Melasma

Overview

What is melasma?

Melasma is a common skin condition in which brown patches appear on the skin. Melasma often affects the skin on the face. The patches tend to appear on the cheeks, forehead, nose or upper lip. Melasma can also develop on the forearms and neck.

Is melasma a serious condition?

No, but it can severely affect your appearance and the way you feel about it.

Causes & Risk Factors

Who gets melasma?

Anyone can get melasma, but it is more common among young women. Melasma often appears during pregnancy, in the second or third trimesters. It is sometimes called "the mask of pregnancy."

Doctors don’t know exactly what causes melasma, but the condition is associated with the female hormones estrogen and progesterone. People who take birth control pills, hormone replacement therapy and certain drugs are at higher risk of developing melasma.

Melasma is also common in people who live in tropical climates. Being out in the sun for too long and too often puts you at risk for this condition. People who have darker skin are also more likely to get it.

Diagnosis & Tests

How can my doctor tell if I have melasma?

Your doctor will be able to tell if you have melasma by looking at your skin. Your doctor may use a special lamp (called a Wood’s lamp) for a closer examination of your skin. In rare cases, your doctor may want to take a very small piece of your skin (biopsy) to make sure that the brown patches are melasma.

Treatment

How is melasma treated?

Most people do not need treatment. Melasma may fade away slowly if you stop taking birth control pills or hormone replacement therapy. If melasma appeared while you were pregnant, it may go away a few months after you have the baby.

If melasma doesn’t gradually fade, it can be treated. Your doctor will probably prescribe a cream that contains hydroquinone. Creams that combine hydroquinone with kojic acid, azelaic acid, tretinoin, corticosteroids or glycolic acid can also treat melasma. In some cases, your doctor may recommend a chemical peel, microdermabrasion or laser treatment to help lighten the dark patches.

It may take several months before you see the results of treatment. It’s important to follow your doctor’s recommendations. It is also important to avoid being in the sun and to use sunscreen daily. Using sunscreen will help prevent melasma from returning.

Questions to Ask Your Doctor

  • Why did I develop melasma?

  • Do I need treatment?

  • What treatment is best for me?

  • Should I stop taking birth control pills or hormone replacement therapy?

  • Will my melasma go away after I have my baby?

  • Is there anything I can do at home?

  • Will the melasma ever go away?

  • Should I change the makeup I use?

  • Should I avoid going outside for long periods of time?

  • What SPF sunscreen would you recommend?