Melasma appears on the face as sections of tan or dark skin not consistent with the patient’s normal skin color. Melasma usually appears slowly and is thought to be the result of sensitivity to hormonal changes. The dark facial patches are irregularly shaped and have no symptoms beyond their appearance. There are no long-term physiological effects of melasma; however, melasma may cause mild depression in people who are concerned about its effect on their appearance.

Melasma is the result of increased production of melanocytes through the hormones progesterone and estrogen when the face is exposed to ultraviolet light.

What are the symptoms?

Melasma appears as sections of skin – almost always on the face – that are darker than the patient’s normal skin tone. These patches can range in color from tan or brown, to gray-brown.

Though melasma may appear on the forearms and neck, these areas are far less likely to show melasma symptoms.

Who gets it?

Almost all melasma patients are women, particularly women who:

Are pregnant
Are pre-menopausal
Take oral contraceptives
Take patch contraceptives
Use hormone replacement therapy drugs
Have a darker (more tan) skin color and live in sunny areas
Have a family history of melasma
Are allergic to certain medications or cosmetics
Thyroid disease may also spur the appearance of melasma.

Treatment Options

Though some women can suffer from melasma for years due to their use of contraceptives, melasma usually subsides of its own accord after time, usually a few months. Dermatologists can treat melasma with topical depigmenting agents or other medications. Continued sun exposure, however, may render such treatments ineffective.

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