Melasma

Written by Jaime Herndon | Published on July 16, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

What Is Melasma?

Melasma is a common skin problem. It is also called chloasma, or the “mask of pregnancy” when it occurs in pregnant women. While men can develop melasma, 90 percent of individuals with the condition are women, according to the American Academy of Dermatology (AAD, 2012).

The condition causes patches of dark discoloration to occur on your skin. These patches are darker than your typical skin color. While the majority of cases occur on the face, other areas of your body that are often exposed to sun can also develop melasma. When it occurs on the face, it is typically symmetrical, with marks on both sides of the face matching.

Estrogen and progesterone have been associated with the condition; birth control pills, pregnancy, and hormone therapy can all trigger melasma. Sun exposure is also a cause of melasma because the ultraviolet rays affect the cells that control pigment. Darker-skinned individuals are more likely to experience melasma than fair-skinned individuals.

Signs and Symptoms of Melasma

There are no bodily symptoms of melasma, but there are visible signs of the condition. Brownish colored patches usually appear on the cheeks, forehead, bridge of the nose, and chin. It can also occur on the neck and forearms. The skin discoloration does not do any physical harm, but individuals may feel self-conscious about the way it looks.

If you notice these signs of melasma, see your doctor. Your doctor might refer you to a dermatologist—a doctor who specializes in treating skin disorders.

How Is Melasma Diagnosed?

Diagnosing melasma can be done with a visual exam of the affected area, but if your doctor wants to rule out specific causes, he or she might also perform some tests.

A Wood’s lamp may be used. This is a special kind of light that is held up to your skin and allows the doctor to check for infections and determine how many layers of skin the melasma affects. To rule out any other skin conditions, your doctor might also choose to perform a biopsy. In a biopsy, your doctor will remove a small piece of the affected skin for testing.

Is Melasma Treatable?

For some women, melasma disappears on its own. This typically occurs when it is caused by pregnancy or birth control pills.

There are creams your doctor can prescribe that can lighten the skin. Your doctor might also prescribe topical steroids to help lighten the affected areas. If these do not work, chemical peels, dermabrasion, and microdermabrasion may be recommended. These procedures strip away the top layers of skin and may help lighten dark patches.

These procedures do not guarantee that the melasma will never come back, and some cases of melasma will not be able to be completely lightened. You might have to return for follow-up visits and follow certain skin treatment guidelines to reduce the risk of the melasma returning. Minimizing your sun exposure and wearing sunscreen can also help prevent worsening of the melasma and reduce the risk of it recurring.

Coping and Living With Melasma

While not all cases of melasma can be successfully treated, there are ways to minimize its appearance. Using makeup to cover the dark patches is always an option. Taking the medications your doctor prescribes and using sunscreen every day with a sun protection factor of 30 can help prevent the condition from getting worse. Wearing a wide-brimmed hat that shields or provides shade for the forehead, cheeks a, nose and chin, especially if you will be out in the sun for an extended amount of time.

If your melasma causes you to be self-conscious, talk with your doctor about any support groups or counselors in your area. Meeting other people with the condition or talking with someone can alleviate the emotional impact of the condition.

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