Published · Updated · SkinWise Clinic
Melasma treatment in Bengaluru: choices, evidence and maintenance
Melasma treatment should begin with a diagnosis and a discussion of previous care. The useful question is what can improve your particular patches without causing avoidable irritation or further pigment change. There is no established permanent cure or standard procedure package that suits everyone.
At SkinWise Clinic, appointments take place at Mitta Plaza in Carmelaram / Hadosiddapura, near Sarjapur Road. You can plan your first visit before deciding whether to have any procedure.
What to bring to a melasma consultation
Bring the creams you currently use, or clear photos of their labels; previous prescriptions; and details of any peels or lasers. Older photographs can show the starting pattern. Mention whether treatment caused burning, persistent redness, lighter spots or more darkening.
Tell the dermatologist about pregnancy, breastfeeding, hormonal contraception and other medicines. These details can change the choices. A new or changing individual lesion needs examination rather than automatic pigment removal.
How the options differ
| Option | Purpose | What needs discussion |
|---|---|---|
| Sun protection | Limit relevant sunlight exposure during treatment and maintenance | A usable sunscreen, shade, clothing and whether an iron-oxide tint is suitable |
| Prescription creams | Treat pigment with an appropriate supervised regimen | Irritation, how to use the actual prescription and when to reassess |
| Oral treatment | A selected option when the benefits justify the risks | Medical history, contraindications and monitoring |
| Peels or lasers | A possible adjunct in selected cases | Evidence for the proposed intervention, recovery, recurrence and pigment worsening |
The international melasma consensus supports photoprotection and medical care, reserving lasers for selected resistant cases. This is expert guidance, not evidence that every patient must complete the same sequence.
Why oral tranexamic acid needs a prescription discussion
Oral tranexamic acid is used off-label for melasma. The Indian expert consensus advises screening for thromboembolic risk and avoiding it in people with a history, active disease or risk of blood clots, and in women using combined hormonal contraception. Discuss the full medicine list and personal or family clotting history with the prescriber. This is not a complete eligibility checklist, and no public dosing schedule can replace that assessment.
What about Pico laser?
“Pico” describes a pulse duration, not one device or one treatment result. A 2023 review found differing results by wavelength. A 2026 review of 755-nm trials favoured triple-combination cream over that laser for melasma severity, with low-certainty evidence and more pigment worsening versus topical comparators. Neither paper predicts your response to an unspecified device. A broader 2026 laser review reported very low certainty and marked differences between studies, reinforcing the limits of blanket laser claims.
Use the Pico suitability guide to prepare questions about the proposed device, alternatives, test spots and recovery. A previous good result does not remove the risk of a later flare.
Sunlight and screens are different exposures
A trial of UV plus visible-light protection supports a role for suitable iron-oxide sunscreen in melasma care, alongside medical treatment. A separate review of electronic-device light did not identify ordinary screen exposure as a melasma hazard, although the evidence was limited. Night mode or reducing laptop brightness is not an established treatment.
Agree on follow-up, not a guaranteed deadline
Ask what to continue, which reactions need contact and how improvement will be judged. Comparable photos can help. Recurrence may lead to a maintenance adjustment or reassessment rather than a stronger procedure. Read the melasma treatment page for the assessment process and next steps.