Melasma 101

Melasma is a common skin disorder where brown patches develop on the face, including the cheeks, bridge of the nose, forehead, and upper lip. Melasma can occur in all skin types and typically darkens and lightens over time, usually worse in summer and better in winter.


Who does melasma affect?

Melasma predominantly occurs in people with skin of color, and 90% are women. Latin America, Asia, Middle East, and Northern Africa are areas with a higher prevalence of melasma. Individuals with skin of color, particularly in areas of high sun exposure, are especially susceptible to getting melasma. This does not mean that individuals with fair-to-light skin tones are not susceptible to melasma.


What is the cause of melasma?

Although the exact cause of melasma is unknown, affected people often have a family history of melasma. In addition, melasma is known as the “mask of pregnancy”, so any change in hormones, including pregnancy can bring on melasma. Sun and light exposure are the most common reasons for the appearance of melasma. Ultraviolet light can stimulate pigment-producing cells in the skin called melanocytes to produce more pigment. Melanocytes are particularly active in those with brown or black skin.


How do I know if I have melasma?

Because of its characteristic appearance, melasma can usually be easily diagnosed by a dermatologist with a skin examination.


How do I treat melasma?

There are melasma treatments available, but each individual requires a personalized course of treatment.

  • Pregnancy-associated melasma usually resolves on its own within a few months after delivery.
  • Because the sun and lighting are major causes of melasma, sunscreens are very important in any treatment plan. Broad-spectrum sunscreens, which protect against UVA and UVB ultraviolet light should be used.
  • If oral contraceptive pills are the cause behind your melasma, they may need to be discontinued.
  • Bleaching treatments are available if your dermatologist determines this is the right course of treatment. These depigmenting agents take3-6 months to reach maximum results and may require a combination approach with creams.
  • Various procedures, including chemical peels, microdermabrasion, and laser treatments can be used to treat melasma, but the results are not consistent from individual to individual.


While melasma can be a persistent, frustrating, and difficult skin disorder, a comprehensive management approach, including avoidance of sun and irritants, use of sunscreens, and close supervision by your dermatologist can lead to a successful outcome.

If you are suffering from melasma and would like to know your treatment options, our board-certified dermatologists are here to help. To find the Forefront dermatologist nearest you, visit the locations page today.