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Heather Hanks
Written by Heather Hanks

Reviewed by Veena Angle, MBBS, MD and Physician Lim Sock Ling on June 20, 2022

Best Natural Melasma Treatment Tips To Improve Skin Health

Although not a dangerous or painful condition, melasma can make your skin look aged or damaged. Learn the best melasma treatment options here.

Melasma min scaled

Melasma treatment can help give you younger-looking skin by reducing the patchy dark spots on your face.

These symptoms usually occur after pregnancy or when there is a major shift in hormones. Melasma can also occur when you have spent too much time in the sun.

Sometimes, the condition clears up by itself, usually after your hormones return to normal. However, for some women, the condition sticks around, causing skin to look aged and damaged.

In this guide, our experts discuss the best melasma treatments to help give you an even skin tone again.

What Is Melasma?

Melasma causes patchy skin or dark spots on the face.

Melasma is a common skin condition that can affect as many as one in every three women. Meanwhile, as many as one out of two pregnant women are prone to melasma. 

It’s sometimes called the “mask of pregnancy” due to the hormonal changes involved. This condition affects women in their reproductive years, and even men, though it is less common. 

What Causes It?

Melanin accumulation is characterized by overactive melanocytes in the skin layers that are responsible for creating the pigment melanin that gives our skin its color. This can cause melasma.

Other causes could be related to sun exposure (similar to hyperpigmentation), or hormonal effects, whether through internal hormonal changes like pregnancy or thyroid disease or externally due to synthetic hormones such as taking birth control pills.

Melasma is also hereditary, so if you have a blood relative with melasma, you could be prone to developing it as well. 

Types and symptoms

Unlike age spots, liver spots, or sun spots, melasma is a type of hyperpigmentation that usually covers a larger area of the face.

It’s not necessarily associated with aging, though hormonal changes can make it worse. It may begin with smaller spots in lighter shades and then darken over time, especially with increased sun exposure.

There are three types of melasma: 

  1. Epidermal: Characterized by dark brown spots
  2. Dermal: Depicted by light brown or bluish spots
  3. Mixed melasma: This condition has both brown and bluish patches. Epidermal melasma seems to respond to treatment the best, depending on the affected areas.

The condition can develop over a period of weeks or months and is considered a chronic condition that may come and go.

For women who get it due to pregnancy, it often disappears once the baby is delivered. However, melasma is not a physically harmful condition, nor is it painful or itchy. 

Melasma Treatment Options

Wearing sunscreen regularly is your best defense in preventing the development or worsening of melasma. Fortunately, there are many options to treat it.

However, it’s important to have a dermatologist diagnose you to confirm that you have melasma and to ascertain the cause. 

The following are topical creams your dermatologist may prescribe: 

  • Hydroquinone: Prevents pigmentation via enzymatic pathways that interrupt the skin’s pigmentation process.  
  • Tretinoin and a mild corticosteroid: Renews skin and controls inflammation.  
  • Triple combination cream: Combines ingredients from the above into one cream. 
  • Azelaic acid, kojic acid, or vitamin C: Possesses renewal and exfoliating properties but are much gentler than other treatments. 
  • Tranexamic acid: May be prescribed for stubborn melasma, whether topically or orally, but with contraindication for those with blood clot risk. 

Melasma Treatment, According To TCM

According to Traditional Chinese Medicine (TCM) Physician Lim Sock Ling, melasma is due to a lack of nourishment of the face. This could arise from three causes: 

  1. Liver Qi (vital energy) Stagnation: This can cause poor Blood Circulation of the face. Over time, the stagnation results in Fire (Yang), which diminishes the Blood (Yin), causing the face to be dull and making it susceptible to melasma. 
  2. Kidney Deficiency: This implies Essence (Jing) Deficiency, and therefore Blood Deficiency, resulting in a lack of nourishment to the face.  
  3. Spleen Deficiency: Causes a lack of Qi and Blood to nourish the face 

TCM treatment principles for melasma, like other hyperpigmentation conditions, focus on: 

  1. Easing Liver Qi, thereby removing Blood Stasis 
  2. Invigorating Qi and nourishing Blood 
  3. Nourishing Yin and invigorating the Kidneys


Facial acupuncture has been shown to help reduce the appearance of melasma.

