Melasma, Dark Patches And Skin Discoloration
March 21, 2025
What is the patchy discoloration on the face, that oftentimes appears in women? A skin condition known as melasma may be to blame.
What Is Melasma?
Melasma is a common skin condition that affects the face and causes patchy, brown, tan or blue-gray spots on the face. It is one of several skin conditions that result in patches of discolored skin.
Most people with melasma get dark patches on their cheeks, chin, nose bridge, forehead, and above the upper lip. This discoloration of the skin is not painful and doesn’t have any health risks, but it can cause emotional distress. Melasma is different from skin cancer in that it often feels flat and can appear on both sides of your face, but your dermatologist should determine whether skin changes are a result of melasma or other skin conditions.
Who Is At Risk For Melasma?
Several factors can put a person at risk for developing melanoma.
Being a woman
The precise cause of melasma is unknown, but it's believed to be related to a change in hormonal status, such as a pregnancy. According to the American Academy of Dermatology, an increase in the hormones estrogen and progesterone, which occurs during pregnancy, is thought to trigger melasma. Melasma is more common in women than in men, accounting for 90 percent of the cases.
Medications
Some medications, including anti-seizure medications and medications that make your skin more sensitive to sunlight, may trigger melasma in some people.
Have a medium or dark skin tone
People with darker skin, such as those of Latin/Hispanic, North African, African-American or Indian descent, are more likely to get melasma. Melanocytes, the cells that give skin its color, are more active in darker complexions, so melasma can be more noticeable with darker skin tones.
Sun exposure or using tanning beds
A tanning bed or sunlamp can produce stronger ultraviolet (UV) rays than sunlight. When you expose your skin to UV light, it triggers the body to produce more pigment. Sometimes, this pigment appears unevenly, causing the blotchy patches and freckle-like spots of melasma.
A relative who has melasma
People who have a blood relative who had melasma also are much more likely to get melasma.
What Causes Melasma?
The exact cause of melasma is not completely clear, but there are factors that have been proven to trigger melasma, especially in people of color.
Melasma triggers
- Sun exposure: Exposure to the sun’s rays can make melasma worse and this includes being in the heat and visible light. It doesn’t have to be a very hot day out, but if the sun is beaming on your skin, the melasma can immediately get worse.
- A change in hormones: Changes that increase your hormonal levels like perimenopause and pregnancy can cause women to get melasma. Birth control pills also can trigger melasma.
- Waxing: Waxing can irritate or inflame the skin, which can worsen melasma.
Can I Prevent Melasma?
Melasma cannot be completely prevented, though there are actions you can take to reduce your risk or prevent this skin condition from getting worse.
Sun protection and melasma
Proper sun protection can help prevent the development or recurrence of melasma.
Sunscreens with a SPF 30 or higher should be used daily, even on cloudy days. Sunscreen should be broad spectrum, protecting against both UVA and UVB rays. Reapply sunscreen every two hours, more often if you have been swimming or sweating.
There are two main types of sunscreens:
- Sunscreens that use chemicals, such as oxybenzone
- Sunscreens that use physical blockers, such as zinc and titanium dioxide.
Consider using tinted sunscreen to protect yourself from the visible light, which has been shown to worsen melasma, especially in people with darker skin tones. Use a tinted sunscreen that contains iron oxides in addition to having an SPF 30 or higher.
Other tips for protecting the skin include:
- Seek shade when outdoors.
- Wear sun-protective clothing, including a lightweight and long-sleeved shirt, pants, a wide-brimmed hat and sunglasses with UV protection.
- Choosing clothing with an ultraviolet protection factor (UPF) number on the label can offer even more protection.
- Protect your skin from irritation by choosing gentle, fragrance-free skin care and makeup products.
- Cover up with makeup. It takes time for melasma treatments to work, so covering uneven skin tone can make your melasma less noticeable if the appearance bothers you. A dermatologist can offer tips.
Does Melasma Go Away On Its Own?
Melasma can sometimes fade away on its own, however, some people can have melasma for years, or forever.
If pregnancy was the trigger, the skin discoloration may begin to fade after the woman has her baby. But this is not always the case.
Melasma triggered by medication use also may go away on its own.
How Do You Treat Melasma?
Your dermatologist will diagnose and treat melasma by visually examining the skin and determining what is causing the melasma.
A dermatologist can create an individualized treatment plan using different therapies to address each patient's concerns. According to the American Academy of Dermatology Association, here are some of the common treatments:
Topical treatments for melasma
- Hydroquinone: This medicine is a common first treatment for melasma and works by lightening the skin. Hydroquinone comes as a cream, lotion, gel, or liquid and is applied to the skin.
- Tretinoin and corticosteroids: Both of these help with lightening the color of the patches on the skin. They come in gels, creams and lotions.
- Other topical (applied to the skin) medicines: Other topical treatments that may be prescribed to help lighten melasma include azelaic acid or kojic acid.
Procedures to treat melasma
If topical treatments do not get rid of melasma, your dermatologist may recommend a procedure to treat melasma. Procedures for melasma include a chemical peel, microdermabrasion, dermabrasion, laser treatment, or a light-based procedure.
It can take months or more than a year to see results from melasma treatment, according to the American Academy of Dermatology.
HealthDay News contributed information to this article.
