One of my past patients who was at her wits end. Aged 37, she had a slew of unsightly dark brown patches all over her face. And they seemed to be getting more pronounced as the years ticked by. “I just look like I have a dirty face ALL the time – even with make-up on!” she wailed. The patient in question did have quite an extreme type of facial pigmentation known as melasma, which is characterised by brown patches on the upper lip, upper cheeks, forehead and chin.