Melasma
Pigmentary
ICD: L81.1
Also known as: Chloasma, Mask of Pregnancy
Description
Melasma is an acquired pigmentary disorder characterised by symmetric brown to grey-brown patches on sun-exposed areas of the face. It is particularly common in women of reproductive age and in Fitzpatrick skin types III–V. UV exposure and hormonal factors (pregnancy, oral contraceptives) are key triggers.
Symptoms
- Symmetric brown or grey-brown macules and patches
- Most common on cheeks, forehead, upper lip, chin
- Worsens with sun exposure
- No associated itching or pain
- Significant cosmetic and psychosocial impact
Causes & Triggers
- UV radiation (primary trigger)
- Hormonal influences (oestrogen, progesterone)
- Genetic predisposition
- Visible light and heat exposure
- Certain medications (phototoxic drugs)
Severity Classification
Epidermal
Brown patches — responds better to topical therapy
Dermal
Grey-blue patches — deeper pigment, more resistant
Mixed
Combination of epidermal and dermal — most common type
Treatment Ladder
- 1 Foundational: Strict broad-spectrum sunscreen (SPF 50+) + visible light protection
- 2 First-line: Triple combination cream (hydroquinone + tretinoin + steroid)
- 3 Alternatives: Azelaic acid 15–20% or tranexamic acid (oral/topical)
- 4 Adjuncts: Vitamin C, niacinamide, glycolic acid peels
- 5 Refractory: Chemical peels, microneedling, or laser (with caution in darker skin)
Relevant Compounds
Acetyl Glucosamine
Tyrosinase glycosylation inhibitor — reduces melanin synthesis through a unique mechanism, especially effective in combination with niacinamide (4% NAG + 5% niacinamide)
Acetyl glucosamine (N-acetyl-D-glucosamine, NAG) is an amino sugar and the acetylated form of glucos…
Alpha Arbutin
Tyrosinase inhibitor for gradual depigmentation
Alpha arbutin is a biosynthetic glycosylated hydroquinone derivative that inhibits melanin productio…
Avobenzone
UVA protection critical — UVA1 is a major trigger for melanocyte activation and melasma exacerbation
Avobenzone is an oil-soluble dibenzoylmethane derivative and the most widely used organic UVA1 filte…
Azelaic Acid
Tyrosinase inhibitor — depigmenting with anti-inflammatory action
Azelaic acid is a naturally occurring dicarboxylic acid produced by Malassezia furfur. It has antiba…
Bakuchiol
Depigmenting agent — inhibits tyrosinase and modulates melanogenesis-related gene expression
Bakuchiol is a meroterpene (terpenoid phenol) isolated from the seeds and leaves of Psoralea corylif…
Coenzyme Q10
Antioxidant — supports cell renewal
Coenzyme Q10 (ubiquinone) is a naturally occurring lipid-soluble benzoquinone that is present in vir…
Ferulic Acid
Anti-pigmentation adjunct — inhibits tyrosinase activity and UV-induced melanogenesis, stabilizes vitamin C in depigmenting formulations
Ferulic acid is a plant-derived phenolic compound abundant in cell walls of grains, fruits, and vege…
Glycolic Acid
Superficial peeling agent — enhances penetration of depigmenting agents
Glycolic acid is the smallest alpha hydroxy acid with the greatest bioavailability due to its low mo…
Kojic Acid
Copper chelation to inhibit tyrosinase
Kojic acid is a natural metabolite produced by several species of fungi (Aspergillus, Penicillium). …
Lactic Acid
Depigmenting agent — inhibits tyrosinase and promotes turnover of melanin-laden keratinocytes
