Symmetrical facial patches
Irregular brown or grey-brown patches often affect both cheeks, forehead or upper lip. Sun exposure and hormonal factors commonly contribute.
Home / Skin Problems / Pigmentation & Melasma Treatment
PIGMENTATION / DERMATOLOGIST IN DEHRADUN
Melasma & Pigmentation Treatment in Dehradun
Dark facial patches? Identify the cause before treating them.
Melasma, post-acne marks and other types of facial pigmentation may look similar but respond to different treatments. Get an evidence-informed plan focused on accurate diagnosis, sun protection, safe topical medicines and realistic long-term control.
Dark facial patchesMelasma & post-acne marksSun and visible-light protection
Consultation ₹800 · Maheshwari Hospital, Dalanwala, Dehradun
Melasma care · Diagnosis firstAI-generated educational medical illustration, not a patient photograph.
UNDERSTANDING MELASMA
What is melasma?
Melasma is an acquired pigmentation disorder that causes irregular brown or grey-brown patches, often on the cheeks, forehead or upper lip. It is not contagious. It can improve with treatment but may relapse, especially with continuing light exposure.
✓ Not an infection✓ Often affects sun-exposed facial skin✓ Several contributing factors✓ Long-term maintenance may be needed
MEET YOUR DERMATOLOGIST
Dr Neeraj Garg
MBBS (IMS-BHU), MD (IMS-BHU)
Dermatologist & Venereologist · Dehradun
Dr Neeraj Garg completed both MBBS and MD at the Institute of Medical Sciences, Banaras Hindu University (IMS-BHU). He provides evidence-based assessment for skin, hair, nail and sexually transmitted conditions, with individualised care, clear counselling and patient privacy.
Book Consultation Consultation ₹800
MBBS + MDBoth from IMS-BHU01 / IDENTIFY THE DARK PATCH
Not every dark patch is melasma
Melasma is only one reason skin becomes darker. Getting the correct diagnosis matters because the treatment and chance of recurrence differ.
Post-inflammatory pigmentation
Acne, eczema, picking, burns and irritated skin can leave dark marks after the original inflammation improves. The underlying problem should be controlled.
Other causes of facial darkness
Freckles, lentigines, pigmented contact dermatitis, lichen planus pigmentosus and some medication-related changes can resemble melasma. Unusual or changing lesions need clinical assessment.
AI-generated illustration · Cheek detail
Why the pattern matters
Colour alone cannot tell which type of pigmentation is present. A dermatologist considers the pattern, recent inflammation, cosmetics, medicines, onset and exposure history before selecting treatment. A single spot that changes size, colour or shape should not be assumed to be melasma.
02 / CONTRIBUTING FACTORS
Why does melasma occur — and why can it return?
Melasma is multifactorial. The visible dark colour comes from increased pigmentation, not poor hygiene or a superficial layer of dirt.
UV radiation and visible light can worsen melasma, including on darker skin tones. Consistent protection is central to treatment.
Pregnancy and certain hormonal treatments may contribute to melasma in susceptible individuals. Not everyone has a hormonal trigger.
Family history and genetic factors can increase predisposition; many patients have no known affected relative.
Harsh skin products, excessive friction and repeated heat exposure may aggravate facial pigmentation in some patients.
Important: Melasma does not mean someone has a liver disorder, a vitamin deficiency or an allergy. Investigations are guided by the medical history and examination rather than ordered routinely for every dark patch.
03 / WHEN TO SEEK CARE
When should facial pigmentation be examined?
Dark patches that continue to spread or do not improve with gentle skin care deserve an accurate diagnosis before trying multiple bleaching products.
Dark patches are spreading
New or increasingly noticeable pigmentation, especially across the cheeks, forehead or upper lip, may need a structured management plan.
Darkness after acne or irritation
Treatment should address the acne, eczema or irritant responsible, as well as the leftover pigmentation.
Unusual or changing dark lesion
A solitary spot changing in shape, colour, border, bleeding or growing differently from surrounding pigmentation needs prompt clinical assessment.
YOUR CONSULTATION / WHAT TO EXPECT
What happens during your pigmentation consultation?
