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Melasma is a skin condition in which patches of brownish discoloration appear on the face, neck, and arms. If you suffer from melasma pigmentation, you’ll know how frustrating and emotionally distressing it is. 

Over the counter melasma cream products are generally ineffective, and lasers or chemical peels for melasma are an expensive way to continually remove melasma hyperpigmentation. Treatment is difficult and expensive as melasma often reoccurs after fading treatments, even with diligent sun protection. Because of this, melasma is considered a chronic skin disorder, and there is unfortunately no cure. 

If you’re suffering from melasma and looking for a safe, effective way to treat it, read on to find out how clinically formulated, prescription melasma treatment creams work!

What is melasma?

Melasma is a skin condition that causes symmetrical, patchy, brown hyperpigmentation on sun-exposed areas of the face and neck (and sometimes the chest and arms). It is more common in females, people with darker skin tones and can run in families. 

It’s also known as the “mask of pregnancy” because it’s common during pregnancy. The condition usually clears up after childbirth or during menopause. There are several different treatments available for melasma including prescription creams for reducing post-inflammatory hyperpigmentation.

Can you customise prescription melasma treatment creams?

The best melasma treatments take your lifestyle into account to help prevent pigment relapse. When visiting a dermatologist or consulting a doctor through a telemedicine provider from the comfort of your home, they should invest the time to learn which triggers, like sun exposure and hormonal changes, could have an effect on your treatment.

The doctor or dermatologist, with the help of their pharmacy, will then design the best melasma treatment cream for you – based on clinical guidelines and the most current and best-available evidence. They use these to create the best treatment for your melasma – a melasma skincare product with a customised blend of active ingredients, available only on prescription.

Is it safe to treat melasma during pregnancy?

The short answer is: yes! While some pigment fading treatments for melasma are not recommended during pregnancy, there are several effective, pregnancy-safe melasma skincare options that can be personalized for you.

The best melasma treatment ingredients

When treating melasma there are a few active ingredients that produce the best results. 


A naturally-occurring acid derived from rye, wheat and barley (although typically made in a lab from vegetable oils), azelaic acid acts as an antioxidant, anti-inflammatory, anti-bacterial and depigmenting agent.


A tried and true corticosteroid, hydrocortisone decreases irritation caused by other actives and super charges the depigmenting effect of tretinoin and hydroquinone. Contrary to popular belief, hydrocortisone is safe when used topically for short periods and under medical supervision.


Hydroquinone is the gold standard treatment for pigmentation (especially melasma) when delivered under medical care. It inhibits the tyrosinase enzyme which is responsible for melanin production.


This organic acid first was isolated from the fungus Aspergillus orizae in 1907 and is commonly used to preserve the natural colour of fresh foods. In skin terms, kojic acid is used topically for its depigmenting and antioxidant benefits. Like hydroquinone, it works by inhibiting the tyrosinase enzyme to prevent melanin synthesis.


Niacinamide (also called Vitamin B3) has anti-inflammatory, skin barrier lipid regulating, sebum-regulating, depigmenting, antimicrobial and photo-protective effects when applied topically.


Resorcinol is a phenol derivative and one of two sister isomers to hydroquinone. It has keratolytic, antiseptic, and depigmenting properties. It is commonly used to encourage epidermal cell turnover and increase the penetration of other actives.


One of the newest players in the war against melasma, tranexamic acid is often used in combination with other topical agents to address multiple pigment-formation pathways.


Tretinoin is known to encourage and normalise skin cell turnover, break up pigmentation, increase collagen production and decrease collagen breakdown caused by skin enzymes called matrix-metalloproteinases (MMPs). Tretinoin also functions in depigmenting treatments by removing pigment granules from skin cells and inhibiting the melanin-producing enzyme, tyrosinase. It is often used in combination with hydroquinone and hydrocortisone to treat pigment and melasma.

These active ingredients, when combined in a prescription treatment cream specific to your skin’s needs and sensitivity, will fade the appearance of your melasma. This sort of cream or serum should be able to fit easily into your current skincare routine.

Preventing melasma relapses

Melasma is considered a chronic skin condition because without ongoing management it will return. Exposure to UV radiation from sunlight, as well as blue light from the sun’s visible rays, are the major triggering and aggravating factors for melasma. Because of our culture of sun-exposure in Australia, melasma is one of the most common skin disorders treated here.

If you have melasma, especially with a darker skin tone, you will benefit from a broad-spectrum sunscreen that specifically blocks UVA1 and blue light from the sun. There is no one sunscreen on the market that can give you total protection, which is why sunglasses, hats, and protective clothing are necessary when the sun is particularly harsh.  

Should you use a prescription melasma cream?

Yes! When it comes to a condition that is as difficult to manage as melasma, having a doctor or dermatologist on the side lines to guide you is one of the best ways to get the results you seek. With correctly prescribed active ingredients and a treatment plan, you will safely and effectively be able to manage your melasma.