Understanding The Causes and Treatments of Melasma

Melasma causes patches of skin that are a shade darker than your usual skin colour. Melasma sometimes disappears on its own. If it doesn’t, treatments such as topical steroids, chemical peels, and dermabrasion may help.

Melasma is a common skin problem. The condition causes dark, discoloured patches on your skin.

It’s also called chloasma, or the “mask of pregnancy,” when it occurs in pregnant women.

The condition is much more common in women than men, though men can get it too. According to the American Academy of Dermatology, 90% of people who develop melasma are women.

Symptoms of melasma

Melasma causes patches of discoloration. The patches are darker than your usual skin colour. It typically occurs on the face and is symmetrical, with matching marks on both sides of the face. Other areas of your body that are often exposed to sun can also develop melasma.

Brownish coloured patches usually appear on the:

  • cheeks
  • forehead
  • bridge of the nose
  • chin

It can also occur on the neck and forearms. The skin discoloration doesn’t do any physical harm, but you may feel self-conscious about the way it looks.

If you notice these symptoms of melasma, see a medical professional. They might refer you to a dermatologist, a doctor who specialises in treating skin disorders.

If you don’t already have a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.

Causes and risk factors of melasma

It isn’t totally clear what causes melasma. Darker-skinned individuals are more at risk than those with fair skin. Oestrogen and progesterone sensitivity are also associated with the condition. This means birth control pills, pregnancy, and hormone therapy can all trigger melasma. Stress and thyroid disease are also thought to be causes of melasma.

Additionally, sun exposure can cause melasma because ultraviolet rays affect the cells that control pigment (melanocytes).

How is melasma diagnosed?

A visual exam of the affected area is often enough to diagnose melasma. To rule out specific causes, your healthcare professional might also perform some tests.

One testing technique is a Wood’s lamp examination. This is a special kind of light that’s held up to your skin. It allows your healthcare professional to check for bacterial and fungal infections and determine how many layers of skin the melasma affects.

To check for any serious skin conditions, they might also perform a biopsy. This involves removing 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’s caused by pregnancy or birth control pills.

There are creams your healthcare professional can prescribe that can lighten the skin. They might also prescribe topical steroids to help lighten the affected areas. If these don’t work, chemical peels, dermabrasion, and microdermabrasion are possible options. These treatments strip away the top layers of skin and may help lighten dark patches.

These procedures don’t guarantee that melasma won’t come back, and some cases of melasma can’t be completely lightened. You might have to return for follow-up visits and stick to certain skin treatment practices to reduce the risk of the melasma returning. These include minimising your sun exposure and wearing sunscreen daily.

Melasma medical treatment

Your doctor may refer you to a dermatologist. They can confirm a diagnosis and suggest medical treatments to even your skin tone. One option may be tri luma cream. This tri luma cream treats hyperpigmentation and melasma. It’s available in prescription strength as cream. Other treatments may include:

  • tretinoin
  • corticosteroids
  • triple cream (combination of hydroquinone, tretinoin, and a corticosteroid)
  • azelaic acid
  • kojic acid

If topicals aren’t working, your dermatologist might recommend a procedure to treat your melasma, such as:

  • chemical peel
  • dermabrasion
  • microdermabrasion
  • laser treatment
  • light-based procedure
  • microneedling

Living with melasma

While not all cases of melasma will clear up with treatment, there are things you can do to make sure the condition doesn’t get worse and to minimise the appearance of the discoloration. These include:

  • using makeup to cover areas of discoloration
  • taking prescribed medication
  • wearing sunscreen every day with SPF 30
  • wearing a wide-brimmed hat that shields or provides shade for your face

Wearing protective clothing is especially important if you’ll be in the sun for an extended period of time.

If you’re self-conscious about your melasma, talk with your healthcare provider about local support groups or counsellors. Meeting other people with the condition or talking with someone can make you feel better.


You may have melasma if you have grey-brown patches of skin on your face. Your doctor can confirm a diagnosis and provide treatment with the best cream tretinoin 0.1 cream .

Be patient during treatment. It often takes months before results are seen. And once your melasma clears, your doctor might recommend maintenance therapy to prevent it from returning.

No matter what treatment is the best option for you, remember prevention is key. Wear sunscreen every day and a wide-brimmed hat whenever you’re outside.

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