Melasma Treatment in Pakistan: Causes, Dermatologist Options and What Serums Can Do
Melasma is a common pigmentation condition that causes brown or grey-brown patches, usually on the cheeks, forehead and upper lip. It is more common in medium to deeper skin tones, including many women in Pakistan, and it tends to come back. This guide explains the causes, the options dermatologists use, and what a cosmetic serum can and cannot do.
For the research, the products and prices in one place, see our tranexamic acid guide.
Our comparison of kojic acid vs tranexamic acid sets the two ingredients side by side.
Key takeaways
- Melasma usually appears as symmetrical brown patches on the forehead, cheeks and chin, often in sun-exposed areas.
- Dermatology reviews say it can usually be controlled and improved, but it can come back, especially with sun exposure.
- Sun protection is essential with any topical lightening product.
- Cosmetic serums can help the look of marks but do not replace a dermatologist’s diagnosis and options.
- Do not self-treat with several products at once; irritation can worsen pigmentation.
What causes melasma?
Melasma comes from a mix of triggers: sun and visible light, hormones (pregnancy, contraceptive pills, thyroid or ovarian conditions), genetics and heat. Sun exposure keeps the pigment active, which is why patches often darken in summer.
What are the melasma treatment options?
No single treatment works for everyone, and melasma often returns. Dermatologists usually combine strict sun protection with prescription creams, peels or procedures.
| Option | Who provides it | Notes |
|---|---|---|
| Sun and visible-light protection | Everyone | The foundation of any plan |
| Hydroquinone creams | Doctor-prescribed | Long regarded as the standard topical, used under supervision |
| Oral tranexamic acid | Doctor-prescribed | Effective in trials but can cause side effects; not suitable for everyone |
| Chemical peels, microneedling, laser | Clinics | Can help, but recurrence is common |
| Cosmetic serums | Over the counter | May help the look of uneven tone; not a treatment for melasma |
What does the research say?
- Neagu et al., J Dermatol Treat, 2022: a systematic review found melasma is chronic, recurrence is high and no single treatment is universally effective. Combination therapies gave the best results, topical hydroquinone is described as the standard, and oral tranexamic acid looked promising but was linked to systemic side effects.
- Calacattawi et al., J Dermatol Treat, 2024: a meta-analysis of 22 randomized trials (1,280 patients) found tranexamic acid, given orally, topically or by injection, reduced melasma severity scores. Oral use showed the largest drop, then injection, then topical. Side effects included stomach upset, skin irritation and menstrual changes, and the studies varied a lot.
- Gan et al., Am J Clin Dermatol, 2024: an update on new and existing melasma treatments, including visible-light photoprotection, non-hydroquinone agents, peels and lasers.
Where does Chelure fit in?
The Brightening & Anti-Aging Serum (30 mL, Rs 2,500) lists 3% tranexamic acid, 3% kojic acid, alpha arbutin and AHAs. It is a cosmetic that may help the look of uneven tone. It is not a treatment for melasma, and the trials above mostly tested doctor-supervised treatments and oral doses, not cosmetic serums. Results vary. Set C (serum plus moisturizer) is Rs 4,499. Delivery is a flat Rs 250: 1 to 3 working days in Karachi, 5 to 7 elsewhere in Pakistan.
When should you see a dermatologist?
See a dermatologist if patches are spreading, darkening quickly, started with pregnancy or a new pill, or have not improved after 8 to 12 weeks of daily sun protection. Do not take tranexamic acid tablets for your skin unless a doctor prescribes them.
See what customers say on our customer reviews page.
What can skincare do, and what needs a doctor?
| Cosmetic care you can do | Medical care a dermatologist provides |
|---|---|
| Daily broad-spectrum sunscreen and shade | Confirming the diagnosis and ruling out other causes |
| A gentle routine without irritating scrubs | Prescription lightening creams |
| A brightening serum to help fade the look of marks | Peels or in-clinic procedures where suitable |
Two dermatology reviews describe sun protection as essential alongside any topical lightening agent. A 2016 expert review also notes that prescription options are the most researched, and that melasma can usually be controlled and improved but may return, especially with sun exposure.
What should you ask a dermatologist?
- Is this melasma, or another kind of pigmentation?
- Which prescription options suit my skin and health?
- Which sunscreen and routine should I use alongside them?
- What can I expect, and how long should I wait before judging results?
What can a cosmetic serum do for melasma?
It can help fade the look of marks, but it does not replace medical care. The trials we cite on tranexamic acid looked at melasma specifically, were small, and used 3% topical tranexamic acid; they do not show that every serum works for every person. The Chelure Brightening & Anti-Aging Serum contains 3% tranexamic acid and 3% kojic acid.