The goal is to identify the cause, review contributing factors and agree on a safe plan with realistic expectations.
History and examination
Discuss onset, pregnancy or hormonal factors, sunlight, cosmetics, procedures, medication use and earlier treatments.
Confirm the type
Examine distribution and skin changes. Dermoscopy or Wood’s lamp can be helpful in selected cases but is not needed for everyone.
Select suitable treatment
Choose suitable sunscreen, prescription creams and, when appropriate, supervised glycolic acid peeling according to your skin type and tolerance.
Review and maintenance
Check improvement and irritation, adjust treatment and plan ongoing protection to help reduce recurrence.
✓Extensive routine testing is usually unnecessary. Melasma is generally diagnosed clinically; investigations are considered when the history or examination suggests another condition.
04 / DIAGNOSIS
Pigmentation treatment starts with the right diagnosis
Melasma, pigmentation after acne and other pigmentary disorders can overlap in appearance. A clinician also checks for ongoing inflammation or contact reactions that keep the skin darkening.
Look at the pattern. The size, symmetry, borders and distribution across facial sites can help distinguish melasma from its mimics.
Review products and exposures. Ask about fairness creams, steroid combinations, hair dyes, fragrances, acne products, sun exposure and previous peels.
Choose tests selectively. Dermoscopy or Wood's lamp examination may support assessment. Most patients do not need a biopsy or extensive blood tests.
Tinted sunscreen is part of treatment
For melasma, use daily broad-spectrum SPF 30 or higher; SPF 50+ is a useful option. Tinted formulations containing iron oxides help protect against visible light, which may aggravate pigmentation. Reapply when outdoors as directed.
Helpful daily routine
Choose a sunscreen that suits your skin, seek shade when possible, use a hat or protective covering, and avoid harsh scrubbing or products that sting. Consistency matters more than applying many products at once.
05 / TREATMENT OPTIONS
Melasma treatment is more than a fairness cream
The approach depends on diagnosis, skin sensitivity, pregnancy plans, earlier treatment and how much pigmentation affects day-to-day confidence.
Sun and visible-light protection
Daily broad-spectrum tinted sunscreen containing iron oxides and practical shade protection help reduce treatment failure and relapse. Even effective creams work poorly when light exposure continues.
Topical pigment-reducing treatment
Selected patients may benefit from hydroquinone-containing regimens, including carefully supervised short courses of triple-combination treatment. Azelaic acid and other agents may suit particular cases. Choice and duration matter.
FEATURED PROCEDURE · AVAILABLE AT OUR CLINIC
Discuss glycolic peel suitability
Glycolic Acid Peel for Melasma
Dermatologist-supervised superficial glycolic acid peels may help selected patients with melasma as part of a comprehensive treatment plan. A carefully planned peel may gradually lighten superficial pigmentation when combined with appropriate home treatment and sun protection.
Tailored to your skinThe need for a peel depends on your diagnosis, sensitivity and pigmentation pattern.
Supervised applicationPeel strength and contact time are chosen to minimise unnecessary irritation.
Part of a complete planTopical medicines, tinted sun protection and follow-up remain important.
GLYCOLIC ACID PEEL / PATIENT GUIDE
Before & after your peel
Appropriate preparation and aftercare help reduce irritation and the risk of post-inflammatory hyperpigmentation.
Before your session
- Tell the dermatologist about pregnancy, sensitive skin, previous peels, active skin irritation, cold sores and all creams currently used.
- Use daily sunscreen and the skin-preparation routine prescribed for you.
- Avoid waxing, scrubs and self-directed exfoliating products around the treatment date.
- Pause or restart retinoids and other active creams only as instructed by your dermatologist.
After your session
- Mild redness, tightness or flaking may occur; visible peeling is not necessary for benefit.
- Use gentle cleanser, moisturiser and tinted sunscreen; avoid excess sun exposure.
- Do not pick, scrub or apply irritating products until your dermatologist advises.
- Contact the clinic for severe burning, blistering or unexpected darkening.
TREATMENT RESULTS & MAINTENANCE
Gradual lightening. Long-term control.
