Melasma is often classified according to the distribution of pigmentation on the face. Understanding the pattern can help a dermatologist assess the condition and plan appropriate treatment.
- Centrofacial melasma
Centrofacial melasma is the most common distribution pattern. Pigmentation occurs mainly over the central face, including the forehead, cheeks, nose, upper lip and chin.
The pigmentation may appear as symmetrical, irregularly shaped brown patches. It can become more prominent with sunlight and other sources of ultraviolet exposure.
- Malar melasma
In malar melasma, pigmentation predominantly affects the cheeks and the bridge of the nose. The patches are generally distributed over the malar or cheek region.
This pattern may sometimes be confused with other causes of facial pigmentation, which is why clinical examination is useful before starting treatment.
- Mandibular melasma
Mandibular melasma primarily involves the lower face, particularly the jawline or mandibular region. This pattern is less common than centrofacial and malar melasma.
What causes melasma?
Melasma is multifactorial. Ultraviolet radiation, visible light, hormonal influences and genetic susceptibility can all contribute. Pregnancy and hormonal medications may trigger or worsen melasma in some individuals.
Melasma can also recur even after successful treatment, making long-term photoprotection an important part of management.
How is melasma treated?
Treatment depends on the severity, pigmentation pattern, skin type and individual factors. A dermatologist may recommend topical depigmenting medications, retinoids, antioxidants, chemical peels or other procedures in selected cases.
Sun protection is essential. Broad-spectrum sunscreen, protective clothing and strategies to minimise direct sun exposure can help reduce worsening and recurrence. For some patients, protection against visible light may also be relevant.
Melasma requires patience because improvement is usually gradual, and treatment needs to be individualised.
If you have persistent facial pigmentation, consult a dermatologist rather than assuming that every brown patch is melasma.
For evaluation and treatment of melasma in Kothrud, Pune, you can consult Dr Neha Athalye at DermcareMD Skin & Hair Clinic.
