Patchy Pigmentation of the Cheeks is very common in Indian women. The causes are many and includes 1) Ultra Violet Ray Damages 2) Oral Contraceptives 3) Pregnancy 4) Menopause 5) Other Hormonal Disorders. Melasma is difficult to treat and therefore requires a combination therapy which includes Chemical Peels, Mesotherapy and in very resistant cases Cryotherapy. Generally 3 to 4 sessions are required. Post treatment, regular use of Sunscreen along with Hydroquinone is very essential; till the face is clear of Hyperpigmentation. Subsequently, Hydroquinone can be discontinued.