Melasma Treatment

Melasma can be one of the most frustrating forms of hyperpigmentation to treat. It often resists over-the-counter products and can come back even after it fades. We take a personalised approach to this complex condition. After a form or video consultation with one of our doctors, they will design a topical cream treatment containing prescription-strength ingredients where appropriate. The treatment targets your specific melasma type, skin tone and sensitivity alongside any other skin concerns you have. Your dedicated doctor will take care of you throughout your journey. They will adjust each course of treatment based on how your skin responds. Best of all, you can access your melasma treatment from the comfort of your home via our online skin clinic, wherever you are in the UK.

Step 1
Choose a form or video consultation with your doctor.

Step 2
Personalised treatment plan with custom cream.

Step 3
Follow-up to refine protocol and reduce side effects.

Understanding Melasma

Melasma is a common form of hyperpigmentation that causes dark, often symmetrical patches on the skin. It most commonly affects the face, particularly the cheeks, forehead, bridge of the nose, chin and above the upper lip. Melasma develops when the skin overproduces melanin (the pigment that gives skin its colour) and is usually triggered by a combination of hormonal changes, sun exposure and genetic factors. Hormonal triggers include pregnancy (where it is sometimes called chloasma or “the mask of pregnancy”), contraceptive use and menopause. However sun exposure plays a major role in both triggering and worsening melasma, which is why sun protection is essential throughout treatment.

In general, melasma tends to develop gradually and usually appears as flat, blotchy patches rather than defined spots. Whilst it is more common in women, it can also affect men. It is especially common in medium to darker skin tones. Unlike some other forms of hyperpigmentation, melasma is a chronic condition that can recur. This is why ongoing personalised management rather than a one-off treatment is usually the most effective approach.

Treating Melasma on the Face

Melasma most commonly affects the face, particularly the cheeks, forehead, nose and upper lip. Because these areas are highly visible, melasma can significantly affect confidence and quality of life. Our treatments are specifically designed for facial use and your doctor will select ingredients and strengths that are effective while being suitable for the delicate skin on the face. If your melasma also affects the neck or other areas, your doctor can advise on treating these during your consultation. Depending on the size of the affected area, you may need to purchase treatment more frequently if the area is larger than the face and neck.

Why Personalised Melasma Treatment Works Better

Melasma varies in depth, pattern, triggers and how it responds to different ingredients. Someone with superficial epidermal melasma may respond well to topical depigmenting agents, while someone with deeper dermal melasma may need a multi-focal longer-term strategy. A treatment that works for one person can irritate or underperform for another, and in hyperpigmentation-prone skin, irritation from aggressive treatment can actually make melasma worse. That’s why we tailor every prescription-strength treatment to you and review it at the end of each course. Your doctor can increase, reduce or swap ingredients based on what is actually happening with your skin rather than continuing you on a fixed formula.

Personalised Prescription Strength Melasma Treatments

We provide personalised topical melasma treatment following an online consultation with a doctor. Your cream formula is built around your melasma pattern, skin tone, medical history and treatment goals then refined at the end of each course. Your doctor will also take into account any wishes or concerns you have as much as possible when designing your treatment. We offer two custom protocol pathways depending on what your skin needs and your preferences:

• MLS: A single once a day treatment cream for mild to moderate melasma or for maintenance once more severe melasma has improved. MLS can also support general skin tone, texture and smoothness depending on the ingredients selected.
• MLS+: A two-product protocol (morning and evening) for more severe or resistant melasma. MLS+ provides more intensive coverage and is typically used for a defined period of usually up to 6 months before stepping down to MLS for ongoing maintenance.

Your doctor will recommend the right pathway at consultation based on your melasma and wishes. They can move you between protocols at the end of each course based on how your skin responds.

Ingredients in Our Melasma Treatments

Every formula is customised and can be adjusted at the end of each course of treatment. We choose ingredients to target the specific drivers behind your melasma, protect against further darkening and support your skin’s overall health. As much as possible we will also take your wishes and preferences into account. These are some of the active ingredients we may use in our topical melasma treatment cream formulas:

