What is Melasma?

Melasma is a common skin condition that causes brown to gray patches on the face.  It is commonly seen on the cheeks, bridges of the nose, chin, forehead, and above the upper lip.  The neck and arms, as well as other portions of the body can also have melasma.  It is most commonly seen in woman ages 20 to 50, and is caused partly from the sun, hormonal changes and genetics.  It is possible for males to have melasma, but it is rarely seen. Most seen with melasma have daily exposure to the sun, but heat can also be a factor in this skin condition. It is more common in pregnant woman, especially those with Asian and Latin descents.  People with olive skin tones, such as those from the Middle East, Asians and Hispanics, have a higher likelihood of getting melasma.

What causes Melasma?

While there is no known cause to melasma, it is suspected that hormone replacement therapy, pregnancy, birth control pills, a family history of melasma, race, and anti-seizure medications, as well as other medications, play a prime role in the disorder.  The leading case of the disorder is believed to be exposure to the sun.

Melasma  symptoms and signs

The only sign and symptom of melasma are the brown to gray patches found on the face or the body.  There are no other signs to look for.  A doctor will be able to look at the skin to determine if melasma is present. To see how deeply melasma goes into the skin, a doctor can use an instrument called a Wood’s light. Since melasma looks similar to other skin conditions, the dermatologist may do a skin biopsy to rule out other skin disorders and conditions.

Melasma Treatment

There are many ways that one can treat melasma.  Sometimes it will fade on its own. Other times a woman can stop birth control pills and they will see an improvement.  However, if birth control pills are desired by the woman, she can use hydroquinone.  This is often used to treat the skin first in patients with melasma.  It is applied to the skin and will lighten it.  It can be in a lotion, gel, cream or liquid form. Sometimes they are available without a prescription, however, a higher strength may be needed.

Trentinoin and corticosteroids can be used to lighten the skin as well. Often times they are prescribed as a cream together in conjunction with hydroquinone.  This is called a triple cream.

To lighten the melasma, a dermatologist could prescribe azelaic acid or kojic acid.  If nothing is working to help treat the melasma,  a medical procedure may need to be performed.  A chemical peel is often used for this.  Microdermabrasion and dermabrasion can also be used.  It will need to be tailored to fit the person with the melasma to make sure it fits their skin  needs properly.

Melasma has a very good outcome.  It can take a few months to see improvements in the skin. Maintenance therapy may be needed in some cases to ensure that the melasma does not come back.  To prevent melasma, always wear a sunscreen, protective eye wear, and a wide brimmed hat.  Sunscreen should be applied to the skin at least 20 minutes before heading outdoors, and reapplied every 2 hours or if the skin gets wet or excessive sweating takes place.   Wear it year round as the sun will trigger melasma.   Pick a sunscreen that is at least SPF 30, has broad spectrum coverage, and contains zinc oxide or titanium oxide to block out the sun’s rays.  Use all medications as directed by your doctor.  To cover up existing melasma, use a  makeup with yellow or white based undertones.

5 replies
  1. Jessica Angie S.
    Jessica Angie S. says:

    If you have Melasma, look into your diet. This could help to enable you from getting melasma in the first place. Do you eat a lot of gluten in your diet? Or sugar? Foods that are high in either one of these can produce candida, which can cause inflammation on the skin. If you are not sure if you are eating too many of these foods, ask yourself how many yeast infections you are getting. Chances are if you are getting a lot of yeast infections, you may be eating too much of the foods with gluten and sugar in them.

  2. Mellany
    Mellany says:

    I take birth control pills and have since I was 21 years old. This is the first time that I am ever hearing about it causing melasma. My doctor has never said that it could cause it and neither has my pharmacist. I would think that they should be telling people this. Is it not that serious enough that they feel the need to tell people about it? If people are getting this skin disorder on their faces, it is not like it would be easy to cover up. I am glad that I read this article as I now have something to think about. Sunscreen will be a daily must for me. I usually only apply it if I will be outside on sunny days or when I know that the UV rays are strong. But now I will make sure that I apply it daily. I usually use a foundation with sunscreen in it, but that is at max I think SPF 15. Not going to cut it anymore! I will take the time to apply an SPF 30 with broad spectrum and look for a product that has the zinc or titanium oxide. I vow to protect my skin as I do cherish it.

  3. Hannah_Sis
    Hannah_Sis says:

    I currently have melasma and am looking for ways to prevent it in the future. I read on one site that you can double up on sunscreen to protect yourself better? Has anyone else heard of this or tried it? You are suppose to take an SPF 15 sunscreen and layer it underneath an SPF 30 sunscreen. My question is why can’t you just use a higher sunscreen than that? Like say an SPF 50 or even SPF 70? Does the lower SPF sunscreen have more protection when applied underneath a higher one?

  4. Giancarla
    Giancarla says:

    I had melasma last year. I tried several treatments for it and nothing really worked for me. That is until I tried treatments that my dermatologist performed on me. I did microdermabrasion. And it worked like a charm for me. I would recommend this procedure to anyone that is not having any luck with other treatments. My skin felt so good afterward. Fine crystals were applied to my skin and the dead skin cells sort of just peeled off. I had four treatments done about 2 weeks apart. I was able to have the melasma go away after a few weeks, or at least improve in appearance to me. I have been faithful about preventing it as well. I go for regular maintenance treatments for microdermabrasion now. Melasma was not bothersome to me, only to my eyes. It was ugly. I hated having others look at me, for I felt like I was a mutant. But it is a good reminder now for me to always, and I do mean ALWAYS wear sunscreen. I feel that the sun was what has caused this for me.


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