Physician Lim reveals that acupuncture is effective in treating melasma. A study of 113 participants who received short acupuncture regimens of five to 10 sessions for melasma treatment had only minor side effects. 

Interestingly, a recent modern development in Western medicine called micro-needling also shares similar principles and mechanisms as facial acupuncture. The idea behind both treatments lies in improving circulation to the face, removing Stasis, and promoting regeneration of skin cells, resulting in a more radiant, uplifting effect.

“In a study conducted at Xiamen University Affiliated Hospital, researchers concluded that acupuncture significantly achieved a better outcome as compared to hydroquinone. Acupuncture along the Yang Ming Stomach meridian was effective in lightening the skin. It had a total efficacy rate of 82.22%, which is higher when compared to the control group using hydroquinone cream with an efficacy rate of 62.50%,” Physician Lim shares.

The World Health Organization (WHO) recognizes acupuncture as a promising treatment for chloasma, another name for melasma. 

Herbal remedies

To complement acupuncture, TCM practitioners also prescribe herbs that help to promote Qi and Blood Circulation, relieve depression, as well as nourish and brighten the skin to slow down the onset of melasma. 

Pearl powder is a popular ingredient in natural skincare products. In ancient times, Wu Ze Tian, a Chinese empress, used it to beautify her skin.

Pearl powder contains amino acids that stimulate skin cells to produce collagen, promote cellular repair, and encourage hydration. It also contains high levels of calcium to promote skin regeneration and hydration and regulates sebum and cell turnover.

Other TCM herbs that are great for melasma treatment include: 

  • Licorice root (Gan Cao): Possesses anti-inflammatory effects and inhibits tyrosinase, a key enzyme responsible for making the pigmentation.  
  • Gotu Kola (Ji Xue Cao): Helps with the lightening of dark spots by clearing Heat and Dampness and reducing toxins and swelling. It has antimicrobial, antidiabetic, anti-inflammatory, anti-depressant, and memory-enhancing properties.  
  • Sanchi (also known as Tian Qi or Panax notoginseng): An active ingredient found in facial creams to improve the condition of melasma. Panax notoginseng saponins (PNS), a constituent of Sanchi, exhibits multiple health benefits, including improvements in microcirculation, anti-inflammation, and anti-oxidation.

Melasma can be quite a confidence dampener. Fortunately, there are effective treatment options from both Western and TCM perspectives. Always consult your doctor or a registered TCM physician for the most accurate melasma treatment options.


  1. Cleveland Clinic. 2020. Melasma. 
  2. American Academy of Dermatology Association. 2022. Melasma: Diagnosis and Treatment.  
  3. The Journal of Clinical and Aesthetic Dermatology. 2019. Tranexamic Acid for Melasma: Evaluating the Various Formulations
  4. American Osteopathic College of Dermatology. Hydroquinone
  5. Frontiers in Public Health. 2021. Short Practical Regimen of Acupuncture for Melasma: A Prospective Cohort Study in a Tertiary Hospital in Thailand.  
  6. Evidence-Based Complementary and Alternative Medicine. 2018. The Effects of Acupuncture Combined with Auricular Acupressure in the Treatment of Chloasma 
  7. Healthcare Medicine Institute. 2018. Acupuncture Beats Drug For Melasma Treatment  
  8. Journal of Cutaneous and Aesthetic Surgery. 2013. Cosmeceuticals for Hyperpigmentation: What is Available? 
  9. Journal of Cosmetic Dermatology. 2019. A cream of herbal mixture to improve melasma
  10. Journal of Food and Drug Analysis. 2018. Efficacy of protein rich pearl powder on antioxidant status in a randomized placebo-controlled trial. 

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