Lactic acid is an alpha hydroxy acid (AHA) with a larger molecular weight (90.08 Da) than glycolic a…
Niacinamide
Inhibits melanosome transfer to keratinocytes
Niacinamide is the physiologically active amide form of vitamin B3. It is a versatile, well-tolerate…
Retinol
Milder retinoid for maintenance therapy
Retinol is an over-the-counter retinoid and a precursor to retinoic acid (tretinoin). It must be con…
Tretinoin
Accelerates epidermal turnover and disperses melanin
Tretinoin is a first-generation retinoid derived from vitamin A. It is one of the most extensively s…
Vitamin C
Tyrosinase inhibitor to reduce melanin synthesis
Vitamin C is a potent water-soluble antioxidant essential for collagen synthesis. In topical skincar…
Vitamin E
Antioxidant — photoprotection adjunct
Vitamin E is a fat-soluble antioxidant vitamin and a key component of the skin's natural antioxidant…
Recommended Drugs
Suggested Cosmetics
A-Ret Tretinoin Gel 0.05%
Tretinoin for epidermal melanin dispersal
AHAGlow Advanced Face Wash Gel
Glycolic acid cleanser as adjunct to depigmenting regimen
Aqualogica Detan+ Dewy Sunscreen SPF 50+ PA++++
PA++++ sunscreen with de-tan benefits for melasma
Aqualogica Glow+ Dewy Sunscreen SPF 50 PA++++
PA++++ sunscreen for melasma management
Aqualogica Illuminate+ Dewy Sunscreen SPF 50+ PA++++
Brightening sunscreen with Alpha Arbutin for melasma
Aqualogica Radiance+ Dewy Sunscreen with Watermelon & Niacinamide SPF 50 PA++++
PA++++ sunscreen with Niacinamide for melasma
Asaya 2% Kojic Acid + 1% Alpha Arbutin Face Serum
Kojic acid + alpha arbutin for depigmentation
Asaya Advanced Spot Pigmentation Face Serum
Multi-active depigmentation
Asaya 10% Vitamin C Face Serum
Vitamin C for brightening
Aziderm Cream (Azelaic Acid 20%)
Azelaic acid as tyrosinase inhibitor for melasma
Beauty of Joseon Relief Sun Rice + Probiotics SPF 50+ PA++++
PA++++ K-beauty sunscreen with Niacinamide for melasma
Bioderma Photoderm Aquafluide SPF 50+ PA++++
Very high protection sunscreen for melasma management
Bioderma Photoderm MAX Cream SPF 50+ UVA38
Very high UVA protection critical for melasma
Bioderma Photoderm Mineral SPF 50+ PA++++
Mineral sunscreen for melasma management
Bioderma Photoderm Spot-Age SPF 50+ PA++++
Anti-spot sunscreen with Vitamin C for melasma
Cetaphil Sun SPF 50 Sunscreen Light Gel
Broad-spectrum sunscreen for melasma management
Cipla Acnelak Z SPF 50 Sunscreen
Broad-spectrum sunscreen for melasma management
Cipla Rivela Tint Sunscreen Lotion SPF 50
Tinted SPF 50 with visible light protection — gold standard for melasma
Conscious Chemist Rapid Glow & Brightening Essence Serum
Vitamin C + niacinamide for brightening
Conscious Chemist SunProtect+ SPF 50+ PA++++ Sunscreen
PA++++ with next-gen filters for melasma
Cos-IQ 10% Niacinamide Face Serum
Niacinamide for brightening
Cos-IQ 20% Niacinamide Face Serum
Niacinamide for depigmentation
Cos-IQ 20% Vitamin C Serum with Vitamin E & Ferulic Acid
CE Ferulic for depigmentation
Cos-IQ 23% Vitamin C Face Serum
High-strength vitamin C for depigmentation
Cos-IQ 8% Vitamin C Face Serum
Vitamin C for mild depigmentation
Cyspera Cream (Cysteamine 5%)
Non-hydroquinone cysteamine for melasma treatment
Deconstruct 5% Niacinamide Serum + 2% Alpha Arbutin
