How to Treat Melasma: A Complete Guide to Pigmentation in Sydney
Melasma is one of the most stubborn and misunderstood forms of pigmentation, and one of the easiest to make worse with the wrong treatment. Here’s what actually causes it, why it behaves differently to sun spots or freckles, and how SDL Australia’s dermal therapists treat it in Sydney’s climate.
TL;DR: Melasma is a hormonally-driven form of pigmentation that presents as symmetrical brown or grey-brown patches, usually on the cheeks, forehead, upper lip and jawline. Unlike sun spots or freckles, it’s triggered from within by oestrogen and progesterone fluctuations, and made worse by UV and heat, which is why Sydney’s climate makes it particularly persistent. Melasma cannot be treated the same way as superficial pigmentation. It needs a medical-grade depigmentation protocol like Dermamelan, strict UV protection, and long-term maintenance, because melasma can recur even after successful treatment if the underlying triggers aren’t managed.
What Is Melasma?
Melasma is a chronic pigmentation condition that shows up as symmetrical, blotchy brown or greyish patches, most commonly across the cheeks, forehead, nose bridge, upper lip and jawline.
It’s one of six recognised pigmentation presentations SDL Australia classifies during diagnostic assessment, alongside post-inflammatory hyperpigmentation, solar lentigines, freckles, periorbital hyperpigmentation and diffuse uneven tone. What makes melasma distinct is both its pattern (it’s almost always symmetrical, appearing on both sides of the face) and its cause, which sits deeper than simple sun exposure.
Melasma is significantly more common in women, particularly during pregnancy (sometimes called the “mask of pregnancy”), while on hormonal contraception, or during perimenopause and menopause. It can also affect men, though less frequently.
What Causes Melasma?
Melasma is driven primarily by hormonal fluctuations that stimulate melanocytes (the skin’s pigment-producing cells) into overdrive, with UV exposure and heat acting as the trigger that makes it visible and keeps it active.
- Hormonal influence, oestrogen and progesterone fluctuations during pregnancy, hormonal contraceptive use, and menopause are the leading drivers of melasma
- UV exposure, the single biggest aggravating factor, stimulating melanocytes to produce excess melanin as a protective response
- Heat and infrared exposure, not just UV, heat from daily activity and even visible light can worsen melasma in already-affected skin
- Genetics, family history plays a significant role in who develops melasma and how stubborn it becomes
This combination is exactly why melasma often appears or worsens during pregnancy in an Australian summer, and why it rarely improves on its own without addressing both the internal hormonal driver and consistent daily sun protection.
Melasma vs Other Pigmentation
Not all brown patches on the skin are melasma, and treating melasma like a sun spot (or vice versa) can make pigmentation worse rather than better.
At SDL Australia, pigmentation is classified as epidermal (surface-level), dermal (deep) or mixed before any treatment begins, because each type responds differently. Melasma is frequently dermal or mixed, which is precisely why it doesn’t respond well to superficial treatments alone, and why treating it with the wrong method can trigger paradoxical darkening in some skin tones.
Solar Lentigines and Age Spots
These are flat brown patches from cumulative UV exposure over years. They tend to be more isolated, appear on sun-exposed areas like the backs of hands and the face, and are generally more responsive to laser toning and resurfacing alone.
Post-Inflammatory Hyperpigmentation (PIH)
PIH develops after inflammation, from acne, injury, or even after aggressive skin treatments. It follows the shape of whatever caused the inflammation, rather than melasma’s characteristic symmetrical facial pattern.
Freckles and Ephelides
Genetic and UV-responsive, freckles are usually smaller, more scattered and lighter than melasma patches, and typically fade somewhat over winter.
Why Melasma Is Hard to Treat
Melasma has a reputation for being stubborn because it isn’t a single, static mark, it’s an ongoing process driven by hyperactive melanocytes that can be reactivated by hormones, heat or UV at any point.
This is also why aggressive, high-heat treatments like some ablative lasers can backfire on melasma-prone skin, triggering more inflammation and, in turn, more pigmentation. Melasma needs a treatment approach that controls melanin production at a cellular level, rather than simply removing the visible pigment from the surface.
It’s also why melasma treatment is rarely a single session. Depigmentation protocols work over months, not days, and results depend heavily on how strictly sun protection and home-care are followed during and after treatment.
How SDL Treats Melasma
SDL Australia’s primary melasma protocol is Dermamelan, a medical-grade depigmentation treatment specifically designed for deep, hormonal and moderate-to-severe pigmentation, including melasma.
