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Melasma (Chloasma)

Written by Kristianne Hannemann, PharmD on Sep 20, 2024.

What Is Melasma?

Melasma is a skin condition characterized by darker patches of skin, known as hyperpigmentation. These patches most commonly appear on the face, especially the forehead, cheeks, and upper lip. The patches are usually symmetrical and can range from light tan to dark brown. Although rare, melasma can also develop on other sun-exposed areas of the body.

Melasma is more prevalent in women than men and is often linked to hormonal fluctuations. For this reason, it frequently occurs during pregnancy or when taking hormonal medications such as birth control pills or hormone replacement therapy (HRT). Melasma during pregnancy is so common that it is sometimes referred to as "the mask of pregnancy" or "chloasma." The dark patches often lighten or disappear after pregnancy ends.

Exposure to sunlight is the most significant factor contributing to the development of melasma. Medications that increase sensitivity to sunlight (photosensitizers) can also increase the risk of melasma. These include certain antibiotics and diabetes medications, as well as some cosmetics. Protecting your skin from the sun is a critical part of managing melasma, and people who avoid sun exposure are less likely to experience this condition.

Symptoms

The primary symptom of melasma is the appearance of dark patches on the skin, typically on the forehead, cheeks, chin, temples, and above the upper lip. These patches are strictly cosmetic; they do not cause pain or discomfort. The patches are usually symmetrical, meaning they look similar on both sides of the face.

Diagnosis

Doctors can usually diagnose melasma by visually examining the affected skin. Your medical history will help determine any contributing factors. In some cases, a healthcare provider may use a special lamp emitting ultraviolet light to better assess the depth and pattern of the pigmentation. Lab tests are usually not performed.

Duration

In many cases, the dark patches of melasma will fade once the underlying cause—such as pregnancy or hormonal medication—has been addressed. The discoloration can take several months to gradually disappear, though in some instances, it may not fully resolve. For some people, melasma lasts for many years or a lifetime.

Prevention

The best way to prevent melasma is to limit your skin's exposure to sunlight. Preventive measures include:

While not always possible, it’s also best to avoid hormonal medications such as birth control pills and hormone replacement therapy.

Treatment

As hormonal levels stabilize, melasma usually begins to fade. Women who develop melasma during pregnancy often notice the dark patches fading several months after giving birth. Similarly, women taking oral contraceptives or hormone replacement therapy may see improvement once they stop the medications.

Several treatments are available to help reduce or eliminate melasma patches:

Treatment options

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

When to Seek Medical Advice

While melasma does not require treatment, you should consult a doctor if you notice any unexplained skin discoloration. A healthcare provider can help distinguish melasma from other skin conditions that may need medical attention.

Prognosis

Melasma is not harmful, and much of the discoloration may resolve on its own once hormone levels stabilize and sun exposure is reduced. For persistent or bothersome patches, treatments can help lighten the skin, and cosmetics can be used to even out skin tone.

Learn more about Melasma

Treatment options

Care guides

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.