Alpha arbutin + niacinamide for depigmentation
Deconstruct Gel Sunscreen SPF 50 PA++++
PA++++ photostable sunscreen for melasma management
Deconstruct 10% Niacinamide Serum with 0.3% Alpha Arbutin
Niacinamide + alpha arbutin for depigmentation
Deconstruct Vitamin C Serum — 10% Vitamin C + 0.5% Ferulic Acid
Vitamin C + ferulic acid for depigmentation
The Derma Co AHA BHA 10% Face Peel
Glycolic acid exfoliation for pigment reduction
The Derma Co 1% Hyaluronic Long Lasting Sunscreen SPF 50 PA++++
PA++++ water-resistant sunscreen for melasma management
The Derma Co 1% Hyaluronic Sunscreen Aqua Gel SPF 50 PA++++
PA++++ sunscreen essential for melasma management
The Derma Co 1% Hyaluronic Sunscreen Hydrating Gel SPF 50 PA++++
PA++++ sunscreen essential for melasma management
The Derma Co 1% Hyaluronic Sunscreen Oil-Free Matte Gel SPF 50 PA++++
PA++++ sunscreen essential for melasma management
The Derma Co 2% Kojic Acid Face Serum with Alpha Arbutin
Multi-pathway tyrosinase inhibition for melasma
The Derma Co 10% Niacinamide Face Serum
Niacinamide reduces melanosome transfer
The Derma Co Pore Minimizing Priming Sunscreen SPF 50 PA+++
Broad-spectrum sunscreen for melasma management
The Derma Co 10% Vitamin C Face Serum with 5% Niacinamide
Vitamin C + niacinamide for depigmentation
The Derma Co 15% Vitamin C Face Serum with 5% Niacinamide
High-potency vitamin C + niacinamide for depigmentation
The Derma Co Ultra Light Zinc Mineral Sunscreen SPF 50 PA+++
Physical sunscreen for melasma management
Dot & Key Blueberry Hydrate Barrier Repair Sunscreen SPF 50+ PA++++
PA++++ sunscreen for melasma management
Dot & Key CICA Calming Mattifying Sunscreen SPF 50 PA++++
PA++++ sunscreen for melasma management
Dot & Key 10% Glycolic Acid Glow Serum
Gentle AHA exfoliation for pigment reduction
Dot & Key 10% Niacinamide + Strawberry Brightening Face Serum
Niacinamide inhibits melanosome transfer
Dot & Key Strawberry Dew Tinted Sunscreen SPF 50+ PA++++
Tinted sunscreen with coverage for melasma
Dot & Key 10% Vitamin C + E Serum with 5% Niacinamide
Vitamin C + alpha arbutin for depigmentation
Dot & Key Vitamin C + E Sunscreen SPF 50 PA+++
SPF 50 protection essential in melasma management
Dot & Key Watermelon Cooling Sunscreen SPF 50+ PA++++
PA++++ sunscreen for melasma management
Dr. Sheth's Ceramide & Vitamin C Sunscreen SPF 50 PA+++
Barrier-supporting SPF 50 sunscreen for melasma
Dr. Sheth's Gulab & 6% Glycolic Acid & 5% Niacinamide Brightening Serum
Glycolic acid + niacinamide for depigmentation
Dr. Sheth's Haldi & Hyaluronic Acid Sunscreen SPF 50 PA+++
Turmeric anti-inflammatory + SPF 50 for melasma
Dr. Sheth's Kesar & 2% Kojic Acid Ampoule Serum
Kojic acid for depigmentation
Ducray Melascreen UV Light Cream SPF 50+
Anti-dark spot sunscreen specifically designed for melasma
Ekran Soft SPF 50+ Silicone Sunscreen
Broad-spectrum sunscreen for melasma management
Episoft AC Moisturiser with SPF 30
SPF 30 moisturiser essential during depigmenting treatment
Episoft AC SPF 50+ Sunscreen
Broad-spectrum sunscreen for melasma management
Eukroma Plus Cream (Hydroquinone 2% + Tretinoin 0.025% + Mometasone 0.1%)
Triple combination cream — most effective topical melasma therapy
Eukroma Cream (Hydroquinone 2%)
First-line tyrosinase inhibitor for melasma
