Melasma

Melasma is a skin condition that causes patches and spots, usually on the face, which are darker than your natural skin tone.

Melasma causes and risk

It may be due to the malfunction of the melanocytes (the color-making cells) in the skin, causing them to produce too much color in certain spots. As a result, people with light brown skin to darker skin tones may be more likely to develop melasma as they have more melanocytes than people with lighter skin do. Risk factors can include Trusted Source:

Sun exposure. Frequent exposure to UV rays can trigger melasma.

Skin color. Melasma occurs most commonly in people with light brown skin tones, particularly if they live in areas with high levels of sun exposure.

Female sex. Melasma affects females about 9 times more than it does males.

Pregnancy. Melasma is more common during pregnancy, affecting 15% to 50% of pregnant people. This may be due to pregnancy hormones.

Genetics. Up to 50% of people with melasma report that close relatives also have the condition.

Potential triggers for melasma can include:

changes in hormones during pregnancy (chloasma)

hormone treatment or taking birth control pills

sun exposure

certain skin care products, if they irritate a person’s skin

some medications, including anti-seizure medications and those that make the skin more sensitive to sun exposure, such as includes retinoids, some blood pressure medications, and certain antibiotics.

Symptoms of melasma

The primary symptom of melasma is hyperpigmentation — the development of discolored patches of skin or uneven skin tone. These patches are typically flat and appear darker than an individual’s skin tone, often brown or gray in color. While melasma does not cause any other physical symptoms, some people may find the appearance of these patches bothersome. Patches caused by melasma should not cause physical pain. Patches most commonly appear on the face. Common locations include the upper lips, bridge of the nose, cheeks, and forehead. Less commonly, a person may also have patches on their arms and neck. It is important to note that melasma is not a form of skin cancer, though it may sometimes look like other skin conditions. It is best to consult a dermatologist for diagnosis and treatment.

Diagnosing melasma

Dermatologists find most cases of melasma easy to diagnose during a visual examination. However, since melasma can resemble other skin conditions, a dermatologist may take a small biopsy during the initial visit. This may help rule out other conditions. A biopsy involves removing a very small portion of the skin for further examination in a laboratory. A doctor may also use a device called a Wood’s light to look more closely at the skin.

Treatment and prevention of melasma

Treatment is not always necessary for melasma. If hormonal changes, such as those that occur during pregnancy or while taking birth control pills, have caused melasma, it will fade after delivery or once a person stops taking the pills. To prevent melasma, a dermatologist will likely recommend a high-SPF sunscreen. For other people, melasma can last for years or even for the rest of their lives. If melasma does not fade over time, a person can seek treatment to help remove or fade the patches. However, not all treatments work for everyone, and melasma may come back even after successful treatment. Treatment options for melasma can include:

Hydroquinone

Doctors often use hydroquinone as the first line of treatment for melasma. Hydroquinone is available as a lotion, cream, or gel. It works by lightening the color of the skin patches. A person can apply the hydroquinone product directly to the patches of skin that are discolored or uneven. Hydroquinone is available as a prescription.

Corticosteroids and tretinoin

Corticosteroids and tretinoin come in creams, lotions, or gels. Both corticosteroids and tretinoin can help lighten the color of the melasma patches.

Combined creams

In some cases, a dermatologist may choose to prescribe combination creams that may contain hydroquinone, corticosteroids, and tretinoin in one. These are called triple creams. Additional topical medications In addition to or instead of other medicated creams, a dermatologist may also prescribe azelaic acid or kojic acid. These acids work to lighten the dark areas of skin. Medical procedures If topical medications do not work, a dermatologist may recommend procedures such as:

microdermabrasion

chemical peel

laser treatment

light therapy

dermabrasion

Some of these treatment options have side effects or may cause additional skin problems. It is best to speak with a doctor or dermatologist about possible risks.