Melasma Treatment in Jammu

Where does melasma usually appear?

Melasma most commonly develops on:

• Cheeks
• Forehead
• Nose
• Upper lip
• Chin
• Jawline

The patches often appear on both sides of the face in a relatively symmetrical pattern.

Less commonly, pigmentation may involve the neck or forearms. An unusual distribution may require evaluation for another pigmentation disorder.

Can pregnancy cause melasma?

Yes. Hormonal changes during pregnancy can trigger or worsen melasma in susceptible individuals.

Patients should inform the dermatologist when they:

• Are pregnant
• Are breastfeeding
• Are trying to conceive
• Use hormonal contraception
• Take hormonal treatment

Some melasma medicines and oral treatments are unsuitable during pregnancy. Treatment during this period may therefore focus on gentle skincare and strict photoprotection.

Why does melasma keep coming back?

Melasma commonly recurs because the underlying tendency remains even after the pigmentation improves.

Recurrence may follow:

• Sun exposure
• Visible-light exposure
• Heat
• Hormonal changes
• Stopping maintenance treatment
• Skin irritation
• Inconsistent sunscreen use

Current consensus approaches treat melasma as a condition that often requires ongoing control and maintenance rather than a one-time permanent cure.

Why is sunscreen essential for melasma?

Ultraviolet radiation can darken melasma, and visible light can also contribute to pigmentation, especially in medium-to-deep skin tones.

The American Academy of Dermatology recommends daily sun protection as a central part of melasma care.

Patients may be advised to use:

• Broad-spectrum sunscreen
• SPF 30 or higher
• A tinted product containing iron oxides where appropriate
• Hats, umbrellas or physical shade
• Regular reapplication
• Protection during travel and outdoor work

A prospective randomised study found that visible-light-protective tinted sunscreen provided greater protection against seasonal melasma worsening than an untinted comparator.

What creams may be prescribed?

Depending on the diagnosis, severity, skin sensitivity and pregnancy status, treatment may include agents such as:

• Hydroquinone
• Retinoids
• Azelaic acid
• Cysteamine
• Kojic-acid-containing preparations
• Tranexamic-acid-containing topical treatment
• Carefully supervised combination creams

These medicines may cause dryness, redness or irritation. The strength, duration and combination should be selected by a qualified medical professional.

Unsupervised long-term use of strong depigmenting or steroid-mixed creams may damage the skin and worsen pigmentation.

Can chemical peels help melasma?

Chemical peels may be used as an additional treatment for selected patients. They work by producing controlled exfoliation of superficial skin layers.

Possible peel options vary according to:

• Skin tone
• Melasma depth
• Skin sensitivity
• Active irritation
• Previous treatments
• Pigmentation risk

Peels are generally used as an adjunct rather than the foundation of treatment. Procedures are not recommended as first-line therapy for every mild case.

Possible temporary effects include:

• Redness
• Dryness
• Peeling
• Sensitivity
• Temporary darkening
• Post-inflammatory pigmentation

Stronger peeling does not automatically produce better results.

Can laser treatment help melasma?

Laser or energy-based treatment may be considered for selected or resistant melasma, but it is not automatically the first treatment.

Possible options may include:

• Q-switched laser
• Low-fluence laser toning
• Other carefully selected procedures

Laser treatment can sometimes improve pigmentation but may also cause rebound darkening, uneven lightening or recurrence. Current consensus recommendations reserve procedural treatments for appropriate cases and combine them with photoprotection and medical therapy.

Patients should not be promised permanent clearance or instant whitening.

What is laser toning?

Laser toning usually refers to repeated low-fluence Q-switched laser sessions performed at controlled settings.

It may be considered when:

• The diagnosis has been confirmed
• Topical treatment has been insufficient
• The skin type and pigment pattern are suitable
• The patient understands recurrence and risks

Potential complications include:

• Irritation
• Rebound pigmentation
• Mottled lighter patches
• Uneven tone
• Temporary sensitivity

The number of sessions and treatment settings must be individualised.

Can tranexamic acid be used for melasma?

Tranexamic acid may be used topically, through selected procedures or orally in carefully screened patients.

Systematic reviews and expert consensus suggest oral tranexamic acid can improve melasma in selected patients, but it requires medical evaluation because of potential clotting risks and contraindications.

Before considering oral treatment, the doctor may review:

• Previous blood clots
• Clotting disorders
• Smoking history
• Hormonal contraception
• Pregnancy
• Cardiovascular risk
• Family history
• Current medicines

Patients should not self-medicate with oral tranexamic acid for pigmentation.

Diagnosis before treatment

Melasma is distinguished from post-acne marks, freckles and deeper pigmentary disorders before selecting a cream, peel or laser.

Dermatologist-led care

Treatment is planned under Dr. Cheena Langer, MBBS, MD Dermatology, Consultant Dermatologist.

Professional focus in pigmentation

Dr. Cheena Langer’s verified professional record includes teaching and conference activity related to melasma and pigmentary disorders.

Medical and procedural options

The clinic offers dermatologist-guided skincare, chemical peels, Q-switched laser and laser toning for selected patients.

Two clinic locations

Melasma and pigmentation treatment are available at Karan Nagar and Paloura.

Realistic counselling

Patients are informed about gradual improvement, relapse risk, maintenance and limitations.