Melasma

Melasma is a pigmentation disorder that produces symmetrical brown or grey-brown patches, usually across the cheeks, forehead, upper lip and bridge of the nose.

It is common in Bangladesh, more common in women, and frequently triggered by hormonal change — pregnancy and hormonal contraception are the usual ones, which is why it is sometimes called the mask of pregnancy. It is more common in medium and deeper skin tones.

The thing that surprises people is that heat alone can trigger it, not only UV. Standing over a stove, a long commute in the sun, even a hot kitchen contributes. That is why it is stubborn here in a way it is not in cooler climates, and why sun protection alone sometimes is not enough.

What helps: rigorous daily sun protection, preferably a tinted sunscreen with iron oxides, which also screens visible light. Then tranexamic acid, azelaic acid or niacinamide, over months. Aggressive exfoliation makes it worse — irritation drives pigment.

Melasma is managed rather than cured and it recurs when protection slips. It is genuinely worth seeing a dermatologist about, and anyone promising permanent removal is promising what no topical can deliver.