Melasma in Shanghai: when to choose sunscreen, creams or laser treatment

Make sure the pigmentation is melasma

Melasma usually produces flat brown or greyish patches, often on the face. Other pigment disorders can resemble it, so buying a laser package before a dermatology examination can start the process in the wrong place. Diagnosis is often clinical; a Wood's lamp, dermatoscope or occasionally a biopsy may help answer uncertainty. Melasma itself is not cancer and does not turn into skin cancer, but that reassurance applies to a correctly identified condition. A changing or unusual mark should be assessed rather than assumed to be part of the same pigmentation problem.

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Light protection is an active part of treatment

Sunlight can worsen melasma and undermine an otherwise appropriate treatment plan. Broad-spectrum sunscreen, shade and a hat work together; sunscreen alone does not provide complete protection. Products containing iron oxides may add protection against visible light. The review should also consider relevant triggers, including pregnancy or hormonal medicines, without telling patients to stop necessary treatment independently. Explain your normal outdoor exposure and which products irritate your skin or are difficult to use. A plan that fits work and daily routines is more likely to be maintained than one relying only on an occasional procedure.

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Prescribed creams require selection and supervision

Topical approaches may include hydroquinone, a retinoid, combination preparations or other pigment-directed ingredients such as azelaic acid. They differ in suitability and irritation potential. More ingredients or a stronger concentration does not automatically produce a better result. Some preparations can cause irritation, excessive lightening or worsening pigmentation, so the clinician should specify duration, review points and what to do if problems appear. Pregnancy changes the discussion: hydroquinone and retinoid creams should be avoided in pregnancy according to British dermatology guidance. Tell the dermatologist about pregnancy plans and every product already used.

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Laser can add benefit, but it can also worsen pigment

Laser and light procedures may be considered in selected patients, often alongside topical care and light protection. Results vary. Redness, pain and swelling may occur, and pigmentation can become darker or unevenly lighter; pigment-related adverse effects are particularly relevant in darker skin tones. Chemical peels and microneedling also have risks and are not automatically gentler substitutes. Ask which feature of your skin makes the proposed procedure reasonable and how its risks compare with continuing medical treatment. The decision should explain the expected additional benefit, rather than assume that a device is necessary because it is available.

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Discuss alternatives and realistic outcomes

The aim is improvement in unwanted pigmentation and its effect on daily life, not a guarantee of permanent clearance. Some people choose camouflage products or defer procedures while optimising topical treatment and sun protection. Tranexamic acid is discussed in dermatology guidance for selected cases, but it requires an individual medical assessment, including a history of blood clots. It should not be treated as a routine beauty supplement or self-prescribed from a clinic advertisement.

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Shanghai pigmentation expertise beyond a single laser

Shanghai Sixth People’s Hospital has a dermatology service with laser resources; its 2026 teaching event discussed combined melasma care using medicines, light-based procedures and skin-barrier repair. That combination is useful because melasma care begins with confirming the pigment disorder and planning light protection, not simply selecting a device. A dermatologist can compare topical therapy, procedural options and the chance of rebound or post-inflammatory darkening for your skin. The outcome to seek is a realistic plan for improvement and maintenance. Explore the Shanghai Sixth People’s Hospital profile and Melasma guide to prepare focused questions.

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Make previous treatment usable evidence

Bring clear dated photos, the names and duration of creams, peels or laser sessions, and note any darkening or irritation after treatment. Share pregnancy, hormonal medicines and daily sun exposure when relevant. eastmedgo helps organize this history and match your question to a suitable Shanghai pigmentation specialist, then coordinates agreed language and visit arrangements. Ask the dermatologist what should change first, what result is realistic and how success will be measured.

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Plan for recurrence and the full cost of maintenance

Ask for the full cost of assessment, medicines, any procedures and review visits. An effective plan also needs daily sun protection and a maintenance strategy after you return home; repeated sessions without that plan may disappoint. eastmedgo can help pass the written skin-care and follow-up instructions to you. Send dated pigmentation photographs and your cream or laser history to eastmedgo. We can prepare a Shanghai dermatology review of whether to strengthen topical care or consider a procedure.

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Common questions