Melasma

Medically reviewed by Drugs.com. Last updated on May 6, 2024.

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What is melasma?

Melasma is a condition that causes dark patches to appear on your skin. The forehead, cheeks, and side of the nose are the most common areas affected. You may also have patches on your neck, upper lip, or the back of your forearms. Melasma is common in pregnant women.

What increases my risk for melasma?

The cause of melasma is not always known. The following may increase your risk:

• Being female
• Increased levels of female hormones from pregnancy, menopause, ovarian cancer, or birth control pills
• Certain medicines, such as some antiseizure medicines
• Sunlight exposure
• Darker skin

How is melasma diagnosed?

Your healthcare provider may know you have melasma by looking at your skin. Tell him or her when your symptoms started and if anything makes symptoms worse or better. Tell him or her if you taking birth control pills or have other risk factors. Your healthcare provider may examine your skin under a light to see how deep the patches are in your skin. He or she may also take a skin sample to test for other conditions that may be causing your symptoms.

How is melasma treated?

Melasma caused by pregnancy may go away without treatment after you give birth. The patches may also go away if you stop using birth control pills (women). You may need any of the following if your melasma does not go away on its own:

• Medicines such as bleaching creams may be used to lighten the dark patches. You will apply the medicine as a cream to your skin 1 to 2 times per day. You may need to do this for up to 8 weeks. You may also need to apply a steroid or acne treatment cream along with the skin lightening cream. Some creams combine all 3 medicines.
• Procedures may be used to improve the appearance of your skin. A chemical peel or dermabrasion may be used to remove the top layers of skin. This can help make your skin appear lighter and more even in tone. Your healthcare provider will need to do these procedures for you. He or she will choose the procedure that is best for your skin type. Home chemical peel or dermabrasion kits may not be right for your skin and may cause skin damage or other problems. Laser treatment may be needed if the patches are severe or do not respond to treatment.

Treatment options

The following list of medications are related to or used in the treatment of this condition.

• Tri-Luma
• tranexamic acid
• Triderma
• fluocinolone/hydroquinone/tretinoin

What can I do to manage my symptoms?

• Maintenance therapy may be needed after treatment. Your healthcare provider will give you specific instructions on how to continue to care for your skin. This may help prevent melasma from coming back.
• Use skin cream medicines as directed. Do not use more cream or apply it more often than instructed. More medicine will not make the dark patches fade more quickly. Too much medicine may irritate your skin or darken the areas more.
• Protect your skin from sunlight. Sunlight can trigger melasma or make it worse. Wear sunscreen daily. Use sunscreen that contains at least 30 SPF, plus UVA and UVB protection. Apply the sunscreen 15 minutes before you go outside, and reapply often. Apply sunscreen even on cloudy days. Wear a wide-brimmed hat outside.
• Use gentle products to care for your skin. This includes soap, lotion, makeup, and sunscreen. Do not use products that contain alcohol. Alcohol may dry your skin. Choose products that will not sting, burn, or irritate your skin.
• Do not wax your skin to remove hair. Waxing can irritate your skin and worsen your symptoms. Your healthcare provider may be able to recommend products to help you remove hair gently. The choice may depend on your skin type.

When should I contact my healthcare provider?

• You have new or worsening symptoms, such as skin irritation.
• You want to stop using birth control pills and need a different form of birth control (women).
• You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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