacing with calming, pigment-inhibiting therapies.

Dermal pigment tends to take longer to fade than epidermal pigment because there are no treatments currently capable of directly removing pigment from the dermis. Since dermal pigment originates in the epidermis, consistent Melanin  suppression in the epidermis can prevent further pigment transfer to the dermis, allowing existing dermal pigment to gradually diminish over time.

• Strict sun protection, especially tinted sunscreens with iron oxides (to block visible light, which worsens Melasma in darker skin) is the first line of defense.
• Retinoids (such as tretinoin at concentrations of 0.5%–1%), when used in combination with Mandelic acid and Sunscreen, have the strongest supporting evidence for effectiveness in managing melasma.
• Azelaic acid 20%, is also recommended for pregnant patients.
• Oral Tranexamic Acid (TA) is recommended for persistent Melasma, especially one with a vascular element.
• Chemical Peels and Laser therapies carry a risk of adverse outcomes and may yield unpredictable results and are associated with undesired cosmetic results and further, epidermal necrosis, post-inflammatory hyperpigmentation, and hypertrophic scars. 
• Hydroquinone 4%, a commonly recommended treatment for Melasma, should be avoided on sensitive skin, as prolonged use—especially when combined with potent topical steroids—can lead to a condition called Exogenous Ochronosis (a bluish-gray discoloration of the skin).
• Pearl and diamond powders, as well as microdermabrasion and all forms of scrubs, should be avoided when treating melasma, as vigorous rubbing or abrasion of hyperpigmented areas can exacerbate the condition.

Recommended Routine: Calm, Consistency, Results

Topical skincare plays a critical role in managing melasma, especially when paired with sun protection and internal wellness strategies. A thoughtfully layered routine can help suppress melanocyte activity, reduce inflammation, and restore skin resilience over time.

Here is a professionally curated melasma-supportive skincare regimen recommended by  Biba:

• Cleanse (AM/PM): THE MANDELIC CLEANSING GEL — a gentle, exfoliating cleanser that helps remove impurities and lightly resurfaces without irritating melasma-prone skin.
• Tone (AM/PM): THE GLYCOLIC LACTIC TONER — provides mild exfoliation and supports cell turnover while prepping the skin to absorb actives.
• Morning Serum: THE META C SERUM — brightens skin and reduces pigmentation with stabilized Vitamin C and antioxidant support.
• Evening Serums - alternate each night:
  • THE PLANT STEM CELL SERUM — soothes and repairs while reducing oxidative stress.
  • THE RETINOL META CONCENTRATE — a potent yet refined retinol that promotes cell turnover and collagen renewal.
• Moisturizer (AM/PM): THE CREAM BARRIER - hydrates and seals in actives while supporting the skin barrier.  If you have oily or acne-prone skin we recommend THE DAILY MOISTURIZER.  

This routine is designed to balance gentle exfoliation with deep nourishment, reducing the risk of irritation while supporting long-term pigmentation control.

Always pair this with strict daily sun protection using a broad-spectrum, tinted sunscreen containing iron oxides.

LIfestyle Tips:

Individuals with melasma should apply skin-lightening topicals only to the darkened areas. With consistent sun avoidance and use of brightening ingredients, visible improvement can take several months, so it's important to set the expectation for gradual, steady lightening.

If you are using hormonal contraceptives, it may be helpful to consider switching to an alternative, if applicable, as certain hormonal treatments can exacerbate melasma. It's important to avoid heat exposure, which can trigger flare-ups. You can do this by using handheld fans or applying cool compresses to your face when needed.

Above all, daily sun protection is crucial—make sure to apply a broad-spectrum sunscreen every morning, and reapply throughout the day, even on cloudy days. These steps will help manage melasma and protect your skin from further damage.