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What Is Melasma?

Melasma is a fairly common skin condition that results in gray-brown patches on the skin. Common sites for melasma to develop are on the cheeks, the bridge of the nose, the forehead, chin, and above the upper lip. It can also appear on the forearms and neck, or on any part of the body that is exposed to the sun.

Women are much more likely to get melasma than men, especially during pregnancy. The condition is so common at this time that it is often referred to as the mask of pregnancy. Hormones seem to play a major role in triggering melasma.

Signs Of Melasma

The brown or gray-brown patches caused by melasma commonly appear on the face. Some people get patches on their forearms or neck, but this is less common. Unlike other skin conditions, melasma does not cause any symptoms or change the way the skin feels. It can, however, affect one’s self-esteem because of how it looks, leading many people to seek treatment for it.

The most visible signs of melasma appear on the:

  • Cheeks
  • Forehead
  • Bridge of the nose
  • Above the upper lip
  • Chin
  • Neck
  • Forearms

What Causes Melasma?

Melasma appears on women’s skin much more often than on men’s skin. Those who have a family history of melasma are much more likely to develop the condition.

The cause of melasma is not yet clear. It likely occurs when the color-making cells in the skin (melanocytes) produce too much color. People with darker skin are more likely to get melasma because they have more active melanocytes than those people with lighter skin.

Common melasma triggers include:

  • Sun exposure: Ultraviolet (UV) light from the sun stimulates melanocytes. In fact, just a small amount of sun exposure can make melasma return after it has faded. Sun exposure is the reason why melasma is often worse during the summer time. It is also the main reason why many people with melasma get it again and again.
  • A change in hormones: Pregnant women often get melasma. When melasma appears in pregnant women, it is called chloasma, or the mask of pregnancy. Birth control pills and hormone replacement medicine can also trigger melasma.
  • Cosmetics: Skin care products that irritate the skin may worsen melasma.

Melasma Treatment Options

Although melasma is not harmful or irritating to the skin, many people who have melasma may want to treat it for aesthetic reasons.

A dermatologist may need to take a small sample of the skin called a biopsy to rule out other skin conditions and to confirm melasma.

For women who develop melasma during pregnancy or while taking birth control pills, it will normally fade on its own following the pregnancy or once oral contraceptive pills are stopped. For people who have melasma for an extended period of time, treatment is available in the following forms:

  • Hydroquinone: This topical medication is commonly used as the first treatment option for melasma. It is applied to the skin and works by lightening the discoloration. It is available in a prescription strength and a weaker, over-the-counter form.
  • Tretinoin and corticosteroids: These are other topical medications that are usually combined with hydroquinone to enhance lightening of the darkened skin.

If topical medications do not help melasma fade from the skin, procedures such as a chemical peel, microdermabrasion, or laser therapy may be useful options. Your dermatologist performs these procedures. Your skin type must be taken into consideration, however, in order to avoid worsening the condition.
Melasma can be a stubborn skin condition that does not go away easily, but under a dermatologist’s care, treatment usually helps. It may take a several months before improvement is noted. After melasma clears from the skin, treatment may need to be continued in order to prevent it from returning.


The causes for melasma are not exact, but the most common triggers are sun exposure, pregnancy, birth control pills, and using cosmetics that irritate the skin.

Here are some tips for helping melasma to fade:

  • Wear sunscreen every day, particularly one that provides broad spectrum protection with an SPF or Sun Protection Factor of 30 or greater. In addition, use a sunscreen that contains zinc oxide and/or titanium dioxide to physically protect your skin from the sun’s damaging rays. Reapply at least every 2 hours.
  • Wear a wide-brimmed hat when outside in the sun and seek the shade whenever possible.
  • Choose gentle and fragrance-free skin care products that do not irritate the skin.
  • Avoid waxing of facial skin and forearms that can inflame the skin and worsen melasma.

Melasma is not painful to the person who has it, but it can be harmful to one’s self-esteem. With appropriate treatment under the guidance of a dermatologist, most people can achieve a good outcome.

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