Fixderma FCL C Scape Serum (Vitamin C 15%)
Vitamin C for mild depigmenting and antioxidant support
Fixderma Nigrifix Cream (for Hyperpigmentation)
AHA-based cream for body hyperpigmentation
Fixderma Reticuram Retinol Serum
Retinol for maintenance depigmenting therapy
Fixderma 2% Salicylic Acid Serum with 5% Azelaic Acid & 4% Mandelic Acid
Azelaic + mandelic acid for depigmentation
Fixderma Shadow Sunscreen SPF 50+ Gel PA+++
Broad-spectrum sunscreen for melasma management
Fixderma Skarfix-Plus Cream
Triple depigmenting cream for melasma management
Fixderma Skarfix-TX Serum with 4% Kojic Acid & 3% Tranexamic Acid
Kojic acid + tranexamic acid for stubborn pigmentation
Foxtale Essentials Dewy Finish Sunscreen SPF 50 PA++++
PA++++ sunscreen with niacinamide for melasma
Foxtale 10% Glutathione + Vitamin C Face Serum
Glutathione + vitamin C for depigmentation
Foxtale 5% Niacinamide Face Serum
Niacinamide inhibits melanosome transfer
Foxtale 3% Tranexamic Acid Face Serum with Peptides & Niacinamide
Tranexamic acid inhibits plasmin and reduces melanin production
Foxtale 15% Vitamin C + E + Ferulic Acid Serum
Antioxidant depigmenting combo
Garnier Bright Complete Vitamin C Booster Serum 30x
Affordable vitamin C + niacinamide for mild depigmenting
Garnier Super UV Invisible Serum Sunscreen SPF 50 PA++++
PA++++ sunscreen with Vitamin C for melasma
Garnier Vitamin C+ Face Serum for Brightening
Vitamin C for brightening and depigmentation
Glyco-A Peel (Glycolic Acid 35%/50%/70%)
Superficial chemical peel for epidermal melasma
Heliocare 360 Gel Oil-Free SPF 50
Premium sunscreen with Fernblock for melasma
Himalaya All Skin Sunprotect+ Ultra-Light Sunscreen Cream SPF 50 PA++++
PA++++ sunscreen for melasma management
Himalaya Dark Spot Clearing Turmeric Face Serum
Turmeric for brightening and depigmentation
Himalaya Brightening Vitamin C Serum
Vitamin C for brightening
Hyphen 18% Brightening + 20% Collagen Double Shot Serum
Vitamin C + alpha arbutin + licorice for depigmentation
Hyphen Advanced De-Pigmentation Serum with 2% Kojic Acid
Kojic acid inhibits tyrosinase for depigmentation
Hyphen Brightening Face Serum 5% Niacinamide + 1% Alpha Arbutin
Niacinamide + alpha arbutin + kakadu plum for depigmentation
IPCA Sunban Ultra SPF 30 PA+++ Gel
Daily photoprotection during depigmenting treatment
Isntree Hyaluronic Acid Watery Sun Gel SPF 50+ PA++++
PA++++ sunscreen for melasma management
Jessner's Solution Peel (Lactic + Salicylic + Resorcinol)
Jessner's peel for superficial melasma
Joy Revivify Vitamin C Sunscreen SPF 50 PA++++
Budget PA++++ sunscreen for melasma patients
Kaya Gluta Glow Face Serum
Glutathione for depigmentation
Kojivit Ultra Gel (Kojic Acid 2% + Arbutin 1%)
Non-hydroquinone depigmenting gel for melasma maintenance
La Roche-Posay Anthelios UVMune 400 Invisible Fluid SPF 50+
Ultra-long UVA protection — gold standard for melasma
La Roche-Posay Anthelios XL Fluid SPF 50+
Very high protection sunscreen for melasma management
La Shield Expert Urban Protect Sunscreen SPF 50 PA+++
Broad-spectrum sunscreen for melasma management
La Shield Fisico Matte Sunscreen Gel SPF 50+ PA+++
High-SPF mineral sunscreen essential in melasma
La Shield Pollution Protect SPF 50 Mineral Sunscreen Gel PA+++
Broad-spectrum sunscreen for melasma management
Lacto Calamine Vitamin C Face Serum
