The most common areas for melasma to appear on the face include:
- the bridge of the nose
- the forehead
- the cheeks
- the upper lip
Melasma* may also appear on other areas of the body, especially those exposed to a lot of sunlight. These areas may include:
- the forearms
- the neck
- the shoulders
According to the American Academy of Dermatology, only 10 percent of all cases of melasma occur in men. Women with darker complexions and who are pregnant are at greater risk of developing melasma.
What is melasma?
Melasma is a skin condition that causes patches and spots, usually on the face, which are darker than your natural skin tone. While common, melasma can be mistaken for another skin condition. Board-certified dermatologists have the expertise required to give you an accurate diagnosis and individualized treatment plan.
Is melasma contagious?
No
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Causes
Doctors do not fully understand why melasma* occurs. It may be due to the malfunction of the melanocytes (the color-making cells) in the skin, causing them to produce too much color.
As a result, people with darker skin tones are more likely to develop melasma, as they have more melanocytes than people with lighter skin.
Potential triggers for melasma* include:
- changes in hormones during pregnancy (chloasma), hormone treatment, or while taking birth control pills
- sun exposure
- certain skin care products, if they irritate a person’s skin
Also, there may be a genetic component to melasma, as people whose close relatives have experienced melasma are more likely to develop it themselves.
Symptoms
The primary symptom of melasma is the development of discolored patches of skin. While it does not cause any other physical symptoms, some people find the appearance of these patches bothersome.
The most common area for patches of melasma* to appear is 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.
Diagnosis
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.
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
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.
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 include:
Hydroquinone
Doctors often use hydroquinone as the first line of treatment for melasma*. Hydroquinone is available as a lotion, cream, or gel.
A person can apply the hydroquinone product directly to the patches of skin that are discolored.
Hydroquinone is available over the counter, but a doctor can also prescribe stronger creams. Hydroquinone works by lightening the color of the skin patches.
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 all the possible risks.
If a person has had melasma before, they can try to avoid triggers by:
- limiting sun exposure
- wearing a hat when outside
- using sunscreen
What can get rid of melasma?
While melasma may go away on its own, this skin condition can also last for years.
If you dislike the discoloration on your skin caused by melasma certain treatments can sometimes help. Dermatologists recommend treating melasma sooner rather than later. It can be difficult to get noticeable results from treatment if you’ve had melasma for many years.
However, if you are pregnant, wait until you have your baby to treat melasma. If you use a melasma treatment that you can buy without a prescription, it can be difficult to know whether it’s safe to use during pregnancy. Also, melasma may improve and sometimes even go away after you give birth.
Is there a cure for melasma?
Treatments such as creams can help fade the discoloration, but treatments cannot make melasma go away forever. This skin condition can come back. It’s common for melasma to return when you spend time outdoors without protecting your skin from the sun.
In fact, many people who have melasma say the dark spots and patches become more noticeable during the summer and fade in winter. For this reason, it is important to use sunscreen every day and wear a wide-brimmed hat to keep the spots from getting darker or returning.
Is melasma a type of cancer?
No, melasma is not a type of cancer. It’s also not a sign of skin cancer. Melasma differs from skin cancer in that it typically feels flat and appears on both sides of your face.
How can a board-certified dermatologist help with melasma?
If you have discolored patches or freckle-like spots on your skin, seeing a dermatologist can help ease your mind. A board-certified dermatologist can tell you whether melasma or another condition is causing the skin discoloration.
If you have melasma, a dermatologist can create an individualized treatment plan for you. Treatment usually begins with sun protection and creams that you apply to the melasma.
Many people who have a darker skin tone see a dermatologist for melasma treatment. In fact, treatment for melasma is one of the most common reasons that people who have a darker skin tone see a dermatologist.
Dermatologists understand that treating melasma in darker skin tones requires a different approach from treating melasma in lighter skin tones. For example, some melasma treatments can irritate darker skin, which can worsen melasma and make it darker.
Dermatologists know which precautions to take to prevent treatments from worsening melasma in darker skin tones. They also understand that it usually takes longer to see results from treatment if you have a dark skin tone.
It’s important to know that no matter your skin tone, melasma can be stubborn. Some people need a prescription strength-cream, procedure, or both.
Outlook
Melasma causes dark patches to form on the skin, most often on the face. While these skin changes are harmless, some people may find them bothersome.
Treatment is effective for some people. Melasma* that is due to hormonal changes may also fade over time, once hormone levels return to normal.
