Melasma Treatment UK: What Actually Works

In short: there is no cure for melasma, but its appearance can usually be improved. Daily broad-spectrum sun protection comes first. Over-the-counter creams with azelaic acid, vitamin C or similar ingredients can help, and prescription creams such as hydroquinone, retinoids or combination creams are used under medical supervision. Melasma often returns after treatment stops, so sun protection needs to continue. (Source: British Association of Dermatologists, Melasma patient leaflet)

How hydroquinone works on pigmentation →

What is melasma?

Melasma (also called chloasma or the “pregnancy mask”) is a common condition in which flat brown or greyish patches develop, usually on the cheeks, forehead, upper lip, nose and chin. It is more common in women, particularly in pregnancy, and in people with darker skin or who tan easily. It is not infectious, not an allergy and not cancerous, and it does not itch or hurt.

What triggers melasma?

Hormones: pregnancy, the contraceptive pill and hormone replacement therapy.
UV light: sun exposure and sunbeds trigger melasma or make it worse, which is why it is often darker in summer.
Visible light: high-energy visible light may also contribute.
Less often: thyroid problems or some medicines, such as anti-epileptics.

Step 1: sun protection

Melasma darkens more than surrounding skin in light, so sun protection is the most important step. Use a broad-spectrum SPF 30 or above with a high UVA rating every day, wear a wide-brimmed hat and avoid sunbeds. Tinted sunscreens containing iron oxides add protection against visible light. Protecting your skin also helps other treatments work better.

Step 2: topical treatments

Ingredient	Status in the UK	Notes
Azelaic acid	Over the counter at lower strengths; 20% on prescription	Also used for acne
Vitamin C (ascorbic acid), kojic acid, cysteamine, thiamidol	Over the counter	Listed by the BAD as helpful
Tranexamic acid	Cream, or tablets on prescription	Can help some people; tablets need medical assessment
Retinoids (e.g. tretinoin)	Prescription-only	Can improve melasma but may irritate
Hydroquinone	Prescription-only	Commonly used; limited courses; may irritate and rarely darken skin
Combination creams	Prescription-only	Hydroquinone, a retinoid and a mild steroid together

Prescription skin-lightening creams should only be used when prescribed and under medical supervision. Hydroquinone and retinoid creams should be avoided in pregnancy. Read our hydroquinone guide →

Procedures

Chemical peels, microneedling and some lasers can help, but results vary and they can make pigmentation worse, particularly in darker skin. They should only be carried out by experienced, qualified practitioners.

How long does melasma treatment take?

Melasma improves gradually, over weeks to months, and often returns when treatment stops or after sun exposure. Melasma that appears in pregnancy may fade a few months after giving birth without treatment. Keeping up sun protection is the best way to maintain any improvement.

Frequently asked questions

Can melasma be cured?

No, there is currently no cure, but several treatments can improve its appearance. It often comes back after treatment stops, so ongoing sun protection matters.

What is the best treatment for melasma in the UK?

Daily broad-spectrum sun protection is the foundation. Beyond that, dermatologists use topical creams such as azelaic acid or vitamin C and, on prescription, hydroquinone, retinoids or combination creams. The right option depends on your skin and is decided after a medical assessment.

Is hydroquinone available in the UK?

Only on prescription. Hydroquinone is not permitted in cosmetic skin-lightening products in the UK. How hydroquinone works →

Can I treat melasma while pregnant?

Sun protection is safe and important. Hydroquinone and retinoid creams should be avoided in pregnancy, and tranexamic acid is not suitable in pregnancy or breastfeeding. Ask a doctor which creams are suitable for you.

Is melasma the same as sun damage or post-inflammatory pigmentation?

No. They look similar but have different causes and respond differently to treatment. Melasma vs sun damage vs PIH →

See if prescription treatment suits you. Prescription treatment is assessed by UK registered doctors. Medical assessment required. Start a consultation →

Sources: British Association of Dermatologists, Melasma patient information leaflet (skinhealthinfo.org.uk); UK Cosmetics Regulation, Annex II (hydroquinone).