How do you recognise melasma?
Dermatology reviews describe melasma as pigmented patches arranged symmetrically on sun-exposed areas, most often the forehead, cheeks and chin. Brown marks after a pimple, by contrast, are usually irregular and sit where inflammation happened. Telling them apart matters, because the right plan differs. A dermatologist can confirm which one you have, and that is the safest first step.
| Feature | Melasma (typical) | Marks after pimples (PIH) |
|---|---|---|
| Pattern | Symmetrical patches | Irregular, where spots were |
| Common places | Forehead, cheeks, upper lip, chin | Anywhere you had acne |
| Link to sun | Strong | Present but less central |
| Where to start | Sun protection and a dermatologist | Sunscreen and a gentle routine; see red vs brown marks |
Why is melasma hard to manage?
An expert review of melasma and post-inflammatory hyperpigmentation says treatment is challenging because it has to work on several fronts: stopping pigment production, breaking down deposited pigment, increasing cell turnover and reducing inflammation. It also says melasma can be controlled, improved and maintained, but not that it is permanently cured, which fits how it behaves in daily life: it can return when sun exposure or hormones change. That is the honest frame for expectations.
What sun protection does melasma need?
The American Academy of Dermatology recommends SPF 30 or higher, broad-spectrum and water-resistant sunscreen, about a teaspoon for the face, and reapplication about every two hours outdoors. For melasma-prone skin, people also use hats, shade and avoiding peak sun, because sun is the factor you can control. See how to choose a sunscreen.
What does a gentle cosmetic routine look like?
| Step | Morning | Night |
|---|---|---|
| Cleanse | Gentle cleanser | Gentle cleanser |
| Treat | None, or as your dermatologist advises | One brightening serum or the product your dermatologist prescribes |
| Moisturize | Light gel moisturizer | Light gel moisturizer |
| Protect | Broad-spectrum SPF 30+ and a hat outdoors | None |
What mistakes make melasma worse?
- Daily sun without sunscreen or shade.
- Scrubs, strong peels and DIY mixes that irritate skin.
- Stacking several lightening products.
- Stopping sun protection once patches fade.
- Expecting a cream to cure it permanently.
How should you prepare for a dermatologist visit?
- Bring photos of your skin from before and during your routine.
- List every product you use, including home remedies.
- Note whether patches changed with pregnancy, hormones or sun.
- Ask which options suit your skin and health, and how long to wait before judging.
- Ask what you should do to keep results once patches improve.
Frequently asked questions
Does melasma go away?
It can fade, especially once a trigger such as pregnancy passes, but it often returns without daily sun protection.
Is sunscreen enough?
Sunscreen is essential but may not be enough on its own. Tinted or visible-light protection is a topic in current reviews.
Can a serum cure melasma?
No. A cosmetic serum may help the look of uneven tone; melasma needs sun protection and often a doctor’s plan.
Can melasma be cured?
It can usually be controlled and improved, but it can return, especially with sun exposure. A dermatologist can explain options.
Is melasma the same as dark spots?
No. Melasma usually appears as symmetrical patches on the cheeks, forehead or upper lip. See how to choose a serum for dark spots.
Does sunscreen help melasma?
Yes. Dermatology reviews describe sun protection as essential.
Is melasma caused by hormones?
Hormonal change is a recognised factor, together with sun exposure and genetics. A doctor can advise on your situation.
Can melasma go away completely?
It can improve and be controlled, but it can return, especially with sun exposure.
Can a brightening serum treat melasma?
It can help the look of marks, but it does not replace medical care. The trials we cite on tranexamic acid were small.
Should I use vitamin C or hydroquinone?
Hydroquinone is a prescription-level decision for a dermatologist. We have not summarised evidence on vitamin C for melasma, so we make no claim.
Can melasma appear on the upper lip?
Yes, the upper lip area is a common place, along with the forehead, cheeks and chin.
Sources
- Sofen B, Prado G, Emer J. Melasma and post inflammatory hyperpigmentation: management update and expert opinion. Skin Therapy Lett, 2016 (PubMed 27224897).
- Guerrero D. Dermocosmetic management of hyperpigmentations. Ann Dermatol Venereol, 2012. doi:10.1016/S0151-9638(12)70130-8 (PubMed 23522633)
- Review of tranexamic acid for melasma. PMC. PMC6715124
- American Academy of Dermatology. Sunscreen FAQs
A gentle reminder
This article is general information, not medical advice. Skincare helps the look and feel of your skin; it does not treat medical conditions. Patch test any new product behind the ear or on the inner arm first, and introduce one new active at a time. See our FAQ for more, or build your own routine.