What Is Melasma?
Melasma is a chronic pigmentation disorder that causes brown-grey patches on the face — most commonly on
cheeks, forehead, chin, upper lip, and nose bridge. It's driven by hormones, UV exposure, and genetic
predisposition.
We see melasma in roughly 30–40% of women who visit Gomti Clinic for pigmentation concerns. It's more common
in Indian skin tones, and Lucknow's intense sun exposure (even in winter months) makes it particularly
challenging.
Common Triggers in Lucknow Patients
- Sun exposure: Even 15 minutes of unprotected sun exposure can trigger a melasma flare.
Patients walking between Hazratganj shops or waiting at Charbagh station without sunscreen are at risk
- Hormonal changes: Pregnancy, oral contraceptives, thyroid disorders
- Heat: Kitchen work, proximity to stoves and tandoors — infrared heat triggers melasma
independent of UV
- Wrong products: Many patients try fairness creams containing steroids, which
temporarily lighten skin but cause rebound darkening and dependency
Our Treatment Protocol
- Wood's lamp assessment: Determines whether pigmentation is epidermal (surface), dermal
(deep), or mixed. This is critical — surface melasma responds much better to treatment than deep melasma
- Triple combination therapy: Gold standard topical treatment combining a mild steroid
(short-term), tretinoin, and hydroquinone. We monitor use carefully to prevent side effects
- Chemical peels: Sequential glycolic or mandelic acid peels every 2–3 weeks to
accelerate pigment removal
- Laser (selected cases): Low-fluence Q-switched Nd:YAG or tranexamic acid
micro-injections for resistant melasma. Not all melasma responds to laser — and aggressive laser can
worsen it
- Oral tranexamic acid: For severe or resistant cases, after discussing benefits and
monitoring requirements
The Sunscreen Conversation
Without proper sunscreen use, no melasma treatment will work long-term. We spend significant time during
consultation on:
- Choosing the right SPF 50+ sunscreen for your skin type (oily, dry, acne-prone)
- Application quantity — most patients apply too little (you need about ½ teaspoon for the face)
- Reapplication schedule — every 2–3 hours for outdoor exposure
- Physical vs chemical sunscreens — and which brands work well for Indian skin
Honest Expectations
- Melasma is manageable, not curable. Anyone promising a "permanent cure" is misleading
you
- Initial improvement: 4–8 weeks with consistent treatment
- Significant improvement: 3–6 months
- Maintenance treatment is needed long-term — typically simplified to sunscreen + mild topicals
- Flare-ups can occur with sun exposure, hormonal changes, or heat — even after successful treatment
Cost
Detailed pricing on our melasma treatment cost page →