What Works Skin — Independent · Evidence-First · Ad-FreeIssue 014 · 20 April 2026 · Next: 04 Maywhatworksskin.com

Concern · Pigmentation Disorders · Melasma

P. 15 · GUIDE

Melasma.

Symmetric, hormone-driven pigment. Controllable, not curable.

The most-misunderstood pigment disorder we see. Hormone-sensitive, UV-driven, recurrence-prone. This is the protocol — molecules, products, routine, supplements, and what to avoid — for keeping it dormant.

— § 01

The triggers worth tracking.

Long-UVA exposure

The single biggest driver. Visible-light contribution is real but secondary.

92%
Hormonal change

Pregnancy, OCPs, HRT. Suppress the trigger, the pigment fades slowly.

70%
Heat / IR

Cooking, hot yoga, steam. Underestimated in Indian kitchens.

55%
Inflammation

Acne, eczema, post-procedure. PIH layered on melasma confounds diagnosis.

44%

— § 02

Ingredients that actually work.

— § 04

On our shelf.

— § 05

Frequently asked.

Is melasma curable?

It's controlled, not cured. The melanocytes that produce it remain hyperresponsive to UV — meaning long-term it's a maintenance condition. The good news: a strict protocol can keep it dormant for years.

Will SPF alone fix it?

It will stabilise it. To actively fade existing pigment you need an active layer (azelaic, tranexamic, or — under derm care — a Kligman-style trio). SPF determines whether your improvement holds.

Can I do this without prescription tretinoin?

Yes. Azelaic 10–20% twice daily, with daily SPF and tranexamic 3%, gets most patients meaningful improvement within 16 weeks.