Melasma is often recurrent. A peel can support a treatment plan, but it does not permanently remove pigmentation.
01Allow time to respond
Improvement is usually gradual and may take several months; individual results vary.
02Review your progress
Follow-up helps decide whether to continue, adjust or pause treatment if irritation occurs.
03Maintain the improvement
Continue tinted sunscreen, gentle skin care and any prescribed maintenance regimen to help limit relapse.
Pregnancy and treatment safety: Avoid self-starting hydroquinone, retinoids, oral tranexamic acid or mixed steroid-containing fairness creams. Tell the dermatologist if you are pregnant, breastfeeding or planning pregnancy before treatment is selected.
06 / EVERYDAY CARE
Practical habits that support pigmentation treatment
Simple consistent skin care reduces avoidable irritation while prescribed treatment works gradually.
Use sun protection daily
A broad-spectrum tinted sunscreen containing iron oxides, combined with shade and hats, helps limit UV and visible-light exposure.
Be gentle with your skin
Avoid aggressive rubbing, exfoliation or irritating DIY remedies. Irritation can leave additional dark marks.
Control acne and inflammation
Active pimples, eczema and picking can keep creating new dark spots. Treat the underlying problem as well.
Avoid steroid-mixed fairness creams
Unsupervised combinations can cause acne, skin thinning and rebound problems. Use doctor-prescribed regimens appropriately.
Keep expectations realistic
Improvement often takes several months. Stopping sun protection after patches fade may contribute to recurrence.
Review new or unusual changes
Seek assessment for rapid change, bleeding, inflammation or a pigmentation pattern unlike your usual patches.
07 / PATIENT QUESTIONS
Frequently asked questions about melasma and pigmentation
Is melasma a fungal infection or contagious?
No. Melasma is a pigmentary disorder, not a fungal infection. It does not spread from one person to another.
Can dark patches on the face be something other than melasma?
Yes. Post-inflammatory pigmentation, freckles, lentigines, pigmented contact dermatitis and other disorders can appear similar. Treatment depends on the diagnosis.
Why do melasma patches appear on both cheeks?
Melasma often follows a symmetrical pattern on sun-exposed facial skin. Hormonal factors and inherited susceptibility may also contribute.
Which sunscreen is best for melasma?
Use a broad-spectrum sunscreen with SPF 30 or higher, preferably tinted with iron oxides to help protect against visible light. Regular application, sufficient amount and outdoor reapplication matter.
Does every melasma patient need blood tests?
No. Melasma is generally diagnosed clinically. Tests are used only if symptoms, history or examination suggest another condition.
Can melasma be cured permanently?
Many patients improve, but melasma may recur even after good clearance. Light protection and an individual maintenance plan are important.
Are triple-combination creams safe to use indefinitely?
No. Triple combinations typically contain hydroquinone, a retinoid and a topical steroid. They should be used only in supervised courses due to potential adverse effects with prolonged unsupervised use.
Can I apply hydroquinone or retinoids during pregnancy?
Do not self-use these medicines during pregnancy. Discuss pregnancy, breastfeeding or plans to conceive with your dermatologist before starting any pigment-reducing treatment.
Do glycolic acid peels remove melasma permanently?
No. Our clinic offers supervised superficial glycolic acid peels for selected patients as an addition to sunscreen and prescribed topical care. They can help lighten some patches but do not permanently cure melasma. Irritation or overly aggressive peeling can worsen pigmentation.
How long does facial pigmentation take to improve?
It varies by diagnosis and treatment. Melasma improvement commonly takes several months, and some cases need longer. Consistency and avoiding irritation are essential.
Are post-acne dark marks and melasma treated the same way?
Not always. Acne-related pigmentation needs control of active acne and irritation, while melasma care places particular emphasis on long-term light protection and recurrence prevention.
Dark patches? Start with the right diagnosis.
Dr Neeraj Garg · MBBS (IMS-BHU), MD (IMS-BHU) · Maheshwari Hospital, Dalanwala, Dehradun. Consultation ₹800 · Pre-booking recommended.