Vitamin C for brightening
Lakme Perfect Radiance Serum
Niacinamide for brightening
Lakme Sun Expert 1% Hyaluronic Water-Light Sunscreen Gel SPF 50 PA++++
PA++++ sunscreen for melasma management
Lakme Sun Expert 1% Nia C Water-Light Sunscreen Gel SPF 50 PA++++
PA++++ sunscreen with brightening actives for melasma
Lakmé Sun Expert Ultra Matte SPF 50 PA+++ Gel Sunscreen
Affordable daily SPF 50 sunscreen
Lakme Sun Expert Tinted Sunscreen SPF 50 PA+++
Tinted sunscreen with coverage for melasma
Lakme 9 to 5 Vitamin C+ Serum
Vitamin C for brightening
L'Oreal Paris Glycolic Bright 8% Face Serum
Glycolic acid for chemical resurfacing and depigmentation
Loreal UV Defender Serum Protector Sunscreen SPF 50+ PA++++
PA++++ sunscreen with Mexoryl for melasma
Lotus Herbals Safe Sun UV Screen Matte Gel SPF 50 PA+++
Affordable daily SPF 50 for melasma patients
Mamaearth Rice Water Dewy Active Serum with 10% Niacinamide
Niacinamide inhibits melanosome transfer
Mamaearth Vitamin C Daily Glow Face Serum
Vitamin C for brightening and depigmentation
Mamaearth Vitamin C Toner
Vitamin C and glycolic acid for mild depigmenting action
Mamaearth Skin Illuminate Face Serum with Vitamin C & Turmeric
Vitamin C + turmeric for depigmentation
Melaglow Rich Cream (Tranexamic Acid 3% + Kojic Acid 2%)
Tranexamic acid + kojic acid for non-hydroquinone melasma therapy
Minimalist 16% Vitamin C Face Serum
Tyrosinase inhibition for depigmentation
Minimalist 2% Alpha Arbutin Serum + Hyaluronic Acid
Alpha arbutin inhibits tyrosinase for depigmentation
Minimalist Cream Sunscreen SPF 50 PA++++
PA++++ sunscreen essential for melasma management
Minimalist Light Fluid Sunscreen SPF 50 PA++++
PA++++ sunscreen essential for melasma management
Minimalist 10% Niacinamide Face Serum
Niacinamide to reduce melanosome transfer
Minimalist 0.3% Retinol + Q10 Face Serum
OTC retinol for maintenance between treatments
Minimalist SPF 50 PA++++ Sunscreen
PA++++ sunscreen essential for melasma
Minimalist Sunscreen SPF 60 PA++++
SPF 60 PA++++ sunscreen for melasma management
Minimalist 3% Tranexamic Acid Serum
Multi-pathway depigmentation with tranexamic acid + HPA
Minimalist 10% Vitamin C Face Serum with Ethyl Ascorbic Acid
Tyrosinase inhibition for depigmentation
Neutrogena Ultrasheer Age Shield Fluid Sunscreen SPF 50+ PA++++
PA++++ sunscreen essential for melasma management
Neutrogena Ultra Sheer Dry-Touch Sunblock SPF 50+ PA+++
Daily broad-spectrum sunscreen for melasma patients
Olay Total Effects Serum with Vitamin C B5 Niacinamide
Vitamin C + niacinamide for brightening
Bello Photostable Gold Plus Sunscreen SPF 55 PA+++
Photostable high-SPF sunscreen with visible light protection
Pilgrim 15% Vitamin C Serum with Ferulic Acid & Vitamin E
High-strength vitamin C + ferulic acid for depigmentation
Pilgrim 25% AHA + 2% BHA + 5% PHA Peeling Solution
Glycolic acid for chemical resurfacing and depigmentation
Pilgrim 2% Alpha Arbutin & 3% Vitamin C Brightening Face Serum
Alpha arbutin + vitamin C for depigmentation
Pilgrim 10% Niacinamide Face Serum
Niacinamide inhibits melanosome transfer
Pilgrim 0.5% Retinol + Vitamin C Serum
Retinol for maintenance depigmenting
Pilgrim 10% Vitamin C Face Serum
Vitamin C + niacinamide for depigmentation
Pilgrim Vitamin C Sunscreen SPF 50 PA++++
