Melasma frequently returns because underlying triggers remain active even after pigment fades. Relapse is often caused by instability, over-treatment, heat exposure, and lack of maintenance planning.

Melasma and hyperpigmentation are biologically different. Treating melasma like standard pigmentation often increases relapse and instability.

High-intensity melasma treatments may produce rapid lightening but increase inflammation and rebound risk, leading to deeper and more volatile pigmentation over time.