Use daily broad-spectrum sunscreen SPF 30+ (reapply as needed)
Treat with hydroquinone (short course, typically 8–12 weeks) under clinician guidance
Use a retinoid at night (adapalene, tretinoin, or retinol)
Consider azelaic acid (10–20%)
Consider vitamin C (ascorbic acid or derivatives) in the morning
Use niacinamide (4–5%)
Consider kojic acid
Consider glycolic acid or lactic acid (start low, 1–3 nights/week)
Consider salicylic acid for spotty or acne-related marks
Use a gentle cleanser and moisturizer; avoid harsh scrubs
Avoid picking, friction, and aggressive exfoliation
Stop or reduce triggers (certain fragranced products, over-washing, hot water)
Get professional options if needed: chemical peels, microneedling, laser/light therapy, or prescription-strength topicals
For melasma specifically: strict sun protection, consider prescription therapies, and consult a dermatologist
Patch test new products and introduce one active at a time
Expect gradual improvement; reassess after 8–12 weeks
Seek medical care if pigmentation changes rapidly, becomes irregular, or bleeds