PA++++ sunscreen with brightening actives
Plum 5% Niacinamide & Rice Water Beginner Friendly Face Serum
Niacinamide inhibits melanosome transfer
Plum 2% Alpha Arbutin & Hyaluronic Acid Face Serum
Alpha arbutin inhibits tyrosinase for depigmentation
Plum 10% Niacinamide Serum with Rice Water
Niacinamide + licorice for depigmentation
Plum SPF 50 PA++++ Sunscreen with 2% Niacinamide
Brightening sunscreen for melasma management
Plum 15% Vitamin C Serum with Mandarin
High-strength vitamin C for depigmentation
POND'S Bright Miracle Ultimate Brightening Serum
Niacinamide for depigmentation
POND'S Serum Boost Sunscreen SPF 50 PA+++
Brightening sunscreen with Niacinamide and Vitamin C
POND'S Bright Beauty 12% Vit C+E+A Serum
Vitamin C for depigmentation
RE'EQUIL Oil Free Aquagel Sunscreen SPF 50+ PA++++
PA++++ sunscreen for melasma management
RE'EQUIL Oxybenzone and OMC Free Sunscreen SPF 50 PA+++
Broad-spectrum sunscreen for melasma management
Re'equil Ultra Matte Dry Touch Sunscreen Gel SPF 50 PA++++
PA++++ broad-spectrum sunscreen for melasma management
Regaliz Brilante Max Brightening Serum
Brightening actives for depigmentation
SalPeel (Salicylic Acid 20%/30%)
Superficial peel adjunct for melasma in dark skin
Simple Booster Serum 10% Vitamins C + E + F
Gentle vitamin C for sensitive melasma-prone skin
Skinoren Gel (Azelaic Acid 15%)
Azelaic acid for melasma — pregnancy-safe option
Suncros Matte Finish Soft Lotion SPF 50+ PA+++
High-SPF mineral sunscreen for melasma
Sunprotek Sunscreen Gel SPF 50 PA++++
PA++++ sunscreen for melasma management
SunScoop 3% Niacinamide Fluid Sunscreen SPF 50+ PA++++
PA++++ sunscreen with Niacinamide for melasma
TCA Peel (Trichloroacetic Acid 15–35%)
Medium-depth TCA peel for resistant melasma
The Ordinary Niacinamide 10% + Zinc 1%
Niacinamide reduces melanosome transfer
Tranexamic Acid 4mg/mL Mesotherapy Solution
Intradermal tranexamic acid for resistant melasma
Tri-Luma Cream (Fluocinolone 0.01% + Hydroquinone 4% + Tretinoin 0.05%)
Gold-standard triple combination cream for melasma
Tvaksh Face Guard Silicone Sunscreen Gel SPF 50 PA+++
Photostable broad-spectrum sunscreen for melasma
UV Doux Gold Silicone Sunscreen Gel SPF 50 PA+++
Visible light protection for melasma management
UV Doux Silicone Sunscreen Gel SPF 50 PA+++
Multi-filter sunscreen for melasma management
VLCC 10% Azelaic Acid Serum
Tyrosinase inhibitor safe in pregnancy
VLCC De-Tan SPF 50 PA+++ Sunscreen Gel Creme
De-tan sunscreen for melasma management
WishCare Super Bright C16 10% Vitamin C Serum
Vitamin C for brightening and depigmentation
WOW Skin Science Vitamin C Serum
Vitamin C serum for depigmentation
Yellow Peel (Retinol 5% + Lactic + Ascorbic)
Retinol peel for melasma-safe for Indian skin
Lifestyle Tips
- Sunscreen is THE most important intervention — reapply every 2 hours outdoors
- Use tinted sunscreen with iron oxides for visible light protection
- Avoid waxing the face during active treatment
- Be patient — visible improvement takes 8–12 weeks minimum
- Hormonal review if linked to oral contraceptives
When to Refer
- Refractory melasma not responding to 6 months of topical therapy
- Consideration of procedural interventions (peels, laser)
- Diagnostic uncertainty (rule out post-inflammatory hyperpigmentation, lichen planus pigmentosus)