Melasma and Dark Marks in South Africa: A Treatment Protocol

Three different problems, often confused

Melasma is hormonal and UV-triggered. It appears as symmetrical, blurry patches, usually across the cheeks, upper lip and forehead, and it is far more common in women and in deeper skin tones. It is chronic: it can be controlled, not cured.

Post-inflammatory hyperpigmentation (PIH) is what a healed pimple, a scratch or an eczema patch leaves behind. A single, well-defined mark in the place the injury was.

Sun-induced pigmentation is cumulative. Years of unprotected exposure produce an uneven, mottled tone rather than a defined patch.

The distinction matters because the order of treatment differs. Getting it wrong is why so many people spend a year on the wrong serum.

The three things that actually work

1. Sunscreen, every day, reapplied

Nothing else in this article works without it. UV is the trigger for melasma and the reason PIH darkens instead of fading. A tinted mineral SPF does double duty, because visible light also drives pigment production, and iron oxides block it in a way clear chemical filters do not.

2. A pigment regulator, used consistently

These are the ingredients that interrupt tyrosinase and the pigment transfer that follows it:

• Vitamin C — antioxidant and mild tyrosinase inhibitor, suitable for daily use
• Azelaic acid — effective on pigmentation and acne, well tolerated
• Tranexamic acid — particularly useful in melasma
• Retinoids — accelerate turnover so pigmented cells are shed sooner
• Hydroquinone — the most effective, and the one that needs supervision

3. Patience, measured in months

Pigment that took years to accumulate does not clear in weeks. Expect twelve weeks before a fair judgement, and expect melasma to need ongoing maintenance rather than a finish line.

What makes it worse

• Skipping sunscreen on cloudy days or in winter
• Picking at breakouts, which turns a pimple into a mark
• Layering several strong actives at once, which inflames skin and drives more pigment
• Harsh scrubs and aggressive exfoliation on deeper skin tones

A workable order of introduction

Start with sunscreen and a gentle cleanser. Add vitamin C in the morning. Once that is tolerated, usually two to three weeks, add one pigment regulator at night and give it twelve weeks. Only then consider adding a second.

If you are pregnant or breastfeeding, or if you are considering hydroquinone, speak to a doctor first.

Shop SK1N's pigmentation edit for products built around these actives, or book a consultation if you would rather have a protocol built for your skin.