Dermamelan works differently to lighter depigmentation options. It’s applied in-clinic two weeks after a preparatory lactic acid peel, then left on the skin for 6 to 12 hours at home, followed by a structured aftercare programme that runs for up to seven months to regulate melanocyte activity and prevent recurrence.
| Cost | Mask duration | Applications | Full protocol |
|---|---|---|---|
| $2,500 per treatment | 6 to 12 hours at home | 1 in-clinic application | Up to 7 months |
Who Dermamelan Is For
Dermamelan is suitable for all skin types and skin tones, and is specifically designed for hormonal pigmentation such as melasma. It’s also used for post-inflammatory hyperpigmentation from acne, uneven skin tone, and pigmentation left behind from previous laser or peel treatments.
Supporting Treatments
Depending on your diagnostic results, a melasma pathway may also include Hollywood Spectra Gold Toning (Q-switched laser toning that breaks up pigment deposits with no significant downtime) or Lumecca intense pulsed light where diffuse redness or vascular components are also present. These are typically sequenced around Dermamelan rather than used as standalone melasma treatments.
Full treatment goals, aftercare and skin conditions targeted are covered in detail on our Dermamelan treatment page.
Melasma Treatment Comparison
Here’s how the treatments most relevant to melasma compare, based on what SDL Australia actually uses.
| Factor | Dermamelan | Hollywood Spectra Toning | Standard chemical peels |
|---|---|---|---|
| Depth addressed | Deep, hormonal and mixed pigmentation | Surface pigment deposits | Superficial layers only |
| Best suited to | Melasma, deep and stubborn hyperpigmentation | General toning, evening out complexion | Mild, new or superficial pigmentation |
| Downtime | Redness and flaking 1-2 days initially | None significant | Minimal to none |
| Protocol length | Up to 7 months (1 in-clinic treatment plus home care) | Multiple sessions, spaced | Often needs repeated sessions for limited effect on melasma |
| Recurrence risk if unmanaged | Reduced significantly with maintenance protocol | Higher without ongoing management | High for melasma specifically |
Sydney’s UV Environment and Melasma
Australia’s UV environment makes melasma management an ongoing commitment, not a one-off fix, which is why sun protection is built into every stage of an SDL melasma pathway.
UV exposure is the single biggest driver of new melanin production and the most common reason melasma returns after successful treatment. Daily broad-spectrum SPF, sun avoidance during peak UV hours, and physical protection like hats are non-negotiable parts of any melasma protocol in Sydney, not an optional add-on.
See how SDL Australia classifies and treats every type of pigmentation, not just melasma, in one place.
The SDL Pathway Approach
Rather than treating melasma as a single problem to erase, SDL Australia builds a structured, long-term pathway that accounts for the hormonal and environmental factors keeping it active.
Every pathway starts with a proper consultation and diagnostic scanning, so your dermal therapist can classify your pigmentation as epidermal, dermal or mixed before recommending anything, since treating the wrong type with the wrong method can worsen the condition. Where hormonal or internal factors are contributing, we also draw on our in-house root-cause expertise, because lasting pigmentation control often depends on more than what’s applied topically.
From there, your dermal therapist sequences Dermamelan alongside supporting treatments and a strict home-care and sun protection plan, adjusting the pathway as your skin responds over the full protocol period.
SDL
SDL Australia Dermal Therapists
Our dermal therapists deliver personalised melasma and pigmentation pathways, including Dermamelan, across SDL Australia’s Sydney clinics in Revesby, Rouse Hill, Clemton Park and Eastgardens.
Not sure if it’s melasma or another type of pigmentation?
Book a consultation with SDL Australia. We’ll run a diagnostic scan to classify your pigmentation correctly and map the pathway that actually fits.
Frequently Asked Questions
Can melasma be completely cured?
Melasma can be significantly reduced and controlled, but because it’s driven by hormonal factors and reactivated by UV exposure, it’s better understood as a condition that’s managed long-term rather than permanently cured in a single treatment. Strict maintenance and sun protection are essential to keeping results.
Is Dermamelan safe for all skin tones?
Yes. Dermamelan is formulated for safe use across all skin tones and has an established safety profile for deeper skin types, which matters for melasma specifically since it can affect a wide range of complexions.
How long until I see results from melasma treatment?
Most clients see meaningful improvement within four to eight weeks of starting their protocol, though melasma in particular may require longer-term management given its hormonal drivers. The full Dermamelan protocol extends up to seven months to properly regulate melanocyte activity.
Will melasma come back after treatment?
Without maintenance and strict sun protection, pigmentation including melasma can recur. This is why an SDL Pathway includes a long-term management plan rather than treating melasma as a one-off procedure.
Can I treat melasma while pregnant or breastfeeding?
Many melasma treatments, including Dermamelan, are not suitable during pregnancy or breastfeeding due to the active ingredients involved. Your dermal specialist will discuss timing and safe options during consultation, since melasma often first appears or worsens during pregnancy.
Why does my pigmentation look worse after a previous treatment?
Treating melasma or other deep pigmentation with the wrong method, particularly overly aggressive heat-based treatments, can trigger inflammation that worsens pigmentation rather than improving it. This is why diagnostic classification of your pigmentation type is essential before any treatment begins.