• Tretinoin: A prescription retinoid that we may use either alone or with other ingredients in your melasma cream. It works by promoting skin cell turnover to help fade pigmentation, smooth texture and improve overall skin tone. Tretinoin is up to 20x more powerful than retinol so it is prescription only and needs careful monitoring, particularly in darker skin tones where irritation can trigger further hyperpigmentation.
• Hydroquinone: The most effective topical depigmenting ingredient available. It works by inhibiting melanin production and we may use it for limited periods in suitable patients when melasma is a dominant concern. Your doctor will determine whether hydroquinone is appropriate for you and monitor its use carefully.
• Tranexamic acid: One of the most important ingredients specifically for melasma. It helps reduce hyperpigmentation by interfering with the interaction between skin cells and melanin-producing cells. Research has shown it can be particularly effective for melasma, especially when used alongside other actives like tretinoin or azelaic acid.
• Azelaic Acid: Has anti-inflammatory and keratolytic properties. It helps fade uneven pigmentation while calming inflammation, making it useful for melasma patients who also experience redness or sensitivity.
• Niacinamide: Reduces inflammation, helps even out skin tone and strengthens the skin barrier. It also works well alongside stronger depigmenting actives to support tolerability and reduce irritation without adding harshness.
• Arbutin: A natural skin-brightening agent that reduces melanin production. It helps lighten dark patches across all skin tones with a lower irritation profile than some stronger alternatives.
• Hydrocortisone: A corticosteroid that reduces inflammation and soothes irritated skin. We sometimes use it in the early stages to help skin adjust to active ingredients without excessive irritation. This is particularly important with melasma where irritation itself can worsen pigmentation.

All prescription ingredients are used only where we deem them safe, appropriate and suitable for you as an individual patient.

How Long Does Melasma Treatment Take to Work?

Melasma treatment is not a quick fix. Melasma is generally one of the slower forms of hyperpigmentation to respond because the pigmentation is often deeper in the skin and driven by ongoing hormonal and environmental factors. Results vary between patients. Some patients begin to notice early improvement within 8 to 12 weeks with more meaningful progress typically developing over 3 to 6 months or longer. However, rate of progress varies from person to person depending on the depth, pattern and triggers of your melasma as well as your skin tone and consistency of use. Additionally, in the first few weeks, some treatments can cause an adjustment phase which may include mild dryness, irritation or temporary sensitivity. This is a recognised part of the process and one of the reasons we start with a strength and frequency suited to your skin rather than pushing maximum intensity from day one.

Because melasma is a chronic condition, maintenance treatment is usually necessary even after your skin has improved. Your doctor will work with you to find a sustainable long-term plan. Sun protection is essential throughout treatment. UV exposure is one of the main triggers of melasma and can reverse progress or cause rebound darkening, particularly when using ingredients like tretinoin or hydroquinone.

Why We Focus on Custom Topical Melasma Treatments

Topical treatment is the gold standard for melasma management. Custom topical treatments allow us to combine multiple depigmenting and skin-improving ingredients in a formula, target them directly to the affected area and adjust at the end of each course according to your skin’s response. For most patients, a well-designed topical treatment can deliver meaningful improvement with lower risk than procedures like chemical peels or laser treatment which can themselves trigger further pigmentation in susceptible skin tones. Our service exclusively uses topical custom melasma treatments. If your melasma is not responding adequately to topical therapy, your doctor will discuss this with you and may advise exploring other treatment options where appropriate.

Who is Suitable for Online Melasma Treatment?

We treat melasma across all skin tones and patterns. This service may be right for you if you:

• Have melasma on the face, including cheeks, forehead, nose, chin or upper lip
• Have pregnancy-related melasma (chloasma) that has not resolved after giving birth (please note we do not treat pregnant or breastfeeding women)
• Have hormonal melasma triggered by contraception or menopause
• Have melasma that hasn’t responded well to over-the-counter products
• Want a structured treatment plan with ongoing doctor follow-up and not a one-off prescription
• Prefer prescription-strength treatment delivered to your home, wherever you are in the UK

If your melasma is not responding to topical treatment or requires further investigation, your doctor may recommend an alternative approach including recommending a more suitable service where appropriate.

Why Choose City Skin Clinic?

We don’t believe in one-size-fits-all generic solutions. Every treatment is prescribed by a doctor, tailored to your skin and adjusted at the end of each course based on how you respond. That means your treatment protocol evolves with you rather than staying the same. Some of the top reasons people choose us for online melasma treatments in the UK:

• Doctor-led care from day one: Your journey starts with either a detailed form consultation or an in-depth video consultation with one of our doctors. The choice is entirely yours based on your availability and preferences. Your doctor will review your concerns, evaluate your skin and design a treatment plan that is unique to you.
• Genuinely personalised: Treatment is designed around your melasma pattern, skin tone, sensitivity and any other concerns. It can be adjusted at the end of each cycle based on how your skin responds.
• Ongoing follow-up: Your journey does not end after your consultation. You can directly contact your prescribing doctor at any point for further advice, progress review and refills.
• Delivered to your door: Treatment shipped to your home with a clear treatment plan and unlimited aftercare. Available UK-wide.